bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of Early and Delayed Open Reduction and Internal Fixation for Treating Closed Tibial Pilon Fractures
Authors: Tang Xin , Liu Lei , Tu Chong-qi , Li Jian , Li Qi , Pei Fu-xing
Published: May 2014

Background:

The timing of surgery for osteosynthesis of type C pilon (AO/OTA) fractures remains controversial. The aim of this study was to determine the outcome of early and delayed open reduction and internal fixation (ORIF) for treating closed type C pilon fractures.

Methods:

Forty-six patients with closed type C pilon fractures matched according to age, gender, soft tissue conditions, and fracture pattern were divided into group A (early group: underwent surgery within 36 hours of the injury) or group B (delayed group: underwent surgery 10 days to 3 weeks postinjury after the soft tissue swelling subsided). In the delayed group, 9 patients were treated first by temporary external fixation. All the closed fractures were managed by ORIF with locking plates. At follow-up, the clinical and radiographic results were retrospectively analyzed. The mean follow-up time was 25.8 months (range, 14 to 48 months) in group A and 26.0 months (range, 15 to 44 months) in group B.

Results:

There was no significant difference ( P > .05) between the 2 groups regarding the rate of soft tissue complication, the rate of fracture union, and the final functional score. The patients in group A had a significantly shorter mean time to fracture union (21.5 ± 4.0 weeks vs 23.3 ± 3.7 weeks, P < .05), operating time (84.3 ± 12.1 months vs 100.6 ± 13.7 months, P < .01), and hospital stay (7.6 ± 2.6 days vs 15.2 ± 4.2 days, P < .01).

Conclusion:

If soft tissue conditions are acceptable, early ORIF for treating closed type C pilon fractures can be safe and effective, with similar rates of wound complication, fracture union, and final good functional recovery but shorter operative time, union time, and hospital stay. These results favorably compare with delayed ORIF treatment.

Level of Evidence:

Level III, retrospective comparative study.
Free vibration analysis of doubly curved shallow shells reinforced by any number of beams with arbitrary lengths
Authors: Jiang Shiliang , Li Wen L , Yang Tiejun , Du Jingtao
Published: May 2014

This study focuses on the free linear vibrations of doubly curved shallow shells reinforced by any number of beams of arbitrary lengths. Distributed elastic restraints are used to specify generally the boundary conditions along the shell edges and the coupling conditions between the shell and its reinforcing beams. Both the shell and stiffening beams are considered as independent structural components carrying three-dimensional displacement fields. Each of the displacements is invariably expressed as a simple trigonometric series with accelerated and uniform convergence over the solution domains of interest. All the unknown expansion coefficients are treated as the generalized coordinates and solved using the Rayleigh-Ritz technique. As illustrated by examples, the current method provides a unified means for solving a wide range of shell problems involving various practical complications with respect to, for example, the boundary conditions, the coupling conditions, the number of stiffeners, and the lengths and locations of the stiffeners.
A new method of updating mass and stiffness matrices simultaneously with no spillover
Authors: Yang Jun , Ouyang Huajiang , Zhang Jia-Fan
Published: May 2014

A method for updating mass and stiffness matrices without spillover is presented, which requires the knowledge of only the few eigenpairs to be updated of the original undamped model. The finite element model updating problem with symmetric preserving and no spillover is formulated as a semi-definite programming problem, which can be efficiently solved by existing semi-definite programming algorithms. Numerical examples show that, using the presented updating method, the updated model accurately reproduces the “measured” modal data, while keeping the symmetry of mass and stiffness matrices and avoiding spillover.
New data identify an increasing sex ratio of multiple sclerosis in Sweden
Authors: Westerlind Helga , Boström Inger , Stawiarz Leszek , Landtblom Anne-Marie , Almqvist Catarina , Hillert Jan
Published: May 2014

Background:

An increasing women-to-men ratio in later birth cohorts of patients with multiple sclerosis (MS) has been observed in several populations and has been hypothesised to be due to one or several environmental factors of importance for disease aetiology. However, in a study based on data from the Swedish MS registry (SMSreg) this ratio was recently reported to be rather stable during the 20th century.

Objective:

The purpose of this study was to reinvestigate the women-to-men ratio in Sweden based on data from all available data sources, including deceased patients.

Method:

We combined data from the SMSreg with data from national patient registers.

Results:

In total we obtained information on 19,510 MS patients born 1931–1985, 13,321 women and 6189 men. The women-to-men ratio increased from 1.70 for patients born in the 1930s to 2.67 for patients born in the 1980s. When comparing the coverage of SMSreg to the full data set, a significantly higher proportion of women born 1931–1935 compared to men born in the same period were found in SMSreg, resulting in a sampling bias hiding the increasing sex ratio in the full material.

Conclusion:

The women-to-men ratio in MS has increased in Sweden during the 20th century similarly to observations in other western countries.
Characterizing cognitive function during relapse in multiple sclerosis
Authors: Benedict Ralph HB , Morrow Sarah , Rodgers Jonathan , Hojnacki David , Bucello Margaret A , Zivadinov Robert , Weinstock-Guttman Bianca
Published: May 2014

Objective:

To characterize neuropsychological (NP) test performance during multiple sclerosis (MS) relapse and recovery.

