bluuebunny/crossref_metadata_2025 huggingface dataset:
A Blueprint for Designing and Developing M-Health Applications for Diverse Stakeholders Utilizing FHIR
Authors: Baihan Mohammed S. , Sánchez Yaira K. Rivera , Shao Xian , Gilman Christopher , Demurjian Steven A. , Agresta Thomas P.
Published: April 2018

FHIR standard is designed to enable interoperability and integration with the newest and adopted technologies by the industry. This chapter presents a number of blueprints for the design and development of FHIR servers that enable the integration between HIT systems with m-health applications via FHIR. Each blueprint is based on the location that FHIR servers can be placed with respect to the components of the m-health application (UI, API, server) or a HIT system in order to define and design the necessary infrastructure to facilitate the exchange of information via FHIR. To demonstrate the feasibility of the work, this chapter utilizes the Connecticut concussion tracker (CT2) m-health application as a proof-of-concept prototype that fully illustrates the blueprints of the design and development steps that are involved. The blueprints can be applied to any m-health application and are informative and instructional for medical stakeholders, researchers, and developers.
Clinical Data Analysis Using IoT Devices
Authors: Govinda K.
Published: April 2018

The most recent couple of decades have seen a sharp rise in the number of elderly individuals. Furthermore, enquiry into this tells us that around 89% of the matured individuals are probably going to live autonomously. As the need be, giving a respectable personal satisfaction for matured individuals has turned into a genuine social test. Doctors need to have clear idea as to the health of these individuals, so they can use proper methodologies to cure them. Hence, IoT develops the idea of the internet and makes it more unavoidable. IoT permits consistent collaborations among various sorts of gadgets, for example, therapeutic sensors, observing cameras, home machines, and so on. This chapter proposes clinical data analysis using the internet of things.
Synthesis of Magnesium Based Nanophosphors and Nanocomposites by Different Techniques
Authors: Naik Ramachandra , Revathi V.  , Prashantha S. C. , Nagabhushana H.
Published: April 2018

This chapter consists of systematic synthesis of magnesium silicate nanoparticles by solution combustion method using ODH fuel. Compared to other fuels, ODH has the better advantages of obtaining crystalline nanomaterials without post calcinations. By doping different rare earth ions to magnesium silicate, the product can be used for luminescent applications. Synthesis of magnesium ferrite nanoparticle is done using molten salt method followed by the synthesis of polymer composite in the form of fibers by the process of electrospinning.
Behavior Studies of Nonlinear Fractional-Order Dynamical Systems Using Bifurcation Diagram
Authors: Rabah Karima
Published: April 2018

Over the past decades, chaos has stimulated the interest of researchers due to its existence in different fields of science and engineering. The chaotic systems are characterized by their sensitivity to the initial conditions. This property makes the system unpredictable long term. Similar to the integer-order differential systems, fractional-order differential systems can exhibit chaotic behaviors. This type of system contains one or more elements of fractional order. The fractional calculus is recognized in the early seventeenth century but it has been widely applied in many fields and with intense growth just over the past decades. To avoid troubles arising from unusual behaviors of a chaotic system, chaos control has gained increasing attention in recent years. An important objective of a chaos controller is to suppress the chaotic oscillations completely or reduce them to the regular oscillations. The goal of this chapter is to present the evolution of chaotic systems in open and closed loop in function of their parameters and designing a controller using bifurcation diagrams.
Effect of Different Processes on Hydrogen Storage Properties of AZ Magnesium Alloy
Authors: Huang Song Jeng , Fang Chieh , Rajagopal Veeramanikandan , Chen Yong Lin
Published: April 2018

In this research, AZ31 and AZ91 magnesium alloys were used as hydrogen storage materials to compare the effects of equal channel angular pressing (ECAP) and high energy ball milling (HEBM) processes on the hydrogen storage properties. In addition, the effects of using different AZ magnesium alloys (AZ31 and AZ91) with the same processes and parameters on the hydrogen storage properties were investigated. The results show that the crystal size of AZ magnesium alloy has been decreased by both ECAP and HEBM processes. It was also revealed that AZ31 magnesium alloy processed by ECAP route BC with 8 passes has faster absorption and desorption rate than AZ31 magnesium alloy processed by HEBM ball material ratio 30:1 with 300rpm. The capacity of two samples is 7.0 and 6.8 wt.%. The AZ91 magnesium alloy processed by HEBM ball material ratio 30:1 with 300rpm has faster hydrogen absorption and desorption rate than that of AZ91 magnesium alloy processed by ECAP route BC with 8 passes at 375oc. The capacity of two samples is both 6.7 wt.%.
The Effect of Flange Length on the Distribution of Longitudinal Strain during the Flexible Roll Forming Process
Authors: Woo Young Yun , Kang Pil Gyu , Oh Il Yeong , Moon Young Hoon
Published: April 2018

Flexible roll forming is an advanced sheet metal forming process which allows the production of variable cross-section profiles. In flexible roll forming process, nonuniform transversal distribution of the longitudinal strain can cause the longitudinal bow, which is deviation in height of the web over the length of the profile. To investigate the effect of flange length on the transversal distribution of the longitudinal strain, FEM simulations are conducted with different flange length for three blank shapes; trapezoid, convex and concave. The result shows that the longitudinal strain and longitudinal bow decrease with increasing flange length for a trapezoid and a concave blank. For a convex blank, the longitudinal strain and longitudinal bow increase with increasing flange length. To validate FEM simulation result, numerically obtained longitudinal strain has been compared with experimental results.
The Respiratory Environment Diverts the Development of Antiviral Memory CD8 T Cells
Authors: Shane Hillary L. , Reagin Katie L. , Klonowski Kimberly D.
Published: April 2018

