bluuebunny/crossref_metadata_2025 huggingface dataset:
Plasmonic metasurface for optical rotation
Authors: Wen Dandan , Yue Fuyong , Zhang Chunmei , Zang Xiaofei , Liu Huigang , Wang Wei , Chen Xianzhong
Published: July 2017

Optical activity, known as optical rotation, has found many applications ranging from optical isolators and concentration determination to sophisticated organic structure analysis. Miniaturization and integration are two continuing trends in the production of photonic devices. However, there are fundamental or technical challenges to further reduce the thickness of the optical elements to generate desirable polarization rotation with broadband and high efficiency. Here, in this paper, an efficient method to realize optical rotation for the visible and near infrared light is experimentally demonstrated using an ultrathin metasurface. The polarization rotation originates from the additional phase difference between the two circular polarizations induced by the rectangular metasurface phase grating. Benefiting from the advantages of the reflective metasurface, the fabricated highly efficient device can operate in the broadband. Good agreement between the designed rotation angle and measured results renders this technique very attractive for practical applications in device miniaturization and system integration.
Electric field control in DC cable test termination by nano silicone rubber composite
Authors: Song Shu-Wei , Li Zhongyuan , Zhao Hong , Zhang Peihong , Han Baozhong , Fu Mingli , Hou Shuai
Published: July 2017

The electric field distributions in high voltage direct current cable termination are investigated with silicone rubber nanocomposite being the electric stress control insulator. The nanocomposite is composed of silicone rubber, nanoscale carbon black and graphitic carbon. The experimental results show that the physical parameters of the nanocomposite, such as thermal activation energy and nonlinearity-relevant coefficient, can be manipulated by varying the proportion of the nanoscale fillers. The numerical simulation shows that safe electric field distribution calls for certain parametric region of the thermal activation energy and nonlinearity-relevant coefficient. Outside the safe parametric region, local maximum of electric field strength around the stress cone appears in the termination insulator, enhancing the breakdown of the cable termination. In the presence of the temperature gradient, thermal activation energy and nonlinearity-relevant coefficient work as complementary factors to produce a reasonable electric field distribution. The field maximum in the termination insulator show complicate variation in the transient processes. The stationary field distribution favors the increase of the nonlinearity-relevant coefficient; for the transient field distribution in the process of negative lighting impulse, however, an optimized value of the nonlinearity-relevant coefficient is necessary to equalize the electric field in the termination.
Design of a plasmonic back reflector using Ag nanoparticles with a mirror support for an a-Si:H solar cell
Authors: Hungerford Chanse D. , Fauchet Philippe M.
Published: July 2017

Plasmonic nanoparticles have unique optical properties and these properties are affected by any surrounding structures, or lack thereof. Nanoparticles are often added to a device without fully assessing the effect that each interface will have on the nanoparticle’s response. In this work, we simulate and fabricate devices utilizing hemispherical nanoparticles integrated into the back reflector of an amorphous silicon solar cell. 3D finite difference time domain simulations were used to calculate the optical absorption of a 300nm amorphous silicon layer as a function of the size of the nanoparticles, the distance between the nanoparticles and the active layer, and the distance between the nanoparticles and the mirror. Two transparent conducting oxides, aluminum doped zinc oxide and indium tin oxide, are investigated to determine the importance of the material properties between the nanoparticles and mirror. Silver hemispherical nanoparticles with a diameter of 150nm placed directly on the a-Si:H and a 60nm aluminum doped zinc oxide layer between the nanoparticles and the mirror lead to a maximum absorption increase of 7.2% in the 500nm to 800nm wavelength range. Experimental devices confirmed the trends predicted by theory but did not achieve enhancement, likely due to fabrication challenges. Fabricating a solar cell with the simulated design requires a high quality transparent conductive oxide and high control over the nanoparticle size distribution.
Suboptimal T-cell receptor signaling compromises protein translation, ribosome biogenesis, and proliferation of mouse CD8 T cells
Authors: Tan Thomas C. J. , Knight John , Sbarrato Thomas , Dudek Kate , Willis Anne E. , Zamoyska Rose
Published: July 2017

Significance

Optimal antigenic stimulation through T-cell receptors is required by T lymphocytes to exert full expansion, effector functions, and memory cell differentiation. Suboptimal TCR stimulation influences both transcription of genes and synthesis of subsets of proteins in a nonconcordant manner. Detailed polysome profiling revealed that weakly activated cells prioritized mRNA translation so that specific transcripts were translationally sequestered. Strikingly, ribosome biogenesis was compromised at both transcriptional and translational levels after weak stimulation, which still allowed the cells to undergo initial cell division, but proliferation was not sustained. Our work has demonstrated that T cells respond to environmental signals and use specific components of the translation machinery to regulate the translation of activation-dependent mRNAs.
Plus ça change? Mining in South Africa in the last 30 years – an overview
Authors: Macmillan Hugh
Published: July 2017

