bluuebunny/crossref_metadata_2025 huggingface dataset:
Accuracy of sonographic fetal gender determination: predictions made by sonographers during routine obstetric ultrasound scans
Authors: Kearin Manette , Pollard Karen , Garbett Ian
Published: December 2015

Objectives: The purpose of this study was to determine the accuracy of sonographer predictions of fetal gender during routine ultrasounds. Primarily, the study sought to investigate the accuracy of predictions made in the first trimester, as requests from parents wanting to know the gender of their fetus at this early scan are becoming increasingly common. Second and third trimester fetuses were included in the study to confirm the accuracy of later predictions. In addition, the mother's decision to know the gender was recorded to determine the prevalence of women wanting prenatal predictions. Methods: A prospective, cross sectional study was conducted in a specialist private obstetric practice in the Illawarra, NSW. A total of 640 fetuses across three trimesters were examined collectively by seven sonographers. Fetal gender was predicted using the sagittal plane only in the first trimester and either the sagittal or transverse plane in later trimesters. Phenotypic gender confirmation was obtained from hospital records or direct telephone contact with women postnatally.

Results: Results confirmed 100% accuracy in predictions made after 14 weeks gestation. The overall success rate in the first trimester group (11–14 weeks) was 75%. When excluding those scans where a prediction could not be made, success rates increased to 91%. Results were less accurate for fetuses younger than 12 weeks, with an overall success rate of 54%. Male fetuses under 13 weeks were more likely to have gender incorrectly or unable to be assigned. After 13 weeks, success rates for correctly predicting males exceeded that of female fetuses. Statistical differences were noted in the success rates of individual sonographers. Sixty seven percent of women were in favour of knowing fetal gender from ultrasound. Publicly insured women were more likely to request gender disclosure than privately insured women.

Conclusions: Sonographic gender determination provides high success rates in the first trimester. Results vary depending on sonographer experience, fetal age and fetal gender. Practice guidelines regarding gender disclosure should be developed. Predictions prior to 12 weeks should be discouraged.
Contrast‐enhanced ultrasound of pancreatic tumours
Authors: De Robertis Riccardo , D'Onofrio Mirko , Crosara Stefano , Dal Corso Flavia , Barbi Emilio , Canestrini Stefano , Mucelli Roberto Pozzi
Published: December 2015

Indication/purpose: To review contrast‐enhanced ultrasound features of the most common pancreatic tumours.

Methods: Contrast‐enhanced ultrasound (CEUS) can provide distinctive features of pancreatic tumours that are reported in the present paper, providing radiologic‐pathological correlations and clarifying the main differential diagnosis.

Conclusion: Contrast‐enhanced ultrasound plays a well‐established role in the evaluation of pancreatic tumours. When possible, CEUS should be always performed after the initial US diagnosis, in order to improve the accuracy of the first line examination.
A sonographic approach to prenatal classification of congenital spine anomalies
Authors: Paoletti Debra , Robertson Meiri , Sia Sock Bee
Published: December 2015

Objective: To develop a classification system for congenital spine anomalies detected by prenatal ultrasound.

Methods: Data were collected from fetuses with spine abnormalities diagnosed in our institution over a five‐year period between June 2005 and June 2010. The ultrasound images were analysed to determine which features were associated with different congenital spine anomalies. Findings of the prenatal ultrasound images were correlated with other prenatal imaging, post mortem findings, post mortem imaging, neonatal imaging, karyotype, and other genetic workup. Data from published case reports of prenatal diagnosis of rare congenital spine anomalies were analysed to provide a comprehensive work.

Results: During the study period, eighteen cases of spine abnormalities were diagnosed in 7819 women. The mean gestational age at diagnosis was 18.8w ± 2.2 SD. While most cases represented open NTD, a spectrum of vertebral abnormalities were diagnosed prenatally. These included hemivertebrae, block vertebrae, cleft or butterfly vertebrae, sacral agenesis, and a lipomeningocele. The most sensitive features for diagnosis of a spine abnormality included flaring of the vertebral arch ossification centres, abnormal spine curvature, and short spine length. While reported findings at the time of diagnosis were often conservative, retrospective analysis revealed good correlation with radiographic imaging. 3D imaging was found to be a valuable tool in many settings.

Conclusions: Analysis of the study findings showed prenatal ultrasound allowed detection of disruption to the normal appearances of the fetal spine. Using the three features of flaring of the vertebral arch ossification centres, abnormal spine curvature, and short spine length, an algorithm was devised to aid with the diagnosis of spine anomalies for those who perform and report prenatal ultrasound.
Sonographic diagnosis of spontaneous uterine rupture at the site of cornual wedge resection scar – a case report
Authors: Wye Deborah , Magotti Robert , Al‐Mashat Dheya , Benzie Ronald , Condous George
Published: December 2015

Introduction: Uterine rupture and uterine dehiscence during pregnancy are known complications of a scarred uterus. Spontaneous uterine rupture at the site of prior cornual wedge resection has been previously reported in the literature, however remains rare.

