bluuebunny/crossref_metadata_2025 huggingface dataset:
Detailed Seismic Performance Assessment of High-Value-Contents Laboratory Facility
Authors: Yang T. Y. , Atkinson J. C. , Tobber L.
Published: April 2014

Recent earthquakes worldwide have shown that even countries with well-established building codes are still vulnerable to economic and societal losses. To properly assess these seismic losses, risk managers and insurers need a well-defined tool to quantify the seismic performance of the facilities. In this paper, detailed performance-based earthquake engineering methodology is applied to assess the seismic vulnerability of a high-value-contents laboratory facility, in Vancouver, Canada. The study demonstrates a detailed implementation of the state-of-the-art performance assessment tools to quantify the seismic loss of facilities that can be readily used by practicing engineers. The results show the first benchmark study to quantify the performance of code-based design and provide valuable information for engineers and facility stakeholders to make informed risk-management decisions.
Results of a Multicenter, Controlled, Randomized Clinical Trial Evaluating the Combination of Piperacillin/Tazobactam and Tigecycline in High-Risk Hematologic Patients With Cancer With Febrile Neutropenia
Authors: Bucaneve Giampaolo , Micozzi Alessandra , Picardi Marco , Ballanti Stelvio , Cascavilla Nicola , Salutari Prassede , Specchia Giorgina , Fanci Rosa , Luppi Mario , Cudillo Laura , Cantaffa Renato , Milone Giuseppe , Bocchia Monica , Martinelli Giovanni , Offidani Massimo , Chierichini Anna , Fabbiano Francesco , Quarta Giovanni , Primon Valeria , Martino Bruno , Manna Annunziata , Zuffa Eliana , Ferrari Antonella , Gentile Giuseppe , Foà Robin , Del Favero Albano
Published: April 2014

Purpose

Empiric antibiotic monotherapy is considered the standard of treatment for febrile neutropenic patients with cancer, but this approach may be inadequate because of the increasing prevalence of infections caused by multidrug resistant (MDR) bacteria.

Patients and Methods

In this multicenter, open-label, randomized, superiority trial, adult, febrile, high-risk neutropenic patients (FhrNPs) with hematologic malignancies were randomly assigned to receive piperacillin/tazobactam (4.5 g intravenously every 8 hours) with or without tigecycline (50 mg intravenously every 12 hours; loading dose 100 mg). The primary end point was resolution of febrile episode without modifications of the initial allocated treatment.

Results

Three hundred ninety FhrNPs were enrolled (combination/monotherapy, 187/203) and were included in the intention-to-treat analysis (ITTA). The ITTA revealed a successful outcome in 67.9% v 44.3% of patients who had received combination therapy and monotherapy, respectively (127/187 v 90/203; absolute difference in risk (adr), 23.6%; 95% CI, 14% to 33%; P < .001). The combination regimen proved better than monotherapy in bacteremias (adr, 32.8%; 95% CI, 19% to 46%; P < .001) and in clinically documented infections (adr, 36%; 95% CI, 9% to 64%; P < .01). Mortality and number of adverse effects were limited and similar in the two groups.

Conclusion

The combination of piperacillin/tazobactam and tigecycline is safe, well tolerated, and more effective than piperacillin/tazobactam alone in febrile, high-risk, neutropenic hematologic patients with cancer. In epidemiologic settings characterized by a high prevalence of infections because of MDR microorganisms, this combination could be considered as one of the first-line empiric antibiotic therapies.
Doxepin Rinse Versus Placebo in the Treatment of Acute Oral Mucositis Pain in Patients Receiving Head and Neck Radiotherapy With or Without Chemotherapy: A Phase III, Randomized, Double-Blind Trial (NCCTG-N09C6 [Alliance])
Authors: Leenstra James L. , Miller Robert C. , Qin Rui , Martenson James A. , Dornfeld Kenneth J. , Bearden James D. , Puri Dev R. , Stella Philip J. , Mazurczak Miroslaw A. , Klish Marie D. , Novotny Paul J. , Foote Robert L. , Loprinzi Charles L.
Published: April 2014

Purpose

Painful oral mucositis (OM) is a significant toxicity during radiotherapy for head and neck cancers. The aim of this randomized, double-blind, placebo-controlled trial was to test the efficacy of doxepin hydrochloride in the reduction of radiotherapy-induced OM pain.

Patients and Methods

In all, 155 patients were randomly allocated to a doxepin oral rinse or a placebo for the treatment of radiotherapy-related OM pain. Patients received a single dose of doxepin or placebo on day 1 and then crossed over to receive the opposite agent on a subsequent day. Pain questionnaires were administered at baseline and at 5, 15, 30, 60, 120, and 240 minutes. Patients were then given the option to continue doxepin. The primary end point was pain reduction as measured by the area under the curve (AUC) of the pain scale using data from day 1.

Results

Primary end point analysis revealed that the AUC for mouth and throat pain reduction was greater for doxepin (−9.1) than for placebo (−4.7; P < .001). Crossover analysis of patients completing both phases confirmed that patients experienced greater mouth and throat pain reduction with doxepin (intrapatient changes of 4.1 for doxepin-placebo arm and −2.8 for placebo-doxepin arm; P < .001). Doxepin was associated with more stinging or burning, unpleasant taste, and greater drowsiness than the placebo rinse. More patients receiving doxepin expressed a desire to continue treatment than did patients with placebo after completion of each of the randomized phases of the study.

