bluuebunny/crossref_metadata_2025 huggingface dataset:
Gewebeversiegelung durch lokale Applikation von Gerinnungsfaktoren
Authors: Blümel G. , Stemberger A.
Published: July 2018

Die Technik der lokalen Applikation von Gerinnungsfaktoren hat in den letzten Iahren zunehmend Eingang in die Medizin gefunden. Die sog. Fibrinklebung ist aufgrund der bisherigen Erfahrungen nur zur Fixierung gering belasteter Gewebestrukturen einsetzbar. Durch die lokale Anwendung von Gerinnungsfaktoren
in Kombination mit resorbierbaren Tragern auf der Basis von Kollagen wird die Blutgerinnung beschleunigt und bei Patienten mit hereditären wie iatrogenen Blutungskomplikationen die Hamostase erleichtert. Von Vorteil ist ferner der initiale gas- und fliissigkeitsdichte Wundverschluß.

Im Gegensatz zu Cyanoacrylatklebstoff wird keine Fremdkörperreaktion ausgelöst. Vergleichbar einem intaktern Gerinnungsfaktor stimulieren die lokal applizierten Gerinnungsfaktoren Fibrinogen und Thrombin in Gegenwart eines polyvalenten Proteinaseninhibitors wie Aprotinin die Wundheilung.
Megakaryocytes and Platelets in Diabetes Mellitus
Authors: Lampeter E. , Schwippert B. , Tschöpe D.
Published: July 2018

In patients with diabetes mellitus vascular diseases and related complications still represent the main cause of death. Neuropathy, nephropathy, retinopathy and disturbed nutritive tissue perfusion result from reduced capillary microcirculation. Macroangiopathic mechanisms lead to accelerated cerebral, coronary and peripheral artery disease precipitating life terminating thrombotic events superimposed to those vascular lesions. Thus morbidity and mortality depend mainly on vascular complications. The functional thromboresistance is reduced in the diabetic state with hyperactive platelets operating by three mechanisms: 1) microembol-isation of the capillaries; 2) local progression of preexisting vascular lesions by secretion of constrictive, mitogenic and oxidative substances; 3) trigger of the prognosis limiting arterial thrombotic event. The increased functional properties of di-abetic platelets result from the primary release of larger platelets with enhanced thromboxane formation capacity and increased numbers of functional glycoprotein receptors GPIb and GPIIb-llla which are synthesized in the megakaryocytes. It could be demonstrated with the Düsseldorf III method of flowcytometric activation marker testing (CD62, CD63, thrombospondin) that predominantly large platelets circulate in an activated state even in very early (pre)diabetic stages sug-gesting that the megakaryocyte-platelet system might be systemically affected. Based on these observation a "stem cell hypothesis" is developed which suggests that bone marrow derived platelets may be systemically involved in the pathogenesis of the vascular complications and eventually of type-l diabetes. The idea of antiplatelet agents as an useful early adjunct to metabolic therapy is promoted.
Therapie von Fibrinogenmangelzuständen
Authors: Rode M. D. , Broder M. , Bonik K.
Published: July 2018

Im Rahmen einer Anwendungbeobachtung an 96 Patienten wurden die Indikationen, Dosierung, Wirksamkeit und Verträglichkeit des Fibrinogenkonzentrats Haemocomplettan HS 1 g/2g dokumentiert, ausgewertet und mit den Daten einer Zwischenauswertung (51 Patienten) verglichen. Hauptindikationen waren Fibrinogenmangelzustände bei Blutungen, Leberschäden, DIC, Hyperfibrinolysen und Leukämien. Im Mittel wurden in 3 Dosen 5,6 g Fibrinogen verabreicht; bei Leberschäden war die Dosierung meist höher als bei anderen Erkrankungen. Durch die Substitution wurde ein Fibrinogenanstieg um etwa 1,1 g/l auf 1,9 g/l erreicht. Haemocomplettan HS wurde allein oder in Kombination mit anderen Gerinnungspräparaten (AT III, PPSB, FFP, Heparin) als sehr wirksames Medikament beurteilt: Bei fast allen Patienten (97,3%) gelang eine Anhebung bzw. Normalisierung des Fibrinogenspiegels. Bei 75% aller Patienten blieb der Fibrinogenspiegel dauerhaft im Normbereich. Blutungen konnten bei 89,1% und die Grundkrankheit bei 82,1% der Fälle erfolgreich behandelt werden. Die Er-gebnisse der Zwischenauswertung wurden damit voll bestätigt.
Simple Workflow Changes Enable Effective Patient Identity Matching in Poison Control
Authors: Cummins Mollie , Ranade-Kharkar Pallavi , Johansen Cody , Bennett Heather , Gabriel Shelley , Crouch Barbara , Del Fiol Guilherme , Hoffman Matt
Published: July 2018

Background U.S. poison control centers pose a special case for patient identity matching because they collect only minimal patient identifying information.

Methods In early 2017, the Utah Poison Control Center (Utah PCC) initiated participation in regional health information exchange by sending Health Level Seven Consolidated Clinical Document Architecture (C-CDA) documents to the Utah Health Information Network and Intermountain Healthcare. To increase the documentation of patient identifiers by the Utah PCC, we (1) adapted documentation practices to enable more complete and consistent documentation, and (2) implemented staff training to improve collection of identifiers.

Results Compared with the same time period in 2016, the Utah PCC showed an increase of 27% (p < 0.001) in collection of birth date for cases referred to a health care facility, while improvements in the collection of other identifiers ranged from 0 to 8%. Automated patient identity matching was successful for 77% (100 of 130) of the C-CDAs.