Our understanding of memory CD8+ T cells has been largely derived from acute, systemic infection models. However, memory CD8+ T cells generated from mucosal infection exhibit unique properties and, following respiratory infection, are not maintained in the lung long term. To better understand how infection route modifies memory differentiation, we compared murine CD8+ T cell responses to a vesicular stomatitis virus (VSV) challenge generated intranasally (i.n.) or i.v. The i.n. infection resulted in greater peak expansion of VSV-specific CD8+ T cells. However, this numerical advantage was rapidly lost during the contraction phase of the immune response, resulting in memory CD8+ T cell numerical deficiencies when compared with i.v. infection. Interestingly, the antiviral CD8+ T cells generated in response to i.n. VSV exhibited a biased and sustained proportion of early effector cells (CD127loKLRG1lo) akin to the developmental program favored after i.n. influenza infection, suggesting that respiratory infection broadly favors an incomplete memory differentiation program. Correspondingly, i.n. VSV infection resulted in lower CD122 expression and eomesodermin levels by VSV-specific CD8+ T cells, further indicative of an inferior transition to bona fide memory. These results may be due to distinct (CD103+CD11b+) dendritic cell subsets in the i.n. versus i.v. T cell priming environments, which express molecules that regulate T cell signaling and the balance between tolerance and immunity. Therefore, we propose that distinct immunization routes modulate both the quality and quantity of antiviral effector and memory CD8+ T cells in response to an identical pathogen and should be considered in CD8+ T cell–based vaccine design.
The development of a model for dealing with secondary traumatic stress in mental health workers in Rwanda
Authors: Iyamuremye Jean D. , Brysiewicz Petra
Published: April 2018

Introduction: Mental health workers who listen to stories of fear, pain and distress of traumatised clients may develop deleterious emotional, cognitive and physical consequences (Cairns, 2007). This phenomenon has been called secondary traumatic stress (STS) (Perez, Jones, Englert, & Sachau, 2010). Rwanda is well-known for the 1994 genocide, with the death of hundreds of thousands of people in a planned campaign of violence. Numerous mental health workers operating in Rwanda were also victims of the violence and it has been suggested that there is a high level of STS in mental health workers in Rwanda (Iyamuremye & Brysiewicz, 2008).Aim: To develop a comprehensive model to manage the effects of STS in mental health workers operating in Rwanda.Method: An action research project was initiated to develop this model and data for the model was collected through individual interviews with mental health workers (nurses, doctors, psychologists, trauma counsellors and social workers) as well as a quantitative tool measuring secondary traumatic stress (Trauma Attachment Belief Scale) in these health workers.Results: The Intervention Model to Manage Secondary Traumatic Stress (IMMSTS) was synthesised from these findings and includes preventive, evaluative and curative strategies to manage STS in mental health workers in Rwanda at the individual, social and organisational levels.Conclusion: The model will offer mental health professionals an effective framework for addressing the issue of STS.
Nurses' perceptions of facilitating genuineness in a nurseepatient relationship
Authors: Van den Heever Anna E. , Poggenpoel M. , Myburgh C. P.H.
Published: April 2018

Background: Genuineness was highlighted as an important concept when nurses' perceptions of facilitating a therapeutic relationship were assessed in a study conducted in private general hospital wards. Training courses are mainly professionally orientated and little attention is given to genuineness, which is underpinned by values and influenced by culture and self-awareness. Reflection on patients' feelings enables mindfulness in the nurse—patient relationship, but nurses often act on instinct or rely on learned knowledge and skills. Despite the increased emphasis on virtue ethics and honest disclosure, hope is offered but nurses are often not honest with themselves or in their response to patients.This poses a challenge when genuineness is facilitated. In this article, nurses' perceptions of facilitating genuineness will be discussed.Method: To assess nurses' genuineness, a quantitative, contextual, deductive and descriptive study was conducted. A purposive sample of nurses was taken from private general hospitals in Gauteng, South Africa. Nurses' (n = 181) perceptions of facilitating genuineness in a nurse—patient relationship were self-assessed on a five-point scale in a questionnaire.Data analysis: Descriptive statistics and non-parametric statistical techniques were used. Specific hypotheses were tested to identify whether statistically significant differences in perceptions of facilitating genuineness existed between two or more groups.Results: When groups were compared, statistically significant differences were identified in nurses' perceptions of facilitating genuineness with respect to age, years' experience as a nurse and qualifications. It is recommended that nurses' awareness of genuineness and its facilitation should involve learning through socialisation and self-awareness.
Reviewer Acknowledgement
Authors: Office Editorial
Published: April 2018

No abstract available.
Clinical judgement within the South African clinical nursing environment: A concept analysis
Authors: Van Graan Anna C. , Williams Martha J.S. , Koen Magdalena P.
Published: April 2018

