bluuebunny/crossref_metadata_2025 huggingface dataset:
Crowdsourcing without profit: the role of the seeker in open social innovation
Authors: Randhawa Krithika , Wilden Ralf , West Joel
Published: February 2019

Crowdsourcing has increasingly been studied as an open innovation (OI) mechanism by which organizations (seekers) engage with an external crowd of potential solvers. Previous crowdsourcing research has focused on solvers and their individual motivations, providing few insights as to why and how seekers use crowdsourcing, and how these choices affect the value that might be realized from these efforts. Prior research has also emphasized profit‐seeking firms, despite the use of OI practices by public sector organizations to achieve societal benefits. This paper examines the organizational and project‐level choices of government agencies that crowdsource from citizens to drive open social innovation, and thus develop new ways to address societal problems, a process sometimes termed ‘citizensourcing.’ Using rich data from 18 local government seekers that use the same intermediary, we develop a model of seeker crowdsourcing implementation that links a previously unstudied variance in seeker intent and engagement strategies to differences in project team motivation and capabilities, in turn leading to varying online engagement behaviors and ultimately project outcomes. Our study compares and contrasts governmental and corporate crowdsourcing to reveal that the non‐pecuniary orientation of both seekers and solvers means that the motives of government crowdsourcing are fundamentally different from corporate crowdsourcing, but the process in our sample more closely resembles that of a firm‐sponsored community rather than government sponsored contests. More generally, we show how seeker organizational factors and choices shape project‐level implementation and success of crowdsourcing efforts, as well as provide insights for OI activities of other smaller, geographically bound organizations.
Preservice teachers’ mathematics task modification for emergent bilinguals
Authors: I Ji–Yeong
Published: February 2019

Implementing mathematically challenging tasks is difficult for teachers when working with emergent bilinguals because cognitively demanding tasks in mathematics commonly have high language demand. Currently, inadequate teacher preparation for teaching emergent bilinguals is becoming a significant concern in the United States as this population of students is rapidly growing. This study investigated how two mathematics preservice teachers (PSTs) support middle school emergent bilinguals to understand cognitively demanding mathematical problems through task modification. Fieldwork with a concurrent intervention was designed for the PSTs to work with emergent bilinguals in a one‐on‐one setting. The PSTs modified cognitively demanding mathematics tasks and designed a lesson for the emergent bilinguals based on the modified tasks. The results revealed that the task modification made by the PSTs tended to shift from reducing cognitive demands in mathematics and language to maintaining the demands through learning strategies of contextual support.
Identification of a novel HLA‐B*40 variant allele, B*40:405 by next‐generation sequencing
Authors: Yu Shinae , Shim Jae Houn , Park Kwang Jun , Choi So‐Jung , Jun Kyung Ran
Published: February 2019

The new allele, HLA‐B*40:405 differs from B*40:02:01:01 by one nucleotide substitution at codon 304.
Genome‐wide analysis of flanking sequences reveals that Tnt1 insertion is positively correlated with gene methylation in Medicago truncatula
Authors: Sun Liang , Gill Upinder S. , Nandety Raja Sekhar , Kwon Soonil , Mehta Perdeep , Dickstein Rebecca , Udvardi Michael K. , Mysore Kirankumar S. , Wen Jiangqi
Published: February 2019

From a single transgenic line harboring five Tnt1 transposon insertions, we generated a near‐saturated insertion population in Medicago truncatula. Using thermal asymmetric interlaced‐polymerase chain reaction followed by sequencing, we recovered 388 888 flanking sequence tags (FSTs) from 21 741 insertion lines in this population. FST recovery from 14 Tnt1 lines using the whole‐genome sequencing (WGS) and/or Tnt1‐capture sequencing approaches suggests an average of 80 insertions per line, which is more than the previous estimation of 25 insertions. Analysis of the distribution pattern and preference of Tnt1 insertions showed that Tnt1 is overall randomly distributed throughout the M. truncatula genome. At the chromosomal level, Tnt1 insertions occurred on both arms of all chromosomes, with insertion frequency negatively correlated with the GC content. Based on 174 546 filtered FSTs that show exact insertion locations in the M. truncatula genome version 4.0 (Mt4.0), 0.44 Tnt1 insertions occurred per kb, and 19 583 genes contained Tnt1 with an average of 3.43 insertions per gene. Pathway and gene ontology analyses revealed that Tnt1‐inserted genes are significantly enriched in processes associated with ‘stress’, ‘transport’, ‘signaling’ and ‘stimulus response’. Surprisingly, gene groups with higher methylation frequency were more frequently targeted for insertion. Analysis of 19 583 Tnt1‐inserted genes revealed that 59% (1265) of 2144 transcription factors, 63% (765) of 1216 receptor kinases and 56% (343) of 616 nucleotide‐binding site‐leucine‐rich repeat genes harbored at least one Tnt1 insertion, compared with the overall 38% of Tnt1‐inserted genes out of 50 894 annotated genes in the genome.
Influence of tibial plateau leveling osteotomy and tibial tuberosity advancement on passive laxity of the cranial cruciate deficient stifle in dogs
Authors: Ober Ciprian A. , Factor Gilad , Meiner Yaron , Segev Gilad , Shipov Anna , Milgram Joshua
Published: February 2019

Objective

To evaluate the effect of tibial plateau leveling osteotomy (TPLO) and tibial tuberosity transposition (TTA) on craniocaudal stability of the cranial cruciate ligament (CCL) deficient stifle at 3 joint angles.