Conclusion

A doxepin rinse diminishes OM pain. Further studies are warranted to determine its role in the management of OM.
Screening, Assessment, and Management of Fatigue in Adult Survivors of Cancer: An American Society of Clinical Oncology Clinical Practice Guideline Adaptation
Authors: Bower Julienne E. , Bak Kate , Berger Ann , Breitbart William , Escalante Carmelita P. , Ganz Patricia A. , Schnipper Hester Hill , Lacchetti Christina , Ligibel Jennifer A. , Lyman Gary H. , Ogaily Mohammed S. , Pirl William F. , Jacobsen Paul B.
Published: April 2014

Purpose

This guideline presents screening, assessment, and treatment approaches for the management of adult cancer survivors who are experiencing symptoms of fatigue after completion of primary treatment.

Methods

A systematic search of clinical practice guideline databases, guideline developer Web sites, and published health literature identified the pan-Canadian guideline on screening, assessment, and care of cancer-related fatigue in adults with cancer, the National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines In Oncology (NCCN Guidelines) for Cancer-Related Fatigue and the NCCN Guidelines for Survivorship. These three guidelines were appraised and selected for adaptation.

Results

It is recommended that all patients with cancer be evaluated for the presence of fatigue after completion of primary treatment and be offered specific information and strategies for fatigue management. For those who report moderate to severe fatigue, comprehensive assessment should be conducted, and medical and treatable contributing factors should be addressed. In terms of treatment strategies, evidence indicates that physical activity interventions, psychosocial interventions, and mind-body interventions may reduce cancer-related fatigue in post-treatment patients. There is limited evidence for use of psychostimulants in the management of fatigue in patients who are disease free after active treatment.

Conclusion

Fatigue is prevalent in cancer survivors and often causes significant disruption in functioning and quality of life. Regular screening, assessment, and education and appropriate treatment of fatigue are important in managing this distressing symptom. Given the multiple factors contributing to post-treatment fatigue, interventions should be tailored to each patient's specific needs. In particular, a number of nonpharmacologic treatment approaches have demonstrated efficacy in cancer survivors.
Impaired Preadipocyte Differentiation Into Adipocytes in Subcutaneous Abdominal Adipose of PCOS-Like Female Rhesus Monkeys
Authors: Keller Erica , Chazenbalk Gregorio D. , Aguilera Paul , Madrigal Vanessa , Grogan Tristan , Elashoff David , Dumesic Daniel A. , Abbott David H.
Published: April 2014

Metabolic characteristics of polycystic ovary syndrome women and polycystic ovary syndrome-like, prenatally androgenized (PA) female monkeys worsen with age, with altered adipogenesis of sc abdominal adipose potentially contributing to age-related adverse effects on metabolism. This study examines whether adipocyte morphology and gene expression in sc abdominal adipose differ between late reproductive-aged PA female rhesus monkeys compared with age-matched controls (C). Subcutaneous abdominal adipose of both groups was obtained for histological imaging and mRNA determination of zinc finger protein 423 (Zfp423) as a marker of adipose stem cell commitment to preadipocytes, and CCAAT/enhancer binding protein (C/EBP)α/peroxisome proliferator-activated receptor (PPAR)δ as well as C/EBPα/PPARγ as respective markers of early- and late-stage differentiation of preadipocytes to adipocytes. In all females combined, serum testosterone (T) levels positively correlated with fasting serum levels of total free fatty acid (r2 = 0.73, P < .002). PA females had a greater population of small adipocytes vs C (P < .001) in the presence of increased Zfp423 (P < .025 vs C females) and decreased C/EBPα (P < .003, vs C females) mRNA expression. Moreover, Zfp423 mRNA expression positively correlated with circulating total free fatty acid levels during iv glucose tolerance testing (P < .004, r2 = 0.66), whereas C/EBPα mRNA expression negatively correlated with serum T levels (P < .02, r2 = 0.43). Gene expression of PPARδ and PPARγ were comparable between groups (P = .723 and P = .18, respectively). Early-to-mid gestational T excess in female rhesus monkeys impairs adult preadipocyte differentiation to adipocytes in sc abdominal adipose and may constrain the ability of this adipose depot to safely store fat with age.
Chromophore-assisted laser inactivation – towards a spatiotemporal–functional analysis of proteins, and the ablation of chromatin, organelle and cell function
Authors: Sano Yukimi , Watanabe Wataru , Matsunaga Sachihiro
Published: April 2014

Chromophore-assisted laser or light inactivation (CALI) has been employed as a promising technique to achieve spatiotemporal knockdown or loss-of-function of target molecules in situ. CALI is performed using photosensitizers as generators of reactive oxygen species (ROS). There are two CALI approaches that use either transgenic tags with chemical photosensitizers, or genetically encoded fluorescent protein fusions. Using spatially restricted microscopy illumination, CALI can address questions regarding, for example, protein isoforms, subcellular localization or phase-specific analyses of multifunctional proteins that other knockdown approaches, such as RNA interference or treatment with chemicals, cannot. Furthermore, rescue experiments can clarify the phenotypic capabilities of CALI after the depletion of endogenous targets. CALI can also provide information about individual events that are involved in the function of a target protein and highlight them in multifactorial events. Beyond functional analysis of proteins, CALI of nuclear proteins can be performed to induce cell cycle arrest, chromatin- or locus-specific DNA damage. Even at organelle level – such as in mitochondria, the plasma membrane or lysosomes – CALI can trigger cell death. Moreover, CALI has emerged as an optogenetic tool to switch off signaling pathways, including the optical depletion of individual neurons. In this Commentary, we review recent applications of CALI and discuss the utility and effective use of CALI to address open questions in cell biology.
Efficacy of a massage roller combined with cooling lotion in the prevention of calf muscle cramps
Authors: Körber K. , Schmidt F.-P.
Published: April 2014

