bluuebunny/crossref_metadata_2025 huggingface dataset:
A computational fluid dynamics investigation of the flow behavior near a wellbore using three-dimensional Navier–Stokes equations
Authors: Ahammad Mohammad Jalal , Rahman Mohammad Azizur , Alam Jahrul , Butt Stephen
Published: September 2019

The analysis of fluid flow near the wellbore region of a hydrocarbon reservoir is a complex phenomenon. The pressure drop and flow rates change in the near wellbore with time, and the understanding of this system is important. Besides existing theoretical and experimental approaches, computational fluid dynamics studies can help understanding the nature of fluid flow from a reservoir into the wellbore. In this research, a near wellbore model using three-dimensional Navier–Stokes equations is presented for analyzing the flow around the wellbore. Pressure and velocity are coupled into a single system which is solved by an algebraic multigrid method for the optimal computational cost. The computational fluid dynamics model is verified against the analytical solution of the Darcy model for reservoir flow, as well as against the analytical solution of pressure diffusivity equation. The streamlines indicate that the flow is radially symmetric with respect to the vertical plane as expected. The present computational fluid dynamics investigation observes that the motion of reservoir fluid becomes nonlinear at the region of near wellbore. Moreover, this nonlinear behavior has an influence on the hydrocarbon recovery. The flow performance through wellbore is analyzed using the inflow performance relations curve for the steady-state and time-dependent solution. Finally, the investigation suggests that the Navier–Stokes equations along with a near-optimal solver provide an efficient computational fluid dynamics framework for analyzing fluid flow in a wellbore and its surrounding region.
Natural convection induced by undulated surfaces in a porous enclosure filled with nanoliquid
Authors: Alhashash Abeer , Saleh Habibis
Published: September 2019

Effect of surface undulation on convective flow in a porous enclosure is investigated in this present article. The porous enclosure is filled with a water-base nanoliquid containing Cu solid nanoparticles, and the porous layer is modeled using the Darcy law. The governing equations are solved numerically using the built-in finite element method of COMSOL. The investigation was carried out for several parameters: the nanoparticle concentration, [Formula: see text]; the amplitude of undulations, [Formula: see text]; the number of undulations, [Formula: see text]; and the Rayleigh number, [Formula: see text]. It is concluded that the strength of the nanoliquid circulation increases with increasing the amplitude or number undulations. It is found that the heat transfer rates were sensitive to the variation of undulation property, convection intensity, and nanoparticle concentration.
Parenting and Self-Control Across Early to Late Adolescence: A Three-Level Meta-Analysis
Authors: Li Jian-Bin , Willems Yayouk E , Stok F. Marijn , Deković Maja , Bartels Meike , Finkenauer Catrin
Published: September 2019

Self-control plays a significant role in positive youth development. Although numerous self-control challenges occur during adolescence, some adolescents control themselves better than others. Parenting is considered a critical factor that distinguishes adolescents with good self-control from those with poor self-control, but existing findings are inconsistent. This meta-analysis summarizes the overall relationship between parenting and self-control among adolescents aged 10 to 22 years. The analysis includes 191 articles reporting 1,540 effect sizes ( N = 164,459). The results show that parenting is associated with adolescents’ self-control both concurrently ( r = .204, p < .001) and longitudinally ( r = .157, p < .001). Longitudinal studies also reveal that adolescents’ self-control influences subsequent parenting ( r = .155, p < .001). Moderator analyses show that the effect sizes are largely invariant across cultures, ethnicities, age of adolescents, and parent and youth gender. Our results point to the importance of parenting in individual differences in adolescent self-control and vice versa.
An improved process for the preparation of pimavanserin tartrate
Authors: Wu Caijiao , Zhou Qifan , Song Dake , Li Hui , Bao Changshun , Liu Xuelong , Bao Xuefei , Chen Guoliang
Published: September 2019

A practical synthetic route to pimavanserin tartrate, in which the target compound was obtained with 99.84% purity and in 46% total yield via a 5-step synthesis starting from 4-hydroxybenzaldehyde and (4-fluorophenyl)methanamine, is reported. The main advantages of the route include inexpensive starting materials, mild reaction conditions and an acceptable overall yield.
Dorsal Barton fracture is a variation of dorsal radiocarpal dislocation: a clinical study
Authors: Bhashyam Abhiram R. , Fernandez Diego L. , Fernandez dell’Oca Alberto , Jupiter Jesse B.
Published: September 2019

Dorsal Barton fractures may be better described as variants of dorsal radiocarpal dislocations. We aimed to better characterize these fractures by reviewing 111 patients in the ICUC® dataset who had a dorsally displaced, intra-articular distal radius fracture. We identified 13 patients with a dorsal Barton fracture on radiographs (dorsal articular margin fracture with radiocarpal subluxation and intact volar cortex). All patients with a dorsal Barton fracture had radial styloid involvement and volar cortical disruption that was subsequently identified on three-dimensional CT. Based on three-dimensional CT and intra-operative findings, none of the patients had classically described dorsal Barton fractures. All patients were treated using a volar exposure. A volar capsular tear was identified intra-operatively in three patients and the volar capsule repaired. This series supports the contention that dorsal Barton fractures are better characterized and treated as a variation of a dorsal radiocarpal dislocation.

