bluuebunny/crossref_metadata_2025 huggingface dataset:
Rotterdam and Amsterdam as Trading Places? In Search of the Economic‐Geographical Nexus between Global Commodity Chains and World Cities
Authors: Jacobs Wouter
Published: September 2014

This Windows on the Netherlands addresses the economic geography of commodity trade by providing insights from two Dutch port cities: Rotterdam and Amsterdam. It is argued that commodity traders provide an empirical site for uncovering the missing links between research on world cities on the one hand, and global commodity chains on the other. Commodity trading is compelling as it is linked both with the financial sector (financing and paper trade) and with the production and distribution of commodities (storage and transportation). However, these two activities do not necessarily need to be in geographical proximity. Rotterdam and Amsterdam handle large volumes of commodities flowing through their ports, but the trading desks of the large commodity houses handle the trade transactions. There is a strong presence of the world's largest commodity traders in the Netherlands, which include not only the port‐based physical‐operational functions but also the trading desks, treasuries and holding companies. The paper concludes with an overview of avenues for further research.
Introduction: The Interlocking Network Model for Studying Urban Networks: Outline, Potential, Critiques, and Ways Forward
Authors: Derudder Ben , Parnreiter Christof
Published: September 2014

The paper begins with an introduction into the interlocking network model (INM) initially specified by Peter Taylor in the context of the Globalization and World Cities (GaWC) research network. For that purpose, the intellectual background, purpose, key principles and subsequent applications of the INM are presented. Since the overall purpose of the Special Issue is to take research inspired by the INM further, this paper gives, second, an overview of some of the main critiques raised against the INM. Third, the relevance of the different papers of the Special Issue is framed within these critiques. The papers in the Special Issue can be divided in two groups: while the first set discusses the measurement framework, the second focuses on the conceptual remit of the INM.
Evaluation of the i‐STAT portable point‐of‐care analyzer for determination of blood gases and acid–base status in newborn calves
Authors: Bleul Ulrich , Götz Eva
Published: September 2014

Objective

To validate the i‐STAT, a portable hand‐held analyzer that allows point‐of‐care measurement of blood gases, acid–base, lactate, and other blood variables in food animal practice for analysis of blood samples of newborn calves.

Design

Prospective observational study.

Setting

University teaching hospital.

Measurements and Main Results

A total of 271 venous blood samples were analyzed for PvO2, PvCO2, pH, base excess (BE), HCO3, venous saturation of oxygen (SvO2), and total carbon dioxide (TCO2) using an i‐STAT and a Rapidlab 248 bench top analyzer that served as the reference method. l‐lactate was measured using the i‐STAT as well as photometrically. Results from the i‐STAT and the reference methods were compared. The analytes BE, HCO3, and TCO2 showed a constant systematic error across the entire range with 2.3, 1.9, and 2.0 mmol/L lower values, respectively, than the values measured by the reference method. Based on the combined inherent imprecision of the 2 analyzers and after correcting the influences of systematic errors, the PvO2, HCO3, and SvO2 were within the acceptable limits in 76% to 91% of the cases. Ninety‐five percent of the measurements of PvCO2 and BE were within acceptable limits.

Conclusions

The overall performance of the i‐STAT was good except for BE, HCO3, and TCO2, thus limiting its usefulness in clinical studies. However this hand‐held device allows rapid, reliable, and accurate point‐of‐care blood analyses and thus can be useful in bovine practice.
Metabolomics of AS‐5 RBC supernatants following routine storage
Authors: D'Alessandro A. , Hansen K. C. , Silliman C. C. , Moore E. E. , Kelher M. , Banerjee A.
Published: September 2014

Background and Objectives

The safety and efficacy of stored red blood cells (RBCs) transfusion has been long debated due to retrospective clinical evidence and laboratory results, indicating a potential correlation between increased morbidity and mortality following transfusion of RBC units stored longer than 14 days. We hypothesize that storage in Optisol additive solution‐5 leads to a unique metabolomics profile in the supernatant of stored RBCs.

Materials and Methods

Whole blood was drawn from five healthy donors, RBC units were manufactured, and prestorage leucoreduced by filtration. Samples were taken on days 1 and 42, the cells removed, and mass spectrometry‐based metabolomics was performed.

Results

The results confirmed the progressive impairment of RBC energy metabolism by day 42 with indirect markers of a parallel alteration of glutathione and NADPH homeostasis. Moreover, oxidized pro‐inflammatory lipids accumulated by the end of storage.

Conclusion

The supernatants from stored RBCs may represent a burden to the transfused recipients from a metabolomics standpoint.
Evaluation of Hand Motion Capture Protocol Using Static Computed Tomography Images: Application to an Instrumented Glove
Authors: Buffi James H. , Sancho Bru Joaquín Luis , Crisco Joseph J. , Murray Wendy M.
Published: September 2014