In dieser offenen Anwendungsbeobachtung wurde an 208 Patienten über 4 Wochen geprüft, ob die Kombination des Massagerollers mit der Waden Massage Pflegelotion die Anzahl der Waden- und Fußkrämpfe senken kann. Zur Prophylaxe wurden täglich über mindestens 5 Minuten die betroffenen Muskeln ausgehend von der Großzehe in Rich-tung der Leiste mit dem Massageroller mit mäßig bis mittelstarkem Druck ausgerollt. Bei 151 Patienten zeigte sich eine deutliche Besserung, indem die Frequenz der Wadenkrämpfe um mehr als die Hälfte abnahm bzw. keine Wadenkrämpfe mehr auftraten. Auch die Krampflänge nahm durch Anwendung des Massagerollers bei einem aktuellen Wadenkrampf ab. Die Häufigkeit und Stärke wurde in einem Fragebogen dokumentiert. Schwangere, jüngere Patienten, solche mit Venenerkrankungen und Männer in jedem sowie Frauen im mittleren Alter profitierten von der Anwendung des Massagerollers am besten.
Ultrasound of the nerves and clinical implications
Authors: Mendoza E.
Published: April 2014

Mit modernen Schallgeräten können die Nerven in der Nähe der Venen ohne weiteres während der Untersuchung gesehen werden. Sie spielen besonders bei der Therapie der Vena saphena parva (VSP) eine Rolle. Hier kann durch Verletzung des N. peroneus eine Fußheberparese verursacht werden (1). Außerdem können Pathologien der Nerven bei genauer Beobachtung gefunden werden, wie Varizen des N. ischiadicus (2). Weniger relevant für die Therapieplanung der Varikose ist der N. femoralis in der Leiste.

Dieser Beitrag soll die Sonomorphologie der Nerven beleuchten und im Fall des Nervus peroneus ein Beispiel zur endoluminalen Therapie der V. saphena parva unter Schonung desselben mit Tumeszenz zeigen. Die Nervenbinnenstruktur selbst kann aber auch pathologisch sein, so gezeigt beim Beispiel eines Nerv-Ödems als Begleiterscheinung einer Poplitealvenenthrombose.
Characteristic skin changes in CVI
Authors: Schnabl S. , Busch C.
Published: April 2014

Im phlebologischen Alltag ist die CVI aufgrund der sie typischerweise begleitenden Stadien-abhängigen Hautveränderungen häufig eine Blickdiagnose, die für die therapeutische Entscheidungsfindung durch apparative Diagnostik bestätigt und spezifiziert wird. Gerade im Hinblick auf die beiden häufigsten Stadieneinteilungen der CVI (nach Widmer bzw. der CEAP-Klassifikation) spielt die klinische Erscheinung eine wesentliche Rolle. Dieser Artikel gibt einen Überblick über die charakteristischen Hautveränderungen der unterschiedlichen Stadien der CVI und soll den klinischen Blick für die Diagnose der CVI schulen.
Enhanced Models for a Mixed Arrival-Departure Aircraft Sequencing Problem
Authors: Ghoniem Ahmed , Sherali Hanif D. , Baik Hojong
Published: April 2014

This paper addresses the static aircraft sequencing problem over a mixed-mode single runway (or closely interacting parallel runways), which commonly constitutes a critical bottleneck at airports. In contrast with disjunctive formulations, our modeling approach takes advantage of the underlying structure of an asymmetric traveling salesman problem with time-windows. This enables the development of efficient preprocessing and probing procedures, and motivates the derivation of several classes of valid inequalities along with partial convex hull representations to enhance problem solvability via tighter reformulations. The lifted model is further embedded within the framework of two proposed heuristics that are compared against the traditional first-come first-served (FCFS) heuristic with landing priority: an optimized FCFS policy (OFCFS) and a threshold-based suboptimized heuristic (TSH) with an a priori fixing of the relative order of aircraft that are sufficiently time-separated. Computational results using real data based on Doha International Airport (DOH) as well as simulated instances are reported to demonstrate the efficacy of the proposed exact and heuristic solution methods. In particular, for the DOH instances, heuristics OFCFS and TSH achieved an attractive runway utilization (4.3% and 5.0% makespan reduction, respectively, over the base FCFS policy with landing priority), while exhibiting limited aircraft position deviations (0.45 and 0.49 deviations on average, respectively, from the base FCFS positions with landing priority, with similar results being obtained for the simulated instances). The superiority of the proposed optimization models over previous disjunctive formulations is also demonstrated for challenging problem instances, resulting in over 50% CPU savings for the larger instances in our test-bed.
Optimal Design for Multi-Item Auctions: A Robust Optimization Approach
Authors: Bandi Chaithanya , Bertsimas Dimitris
Published: April 2014