Methods:

Clinical status was assessed with NP testing and Expanded Disability Status Scale (EDSS) in 24 relapsing patients, and 24 individually-matched, stable controls. All presented with cognitive symptoms as indicated by patient, clinician or caregiver perceived decline, but were free of optic neuritis, ataxia and upper extremity weakness that could compromise NP testing. The presence of enhancing magnetic resonance imaging (MRI) lesions was considered confirmatory of relapse. Relapsing patients were treated with corticosteroids. NP testing and EDSS were compared to pre-relapse baseline levels, and three-month, post-relapse, follow-up.

Results:

Analyses revealed significant decline on the Symbol Digit Modalities Test (SDMT) ( p=0.005) and worsening on EDSS ( p=0.019). Impairment was observed at the point of relapse in cases but not controls. The groups were no longer different at three-month follow-up. The increment of decline on SDMT was 3.5 raw score points, or roughly 6%.

Conclusions:

This is the first study to assess NP status changes during MS relapse using well established, reliable metrics. The presence of a clinically meaningful event is substantiated by decline in NP testing, observed or reported cognitive change, and in a subset of patients, gadolinium-enhancing MRI lesions.
Deficiency of CD8+ effector memory T cells is an early and persistent feature of multiple sclerosis
Authors: Pender Michael P , Csurhes Peter A , Pfluger Casey MM , Burrows Scott R
Published: May 2014

Background:

Patients with multiple sclerosis (MS) have a deficiency of circulating CD8+ T cells, which might impair control of Epstein–Barr virus (EBV) and predispose to MS by allowing EBV-infected autoreactive B cells to accumulate in the central nervous system. Based on the expression of CD45RA and CD62L, CD4+ T cells and CD8+ T cells can be subdivided into four subsets with distinct homing and functional properties, namely: naïve, central memory, effector memory (EM) and effector memory re-expressing CD45RA (EMRA) cells.

Objective:

Our aim was to determine which memory subsets are involved in the CD8+ T cell deficiency and how these relate to clinical course.

Methods:

We used flow cytometry to analyze the memory phenotypes of T cells in the blood of 118 MS patients and 112 healthy subjects.

Results:

MS patients had a decreased frequency of EM (CD45RA–CD62L–) and EMRA (CD45RA+CD62L–) CD8+ T cells, which was present at the onset of disease and persisted throughout the clinical course. The frequencies of CD4+ EM and EMRA T cells were normal.

Conclusion:

Deficiency of effector memory CD8+ T cells is an early and persistent feature of MS and might underlie the impaired CD8+ T cell control of EBV.
Global democracy and the democratic minimum: Why a procedural account alone is insufficient
Authors: Dingwerth Klaus
Published: May 2014

In this critical comment on the global democracy debate, I take stock of contemporary proposals for democratizing global governance. In the first part of the article, I show that, empirically, many international institutions are now evaluated in terms of their democratic credentials. At the same time, the notions of democracy that underpin such evaluations are often very formalistic. They focus on granting access to civil society organizations, making policy-relevant documents available online or establishing global parliamentary assemblies to give citizens a voice in the decision-making of international organizations. In the second part, I challenge this focus on formal procedures and argue that a normatively persuasive conception of global democracy would shift our focus to areas such as health, education and subsistence. Contrary to much contemporary thinking about global democracy, I thus defend the view that the institutions we have are sufficiently democratic. What is needed are not better procedures, but investments that help the weaker members of global society to make effective use of the democracy-relevant institutions that exist in contemporary international politics.
Mental health disability discrimination
Authors: Lockwood Graeme , Henderson Claire , Thornicroft Graham
Published: May 2014

This article analyses data collected on mental health discrimination (MHD) litigation in Britain between 2005 and 2012. The data on MHD litigation are presented by an examination of the following: population of cases reaching the Employment Appeal Tribunal and the additional (to MHD) claims brought in the cases, findings relating to the characteristics of the claimant and respondent and the workplace and organizational context from which the legal action arises, the forms of the MHD being claimed and key legal issues arising from the analysis of case law. Results suggest that a substantial gap between law, policy and practice remains and that organizations are not being proactive enough in preventing and tackling the issue of MHD arising in the workplace.
Perpetuating Traveller children’s educational disadvantage in Ireland
Authors: Smith Olivia
Published: May 2014