Discussion: We present a case of uterine rupture at 30 weeks gestation. This woman had previous right sided interstitial pregnancy treated with uncomplicated laparoscopic cornual wedge resection at eight weeks gestation. The index pregnancy occurred eight months after surgery. An emergency ultrasound prompted by non‐specific abdominal pain and tenderness at 30 weeks gestation enabled diagnosis of uterine dehiscence. At emergency caesarean section four hours later full thickness wall rupture and haemoperitoneum were found. Surgical intervention resulted in a good outcome for both mother and baby.

Conclusion: A brief account on uterine rupture in late pregnancy and relevant sonographic features related to this case are presented. This case demonstrates the value of ultrasound in the assessment of subtle clinical signs and symptoms in patients at risk of uterine rupture.
Congenital high airways obstruction syndrome – first and second trimester diagnosis
Authors: Paoletti Debra , Robertson Meiri
Published: December 2015

Congenital High Airways Obstruction Syndrome (CHAOS) is a rare condition associated with high fetal or neonatal mortality. Prenatal diagnosis in the second trimester is made by the typical ultrasound features of large echogenic lungs, a flattened or inverted diaphragm, and fetal ascites or hydrops. We present two cases diagnosed at our institution; one in the second trimester, and a first trimester diagnosis. To the best of our knowledge, first trimester diagnosis of CHAOS has not been previously reported.
An ovarian torsion around a remnant of the urachus
Authors: Dickfos Marilla , Sharif Zakia
Published: December 2015

We report a case of ovarian torsion around a remnant of the urachus. Though it usually develops into the median umbilical ligament, abnormalities in urachal development can occur which can lead to remnants being present in the adult abdomen.

This case describes a young female who had intermittent lower abdominal pain over a period of three weeks. During this period several ultrasound scans were performed which reported different anatomy and possible causes of the pain. Only on diagnostic laparoscopy and confirmed via histology, was it found that she had experienced ovarian torsion around an urachal remnant.

Unfortunately due to the delay from symptom onset to her operation, her ovary was not salvageable. This case highlights the variability of ultrasound findings and demonstrates how a remnant can contribute to ovarian torsion and subsequent infarction.
The key to using a learning or skill acquisition plan
Authors: Nicholls Delwyn , Sweet Linda , Westerway Sue Campbell , Gibbins Annie
Published: December 2015

A learning plan is a tool to guide the development of knowledge, skills and professional attitudes required for practice. A learning plan is an ideal tool for both supervisors and mentors to guide the process of teaching and learning a medical ultrasound examination. A good learning plan will state the learning goal, identify the learning activities and resources needed to achieve this goal, and highlight the outcome measures, which when achieved indicate the goal has been accomplished. A skill acquisition plan provides a framework for task acquisition and skill stratification; and is an extension of the application of the student learning plan. One unique feature of a skill acquisition plan is it requires the tutor to first undertake a task analysis. The task steps are progressively learnt in sequence, termed scaffolding. The skills to develop and use a learning or skill acquisition plan are also learnt, but are an integral component to the ultrasound tutors skill set. This paper will provide an outline of how to use and apply a learning and skill acquisition plan. We will review how these tools can be personalised to each student and skill teaching environment.
Uhl's anomaly detected in‐utero
Authors: Matic Marta K , Kirsop Rodney , Ramsay Philippa A
Published: December 2015

Uhl's anomaly is rarely diagnosed antenatally. It is a condition characterised by partial or complete absence of the right ventricular myocardium and the heart conducting system. We present a case of Uhl's anomaly diagnosed during fetal life on prenatal ultrasound, with eight years postnatal follow‐up.
Cervical length measurement: Comparison of transabdominal and transvaginal approach
Authors: Westerway Susan Campbell , Pedersen Lars Henning , Hyett Jon
Published: December 2015

Objective: To compare transabdominal (TA) and transvaginal (TV) ultrasound assessment of cervical length at 16–41 weeks gestation.

Methods: TA and TV ultrasound measurements of cervical length were made on 491 pregnancies of 16–41 weeks gestation. Cervical length was measured from internal to external cervical os. Bland‐Altman plots and Wilcoxon signed rank test were used to evaluate differences between TA and TV measurements.

Results: The validity of the TA method depended on cervical length. Although the TA method underestimated cervical length by 2.0 mm on average (P < 0.001), Bland Altman plots showed an inverse trend with shorter cervixes. In women with a cervix < 25 mm (n = 30) based on TV scan measurement, TA overestimated cervical length by 12 mm (P < 0.001). The sensitivity and specificity of TA as a test to detect cervical length < 25 mm were 10% (95% CI: 2.1–26%) and 94% (95% CI: 92–96%) respectively; the negative LR was 0.96 (95% CI: 0.84–1.08). The maximum area under the ROC curve would be obtained at a TA cut‐off = 32 mm (to detect a cervix < 25 mm), corresponding to a sensitivity of 77% and a specificity of 58%.

Conclusion: TA measurements do not reflect TV assessment accurately, particularly if the cervix is short. At 24–34 weeks, a policy of proceeding to TV scan if TA measurement is < 25 mm will only detect 10% of affected pregnancies and has a poor positive predictive value so is of limited value as a predictive tool for women attending with symptoms and signs of preterm labour > 24 weeks gestation. There is no value in TA assessment of the cervix > 36 weeks.
Retrospective audit of patients presenting for ultrasound with suspicion of appendicitis
Authors: Yuan Fei , Necas Martin
Published: December 2015

Purpose: To assess the ultrasound performance on patients presenting to Waikato hospital ultrasound department with a clinical suspicion of appendicitis.