There has been a marked increase in the use of hand motion capture protocols in the past 20 yr. However, their absolute accuracies and precisions remain unclear. The purpose of this technical brief was to present a method for evaluating the accuracy and precision of the joint angles determined by a hand motion capture protocol using simultaneously collected static computed tomography (CT) images. The method consists of: (i) recording seven functional postures using both the motion capture protocol and a CT scanner; (ii) obtaining principal axes of the bones in each method; (iii) calculating the flexion angle at each joint for each method as the roll angle of the composite, sequential, roll-pitch-yaw rotations relating the orientation of the distal bone to the proximal bone; and (iv) comparing corresponding joint angle measurements. For demonstration, we applied the method to a Cyberglove protocol. Accuracy and precision of the instrumented-glove protocol were calculated as the mean and standard deviation, respectively, of the differences between the angles determined from the Cyberglove output and the CT images across the seven postures. Implementation in one subject highlighted substantial errors, especially for the distal joints of the fingers. This technical note both clearly demonstrates the need for future work and introduces a solid, technical approach with the potential to improve the current state of such assessments in our field.
Altered Load Transfer in the Pelvis in the Presence of Periprosthetic Osteolysis
Authors: Munro Jacob T. , Fernandez Justin W. , Millar James S. , Walker Cameron G. , Howie Donald W. , Shim Vickie B.
Published: September 2014

Periprosthetic osteolysis in the retroacetabular region with cancellous bone loss is a recognized phenomenon in the long-term follow-up of total hip replacement. The effects on load transfer in the presence of defects are less well known. A validated, patient-specific, 3D finite element (FE) model of the pelvis was used to assess changes in load transfer associated with periprosthetic osteolysis adjacent to a cementless total hip arthroplasty (THA) component. The presence of a cancellous defect significantly increased (p < 0.05) von Mises stress in the cortical bone of the pelvis during walking and a fall onto the side. At loads consistent with single leg stance, this was still less than the predicted yield stress for cortical bone. During higher loads associated with a fall onto the side, highest stress concentrations occurred in the superior and inferior pubic rami and in the anterior column of the acetabulum with larger cancellous defects.
A Method for Selecting Velocity Filter Cut-Off Frequency for Maximizing Impedance Width Performance in Haptic Interfaces
Authors: Chawda Vinay , Celik Ozkan , O'Malley Marcia K.
Published: September 2014

This paper analyzes the effect of velocity filtering cut-off frequency on the Z-width performance of haptic interfaces. Finite difference method (FDM) cascaded with a low pass filter is the most commonly used technique for estimating velocity from position data in haptic interfaces. So far, there is no prescribed method for obtaining the FDM + filter cut-off frequency that will maximize Z-width performance. We present a simulation based method to demonstrate that there exists such an ideal FDM + filter cut-off frequency, and that it can be predicted by numerical simulation based on an identified model of a haptic interface. Experiments are conducted on a single degree-of-freedom (DOF) linear haptic interface to validate the simulation results.
A Fully Coupled Theory and Variational Principle for Thermal–Electrical–Chemical–Mechanical Processes
Authors: Yu Pengfei , Shen Shengping
Published: September 2014

Thermal–electrical–chemical–mechanical coupling controls the behavior of many transport and electrochemical reactions processes in physical, chemical and biological systems. Hence, advanced understanding of the coupled behavior is crucial and attracting a large research interest. However, most of the existing coupling theories are limited to the partial coupling or particular process. In this paper, on the basis of irreversible thermodynamics, a variational principle for the thermal electrical chemical mechanical fully coupling problems is proposed. The complete fully coupling governing equations, including the heat conduction, mass diffusion, electrochemical reactions and electrostatic potential, are derived from the variational principle. Here, the piezoelectricity, conductivity, and electrochemical reactions are taken into account. Both the constitutive relations and evolving equations are fully coupled. This theory can be used to deal with coupling problems in solids, including conductors, semiconductors, piezoelectric and nonpiezoelectric dielectrics. As an application of this work, a developed boundary value problem is solved numerically in a mixed ion-electronic conductor (MIEC). Numerical results show that the coupling between electric field, diffusion, and chemical reactions influence the defect distribution, electrostatic potential and mechanical stress.
Miura-Base Rigid Origami: Parametrizations of Curved-Crease Geometries
Authors: Gattas Joseph M. , You Zhong
Published: September 2014

Curved-crease (CC) origami differs from prismatic, or straight-crease origami, in that the folded surface of the pattern is bent during the folding process. Limited studies on the mechanical performance of such geometries have been conducted, in part because of the difficulty in parametrizing and modeling the pattern geometry. This paper presents a new method for generating and parametrizing rigid-foldable, CC geometries from Miura-derivative prismatic base patterns. The two stages of the method, the ellipse creation stage and rigid subdivision stage, are first demonstrated on a Miura-base pattern to generate a CC Miura pattern. It is shown that a single additional parameter to that required for the straight-crease pattern is sufficient to completely define the CC variant. The process is then applied to tapered Miura, Arc, Arc-Miura, and piecewise patterns to generate CC variants of each. All parametrizations are validated by comparison with physical prototypes and compiled into a matlab Toolbox for subsequent work.
Heart Rate and Perceived Exertion in Healthy Weight and Obese Children During a Self-Selected Physical Activity Program
Authors: Tompkins Connie L. , Flanagan Timothy , Lavoie John , Brock David W.
Published: September 2014

Background:

Compared with structured/organized activities, unstructured, self-selected physical activity (PA) may be more appealing for children in particular obese (OB) children. We examined whether both healthy-weight (HW) and OB children would engage in moderate to vigorous intensity PA during an unstructured PA program and compared heart rate (HR) and rate of perceived exertion (RPE) between the children.