In this paper, we revisit the auction design problem for multi-item auctions with budget constrained buyers by introducing a robust optimization approach to model (a) concepts such as incentive compatibility and individual rationality that are naturally expressed in the language of robust optimization and (b) the auctioneer’s beliefs on the buyers' valuations of the items. Rather than using probability distributions (the classical probabilistic approach) or an adversarial model to model valuations, we introduce an uncertainty set based model for these valuations. We construct these uncertainty sets to incorporate historical information available to the auctioneer in a way that is consistent with limit theorems of probability theory or knowledge of the probability distribution. In this setting, we formulate the auction design problem as a robust optimization problem and provide a characterization of the optimal solution as an auction with reservation prices, thus extending the work of Myerson [Myerson RB (1981) Optimal auction design. Math. Oper. Res. 6(1):58–73] from single item without budget constraints to multiple items with budgets, potentially correlated valuations, and uncertain budgets. Unlike the Myerson auction where the reservation prices do not depend on the item, the reservation prices in our approach are a function of both the bidder and the item. We propose an algorithm for calculating the reservation prices by solving a bilinear optimization problem that, although theoretically difficult in general, is numerically tractable for the polyhedral uncertainty sets we consider. Moreover, this bilinear optimization problem reduces to a linear optimization problem for auctions without budget constraints and the auction becomes the classical second price auction. We report computational evidence that suggests the proposed approach (a) is numerically tractable for large scale auction design problems with the polyhedral uncertainty sets we consider, (b) leads to improved revenue compared to the classical probabilistic approach when the true distributions are different from the assumed ones, and (c) leads to higher revenue when correlations in the buyers' valuations are explicitly modeled.
Built to Last or Meant to End: Intertemporal Choice in Strategic Alliance Portfolios
Authors: Bakker Rene M. , Knoben Joris
Published: April 2014

Asalient but rarely explicitly studied characteristic of interfirm relationships is that they can intentionally be formed for finite periods of time. What determines firms’ intertemporal choices between different alliance time horizons? Shadow of the future theorists suggest that when an alliance has an explicitly set short-term time frame, there is an increased risk that partners may behave opportunistically. This does not readily explain the high incidence of time-bound alliances being formed. Reconciling insights from the shadow of the future perspective with nascent research on the flexibility of temporary organizations, and shifting the focus from the level of individual transactions to that of strategic alliance portfolios, we argue that firms may be willing to accept a higher risk of opportunism when there are offsetting gains in strategic flexibility in managing their strategic alliance portfolio. Consequently, we hypothesize that environmental factors that increase the need for strategic flexibility—namely, dynamism and complexity in the environment—are likely to increase the relative share of time-bound alliances in strategic alliance portfolios. Our analysis of longitudinal data on the intertemporal alliance choices of a large sample of small and medium-sized enterprises provides support for this argument. Our findings fill an important gap in theory about time horizons in interfirm relationships and temporary organizations and show the importance of separating planned terminations from duration-based performance measures.
The Privilege against Self-Incrimination from Early Origins to Judges' Rules: Challenging the ‘Orthodox View’
Authors: McInerney Pat
Published: April 2014

The history of the privilege against self-incrimination is one replete with contention and indeed confusion. This stems from the fact that the exact origin, initial purposes and very meaning of the privilege are disputed. Various interpretations have been ascribed to the privilege since its inception. In order to avoid these interpretational issues, and to properly contextualise the development of the privilege, it must be recognised that the broadly conceived concept of the privilege against self-incrimination incorporates three distinct sub-rights. First, the privilege against self-incrimination afforded to witnesses in criminal, civil or non-judicial investigative proceedings; secondly, the right of a defendant not to give evidence at trial; and, thirdly, the right to silence of a suspect in the pre-trial criminal investigation. Each of these sub-rights has a distinct though necessarily related historical trajectory. It is suggested that a significant cause of the disputed history of the privilege is the failure to recognise the various strands inherent therein. The origins and historical development of each of these elements of the privilege are considered in this article, in an effort to resolve the historiographical controversy and to challenge the orthodox view that has come to the fore in recent times.
El uso de entonces/así que en contexto narrativo sobre datos del PRESEEA-Buenos Aires
Authors: Borzi Claudia
Published: April 2014

En este trabajo se estudian comparativamente los usos de entonces y de así que en el marco del Enfoque Cognitivo-Prototípico, que presupone que cada forma tiene un significado y una función propios, los que, a su vez, responden a distintas intenciones comunicativas del hablante. Siguiendo una metodología cualitativa y cuantitativa se analizan datos provenientes del nivel sociocultural alto del PRESEEA_BUENOS AIRES (Proyecto para el Estudio Sociolingüístico del Español de España y de América de la Ciudad de Buenos Aires) 2000-2010. Se identifica un contexto de uso particular para cada una de las formas: entonces en tematización de información y así que en abandono de turno. Se diferencian los contextos narrativos de los argumentativos. Se describe el uso más prototípico de cada una de las formas en el contexto narrativo. Se comparan los resultados con los obtenidos por Borzi (1997) sobre el cuerpo de datos oral de El Habla Culta de la Ciudad de Buenos Aires (PILEI) 1965-1969.
Las etiquetas discursivas: del mantenimiento a la construcción del referente
Authors: López Samaniego Anna
Published: April 2014