Method: This was a retrospective audit of 309 patients presenting to our department within business hours with clinical suspicion of appendicitis between September 2012 and March 2014. The patients were evaluated by operators of mixed experience. The scan reports, surgical reports, histology and discharge summaries were reviewed.

Results: The overall sensitivity of ultrasound on detecting appendicitis was 50%, the specificity was 98.5%. The positive predictive value and the negative predictive value were 84% and 92.6% respectively. The appendix was visualised in 14% of the true positive cases. When the appendix was visualised, the sensitivity and specificity of ultrasound was 95.2% and 69.2% respectively. Conclusion: The sensitivity of ultrasound to appendicitis was lower than that commonly reported in the literature, but on a par with a recent audit from another tertiary hospital in New Zealand.
A ‘snapshot’ of the visual search behaviours of medical sonographers
Authors: Carrigan Ann J , Brennan Patrick C , Pietrzyk Mariusz , Clarke Jillian , Chekaluk Eugene
Published: December 2015

Introduction: Visual search is a task that humans perform in everyday life. Whether it involves looking for a pen on a desk or a mass in a mammogram, the cognitive and perceptual processes that underpin these tasks are identical. Radiologists are experts in visual search of medical images and studies on their visual search behaviours have revealed some interesting findings with regard to diagnostic errors. In Australia, within the modality of ultrasound, sonographers perform the diagnostic scan, select images and present to the radiologist for reporting. Therefore the visual task and potential for errors is similar to a radiologist. Our aim was to explore and understand the detection, localisation and eye‐gaze behaviours of a group of qualified sonographers.

Method: We measured clinical performance and analysed diagnostic errors by presenting fifty sonographic breast images that varied on cancer present and degree of difficulty to a group of sonographers in their clinical workplace. For a sub‐set of sonographers we obtained eye‐tracking metrics such as time‐to‐first fixation, total visit duration and cumulative dwell time heat maps. Results: The results indicate that the sonographers' clinical performance was high and the eye‐tracking metrics showed diagnostic error types similar to those found in studies on radiologist visual search.

Conclusion: This study informs us about sonographer visual search patterns and highlights possible ways to improve diagnostic performance via targeted education.
Early 2nd trimester fetal demise in a monochorionic twin pregnancy: A cautionary tale
Authors: Walsh Colin A
Published: December 2015

It is well established that the death of one fetus in a monochorionic twin pregnancy places the surviving twin at significant risk for neuro‐developmental delay or death. Although the early 1st trimester “vanishing twin” has not traditionally been considered a major risk, the precise gestational threshold beyond which a surviving twin is at risk remains uncertain. Most experts recommend serial ultrasounds and fetal MRI in the survivor, to look for evidence of ischaemic brain injury. We present a case of early monochorionic twin demise at 14–16 weeks, with evolving ventriculomegaly and ischaemic changes on fetal MRI in the co‐twin, leading to termination of pregnancy at 28 weeks.
The effect of applied transducer force on acoustic radiation force impulse quantification within the left lobe of the liver
Authors: Porra Luke , Swan Hans , Ho Chien
Published: December 2015

Introduction: Acoustic Radiation Force Impulse (ARFI) Quantification measures shear wave velocities (SWVs) within the liver. It is a reliable method for predicting the severity of liver fibrosis and has the potential to assess fibrosis in any part of the liver, but previous research has found ARFI quantification in the right lobe more accurate than in the left lobe. A lack of standardised applied transducer force when performing ARFI quantification in the left lobe of the liver may account for some of this inaccuracy. The research hypothesis of this present study predicted that an increase in applied transducer force would result in an increase in SWVs measured.

Methods: ARFI quantification within the left lobe of the liver was performed within a group of healthy volunteers (n = 28). During each examination, each participant was subjected to ARFI quantification at six different levels of transducer force applied to the epigastric abdominal wall.

Results: A repeated measures ANOVA test showed that ARFI quantification was significantly affected by applied transducer force (p = 0.002). Significant pairwise comparisons using Bonferroni correction for multiple comparisons showed that with an increase in applied transducer force, there was a decrease in SWVs.

Conclusion: Applied transducer force has a significant effect on SWVs within the left lobe of the liver and it may explain some of the less accurate and less reliable results in previous studies where transducer force was not taken into consideration. Future studies in the left lobe of the liver should take this into account and control for applied transducer force.
The effectiveness of the use of high fidelity simulators in obstetric ultrasound training: A systematic review
Authors: Osborne Brooke , Parange Nayana , Thoirs Kerry
Published: December 2015

Introduction: The benefits of the use of ultrasound technology for point of care obstetric health evaluation have led to increased focus on training programs for physicians wanting to develop skills in this area. Simulation, in a variety of formats, has always played a role in medical and health training, with proven benefits. This systematic review determines the level of evidence available to support the use of high fidelity ultrasound simulators in the training of obstetric ultrasound scanning skills to health professionals.

Methods: A systematic review of the literature was performed to define previous investigations into the incorporation of high fidelity ultrasound simulators into obstetric ultrasound training programs. The included studies were reviewed by the authors to evaluate their overall strength and quality. Data surrounding the study participants, simulator types, study design, training program format, outcome measures, and results were extracted.