The impact of ‘subtle’ admission policies utilized by many secondary schools in Ireland on children from minority groups has been recently flagged as problematic by the Irish Department of Education. A new regulatory framework has been promised to address this issue but has yet to emerge. In the meantime, such policies, which include preferential parental legacy rules, certainly trigger the reconfigured principle of indirect discrimination in the access to and enjoyment of goods and services under the Equal Status Acts 2000–2012, which transpose a number of EU Equality Directives. This article considers the approaches taken to the demonstration of how suspect policies give rise to ‘particular disadvantage’ for protected groups in light of the shift away from the mandatory use of statistical evidence in the context of a discussion of a recent High Court case, Stokes v. Christian Brothers High School. This decision concerned the impact of a parental legacy rule on a child from Ireland’s Traveller community, a community that has a long and virulent history of educational (and other forms of) disadvantage. In response to the limited understanding of indirect discrimination taken in the High Court (which pivoted on the Oxford English Dictionary), which significantly undermines the principle’s ability to tackle structural inequalities, I go on to demonstrate how use of both the ‘social facts’ approach and a statistical approximation of the impact of the policy on the complainant’s group reveals ‘particular disadvantage’ in the use of legacy rules on Traveller children, children of migrants and children raised in non-traditional families.
Parental perceptions of child vulnerability in a community-based sample
Authors: Houtzager Bregje A , Möller Eline L , Maurice-Stam Heleen , Last Bob F , Grootenhuis Martha A
Published: May 2014

The study aimed to assess the prevalence of parental perceptions of a child’s vulnerability (PPCV) in a Dutch community-based sample and its relationship with children’s health and health-related quality of life (HRQoL). Parents completed the Child Vulnerability Scale and a socio-demographic questionnaire. The Pediatric Quality of Life Inventory 4.0 was administered to measure HRQoL. The prevalence of PPCV was assessed in relation to socio-demographic and health-related characteristics. In a three-step multiple hierarchical regression model, the mediational role of PPCV in the association between chronic illness and HRQoL was investigated. Participants were 520 Dutch children aged 5–18 years from nine Dutch schools. In all, 69 (13.3%) had a chronic illness; 1.9% was perceived vulnerable, 3.0% in groups 5–7 and 1.7% in groups 8–12 and 13–18. Younger age of the child, presence of a chronic illness and low HRQoL were associated with PPCV. PPCV partially mediated the negative association between chronic illness and HRQoL. In conclusion, PPCV is associated with adjustment to chronic illness. More research is needed regarding the mechanisms through which PPCV affects HRQoL and to examine whether PPCV can be targeted in parenting interventions.
Ensuring a political space for conflict by applying Chantal Mouffe to post-war reconstruction and development
Authors: Jones Briony
Published: May 2014

Post-war reconstruction and development are no longer viewed as separate conceptual or practical domains. This evolving concept is underpinned by a series of assumptions that assert the necessary links between democratization, economic reform and sustainable peace. This article builds on critiques of these assumptions by applying Chantal Mouffe’s political philosophy. In particular, the article will focus on democratization and the way in which Mouffe’s theoretical work leads us to consider a broader space for politics, the constructive role of conflict and the possibility of a more nuanced approach to the nature of post-war societies and processes of sustainable peace.
Historicizing the state in development theory: Michael Mann’s model of social power
Authors: Hawkins Jessica R.
Published: May 2014

Michael Mann seeks to explain the nature of power and its effects on the development of the state. His work has had a considerable impact within the field of macro-historical sociology, but has primarily been applied to Western case studies. This article builds upon an emerging literature that considers the expediency of using this lens to examine developing countries. It analyzes how the framework of social power can be used to provide a historical analysis of the reach, origins and effects of state power within developing countries. Through a consideration of Mann’s historiography, the article demonstrates the value of his social power framework for development theory.
It’s Not Over ‘til the Fat Lady Sings
Authors: Driskill Robert , Vrooman John
Published: May 2014

There have been major disputes about the appropriate game-theoretic analyses of sports leagues. The basic sports-league model assumes a two-team league where each team is seen as a monopolist in its product market and a passive price taker in a duopsony talent market. For simplicity, these models assume talent supply is either perfectly inelastic or perfectly elastic. It has been argued that perfectly inelastic supply is ill suited for duopsony analysis. This article solves the problem of multiple equilibria by proposing a selection criterion that finds a unique equilibrium in a duopsony limit game as talent supply approaches perfect inelasticity.
The National Hockey League and Cross-Border Fandom
Authors: Mills Brian M. , Rosentraub Mark S.
Published: May 2014

This article uses daily border-crossing data within the Niagara region of Ontario and New York to evaluate the Canadian market for a U.S.-based National Hockey League (NHL) team, the Buffalo Sabres. We conservatively estimate that 15% of attendees at Buffalo Sabres home games travel from Canada. This effect is heterogeneous with respect to the opponent country of origin, with higher levels of game day border crossing associated with a Canadian visiting team. We also find fan substitution effects between Buffalo and the Toronto Maple Leafs with respect to both the price of attendance and the quality of each team. Implications extend to NHL expansion near international borders and compensation to incumbent teams both within and across the national border near where an expansion or relocated team is placed.
Testing Judicial Power
Authors: Hall Matthew E. K.
Published: May 2014

The U.S. Supreme Court is traditionally thought to hold little influence over social or political change; however, recent evidence suggests the Court may wield significant power, especially with regard to criminal justice. Most studies evaluate judicial power by examining the effects of individual rulings on the implementation of specific policies, but this approach may overlook the broader impact of courts on society. Instead, I adopt an aggregate approach to test U.S. Supreme Court power. I find that aggregate conservative decision making by the Court is positively associated with long-term shifts in new admissions to U.S. federal prisons. These results suggest the Court possesses significant power to influence important social outcomes, at least in the context of the criminal justice system.
Open Access
Authors: Cirasella Jill
Published: May 2014