Methods:

Twenty-one children [9 OB (≥95th BMI percentile, 12 HW (5th – <85th), 8.6 ± 0.8 years; 9 males, 12 females] participated in before-school (7:30 AM to 8:15 AM) PA for 18 weeks, 3 consecutive days/week. Each child wore a Polar E600 HR monitor and was provided a vigorous, age-targeted heart rate (THR) of 70%.

Results:

Mean HR ≥ vigorous THR for all children in 65.3% of the sessions and exceeded moderate intensity in 100%. Over the 18-weeks, no significant difference was observed in the overall mean HR between the HW (171.4 ± 12.0) and OB (169.3 ± 13.0), however the OB reported significantly lower RPEs than the HW (16.9 ± 2.6 vs. 17.6 ± 1.5, respectively; P < .05).

Conclusions:

Both the HW and OB children consistently sustained PA of moderate and vigorous intensity. The current study provides insight regarding the physiological capabilities and perceptual responses of HW and OB children participating in PA programs.
The coordination of S-sulfhydration, S-nitrosylation, and phosphorylation of endothelial nitric oxide synthase by hydrogen sulfide
Authors: Altaany Zaid , Ju YoungJun , Yang Guangdong , Wang Rui
Published: September 2014

S-Sulfhydration increases the activity of endothelial nitric oxide synthase, an enzyme important in vasodilation.
Sirtuins and the circadian clock: Bridging chromatin and metabolism
Authors: Masri Selma , Sassone-Corsi Paolo
Published: September 2014

The sirtuin family of protein deactylases contributes to the regulation of circadian functions.
Site- and kinase-specific phosphorylation-mediated activation of SLAC1, a guard cell anion channel stimulated by abscisic acid
Authors: Maierhofer Tobias , Diekmann Marion , Offenborn Jan Niklas , Lind Christof , Bauer Hubert , Hashimoto Kenji , S. Al-Rasheid Khaled A. , Luan Sheng , Kudla Jörg , Geiger Dietmar , Hedrich Rainer
Published: September 2014

Kinases from three different families can activate an anion channel that helps plants tolerate drought stress.
Autophagy Goes Social
Authors: Berndt Jason D.
Published: September 2014

Hyperactivation of mTORC1 and associated inhibition of autophagy reduces pruning of dendritic spines in mice and humans with autism spectral disorders.
Sox2 Holds the Key to Lung Cancer Susceptibility
Authors: Gough Nancy R.
Published: September 2014

Susceptibility to oncogenic transformation by K-RAS depends on Sox2-mediated inhibition of Notch signaling.
Promoting Ciliogenesis with a Prostaglandin
Authors: Wong Wei
Published: September 2014

Export of PGE
2
by the transporter ABCC4 promotes cilia formation.
ZEB1 Teams Up with the DNA Damage Response
Authors: Ferrarelli Leslie K.
Published: September 2014

A protein that mediates epithelial-to-mesenchymal transition enhances DNA repair to prevent radiotherapy-induced death in cancer cells.
Clinical and Molecular Epidemiology of Escherichia coli Sequence Type 131 among Hospitalized Patients Colonized Intestinally with Fluoroquinolone-Resistant E. coli
Authors: Han Jennifer H. , Johnston Brian , Nachamkin Irving , Tolomeo Pam , Bilker Warren B. , Mao Xiangqun , Clabots Connie , Lautenbach Ebbing , Johnson James R.
Published: September 2014

This study examined molecular and epidemiologic factors associated with
Escherichia coli
sequence type 131 (ST131) among hospitalized patients colonized intestinally with fluoroquinolone (FQ)-resistant
E. coli
between 2002 and 2004. Among 86 patients, 21 (24%) were colonized with ST131. The proportion of ST131 isolates among colonizing isolates increased significantly over time, from 8% in 2002 to 50% in 2004 (
P
= 0.003). Furthermore, all 19 clonally related isolates were ST131. Future studies should identify potential transmissibility differences between ST131 and non-ST131 strains.
In Vitro
Potential of Lycosin-I as an Alternative Antimicrobial Drug for Treatment of Multidrug-Resistant Acinetobacter baumannii Infections
Authors: Wang Ling , Wang Yong-Jun , Liu Yin-Yin , Li Hui , Guo Ling-Xia , Liu Zhong-Hua , Shi Xiao-Liu , Hu Min
Published: September 2014

The resistance of multidrug-resistant
Acinetobacter baumannii
(MDRAB) isolates to most traditional antibiotics results in huge challenges for infection therapy. We investigated the
in vitro
activities of both
l
- and
d
-lycosin-I against MDRAB. These two compounds displayed high antibacterial activities and rapid bactericidal effects against MDRAB. Moreover, the compounds retained their activity even at high salt (Mg
2+
or Ca
2+
) concentrations. These results demonstrate the potential of lycosin-I to be developed as a new antibiotic.
Temporal Trends in Antimicrobial Resistance and Virulence-Associated Traits within the Escherichia coli Sequence Type 131 Clonal Group and Its
H
30 and
H
30-Rx Subclones, 1968 to 2012
Authors: Olesen Bente , Frimodt-Møller Jakob , Leihof Rikke Fleron , Struve Carsten , Johnston Brian , Hansen Dennis S. , Scheutz Flemming , Krogfelt Karen A. , Kuskowski Michael A. , Clabots Connie , Johnson James R.
Published: September 2014