Level of evidence: IV
The Importance of Melatonin Detection in Pediatric Deaths
Authors: Labay Laura M. , Kraner James C. , Mock Allen R. , Sozio Thomas J.
Published: September 2019

Melatonin is an endogenous hormone that regulates sleep patterns. It is available in varying formulations and dosages and is marketed as a natural substance that can alleviate insomnia. Recent news reports indicate that melatonin has been administered without appropriate authorization in daycare settings. Even though lethal outcomes have not been solely attributed to exogenous melatonin overdose, it has been relevant to select police and postmortem investigations.

A quantitative liquid chromatography-tandem mass spectrometry (LC-MS/MS) assay was developed for the analysis of biological specimens. Results of 22 positive blood samples were evaluated based upon gender, age, and melatonin concentration from cases submitted by clinical, police, and death investigation agencies. Two cases are described. In Case 1, a 9-month-old was found unresponsive after cosleeping with a sibling. Allegations included exposure to an unspecified pesticide and dextromethorphan, and consumption of half a cigarette. There was admitted use of melatonin. Melatonin was quantified in blood and gastric fluid at concentrations of 13 ng/mL and 1200 ng/mL, respectively. In Case 2, a 13-month-old was found nonresponsive in a shared room. Melatonin was found within some of the sippy cups. The infant was extremely warm to the touch. Resuscitative efforts were unsuccessful and death was pronounce3d. Analysis showed a result of 210 ng/mL in blood.

The presented quantitative LC-MS/MS method can successfully be applied to evaluate exposure to exogenous melatonin. Toxicology testing can assist in the investigation of these case types by substantiating the purposeful administration of melatonin.
Application of the Drowning Index to Opioid & Multidrug Intoxication Deaths: A Retrospective Analysis
Authors: Ellis Lindsey T , Opsahl Madeleine , Duff Deiter J. , Stacy Carl C.
Published: September 2019

Introduction:

Drowning deaths present a challenge for forensic pathologists, because the autopsy findings may occur in many nondrowning scenarios. Previous studies have attempted to identify patterns in organ weights that may be specific for drowning. The drowning index (DI) has been defined as the weight ratio of the lungs and pleural effusion fluid to the spleen. Studies have suggested DI may be useful in confirming drowning as the cause of death. No studies have yet compared autopsy findings in drownings to those in drug-related deaths, in spite of their qualitative similarities.

Materials and Methods:

We compared the lung and pleural effusion weight, spleen weight, and DI from 536 autopsies ruled drowning, opioid, or multidrug intoxication, or hanging in Columbia, Missouri, from 2011 to 2016.

Results:

Opioid overdoses result in heavier lungs and spleens than drownings, multidrug overdoses, or hangings. There is no DI value at which a death can be definitively ascribed to drowning. The median DI was significantly higher in drownings than in opioid intoxications, multidrug intoxications, or hangings ( P < .0001; P = .001; P = .005). However, very few drowning cases (13.33%) had a DI >14.1. Additionally, many opioid and multidrug overdoses had a DI >14.1. The highest calculated DI value (DI = 33) was associated with multidrug intoxication.

Conclusion:

In our opinion, the DI has little, if any, utility in distinguishing between drowning and drug-related deaths.
Hyperoxalosis Secondary to Intravenous Vitamin C Administration as a Non-Allopathic Treatment for Cancer
Authors: Giffen Mark A. , McLemore Jerri L.
Published: September 2019

Vitamin C (ascorbic acid) has long been known to have antioxidant properties, with associated claims that it can boost the immune system, fight off infection, and help in the treatment of cancer. Similar to many other over-the-counter and herbal medicines, vitamin C can cause potential side effects with significant morbidity and rarely mortality. We discuss a case of an elderly woman with metastatic adenocarcinoma of the lung that was treated with several rounds of allopathic chemotherapy; however, treatment was stopped because of worsening quality of life and disease progression. She was treated with 10 courses of intravenous high-dose vitamin C at a local homeopathic medical center as an alternative treatment method. Five days after the last vitamin C administration, she was admitted to an allopathic hospital due to acute renal failure and oliguria culminating in a myocardial infarct due to underlying atherosclerotic disease. Workup revealed dehydration secondary to poor oral intake and acute renal failure which was clinically concerning for calcium oxalate– induced kidney injury. At the time of autopsy, in addition to her widely metastatic adenocarcinoma and myocardial damage, hyperoxalosis of the kidney with acute kidney injury was present. Hyperoxalosis of the kidney is a documented phenomenon related to administration of intravenous and oral vitamin C at superphysiologic doses as recommended by some natural and homeopathic practitioners and is, therefore, a significant complication of treatment. This case highlights the renal complications of supertherapeutic vitamin C administration and the associated morbidity which can contribute to death.
A Case of Previously Unsuspected Cardiac Sarcoidosis Diagnosed at Autopsy and 23-Year Review of One Institution’s Sarcoidosis Deaths
Authors: Miller Catherine R. , Boor Paul J. , Campbell Gerald A.
Published: September 2019