Librarian Jill Cirasella describes some problems with the traditional system of scholarly journal publishing and explains how scholars can make their works open access, or freely available online. She discusses some of the benefits of open access, as well as some of the challenges to achieving widespread openness.
Working Class Growing Pains
Authors: Silva Jennifer M.
Published: May 2014

Sociologist Jennifer M. Silva examines how working-class men and women navigate the transition to adulthood amid economic insecurity and social isolation. She finds that young adults experience fear of intimate relationships, low expectations of work, and widespread distrust of institutions as they come of age.
What Does Sustainability Mean? Knowledge Gleaned From Applying Mixed Methods Research to Wine Grape Growing
Authors: Santiago-Brown Irina , Jerram Cate , Metcalfe Andrew , Collins Cassandra
Published: May 2014

We present outcomes from a mixed methods research project in agricultural sciences. An atypical methodology for sciences was developed as the only way to avoid embedded assumptions commonly seen in sustainability investigations. Eighty-three upper echelon participants from the wine grape industry participated in 14 focus groups in five countries: Australia, Chile, New Zealand, South Africa, and the United States. Quantitative measures were compared with results from qualitatively coded participant utterances using two content analysis software tools: Leximancer and NVivo. This article presents the strategies and method applied in this investigation to define sustainability. A consensual sustainability definition prior to the establishment of assessment systems is essential. The model developed seems to be viable for similar sustainability investigations of individual organizations.
Cartilage Repair With Autologous Bone Marrow Mesenchymal Stem Cell Transplantation
Authors: Yamasaki Shinya , Mera Hisashi , Itokazu Maki , Hashimoto Yusuke , Wakitani Shigeyuki
Published: May 2014

Clinical trials of various procedures, including bone marrow stimulation, mosaicplasty, and autologous chondrocyte implantation, have been explored to treat articular cartilage defects. However, all of them have some demerits. We focused on autologous culture-expanded bone marrow mesenchymal stem cells (BMSC), which can proliferate without losing their capacity for differentiation. First, we transplanted BMSC into the defective articular cartilage of rabbit and succeeded in regenerating osteochondral tissue. We then applied this transplantation in humans. Our previous reports showed that treatment with BMSC relieves the clinical symptoms of chondral defects in the knee and elbow joint. We investigated the efficacy of BMSC for osteoarthritic knee treated with high tibial osteotomy, by comparing 12 BMSC-transplanted patients with 12 cell-free patients. At 16-month follow-up, although the difference in clinical improvement between both groups was not significant, the arthroscopic and histological grading score was better in the cell-transplanted group. At the over 10-year follow-up, Hospital for Special Surgery knee scores improved to 76 and 73 in the BMSC-transplanted and cell-free groups, respectively, which were better than preoperative scores. Additionally, neither tumors nor infections were observed in all patients, and in the clinical study, we have never observed hypertrophy of repaired tissue, thereby guaranteeing the clinical safety of this therapy. Although we have never observed calcification above the tidemark in rabbit model and human histologically, the repair cartilage was not completely hyaline cartilage. To elucidate the optimum conditions for cell therapy, other stem cells, culture conditions, growth factors, and gene transfection methods should be explored.
MCL: Driving Expansion Through Mergers and Acquisitions
Authors: Kayoma Irene , Adeleye Ifedapo
Published: May 2014

Abisola Aworinde, executive director of May Clinics Ltd. (MCL) had initiated several programmes to transform the healthcare institution and position it as a leading healthcare organization in Lagos, Nigeria. One of the major challenges he and the MCL management team faced was how best to drive the expansion of the hospital, with an ambitious goal to increase the number of hospitals they operated from two to fifteen within three years. They opted for mergers and acquisitions, using a hub and spoke model, but faced several challenges as they sought to complete their first acquisition deal. Aworinde must now decide which of the two deals being considered should be prioritized, ensuring that decisions met not only the investment criteria and strategic objectives of his institution, but also those of the target institutions.
Foundations and Principles of the Canadian Living Donor Paired Exchange Program
Authors: Malik Shafi , Cole Edward
Published: May 2014

Purpose of review:

Kidney paired donation (KPD) remains an important strategy to facilitate transplantation in patients who have a healthy and willing donor, but are unable to proceed with directed donation due to either ABO incompatibility or a positive cross-match against their intended donor.

Sources of information:

Personal knowledge, The Canadian Blood Services Database for Living Donor Exchange, published reports and personal communications.

Findings:

The national Living Donor Paired Exchange Programme (LDPE) in Canada was established in 2009. 235 transplants were completed of which 190 were registered recipients and 45 were from the deceased donor (DD) wait list. At 1 year, patient survival was 100%, graft survival 98%, with a biopsy proven acute rejection rate of 8%. The mean serum creatinine (Cr) at the end of one year was 109 mmol/l. Donor survival is 100%. Key to success are national standards for antibody testing and cross-matching, and for evaluating donors and recipients, as well infrastructure (software and personnel) to run the program. The structure of the Canadian program is compared with that of other programs in the United Kingdom, Australia, the Netherlands, and the United States.