Las etiquetas discursivas se definen en este artículo como sintagmas nominales anafóricos que condensan el contenido de una o más predicaciones del discurso y las categorizan o conceptualizan de acuerdo con el plan del discurso elaborado por el emisor (ej. este fenómeno, tal argumento). El objetivo de este artículo es caracterizar el funcionamiento anafórico de las etiquetas discursivas. Para ello, se parte de un análisis manual de corpus con el propósito de identificar las diferentes unidades sintáctico-discursivas que pueden funcionar como antecedente textual de una etiqueta discursiva. Una vez delimitadas e identificadas estas unidades, se analiza la capacidad de cada una de ellas para funcionar como expresiones referenciales, siguiendo la concepción de referencia definida por la gramática cognitiva, que gira en torno a la noción de anclaje (grounding). El análisis realizado permite, por una parte, situar el etiquetaje discursivo en el continuo entre las relaciones de anáfora directa y las de anáfora indirecta; y por otra, diferenciar tres posibilidades de funcionamiento cognitivo de las etiquetas discursivas (mantenimiento del referente, reificación del referente o construcción del referente), en función de la unidad sintáctico-discursiva que actúa como antecedente textual. Este artículo pone de relieve la necesidad de tener en cuenta estas unidades a la hora de caracterizar el funcionamiento de procedimientos de encapsulación como las etiquetas discursivas.
Redes polisémicas y niveles de interpretación. Representación semántica de unidades lingüísticas complejas: el caso de vamos
Authors: Polanco Martínez Fernando
Published: April 2014

La polifuncionalidad de marcadores funcionalmente complejos como vamos no se reduce a la mera variación contextual a partir de un único significado invariante, sino que revela, más bien, su naturaleza heterosémica, esto es, polisémica y policategorial. Estos elementos complejos presentan más de un significado convencional asociado a determinadas funciones discursivo-interactivas con rasgos gramaticales y semántico-pragmáticos estables diferenciados, así como varios sentidos contextuales con distinto grado de prominencia derivados de la interacción de los significados codificados con determinados contextos. Por ello, para el tratamiento semántico-funcional de esta unidad discursiva, en este trabajo proponemos un modelo polisémico radial (Lakoff, 1987; Hansen, 2005; Evans, 2004, 2006). Creemos que un modelo polisémico de este tipo permite describir y explicar adecuadamente (i) la variabilidad categorial, semántica y funcional de unidades discursivas complejas como vamos; (ii) los vínculos que existen entre los distintos usos de estas unidades; y, en definitiva, (iii) la estructura gramático-funcional subyacente de estos elementos.
Especificación semántica versus neutralización entre español y portugués. Su formalización en los diccionarios bilingües
Authors: Vázquez Diéguez Ignacio
Published: April 2014

Las lenguas española y portuguesa poseen un elevado número de voces comunes que se usan en la lengua cotidiana de modo diferente. Dicha afirmación se verifica en portugués en una especificación semántica en el uso de las voces habituales que no presenta el castellano. Los diccionarios bilingües español-portugués deberían partir de la frecuencia de uso y marcarla en la microestructura a través de los discriminadores de contexto. Hasta épocas recientes estos diccionarios, confeccionados a la sombra de la RAE, atendían a un registro culto, casi literario de la lengua. Es nuestro propósito demostrar la importancia de especificar apropiadamente los marcadores de contexto para ofrecer el equivalente portugués adecuado de la acepción española.
U.S. National Security Culture: From Queer Psychopathology to Queer Citizenship
Authors: Bean Hamilton
Published: April 2014

The case of Chelsea Manning represents both continuity and change in the history of U.S. national security culture. Manning’s stated motives are similar to the motives of other national security leakers; however, pre-court-martial media discourse (June 2010–January 2012) often emphasizes Manning’s sexual orientation, implying that queer psychopathology uniquely explains her decision to provide classified material to WikiLeaks. Such commentary reflects and reinforces the persistent institutional and cultural myth that homosexuality endangers national security. Manning’s case, however, suggests opportunities for the development of queer citizenship within U.S. national security affairs.
Applying the Superposition Procedure for the Harmonic Sharing Responsibility between Renewable Energy Power Plants and the Network
Authors: Santos Ivan N. , Oliveira José C. , Ribeiro Paulo F. , Reis Alex , Santos Andréia C. , Gondim Isaque N.
Published: April 2014

The increasing penetration of renewable energy sources with nonlinear characteristics, such as wind and photovoltaic power plants, demands a clear procedure for harmonic sharing responsibility between this new kind of generation and the network at the point of common coupling. In fact, there are in literature many procedures regarding the determination of responsibility for violating harmonic distortion limits. Among these proposals, the methodology based on the superposition principle has been one of the most promising procedures. In this context, the present paper is focused on a procedure that applies the superposition methodology to find the harmonic sharing responsibility between a wind power plant and the utility network. To exemplify this application, a case study is performed and analyzed.
Optimal Signal Extraction with Correlated Components
Authors: McElroy Tucker S. , Maravall Agustin
Published: April 2014

While it is typical in the econometric signal extraction literature to assume that the unobserved signal and noise components are uncorrelated, there is nevertheless an interest among econometricians in the hypothesis of hysteresis, i.e. that major movements in the economy are fundamentally linked. While specific models involving correlated signal and noise innovation sequences have been developed and applied using state space methods, there is no systematic treatment of optimal signal extraction with correlated components. This paper provides the mean square error optimal formulas for both finite samples and bi-infinite samples and furthermore relates these filters to the more well-known Wiener–Kolmogorov (WK) and Beveridge–Nelson (BN) signal extraction formulas in the case of ARIMA component models. Then we obtain the result that the optimal filter for correlated components can be viewed as a weighted linear combination of the WK and BN filters. The gain and phase functions of the resulting filters are plotted for some standard cases. Some discussion of estimation of hysteretic models is presented, along with empirical results on an economic time series. Comparisons are made between signal extractions from traditional WK filters and those arising from the hysteretic models.
Electronic Records of the Air War Over Southeast Asia
Authors: High Holly , Curran James R. , Robinson Gareth
Published: April 2014