Reform in the South African healthcare and educational system were characterized by the ideals that the country needs to produce independent, critical thinkers. Nurses need to cope with diversity in a more creative way, defining their role in a complex, uncertain, rapidly changing health care environment. Quality clinical judgement is therefore imperative as an identified characteristic of newly qualified professional nurses. The objective of this study was to explore and describe clinical judgement through various data sources and review of literature to clarify the meaning and promote a common understanding through formulating the characteristics and developing a connotative (theoretical) definition of the concept. An explorative, descriptive qualitative design was used to discover the complexity and meaning of the phenomenon. Multiple data sources and search strategies were used, for the time frame 1982—2013. A concept analysis was used to arrive at a theoretical definition of the concept of ‘clinical judgement’ as a complex cognitive skill to evaluate patient needs, adaption of current treatment protocols as well as new treatment strategies, prevention of adverse side effects through being proactive rather than reactive within the clinical nursing environment. The findings emphasized clinical judgement as skill within the clinical nursing environment, thereby improving autonomous and accountable nursing care. These findings will assist nurse leaders and clinical nurse educators in developing a teaching-learning strategy to promote clinical judgement in undergraduate nursing students, thereby contributing to the quality of nursing care.
HIV stigma experiences and stigmatisation before and after an intervention
Authors: Chidrawi H. C. , Greeff Minrie , Temane Q. M. , Doak Colleen M.
Published: April 2018

This study focuses on one aspect of a more extensive SANPAD-funded HIV stigma reduction research project. The study addresses not only the continuous burden of HIV stigma, but more specifically on the low rate of participation in healthcare opportunities and HIV stigma reduction interventions by people living with HIV (PLWH) This study tested both change-over-time in HIV stigma experiences of PLWH and change-over-time in the HIV stigmatisation behaviour of people living close to them (PLC) in an urban and rural setting in the North-West in South Africa. These aspects were measured before and after the comprehensive community-based HIV stigma reduction intervention. A quantitative single system research design, with a pre-test and four repetitive post-tests, and purposive voluntary and snowball sampling were used. Findings did not indicate significant differences between urban and rural settings, but demonstrated some significance in change-over-time in the HIV stigma experiences of PLWH as well as the HIV stigmatisationbehaviour of PLC after the intervention. Recommendations include the continuation of this intervention, following the same guidelines that were implemented during the study.
Reasons for Picture Archiving and Communication System (PACS) data security breaches: Intentional versus non-intentional breaches
Authors: Mahlaola Tintswalo B. , Van Dyk Barbara
Published: April 2018

Background: The Picture Archiving and Communication System (PACS) has led to an increase in breached health records and violation of patient confidentiality. The South African constitution makes provision for human dignity and privacy, virtues which confidentiality seeks to preserve. Confidentiality thus constitutes a human right which is challenged by the use of technology. Humans, as managers of information technology, constitute the weakest link in safeguarding confidentiality. Nonetheless, it is argued that most security breaches are nonintentionally committed by well-meaning employees during routine activities.Objective: The purpose of this article is to explore the nature of and reasons for confidentiality breaches by PACS users in a South African context.Methods: A closed-ended questionnaire was used to collect quantitative data from 115 health professionals employed in a private hospital setting, including its radiology department and a second independent radiology department. The questionnaire sought to explore the attitudes of participants towards confidentiality breeches and reasons for suchbehaviour.Results: Breach incidences were expressed as percentage compliance and classified according to the nature and reasons provided by Sarkar's breach classification. Cross tabulations indicated a statistical significance (p < 0.00) between the expected and observed confidentiality practices of participants and also the adequacy of training, system knowledge and policy awareness.Conclusion: Our study supports previous findings that, in the absence of guidelines, most security breaches were non-intentional acts committed due to ignorance. Of concern are incidents in which sensitive information was intentionally shared via social media.
Professional nurses' understanding of clinical judgement: A contextual inquiry
Authors: Van Graan Anna C. , Williams Martha J.S. , Koen Magdalena P.
Published: April 2018

Higher cognitive skills are essential competencies for nurses joining the technologically and increasingly complex health care environment to provide safe and effective nursing care. Educators and clinical facilitators have recognised that newly qualified nurses do not meet the expectations for entry level clinical judgement and are held accountable for finding adequate learning experiences as preparation for such practice demands. An explorative and descriptive qualitative design was followed in this study to reach an understanding of clinical judgement in the clinical nursing environment from the perspective of professional nurses. Eleven professional nurses (n = 11) working at primary health care clinics, public and private hospitals participated voluntarily. Data was collected by means of the “World Cafe” method, incorporating a combination of techniques such as interviewing, discussions, drawings, narratives and reflection. The focus was on professional nurses' knowledge of the meaning of clinical judgement and factors influencing the development of clinical judgement in the clinical environment. Qualitative thematic content analysis principles were applied during data analysis. The findings were integrated with the relevant literature to culminate in conclusions that should add to the knowledge base of clinical judgement as an essential skill for improving autonomous and accountable nursing care.
Best practice during intrapartum care: A concept analysis
Authors: Chabeli Mary M. , Malesela Jackie M.L. , Nolte Anna G.W.
Published: April 2018