To identify possible explanations for the recent global emergence of
Escherichia coli
sequence type (ST) 131 (ST131), we analyzed temporal trends within ST131 O25 for antimicrobial resistance, virulence genes, biofilm formation, and the
H
30 and
H
30-Rx subclones. For this, we surveyed the WHO
E. coli
and
Klebsiella
Centre's
E. coli
collection (1957 to 2011) for ST131 isolates, characterized them extensively, and assessed them for temporal trends. Overall, antimicrobial resistance increased temporally in prevalence and extent, due mainly to the recent appearance of the
H
30 (1997) and
H
30-Rx (2005) ST131 subclones. In contrast, neither the total virulence gene content nor the prevalence of biofilm production increased temporally, although non-
H
30 isolates increasingly qualified as extraintestinal pathogenic
E. coli
(ExPEC). Whereas virotype D occurred from 1968 forward, virotypes A and C occurred only after 2000 and 2002, respectively, in association with the
H30
and
H30
-Rx subclones, which were characterized by multidrug resistance (including extended-spectrum-beta-lactamase [ESBL] production:
H
30-Rx) and absence of biofilm production. Capsular antigen K100 occurred exclusively among
H
30-Rx isolates (55% prevalence). Pulsotypes corresponded broadly with subclones and virotypes. Thus, ST131 should be regarded not as a unitary entity but as a group of distinctive subclones, with its increasing antimicrobial resistance having a strong clonal basis, i.e., the emergence of the
H
30 and
H
30-Rx ST131 subclones, rather than representing acquisition of resistance by diverse ST131 strains. Distinctive characteristics of the
H
30-Rx subclone—including specific virulence genes (
iutA
,
afa
and
dra
,
kpsII
), the K100 capsule, multidrug resistance, and ESBL production—possibly contributed to epidemiologic success, and some (e.g., K100) might serve as vaccine targets.
A Propensity Score Analysis Shows that Empirical Treatment with Linezolid Does Not Increase the Thirty-Day Mortality Rate in Patients with Gram-Negative Bacteremia
Authors: Ternavasio-de la Vega Hugo-Guillermo , Mateos-Díaz Ana-María , Martinez Jose-Antonio , Almela Manel , Cobos-Trigueros Nazaret , Morata Laura , De-la-Calle Cristina , Sala Marta , Mensa Josep , Marcos Miguel , Soriano Alex
Published: September 2014

The role of linezolid in empirical therapy of suspected bacteremia remains unclear. The aim of this study was to evaluate the influence of empirical use of linezolid or glycopeptides in addition to other antibiotics on the 30-day mortality rates in patients with Gram-negative bacteremia. For this purpose, 1,126 patients with Gram-negative bacteremia in the Hospital Clinic of Barcelona from 2000 to 2012 were included in this study. In order to compare the mortality rates between patients who received linezolid or glycopeptides, the propensity scores on baseline variables were used to balance the treatment groups, and both propensity score matching and propensity-adjusted logistic regression were used to compare the 30-day mortality rates between the groups. The overall 30-day mortality rate was 16.0% during the study period. Sixty-eight patients received empirical treatment with linezolid, and 1,058 received glycopeptides. The propensity score matching included 64 patients in each treatment group. After matching, the mortality rates were 14.1% (9/64) in patients who received glycopeptides and 21.9% (14/64) in those who received linezolid, and a nonsignificant association between empirical linezolid treatment and mortality rate (odds ratio [OR], 1.63; 95% confidence interval [CI], 0.69 to 3.82;
P
= 0.275, McNemar's test) was found. This association remained nonsignificant when variables that remained unbalanced after matching were included in a conditional logistic regression model. Further, the stratified propensity score analysis did not show any significant relationship between empirical linezolid treatment and the mortality rate after adjustment by propensity score quintiles or other variables potentially associated with mortality. In conclusion, the propensity score analysis showed that empirical treatment with linezolid compared with that with glycopeptides was not associated with 30-day mortality rates in patients with Gram-negative bacteremia.
Cell Envelope Components Influencing Filament Length in the Heterocyst-Forming Cyanobacterium Anabaena sp. Strain PCC 7120
Authors: Burnat Mireia , Schleiff Enrico , Flores Enrique
Published: September 2014

Heterocyst-forming cyanobacteria grow as chains of cells (known as trichomes or filaments) that can be hundreds of cells long. The filament consists of individual cells surrounded by a cytoplasmic membrane and peptidoglycan layers. The cells, however, share a continuous outer membrane, and septal proteins, such as SepJ, are important for cell-cell contact and filament formation. Here, we addressed a possible role of cell envelope components in filamentation, the process of producing and maintaining filaments, in the model cyanobacterium
Anabaena
sp. strain PCC 7120. We studied filament length and the response of the filaments to mechanical fragmentation in a number of strains with mutations in genes encoding cell envelope components. Previously published peptidoglycan- and outer membrane-related gene mutants and strains with mutations in two genes (
all5045
and
alr0718
) encoding class B penicillin-binding proteins isolated in this work were used. Our results show that filament length is affected in most cell envelope mutants, but the filaments of
alr5045
and
alr2270
gene mutants were particularly fragmented. All5045 is a
dd
-transpeptidase involved in peptidoglycan elongation during cell growth, and Alr2270 is an enzyme involved in the biosynthesis of lipid A, a key component of lipopolysaccharide. These results indicate that both components of the cell envelope, the murein sacculus and the outer membrane, influence filamentation. As deduced from the filament fragmentation phenotypes of their mutants, however, none of these elements is as important for filamentation as the septal protein SepJ.
ECG findings in competitive rowers: normative data and the prevalence of abnormalities using contemporary screening recommendations
Authors: Wasfy Meagan M , DeLuca James , Wang Francis , Berkstresser Brant , Ackerman Kathryn E , Eisman Aaron , Lewis Gregory D , Hutter Adolph M , Weiner Rory B , Baggish Aaron L
Published: September 2014