Study design

Ex vivo biomechanical study.

Sample population

Eight stifles from 4 dogs.

Methods

One of the hind limbs was randomly assigned to undergo TPLO or TTA, with the contralateral limb assigned to the alternate procedure. Each specimen was tested with the stifle at 150°, 135°, and 120° of flexion. Cranial translation of the tibia relative to the femur was measured under cranial loads ranging from 0.2 to 2.0 kg with a single motion tracking sensor (Nest of Birds) fixed to the tibia. Each stifle was tested before and after transection of the CCL and after performing the assigned procedure.

Results

Tibial plateau leveling osteotomy and TTA caused a decrease in the cranial translation of the tibia relative to the femur, especially at greater angles of flexion. Tibial plateau leveling osteotomy caused a greater decrease in tibial cranial translation and was associated with a degree of translation that did not differ from joints with intact CCL, regardless of the degree of stifle flexion.

Conclusion

Tibial plateau leveling osteotomy and TTA caused an angle dependent decrease in craniocaudal translation of the tibia in the CCL deficient stifle. Only TPLO restored translations similar to those of the intact joint at all angles tested.

Clinical impact

Tibial plateau leveling osteotomy and TTA provide passive stability to the stifle. Tibial plateau leveling osteotomy seems more effective than TTA at restoring craniocaudal stability of the stifle.
Subtourniquet pressures generated by application of wide‐rubber tourniquets in standing, sedated horses
Authors: Plunkett Amanda H. , Schoonover Mike J. , Young Jenna M. , Taylor Jared D. , Holbrook Todd C.
Published: February 2019

Objective

To determine the influence of location and movement on subtourniquet pressure (STP) generated by application of a wide‐rubber tourniquet (WRT) on equine limbs.

Study design

Randomized experimental cross‐over design.

Animals

Six standing, sedated horses.

Methods

Horses were sedated with detomidine hydrochloride (0.2 μg/kg IV), and 4 investigators applied WRTs to the antebrachium (AB), gaskin (GK), and midmetacarpus (MC) of each horse in a predetermined, randomized order. Subtourniquet pressure was consequently measured at 10‐minute intervals (T0, T10, T20, T30) for 30 minutes. Indirect systolic blood pressure (SBP) was measured presedation, postsedation, and throughout the tourniquet application period. Target STP was established as SBP + 100 mm Hg. Limb movements at each location were classified as none, low, moderate, or high, on the basis of counts and magnitude.

Results

Mean STP did not change with time (P = .93) and exceeded SBP by 163 mm Hg (95% CI 122–205), 185 mm Hg (95% CI 156–214), and 402 mm Hg (95% CI 351–454) at the AB, GK, and MC, respectively. Mean STP at each location exceeded the target STP in 59 of 70 (81%) of the trials. Limb movements affected STP generated by tourniquets at the AB (P = .04) and MC (P < .0001) but not at the GK (P = .67).

Conclusion

Wide‐rubber tourniquets applied at the AB, GK, and MC generated STP >100 mm Hg above SBP for 30 minutes in standing, sedated horses.

Clinical significance

Wide‐rubber tourniquets as applied in this study can achieve and maintain the current recommended STP (SBP + 100 mm Hg) for equine IV regional limb perfusion. Number and magnitude of limb movement can decrease STP over time, potentially reducing the efficacy of a WRT.
An Evaluation of Students’ and Teachers’ Opinions About Enriched Libraries (Z-Libraries)
Authors: Alver Mehmet
Published: February 2019

The purpose of this study is to evaluate Enriched libraries, established in schools in Turkey in the recent years. In particular, the study intended to investigate how relevant, effective, useful and functional Enriched libraries have been in real life, regarding students’ and teachers’ opinions. The research was conducted in line with the mixed model approach. In other words, both the quantitative and qualitative research methods were used in the research. Quantitative data was gathered from 469 students from one primary school, two secondary schools and two high schools with an enriched library in Giresun/Turkey in 2017-2018 academic year and the qualitative data was obtained from 18 teachers. Two types of data collection tools were used to collect quantitative and qualitative data in the study. Quantitative data of the research was collected from the students through the Z-Library Student Assessment Questionnaire developed by the researcher. The qualitative data of the study were collected from the teachers by the semi-structured interview form prepared by the researcher. Quantitative data of the study were analyzed using the SPSS statistical package program. In the analysis of the qualitative data descriptive analysis techniques were used to interpret the data. The results obtained from the analysis of quantitative and qualitative data were evaluated and interpreted together. According to the results of the survey, students and teachers think that they are appropriate, effective, functional and useful in compliance with the purpose of establishing Z-Library; they meet the expectations.
Actuar político para el control del cáncer en Colombia
Authors: Salazar Lida , Benavides Mónica , Murcia Monroy Eliana Marcela
Published: February 2019