Results and conclusions: While the small body of evidence discovered in this review demonstrates positive results for the use of high fidelity simulators in obstetric ultrasound training, the studies included in this review demonstrate a moderate level of evidence, with some potential of bias throughout. A number of gaps in the literature were identified that could be addressed in further research.
Fetal manifestations of maternal anti‐Ro and La antibodies – more than complete heart block
Authors: Brooks Paul
Published: December 2015

Complete heart block (CHB) is a potentially fatal condition occurring in approximately 1:10000 fetuses. Whilst it is well recognised that maternal anti‐Ro and La antibodies are associated with fetal CHB, there are multiple other manifestations of fetal exposure to these autoantibodies which are not widely appreciated and rarely diagnosed. The importance of identifying affected fetuses lies in the significantly increased risk of recurrence in future pregnancies, and the potential for treatments which may modify this risk. This paper presents several cases to highlight the varying fetal presentations of maternal anti‐Ro and La antibodies.
The importance of placental evaluation following perinatal death
Authors: Sethna Farah , Phillips Tessa , Fadia Mitali , Robertson Meiri
Published: December 2015

Although uncommon, abnormalities of the placenta are important to recognise owing to the potential for both maternal and fetal morbidity and mortality. The placenta is often overlooked in the routine evaluation of a normal gestation, receiving attention only when an abnormality is detected. During the formal scan to confirm a fetal death, the information gathering process to elucidate a possible cause of death begins, yet, even in this instance, the placenta is seldom examined. We aim to draw attention to the importance of placental assessment by presenting a case of a stillbirth where the answer to the cause of death lay in the placenta.
Technical and Professional Skills of Engineers Involved and Not Involved in Engineering Service
Authors: Litchfield Kaitlin , Javernick‐Will Amy , Maul Andrew
Published: December 2015

Background

Engineers must acquire increasing technical and professional skills to meet pressing global challenges, but fitting training for these skills into already crowded curricula is difficult. Engineering service may provide opportunities to gain such skills; however, prior research about learning outcomes from such activities has been primarily small‐scale, anecdotal, or lacking a comparison group.

Purpose/Hypothesis

We aim to understand whether self‐reported learning outcomes differ between engineers involved and not involved with engineering service activities. Specifically, do the two groups experience and learn different technical and professional skills in their engineering activities?

Design/Method

We used a sequential mixed methods approach that began with interviews and focus groups with 165 participants and continued with a questionnaire administered to over 2,500 engineering students and practicing engineers both involved and not involved with engineering service. Analyses included variable‐oriented qualitative analysis and multiple linear regression models to compare perceived technical and professional skills.

Results

Quantitative results show that engineers involved and not involved with engineering service report comparable perceived technical skills, and that those involved in engineering service report significantly higher perceived professional skills, even when controlling for age, gender, and grade point average. Qualitative results indicate that higher professional skills can be partially attributed to the realistic, complex, and contextualized learning experiences within engineering service activities.

Conclusions

Engineers involved with engineering service may gain strong professional engineering skills that do not compromise their technical skills. Thus, engineering service may help educate the type of engineers the field needs to confront pressing global challenges.
Apoptosis, proliferation and presence of estradiol receptors in the testes and Bidder's organ of the toad Rhinella arenarum (Amphibia, Anura)
Authors: Scaia María Florencia , Czuchlej Silvia Cristina , Cervino Nadia , Ceballos Nora Raquel
Published: December 2015

The dynamic equilibrium between spermatogonial proliferation and testicular apoptosis determines the progression of spermatogenesis in amphibians. Estrogens and their receptors play a central role in regulating spermatogenesis in vertebrates, and in some species of anurans, estradiol (E2) is involved in the regulation of spermatogonial proliferation and apoptosis of germ cells. Bidder's organ (BO) is a structure characteristic of Bufonidae that has historically been compared to an undeveloped ovary. In adult Rhinella arenarum males, BO is one of the main sources of plasma E2. The aim of this study was 1) to describe the seasonal variations in testicular apoptosis, spermatogonial proliferation, and cellular proliferation in BO; and 2) to analyze the presence and localization of estrogen receptor β (ERβ) in the testes and BO of R. arenarum. Testicular fragments and BOs from animals collected during the year were labeled with 5‐bromo‐2′‐deoxyuridine (BrdU) and BrdU incorporation was determined using immunohistochemistry. Apoptosis in testicular sections was detected using the TUNEL method, and ERβ localization was assessed using immunohistochemistry in testes and BOs. The results indicate that spermatogonial proliferation is highest during the reproductive season and that cysts of spermatocytes and spermatids undergo apoptosis during the postreproductive season. Furthermore, the proliferation of follicular cells is highest during the reproductive and postreproductive seasons. ERβ was primarily detected by immunolocalization in Sertoli cells, follicular cells, and oocytes. Taken together, these results suggest that cysts that do not form spermatozoa are removed from testes by apoptosis and that estrogens regulate both spermatogenesis and oogenesis in adult males of R. arenarum. J. Morphol. 277:412–423, 2016. © 2015 Wiley Periodicals, Inc.
Signal decay mapping of myocardial edema using dual‐contrast fast spin‐echo MRI
Authors: Krumm Patrick , Martirosian Petros , Rath Dominik , Zitzelsberger Tanja , Ruff Christer Andreas , Klumpp Bernhard Daniel , Nikolaou Konstantin , Gawaz Meinrad , Geisler Tobias , Schick Fritz , Kramer Ulrich
Published: December 2015

Purpose

To introduce a dual‐contrast fast spin‐echo (dcFSE) sequence for signal decay mapping of myocardial edema.