Rationale: Best practice is an abstract word open to different interpretations. The definition of best practice depends on the context.Purpose: The purpose is to explore the meaning of the concept of best practice within the context of intrapartum care.Method: The concept of best practice was analysed using Wilson's method of concept analysis. Dictionaries, a thesaurus, and an internet search were employed. References of journals were used to identify extra sources. Data saturation was reached at 117 definitions and uses of the concept of best practice. The definitions and uses of the concept of best practice listed in column one were read repeatedly. Common and similar patterns of words were highlighted. Grouping of common attributes and connotations occurred in column two and further deductive analysis and synthesis occurred in column three where derived essential attributes of the concept of best practice were categorised.Results: Three broad categories emerged, namely (1) Values as antecedents of best practice; (2) A three-phased interactive integrative cyclic process of best practice; (phase one: awareness; phase two: need analysis and interactive process; phase three: consolidation);and (3) Desired outcomes of best practice, with resultant theoretical definition of the concept best practice during intra-partum care. Theoretical validity was attained through117 sources used.Recommendation: The results of the concept analysis of best practice should be used to develop a model to facilitate best practice during intra-partum care.
Needs and challenges of lay community health workers in a palliative care environment for orphans and vulnerable children
Authors: Visagie Bonita Bernice , Pillay Jace
Published: April 2018

Introduction: The escalation of HIV/AIDS infections in the last decade has increased the need for palliative care community organizations to care for orphans and vulnerable children, who are in dire need of support. Many of these organizations depend on the services of lay community health workers to provide constant care to those in need of it in their local communities. The focus of this study is to explore the role of lay health workers in a community organization located in rural Bronkhorstspruit, Gauteng Province of South Africa. That provides palliative care for orphans and vulnerable children diagnosed with HIV/AIDS. Their roles were analysed critically through a job-demands and job-resources theoretical framework.Methods: A descriptive phenomenological case study design was employed to collect data through twenty five individual interviews, two separate focus groups consisting of ten participants in one group and eleven participants in the other group, observations and document analysis. Data were processed through a rigorous thematic analysis.Results: The findings pointed out specific knowledge and skills these lay community health workers needed in order to be satisfied with, and successful in, their administration of palliative care to orphans and vulnerable children. Participants identified the following organizational challenges that were deemed to be impacting negatively on their work experiences: the lack of career pathing processes; sufficient career guidance; and inadequate employment processes, such as staff retention, succession planning, and promotion.Conclusion: Through the findings, a framework for enhancing the work experiences of the lay community health workers was developed. The uniqueness of this framework is that the focus is on improving the work lives of the lay community health workers, who have serious skills-resourcing needs. There were specific concrete strategies that the organization could adopt to support the knowledge and skills requirements of the lay community health workers in relation to the needs and challenges that will enhance their efficiency in the palliative care environment. The findings and framework that emanated from this study could be used to support lay community health workers in their respective organizations to be more effective in the support they provide to orphans and vulnerable children. Because South Africa is afflicted by the HIV/AIDS epidemic, this framework can be used in similar organizations that are working with lay community health workers with skill-resourcing needs not only in the health sector, but also in other sectors, such as in education and agriculture.
Chitosan Pad, Cellulose Membrane, or Gelatin Sponge for Peridural Bleeding: An Efficacy Study on a Lumbar Laminectomized Rat Model
Authors: Sae-Jung Surachai , Apiwatanakul Punyawat
Published: April 2018

Study Design

Experimental study in an animal model.

Purpose

This study aims to evaluate the hemostatic properties of four common hemostatic materials including the chitosan clot pad, absorbable gelatin sponge, cellulose membrane, and gauze on peridural bleeding using a rat model.

Overview of Literature

Intraoperative bleeding during spinal surgery can lead to morbidities. Hemostatic materials have been developed, but the efficacy of these materials on peridural bleeding remains unclear.

Methods

Forty 8-week-old Sprague-Dawley rats were used in this study. Under adequate anesthesia, each rat was posteriorly dissected to their L5 and L6 spinous processes. Bleeding from muscles and soft tissue dissections was stopped before lumbar bone cutting. Immediately after the L5–L6 laminae were cut and removed, the rats were randomly allocated to receive one of the abovementioned hemostatic materials. All hemostatic materials were placed over the raw surface of cut bone and dura and changed every 60 seconds. The procedure was stopped when there was no further bleeding. Time to staunching and amount of bleeding were recorded for statistical analysis.

Results

The respective mean±standard deviation hemorrhage volume and time for the cellulose membrane, gelatin sponge, chitosan pad, and gauze were 1.19±0.44, 1.03±0.72, 0.96±0.57, and 1.98±0.62 mL, respectively, and 2.9±0.6, 2.1±0.6, 1.7±0.5, and 2.9±1.0 minutes, respectively. The overall bleeding volumes for the cellulose membrane, gelatin sponge, and chitosan pad were significantly lower than the overall bleeding volume for gauze.

Conclusions

Chitosan clot pads, gelatin sponges, and cellulose membranes have better hemostatic properties than gauze. The chitosan pad had the lowest average bleeding volume, followed by gelatin sponge and cellulose membrane.
Efficacy of Trigger Point Injections in Patients with Lumbar Disc Hernia without Indication for Surgery
Authors: Dernek Bahar , Adiyeke Levent , Duymus Tahir Mutlu , Gokcedag Akın , Kesiktas Fatma Nur , Aksoy Cihan
Published: April 2018

Study Design

Prospective comparative study.

Purpose

To investigate the efficacy of gluteal trigger point (TP) injections with prilocaine in patients with lumbosacral radiculopathy complaining of gluteal pain.