Sarcoidosis is a noncaseating granulomatous disease of unknown etiology. The incidence is 11 per 100 000 white individuals and 34 per 100 000 black individuals. Cardiac involvement is seen in 2% to 5% of patients with systemic sarcoidosis and is often clinically undetected. This may be due to relative rarity of cardiac involvement, variability in presentation, or that there are no good clinical criteria for the diagnosis of cardiac sarcoidosis. Patients may be totally asymptomatic or have heart block, myocardial infarctions, heart failure, or sudden cardiac death, which may be due to involvement of the conduction system by sarcoidosis. We present a case of a 54-year-old black male with hypertension and hyperlipidemia. Prior to his death, he was witnessed to suddenly stand up, grab his chest, and collapse. His clinical cause of death was hypertensive and atherosclerotic cardiovascular disease. A retrospective review of autopsy cases over the last 23 years (1995-2018) at our institution (n = 6900) was undertaken. This case illustrates a rare disease and highlights the importance of complete autopsy even in patients who might otherwise be signed out as an external exam or records review only.
A Review of the Different Methods Applied in Ginsenoside Extraction From Panax ginseng and Panax quinquefolius Roots
Authors: Jegal Jonghwan , Jeong Eun Ju , Yang Min Hye
Published: September 2019

Ginseng saponins, also called ginsenosides, are the main active ingredients of Panax ginseng and Panax quinquefolius and are often used as qualitative and quantitative markers in the regulation of ginseng products. Various methods have been used to extract the major ginsenosides, such as ginsenosides Rb1, Rb2, Rc, Rd, and Rf from P. ginseng and P. quinquefolius. The objective of this paper is to review the studies regarding the influence of different extraction systems on ginsenoside amount and pattern in P. ginseng and P. quinquefolius roots. Although traditional extraction methods, Soxhlet and heat reflux extractions, have many disadvantages, including long extraction times and low extraction efficiency, they are the most widely used methods for ginseng saponin extraction. The amount and pattern of ginsenosides found in P. ginseng and P. quinquefolius roots differ depending on the method of extraction. In particular, the total ginsenoside amount and extraction efficiency can be significantly increased with the use of advanced extraction techniques that apply the conditions of high temperature and/or high pressure, such as pressurized liquid extraction, high-pressure microwave-assisted extraction, supercritical fluid extraction, and pulsed electric field extraction. Among several advanced extraction procedures, ultrahigh-pressure extraction is thought to offer the most advanced and efficient technology in that it requires only a few minutes for ginseng saponin extraction.
Pancreatic Lipase Inhibitory Activity of Citrus unshiu Leaf Extract
Authors: Itoh Kimihisa , Matsukawa Tetsuya , Murata Kazuya , Nishitani Ryota , Yamagami Momona , Tomohiro Norimichi , Kajiyama Shin'ichiro , Fumuro Masahiko , Iijima Morio , Shigeoka Shigeru , Endo Yuichi , Matsuda Hideaki
Published: September 2019

In the cultivation of Citrus fruit, pruning in late winter after harvest is important to obtain excellent flower buds in the next spring and a rich harvest of superior fruit in the following winter; a large number of pruned leaves are usually discarded. The purpose of this study was to determine the utility value of pruned leaves of Citrus unshiu. A methanol extract of pruned C. unshiu leaves showed a porcine pancreatic lipase inhibitory activity. Fractionation of C. unshiu leaf extract (CUL-ext) followed by bibliographic and chromatographic analyses revealed that a part of the pancreatic lipase inhibitory activity of CUL-ext was attributable to nobiletin (1), rutin (2), and hesperidin (3). Thus, pruned C. unshiu leaves may be a reasonable natural resource for the preparation of ingredients with lipase inhibitory activity.
The issue with issues management: Considering the emotional and gendered core of issues
Authors: Madden Stephanie
Published: September 2019

Issues managers have power over defining issues and legitimizing their importance. While discussion has increased about organizations taking a stand on polarizing social issues, there remains a gap in the issues management literature on how to address stigmatized issues, particularly those with a gendered component. This article offers a revised set of issues motivators that better encompass the gendered and emotional components of issues and guiding questions to assist issues managers in ensuring that organizational policies and practices are more inclusive. Finally, the emotional underpinnings of all phases of the issue life cycle are considered.
The privacy implications of social robots: Scoping review and expert interviews
Authors: Lutz Christoph , Schöttler Maren , Hoffmann Christian Pieter
Published: September 2019

In this contribution, we investigate the privacy implications of social robots as an emerging mobile technology. Drawing on a scoping literature review and expert interviews, we show how social robots come with privacy implications that go beyond those of established mobile technology. Social robots challenge not only users’ informational privacy but also affect their physical, psychological, and social privacy due to their autonomy and potential for social bonding. These distinctive privacy challenges require study from varied theoretical perspectives, with contextual privacy and human–machine communication emerging as particularly fruitful lenses. Findings also point to an increasing focus on technological privacy solutions, complementing an evolving legal landscape as well as a strengthening of user agency and literacy.
Mobile media beyond mobile phones
Authors: Frith Jordan , Özkul Didem
Published: September 2019

In this introduction, we argue for an expanded focus in mobile media and communication studies (MMCS) that accounts for the many types of mobile media that affect our lives. We begin by pointing out that mobile phone/smartphone research has dominated MMCS as a field. That focus makes sense, but it runs the risk of MMCS essentially turning into “smartphone studies,” which we argue would limit our impact. To make that case, we identify a few examples of the types of oft-ignored technologies that could add to the depth and breadth of MMCS research (e.g., RFID [radio frequency identification] tags, the Walkman, barcodes). We then summarize the articles in this special issue to categorize the breadth of this research, which ranges from analyses of mobile fans to autonomous cars to mobile infrastructure.
Mobilized networked infrastructures: Implications for action, space, and knowledge
Authors: Glover-Rijkse Ragan
Published: September 2019