Materials and Methods

After consultation with the Institutional Review Board, 22 acute myocardial infarction (MI) patients were examined with magnetic resonance imaging (MRI) at 1.5T 2 days after revascularization. Edema was evaluated in 16 myocardial segments with an exponential fit for signal decay time (SDT) in dcFSE mapping and T2 signal intensity ratio for single‐contrast FSE. Myocardial viability was evaluated in late gadolinium enhancement (LGE). A control group of 10 volunteers was examined for edema imaging. SDT was compared in segment groups: 1) with LGE in MI, 2) penumbra, 3) remote from LGE, 4) controls. Groups 1/3 and 3/4 were tested on difference. Three phantoms providing similar T2 but different T1 relaxation times (low, intermediate, high) were examined with dcFSE and multicontrast spin echo sequence as a reference.

Results

The SDT/T2ratio for segment groups was 1) 82msec/1.7 in segments with LGE; 2) 65msec/1.6 for penumbra, 3) 62msec/1.7 for remote segments, and 4) 50msec/1.6 in controls. In dcFSE group 1/3 (P < 0.0001) and in group 3/4 (P = 0.0002) SDT was significantly different. In single‐contrast FSE the T2ratio was not significantly different for both tests: 1/3 P = 0.1889; 3/4 P = 0.8879. T2‐overestimation of dcFSE was 23% in low, 29% in intermediate, and 35% in highly T1 contaminated phantoms.

Conclusion

dcFSE signal decay edema mapping is feasible in volunteers and patients. DcFSE SDT is superior to T2ratio for detection of high‐grade and diffuse myocardial edema. J. Magn. Reson. Imaging 2016;44:186–193.
Creative Expression and Its Evaluation on Work‐Related Verbal Tasks: A Comparison of Chinese and German Samples
Authors: Tang Min , Werner Christian , Cao Guikang , Tumasjan Andranik , Shen Jiliang , Shi Jiannong , Spörrle Matthias
Published: December 2015

Two studies comparing Chinese and German samples by using work‐related verbal creativity tasks examined the role of culture in creative expression thereby also exploring culture's potential influence on creativity judgements. In Study 1, German participants (N = 60) scored higher than Chinese respondents (N = 60) in a work‐related unusual uses test on all objective creativity measures. Study 2 (Chinese: N = 59, German: N = 52) replicated these findings by applying an occupational creative problem‐solving task evaluated by using the Consensual Assessment Technique with judges from China as well as Germany. We observed high consensus among judges of each country as well as between the two cultures. Both German and Chinese judges rated the German respondents’ outcomes higher on most creativity dimensions (e.g., originality). Overall, German judges provided lower ratings. Our research extends previous intercultural findings solely based on art‐based creative performance to the occupational domain and indicates that higher creativity ascriptions toward the performance of Western people cannot be explained by assessments from Western raters.
Mass spectrometric analysis of free fatty acids in infant milk powders by frozen pretreatment coupled with isotope‐labeling derivatization
Authors: Zhou Tianxiao , Leng Jiapeng , Peng Yaoshan , Zhang Lei , Guo Yinlong
Published: December 2015

In combination with frozen pretreatment and carboxyl group derivatization, a novel workflow was developed for the determination of free fatty acids in milk powder. The workflow showed a significantly enhanced performance for comprehensive free fatty acid analysis owing to a highly efficient frozen extraction method. In addition, the advantages of the workflow also involved high sensitivity and great tolerance to a complex matrix. Characteristic fragment ions of derivatization reagents also provide clear evidence for the qualitative analysis of free fatty acids. Fourteen types of free fatty acids in a number of domestic and overseas infant milk powders have been successfully detected. The content of free fatty acids in the different samples was different, which probably indicates the diverse quality of infant milk powder. The workflow is expected to be a pragmatic tool for the analysis of free fatty acids in intricate matrices.
One‐pot synthesis of a new high vinyl content hybrid silica monolith dedicated to nanoliquid chromatography
Authors: Racha El‐Debs , Gay Pauline , Dugas Vincent , Demesmay Claire
Published: December 2015