The United States conducted a massive bombing campaign over Southeast Asia during the Second Indochina War. The joint chiefs of staff attempted to compile comprehensive databases of all US and allied air sorties during the conflict. In this article, we show how we tested the reliability of two of the most commonly used databases and then determined what they tell us about the air war, especially in terms of the tons of ordnance expended. The database indicates tonnage figures similar to those in existing accounts of the bombing of Laos, Vietnam or Cambodia and also contains new evidence of some limited bombing of Thailand. It suggests each target country suffered markedly distinct bombing patterns that were often related inversely to each other. This supports the interpretation that the use of air power was not purely tactical but also driven by the availability of air power.
Pain Insensitivity Syndrome Misinterpreted as Inflicted Burns
Authors: van den Bosch Gerbrich E. , Baartmans Martin G. A. , Vos Paul , Dokter Jan , White Tonya , Tibboel Dick
Published: April 2014

We present a case study of a 10-year-old child with severe burns that were misinterpreted as inflicted burns. Because of multiple injuries since early life, the family was under suspicion of child abuse and therefore under supervision of the Child Care Board for 2 years before the boy was burned. Because the boy incurred the burns without feeling pain, we conducted a thorough medical examination and laboratory testing, evaluated detection and pain thresholds, and used MRI to study brain morphology and brain activation patterns during pain between this patient and 3 healthy age- and gender-matched controls. We found elevated detection and pain thresholds and lower brain activation during pain in the patient compared with the healthy controls and reference values. The patient received the diagnosis of hereditary sensory and autonomic neuropathy type IV on the basis of clinical findings and the laboratory testing, complemented with the altered pain and detection thresholds and MRI findings. Hereditary sensory and autonomic neuropathy IV is a very rare congenital pain insensitivity syndrome characterized by the absence of pain and temperature sensation combined with oral mutilation due to unawareness, fractures, and anhidrosis caused by abnormalities in the peripheral nerves. Health care workers should be aware of the potential presence of this disease to prevent false accusations of child abuse.
Technology-Enhanced Simulation and Pediatric Education: A Meta-analysis
Authors: Cheng Adam , Lang Tara R. , Starr Stephanie R. , Pusic Martin , Cook David A.
Published: April 2014

BACKGROUND AND OBJECTIVE:

Pediatrics has embraced technology-enhanced simulation (TES) as an educational modality, but its effectiveness for pediatric education remains unclear. The objective of this study was to describe the characteristics and evaluate the effectiveness of TES for pediatric education.

METHODS:

This review adhered to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) standards. A systematic search of Medline, Embase, CINAHL, ERIC, Web of Science, Scopus, key journals, and previous review bibliographies through May 2011 and an updated Medline search through October 2013 were conducted. Original research articles in any language evaluating the use of TES for educating health care providers at any stage, where the content solely focuses on patients 18 years or younger, were selected. Reviewers working in duplicate abstracted information on learners, clinical topic, instructional design, study quality, and outcomes. We coded skills (simulated setting) separately for time and nontime measures and similarly classified patient care behaviors and patient effects.

RESULTS:

We identified 57 studies (3666 learners) using TES to teach pediatrics. Effect sizes (ESs) were pooled by using a random-effects model. Among studies comparing TES with no intervention, pooled ESs were large for outcomes of knowledge, nontime skills (eg, performance in simulated setting), behaviors with patients, and time to task completion (ES = 0.80–1.91). Studies comparing the use of high versus low physical realism simulators showed small to moderate effects favoring high physical realism (ES = 0.31–0.70).

CONCLUSIONS:

TES for pediatric education is associated with large ESs in comparison with no intervention. Future research should include comparative studies that identify optimal instructional methods and incorporate pediatric-specific issues into educational interventions.
Childhood Sexual Abuse and Suicidal Behavior: A Meta-analysis
Authors: Devries Karen M. , Mak Joelle Y. T. , Child Jennifer C. , Falder Gail , Bacchus Loraine J. , Astbury Jill , Watts Charlotte H.
Published: April 2014

BACKGROUND AND OBJECTIVE:

Self-inflicted injuries are one of the major causes of disease burden and death globally. Understanding the extent to which this is associated with childhood sexual abuse (CSA) exposure can help inform prevention strategies. We aimed to quantify to what extent CSA was associated with incident suicide attempts in men and women.

METHODS:

We searched 20 health and social science databases from first record until February 2009 and updated the search in Medline from February 2009 to February 1, 2013. Longitudinal studies and cotwin analyses from twin studies in any population from any year were eligible for inclusion. Of 22 235 abstracts screened as part of a series of reviews, 9 studies met the inclusion criteria for this review. Characteristics, effect estimates, and quality data were extracted. Random-effects meta-analysis was used to generate pooled odds ratios (ORs).

RESULTS:

Seven longitudinal and 2 twin studies with 8733 participants met the inclusion criteria. The overall pooled estimate for longitudinal studies was OR = 2.43 (95% confidence interval: 1.94–3.05), I2 = 87.5%, P < .0001. The pooled OR from cotwin analysis was 2.65 (95% confidence interval: 0.82–4.49, I2 = 0%, P = .867). Studies adjusted for a range of confounders, but baseline suicidal behavior was not well-controlled. Too few studies met the inclusion criteria to quantitatively examine sources of heterogeneity.