Networked infrastructures support the flows of information and communication. While traditional conceptions of networked infrastructures render them necessarily immobile and centralized, this article rethinks the concept of networked infrastructures to instead consider their mobility. In doing so, this article conceptualizes mobilized networked infrastructures (MNIs) and examines their implications in three sections: Forms of Action, Production of Networked Space, and Ways of Knowing. The Forms of Action section indicates that, over time, MNIs have allowed for new spaces and practices of communicative mobility. The Production of Networked Space section considers the speculative potential for MNIs to deterritorialize networked space, but argues that MNIs often reinforce already networked spaces and reterritorialize deterritorialized networked space. Finally, the Ways of Knowing section examines the mobility of networked infrastructures as a new way of knowing by allowing the tracking of infrastructural mobilities in addition to, and in concert with, the tracking of human and nonhuman actors.
Transurethral resection of bladder tumour as day-case surgery: Evidence of effectiveness from the UK Getting it Right First Time (GIRFT) programme
Authors: Gray William K , Day Jamie , Briggs Tim WR , Harrison Simon
Published: September 2019

We aimed to investigate outcomes of transurethral resection of bladder tumour (TURBT) surgery when performed as day-case surgery compared to outcomes for patients who stayed ⩾ 1 night in hospital. Data were taken from the 2017–2018 Hospital Episodes Statistics data set, which contains data for all TURBT procedures conducted within the National Health Service in England. Data were categorised as those seen as day-cases and those that involved an overnight stay. Of 19,383 TURBT procedures, 3466 (17.9%) were classified as day-case surgery. Those who had an overnight stay were significantly older and were significantly more likely to be male, and have significantly greater frailty and comorbidity. After adjusting for confounders, those with an overnight stay had significantly poorer outcomes with regard to mortality and emergency readmission rates. Comparing trusts with the highest and lowest rate, of overnight stay, there were no differences in the profiles of the patients seen or in outcomes. Patients undergoing TURBT as day-case surgery have at least as good outcomes as those having an overnight stay. Investigation of the technical quality of the tumour resection, patient experience and quality of life after day-case surgery for TURBT would provide further insight.

Evidence level: 2b
Percutaneous Cement Discoplasty for the Treatment of Advanced Degenerative Disc Conditions: A Case Series Analysis
Authors: Camino Willhuber Gaston , Kido Gonzalo , Pereira Duarte Matias , Estefan Martin , Bendersky Mariana , Bassani Julio , Petracchi Matias , Gruenberg Marcelo , Sola Carlos
Published: September 2019

Study Design:

Retrospective analysis. Level of evidence III.

Objectives:

To describe the results after a minimum 1-year follow-up in patients treated with percutaneous discoplasty (PD), a minimally invasive technique to treat low back pain in elderly patients with advanced degenerative disc disease. The procedure consists in improving stability by injecting bone cement in a severely degenerated pneumodisc. There are few reports in the literature about this technique.

Methods:

Fifty-four patients with advanced disc disease with/without degenerative scoliosis treated with PD with at least 1 year follow-up were studied, variables included clinical (visual analogue scale [VAS] and Owestry Disability Index [ODI]) and radiological parameters (lumbar lordosis and Cobb angle), as well as hospital length of stay and complications.

Results:

At 1-year postoperation, significant pain reduction (VAS: preoperative 7.8 ± 0.90; postoperative 4.4 ± 2.18) and improvement in the ODI (preoperative 62 ± 7.12; postoperative 36.2 ± 15.47) were observed with partial correction of radiological parameters (5° mean increase in lumbar lordosis and decrease in Cobb angle). Mean surgical time was 38 minutes, and the mean length of hospital stay was 1.2 days.

Conclusion:

PD, currently not a very well-known technique, appears to be—at least in the short-term follow-up—an effective treatment option in selected cases with low back pain due to advanced degenerative disc disease.
Prediction of organ involvement and survival in systemic sclerosis patients in the first 5 years from diagnosis
Authors: van den Hombergh Wieneke MT , Knaapen-Hans Hanneke KA , van den Hoogen Frank HJ , Carreira Patricia , Distler Oliver , Hesselstrand Roger , Hunzelmann Nicolas , Vettori Serena , Fransen Jaap , Vonk Madelon C
Published: September 2019

Background:

Organ involvement often occurs in early systemic sclerosis and has been related to premature death. Identifying patients at diagnosis at risk of developing early organ involvement would be useful to optimize screening and management strategies.

Objective:

To develop prediction models for the 5-year development of interstitial lung disease, pulmonary arterial hypertension and death.

Methods:

A European multicentre inception cohort was created. For modelling, predefined clinical variables with known predictive value at diagnosis were used. Univariate and multivariate regression analysis were done to select baseline predictors and build the prediction models. The models were tested using the area under the receiver operating characteristic curve comparing observed and expected frequencies.