A new vinyltrimethoxysilane‐based hybrid silica monolith was developed and used as a reversed‐phase capillary column. The synthesis of this rich vinyl hybrid macroporous monolith, by cocondensation of vinyltrimethoxysilane with tetramethoxysilane, was investigated using an unconventional (formamide, nitric acid) porogen/catalyst system. A macroporous hybrid silica monolith with 80% in mass of vinyltrimethoxysilane in the feeding silane solution was obtained and compared to a more conventional low vinyl content hybrid monolith with only of 20% vinyltrimethoxysilane. Monoliths were characterized by scanning electron microscopy, 29Si nuclear magnetic resonance spectroscopy and N2 adsorption–desorption. About 80% of the vinyl precursor was incorporated in the final materials, leading to 15.9 and 61.5% of Si atoms bonded to vinyl groups for 20% vinyltrimethoxysilane and 80% vinyltrimethoxysilane, respectively. The 80% vinyltrimethoxysilane monolith presents a lower surface area than 20% vinyltrimethoxysilane (159 versus 551 m2/g), which is nevertheless compensated by a higher vinyl surface density. Chromatographic properties were evaluated in reversed‐phase mode. Plots of ln(k) versus percentage of organic modifier were used to assess the reversed‐phase mechanism. Its high content of organic groups leads to high retention properties. Column efficiencies of 170 000 plates/m were measured for this 80% vinyltrimethoxysilane hybrid silica monolith. Long capillary monolithic columns (90 cm) were successfully synthesized (N = 120 000).
Complete resolution of minocycline pigmentation following a single treatment with non‐ablative 1550‐nm fractional resurfacing in combination with the 755‐nm Q‐switched alexandrite laser
Authors: Vangipuram Ramya K. , DeLozier Whitney L. , Geddes Elizabeth , Friedman Paul M.
Published: December 2015

Pigmentation secondary to minocycline ingestion is an uncommon adverse event affecting 3.7–14.8% of treated individuals for which few effective therapies are available. Three patterns of minocycline pigmentation have a characteristic clinical and histological appearance. The pigment composition in each variety is different and occurs at varying skin depths. Accordingly, a tailored approach according to the type of minocycline pigmentation is crucial for treatment success. The purpose of this intervention was to evaluate the efficacy of non‐ablative fractional photothermolysis in combination with the Q‐switched alexandrite laser for the treatment of type I minocycline pigmentation on the face. A patient with type I minocycline pigmentation was treated with non‐ablative 1550‐nm fractional photothermolysis followed immediately by 755‐nm Q‐switched alexandrite laser and then observed clinically to determine the outcome of this modality. The patient was seen in clinic 1 month later following her single treatment session and 100% clearance of all blue facial pigment was observed. Non‐ablative fractional photothermolysis in combination with the 755‐nm Q‐switched alexandrite laser should be considered for treatment of type I minocycline pigmentation. Lasers Surg. Med. 48:234–237, 2016. © 2015 Wiley Periodicals, Inc.
Relationship between chronic hepatitis B and metabolic syndrome: A structural equation modeling approach
Authors: Huang Chiao‐Yu , Lu Chia‐Wen , Liu Yi‐Lien , Chiang Chien‐Hsieh , Lee Long‐Teng , Huang Kuo‐Chin
Published: December 2015

Objective

Investigate the nature of the relationship between chronic hepatitis B virus (HBV) infection and metabolic syndrome among nondiabetic adults.

Methods

This was a cross‐sectional analysis of 17,030 nondiabetic adults (7437 males and 9593 females; mean age, 36.0 ± 3.9 years) in northern Taiwan from 2008 to 2009. The associations of hepatitis B surface antigen (HBsAg) seropositivity with metabolic syndrome and cardio‐metabolic parameters were assessed. A structural equation model was constructed to elucidate the pathways between chronic HBV infection and individual cardiometabolic risk factors.

Results

A total of 2982 (17.5%) participants were HBsAg‐seropositive. Of the seropositive and seronegative subjects, 15.5 and 16.9% had metabolic syndrome, respectively. The HBsAg‐seropositive subjects had a lower odds of having metabolic syndrome compared with the seronegative subjects irrespective of gender and age (OR: 0.76, 95% CI: 0.68‐0.85). The inverse associations remained significant after adjusting for body mass index and serum alanine aminotransferase levels. HBsAg seropositivity was inversely associated with hypertriglyceridemia (OR: 0.59, 95% CI: 0.52‐0.66), and low serum levels of high‐density lipoprotein cholesterol (OR: 0.86, 95% CI: 0.79‐0.93) after adjustments. The structural equation model revealed chronic HBV infection had a significant negative effect on dyslipidemia both in males (B = −0.054) and females (B = −0.064).

Conclusions

The inverse relationship between chronic HBV infection and metabolic syndrome may be attributable to the net beneficial effects on lipid profiles.
Adhesion property of crosslinked epoxidized (natural rubber)/(acrylonitrile‐butadiene) rubber blend adhesives in the presence of petro resin tackifier
Authors: Poh Beng Teik , Soo Kai Wai , Azahari Baharin
Published: December 2015

Loop tack, peel strength, shear strength, and morphology of (benzoyl peroxide)‐cured epoxidized natural rubber (ENR 25)/(acrylonitrile‐butadiene) rubber (NBR) blend adhesive were investigated by using petro resin as the tackifying resin. Benzoyl peroxide loading varied from 1 to 5 parts by weight per hundred parts of resin (phr), whereas the petro resin loading was fixed at 40 phr. A SHEEN hand coater was used to coat the adhesive on the polyethylene terephthalate substrate at 30 μm and 120 μm coating thicknesses. (ENR 25)/NBR adhesive was crosslinked at 80°C for 30 min prior to the determination of adhesion strength by a Lloyd adhesion tester operating at 10–60 cm/min. Results show that maximum loop tack and peel strength occur at 2 phr of benzoyl peroxide loading, whereby optimum cohesive and adhesive strength are obtained. However, shear strength increases with increasing benzoyl peroxide concentration, an observation that is associated with the steady increase in the cohesive strength. Scanning electron microscopy micrograph shows that little adhesive remained on the substrate at 0 phr compared with 2 phr of benzoyl peroxide loading, indicating that crosslinking increases the peel strength of the adhesive. In all cases, the adhesion properties increase with coating thickness and testing rate. J.VINYL ADDIT. TECHNOL., 24:93–98, 2018. © 2015 Society of Plastics Engineers
AORN's Revised Model for Evidence Appraisal and Rating
Authors: Spruce Lisa , Van Wicklin Sharon A. , Wood Amber
Published: December 2015