Limitations:

This review does not include information on travel distances and difficulties, or patient satisfaction.

Implications:

National collaboration and acceptance of common standards is possible and leads to substantial benefits, especially for those patients who are hardest to match. What was known before: Kidney paired donation is considered ethically acceptable. National and regional programs have been created in a number of countries. What this paper adds: Key to the success of the Canadian national program are acceptance of standardized procedures and national and provincial support and oversight.
Multivariate statistical models of metabolomic data reveals different metabolite distribution patterns in isonitrosoacetophenone-elicited Nicotiana tabacum and Sorghum bicolor cells
Authors: Madala Ntakadzeni E , Piater Lizelle A , Steenkamp Paul A , Dubery Ian A
Published: May 2014

Isonitrosoacetophenone (INAP, 2-keto-2-phenyl-acetaldoxime) is a novel inducer of plant defense. Oxime functional groups are rare in natural products, but can serve as substrates depending on existing secondary pathways. Changes in the metabolomes of sorghum and tobacco cells treated with INAP were investigated and chemometric tools and multivariate statistical analysis were used to investigate the changes in metabolite distribution patterns resulting from INAP elicitation. Liquid chromatography combined with mass spectrometry (UHPLC-MS) supplied unique chemical fingerprints that were generated in response to specific metabolomic events. Principal component analysis (PCA) together with hierarchical cluster analysis (HCA) and Metabolic Trees were used for data visualization. Orthogonal projections to latent structures discriminant analysis (OPLS-DA) and shared and unique structure (SUS) plots were exploited in parallel to reveal the changes in the metabolomes. PCA indicated that the cells responded differentially to INAP through changes in the metabolite profiles. Furthermore, HCA and Metabolic Trees showed that INAP induced metabolic perturbations in both cell lines and that homeostasis was re-established over time. OPLS-DA-based shared and unique structure (SUS) plots confirmed the results and revealed differences in the metabolites distribution patterns between tobacco and sorghum cells. Chemometric analyses of metabolomic data offers insight into changes in metabolism in response to chemical elicitation. Although similar, the response in sorghum cells was found to be more consistent and well-coordinated when compared to tobacco cells, indicative of the differences in secondary metabolism between cyanogenic and non-cyanogenic plants for oxime metabolism.
Breast cancer intra-tumor heterogeneity
Authors: Martelotto Luciano G , Ng Charlotte KY , Piscuoglio Salvatore , Weigelt Britta , Reis-Filho Jorge S
Published: May 2014

In recent years it has become clear that cancer cells within a single tumor can display striking morphological, genetic and behavioral variability. Burgeoning genetic, epigenetic and phenomenological data support the existence of intra-tumor genetic heterogeneity in breast cancers; however, its basis is yet to be fully defined. Two of the most widely evoked concepts to explain the origin of heterogeneity within tumors are the cancer stem cell hypothesis and the clonal evolution model. Although the cancer stem cell model appeared to provide an explanation for the variability among the neoplastic cells within a given cancer, advances in massively parallel sequencing have provided several lines of evidence to suggest that intra-tumor genetic heterogeneity likely plays a fundamental role in the phenotypic heterogeneity observed in cancers. Many challenges remain, however, in the interpretation of the next generation sequencing results obtained so far. Here we review the models that explain tumor heterogeneity, the causes of intra-tumor genetic diversity and their impact on our understanding and management of breast cancer, methods to study intra-tumor heterogeneity and the assessment of intra-tumor genetic heterogeneity in the clinic.
Efficacy and adverse events of high-frequency oscillatory ventilation in adult patients with acute respiratory distress syndrome: a meta-analysis
Authors: Huang Chun-Ta , Lin Hsien-Ho , Ruan Sheng-Yuan , Lee Meng-Sui , Tsai Yi-Ju , Yu Chong-Jen
Published: May 2014

Introduction

Theoretically, high-frequency oscillatory ventilation (HFOV) achieves all goals of a lung-protective ventilatory mode and seems ideal for the treatment of adult patients with acute respiratory distress syndrome (ARDS). However, its effects on mortality and adverse clinical outcomes remain uncertain given the paucity of high-quality studies in this area. This meta-analysis was performed to evaluate the efficacy and adverse events of HFOV in adults with ARDS.

Methods

We searched PubMed, EMBASE and Cochrane Central Register of Controlled Trials through February 2014 to retrieve randomized controlled trials of HFOV in adult ARDS patients. Two independent reviewers extracted data on study methods, clinical and physiological outcomes and adverse events. The primary outcome was 30-day or hospital mortality. Risk of bias was evaluated with the Cochrane Collaboration’s tool. Mortality, oxygenation and adverse effects of HFOV were compared to those of conventional mechanical ventilation. A random-effects model was applied for meta-analysis.