Results:

Of 735 patients, 23% developed interstitial lung disease, 8% developed pulmonary arterial hypertension 12% died. The interstitial lung disease model included diffuse cutaneous systemic sclerosis (OR = 1.8), systemic sclerosis disease duration < 3 years (OR = 1.4), puffy fingers (OR = 1.6), and anti-topoisomerase-I-antibodies (OR = 1.8). The pulmonary arterial hypertension model included age > 65 years (OR = 3.2), forced vital capacity < 70% (OR = 2.5) and diffusing capacity of the lung for carbon monoxide < 55% (OR = 1.9). Death was predicted best by age > 65 years (OR = 4.1), male gender (OR = 1.9), no anti-centromere antibodies (OR = 0.5), proteinuria (OR = 1.9), forced vital capacity < 70% (OR = 1.8) and pulmonary arterial hypertension at diagnosis (OR = 10.1). The area under the receiver operating characteristic was 0.66 (95% CI 0.64–0.67), 0.66 (95% CI 0.64–0.68) and 0.70 (95% CI 0.69–0.72), respectively.

Conclusion:

We have shown that it is possible to predict interstitial lung disease, pulmonary arterial hypertension and death using established variables already available at the moment of systemic sclerosis diagnosis. Discriminatory performance of the models was suboptimal. Further research including new variables is necessary to improve performance.
LINC01123, a c-Myc-activated long non-coding RNA, promotes proliferation and aerobic glycolysis of non-small cell lung cancer through miR-199a-5p/c-Myc axis
Authors: Hua Qian , Jin Mingming , Mi Baoming , Xu Fei , Li Tian , Zhao Li , Liu Jianjun , Huang Gang
Published: September 2019

Background

Long non-coding RNAs (lncRNAs) have been associated with non-small cell lung cancer (NSCLC), but the underlying molecular mechanisms of their specific roles in mediating aerobic glycolysis have been poorly explored.

Methods

Next-generation RNA sequencing assay was performed to identify the differentially expressed RNAs between NSCLC tissues with high 18F-fluorodeoxyglucose (FDG) uptake and their adjacent normal lung tissues. LINC01123 expression in NSCLC tissues was measured by real-time PCR and in situ hybridization (ISH) assay. The biological role of LINC01123 in cell growth and aerobic glycolysis capability was determined by performing functional experiments in vitro and in vivo. Further, the transcription of LINC01123 was explored by bioinformatics analysis, dual-luciferase reporter assay, and chromatin immunoprecipitation (ChIP) assay. RNA immunoprecipitation (RIP) and luciferase analyses were used to confirm the predicted competitive endogenous RNA (ceRNA) mechanisms between LINC01123 and c-Myc.

Results

Three hundred sixty-four differentially expressed genes were identified in RNA-seq assay, and LINC01123 was one of the most overexpressed lncRNAs. Further validation in expanded NSCLC cohorts confirmed that LINC01123 was upregulated in 92 paired NSCLC tissues and associated with poor survival. Functional assays showed that LINC01123 promoted NSCLC cell proliferation and aerobic glycolysis. Mechanistic investigations revealed that LINC01123 was a direct transcriptional target of c-Myc. Meanwhile, LINC01123 increased c-Myc mRNA expression by sponging miR-199a-5p. In addition, rescue experiments showed that LINC01123 functioned as an oncogene depending on miR-199a-5p and c-Myc.

Conclusion

Since LINC01123 is upregulated in NSCLC, correlates with prognosis, and controls proliferation and aerobic glycolysis by a positive feedback loop with c-Myc, it is expected to be a potential biomarker and therapeutic target for NSCLC.
Arterial Catheters for Early Detection and Treatment of Hypotension During Major Noncardiac Surgery: A Randomized Trial
Authors: Naylor Amanda J. , Sessler Daniel I. , Maheshwari Kamal , Khanna Ashish K. , Yang Dongsheng , Mascha Edward J. , Suleiman Iman , Reville Eric M. , Cote Devan , Hutcherson Matthew T. , Nguyen Bianka M. , Elsharkawy Hesham , Kurz Andrea
Published: September 2019

BACKGROUND:

Continuous blood pressure monitoring may facilitate early detection and prompt treatment of hypotension. We tested the hypothesis that area under the curve (AUC) mean arterial pressure (MAP) <65 mm Hg is reduced by continuous invasive arterial pressure monitoring.

METHODS:

Adults having noncardiac surgery were randomly assigned to continuous invasive arterial pressure or intermittent oscillometric blood pressure monitoring. Arterial catheter pressures were recorded at 1-minute intervals; oscillometric pressures were typically recorded at 5-minute intervals. We estimated the arterial catheter effect on AUC-MAP <65 mm Hg using a multivariable proportional odds model adjusting for imbalanced baseline variables and duration of surgery. Pressures <65 mm Hg were categorized as 0, 1–17, 18–91, and >91 mm Hg × minutes of AUC-MAP <65 mm Hg (ie, no hypotension and 3 equally sized groups of increasing hypotension).