Conclusion Historical processes and procedures for matching patient identities require adaptation or added functionality to adequately support the PCC use case.
Prevalence and Topography of the Peroneus tertius Muscle: a Study of Human Cadavers
Authors: Vieira A. , Monteiro A. , Nacur F. , Coutinho R. , Direito T. , Torres D.
Published: July 2018

Introduction The peroneus tertius muscle, also known as fibularis tertius, is classified as an anatomic variation and has been described as inconstant in a wide variety of contemporaneous studies and in the classical medical literature. Its fibers are sometimes mistaken for those of the extensor digitorum longus muscle. In fact, peroneus tertius is detached from the extensor digitorum longus muscle through a tendon inserted into the base of the fifth metatarsal bone, after passing through the frondiform ligament of the extensor retinaculum.

Objectives The present study evaluated the prevalence, origin and insertion point of the peroneus tertius muscle in human cadavers.

Methods and Results Thirty-two lower limbs, 18.75% of which came from female cadavers, were obtained from two different anatomy laboratories at two separate institutes. The cadaver parts were dissected and photographed. Overall, the muscle was present in 93.75% of the samples and in 100% of the samples from female cadavers. The fibers of the muscle originated in the proximal third of the fibula in 6.68% of cases, in the middle third in 46.66% and in the distal third in 46.66% of cases. Insertion of the tendon was at the base of the fifth metatarsal in 70% of cases and in the space between the fourth and the fifth metatarsal in 30%.

Conclusion Therefore, the peroneus tertius muscle was present in the majority of the cadaver parts analyzed; however, the sites of origin and insertion varied. These results contradict data in the classical literature and in contemporaneous studies.
Nachrichten der BGPN
Authors: Brakemeier Eva-Lotta
Published: July 2018

Prof. Dr. Eva-Lotta Brakemeier ist Professorin für Psychologie in der Klinischen Psychologie und Psychotherapie der Philipps-Universität Marburg und seit einigen Jahren BGPN Mitglied. Als bekennenden großen Fußballfan haben wir sie in Vorfreude auf die bevorstehende Fußball-Weltmeisterschaft um ein Interview gebeten.
Versorgung von Traumapatienten mit dem „REBEL“-Set
Authors: Kippnich Maximilian , Jelting Yvonne , Kraus Martin , Artmann Thorsten , Wurmb Thomas , Kranke Peter
Published: July 2018

Die zunehmende Terrorbedrohung und ein verändertes Einsatzspektrum für den Rettungsdienst erfordern eine Anpassung und Erweiterung von Notfallrettungsmitteln und Einsatztaktik. Ein Beispiel hierfür ist die bayerische „Handlungsempfehlung für Rettungsdienst bei besonderen Einsatzlagen (REBEL)“. Es werden 3 Fälle vorgestellt, bei denen „neue Hilfsmittel“ wie Hämostyptika, Thoraxverschlusspflaster und Tourniquet aus dem REBEL-Set bei Rettungsdiensteinsätzen angewandt wurden.
Scaling of the self-energy correction to the HOMO-LUMO gap with magnesium cluster size and its potential for extrapolating to larger magnesium clusters
Authors: Zeng Taofang , He Yi
Published: July 2018

This paper presents a computational method for the estimation of the highest occupied molecular orbitals (HOMOs) and the lowest unoccupied molecular orbitals (LUMOs) of metallic nano-clusters using efficient density functional computations with the high accuracy of the GW method. Electronic structures of magnesium nano-clusters Mgn (n = 1–22, 25, 30, 35, and 40) are computed using the density functional theory (DFT) and the quasiparticle GW method. It is found that the energy difference between the DFT and GW results, defined as the scissors operator or correction, is only dependent on the cluster size and independent of the electronic shell filling effect. The scissors operators of HOMOs and LUMOs of metallic clusters can thus be fitted by using simple power functions of the cluster size n. Therefore, the HOMOs and LUMOs of metallic clusters can be efficiently calculated using DFT with a modification of scissors operators. The scissors operators are also demonstrated to be applicable to occupied and unoccupied states near the Fermi level.
Non-Markovian rotational relaxation matrix for fast collisions between two linear molecules in high-pressure gaseous media. I. General formalism and preliminary testing
Authors: Kouzov Alexander P. , Buldyreva Jeanna V. , Sokolov Andrei V.
Published: July 2018

Collisional mixing of (vib)rotational lines appearing in spectroscopic signatures of dense planetary atmospheres and combustion environments is rigorously handled for the case of two linear colliders in terms of incomplete (non-Markovian) collisions related to off-energy-shell scattering amplitudes. Contrary to the standard impact-approximation approaches valid solely in band-centre regions, a new uniform broadband spectrum description is developed on the basis of a frequency-dependent rotational relaxation matrix which accurately accounts for the influence of the extra photon energy with respect to the molecular transitions. This matrix is built using a symmetric Liouville-space metric and obeys all known fundamental rules. Its direct calculation from refined potential-energy surfaces and promising modeling methods for forthcoming practical computations are outlined. A simple preliminary test for N2–N2 isotropic Raman line widths argues in favor of considerable effects of the internal perturber’s structure on modeled spectral characteristics.
Explicit construction of diabatic state and its application to the direct evaluation of electronic coupling
Authors: Lin Xuhui , Liu Xin , Ying Fuming , Chen Zhenhua , Wu Wei
Published: July 2018