El cáncer es un tema de interés en salud pública, debido al progresivo aumento del número de casos, los altos costos para los sistemas de salud y el número de muertes. Para controlarlo, no es suficiente con promover la salud, puesto que la implementación de estilos de vida saludables no solo requiere voluntad individual, sino también creación de políticas, leyes, programas, planes, entre otros, que favorezcan cambios de comportamiento en individuos hacia estos estilos, que además posicionen las opciones saludables como iniciativas atractivas que tomar. Colombia ha entendido el cáncer como tema de atención prioritaria y como tal estableció un marco normativo que busca su control desde la prevención y la detección temprana, pasando por el tratamiento integral hasta la rehabilitación e incorporación a la vida laboral. Esta revisión pretende hacer un acercamiento a la normatividad y reglamentación colombiana para el control del cáncer, registrando su evolución histórica y destacando sus posibles alcances e inconvenientes.
Remodeling of pSK1 Family Plasmids and Enhanced Chlorhexidine Tolerance in a Dominant Hospital Lineage of Methicillin-Resistant
Staphylococcus aureus
Authors: Baines Sarah L. , Jensen Slade O. , Firth Neville , Gonçalves da Silva Anders , Seemann Torsten , Carter Glen P. , Williamson Deborah A. , Howden Benjamin P. , Stinear Timothy P.
Published: February 2019

Staphylococcus aureus
is a significant human pathogen whose evolution and adaptation have been shaped in part by mobile genetic elements (MGEs), facilitating the global spread of extensive antimicrobial resistance. However, our understanding of the evolutionary dynamics surrounding MGEs, in particular, how changes in the structure of multidrug resistance (MDR) plasmids may influence important staphylococcal phenotypes, is incomplete.
False-Positive Carbapenem-Hydrolyzing Confirmatory Tests Due to ACT-28, a Chromosomally Encoded AmpC with Weak Carbapenemase Activity from Enterobacter kobei
Authors: Jousset Agnès B. , Oueslati Saoussen , Bernabeu Sandrine , Takissian Julie , Creton Elodie , Vogel Anaïs , Sauvadet Aimie , Cotellon Garance , Gauthier Lauraine , Bonnin Rémy A. , Dortet Laurent , Naas Thierry
Published: February 2019

In
Enterobacter cloacae
complex (ECC), the overproduction of the chromosome-encoded cephalosporinase (cAmpC) associated with decreased outer membrane permeability may result in carbapenem resistance. In this study, we have characterized ACT-28, a cAmpC with weak carbapenemase activity, from a single
Enterobacter kobei
lineage.
Evaluation of Mass Spectrometry-Based Detection of Panfungal Serum Disaccharide for Diagnosis of Invasive Fungal Infections: Results from a Collaborative Study Involving Six European Clinical Centers
Authors: Cornu Marjorie , Sendid Boualem , Mery Alexandre , François Nadine , Mikulska Malgorzata , Letscher-Bru Valérie , De Carolis Elena , Damonti Lauro , Titecat Marie , Bochud Pierre-Yves , Alanio Alexandre , Sanguinetti Maurizio , Viscoli Claudio , Herbrecht Raoul , Guerardel Yann , Poulain Daniel
Published: February 2019

A mass spectrometry (MS) method that detects a serum disaccharide (DS) (MS-DS) was recently described for the diagnosis of invasive fungal infections (IFI). We carried out a European collaborative study to evaluate this assay.
Development of a Multiplexed Assay for Detection of
Leishmania donovani
and
Leishmania infantum
Protein Biomarkers in Urine Samples of Patients with Visceral Leishmaniasis
Authors: Abeijon Claudia , Alves Fabiana , Monnerat Severine , Wasunna Monique , Mbui Jane , Viana Agostinho G. , Bueno Lilian L. , Siqueira Williane F. , Carvalho Silvio G. , Agrawal Neha , Fujiwara Ricardo , Sundar Shyam , Campos-Neto Antonio
Published: February 2019

Visceral leishmaniasis (VL) is a serious and fatal disease caused by the parasites
Leishmania infantum
and
Leishmania donovani
. The gold standard diagnostic test for VL is the demonstration of parasites or their DNA in spleen, lymph node, or bone marrow aspirates.
Structure and Mechanism of LcpA, a Phosphotransferase That Mediates Glycosylation of a Gram-Positive Bacterial Cell Wall-Anchored Protein
Authors: Siegel Sara D. , Amer Brendan R. , Wu Chenggang , Sawaya Michael R. , Gosschalk Jason E. , Clubb Robert T. , Ton-That Hung
Published: February 2019

In Gram-positive bacteria, the conserved LCP family enzymes studied to date are known to attach glycopolymers, including wall teichoic acid, to the cell envelope. It is unknown if these enzymes catalyze glycosylation of surface proteins. We show here in the actinobacterium
Actinomyces oris
by X-ray crystallography and biochemical analyses that
A. oris
LcpA is an LCP homolog, possessing pyrophosphatase and phosphotransferase activities known to belong to LCP enzymes that require conserved catalytic Arg residues, while harboring a unique disulfide bond critical for protein stability. Importantly, LcpA mediates glycosylation of the surface protein GspA via phosphotransferase activity. Our studies provide the first experimental evidence of an archetypal LCP enzyme that promotes glycosylation of a cell wall-anchored protein in Gram-positive bacteria.
The Molecular Mechanism of Nitrate Chemotaxis via Direct Ligand Binding to the PilJ Domain of McpN
Authors: Martín-Mora David , Ortega Álvaro , Matilla Miguel A. , Martínez-Rodríguez Sergio , Gavira José A. , Krell Tino
Published: February 2019