CONCLUSIONS:

CSA exposure is associated with suicide attempts when a range of different confounders are controlled for, but the temporality of the association is not well established, and the association is highly heterogeneous.
Putting the Pediatrics Milestones Into Practice: A Consensus Roadmap and Resource Analysis
Authors: Schumacher Daniel J. , Spector Nancy D. , Calaman Sharon , West Daniel C. , Cruz Mario , Frohna John G. , Gonzalez del Rey Javier , Gustafson Kristina K. , Poynter Sue Ellen , Rosenbluth Glenn , Southgate W. Michael , Vinci Robert J. , Sectish Theodore C.
Published: April 2014

The Accreditation Council for Graduate Medical Education has partnered with member boards of the American Board of Medical Specialties to initiate the next steps in advancing competency-based assessment in residency programs. This initiative, known as the Milestone Project, is a paradigm shift from traditional assessment efforts and requires all pediatrics residency programs to report individual resident progression along a series of 4 to 5 developmental levels of performance, or milestones, for individual competencies every 6 months beginning in June 2014. The effort required to successfully make this shift is tremendous given the number of training programs, training institutions, and trainees. However, it holds great promise for achieving training outcomes that align with patient needs; developing a valid, reliable, and meaningful way to track residents’ development; and providing trainees with a roadmap for learning. Recognizing the resources needed to implement this new system, the authors, all residency program leaders, provide their consensus view of the components necessary for implementing and sustaining this effort, including resource estimates for completing this work. The authors have identified 4 domains: (1) Program Review and Development of Stakeholders and Participants, (2) Assessment Methods and Validation, (3) Data and Assessment System Development, and (4) Summative Assessment and Feedback. This work can serve as a starting point and framework for collaboration with program, department, and institutional leaders to identify and garner necessary resources and plan for local and national efforts that will ensure successful transition to milestones-based assessment.
Prenatal SSRI Use and Offspring With Autism Spectrum Disorder or Developmental Delay
Authors: Harrington Rebecca A. , Lee Li-Ching , Crum Rosa M. , Zimmerman Andrew W. , Hertz-Picciotto Irva
Published: April 2014

OBJECTIVE:

To examine associations between prenatal use of selective serotonin reuptake inhibitors (SSRIs) and the odds of autism spectrum disorders (ASDs) and other developmental delays (DDs).

METHODS:

A total of 966 mother-child pairs were evaluated (492 ASD, 154 DD, 320 typical development [TD]) from the Childhood Autism Risks from Genetics and the Environment (CHARGE) Study, a population-based case-control study. Standardized measures confirmed developmental status. Interviews with biological mothers ascertained prenatal SSRI use, maternal mental health history, and sociodemographic information.

RESULTS:

Overall, prevalence of prenatal SSRI exposure was lowest in TD children (3.4%) but did not differ significantly from ASD (5.9%) or DD (5.2%) children. Among boys, prenatal SSRI exposure was nearly 3 times as likely in children with ASD relative to TD (adjusted odds ratio [OR]: 2.91; 95% confidence interval [CI]: 1.07–7.93); the strongest association occurred with first-trimester exposure (OR: 3.22; 95% CI: 1.17–8.84). Exposure was also elevated among boys with DD (OR: 3.39; 95% CI: 0.98–11.75) and was strongest in the third trimester (OR: 4.98; 95% CI: 1.20–20.62). Findings were similar among mothers with an anxiety or mood disorder history.

CONCLUSIONS:

In boys, prenatal exposure to SSRIs may increase susceptibility to ASD or DD. Findings from published studies on SSRIs and ASD continues to be inconsistent. Potential recall bias and residual confounding by indication are concerns. Larger samples are needed to replicate DD results. Because maternal depression itself carries risks for the fetus, the benefits of prenatal SSRI use should be carefully weighed against potential harms.
Functional outcome of arthroscopic rotator cuff repair
Authors: Sallai Imre , Kővári Eszter , Koteczki Ádám , Kovács Balázs , Magyar Péter , Futácsi Balázs , Antal Imre , Skaliczki Gábor
Published: April 2014

Introduction:Functional outcome after rotator cuff reconstruction is influenced by several factors of which re-rupture is probably the most important. Aim: The aim of the study was to evaluate the postoperative outcome including re-rupture rate after arthroscopic rotator cuff reconstruction. Method: 23 shoulders of 22 patients were examined prospectively. Physical examination, ultrasound and radiography were performed. Quality of life and functional outcome were evaluated using Constant Score and Visual Analog Scale. Results: Excellent or good results were found in 80% of the patients. The Constant Score has increased from 45 to 79, and the level of pain decreased from 6.6 to 2.5. Full-thickness rotator cuff tear was absent, but partial tear occurred in 7 cases (30%). Average acromiohumeral distance in the operated side was 8.5 mm compared to 9.5 mm measured on the contralateral shoulder. Conclusions: Arthroscopic rotator cuff repair is a safe and reliable procedure that provides good results. Orv. Hetil., 2014, 155(16), 620–626.
Effect of diabetes on the relation between troponin T and inflammatory markers in patients on hemodialysis
Authors: Mácsai Emília , Németh Ilona , Benke Attila , Dávid Gyula
Published: April 2014