AORN perioperative practice specialists responsible for authoring the Guidelines for Perioperative Practice have spent several years using evidence‐based practice tools adapted from other organizations. AORN now has its own evidence appraisal tools and model for evidence‐based practice that can be used by nurses and students to appraise research and nonresearch articles and assign an evidence rating to help inform perioperative practice decisions. The new and revised tools include a new evidence rating model, hierarchy of evidence, and expanded appraisal tools.
Efectos del miedo en los trabajadores y la organización
Authors: Bedoya Dorado Cristian , García Solarte Mónica
Published: December 2015

A partir de la propuesta de Deming sobre erradicar el miedo en el lugar de trabajo, diferentes investigaciones han encontrado que esta emoción es negativa para los trabajadores y las organizaciones. Este artículo tiene como objetivo identificar los efectos que el miedo genera en los trabajadores y en las organizaciones. Para ello, se realizó una revisión bibliográfica sobre los estudios del miedo en la organización y sus implicaciones en el trabajo. De este modo se agruparon los efectos del miedo en el trabajador y en la organización y se analizaron sus implicaciones, a partir de lo cual se encontró que identificar los efectos que tiene el miedo en la organización contribuye a la comprensión del papel que tienen las subjetividades en el contexto organizacional y el funcionamiento de estas.
Interim analysis of a randomized controlled trial comparing laparoscopic radiofrequency volumetric thermal ablation of uterine fibroids with laparoscopic myomectomy
Authors: Krämer Bernhard , Hahn Markus , Taran Florin‐Andrei , Kraemer Dorit , Isaacson Keith B. , Brucker Sara Y.
Published: December 2015

Objective

To compare 24‐month patient‐reported outcomes following laparoscopic radiofrequency volumetric thermal ablation (RFVTA) and laparoscopic myomectomy in patients with uterine fibroids.

Method

An interim analysis of 24‐month follow‐up data from a randomized controlled trial was performed at Tübingen University Women's Hospital between November 1, 2012 and May 30, 2015. Premenopausal patients, at least 18 years of age, who were menstruating, were randomly assigned to be treated for symptomatic uterine fibroids with either RFVTA or laparoscopic myomectomy. The outcomes included in the present per‐protocol analysis were patients’ responses to validated questionnaires and long‐term safety.

Results

The study enrolled 51 patients; 21 and 22 patients in the RFVTA and laparoscopic myomectomy groups, respectively, completed 24 months of follow‐up. Improvements in the severity of symptoms from baseline were reported by participants in both the RFVTA (P < 0.001) and laparoscopic myomectomy groups (P = 0.001). A significant improvement in health‐related quality of life was observed in the laparoscopic myomectomy group (P = 0.040); a non‐significant improvement was recorded in the RFVTA group (P = 0.083). A trocar‐site hematoma occurred in one patient in the laparoscopic myomectomy group. Further surgical interventions were recorded in three patients in the RFVTA group but these were unrelated to fibroid symptoms.

Conclusions

These 24‐month data suggest equivalence in safety and patient‐reported efficacy of RFVTA and laparoscopic myomectomy.

ClinicalTrials.gov: NCT01750008
Cutter-workpiece engagement determination for general milling using triangle mesh modeling
Authors: Gong Xun , Feng Hsi-Yung
Published: December 2015

Cutter-workpiece engagement (CWE) is the instantaneous contact geometry between the cutter and the in-process workpiece during machining. It plays an important role in machining process simulation and directly affects the calculation of the predicted cutting forces and torques. The difficulty and challenge of CWE determination come from the complexity due to the changing geometry of in-process workpiece and the curved tool path of cutter movement, especially for multi-axis milling. This paper presents a new method to determine the CWE for general milling processes. To fulfill the requirement of generality, which means for any cutter type, any in-process workpiece shape, and any tool path even with self-intersections, all the associated geometries are to be modeled as triangle meshes. The involved triangle-to-triangle intersection calculations are carried out by an effective method in order to realize the multiple subtraction Boolean operations between the tool and the workpiece mesh models and to determine the CWE. The presented method has been validated by a series of case studies of increasing machining complexity to demonstrate its applicability to general milling processes.