Background/aim

The international governing body for competitive rowing recently mandated the inclusion of 12-lead ECG during preparticipation screening. We therefore sought to describe normative ECG characteristics and to examine the prevalence of abnormal ECG findings as defined by contemporary athlete ECG interpretation criteria among competitive rowers.

Methods

Competitive rowers (n=330, 56% male) underwent standard 12-lead ECG at the time of collegiate preparticipation screening. ECGs were analysed quantitatively to develop a sport-specific normative database and then for the presence of abnormalities in accordance with the 2010 European Society of Cardiology (ESC) recommendations and 2013 ‘Seattle Criteria.’

Results

94% of rowers had one or more training-related ECG patterns including sinus bradycardia (51%), sinus arrhythmia (55%), and incomplete right bundle branch block (42%). Males were more likely than females to have isolated voltage criteria for left ventricular hypertrophy (LVH) (51% vs 8%, p<0.001) and early repolarisation pattern (76% vs 23%, p<0.001). Application of the 2010 ESC criteria, compared to the Seattle criteria, resulted in the classification of a significantly greater number of abnormal ECGs (47% vs 4%; p<0.001). The detection of true pathology, accomplished by both interpretation criteria, was confined to a single case of ventricular pre-excitation.

Conclusions

Training-related ECG patterns with several gender-based differences are common among competitive rowers. The diagnostic accuracy and down-stream clinical implications of ECG-inclusive preparticipation screening among rowers will be dictated by the choice and future refinement of ECG interpretation criteria.
Birth weight and blood pressure: ‘J’ shape or linear shape? Findings from a cross-sectional study in Hong Kong Chinese women
Authors: Xie Yao Jie , Ho Suzanne C , Liu Zhao-Min , Hui Stanley Sai-Chuen
Published: September 2014

Objectives

To investigate the association between birth weight and blood pressure (BP) and to determine the effect of body size change from birth to adulthood on BP.

Design

A cross-sectional design to collect retrospective data.

Participants

1253 female nurses aged 35–65 years in Hong Kong.

Main outcome measures

Birth weight, height, weight, BP, waist circumference, demographics and lifestyle factors were collected by a self-administered questionnaire through mail survey. These self-reported variables have been validated in a pilot study. The conditional relative weight (CRW), which was calculated as a residual of current weight regressed on birth weight, was used to express higher or lower relative weight gain from birth to adulthood.

Results

No significant linear association between overall range of birth weight and BP was found. The curve estimation showed a significant quadratic curvilinear association (‘J’ shape). In the piecewise-linear analysis, a significant inverse association between birth weight z-scores and BP was observed in the birth weight ≤3.1 kg group (systolic BP (SBP): coefficient B=−1.73, 95% CI −3.17 to −0.30; diastolic BP (DBP): B=−1.12, 95% CI −2.19 to −0.06). A positive but non-significant association occurred in the birth weight >3.1 kg group. Participants who belonged to the lowest 10% birth weight category but at the current top 10% BMI group had higher BP than participants in other BMI groups. The CRW z-score was positively associated with BP (coefficient B: 4.18 for SBP and 2.87 for DBP).

Conclusions

Unlike most previous studies, we found a ‘J’ shape association rather than a linear association between birth weight and BP. Women with large percentile crossing of body size from birth to adulthood were more likely to have elevated BP. A higher weight gain from birth to adulthood than expected led to higher BP.
Effects of gastric bypass surgery in patients with hypertension: rationale and design for a randomised controlled trial (GATEWAY study)
Authors: Schiavon Carlos Aurélio , Ikeoka Dimas Tadahiro , de Sousa Marcio Gonçalves , Silva Cellys Roberta Ananias , Bersch-Ferreira Angela Cristine , de Oliveira Juliana Dantas , Noujaim Patrícia Malvina , Cohen Ricardo Vitor , Amodeo Celso , Berwanger Otávio
Published: September 2014

Introduction

Obesity and overweight are becoming progressively more prevalent worldwide and are independently associated with a significant increase in the risk of cardiovascular diseases. Systemic arterial hypertension is frequently found in association with obesity and contributes significantly to increased cardiovascular risk. We hypothesise that Roux-en-Y gastric bypass (RYGB) surgery, a procedure that effectively reduces body weight, can also positively impact blood pressure control in obese and hypertensive individuals.