Nitrate is of central importance in bacterial physiology. Previous studies indicated that movements toward nitrate are due to energy taxis, which is based on the cytosolic sensing of consequences of nitrate metabolism. Here we present the first report on nitrate chemotaxis. This process is initiated by specific nitrate binding to the periplasmic ligand binding domain (LBD) of McpN. Nitrate chemotaxis is highly regulated and occurred only under nitrate starvation conditions, which is helpful information to explore nitrate chemotaxis in other bacteria. We present the three-dimensional structure of the McpN-LBD in complex with nitrate, which is the first structure of a chemoreceptor PilJ-type domain. This structure reveals striking similarities to that of the abundant 4-helix bundle domain but employs a different sensing mechanism. Since McpN homologues show a wide phylogenetic distribution, nitrate chemotaxis is likely a widespread phenomenon with importance for the life cycle of ecologically diverse bacteria.
Alternative Splicing in Apicomplexan Parasites
Authors: Yeoh Lee M. , Lee V. Vern , McFadden Geoffrey I. , Ralph Stuart A.
Published: February 2019

Alternative splicing is a widespread, essential, and complex component of gene regulation. Apicomplexan parasites have long been recognized to produce alternatively spliced transcripts for some genes and can produce multiple protein products that are essential for parasite growth.
Remodeling of O Antigen in Mucoid Pseudomonas aeruginosa via Transcriptional Repression of
wzz2
Authors: Cross Ashley R. , Goldberg Joanna B.
Published: February 2019

Detection of mucoid
Pseudomonas aeruginosa
, characterized by the overproduction of alginate, is correlated with the establishment of a chronic pulmonary infection and disease progression in people with cystic fibrosis (CF). In addition to the overproduction of alginate, loss of O antigen lipopolysaccharide production is also selected for in chronic infection isolates. In this study, we have identified the regulatory network that inversely regulates O antigen and alginate production. Understanding the regulation of these chronic phenotypes will elucidate mechanisms that are important for the establishment of a long-term
P. aeruginosa
lung infection and ultimately provide an opportunity for intervention. Preventing
P. aeruginosa
from chronically adapting to the CF lung environment could provide a better outcome for people who are infected.
Checklist design and implementation: critical considerations to improve patient safety for low-frequency, high-risk patient events
Authors: Turkelson Carman , Keiser Megan , Sculli Gary , Capoccia Diane
Published: February 2019

Purpose: This pilot project describes the development and implementation of two specialised aviation-style checklist designs for a low-frequency high-risk patient population in a cardiac intensive care unit. The effect of the checklist design as well as the implementation strategies on patient outcomes and adherence to best practice guidelines were also explored. The long-term objective was to improve adherence to accepted processes of care by establishing the checklists as standard practice thereby improving patient safety and outcomes.

Methods: During this project, 10specialised crisis checklists using two specific aviation-style designs were developed. A quasiexperimental prospective pre-post repeated measure design including surveys along with repetitive simulations were used to evaluate self-confidence and self-efficacy over time as well as the perceived utility, ease of use, fit into workflow and benefits of the checklists use to patients. Performance, patient outcomes and manikin outcomes were also used to evaluate the effectiveness of the crisis checklists on provider behaviours and patient outcomes.

Results: Overall self-confidence and self-confidence related to skills and knowledge while not significant demonstrated clinically relevant improvements that were sustained over time. Perceptions of the checklists were positive with consistent utilisation sustained over time. More importantly, use of the checklists demonstrated a reduction in errors both in the simulated and clinical setting.

Conclusion: Recommendations from this study consist of key considerations for development and implementation of checklists including: utilisation of stakeholders in the development phase; implementation in real and simulated environments; and ongoing reinforcement and training to sustain use.
P30 A PRISMA systematic review and meta-analysis of open and novel ‘minimally invasive’ techniques for mesial temporal lobe epilepsy (MTLE)
Authors: Vakharia N , Xiao F , O’Keeffe A , Sparks R , McEvoy W , Miserocchi A , Ourselin S , Duncan S
Published: February 2019

Objectives

One third of patients with focal epilepsy fail to achieve seizure freedom despite best medical therapy. Surgery may provide seizure freedom if the epileptogenic zone can be safely remove. We compare the outcomes following open surgery, laser interstitial thermal therapy (LITT), radiofrequency ablation (RFA) and radiosurgery (RS).

Design

PRISMA systematic review and meta-analysis.

Subjects

MTLE

Methods

Structured searchs of PubMed, Embase and Cochrane databases. Random effects meta-analysis to calculate effects sizes and a pooled estimate of the probability of remaining seizure free at one year following intervention.

Results

From 1212 screened publications, 57 articles were included in the quantitative analysis. Open surgery included anterior temporal lobectomy as well as transcortical, subtemporal and transsylvian selective amygdalohippocampectomy. The probability of remaining seizure free at one year was 0.89 (95% CI 0.83–0.93) with open surgery based on Level 1 and 2 evidence. RS resulted in 0.88 (95% CI 0.84–0.90) probability and a single RCT revealed RS was less efficacious than open surgery. Follow up duration and study sizes were limited with LITT and RFA providing a probability of remaining seizure free at one year of 0.71 (95% CI 0.65–0.76) and 0.86 (95% CI 0.76–0.92) respectively.

Conclusions

There is no evidence supporting novel ‘minimally invasive’ approaches as being as efficacious as open surgery. Secondary outcome measures such as neuropsychological outcome and intervention morbidity are poorly reported.
P55 The neurosurgical physician: a new role in the UK
Authors: Stewart PJ , Martin J , Thomas J , Hayhurst C
Published: February 2019

Objectives

With reduction in numbers of junior doctors and strict deanery requirements for training opportunities, the provision of ward cover and continuity has consistently fallen. Various methods of addressing this have been implemented in the UK, including increased nurse practitioners and physician associates. We introduced a new position of GP with a specialist neuroscience interest in line with the North American model of hospitalist and review the impact on patients and trainees.