Overview of Literature

TP injections can be performed using several anesthetic agents, primarily lidocaine and prilocaine. While several studies have used lidocaine, few have used prilocaine.

Methods

A total of 65 patients who presented at the polyclinic with complaints of lower back pain with lumbar disc herniation (based on physical examination and magnetic resonance imaging) and TPs in the gluteal region were included in this prospective comparative study. Group 1 comprised 30 patients who were given TP injections, a home exercise program, and oral medications, and group 2 comprised 35 patients who were only treated with a home exercise program and oral medications. The patients' demographic data, Oswestry Disability Index (ODI) scores, and Visual Analog Scale (VAS) scores were recorded, and these data were evaluated at 1- and 3-month follow-ups.

Results

The ODI and VAS scores of both groups significantly decreased initially and at the follow-up examinations, but the decreases were more marked in group 1.

Conclusions

We obtained better results with TP injections than only a home exercise program and oral medications in patients with radiculopathy and TPs in the gluteal region.
Assessment of Paraspinal Muscle Atrophy Percentage after Minimally Invasive Transforaminal Lumbar Interbody Fusion and Unilateral Instrumentation Using a Novel Contralateral Intact Muscle-Controlled Model
Authors: Ortega-Porcayo Luis Alberto , Leal-López Andres , Soriano-López Miroslava Elizabeth , Gutiérrez-Partida Carlos Francisco , Ramírez-Barrios Luis Rodolfo , Soriano-Solis Sergio , Rodríguez-García Manuel , Soriano-Solis Hector Antonio , Soriano-Sánchez José Antonio
Published: April 2018

Study Design

Retrospective comparative clinical study.

Purpose

This study aimed to assess paraspinal muscle atrophy in patients who underwent minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) and unilateral pedicle screw fixation using a novel contralateral intact muscle-controlled model.

Overview of Literature

The increased incidence of paravertebral lumbar muscle injuries after open techniques has raised the importance of implementing minimally invasive spine surgical techniques using tubular retractors and minimally invasive screw placement. The functional cross-sectional area (FCSA) represents the lean muscle mass; furthermore, FCSA is a useful marker of the contractile ability of a muscle following a spine surgery. However, the benefits of unilateral fixation and MI-TLIF on paraspinal muscles have not been defined.

Methods

We performed a retrospective imagenological review on eleven patients who underwent unilateral MI-TLIF and unilateral transpedicular screw lumbar placement. FCSAs of the multifidus and erector spinae were measured 1 year after surgery at adjacent levels and were compared to the contralateral intact muscles. Measurement differences between the surgical and nonsurgical sites were compared. The interobserver reliability was calculated using an intraclass correlation coefficient.

Results

The mean FCSA at the surgical site was 20.97±5.07 cm2 at the superior level and 8.89±2.87 cm2 at the inferior level. The mean FCSA at the contralateral nonsurgical site was 20.15±5.95 cm2 at the superior level and 9.20±2.66 cm2 at the inferior level was. The superior and inferior FCSA measurements showed no significant difference between the surgical and nonsurgical sites (p=0.5, p=0.922, respectively).

Conclusions

Using a mini-open tubular approach through the sulcus between the longissimus and iliocostalis, MI-TLIF and unilateral pedicle screw instrumentation produced minimal paraspinal muscle damage at the superior and inferior adjacent levels.
The Incidence of Adjacent Segment Degeneration after the Use of a Versatile Dynamic Hybrid Stabilization Device in Lumbar Stenosis: Results of a 5–8-Year Follow-up
Authors: Dobran Mauro , Nasi Davide , Esposito Domenico Paolo , Gladi Maurizio , Scerrati Massimo , Iacoangeli Maurizio
Published: April 2018

Study Design

Retrospective study with long-term follow-up.

Purpose

To evaluate the long-term incidence of adjacent segment degeneration (ASD) and clinical outcomes in a consecutive series of patients who underwent spinal decompression associated with dynamic or hybrid stabilization with a Flex+TM stabilization system (SpineVision, Antony, France) for lumbar spinal stenosis.

Overview of Literature

The incidence of ASD and clinical outcomes following dynamic or hybrid stabilization with the Flex+TM system used for lumbar spinal stenosis have not been well investigated.

Methods

Twenty-one patients with lumbar stenosis and probable post-decompressive spinal instability underwent decompressive laminectomy followed by spinal stabilization using the Flex+TM stabilization system. The indication for a mono-level dynamic stabilization was a preoperative magnetic resonance imaging (MRI) demonstrating evidence of severe disc disease associated with severe spinal stenosis. The hybrid stabilization (rigid-dynamic) system was used for multilevel laminectomies with associated initial degenerative scoliosis, first-grade spondylolisthesis, or rostral pathology.

Results

The improvement in Visual Analog Scale and Oswestry Disability Index scores at follow-up were statistically significant (p<0.0001 and p<0.0001, respectively). At the 5–8-year follow-up, clinical examination, MRI, and X-ray findings showed an ASD complication with pain and disability in one of 21 patients. The clinical outcomes were similar in patients treated with dynamic or hybrid fixation.