This article examines the history of South African mining over the last 30 years. It notes the declining contribution of mining to the economy, and a drop in employment levels and labour migration. It considers political, legislative and macro-economic changes, as well as mine ownership and control. It addresses the question why a democratically elected government, progressive labour legislation, trade-unionisation and Black Economic Empowerment have made remarkably little difference to working conditions. After examining the trajectories of individual commodities, such as gold, platinum, coal and diamonds, it concludes there has been no fundamental change in the relationship between state and capital.
Saccharomyces cerevisiae MSA1 mRNA has a sequence for localization at the bud tip
Authors: Takeuchi-Andoh Tomoko , Hayano-Oshiro Yukiko , Nishiyoshi Emi , Mutazono Masatoshi , Hayashi Sachiko , Tani Tokio
Published: July 2017

MSA1 mRNA encodes Msa1p, a protein associated with the SCB-binding factor (SBF) and MCB-binding factor (MBF) complex. Msa1p promotes the transcription of G1 phase-specific genes, and is subjected to cell cycle-dependent regulation for its abundance and subcellular localization. MSA1 mRNA and Msa1p levels oscillate in the cell cycle with peaks at the late M/early G1 phase and early G1 phase, respectively. Phosphorylation by CDK1 negatively regulates the nuclear localization of Msa1p. In the present study, we identified MSA1 mRNA as a bud tip-localized mRNA in screening using a Tag-GFP system. A fragmentation analysis revealed a sequence of ~145 bases for the bud tip localization. Endogenous MSA1 mRNA localized at the bud tip in a manner that depended on SHE2. Msa1p levels were also affected by SHE2 in cells constitutively expressing MSA1 mRNA. These results suggest the existence of a regulatory mechanism for Msa1p through the localized control of MSA1 mRNA.
Investigation of the efficacy and safety of CyberKnife hypofractionated stereotactic radiotherapy for brainstem metastases using a new evaluation criterion: ‘symptomatic control’
Authors: Nakamura Masaki , Nishimura Hideki , Mayahara Hiroshi , Uezono Haruka , Harada Aya , Hashimoto Naoki , Ejima Yasuo , Ishihara Takeaki , Nishikawa Ryo , Sasaki Ryohei
Published: July 2017

The treatment of brainstem metastases remains a challenge as the brainstem itself is considered a neurological organ at risk. We aimed to investigate the efficacy and safety of CyberKnife hypofractionated stereotactic radiotherapy (HFSRT) for brainstem metastases, and to examine the balance between efficacy and safety for the management of neurological symptoms. A total of 26 lesions [pons (n = 18), medulla (n = 4) and midbrain (n = 4)] in 20 patients treated with CyberKnife hypofractionated stereotactic radiotherapy were retrospectively analyzed. The total radiation doses (18–30 Gy) were delivered in 3 or 5 equal fractions. The median follow-up was 6.5 (range, 0.5–38.0) months. The 6- and 12-month local control rates were 100% and 90%, respectively. Symptomatic failures, defined as the worsening and appearance of neurological symptoms due to the brainstem lesion after CyberKnife HFSRT, were observed in 6 patients [local failure (n = 1) and adverse events (n = 5). The symptomatic control and overall survival rates were 90% and 72% (after 6 months), respectively, and 76% and 53% (after 12 months), respectively. Longer symptomatic control was associated with site of lesion origin, and longer overall survival was associated with a graded prognostic assessment score of >2. To our knowledge, this is the second study to investigate the efficacy and safety of CyberKnife HFSRT for brainstem metastases. The local control rate was comparable with that of prior stereotactic radiosurgery studies. We propose a new evaluation criterion—‘symptomatic control’—to evaluate the efficacy and safety of brainstem radiotherapy.
Predicting Ascospore Release of Monilinia vaccinii-corymbosi of Blueberry with Machine Learning
Authors: Harteveld Dalphy O. C. , Grant Michael R. , Pscheidt Jay W. , Peever Tobin L.
Published: July 2017

Mummy berry, caused by Monilinia vaccinii-corymbosi, causes economic losses of highbush blueberry in the U.S. Pacific Northwest (PNW). Apothecia develop from mummified berries overwintering on soil surfaces and produce ascospores that infect tissue emerging from floral and vegetative buds. Disease control currently relies on fungicides applied on a calendar basis rather than inoculum availability. To establish a prediction model for ascospore release, apothecial development was tracked in three fields, one in western Oregon and two in northwestern Washington in 2015 and 2016. Air and soil temperature, precipitation, soil moisture, leaf wetness, relative humidity and solar radiation were monitored using in-field weather stations and Washington State University’s AgWeatherNet stations. Four modeling approaches were compared: logistic regression, multivariate adaptive regression splines, artificial neural networks, and random forest. A supervised learning approach was used to train the models on two data sets: training (70%) and testing (30%). The importance of environmental factors was calculated for each model separately. Soil temperature, soil moisture, and solar radiation were identified as the most important factors influencing ascospore release. Random forest models, with 78% accuracy, showed the best performance compared with the other models. Results of this research helps PNW blueberry growers to optimize fungicide use and reduce production costs.
Risk of Subsequent Ovarian Cancer After Ovarian Conservation in Young Women With Stage I Endometrioid Endometrial Cancer
Authors: Matsuo Koji , Machida Hiroko , Stone Rebecca L. , Soliman Pamela T. , Thaker Premal H. , Roman Lynda D. , Wright Jason D.
Published: July 2017