Design

Qualitative descriptive study.

Subjects

14 core and speciality trainees.

Methods

Retrospective review of the impact of a permanent neurosurgical physician on ward care and provision of training with a qualitative study of trainee experience. Saturation was reached at 14 interviews.

Results

A neurosurgical physician role was instituted in 2013, enabling a formal training rota to fulfil deanery requirements for core training and provide continuity of care at senior medical level, reducing medical ward consults to zero, improved communication with relatives and reduced the need for ST ward rounds. Qualitative assessment revealed a senior medical presence aided trainees own knowledge, resulted in better rapport and communication with patients and improved patient care through knowledge of best medical practice guidelines.

Conclusions

The addition of the neurosurgical physician role has positively impacted on the quality of patient care and junior doctor training. Senior medical care is provided with continuity, in contrast to other models.
P68 Activation of the geste antagoniste improves speed of finger tapping in organic and functional dystonia
Authors: Newby RE , Muhamed S , Smith S , Alty JE , Jamieson S , Kempster PA
Published: February 2019

Objectives

The geste antagoniste is a typical feature of dystonia’s motor phenomenology. Gestes may also occur in functional dystonia. We investigated how gestes affect the kinematics of voluntary movement.

Design

Cross-sectional study.

Subjects

Twenty-three patients with organic dystonia and three with functional dystonia were studied.

Methods

Finger tapping was assessed while subjects wore electromagnetic sensors secured to index finger and thumb. Subjects were instructed to tap ‘as fast and as big as possible’ for 15 s, first with and then without activation of their geste. Precise position and orientation data, in six degrees of freedom, were recorded. Separable motor components were derived from a comparison of the x, y and z coordinates of each sensor. The product of amplitude and frequency, giving the sensor excursion per unit time, was used as a measure of average speed. A repeated measures ANOVA was conducted, with the factors CONDITION (with vs without geste), HAND (dominant vs non-dominant) and GROUP (organic vs functional).

Results

For average speed, there was a significant effect of CONDITION—patients with both organic and functional dystonia performed better with geste (F1,24=13.5; p=0.001). There was no main effect of HAND or GROUP.

Conclusions

Geste antagonistes enhance motor performance in organic and functional dystonia. These selective voluntary movements may have a general effect on the execution of motor plans in dystonia. Sample numbers were too small to allow meaningful analysis of GROUP effects.
P81 Intraoperative MEP recordings from a urethral sphincter electrode for spinal conus tumour surgery and its importance
Authors: Shaikh A , Hilaya LA , Wilma G , Forster A , Ross S
Published: February 2019

Objectives

To emphasise the importance of motor evoked potential (MEP) recordings from a simple urethral sphincter electrode along with routine use of bulbocavernosus reflex recordings, anal sphincter and other lower limb muscle free running and stimulated EMG and MEP’s, and SEP techniques for sphincter preservation.

Design

Case report.

Subjects

Patients with conus or other spinal lesions at risk of postoperative sphincter disturbance.

Methods

Transcranial ‘train of 5’ stimulation (5 pulses, interstimulus interval 4msec, 200 µsec pulse width) was applied, with recordings from the urethral sphincter (small electrode taped to Foley catheter to lie just inside the urethra, referred to nearby needle anteriorly in mons pubis) and anal sphincter (paired needle electrodes in both left and right sides of external sphincter).

Results

Intraoperative stimuli of structures during dissection at one point gave a motor response confined to the urethral sphincter suggesting that these fibres may have been considered non-functional and cut had these not been assessed separately. Urethral sphincter MEP’s during the dissection confirmed that these motor fibres remained in continuity throughout.. The patient was intact after tumour removal.

Conclusions

This is an avant-garde technique by which we managed to save the nerve supply to the urethral sphincter and eventually urinary continence which would have been compromised if separate urethral monitoring was not attempted along with usual intraoperative nerve monitoring. We believe its first in the UK.
P91 Post-operative pain in neurosurgery
Authors: Haigh PM , Al-Hatimi F , Stewart H , Rajagopal S , Khalifa S , Smart J
Published: February 2019

Objectives

Are the analgesic guidelines for those neurosurgical operations associated with major and complex major pain consistently followed? Is there a correlation between adherence and post-operative pain?

Design

Patients undergoing spinal surgery and foramen magnum decompressions were visited on the first post-operative day (D1). They provided their pain score subjectively (0=nil; 10=worst ever experienced); objectively we recorded whether they could move in/out of bed without pain limitation.

Subjects

n=57 consecutive patients undergoing elective major and complex major pain neurosurgery between April and June 2018 at the NHNN, Queen Square.

Methods

A proforma was completed on D1. The patients consented to take part and answered three questions. We examined what (if any) analgesics they were admitted on, and what had been prescribed to cover the post-operative period. This was compared against the appropriate guideline for that category of operation.

Results

Guidelines were only followed in 16/57 (28.1%) cases; not followed in 41/57 (71.9%). On an unpaired T-test: 2-tailed P value=0.0195. Where guidelines were followed, the mean pain score reported was: 3.75 (SD 2.72) Where not followed, the mean pain score was 5.46 (SD 2.29). So with a 95% confidence interval −3.41 to −0.29, there is a significant difference between the pain in those prescribed according to the guidelines and those that were not.