A valence bond (VB) block-diagonalization approach, named VBBDA, is proposed to construct the charge-localized diabatic state explicitly within the framework of ab initio VB theory. Since the VB structure built upon the localized orbitals represents the charge localized character of the diabatic state faithfully, we are able to obtain accurate electronic coupling between diabatic states by using a very compact VB wave function. Moreover, the potential energy curves of the diabatic states and hence the crossing points of them can be accurately evaluated. The pilot applications showed that the electronic couplings computed by the VB method are consistent with the complete active space self-consistent field method and may even be close to the results of other high-level ab initio methods such as full configuration interaction and multireference configuration interaction. In addition, the computed electronic couplings show the expected exponential attenuation for the donor-acceptor systems as the distance increases. Moreover, VBBDA has the capability for handling complicated systems based on either two-state or multi-state treatment. Finally, because of the outstanding performance of the Xiamen Valence Bond software package, which is an ab initio VB program, VBBDA is capable for systems consisting more than 1000 basis functions.
On the quantization of the massive Bateman system
Authors: Takahashi K.
Published: July 2018

Bateman’s dual system (BDS) is a linear time-reversal invariant system that consists of damping and amplifying coordinate variables subjected to a harmonic oscillator potential. It is known that canonical quantization of the BDS in the underdamping region suffers from pathologies such as the non-stationary vacuum and the breakdown of Heisenberg’s uncertainty principle. In this paper, following a previous study that targeted the pathology-free massless BDS, the massive BDS is quantized by decomposing it into two independent effectively massless subsystems with reduced degrees of freedom. In each subsystem, the amplifying variable is the conjugate momentum of a damping variable that obeys a non-canonical quantization condition. By virtue of general scaling invariance including U(1), the variables in BDS are treated as non-self-adjoint without changing the total degrees of freedom. The physical states are constructed with time-reversal normalization and are shown to satisfy the time-independent uncertainty relation. The original massive BDS that fulfills the canonical quantization condition is reconstructed by superposing the two subsystems. The same method is also applied to the underdamped BDS to obtain the time-independent uncertainty relations. The expectation values of the coordinate operators represent the complex representation of the solution of the classical equation of motion. The scaling invariance may be broken by coupling with the environment.
Orbital-invariant spin-extended approximate coupled-cluster for multi-reference systems
Authors: Tsuchimochi Takashi , Ten-no Seiichiro L.
Published: July 2018

We present an approximate treatment of spin-extended coupled-cluster (ECC) based on the spin-projection of the broken-symmetry coupled-cluster (CC) ansatz. ECC completely eliminates the spin-contamination of unrestricted CC and is therefore expected to provide better descriptions of dynamical and static correlation effects, but introduces two distinct problems. The first issue is the emergence of non-terminating amplitude equations, which are caused by the de-excitation effects inherent in symmetry projection operators. In this study, we take a minimalist approach and truncate the Taylor series of the exponential ansatz at a certain order such that the approximation safely recovers the traditional CC without spin-projection. The second issue is that the nonlinear equations of ECC become underdetermined, although consistent, yielding an infinitude of solutions. This problem arises because of the redundancies in the excitation manifold, as is common in other multi-reference approaches. We remove the linear dependencies in ECC by employing an orthogonal projection manifold. We also propose an efficient solver for our method, in which the components are usually sparse but not diagonal-dominant. It is shown that our approach is rigorously orbital-invariant and provides more accurate results than its configuration interaction and linearized CC analogues for chemical systems.
Scavenging effects of ascorbic acid and mannitol on hydroxyl radicals generated inside water by an atmospheric pressure plasma jet
Authors: Ghimire Bhagirath , Lee Geon Joon , Mumtaz Sohail , Choi Eun Ha
Published: July 2018

In this study, we have studied the scavenging effects of radical scavengers (ascorbic acid and mannitol) on •OH radicals generated inside water by an atmospheric pressure plasma jet. Plasma was generated by using a sinusoidal power supply (applied voltage: 2.4 kV, frequency: 40 kHz) at a constant argon gas flow rate of 400 sccm and it was characterized by electrical and optical measurements. The technique of ultra-violet (UV) absorption spectroscopy was applied to investigate the effects of scavenging at 3, 6 and 9 mm depths below the water surface by using terephthalic acid as a •OH radical sensitive probe. Also, the effects of scavenging were studied by changing the concentration of radical scavengers and plasma exposure time. For both radical scavengers, the reduced concentrations of •OH radicals were found to decrease with increasing depths as their production would also be reduced by decreasing intensities of plasma-initiated UVs with increasing depths. The effectiveness of ascorbic acid on the scavenging of •OH radicals appeared much stronger than mannitol at all depths inside water since the deprotonated form of ascorbic acid consumes two •OH radicals whereas mannitol consumes only one. Also, the reduced concentration of OH radicals with addition of scavengers was found to be increased under longer plasma exposure time even though the generation of OH radicals were also increased. The detailed mechanism on the formation of •OH radicals inside water has been discussed along with the causes of scavenging. These results can be an important milestone in the applications of non-thermal plasma sources requiring the reduction of •OH radicals.
Kinetic analysis of homogeneous droplet nucleation using large-scale molecular dynamics simulations
Authors: Ayuba Sho , Suh Donguk , Nomura Kentaro , Ebisuzaki Toshikazu , Yasuoka Kenji
Published: July 2018