Results

A total of five trials randomly assigning 1,580 patients met inclusion criteria. Pooled data showed that HFOV significantly improved oxygenation on day one of therapy (four studies; 24% higher; 95% confidence interval (CI) 11 to 40%; P <0.01). However, HFOV did not reduce mortality risk (five studies; risk ratio (RR) 1.04; 95% CI 0.83 to 1.31; P = 0.71) and two early terminated studies suggested a harmful effect of HFOV in ARDS (two studies; RR 1.33; 95% CI 1.09 to 1.62; P <0.01). Safety profiles showed that HFOV was associated with a trend toward increased risk of barotrauma (five studies; RR 1.19; 95% CI 0.83 to 1.72; P = 0.34) and unfavorable hemodynamics (five studies; RR 1.16; 95% CI 0.97 to 1.39; P = 0.12).

Conclusions

HFOV improved oxygenation in adult patients with ARDS; however, it did not confer a survival benefit and might cause harm in the era of lung-protective ventilation strategy. The evidence suggests that HFOV should not be a routine practice in ARDS and further studies specifically selecting patients for this ventilator mode should be pursued.
CSEM-driven exploration over the Nordland Ridge
Authors: Stefatos Aristofanis , Vereshagin Alexander , Hesthammer Jonny , Kalstø Trond Kristian , Sperrevik Susanne , Robson Adrian
Published: May 2014

Exploration efforts in the Nordland Ridge over the past two decades have resulted in the Norne, Urd, Alve, Falk, and Linerle discoveries. Besides these discoveries, several wells have failed expectations. Exploration efforts in this area are challenging because of the large variation in the rock properties of potential Triassic to early Jurassic traps that could be filled with viscous (heavy) oil. Application of controlled-source electromagnetic (CSEM) technology to derive the electrical resistivity distribution of the subsurface was thought by some oil companies to be the key that could unlock the exploration potential in the area. However, two dry wells in 2006 (6608/11-5 “Valkyrie”) and 2011 (6608/11-7s “Phoenix”) drew negative attention to CSEM within the exploration community because CSEM data were available in both cases prior to drilling. The wells targeted Jurassic Åre sands very close to the existing Linerle discovery with heavy oil in reservoir-quality Åre sandstones. The first well encountered less than 5 m of hydrocarbon traces in the Åre sands, while the second well was dry with a poorer-than-expected reservoir at target depth. This work examines the quality and reliability of the most recently acquired 3D CSEM survey. Previous interpretations are discussed in light of the 3D data and the latest drilling results. The CSEM-derived distribution of resistivity in the subsurface is in good agreement with all well log data proving that CSEM provides reliable information that can be used for interpretation and decision making. A strong and localized resistivity anomaly remains untested, although the last two wells drilled very close to it. Two interpretations were evaluated to explain the measured resistivity. The first inferred the presence of a localized sabkha evaporite in the late Carnian, while the second suggested the presence of a hydrocarbon-filled reservoir in erosional products near the base Cretaceous unconformity.
Marine controlled-source electromagnetic methods in the hydrocarbon industry: A tutorial on method and practice
Authors: MacGregor Lucy , Tomlinson James
Published: May 2014

We provide a tutorial on the marine controlled-source electromagnetic (CSEM) method aimed at geoscientists and explorationists who are new to EM methods. This tutorial highlights some of the issues to be considered in planning and executing a CSEM survey, and interpreting the results. CSEM methods can add valuable information on the resistivity structure of the subsurface, which complements measurements obtained from seismic or other geophysical methods. We also discuss the development of the method and provide an overview of the CSEM acquisition approaches applied today. Understanding the sensitivity of the CSEM method to seafloor resistivity structures is key to ensuring a successful survey. We illustrate this with simple examples, demonstrating the effect of reservoir and overburden properties and the effect of electrical anisotropy. It is also important to understand how well a given resistivity structure can be recovered from realistic survey data. We apply an inversion approach to illustrate this for 2D resistivity structures. Finally, we discuss the importance of interpreting CSEM in an integrated framework alongside seismic and well log data.
CSEM as a tool for better exploration decisions: Case studies from the Barents Sea, Norwegian Continental Shelf
Authors: Fanavoll Stein , Gabrielsen Pål T. , Ellingsrud Svein
Published: May 2014

After more than 30 years of exploration and more than 100 wells drilled in the Barents Sea, only one field is in production and one is under development. However, recent discoveries made over the last three years have heightened the interest for exploration in the region. Nevertheless, the industry is still facing major challenges in finding commercial volumes of hydrocarbons, despite the fact that numerous wells have encountered shows or minor amounts of gas and oil, proving a working hydrocarbon system in large parts of the area. Since 2008, 3D controlled-source electromagnetic (CSEM) data have been acquired in the Barents Sea, providing additional geophysical information in the last three licensing rounds. In this paper, we showed how CSEM data can help the industry make better decisions in various stages of exploration. CSEM data, being sensitive to hydrocarbon saturation and volume, have the potential to reduce the risk of exploration failures of a prospect by influencing the chance of success and the expected size and volume. To illustrate this, we showed three case examples. (1) How CSEM can support certain play models, and hence, give valuable information in a license application phase as well as in drilling decisions. (2) How CSEM can support decisions to apply or not apply for certain blocks in a licensing round. (3) How CSEM can help prospect ranking and drill-or-drop decisions. All these three cases demonstrate the power of using CSEM as a complementary tool together with seismic data and other geologic information. This paper argues that CSEM data could have provided a correct prediction for all of the wells drilled in the Barents Sea where 3D CSEM data are available, provided there are sufficient sensitivity and 3D inversion results. This in turn proves the value of acquiring CSEM data in addition to seismic.
Assessment of real-time traffic performance
Authors: So A TP , Suen W SM
Published: May 2014