RESULTS:

One hundred fifty-two patients were randomly assigned to arterial catheter use and 154 to oscillometric monitoring. For various clinical reasons, 143 patients received an arterial catheter, while 163 were monitored oscillometrically. There were a median [Q1, Q3] of 246 [187, 308] pressure measurements in patients with arterial catheters versus 55 (46, 75) measurements in patients monitored oscillometrically. In the primary intent-to-treat analysis, catheter-based monitoring increased detection of AUC-MAP <65 mm Hg, with an estimated proportional odds ratio (ie, odds of being in a worse hypotension category) of 1.78 (95% confidence interval [CI], 1.18–2.70; P = .006). The result was robust over an as-treated analysis and for sensitivity analyses with thresholds of 60 and 70 mm Hg.

CONCLUSIONS:

Intraoperative blood pressure monitoring with arterial catheters detected nearly twice as much hypotension as oscillometric measurements.
“Chemotherapy-periodized” Exercise to Accommodate for Cyclical Variation in Fatigue
Authors: KIRKHAM AMY A. , BLAND KELCEY A. , ZUCKER DAVID S. , BOVARD JOSHUA , SHENKIER TAMARA , MCKENZIE DONALD C. , DAVIS MARGOT K. , GELMON KAREN A. , CAMPBELL KRISTIN L.
Published: September 2019

Purpose

The purpose of this study was to provide a rationale for “chemotherapy-periodized” exercise by characterizing cyclical variations in fatigue and exercise response across a chemotherapy cycle and comparing exercise adherence during chemotherapy between a prescription that is periodized according to chemotherapy cycle length and a standard linearly progressed prescription.

Methods

Women with breast cancer who were prescribed taxane-based chemotherapy were randomly assigned to a supervised aerobic and resistance exercise program after a chemotherapy-periodized exercise prescription (n = 12) or to usual care during chemotherapy (n = 15). Fatigue and steady state exercise responses were assessed in both groups before the first taxane treatment and across the third treatment (i.e., 0–3 d prior and 3–5 d after the third treatment, and 0–3 d before the fourth treatment) to assess cyclical variations. Adherence to the chemotherapy-periodized exercise prescription was compared with adherence to a standard linear prescription from a prior study in a similar population (n = 51).

Results

Fatigue increased from baseline (marginal mean ± standard error: 3.2 ± 0.4) to before the third treatment (4.1 ± 0.4, P = 0.025), then peaked at 3 to 5 d after the third treatment (5.1 ± 0.4, P = 0.001), before recovering before the fourth treatment (4.3 ± 0.5, P = 0.021). The peak in fatigue at 3 to 5 d post–third treatment corresponded to a decrease in steady state exercise oxygen consumption (V˙O2) (P = 0.013). Compared with a standard linear exercise prescription during chemotherapy, a chemotherapy-periodized exercise prescription resulted in higher attendance during the week after chemotherapy (57% ± 30% vs 77% ± 28%, P = 0.04) and overall attendance (63% + 25% vs 78% ± 23%, P = 0.05).

Conclusions

Fatigue and exercise V˙O2 vary across a chemotherapy cycle. A chemotherapy-periodized exercise prescription that accommodates cyclical variations in fatigue may increase adherence to supervised exercise.
Moving Toward Collaborative Service Recovery: A Multiactor Orientation
Authors: Arsenovic Jasenko , Edvardsson Bo , Tronvoll Bård
Published: September 2019

Within service recovery research, service failures have traditionally been handled by the firm in an effort to turn an unpleasant experience into a more favorable one. More recent service research, in which the customer’s role is more pronounced, suggests that the customer is not a passive recipient of a firms recovery efforts but a cocreator of the recovery solution. As a response, considerable effort has been devoted to exploring how the customer and the firm together can effectively integrate resources such as time and effort to rectify an unpleasant experience. However, prior conceptualizations fall short of taking adequate account of the complexity of service recovery encounters in which multiple actors collaborate and integrate resources. To address this, the present study explores how multiactor collaborations influence the customer’s experience of service recovery by adopting a multiactor orientation and by applying service-dominant logic. After reviewing the customer experience literature, a collaborative recovery experience framework is developed that emphasizes the joint efforts of multiple actors and customers to achieve a favorable recovery experience. In a contextualization, this study presents the usefulness of the new framework in how to explain customer experiences in collaborative service processes, and further research avenues are proposed.
E-Coverage of Fisheries Ecosystem and Usage Pattern of Social Media
Authors: Thangavel Velumani , Shanmugam Ananthan Pachampalayam , Inbaraj Lloyd Chrispin Christy
Published: September 2019

The penetration of internet and subsequent usage of social media, especially among the youth is increasing day by day. In this context, a study was conducted to identify the internet and social media usage by students as well as their mode of accessing professional (fisheries) information through social media. For this study, social media has been classified into two broad categories namely Social networking sites and Instant messaging applications. A pre-tested questionnaire was used to collect data, through online and offline modes, from 223 respondents consisting of undergraduate, Masters and Ph.D.students. The data obtained by the survey was analysed using MS-Excel and SPSS software. Results showed that fisheries professionals spent a significant amount of their time using social media especially Facebook and YouTube with nearly half of them spending >4 hrs / day. ResearchGate (68.5%), Google Scholar (67.5%), YouTube (65.3%), and Facebook (55.2%) were the most preferred / used applications for accessing fisheries related information while WhatsApp (82.1%) and FB Messenger (53%) were the top choices among instant messaging Apps. Though entertainment was prime reason for majority (58.3%) for accessing Facebook, News (49.5%) and professional information (46.6%) are also considered important by almost half the students. In the case of YouTube, it was entertainment (81%), professional information (60%) and news (50.6%), the same reasons but slightly varying degrees. Analysis of tests of significance showed that usage pattern was similar across both male and female students except for FB usage, which females accessed less frequently. The study also documents the list of Facebook pages maintained by various fisheries professional groups.
HÁ MEMÓRIA POLÍTICA NA BAIXADA FLUMINENSE? MEMÓRIAS DE UM TERRITÓRIO EM DISPUTA POR UM PRESENTE
Authors: Silva Lidiane Gonçalves Gama
Published: September 2019