Methods and analysis

A unicentric, randomised, controlled, unblinded clinical trial. Sixty obese (body mass index between 30 and 39.9) and moderately well controlled hypertensive patients, in use of at least two antihypertensive medications at maximum doses or more than two in moderate doses, will be randomly allocated, using an online, electronic and concealed method, to receive either RYGB plus optimised clinical treatment (OCT) or OCT alone. The primary end point is the reduction of antihypertensive medication at 1 and 2 years of follow-up. Data analysis will primarily be conducted on an intention-to-treat basis.

Ethics and dissemination

The study was approved by the local institutional review board that works in total compliance with the latest version of the Helsinki Declaration, the Good Clinical Practices (GCP), the ‘America's Document’ and the national regulatory laws. Before the beginning of any study-related activities, each study participant is asked to provide a signed informed consent.

Trial registration number

NCT01784848.
Acupuncture for discomfort in patients during gastroscopy: a systematic review protocol
Authors: Wang Weiming , Zhang Tao , Peng Weina , Wu Jiani , Liu Zhishun
Published: September 2014

Introduction

This systematic review aims to assess the effectiveness and safety of acupuncture for discomfort in patients during gastroscopy.

Methods and analysis

Randomised controlled trials will be searched electronically in several databases including OVID MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), Chinese Biomedical Literature Database (CBM), Chinese Medical Current Content (CMCC), Chinese Scientific Journal Database (VIP database), Wan-Fang Database and China National Knowledge Infrastructure (CNKI) from their respective founding dates to 30 April 2014. We will also try to find the literature by manually searching conference abstracts and reference lists. The study selection, extraction of data and assessment of study quality will be conducted independently by two researchers. Meta-analysis will be performed using RevMan V.5.2 statistical software. Data will be combined with either the fixed or random effect model based on a heterogeneity test. The results will be presented as a risk ratio for dichotomous data and standardised mean difference for continuous data.

Dissemination

This systematic review will evaluate the current evidence of acupuncture therapy for discomfort in patients during gastroscopy. The findings will be disseminated through peer-reviewed publication or conference presentations.

Trial registration number

PROSPERO CRD42014008966.
Patients’ online access to their electronic health records and linked online services: a systematic interpretative review
Authors: de Lusignan Simon , Mold Freda , Sheikh Aziz , Majeed Azeem , Wyatt Jeremy C , Quinn Tom , Cavill Mary , Gronlund Toto Anne , Franco Christina , Chauhan Umesh , Blakey Hannah , Kataria Neha , Barker Fiona , Ellis Beverley , Koczan Phil , Arvanitis Theodoros N , McCarthy Mary , Jones Simon , Rafi Imran
Published: September 2014

Objectives

To investigate the effect of providing patients online access to their electronic health record (EHR) and linked transactional services on the provision, quality and safety of healthcare. The objectives are also to identify and understand: barriers and facilitators for providing online access to their records and services for primary care workers; and their association with organisational/IT system issues.

Setting

Primary care.

Participants

A total of 143 studies were included. 17 were experimental in design and subject to risk of bias assessment, which is reported in a separate paper. Detailed inclusion and exclusion criteria have also been published elsewhere in the protocol.

Primary and secondary outcome measures

Our primary outcome measure was change in quality or safety as a result of implementation or utilisation of online records/transactional services.

Results

No studies reported changes in health outcomes; though eight detected medication errors and seven reported improved uptake of preventative care. Professional concerns over privacy were reported in 14 studies. 18 studies reported concern over potential increased workload; with some showing an increase workload in email or online messaging; telephone contact remaining unchanged, and face-to face contact staying the same or falling. Owing to heterogeneity in reporting overall workload change was hard to predict. 10 studies reported how online access offered convenience, primarily for more advantaged patients, who were largely highly satisfied with the process when clinician responses were prompt.

Conclusions

Patient online access and services offer increased convenience and satisfaction. However, professionals were concerned about impact on workload and risk to privacy. Studies correcting medication errors may improve patient safety. There may need to be a redesign of the business process to engage health professionals in online access and of the EHR to make it friendlier and provide equity of access to a wider group of patients.

A1. Systematic review registration number

PROSPERO CRD42012003091.
Termination of pregnancy at very early gestation without visible yolk sac on ultrasound
Authors: Heller Rebecca , Cameron Sharon
Published: September 2014

Introduction

Requests for termination of pregnancy (TOP) at very early gestation (≤6 weeks) can prove challenging for abortion services as the ultrasound feature usually accepted as definitive evidence of an intrauterine pregnancy (IUP), the presence of a yolk sac within a gestational sac, may not yet be evident. In 2011 the Edinburgh TOP service introduced a protocol permitting women to proceed to treatment without further investigations provided that ultrasound showed the features of an eccentrically placed gestational sac (≥3 mm) with a decidual reaction, and there were no signs, symptoms or risk factors for ectopic pregnancy.

Methods

A retrospective audit was conducted of outcomes of women presenting for TOP at ≤6 weeks’ gestation over a 2-year period using the hospital computerised database.

Results

A total of 1155 women presented for TOP with an ultrasound gestational age of ≤6 weeks. Of these, 1030 (89%) had ultrasound evidence of a yolk sac. Eighty-seven women (7.5%) had an eccentrically placed gestational sac with a decidual reaction. All 87 women fulfilled our criteria to proceed to medical TOP, and 66 did so. In the remaining 21 cases, further investigations were performed before they proceeded to medical TOP. Two (0.17%) medical TOPs failed, both in women whose initial ultrasound had shown a yolk sac.