Conclusions

Patients treated with laminectomy and Flex+TM stabilization presented a satisfactory clinical outcome after 5–8 years of follow-up, and ASD incidence in our series was 4.76% (one patient out of 21). We are aware that this is a small series, but our long-term follow-up may be sufficient to contribute to the expanding body of literature on the development of symptomatic ASD associated with dynamic or hybrid fixation.
Reciprocal Changes in Sagittal Alignment in Adolescent Idiopathic Scoliosis Patients Following Strategic Pedicle Screw Fixation
Authors: Dumpa Srikanth Reddy , Shetty Ajoy Prasad , Aiyer Siddharth N. , Kanna Rishi Mugesh , Rajasekaran S
Published: April 2018

Study Design

Retrospective observational study.

Purpose

To analyze the effect of low-density (LD) strategic pedicle screw fixation on the correction of coronal and sagittal parameters in adolescent idiopathic scoliosis (AIS) patients.

Overview of Literature

LD screw fixation achieves favorable coronal correction, but its effect on sagittal parameters is not well established. AIS is often associated with decreased thoracic kyphosis (TK), and the use of multi-level pedicle screws may result in further flattening of the sagittal profile.

Methods

A retrospective analysis was performed on 92 patients with AIS to compare coronal and sagittal parameters preoperatively and at 2-year follow-up. All patients underwent posterior correction via LD strategic pedicle screw fixation. Radiographs were analyzed for primary Cobb angle (PCA), coronal imbalance, cervical sagittal angle (CSA), TK, lumbar lordosis (LL), pelvic incidence, pelvic tilt (PT), sacral slope (SS), C7 plumb line, spino-sacral angle, curve flexibility, and screw density.

Results

PCA changed significantly from 57.6°±13.9° to 19°±8.4° (p <0.0001) with 67% correction, where the mean curve flexibility was 41% and screw density was 68%. Regional sagittal parameters did not change significantly, including CSA (from 10.76° to 10.56°, p =0.893), TK (from 24.4° to 22.8°, p =0.145), and LL (from 50.3° to 51.1°, p =0.415). However, subgroup analysis of the hypokyphosis group (<10°) and the hyperkyphosis group (>40°) showed significant correction of TK (p <0.0001 in both). Sacro-pelvic parameters showed a significant decrease of PT and increase of SS, suggesting a reduction in pelvic retroversion SS (from 37° to 40°, p =0.0001) and PT (from 15° to 14°, p =0.025).

Conclusions

LD strategic pedicle screw fixation provides favorable coronal correction and improves overall sagittal sacro-pelvic parameters. This technique does not cause significant flattening of TK and results in a favorable restoration of TK in patients with hypokyphosis or hyperkyphosis.
Evaluation of Lumbar Intervertebral Disc Degeneration Using T1ρ and T2 Magnetic Resonance Imaging in a Rabbit Disc Injury Model
Authors: Ishikawa Tetsuhiro , Watanabe Atsuya , Kamoda Hiroto , Miyagi Masayuki , Inoue Gen , Takahashi Kazuhisa , Ohtori Seiji
Published: April 2018

Study Design

An in vivo histologic and magnetic resonance imaging (MRI) study of lumbar intervertebral disc (IVD) degeneration was conducted.

Purpose

To clarify the sensitivity and efficacy of T1ρ/T2 mapping for IVD degeneration, the correlation between T1ρ/T2 mapping and degenerative grades and histological findings in the lumbar IVD were investigated.

Overview of Literature

The early signs of IVD degeneration are proteoglycan loss, dehydration, and collagen degradation. Recently, several quantitative MRI techniques have been developed; T2 mapping can be used to evaluate hydration and collagen fiber integrity within cartilaginous tissue, and T1ρ mapping can be used to evaluate hydration and proteoglycan content.

Methods

Using New Zealand White rabbits, annular punctures of the IVD were made 10 times at L2/3, 5 times at L3/4, and one time at L4/5 using an 18-gauge needle (n=6) or a 21-gauge needle (n=6). At 4 and 8 weeks post-surgery, MRI was performed including T1ρ and T2 mapping. The degree of IVD degeneration was macroscopically assessed using the Thompson grading system. All specimens were cut for hematoxylin and eosin, safranin-O, and toluidine blue staining.

Results

Disc degeneration became more severe as the number of punctures increased and when the larger needle was used. T1ρ and T2 values were significantly different between grade 1 and grade 3 IVDs, grade 1 and grade 4 IVDs, grade 2 and grade 3 IVDs, and grade 2 and grade 4 IVDs (p<0.05). There was a significant difference between grade 1 and grade 2 IVDs only in terms of T1ρ values (p<0.05).

Conclusions

T1ρ and T2 quantitative MRI could detect these small differences. Our results suggest that T1ρ and T2 mapping are sensitive to degenerative changes of lumbar IVDs and that T1ρ mapping can be used as a clinical tool to identify early IVD degeneration.
Emergence of Three-Dimensional Printing Technology and Its Utility in Spine Surgery
Authors: Gadia Akshay , Shah Kunal , Nene Abhay
Published: April 2018

In the last decade, spine surgery has advanced tremendously. Tissue engineering and three-dimensional (3D) printing/additive manufacturing have provided promising new research avenues in the fields of medicine and orthopedics in recent literature, and their emergent role in spine surgery is encouraging. We reviewed recent articles that highlighted the role of 3D printing in medicine, orthopedics, and spine surgery and summarized the utility of 3D printing. 3D printing has shown promising results in various aspects of spine surgery and can be a useful tool for spine surgeons. The growing research on tissue bioengineering and its application in conjunction with additive manufacturing has revealed great potential for tissue bioengineering in the treatment of spinal ailments.
Présence, dans le sérum d’Ovins, d’anticorps inhibant l’hémagglutination par Myrovirus parainfluenzae
Authors: Faye P. , Charton André , Le Layec Cl.
Published: April 2018