Highlights A new method to determine cutter-workpiece engagement geometry in milling. Applicable to general milling processes: all cutter types, in-process workpiece shapes and tool paths containing even self-intersections. Results validated by a series of case studies of increasing machining complexity.
El proceso de la evaluación formativa desde el modelo Weisbord en educación médica
Authors: González Castillo Diana Elena , Varela Ruiz Margarita , Fortoul van der Goes Teresa Imelda
Published: December 2015

Introducción: Las organizaciones son sistemas abiertos con dinámicas particulares respecto a las tareas y funciones a lograr, determinadas por los objetivos de la estructura. En este sentido, es preciso realizar un diagnóstico organizacional con el propósito de determinar las áreas de oportunidad cuando la organización educativa (Facultad de Medicina de la UNAM) establece una nueva estrategia para el cumplimiento de sus objetivos institucionales, en este caso a través de la implementación de la evaluación formativa.
Objetivo: Realizar un diagnóstico organizacional a través del modelo Weisbord, que consiste en el análisis de 6 categorías de la organización.
Método: Se utilizó el método cualitativo para comprender los fenómenos sociales desde la perspectiva del involucrado, con un cuestionario de respuesta abierta para explorar las diferentes etapas del proceso de evaluación. Se complementó con 3 grupos focales y 12 entrevistas hasta alcanzar el punto de saturación. La categorización y la codificación de los resultados se realizó de acuerdo con el árbol de categorías previamente estructurado y el análisis fue sustentado en el modelo Weisbord.
Resultados: El resultado diagnóstico se centró en las cuestiones internas de la organización y planteó principalmente las preguntas relacionadas con el ajuste entre lo que es y lo que debería ser en las 6 categorías del modelo Weisbord  propósito, estructura, relaciones, recompensas, liderazgo y mecanismos útiles).
Conclusiones: El uso coherente de la evaluación formativa en el sistema puede ayudar a los involucrados a enfrentar los obstáculos que se presentan para desempeñar su práctica profesional de una forma más amplia en el campo clínico y en las aulas.
Synergistic killing of human small cell lung cancer cells by the Bcl-2-inositol 1,4,5-trisphosphate receptor disruptor BIRD-2 and the BH3-mimetic ABT-263
Authors: Greenberg E F , McColl K S , Zhong F , Wildey G , Dowlati A , Distelhorst C W
Published: December 2015

Small cell lung cancer (SCLC) has an annual mortality approaching that of breast and prostate cancer. Although sensitive to initial chemotherapy, SCLC rapidly develops resistance, leading to less effective second-line therapies. SCLC cells often overexpress Bcl-2, which protects cells from apoptosis both by sequestering pro-apoptotic family members and by modulating inositol 1,4,5-trisphosphate receptor (IP3R)-mediated calcium signaling. BH3-mimetic agents such as ABT-263 disrupt the former activity but have limited activity in SCLC patients. Here we report for the first time that Bcl-2-IP3 receptor disruptor-2 (BIRD-2), a decoy peptide that binds to the BH4 domain of Bcl-2 and prevents Bcl-2 interaction with IP3Rs, induces cell death in a wide range of SCLC lines, including ABT-263-resistant lines. BIRD-2-induced death of SCLC cells appears to be a form of caspase-independent apoptosis mediated by calpain activation. By targeting different regions of the Bcl-2 protein and different mechanisms of action, BIRD-2 and ABT-263 induce cell death synergistically. Based on these findings, we propose that targeting the Bcl-2–IP3R interaction be pursued as a novel therapeutic strategy for SCLC, either by developing BIRD-2 itself as a therapeutic agent or by developing small-molecule inhibitors that mimic BIRD-2.
Targeting RING domains of Mdm2–MdmX E3 complex activates apoptotic arm of the p53 pathway in leukemia/lymphoma cells
Authors: Wu W , Xu C , Ling X , Fan C , Buckley B P , Chernov M V , Ellis L , Li F , Muñoz I G , Wang X
Published: December 2015

Reactivation of tumor-suppressor p53 for targeted cancer therapy is an attractive strategy for cancers bearing wild-type (WT) p53. Targeting the Mdm2–p53 interface or MdmX ((MDM4), mouse double minute 4)–p53 interface or both has been a focus in the field. However, targeting the E3 ligase activity of Mdm2–MdmX really interesting new gene (RING)–RING interaction as a novel anticancer strategy has never been explored. In this report, we describe the identification and characterization of small molecule inhibitors targeting Mdm2–MdmX RING–RING interaction as a new class of E3 ligase inhibitors. With a fluorescence resonance energy transfer-based E3 activity assay in high-throughput screening of a chemical library, we identified inhibitors (designated as MMRis (Mdm2–MdmX RING domain inhibitors)) that specifically inhibit Mdm2–MdmX E3 ligase activity toward Mdm2 and p53 substrates. MMRi6 and its analog MMRi64 are capable of disrupting Mdm2–MdmX interactions in vitro and activating p53 in cells. In leukemia cells, MMRi64 potently induces downregulation of Mdm2 and MdmX. In contrast to Nutlin3a, MMRi64 only induces the expression of pro-apoptotic gene PUMA (p53 upregulated modulator of apoptosis) with minimal induction of growth-arresting gene p21. Consequently, MMRi64 selectively induces the apoptotic arm of the p53 pathway in leukemia/lymphoma cells. Owing to the distinct mechanisms of action of MMRi64 and Nutlin3a, their combination synergistically induces p53 and apoptosis. Taken together, this study reveals that Mdm2–MdmX has a critical role in apoptotic response of the p53 pathway and MMRi64 may serve as a new pharmacological tool for p53 studies and a platform for cancer drug development.