Resumo: O presente artigo busca propor uma reflexão sobre a memória política na Baixada Fluminense – território integrante da região metropolitana do Estado do Rio de Janeiro –, considerando os postulados elencados por Lifschitz para tal conceito e a atividade recente de coletivos culturais na região. A proposta nasce de uma inquietação resultante de pesquisa anterior, realizada por Silva (2014), na qual, como conclusão, pouco se percebeu continuidade e ancoragem de iniciativas contemporâneas na trajetória de movimentos passados. Para o alcance do objetivo delineado, é primeiramente apresentada, com brevidade, a história local, bem como sua associação com a violência e a atuação como resistência. Em seguida, desenvolve-se o conceito de memória política para, enfim, correlaciona-lo com a proposição de releitura por meio do esquecimento pensado por Nietzsche, que serve à vida. Conclui-se com a ideia de que – apesar de diferenças que a fazem escapar, por vezes, do enquadramento no conceito em si – a Baixada Fluminense possui uma memória política em formação, que responde a um espectro não definido justamente porque encontra no presente novos contornos, mas que, entretanto, permanece ali impelindo movimentos, como os coletivos, à ações no espaço público revestidas de intencionalidades.Palavras-chave: Memória política. Baixada Fluminense. Cultura. Coletivo. Memória e esquecimento.Abstract: This paper proposes a reflection on the political memory in the Baixada Fluminense - an integral territory of the metropolitan region of Rio de Janeiro State -, considering the postulates listed by Lifschitz for such concept and the recent activity of cultural collectives in this region. The proposal rises from a concern resulting from previous research by Silva (2014), which, did not perceived complete continuity and anchoring of contemporary initiatives in the trajectory of past movements. In order to reach the objective outlined, the local history is first briefly presented, as well as its association with violence and acting as resistance. Then the concept of political memory is developed to finally correlate it with the proposition of rereading through the oblivion, by Nietzsche, which serves life. It concludes with the idea that – despite the differences that sometimes make it escape the framing of the concept itself - Baixada Fluminense has a political memory in formation, which responds to an undefined spectrum precisely because it finds in the present new but, however, it remains there impelling movements, like the collective ones, to actions in the public space with intentionalities.Keywords: Political memory Baixada Fluminense. Culture. Collective. Memory and oblivion.
Better Births: early findings from North-West London
Authors: Lang Nicola , Jose Sophie , Rogers Amanda , Maric Helen , Lyon Victoria , Nightingale Pippa
Published: September 2019

Background

Better Births recommends that women receive continuity of carer in order to improve outcomes.

Aim

To measure changes from implementing a continuity of carer approach, in terms complicated or uncomplicated births.

Method

In North-West London in 2017-2018, funding was allocated to establish an early adopters' programme across six maternity units. The implementation of this programme and the outcomes in terms of birth complications and women's feedback are described.

Findings

Although most changes were not statistically significant, positive maternal views, and some changes in the use of diet control or insulin for women with gestational diabetes, were found.

Conclusions

The evaluation was limited by missing data, and in future, maternity outcomes should be extracted routinely from women's records without requiring manual data entry by midwives.
People with learning disabilities accessing maternity services
Authors: Vernon Samantha
Published: September 2019

From September 2018–June 2019, I was fortunate enough to undertake a research internship with the National Institute for Health Research (NIHR). My chosen topic was ‘people with learning disabilities accessing maternity services'. This was because, through 19 years of clinical practice, I identified an increasing number of women and families with learning disabilities presenting for care in my Trust, but found no specific mention of learning disabilities in the National Institute for Health and Care Excellence (NICE) (2019) guidelines, nor a standard definition within which to work.

This led me to reflect on my experience and how midwives can assist women and families with learning disabilities. This refelection has been guided by Gibbs (1988) .
Risk factors for leak, complications and mortality after ileocolic anastomosis: comparison of two anastomotic techniques
Authors: Sánchez-Guillén L , Frasson M , García-Granero Á , Pellino G , Flor-Lorente B , Álvarez-Sarrado E , García-Granero E
Published: September 2019

Introduction

There are no definitive data concerning the ideal configuration of ileocolic anastomosis. Aim of this study was to identify perioperative risk factors for anastomotic leak and for 60-day morbidity and mortality after ileocolic anastomoses (stapled vs handsewn).

Materials and methods

This is a STROBE-compliant study. Demographic and surgical data were gathered from patients with an ileocolic anastomosis performed between November 2010 and September 2016 at a tertiary hospital. Anastomoses were performed using standardised techniques. Independent risk factors for anastomotic leak, complications and mortality were assessed.