Conclusion

Women with ultrasound features consistent with a very early IUP (≥3 mm eccentrically placed gestational sac with a decidual reaction) and without signs, symptoms or risk factors for ectopic pregnancy can proceed directly to medical TOP without the need for delay for further ultrasonography.
Aneurysmal subarachnoid hemorrhage: a statewide assessment of outcome based on risk factors, aneurysm characteristics, and geo-demography
Authors: Larrew Thomas , Pryor Will , Weinberg James , Webb Sharon , Battenhouse H , Turk Aquilla S , Chaudry Imran , Spiotta Alejandro , Turner Raymond
Published: September 2014

Objective

Aneurysmal subarachnoid hemorrhage (aSAH) is a devastating illness with nationwide mortality rates reaching almost 50% within the first 30 days. A study was undertaken to evaluate how treatment modality, physical findings, and geo-demography contribute to the outcome of these cases, including complications and disposition status.

Methods

All cases of aSAH in the fiscal year of 2012 (July 2011–June 2012) at the Medical University of South Carolina and Palmetto Health Richland were studied. These healthcare facilities represent 88.5% of aneurysm treatment in the state of South Carolina. Information including aneurysm properties, Hunt–Hess grade, Fisher grade, and symptoms occurring at and after admission were analyzed.

Results

131 patients (94 women and 37 men) with aSAH were treated. 92.4% of cases were treated endovascularly, with more than a third of all cases using balloon-assisted coiling. Hypertension, tobacco use, and hyperlipidemia were the most prevalent comorbidities. Headache, followed by hydrocephalus, motor disturbance, and nausea/vomiting were the most common presenting symptoms. The most common adverse event occurring after hospital admission was acute respiratory failure followed by urinary tract infection, hydrocephalus, and vasospasm. 42.0% were discharged home and nine patients (6.9%) died during hospitalization.

Conclusions

Previously established risk factors such as hypertension and smoking were identified as the most prevalent comorbidities, with disparity between subgroups, particularly women and African Americans. Endovascular treatment was the primary modality of treatment. Mortality rates were lower than previously reported.
Development of a tool to improve performance debriefing and learning: the paediatric Objective Structured Assessment of Debriefing (OSAD) tool
Authors: Runnacles Jane , Thomas Libby , Sevdalis Nick , Kneebone Roger , Arora Sonal , Cooper Mehrengise
Published: September 2014

Background

Simulation is an important educational tool to improve medical training and patient safety. Debriefing after simulation is crucial to maximise learning and to translate the lessons learnt to improve real clinical performance, and thus to reduce medical error. Currently there are few tools to improve performance debriefing and learning after simulations of serious paediatric situations.

Purpose

The purpose of this study was to develop a tool to guide and assess debriefings after simulations of serious paediatric situations, applying the current evidence base and user-based research.

Study design

A literature review and semistructured interviews (performed in 2010) to identify important features of a paediatric simulation debriefing. Emergent theme analysis was used to identify key components of an effective debriefing which could be used as a tool for assessing debriefing effectiveness.

Results

The literature review identified 34 relevant studies. Interviews were carried out with 16 paediatricians, both debriefing facilitators and learners. In total, 307 features of a debriefing were identified. These were grouped into eight dimensions representing the key components of a paediatric debriefing: the facilitator’s approach, learning environment, engagement of learners, reaction, descriptive reflection, analysis, diagnosis and application. These eight dimensions were used to create a tool, the Objective Structured Assessment of Debriefing (OSAD). Each dimension can be scored on a five-point Likert scale containing descriptions for scores 1, 3 and 5 to serve as anchors and aid scoring.

Conclusions

The study identified the important features of a paediatric simulation debriefing, which were developed into the OSAD tool. OSAD offers a structured approach to paediatric simulation debriefing, and is based on evidence from published literature and views of simulation facilitators and learners. OSAD may be used as a guide or assessment tool to improve the quality of debriefing after paediatric simulation.
Understanding antimicrobial use and prescribing behaviours by pig veterinary surgeons and farmers: a qualitative study
Authors: Coyne L. A. , Pinchbeck G. L. , Williams N. J. , Smith R. F. , Dawson S. , Pearson R. B. , Latham S. M.
Published: September 2014

Increasing awareness of bacterial antimicrobial resistance in human beings and veterinary medicine has raised concerns over the issue of overprescribing and the indiscriminate use of antimicrobials. Their use in food‐producing animals is under scrutiny due to the perceived risk from the zoonotic transfer of resistant pathogens from animals to human beings. This study used focus groups to explore the drivers and motivators behind antimicrobial use and prescribing by veterinary surgeons and farmers in the pig industry in the UK. Studies of two veterinary and four farmer focus groups were undertaken, each with between three and six participants, in three geographically distinct regions of low, moderate and high pig density in England. Thematic analysis of the focus group transcriptions revealed convergent themes, both within and across, the veterinary and farmer focus groups. Veterinary opinion was such that ‘external pressures’, such as pressure from clients, legislation and public perception, were considered to strongly influence prescribing behaviour, whereas, farmers considered issues surrounding farming systems and management to be greater drivers towards antimicrobial use. Acquiring such in‐depth insight into the antimicrobial prescribing behaviours in veterinary medicine provides more detailed understanding of prescribing practice and will aid the development of interventions to promote the responsible use of antimicrobials.
Fault-tolerant algorithms for tick-generation in asynchronous logic
Authors: Dolev Danny , Függer Matthias , Schmid Ulrich , Lenzen Christoph
Published: September 2014

Today’s hardware technology presents a new challenge in designing robust systems. Deep submicron VLSI technology introduces transient and permanent faults that were never considered in low-level system designs in the past. Still, robustness of that part of the system is crucial and needs to be guaranteed for any successful product. Distributed systems, on the other hand, have been dealing with similar issues for decades. However, neither the basic abstractions nor the complexity of contemporary fault-tolerant distributed algorithms match the peculiarities of hardware implementations.