Studies on homogeneous nucleation have been conducted for decades, but a large gap between experiment and theory persists when evaluating the nucleation rate because the classical nucleation theory (CNT) with all its modifications still cannot fully incorporate the kinetics of homogeneous nucleation. Recent large-scale molecular dynamics (MD) simulations on homogeneous nucleation estimated a nucleation rate around the same order of magnitude as that obtained in experiments. This immensely improved agreement between experiment and theory is exciting because MD can provide detailed information on molecular trajectories. Therefore, a better understanding of the kinetics of homogeneous nucleation can now be obtained. In this study, large-scale MD simulations on homogeneous nucleation were performed. Through kinetic analysis of the simulation results, the nucleation rate, free energy barrier, and critical cluster size were found. Although the nucleation rates directly obtained from the simulations differed from those calculated from the CNT by 8–13 orders of magnitude, when the parameters calculated from the molecular trajectories were substituted into the classical theory, the discrepancy between the nucleation rates decreased to within an order of magnitude. This proves that the fundamental formulation of the theoretical equation is physically sound. We also calculated the cluster formation free energy and confirmed that the free energy barrier decreases with increasing supersaturation ratio. The estimated barrier height was twice that determined by theory, whereas the critical cluster size showed very good agreement between simulation and theory.
Alternative forms and transferability of electron-proton correlation functionals in nuclear-electronic orbital density functional theory
Authors: Brorsen Kurt R. , Schneider Patrick E. , Hammes-Schiffer Sharon
Published: July 2018

Multicomponent density functional theory (DFT) allows the consistent quantum mechanical treatment of both electrons and nuclei. Recently the epc17 electron-proton correlation functional was derived using a multicomponent extension of the Colle-Salvetti formalism and was implemented within the nuclear-electronic orbital (NEO) framework for treating electrons and specified protons quantum mechanically. Herein another electron-proton correlation functional, denoted epc18, is derived using a different form for the functional parameter interpreted as representing the correlation length for electron-proton interactions. The epc18 functional is shown to perform similarly to the epc17 functional for predicting three-dimensional proton densities and proton affinities. Both functionals are shown to be transferable for use with a series of diverse electronic exchange-correlation functionals, indicating that any reasonable electronic exchange-correlation functional may be used in tandem with the epc17 and epc18 electron-proton correlation functionals. Understanding the impact of different forms of the electron-proton correlation functional, as well as the interplay between electron-proton and electron-electron correlation, is critical for the general applicability of NEO-DFT.
Scaling analysis of the viscoelastic response of linear polymers
Authors: Mohamed F. , Flämig M. , Hofmann M. , Heymann L. , Willner L. , Fatkullin N. , Aksel N. , Rössler E. A.
Published: July 2018

Viscoelastic response in terms of the complex shear modulus G*(ω) of the linear polymers poly(ethylene-alt-propylene), poly(isoprene), and poly(butadiene) is studied for molar masses (M) from 3k up to 1000k and over a wide temperature range starting from the glass transition temperature Tg (174 K–373 K). Master curves G′(ωτα) and G″(ωτα) are constructed for the polymer-specific relaxation. Segmental relaxation occurring close to Tg is independently addressed by single spectra. Altogether, viscoelastic response is effectively studied over 14 decades in frequency. The structural relaxation time τα used for scaling is taken from dielectric spectra. We suggest a derivative method for identifying the different power-law regimes and their exponents along G″(ωτα) ∝ ωε″. The exponent ε″ = ε″(ωτα) ≡ d ln G″(ωτα)/d ln(ωτα) reveals more details compared to conventional analyses and displays high similarity among the polymers. Within a simple scaling model, the original tube-reptation model is extended to include contour length fluctuations (CLFs). The model reproduces all signatures of the quantitative theory by Likhtman and McLeish. The characteristic times and power-law exponents are rediscovered in ε″(ωτα). The high-frequency flank of the terminal relaxation closely follows the prediction for CLF (ε″ = −0.25), i.e., G″(ω) ∝ ω−0.21±0.02. At lower frequencies, a second regime with lower exponent ε″ is observed signaling the crossover to coherent reptation. Application of the full Likhtman-McLeish calculation provides a quantitative interpolation of ε″(ωτα) at frequencies below those of the Rouse regime. The derivative method also allows identifying the entanglement time τe. However, as the exponent in the Rouse regime (ωτe > 1) varies along εeRouse = 0.66 ± 0.04 (off the Rouse prediction εRouse = 0.5) and that at ωτe < 1 is similar, only a weak manifestation of the crossover at τe is found at highest M. Yet, calculating τe/τα= (M/Mo)2, we find good agreement among the polymers when discussing ε″(ωτe). The terminal relaxation time τt is directly read off from ε″(ωτα). Plotting τt/τe as a function of Z = M/Me, we find universal behavior as predicted by the TR model. The M dependence crosses over from an exponent significantly larger than 3.0 at intermediate M to an exponent approaching 3.0 at highest M in agreement with previous reports. The frequency of the minimum in G″(ωτα) scales as τmin ∝ M1.0±0.1. An M-independent frequency marks the crossover to glassy relaxation at the highest frequencies. Independent of the amplitude of G″(ω), which may be related to sample-to-sample differences, the derivative method is a versatile tool to provide a detailed phenomenological analysis of the viscoelastic response of complex liquids.
Reference Correlation of the Viscosity of n-Hexadecane from the Triple Point to 673 K and up to 425 MPa
Authors: Meng X. Y. , Sun Y. K. , Cao F. L. , Wu J. T. , Vesovic V.
Published: July 2018