Conclusions

The pain guidelines are not routinely followed. Most commonly this was due to no prescription for a non-steroidal anti-inflammatory agent. We suggest regular sessions of education of the guidelines. Cycle 2 closed the loop of the audit. We re-reviewed adherence and pain scores and found guidelines were followed in 34% of cases, which represented a 6% improvement. On a paired two-tailed P value=0.0794. The mean pain score where guidelines were followed=3.42 (SD1.62) against a mean=4.74 (SD 1.89) where guidelines were not followed.
P102 Shunting slit ventricles: a comparison of the parieto-occipital vs frontal approach
Authors: Craven CL , D’Antona L , Thompson S , Ramos J , Sennik S , Watkins LD , Toma AK
Published: February 2019

Objectives

Slit ventricles can be a challenging target during shunt catheter insertion. Traditionally, the frontal approach has been considered optimal. At this centre, routine use of electromagnetic (EM) stereotatic guidance (StealthTM, Medtronic) has enabled a parieto-occipital burr hole approach to the frontal horns. We compare shunt placement and revisions required for patients with slit ventricles who had shunts inserted via a parieto-occipital (P-O) approach vs. frontal shunt.

Design

Retrospective cohort.

Subjects

Patients with slit ventricles and a ventricular shunt inserted using EM guidance between 2012–2018.

Methods

Slit ventricles were defined as <3 mm (widest). Outcome measures included placement accuary and survival using Kaplan-Meier curve.

Results

82 patients (77F:5M) aged 34.9±10.8 years (mean ±SD) had shunts inserted for IIH (n=63), chiari/syrinx (n=8), congenital hydrocephalus (n=10), pseudomeningocoele (n=1). 35 had primary P-O shunts and 46 had frontal shunts. Overall, 94% of cases had the catheter tip sitting in the frontal horn. The P-O approach was just as accurate as the frontal approach. Eight P-O shunts and 9 frontal shunts required revision over a 60 month periods. There was no significant different in shunt survival between the two approaches (p=0.99).

Conclusions

EM guided placement has enabled the P-O approach to be as safe and with equivalent survival to frontal approach. The accuracy of shunt placement between the two approaches was equivocal.
P109 Experience of tunnelled vs. bolt EVDs on the intensive care unit
Authors: Asif H , Craven CL , Reddy U , Watkins LD , Toma AK
Published: February 2019

Objectives

The placement of an external ventricular drain (EVD) is a common neurosurgical operation that carries great benefit in acute hydrocephalus but is not without risk. In our centre, bolt EVDs (B-EVD) are being placed in favour of tunnelled EVDs (T-EVD). The former has allowed for urgent CSF diversion in ITU. We compared EVD survival and complication rates between the two types of EVDs.

Design

Single centre prospective case-cohort.

Subjects

Twenty-five patients with B-EVDs and thirty-four patients with T-EVDs.

Methods

Clinical notes and radiographic reports were collected before and after the placement of EVDs for patients in ITU between January 2017 and June 2018.

Results

Fourteen of the 25 B-EVDs were placed on ITU, of which 2 were under stealth guidance. All 34 T-EVDs were placed in theatre. Mean time to CSF access after decision for diversion was 134 min in the B-EVD group and 227 min in the T-EVD group (p<0.05). Mean survival was 35 days for B-EVDs and 29 days for T-EVDs (p<0.05). Eight T-EVDs went onto be replaced as B-EVDs due to retraction or infection. Complications including infection, detachment or retraction were higher in the T-EVD group at 32% compared to 20% in the B-EVD group.

Conclusions

Bolt EVDs have a lower frequency of complications and higher survival compared to tunnelled EVDs. Since B-EVDs require fewer resources they can be placed faster and on ITU.
P111 Successful treatment of type 1 spinal dural arteriovenous fistula results in reduction of spinal cord volume
Authors: Visagan R , Norman I , Elhag A , Correia J , Walsh D
Published: February 2019

Objectives

To examine the utility of standardised volumetric spinal cord measurement as an indicator of successful disconnection of a Type 1 spinal dural arteriovenous fistula.

Design

Retrospective analysis at a tertiary neuroscience centre.

Subjects

Patients with symptomatic Type 1 spinal dAVFs presenting to the senior author and neurovascular MDT (June 2009 – December 2017). Inclusion based on availability of appropriate cross-sectional imaging. DAVFs arising below T12 excluded: 18 patients with a total 19 dAVFs identified.

Methods

Type 1 fistulation demonstrated on TRICKS MR angiography and spinal catheter angiography. Sagittal volumes evaluated using Horos (Purview, Annapolis, USA) and wireframe models created. Measurement arbitrarily standardised at ±2 levels from the origin of the fistulous draining vein. Pre- and post-operative clinical outcomes assessed using the Aminoff-Logue Scale. Wilcoxon test employed for between-group comparisons and Spearman’s rank test for clinico-radiological correlation (Prism 7, GraphPad Software, Inc. California).

Results

Cord volumes reduced by a mean of 0.854 cm3 (p=0.0181; 95% CI=−1.55,–0.16; SD=1.44). Volume change was not related to gait (r=0.037, p=0.8812, 95% CI=−0.44, 0.49) or micturition scores (r=−0.24, p=0.3165, 95% CI=−0.64, 0.25).