This article is intended to be part of an attempt striving to bridge over this gap between theory and practice for the clock synchronization problem. Solving this task sufficiently well will allow to build an ultra-robust high-precision clocking system for hardware designs like systems-on-chips in critical applications. As our first building block, we describe and prove correct a novel distributed, Byzantine fault-tolerant, probabilistically self-stabilizing pulse synchronization protocol, called FATAL, that can be implemented using standard asynchronous digital logic: Correct FATAL nodes are guaranteed to generate pulses (i.e., unnumbered clock ticks) in a synchronized way, despite a certain fraction of nodes being faulty. FATAL uses randomization only during stabilization and, despite the strict limitations introduced by hardware designs, offers optimal resilience and smaller complexity than all existing protocols. Finally, we show how to leverage FATAL to efficiently generate synchronized, self-stabilizing, high-frequency clocks.
Peer Review on Open-Source Software Projects
Authors: Rigby Peter C. , German Daniel M. , Cowen Laura , Storey Margaret-Anne
Published: September 2014

Peer review is seen as an important quality-assurance mechanism in both industrial development and the open-source software (OSS) community. The techniques for performing inspections have been well studied in industry; in OSS development, software peer reviews are not as well understood.

To develop an empirical understanding of OSS peer review, we examine the review policies of 25 OSS projects and study the archival records of six large, mature, successful OSS projects. We extract a series of measures based on those used in traditional inspection experiments. We measure the frequency of review, the size of the contribution under review, the level of participation during review, the experience and expertise of the individuals involved in the review, the review interval, and the number of issues discussed during review. We create statistical models of the review efficiency, review interval, and effectiveness, the issues discussed during review, to determine which measures have the largest impact on review efficacy.

We find that OSS peer reviews are conducted asynchronously by empowered experts who focus on changes that are in their area of expertise. Reviewers provide timely, regular feedback on small changes. The descriptive statistics clearly show that OSS review is drastically different from traditional inspection.
Energy-Balanced Scheduling for Target Tracking in Wireless Sensor Networks
Authors: Hu Xiaoqing , Hu Yu Hen , Xu Bugong
Published: September 2014

A novel energy-balanced task-scheduling method is proposed that extends the lifespan of wireless sensor networks (WSNs) for collaborative target tracking using an unscented Kalman filter (UKF) algorithm. It is shown that the tracking accuracy is approximately proportional to the number of active sensor nodes participating in collaborative tracking. Excessive sensor nodes thus may be put to sleep mode to conserve energy provided there are a sufficient number of active sensor nodes. It is then shown that the lifespan of a WSN is dictated by the distribution of residue energy of sensor nodes. Specifically, we have shown that an energy-balanced WSN is likely to maximize its lifespan. As such, at each step of the tracking task, the head node must judiciously select active nodes from all sensors within the sensing range to minimize residue energy variations (energy balanced) while achieving desired tracking accuracy. This is formulated as a subset selection problem, which is shown to have a complexity that is NP-hard. Several energy-balanced scheduling for tracking (EBaST) heuristic algorithms are proposed to solve this problem with polynomial execution complexities. Extensive simulations have been conducted to compare EBaST against some state-of-the-art scheduling algorithms. It is observed that EBaST is more capable of significantly extending the WSNs lifespan than competing algorithms while delivering comparable or better tracking accuracy.
A Novel Algorithm for Distributed Localization in Wireless Sensor Networks
Authors: Naraghi-Pour Mort , Rojas Gustavo Chacon
Published: September 2014

We present a novel algorithm for localization of Wireless Sensor Networks (WSNs) called Distributed Randomized Gradient Descent (DRGD) and prove that in the case of noise-free distance measurements, the algorithm converges and provides the true location of the nodes. For noisy distance measurements, the convergence properties of DRGD are discussed and an error bound on the location estimation error is obtained. In contrast to several recently proposed methods, DRGD does not require that the blind nodes be contained in the convex hull of the anchor nodes, and it can accurately localize the network with only a few anchors. Performance of DRGD is evaluated through extensive simulations and compared with three other algorithms, namely, the relaxation-based Second-Order Cone Programming (SOCP), the Simulated Annealing (SA), and the Semi-Definite Programing (SDP). Similar to DRGD, SOCP and SA are distributed algorithms, whereas SDP is centralized. The results show that DRGD successfully localizes the nodes in all the cases, whereas in many cases SOCP and SA fail. Finally, we present a modification of DRGD for mobile WSNs and demonstrate the efficacy of DRGD for localization of mobile networks with several simulation results.