A new correlation for the viscosity of n-hexadecane is presented. The correlation is based upon a body of experimental data that has been critically assessed for internal consistency and for agreement with theory. It is applicable in the temperature range from the triple point to 673 K at pressures up to 425 MPa. The overall uncertainty of the proposed correlation, estimated as the combined expanded uncertainty with a coverage factor of 2, varies from 1% for the viscosity at atmospheric pressure to 10% for the viscosity of the vapor phase at low temperatures. Tables of the viscosity generated by the relevant equations are provided at selected temperatures and pressures and along the saturation line.
Polarization-independent two-dimensional diffraction metal-dielectric grating
Authors: Chen Junming , Zhang Yibing , Wang Yonglu , Kong Fanyu , Jin Yunxia , Chen Peng , Xu Jiao , Sun Shuhui , Shao Jianda
Published: July 2018

Two-dimensional (2D) diffraction gratings have been developed rapidly in several growing areas of research, but most of them were polarization sensitive with limitations toward practical applications. We report a 2D diffraction grating solution for achieving polarization-independent high efficiency property. The grating was designed and fabricated based on thin-film coatings, orthogonally lithography, and ion-beam etching technology. The measured average (−1, 0) order reflective diffraction efficiency (DE) is 74.8% (p-polarization) and 68.2% (s-polarization) from 770 nm to 790 nm and the lowest difference of DE between two polarizations is 0.593% at 785.5 nm incident wavelength of our sample.
Voltage controlled sub-THz detection with gated planar asymmetric nanochannels
Authors: Sánchez-Martín H. , Mateos J. , Novoa J. A. , Delgado-Notario J. A. , Meziani Y. M. , Pérez S. , Theveneau H. , Ducournau G. , Gaquière C. , González T. , Íñiguez-de-la-Torre I.
Published: July 2018

This letter reports on room temperature sub-THz detection using self-switching diodes based on an AlGaN/GaN heterostructure on a Si substrate. By means of free-space measurements at 300 GHz, we demonstrate that the responsivity and noise equivalent power (NEP) of sub-THz detectors based on planar asymmetric nanochannels can be improved and voltage controlled by means of a top gate electrode. A simple quasi-static model based on the DC measurements of the current-voltage curves is able to predict the role of the gate bias in its performance. The best values of voltage responsivity and NEP are achieved when the gate bias approaches the threshold voltage, around 600 V/W and 50 pW/Hz1/2, respectively. A good agreement is found between modeled results and those obtained from RF measurements under probes at low frequency (900 MHz) and in free-space at 300 GHz.
Stability of non-constant equilibrium solutions for two-fluid non-isentropic Euler-Maxwell systems arising in plasmas
Authors: Feng Yue-Hong , Li Xin , Wang Shu
Published: July 2018

We consider the periodic problem for two-fluid non-isentropic Euler-Maxwell systems in plasmas. By means of suitable choices of symmetrizers and an induction argument on the order of the time-space derivatives of solutions in energy estimates, the global smooth solution with small amplitude is established near a non-constant equilibrium solution with asymptotic stability properties. This improves the results obtained in the work of Li et al. [Z. Angew. Math. Phys. 67(5), 133 (2016)] for models with temperature diffusion terms by using the pressure functions pν in place of the unknown variable densities nν.
Effect of illegal glass eel (Anguilla anguilla) fishery on estuarine fish stocks: a case study in the Mondego Estuary, Portugal
Authors: Neves João Bernardo , Martinho Filipe , Pardal Miguel Ângelo
Published: July 2018

Illegal fishing is a critical activity that affects a wide range of species, leading to a decline in total abundance and the overexploitation of target and non-target species. In Portugal, despite fishing for eel juveniles not being allowed, a substantial amount of illegal fishing takes place during the migratory season (October–March). The aim of this study was to investigate the effects of glass eel fishing in the Mondego estuary on target and non-target species. Samples were collected between November 2011 and March 2013 during the autumn and winter (dry and regular respectively with regard to hydrological characteristics) in 2 years. No differences in glass eel catches were observed between fishing seasons; however, a higher number of non-target species was observed in 2012–13 (regular year). There was higher species diversity in the regular year, as well as the highest number of individuals. Higher catches of the most abundant species were also observed in the regular year, compared with the dry year, suggesting that the magnitude of the effect of these illegal practices is related to hydrological cycles. Despite the low replication (2 years), the present study shows that non-selective practices have considerable effects on the species captured, as well as on the functioning of the estuarine ecosystem.
An improved bound on the Hausdorff dimension of Besicovitch sets in ℝ³
Authors: Katz Nets , Zahl Joshua
Published: July 2018

We prove that every Besicovitch set in

R

3

\mathbb {R}^3

must have Hausdorff dimension at least

5

/

2
+

ϵ
0

5/2+\epsilon _0

for some small constant

ϵ
0

>
0

\epsilon _0>0

. This follows from a more general result about the volume of unions of tubes that satisfies the Wolff axioms. Our proof grapples with a new “almost counterexample” to the Kakeya conjecture, which we call the

SL
2

\operatorname {SL}_2

example; this object resembles a Besicovitch set that has Minkowski dimension 3 but Hausdorff dimension

5

/

2

5/2

. We believe this example may be an interesting object for future study.
The influence of childhood intelligence, social class, education and social mobility on memory and memory decline in late life
Authors: Staff R T , Hogan M J , Whalley L J
Published: July 2018

In an observational longitudinal study of a sub-sample of the Aberdeen 1936 birth cohort, from age 62 to 77 years, we investigated childhood intelligence, social class, education, life-course social mobility, memory test performance and memory decline in late life. We examined 388 local residents who had attended school in Aberdeen in 1947 and measured Auditory-Verbal Learning Test (AVLT) at recruitment age about 64 years and up to five times until age about 77 years. Better performance at age about 64 on AVLT was predicted by early socioeconomic status (SES), social mobility and childhood intelligence. The trajectory of AVLT decline was steeper in those who had received less education. This relationship was independent of childhood ability, sex, SES in childhood and social mobility. The protection of memory by education suggests that education supports resilience to age-related cognitive impairment. Upward social mobility does not enhance this effect, suggesting that resilience to age-related decline may be established in early life.
An Endpoint Estimate for Rough Maximal Singular Integrals
Authors: Honzík Petr
Published: July 2018