Results

We included 477 patients: 53.7% of the anastomoses were hand sewn and 46.3% stapled. Laterolateral anastomosis was the most common configuration (93.3%). Anastomotic leak was diagnosed in 8.8% of patients and 36 were classified as major anastomotic leak (7.5%). In the multivariate analysis, male sex (P = 0.014, odds ratio, OR, 2.9), arterial hypertension (P = 0.048, OR 2.29) and perioperative transfusions (P < 0.001, OR 2.4 per litre) were independent risk factors for major anastomotic leak. The overall 60-day complication rate was 27.3%. Male sex (31.3% vs female 22.3%, P = 0.02, OR 1.7), diabetes (P = 0.03 OR 2.0), smoking habit (P = 0.04, OR 1.8) and perioperative transfusions (P < 0.001, OR 3.3 per litre) were independent risk factors for postoperative morbidity. The 60-day-mortality rate was 3.1% and no significant risk factors were identified.

Conclusion

Anastomotic leak after ileocolic anastomosis is a relevant problem. Male sex, arterial hypertension and perioperative transfusions were associated with major anastomotic leak. Conversion to open surgery was more frequently associated with perioperative death.
Mid-term bariatric surgery outcomes for obese patients: does weight matter?
Authors: Samuel N , Jalal Q , Gupta A , Mazari FAK , Vasas P , Balachandra S
Published: September 2019

Introduction

Studies have attempted to identify prognostic indicators for successful outcomes following bariatric surgery for obesity. The aim of this study was to determine whether the degree of obesity affects outcomes in patients who are morbidly obese (basal metabolic index, BMI, 40–49.9 kg/m2), super-obese (BMI 50–59.9 kg/m2) and super-super-obese (BMI greater than 60 kg/m2) undergoing restrictive or malabsorptive bypass procedures.

Material and methods

Retrospective analysis of a prospectively maintained database was undertaken to include all consecutive laparoscopic adjustable gastric bands (LAGB), laparoscopic sleeve gastrectomies (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB) procedures since 2010. Patients with at least two years of follow-up were included. At each visit, the patient’s weight, BMI, excess weight loss and comorbidity status were recorded.

Results

A total of 353 patients (75% women) were included in the analysis; 65 (18.4%) underwent LAGB; 70 (19.8%) LSG and 218 (61.8%) LRYGB. At presentation, the median BMI for the morbidly obese sub-group was 47.2 kg/m2 for LAGB, 46.4 kg/m2 for LSG and 46.6 kg/m2 for LRYGB (P = 0.625); for the super-obese sub-group it was 53.2 kg/m2 for LAGB, 52.9 kg/m2 for LSG and 52.4 kg/m2 for LRYGB (P = 0.481); and for the super-super-obese sub-group 66.9 kg/m2 for (LAGB, 66.7 kg/m2 for LSG and 61.5 kg/m2 for LRYGB (P = 0.169). Percentage of excess weight loss at the end of two years was significantly higher in the morbidly obese and super-morbidly obese sub-groups undergoing LRYGB (median 68.5% and 69.5%, respectively; P < 0.001) than in the sub-groups undergoing LAGB and LSG. This was also reflected in the reduction of BMI achieved with bypass in the two sub-groups (P < 0.001). Complete diabetes remission was significantly higher in the morbidly obese and super-morbidly obese sub-groups undergoing LRYGB treatment (P < 0.05). Sleep apnoea, asthma and exercise tolerance had significantly improved in the super-morbidly obese undergoing LRYGB (P < 0.05). There was no significant difference between the three treatment groups in remission of hypertension; dyslipidaemia; gastro-oesophageal reflux disease and depression in all three BMI sub-groups.

Conclusion

The mid-term results for weight loss and resolution of obesity-related comorbidities is best achieved in super-obese patients undergoing LRYGB, without any significant increase in complications with this procedure as compared with LAGB and LSG.
The Lister AirSeal® port closure technique – Initial patient outcomes
Authors: Mirmilstein G , Noel J , Gbolahan O , Vasdev N , Lane T , Adshead J
Published: September 2019

Introduction

The 12-mm AirSeal® port is widely used in robotically assisted laparoscopic prostatectomy due to its ability to maintain stable pneumoperitoneal pressures and smoke evacuation. However, it creates a potential risk of port site hernia. We have traditionally used EndoClose™ to perform full thickness closure of this port, but noted that patients experienced increased pain related to this procedure, which sometimes persisted for several months. Using the Da Vinci Si we performed peritoneal closure with 2-0 vicryl by switching the fourth arm to the right master controller. The external oblique sheath was closed outside with 1 Ethibond.

Materials and methods

We performed this closure in 20 consecutive patients (group 1). Postoperative day 1, 2 and post-discharge telephone consultation pain scores (1–10) were recorded and compared with the previous 20 consecutive patients who had the EndoClose closure (group 2).

Results

We recorded an instructional video to enable reproduction of the new technique. The mean length of stay was 1.5 days for patients in group 1 and 1.9 days for those in group 2 (P = 0.04). There was no difference in operating time or average day 1 pain scores. Post-discharge follow-up call revealed 1 of 20 patients who had AirSeal port site pain in group 1 and 5 of 17 in group 2 (P = 0.04). Pain scores also tended to be higher for group 2.

Conclusions

Our preliminary analysis of this novel technique to close the AirSeal port in two separate layers improves postoperative pain related to this port site.