The operation of lifts is highly complicated and dynamic. Researchers have been searching for minimum and key parameters to describe and then assess the realtime performance of a lift system. One single parameter was proposed to describe the comfort level of a lift car. For traf” c performance, statistical formulae for estimating the round trip time, interval, handling capacity, average waiting time and average journey time were proposed to describe the overall traf” c performance of a lift system. In this paper, the actual techniques, methods and procedures to arrive at two key parameters, namely the average journey time which is equal to the sum of average waiting time and average travel time, and the average electrical power per passenger, are proposed and discussed in detail. The application of these two parameters to a hall-call-allocation system, Miconic-10 of Schindler, in Hong Kong was carried out and discussed.
The performance characteristics of multi-outlet siphonic roof drainage systems
Authors: Wright G B , Swaffleld J A , Arthur S
Published: May 2014

Siphonic roof drainage systems have been in existence for approximately 30 years, and are becoming an increasingly common element of urban drainage infrastructure. In that time, the construction sectorin most developed countries have been gradually persuaded of the benefits that these systems offer when compared to conventional roof drainage technologies. The work reported herein details anongoing UK government-funded research programme to investigate the performance characteristics of multi-outlet siphonic roof drainage systems. The experimental aims, apparatus and procedures are described, and results are illustrated. In addition, ‘real’ data obtained from three installed siphonic roof drainage systems are discussed. Conclusions are drawn regarding the performance characteristics of multi-outlet systems, and plans for future work are outlined.
Ventilation performance for spaces where smoking is permitted: a review of previous work and field study results
Authors: Geens A J , Snelson D G , Littlewood J R , Ryan J
Published: May 2014

This paper reviews previous studies and reports on the first stage of a series of field studies developed with the aim of assessing the performance of ventilation systems currently in use in public houses where smoking is permitted. Established ventilation theory is used to hypothesize the behaviour of these systems predicting that exposure to environmental tobacco smoke will be substantially reduced. The problems associated with conducting field studies in buildings of this nature are discussed, and the results of some representative studies are presented. The effectiveness of the ventilation systems is clearly demonstrated. Limitations of the study are identified and further work is proposed. Practical application: This paper informs the current debate on the value of ventilation systems in spaces where smoking is permitted. Despite the proposed ban on smoking in public places in England and the ban in Scotland there will be a variety of exemptions where the building is also someone's place of residence. Internationally, alternatives to a ban including the better use of ventilation systems are under consideration. In addition to making the case for the use of ventilation, the paper provides some interesting pointers on innovative supply strategies for this application.
A method of assessing the acceptability of noise levels in air-conditioned offices
Authors: Mui K W , Wong L T
Published: May 2014

This study examined the acceptable noise level in an office environment by interviewing 422 occupants about the aural environment being perceived in 61 air-conditioned offices in Hong Kong. The survey samples covered different types of building and prevalent mechanical air supply system. In particular, the measured equivalent continuous noise level Leq in the offices was chosen as an indicator and correlated with the subjective responses from occupants on a visual analogue assessment scale and a dichotomous assessment scale. The results showed that this acceptability was significantly influenced by the office noise level and it would be correlated with a logistic regression model. A satisfaction criterion of the noise level could be evaluated from the frequency distribution of the occupants’ response at certain Leq. In addition, the proposed satisfaction criterion of aural comfort in current design practice was confirmed by the survey samples: an indoor environment with an equivalent continuous noise level Leq of 57.5 dBA would be adopted as a design criterion for some offices. Practical application: The neutral criterion for aural comfort indicated by the equivalent continuous noise level Leq in air-conditioned offices was determined within the range of 45-70 dBA and the ‘optimum’ noise level La/57.5 dBA to be maintained in an office was determined from the survey. This study provides a template for applying a statistical frequency analysis and logistic regression model to examine the ‘optimum’ criteria for aural environment indicated by equivalent continuous noise level Leq in air-conditioned offices elsewhere.
A quantitative evaluation method for rainwater use guideline
Authors: Cheng C L , Liao M C , Lee M C
Published: May 2014

Rainwater use as a supplement to the potable water supply has been demonstrated as a practical and promising alternative solution for water shortage. This paper aims to develop a practical evaluation program for water conservation, in particular, a rainwater use system for architectural planning. The proposed system involves a quantitative methodology to evaluate and improve the decision making for rainwater use systems in building design. Furthermore, a simplified scheme is proposed using daily rainfall probability to provide a new guideline for water conservation evaluation procedures and link to the National Building Code in Taiwan. The practical evaluation method could also be of benefit to the comprehensive applications in other countries.