Introduction: Cardiac troponin T in renal failure is used for the assessment of cardiovascular risk and mortality. Elevated cardiac troponin T levels correlate with subclinical myocardial necrosis, coronary heart disease, several echocardiographic parameters, metastatic calcification, as well as the presence of diabetes and uremic toxins. Aim: The aim of the authors was to examine the impact of factors, mainly the independent effects of inflammatory laboratory parameters, which may influence hypersensitive troponin T levels in hemodialysed patient groups with and without diabetes. Method: Hemodialysed patient groups with (n = 44) and without diabetes (n = 76) were studied. Difference in serum hypersensitive troponin T values before and after dialysis were analysed by paired Wilcoxon test. Factors possibly affecting the level of hypersensitive troponin T (especially inflammatory markers) were evaluated by multiregression analysis. Results: Hypersensitive troponin T levels in patients without diabetes (p = 0.0003) and those with diabetes (p = 0.0032) significantly increased during hemodialysis. In patients without diabetes several factors had significant effect on hypersensitive troponin T including age (p = 0.025), duration of hemodialysis (p = 0.0002), presence of cardiovascular complications (p = 0.0002), high sensivivity C-reactive protein (p = 0.0021), white blood cell count (p = 0.038), and the monocyte ratio (p = 0.0202). However, in patients with diabetes only high sensivivity C-reactive protein (p = 0.0024) showed association with hypersensitive troponin T levels. Conclusions: In hemodyalised patients with and without diabetes the hypersensitive troponin T levels are differently influenced by clinical and inflammatory laboratory parameters, which should be taken into consideration during clinical judgement. Orv. Hetil., 2014, 155(16), 627–633.
Clinical significance and treatment options of increased lipoprotein(a)
Authors: Zsíros Noémi , Paragh György , Harangi Mariann
Published: April 2014

Lipoprotein(a) has been shown to be associated with an increased incidence of cardiovascular diseases for decades. However, only recent research revealed more about its physiological function and its role in the development of cardiovascular diseases. The authors summarize the physiological role of lipoprotein(a), causes and treatment of elevated lipoprotein(a) level, and the association between lipoprotein(a) and cardiovascular diseases. Orv. Hetil., 2014, 155(16), 607–614.
Efficacy and Tolerability of Different Starting Doses of Sorafenib in Patients With Differentiated Thyroid Cancer
Authors: Dadu Ramona , Waguespack Steven G. , Sherman Steven I. , Hu Mimi I. , Busaidy Naifa L. , Jimenez Camilo , Habra Mohammed A. , Ying Anita K. , Bassett Roland L. , Cabanillas Maria E.
Published: April 2014

Background.

Sorafenib has proven efficacy in advanced differentiated thyroid cancer (DTC), but many patients must reduce the dose or discontinue treatment because of toxicity. The tolerability and efficacy of lower starting doses of sorafenib for DTC remain largely unstudied.

Methods.

We retrospectively examined overall survival, time to treatment failure, time to progression, discontinuation rates, and dose-reduction and interruption rates in patients with metastatic DTC treated with first-line sorafenib outside of a clinical trial. Two patient groups were compared; group 1 received the standard starting dose of 800 mg/day, and group 2 received any dose lower than 800 mg/day.

Results.

We included 75 adult patients, with 51 in group 1 and 24 in group 2. Mean age at diagnosis was 54 years, and 56% were male. The most common histologies included 43% papillary thyroid cancer of the conventional type, 15% papillary thyroid cancer of the follicular variant, and 15% Hürthle cell carcinoma. Time to treatment failure was 10 months (95% confidence interval [CI]: 5.6–14.3) in group 1 and 8 months (95% CI: 3.4–12.5) in group 2 (p = .56). Median overall survival was 56 months (95% CI: 30.6–81.3) in group 1 and 30 months (95% CI: 16.1–43.8) in group 2 (p = .08). Rates of discontinuation due to disease progression were 79% in group 1 and 91% in group 2, and 21% in group 1 and 9% in group 2 (p = .304) stopped treatment because of toxicity. Dose-reduction rates were 59% and 43% (p = .29), and interruption rates were 65% and 67% (p = .908) in group 1 and group 2, respectively.

Conclusion.

Efficacy and tolerability of sorafenib in treatment-naïve DTC patients does not appear to be negatively influenced by lower starting daily doses.
Building information modelling in practice: transforming Gatwick airport, UK
Authors: Neath Stephanie , Hulse Rod , Codd Andy
Published: April 2014

Gatwick is the UK's second largest airport and the busiest single-runway airport in the world. This paper describes how it has placed building information modelling (BIM) at the heart of its ongoing infrastructure investment programme, which is helping to transform the airport for passengers and airlines. Working in partnership with the airport's construction manager and software supplier, the application of BIM methodology has transformed project delivery and asset management at the airport.
Greening Richmond, USA: a sustainable urban drainage demonstration project
Authors: Sample David , Lucas William , Janeski Todd , Roseen Rob , Powers David , Freeborn John , Fox Laurie
Published: April 2014

This paper describes a unique sustainable urban drainage demonstration project at the Science Museum of Virginia in Richmond, USA. The retrofitted scheme includes bio-retention, planter trenches, permeable pavement and a vegetated roof. A description of the comprehensive monitoring programme and a summary of performance are also presented. A review of the various infrastructure solutions to reduce combined sewer overflows is provided, as well as a discussion on the invaluable demonstration potential of the site.