We study the rough maximal singular integral $$T^{\#}_\Omega\big(\,f\big)\big(x\big)=\sup_{\varepsilon>0} \left| \int_{\mathbb{R}^{n}\setminus B(0,\varepsilon)}|y|^{-n} \Omega(y/|y|)\,f(x-y) \mathrm{d}y\right|,$$where $\Omega$ is a function in $L^\infty (\mathbb{S}^{n-1})$ with vanishing integral. It is well known that the operator is bounded on $L^p$ for $1<p<\infty ,$ but it is an open question whether it is of the weak type 1-1. We show that $T^{\#}_\Omega$ is bounded from $L(\log \log L)^{2+\varepsilon }$ to $L^{1,\infty }$ locally.
“The Atmosphere is Permissive and Free”: The Gendering of Activism in the British Adventure Playgrounds Movement, ca. 1948–70
Authors: Cowman Krista
Published: July 2018

This article explores how gender shaped activities on British adventure playgrounds, designated abandoned spaces where children engaged in free play with urban materials under loose adult supervision. It argues that as these bold experiments emerged in postwar Britain in a period when women’s traditional roles were beginning to be scrutinized and questioned, they might have been expected to develop into spaces where traditional gendered norms were challenged, girls and boys were offered different forms of play, and mothers were drawn into wider community activism. This potential was limited through the emergence of the figure of the heroic playleader, a charismatic man capable of taming potentially delinquent urban youth through extreme displays of masculinity. Consequently, it was not until the late 1970s, a decade after the establishment of an autonomous Women’s Liberation Movement, that adventure playgrounds began to challenge gendered play behaviors.
Prevalence of Fetal Alcohol Spectrum Disorders in 4 US Communities
Authors: May Philip A. , Chambers Christina D. , Kalberg Wendy O. , Zellner Jennifer , Feldman Haruna , Buckley David , Kopald David , Hasken Julie M. , Xu Ronghui , Honerkamp-Smith Gordon , Taras Howard , Manning Melanie A. , Robinson Luther K. , Adam Margaret P. , Abdul-Rahman Omar , Vaux Keith , Jewett Tamison , Elliott Amy J. , Kable Julie A. , Akshoomoff Natacha , Falk Daniel , Arroyo Judith A. , Hereld Dale , Riley Edward P. , Charness Michael E. , Coles Claire D. , Warren Kenneth R. , Jones Kenneth Lyons , Hoyme H. Eugene
Published: July 2018

(Abstracted from JAMA 2018;319(5):474–482)

Several single-site, active-case ascertainment studies in the United States have shown widely varying prevalence estimates for fetal alcohol spectrum disorders, composed of fetal alcohol syndrome, partial fetal alcohol syndrome, and alcohol-related neurodevelopmental disorder. Prevalence of fetal alcohol spectrum disorders are challenging to estimate using routine surveillance methods, and cases are often misdiagnosed or undiagnosed.
Lumbar Disk Herniation and SPORT: A Review of the Literature
Authors: Ilyas Haariss , Savage Jason
Published: July 2018

The Spine Patient Outcomes Related Trial (SPORT) is arguably one of the most impactful and insightful studies conducted in spine surgery. Designed as a prospective, multicenter study with a randomized and observational cohort, SPORT has provided vast data on the pathogenesis, treatment effects, clinical outcomes, cost effectiveness of both disk herniation and lumbar spinal stenosis. With regards to lumbar disk herniation, SPORT has demonstrated a sustained benefit from surgical intervention and acceptable cost-effectiveness at 2, 4, and 8 years postoperatively. Myriad subgroup analyses have subsequently been performed that have also resulted in clinically relevant findings. These analyses have assessed optimal timing for surgery, incidence and risk factors for reoperation, impact of obesity and other comorbidities, influence of epidural injections, and evaluation of socioeconomic factors. This has resulted in significant findings that may allow spine surgeons to optimize patient outcomes while managing expectations appropriately.
Fibrous Papule: A Histopathologic Review
Authors: Damman Jeffrey , Biswas Asok
Published: July 2018

Fibrous papule (FP) is a common benign lesion located primarily in the nose. Although its histogenesis has been marred with controversies in the past, the dermal dendrocyte is now largely accepted to be the putative cell of origin. Histopathologic diagnosis of an FP is straightforward in most cases, which shows characteristics of an angiofibroma. Several histologic variants have been described, recognition of which is important to avoid a misdiagnosis and inappropriate treatment. This review presents a historical perspective into the histogenesis, discusses the histopathologic features and potential diagnostic pitfalls of classic FP, and lists the various histologic variants and their differential diagnoses.
A Comparison of the Histopathologic Growth Patterns Between Non–Merkel Cell Small Round Blue Cell Tumors and Merkel Cell Carcinoma
Authors: Bandino Justin P. , Purvis Caitlin G. , Shaffer Blake R. , Gad AbdAllah , Elston Dirk M.
Published: July 2018

Background:

Merkel cell carcinoma (MCC) is a rare neuroendocrine cutaneous malignancy that shares cytologic, histopathologic, and immunohistochemical features with other small round blue cell (SRBC) tumors. Although the trabecular pattern is anecdotally associated with MCC, objective data are lacking.