Practical application: This article relates to the practice of professionals in building water supply, sanitation and water conservation areas. The paper introduces a practical evaluation program for rainwater harvesting systems for domestic water-use, which can link to the national building code as a new guideline. The importance of utility performance will be stressed and a method that allows reliable verification for general building categories has been presented. The proposed method has been adopted within the evaluation manual for the Taiwan Green Buildings Level System.
Randomized Phase III Trial of Erlotinib Versus Docetaxel As Second- or Third-Line Therapy in Patients With Advanced Non–Small-Cell Lung Cancer: Docetaxel and Erlotinib Lung Cancer Trial (DELTA)
Authors: Kawaguchi Tomoya , Ando Masahiko , Asami Kazuhiro , Okano Yoshio , Fukuda Masaaki , Nakagawa Hideyuki , Ibata Hidenori , Kozuki Toshiyuki , Endo Takeo , Tamura Atsuhisa , Kamimura Mitsuhiro , Sakamoto Kazuhiro , Yoshimi Michihiro , Soejima Yoshifumi , Tomizawa Yoshio , Isa Shun-ichi , Takada Minoru , Saka Hideo , Kubo Akihito
Published: May 2014

Purpose

To investigate the efficacy of erlotinib versus docetaxel in previously treated patients with advanced non–small-cell lung cancer (NSCLC) in an epidermal growth factor receptor (EGFR) –unselected patient population.

Patients and Methods

The primary end point was progression-free survival (PFS). Secondary end points included overall survival (OS), response rate, safety, and analyses on EGFR wild-type tumors. Patients with stage IIIB or IV NSCLC, previous treatment with one or two chemotherapy regimens, evaluable or measurable disease, and performance status of 0 to 2 were eligible.

Results

From August 2009 to July 2012, 150 and 151 patients were randomly assigned to erlotinib (150 mg daily) and docetaxel (60 mg/m2 every 3 weeks), respectively. EGFR wild-type NSCLC was present in 109 and 90 patients in the erlotinib and docetaxel groups, respectively. Median PFS for erlotinib versus docetaxel was 2.0 v 3.2 months (hazard ratio [HR], 1.22; 95% CI, 0.97 to 1.55; P = .09), and median OS was 14.8 v 12.2 months (HR, 0.91; 95% CI, 0.68 to 1.22; P = .53), respectively. In a subset analysis of EGFR wild-type tumors, PFS for erlotinib versus docetaxel was 1.3 v 2.9 months (HR, 1.45; 95% CI, 1.09 to 1.94; P = .01), and OS was 9.0 v 10.1 months (HR, 0.98; 95% CI, 0.69 to 1.39; P = .91), respectively.

Conclusion

Erlotinib failed to show an improvement in PFS or OS compared with docetaxel in an EGFR-unselected patient population.
Cognitive Impairment in Older Patients With Breast Cancer Before Systemic Therapy: Is There an Interaction Between Cancer and Comorbidity?
Authors: Mandelblatt Jeanne S. , Stern Robert A. , Luta Gheorghe , McGuckin Meghan , Clapp Jonathan D. , Hurria Arti , Jacobsen Paul B. , Faul Leigh Anne , Isaacs Claudine , Denduluri Neelima , Gavett Brandon , Traina Tiffany A. , Johnson Patricia , Silliman Rebecca A. , Turner R. Scott , Howard Darlene , Van Meter John W. , Saykin Andrew , Ahles Tim
Published: May 2014

Purpose

To determine if older patients with breast cancer have cognitive impairment before systemic therapy.

Patients and Methods

Participants were patients with newly diagnosed nonmetastatic breast cancer and matched friend or community controls age > 60 years without prior systemic treatment, dementia, or neurologic disease. Participants completed surveys and a 55-minute battery of 17 neuropsychological tests. Biospecimens were obtained for APOE genotyping, and clinical data were abstracted. Neuropsychological test scores were standardized using control means and standard deviations (SDs) and grouped into five domain z scores. Cognitive impairment was defined as any domain z score two SDs below or ≥ two z scores 1.5 SDs below the control mean. Multivariable analyses evaluated pretreatment differences considering age, race, education, and site; comparisons between patient cases also controlled for surgery.

Results

The 164 patient cases and 182 controls had similar neuropsychological domain scores. However, among patient cases, those with stage II to III cancers had lower executive function compared with those with stage 0 to I disease, after adjustment (P = .05). The odds of impairment were significantly higher among older, nonwhite, less educated women and those with greater comorbidity, after adjustment. Patient case or control status, anxiety, depression, fatigue, and surgery were not associated with impairment. However, there was an interaction between comorbidity and patient case or control status; comorbidity was strongly associated with impairment among patient cases (adjusted odds ratio, 8.77; 95% CI, 2.06 to 37.4; P = .003) but not among controls (P = .97). Only diabetes and cardiovascular disease were associated with impairment among patient cases.

Conclusion

There were no overall differences between patients with breast cancer and controls before systemic treatment, but there may be pretreatment cognitive impairment within subgroups of patient cases with greater tumor or comorbidity burden.