Dans un lot composé de trente brebis et de leurs agneaux, la proportion des sujets dont le sérum inhibe, à des titres élevés de dilution, l’hémagglutination des érythrocytes de cobaye par une souche bovine de Myxovirus parainfluenzae dépasse 80 p. 100. Les résultats obtenus, en inhibition d’hémagglutination et en séro-neutralisation, avec la fraction globulinique du sérum précipitable par le sulfate d’ammoniaque, sont quantitativement plus faibles, mais qualitativement analogues.
A propos de quelques souches de Miyagawanella psittaci
Authors: Virat J. , Vallée André , Guillon J.-C. , Chaumont L.
Published: April 2018

En France l’importance de l’ornithose, sous sa forme psittacosique, ne doit pas être sous-estimée. L’examen de 10 perroquets ou perruches reçus dans les services spécialisés de l’Institut Pasteur, au cours des 4 dernières années, a permis d’isoler Miyagawanella psittaci chez 8 oiseaux. En outre, 114 cas probables d’ornithose humaine ont été détectés par la sérologie de 1959 à 1966.
Notes sur la pathologie spontanée du chien de laboratoire. 4e note : Un cas de gestation dite abdominale
Authors: Vérine H. , Gignoux M. , Murat J.
Published: April 2018

A propos d’une observation de gestation abdominale secondaire, avec déchirure utérine, les auteurs envisagent le devenir expérimental de l’animal et les problèmes soulevés en chirurgie canine : diagnostic radiologique et traitement chirurgical.
Réapparition de la rage en France. Premier cas chez un Renard dans la Moselle.
Authors: Atanasiu P. , Gamet A. , Gravière P. , Le Guilloux M. , Guillon J. C. , Vallée André , Lavault R. , Saorine A.
Published: April 2018

Un cas de rage vient d’être diagnostiqué chez un renard, dans la Moselle. La réapparition de cette virose en France nous fait une obligation de prendre des mesures sanitaires très énergiques.
Nitrate-driven urban haze pollution during summertime over the North China Plain
Authors: Li Haiyan , Zhang Qiang , Zheng Bo , Chen Chunrong , Wu Nana , Guo Hongyu , Zhang Yuxuan , Zheng Yixuan , Li Xin , He Kebin
Published: April 2018

Abstract. Compared to the severe winter haze episodes in the North China Plain (NCP),
haze pollution during summertime has drawn little public attention. In this
study, we present the highly time-resolved chemical composition of submicron
particles (PM1) measured in Beijing and Xinxiang in the NCP region
during summertime to evaluate the driving factors of aerosol pollution.
During the campaign periods (30 June to 27 July 2015, for Beijing and 8 to
25 June 2017, for Xinxiang), the average PM1 concentrations were 35.0
and 64.2 µg m−3 in Beijing and Xinxiang. Pollution episodes
characterized with largely enhanced nitrate concentrations were observed at
both sites. In contrast to the slightly decreased mass fractions of sulfate,
semivolatile oxygenated organic aerosol (SV-OOA), and low-volatility
oxygenated organic aerosol (LV-OOA) in PM1, nitrate displayed a
significantly enhanced contribution with the aggravation of aerosol
pollution, highlighting the importance of nitrate formation as the driving
force of haze evolution in summer. Rapid nitrate production mainly occurred
after midnight, with a higher formation rate than that of sulfate, SV-OOA, or
LV-OOA. Based on observation measurements and thermodynamic modeling, high
ammonia emissions in the NCP region favored the high nitrate production in
summer. Nighttime nitrate formation through heterogeneous hydrolysis of
dinitrogen pentoxide (N2O5) enhanced with the development of haze
pollution. In addition, air masses from surrounding polluted areas during
haze episodes led to more nitrate production. Finally, atmospheric
particulate nitrate data acquired by mass spectrometric techniques from
various field campaigns in Asia, Europe, and North America uncovered a higher
concentration and higher fraction of nitrate present in China. Although
measurements in Beijing during different years demonstrate a decline in the
nitrate concentration in recent years, the nitrate contribution in PM1
still remains high. To effectively alleviate particulate matter pollution in
summer, our results suggest an urgent need to initiate ammonia emission
control measures and further reduce nitrogen oxide emissions over the NCP
region.
Spatial distribution analysis of the OMI aerosol layer height: a pixel-by-pixel comparison to CALIOP observations
Authors: Chimot Julien , Veefkind J. Pepijn , Vlemmix Tim , Levelt Pieternel F.
Published: April 2018