Conclusions

Surgical disconnection of type 1 dAVF resulted in a reduction in spinal cord volume. This was not predictive of change in clinical indices in this small series but perhaps merits investigation of this as a surrogate marker in a larger series.
P118 A novel technique for repair of the vertebral artery during cranial surgery
Authors: Bonanos G , Prasad M , Mukerji N
Published: February 2019

Objectives

To demonstrate a novel/alternative technique for repair of the vertebral artery intraoperatively.

Design

Left-sided retromastoid craniotomy in one patient.

Subjects

A 61-year-old male patient with meningioma in the foramen magnum encasing the vertebral artery on the left side.

Methods

Standard retrosigmoid craniotomy performed with preservation of transverse and sigmoid sinuses. The dura was opened and the cerebellum was retracted with CSF release. The tumour was debulked gradually. The attempt to peel the tumour from the vertebral artery resulted in arterial bleeding. The hole in the artery was sealed using an N-hydroxysuccinimide functionalised polyethylene glycol-coated collagen patch (Hemopatch®, Baxter Healthcare Ltd) as an onlay, applying pressure for 2 minutes. Another patch was applied for further support and the artery checked for haemostasis. The dura was closed with 3–0 vicryl and Hemopatch® onlay after further tumour debulking.

Results

Haemostasis of the vertebral artery was achieved at 140 mmHg SBP and a catheter angiogram found no dissection or false lumen. The patient did not suffer postoperative haemorrhage and after three months of inpatient rehabilitation was discharged with significantly improved cranial nerve function. There was no CSF leak.

Conclusions

Haemostasis was successfully achieved in the vertebral artery with this novel technique. It can prove to be important in such scenarios where direct cross-clamping and arterial repair is technically challenging and can lead to brainstem ischemia.
WP1-1 Sphenopalatine ganglion stimulation for chronic cluster headache
Authors: Miller S , Lagrata S , Matharu M , Zrinzo L
Published: February 2019

Objectives

To assess outcome of sphenopalatine ganglion stimulation (SPGS) in chronic cluster headache (CCH) in a UK centre.

Design

Uncontrolled open-label single centre prospective study.

Subjects

Nine patients with medically refractory CCH.

Methods

Participants underwent sphenopalatine ganglion stimulator implantation, ipsilateral to CCH symptoms via a gingival incision, with fluoroscopy guidance and dyna-CT confirmation of contact location adjacent to the Vidian canal in the pterygopalatine fossa. One month after surgery, the device was programmed. Patients were instructed to provide stimulation as early as possible after attack onset and at least twice daily. The primary outcome was change in headache frequency as well as adverse events.

Results

Mean follow up was 14 months (SD 11.1, range: 3–31) with median reduction in headache frequency at last follow up of 73% (IQR: 67%–88%). At 3 months post op, 4/9 (45%) had at least 50% reduction in frequency of attacks; this increased to 8/9 patients (89%) at last follow up. Two patients became pain free (after 3 and 9 months). Preventative effects were seen in 7/9 and an acute effect in 2/9. One patient suffered numbness over the V2 distribution and did not respond to SPGS. The stimulator was removed 1 year later at the patient’s request. One wound infection settled with oral antibiotics.

Conclusions

Initial data from the UK confirms the results from previous studies and compares well with the results of occipital nerve stimulation for CCH.
P15 Resuming antiplatelet and anticoagulant therapy following isolated traumatic brain injury in adults: a national survey and review of literature
Authors: Valenzuela T , Fellows D , Zaben M , Shastin D , Leach P
Published: February 2019

Objectives

Antithrombotics use in the elderly is widespread and is seen as a risk factor for intracranial complications following TBI. Antithrombotics are commonly discontinued on admission, with little guidance on when or how to restart them. This study aims to establish current national practices with restarting antithrombotic medications following TBI and review available evidence identifying areas for further research.

Design

An online survey and a literature review.

Subjects

SBNS members.

Methods

A SBNS Academic Committee approved survey with five TBI scenarios dealing with different antithrombotics. Respondents were asked to indicate when they would restart the medications for each scenario and what drives their decision.

Results

Preliminary results included responses from 22 consultants. The most common practice was to restart antithrombotics after two weeks; however, less than 50% agreed on each individual option. About 50% had the same approach to everything and 1/3 believed single antiplatelet can be resumed earlier than dual antiplatelets. Other deciding factors included size of intracranial bleed, patient’s neurological recovery, and follow up imaging. Some advocated involving the physicians. Final results following a repeat dissemination of the survey will be presented at the meeting.

Conclusions

There is obvious discrepancy in how the problem of restarting antithombotics following TBI is approached nationally. Further research is needed to help decision making with this everyday clinical problem.
Planar plasmonic lens based on circular nanohole in a gold film in visible light range
Authors: Chen Fang , Sun Lihui , Zhang Huafeng , Li Jijun , Yu Chunchao
Published: February 2019

Plasmonic planar lens consisting of circular nanohole etched on the gold film have been investigated, the proposed plamonic lens was immersed in a high index medium to improve the focusing efficiency. The focal length and the full-width half-maximum beams width of the focal point were calculated in detail. The focal length calculated by FDTD simulation agrees well with Rayleigh–Sommerfeld integral. Moreover, the proposed lens structure is polarization-independent since circularly symmetric. The easy fabricate structure and excellent focusing performance of this plasmonic lens will open new avenues for optical storage and optical integration.
Integer-valued polynomials over block matrix algebras
Authors: Sedighi Hafshejani J. , Naghipour A. R. , Rismanchian M. R.
Published: February 2019