Methods:

This was a retrospective institutional review board–approved observational study conducted on microscopic images of 79 MCCs and 74 other SRBC tumors (desmoplastic small round cell tumor, primitive neuroectodermal tumor, neuroblastoma, embryonal rhabdomyosarcoma, alveolar rhabdomyosarcoma, synovial sarcoma, carcinoid, metastatic small cell lung cancer, non-Hodgkin small cell lymphoma, retinoblastoma, medulloblastoma, nephroblastoma, small cell osteosarcoma, and round cell liposarcoma). An expert dermatopathologist evaluated blinded and randomized microscopic specimens and recorded histologic patterns (diffuse, infiltrative, large anastomosing nests, small islands, any trabecular, focal trabecular, mixed trabecular, and predominately trabecular).

Results:

Trabecular features were identified in over 72% of MCCs but only rarely in non-MCC SRBC tumors. The presence of any amount of a trabecular pattern favored a diagnosis of MCC over SRBC tumors with a sensitivity of 72.2% and a specificity of 87.8%. If “any” and “focal” trabecular patterns were discounted, specificity rose to 93.2%.

Conclusion:

The presence of a trabecular pattern helps to differentiate MCC from other SRBC tumors, and specificity approaches that achieved with immunostaining.
Evaluation of Omeprazole Limited Sampling Strategies to Estimate Constitutive Cytochrome P450 2C19 Activity in Healthy Adults
Authors: Lin Swan , Nikanjam Mina , Capparelli Edmund V. , Allegrini Alessandro , Pavone Daniele , Yim Dong-Seok , Hammami Muhammad M. , Bertino Joseph S. , Nafziger Anne N. , Park Yoo-Sin , Yin Ophelia Q. , Ma Joseph D.
Published: July 2018

Background:

Limited sampling strategy (LSS) is a validated method to estimate pharmacokinetic (PK) parameters from a reduced number of samples. Omeprazole is used to phenotype in vivo cytochrome P450 (CYP) 2C19 activity. This study examined an LSS using 2 estimation methods to determine apparent oral clearance (CL/F) and thus CYP2C19 activity.

Methods:

Data from 7 previously published studies included healthy subjects receiving a single, oral dose of omeprazole with intensive PK sampling. CL/F was estimated using noncompartmental analysis (NCA) and population PK modeling. LSS was simulated by selecting the 1, 2, 4, and/or 6-hour postdose time points. Linear regression was performed to assess whether CL/F estimated from limited sampling could accurately predict CL/F from the full PK profile.

Results:

Median CL/F was 23.7 L/h by NCA and 19.3 L/h by population PK modeling. In comparing the LSS NCA estimated versus observed CL/F, all evaluated linear regression models had unacceptable coefficients of determination (r
2, range: 0.14–0.81). With the population PK approach, 737 plasma concentrations (n = 71) and CYP2C19 genotype data were described with a 1-compartment structural model with mixed zero and first-order absorption and lag time. In comparing the population PK LSS estimated versus observed CL/F, all evaluated linear regression models had unacceptable r
2 (range: 0.02–0.74). Post hoc comparison of CYP2C19 poor metabolizers versus CYP2C19 extensive metabolizers resulted in significantly lower CL/F in poor metabolizers versus extensive metabolizers.

Conclusions:

Omeprazole LSS performed poorly in estimating CL/F using 2 separate estimation approaches and does not seem to be a suitable method for determining CYP2C19 activity.
Parental Presence and Activities in a Dutch Neonatal Intensive Care Unit
Authors: Kamphorst Kim , Brouwer Annemieke J. , Poslawsky Irina E. , Ketelaar Marjolijn , Ockhuisen Hetty , van den Hoogen Agnes
Published: July 2018

The presence of parents during a neonatal intensive care unit (NICU) admission is important for the well-being of both infants and their parents. Therefore, the aim of this study was to identify parental presence in terms of frequency, duration, and activities in the NICU in relation to characteristics of both infants and parents. An observational study was performed in a Dutch level III NICU. All infants admitted for more than 24 hours were included. One hundred sixty-two infants were included. For a median duration of 3 to 4 hours a day, at least one of the parents was present. After the first week after birth, 80% of both parents participated in the care of their infant. A vaginal delivery, longer duration of kangaroo care, higher birth weight, bronchopulmonary dysplasia, being a first child, the second and following admission week(s) after birth, and a short driving distance led to a significantly longer duration of presence for both parents. Mothers were present for a significantly longer duration of time than fathers (P = .00). It is recommended that public and employer policies, as well as physical conditions and necessary facilities, in the NICU be examined for their support of parental presence.
Prevalence and characteristics of hepatopulmonary syndrome in children with cirrhosis in southern Brazil
Authors: Ceza Marília R. , Garcia Eduardo , Anselmi Carlos E. , Epifanio Matias , Melere Melina U. , Ferreira Cristina T. , Steinhaus Cintia , Coral Gabriela P.
Published: July 2018

Background

Hepatopulmonary syndrome (HPS) is defined as a triad characterized by arterial deoxygenation, intrapulmonary vascular dilatations (IPVDs), and liver disorder. The aims of this study were to assess the prevalence of HPS in children with cirrhosis, the clinical characteristics of patients with HPS, and the tests used for the diagnosis of IPVD.