Abstract. A global picture of atmospheric aerosol vertical distribution with a high temporal resolution is of key importance not only for
climate, cloud formation, and air quality research studies but also for correcting scattered radiation induced by aerosols in
absorbing trace gas retrievals from passive satellite sensors. Aerosol layer height (ALH) was retrieved from the OMI 477 nm
O2−O2 band and its spatial pattern evaluated over selected cloud-free scenes. Such retrievals benefit from a synergy with
MODIS data to provide complementary information on aerosols and cloudy pixels. We used a neural network approach previously trained
and developed. Comparison with CALIOP aerosol level 2 products over urban and industrial pollution in eastern China shows consistent
spatial patterns with an uncertainty in the range of 462–648 m. In addition, we show the possibility to determine the height
of thick aerosol layers released by intensive biomass burning events in South America and Russia from OMI visible
measurements. A Saharan dust outbreak over sea is finally discussed. Complementary detailed analyses show that the assumed aerosol
properties in the forward modelling are the key factors affecting the accuracy of the results, together with potential cloud
residuals in the observation pixels. Furthermore, we demonstrate that the physical meaning of the retrieved ALH scalar corresponds to
the weighted average of the vertical aerosol extinction profile. These encouraging findings strongly suggest the potential of the OMI
ALH product, and in more general the use of the 477 nm O2−O2 band from present and future similar satellite
sensors, for climate studies as well as for future aerosol correction in air quality trace gas retrievals.
Natural ocean acidification at Papagayo upwelling system (north Pacific Costa Rica): implications for reef development
Authors: Sánchez-Noguera Celeste , Stuhldreier Ines , Cortés Jorge , Jiménez Carlos , Morales Álvaro , Wild Christian , Rixen Tim
Published: April 2018

Abstract. Numerous experiments have shown that ocean acidification impedes coral calcification, but knowledge about in situ reef ecosystem response to ocean acidification is still scarce. Bahía Culebra, situated at the northern Pacific coast of Costa Rica, is a location naturally exposed to acidic conditions due to the Papagayo seasonal upwelling. We measured pH and pCO2 in situ during two non-upwelling seasons (June 2012, May–June 2013), with a high temporal resolution of every 15 and 30 min, respectively, using two Submersible Autonomous Moored Instruments (SAMI-pH, SAMI-CO2). These results were compared with published data from the 2009 upwelling season. Findings revealed that the carbonate system in Bahía Culebra shows a high temporal variability. Incoming offshore waters drive intra- and interseasonal changes. Lowest pH (7.8) and highest pCO2 (658.3 µatm) values measured during a cold-water intrusion event in the non-upwelling season were similar to those minimum values reported from upwelling season (pH  =  7.8, pCO2  =  643.5 µatm), unveiling that natural acidification also occurs sporadically in the non-upwelling season. This affects the interaction of photosynthesis, respiration, calcification and carbonate dissolution and the resulting diel cycle of pH and pCO2 in the reefs of Bahía Culebra. During the non-upwelling season, the aragonite saturation state (Ωa) rises to values of  >  3.3 and during the upwelling season falls below 2.5. The Ωa threshold values for coral growth were derived from the correlation between measured Ωa and coral linear extension rates which were obtained from the literature and suggest that future ocean acidification will threaten the continued growth of reefs in Bahía Culebra. These data contribute to building a better understanding of the carbonate system dynamics and coral reefs' key response (e.g., coral growth) to natural low-pH conditions, in upwelling areas in the eastern tropical Pacific and beyond.
Interannual drivers of the seasonal cycle of CO2 in the Southern Ocean
Authors: Gregor Luke , Kok Schalk , Monteiro Pedro M. S.
Published: April 2018

Abstract. Resolving and understanding the drivers of variability of CO2 in the Southern Ocean and its potential climate feedback is one of the major scientific challenges of the ocean-climate community. Here we use a regional approach on empirical estimates of pCO2 to understand the role that seasonal variability has in long-term CO2 changes in the Southern Ocean. Machine learning has become the preferred empirical modelling tool to interpolate time- and location-restricted ship measurements of pCO2. In this study we use an ensemble of three machine-learning products: support vector regression (SVR) and random forest regression (RFR) from Gregor et al. (2017), and the self-organising-map feed-forward neural network (SOM-FFN) method from Landschützer et al. (2016). The interpolated estimates of ΔpCO2 are separated into nine regions in the Southern Ocean defined by basin (Indian, Pacific, and Atlantic) and biomes (as defined by Fay and McKinley, 2014a). The regional approach shows that, while there is good agreement in the overall trend of the products, there are periods and regions where the confidence in estimated ΔpCO2 is low due to disagreement between the products. The regional breakdown of the data highlighted the seasonal decoupling of the modes for summer and winter interannual variability. Winter interannual variability had a longer mode of variability compared to summer, which varied on a 4–6-year timescale. We separate the analysis of the ΔpCO2 and its drivers into summer and winter. We find that understanding the variability of ΔpCO2 and its drivers on shorter timescales is critical to resolving the long-term variability of ΔpCO2. Results show that ΔpCO2 is rarely driven by thermodynamics during winter, but rather by mixing and stratification due to the stronger correlation of ΔpCO2 variability with mixed layer depth. Summer pCO2 variability is consistent with chlorophyll a variability, where higher concentrations of chlorophyll a correspond with lower pCO2 concentrations. In regions of low chlorophyll a concentrations, wind stress and sea surface temperature emerged as stronger drivers of ΔpCO2. In summary we propose that sub-decadal variability is explained by summer drivers, while winter variability contributes to the long-term changes associated with the SAM. This approach is a useful framework to assess the drivers of ΔpCO2 but would greatly benefit from improved estimates of ΔpCO2 and a longer time series.