In this paper, we state a generalization of the ring of integer-valued polynomials over upper triangular matrix rings. The set of integer-valued polynomials over some block matrix rings is studied. In fact, we consider the set of integer-valued polynomials [Formula: see text] for each [Formula: see text], where [Formula: see text] is an integral domain with quotient field [Formula: see text] and [Formula: see text] is a block matrix ring between upper triangular matrix ring [Formula: see text] and full matrix ring [Formula: see text]. In fact, we have [Formula: see text]. It is known that the sets of integer-valued polynomials [Formula: see text] and [Formula: see text] are rings. We state some relations between the rings [Formula: see text] and the partitions of [Formula: see text]. Then, we show that the set [Formula: see text] is a ring for each [Formula: see text]. Further, it is proved that if the ring [Formula: see text] is not Noetherian then the ring [Formula: see text] is not Noetherian, too. Finally, some properties and relations are stated between the rings [Formula: see text], [Formula: see text] and [Formula: see text].
Stability of depth functions of cover ideals of balanced hypergraphs
Authors: Hang Nguyen Thu
Published: February 2019

We prove that the depth functions of cover ideals of balanced hypergraph have the nonincreasing property. Furthermore, we also give a bound for the index of depth stability of these ideals.
Response of a Two‐Degree‐of‐Freedom Vibration System with Rough Contact Interfaces
Authors: Huang Zhiqiang , Peng Xun , Li Gang , Hao Lei
Published: February 2019

This paper is focused on the influence of the rough contact interfaces on the dynamics of a coupled mechanical system. For this purpose, a two‐degree‐of‐freedom model of a coupled seismic‐vibrator‐rough‐ground system is proposed with which the nonlinear vibration properties are analyzed. In this model, the force‐deflection characteristic of the contact interfaces is determined by finite element analysis. By analyzing the undamped free vibration, it was found that the variation of the second‐order natural frequency with amplitude increases with rougher contact interfaces; however, the amplitude has little influence on the first‐order natural frequency of the system. For the harmonic excited analysis, the jump frequencies and hysteretic region both decrease with rougher contact interfaces. Moreover, it is inferred from the bifurcation diagrams that, increasing the excitation force, the system can bring about chaotic motions on rough contact interfaces.
Association of FMO3 Variants with Blood Pressure in the Atherosclerosis Risk in Communities Study
Authors: Bryant Tyler S. , Duggal Priya , Yu Bing , Morrison Alanna C. , Shafi Tariq , Ehret Georg , Franceschini Nora , Boerwinkle Eric , Coresh Josef , Tin Adrienne
Published: February 2019

Flavin containing monooxygenase 3 [FMO3] encodes dimethylaniline monooxygenase [N-oxide-forming] 3, which breaks down nitrogen-containing compounds, and has been implicated in blood pressure regulation. Studies have reported conflicting results of the association of a common nonsynonymous variant, E158K (rs2266782), with hypertension. We examined the associations of E158K, along with rare and low frequency exonic variants (minor allele frequency [MAF]<5%) in FMO3 with hypertension, systolic blood pressure (SBP), and diastolic blood pressure (DBP). We included 7,350 European Americans and 2,814 African Americans in the Atherosclerosis Risk in Communities (ARIC) study with exome sequencing of FMO3. The association of FMO3 variants with SBP and DBP was tested using single variant and gene-based tests followed by the replication or interrogation of significant variants in ancestry-specific cohorts based on Bonferroni corrected thresholds. E158K had significant association with higher SBP in African Americans in ARIC (p=0.03), and two low frequency variants had significant association with higher SBP in African Americans (rs200985584, MAF 0.1%, p=0.0003) and European Americans (rs75904274, MAF 1.7%, p=0.006). These associations were not significant with additional samples: E158K in a meta-analysis of SBP of African ancestry (N=30,841, p=0.43) that included ARIC participants and the two low frequency variants in an independent ancestry-specific exome sequencing study of blood pressure (rs200985584, p=0.94; rs75904274, p=0.81). Our study does not support the association of E158K and low frequency variants in FMO3 with blood pressure and demonstrates the importance of replication in genetic studies.
Gut Microbiota, a Potential New Target for Chinese Herbal Medicines in Treating Diabetes Mellitus
Authors: Zhang Boxun , Yue Rensong , Chen Yuan , Yang Maoyi , Huang Xiaoying , Shui Jiacheng , Peng Yuliang , Chin Jiawei
Published: February 2019

The gut microbiota, as an important factor affecting host health, plays a significant role in the occurrence and development of diabetes mellitus (DM), and the mechanism may be related to excessive endotoxins, altered short-chain fatty acids (SCFAs), and disordered bile acid metabolism. Traditional Chinese medicine (TCM) has a long history of treating DM, but its mechanism is not very clear. Recent research has suggested that Chinese herbal medicine can improve glucose metabolism by remodeling the gut microbiota, which opens new avenues for further research on hypoglycemic mechanisms. This review presents the recent progress of Chinese herbs, herbal extracts, and herbal compound preparations in treating DM through regulating the gut microbiota and summarizes the main mechanisms involved, namely, anti-inflammatory and antioxidative effects, protecting the intestinal barrier and inhibiting lipotoxicity. In addition, some suggestions for improvement are also proposed.