Patients and methods

This was a prospective, cross-sectional study of 40 children with cirrhosis (median age: 44 months). Investigations of HPS included arterial blood gas analysis, contrast-enhanced transthoracic echocardiography (CE-TTE), and perfusion lung scanning using technetium-99m-labeled macroaggregated albumin (99mTc-MMA). Patients’ clinical characteristics (age, etiology of cirrhosis, and severity of hepatopathy) were assessed. HPS was defined as liver disease; alveolar–arterial oxygen gradient of at least 15 mmHg and/or partial pressure of arterial oxygen less than 80 mmHg; and detection of IPVD by CE-TTE or 99mTc-MMA scanning. Statistical significance was indicated by a P value less than 0.05.

Results

The prevalence of HPS was 42.5% (17/40). Eight patients had moderate HPS (47%) and two patients had severe HPS (12%). In bivariate analysis, biliary atresia (P=0.033) and median age (10 months; P=0.005) were associated with HPS. In multivariate analysis, only age remained statistically significant (prevalence ratio=0.99; 95% confidence interval=0.98–0.99; P=0.010). Sixteen patients with HPS had IPVD detected by CE-TTE (94.1%) and six patients had IPVD detected by 99mTc-MMA scanning (35.3%), with no significant agreement between these methods (κ=−0.12; P=0.163).

Conclusion

HPS is a common complication of cirrhosis in children. A combination of clinical and imaging criteria should be used to diagnose HPS.
Next-Generation Sequencing Reveals A JAGN1 Mutation in a Syndromic Child With Intermittent Neutropenia
Authors: Cifaldi Cristina , Serafinelli Jessica , Petricone Davide , Brigida Immacolata , Di Cesare Silvia , Di Matteo Gigliola , Chiriaco Maria , De Vito Rita , Palumbo Giuseppe , Rossi Paolo , Palma Paolo , Cancrini Caterina , Aiuti Alessandro , Finocchi Andrea
Published: July 2018

Background:

Jagunal homolog 1 (JAGN1) gene was identified as a novel responsible for severe congenital neutropenia. The protein encoded by this gene is required for neutrophil differentiation, survival and function in microbial activity. JAGN1-deficient human neutrophils are characterized by alterations in trafficking within the endoplasmic reticulum and golgi compartments because of ultrastructural defects in endoplasmic reticulum and susceptibility to apoptosis.

Observations:

We report a patient exhibiting an intermittent neutropenia, for which a next-generation sequencing revealed a homozygous mutation in the JAGN1 gene.

Conclusions:

The patient extends the clinical variability associated to JAGN1 mutations, and this case highlights the importance of genetic investigations in patients with suspected neutropenia.
Postpartum Hemorrhage: Management of Massive Transfusion
Authors: Jackson Daneil L. , DeLoughery Thomas G.
Published: July 2018

In women with postpartum hemorrhage, the need to transfuse a large amount of blood products is frequent. The ABCD of massive transfusions—Assessment/Activation, Blood products, Complications, and Drugs—can help manage this complex situation. There needs to be a defined method to activate the massive transfusion protocol and a well-defined means to assess the coagulation status of the patient by either traditional laboratory tests or point of care methods such as thromboelastography. Recent data supports more aggressive use of plasma in the massively transfused patient. Obstetricians need to be vigilant in assessing compilations, especially hypothermia. Given the increased use of antithrombotic drugs in bleeding patients, one needs to consider reversal of these agents. Finally, consideration of the role of other agents such as antifibrinolytic agents in the management of the bleeding patient is important. It is important for every hospital to have a well-defined massive transfusion protocol to streamline the care of postpartum hemorrhage.

Target Audience

Obstetricians and gynecologists, family physicians.

Learning Objectives

After completing this activity, the learner should be better able to have a systematic approach to massive transfusions in postpartum hemorrhage, describe recent clinical trials on more aggressive use of plasma and tranexamic acid, and effectively monitor coagulation and for complications of massive transfusion.
Concurrent Primary Chancre and Ocular Syphilis in an Human Immunodeficiency Virus-Negative Man
Authors: Hamill Matthew M. , Seppings Louise , Kit Vivienne , Antao Sheelah
Published: July 2018

We believe this to be the first report of coexisting polymerase chain reaction (PCR)-confirmed primary genital and ocular syphilis in a patient with penicillin allergy treated with doxycycline. The case examines the use of nonpenicillin and corticosteroid treatment of ocular syphilis and highlights the risk of eye involvement early in the disease process.
Illness Perception Mediates the Relationship Between the Severity of Symptoms and Perceived Health Status in Patients With Behçet Disease
Authors: Yankouskaya Alla , Boughey Alexandra , McCagh Jane , Neal Alison , de Bezenac Christophe , Davies Simon J.
Published: July 2018

Objective

The aim of this study was to investigate the relationship between psychological representations of illness, perceived health status, and self-assessment of symptom severity in patients with Behçet disease, a rare long-term incurable condition with unclear etiology.

Methods

Using cross-sectional survey design, data on self-administered questionnaires on illness perception, health status, symptoms severity, and demographic characteristics were collected from 273 patients with Behçet disease (age range, 18–65 years). The data were subjected to mediation analysis to test whether cognitive and emotional components of illness perception mediate the relationship between the severity of symptoms and heath status.

Results

The results support our hypotheses that cognitive components of illness perception (perceived consequences and identity of the illness) mediate the link between symptom activity and pain, whereas emotional components of the illness (emotional representations about the illness) mediate the relationship between disease activity and perceived energy level.

Conclusions

The robustness of these mediation effects suggests potential directions for clinical psychologists and health care practitioners in developing support programs. We supplement our study with Open Access database containing information about type of medication, comorbid mood disorder, and detailed measurement of the severity of BD symptoms for sharing and accumulating multidisciplinary knowledge aiming to support the development of interventions. Addressing psychological aspects of BD will help to manage complex patients effectively.