OBJECTIVE:

To examine the cumulative incidence of subsequent ovarian cancer among young women with stage I endometrioid endometrial cancer who had ovarian conservation at surgical treatment.

METHODS:

This retrospective study examined the Surveillance, Epidemiology, and End Results Program to identify women aged younger than 50 years who underwent hysterectomy with ovarian conservation for stage I endometrioid endometrial cancer between 1983 and 2013. Time-dependent risk of ovarian cancer diagnosed during the follow-up after endometrial cancer diagnosis was examined.

RESULTS:

Among 1,322 women in the study cohort, 16 women developed subsequent ovarian cancer with 5- and 10-year cumulative incidences of 1.0% and 1.3%, respectively. Median time to develop subsequent ovarian cancer was 2.4 years, and the majority of subsequent ovarian cancer was diagnosed within the first 3 years from the diagnosis of endometrial cancer (68.8%). The majority of subsequent ovarian cancer was endometrioid type (81.3%) and stage I disease (75.0%). With a median follow-up time of 11.6 years, there were no ovarian cancer deaths. Younger age at endometrial cancer diagnosis was significantly associated with increased risk of subsequent ovarian cancer (10-year cumulative incidences: age younger than 40 compared with 40–49 years, 2.6% compared with 0.4%, hazard ratio 5.00, 95% confidence interval [CI] 1.60–15.7,P=.002).

CONCLUSION:

Young women with stage I endometrioid endometrial cancer have an approximately 1% risk of developing subsequent ovarian cancer after ovarian conservation at the time of hysterectomy that was associated with favorable tumor factors resulting in good ovarian cancer-specific survival. Our results endorse the importance of genetic testing and close follow-up when counseling about this procedure, especially for those who are younger than 40 years.
Risk Factors for Emergency Department Visits After Hysterectomy for Benign Disease
Authors: Mahnert Nichole , Kamdar Neil , Lim Courtney S. , Skinner Bethany , Hassett Afton , Kocher Keith E. , Morgan Daniel M. , As-Sanie Sawsan
Published: July 2017

OBJECTIVE:

To identify the incidence, indications, and risk factors for emergency department visits that do not result in readmission within 30 days of hysterectomy for benign disease.

METHODS:

We conducted a secondary data analysis of hysterectomies for benign disease using the Michigan Surgical Quality Collaborative, a statewide group of hospitals that voluntarily reports perioperative outcomes. Hysterectomies for benign disease were abstracted from January 1, 2013, to July 2, 2014. We examined the incidence of emergency department visits within 30 days after hysterectomy for benign disease and constructed a multivariable logistic regression model to identify risk factors for these visits. We focused on emergency department visits that did not result in readmission because they are more likely to represent avoidable encounters.

RESULTS:

Among the 10,274 women who underwent hysterectomy for benign disease during the study period, 932 (9.1%) presented to the emergency department and were not readmitted to the hospital. Based on a multivariable regression model, risk factors for emergency department visits after hysterectomy for benign disease were younger age, higher parity, Medicaid or self-pay insurance, prior venous thromboembolism, chronic obstructive pulmonary disease, preoperative surgical indication of chronic pelvic pain, and postoperative day 1 pain scores greater than 4 on a 0–10 numeric rating scale. The most common primary emergency department International Classification of Diseases, 9th Revision diagnoses were for pain (29.5% [n=275]), gastrointestinal (12.8% [n=118]), and genitourinary (10.7% [n=99]) complaints.

CONCLUSION:

Approximately 1 in 11 women present to the emergency department, but do not result in readmission within 30 days of hysterectomy for benign disease. Emergency department visits might be avoided with expanded perioperative education and improved communication pathways for high-risk patients.
Transient Fetal Tachycardia After Intravenous Diphenhydramine Administration
Authors: Abernathy Alice , Alsina Laura , Greer Jessica , Egerman Robert
Published: July 2017

BACKGROUND:

Fetal tachycardia is attributable to a variety of etiologies, including an untreated maternal medical condition or an indicator of potential fetal compromise. Maternal medication administration may also affect the fetal heart rate.

CASE:

A 28-year-old nulliparous patient at 41 weeks of gestation was treated for pruritus with intravenous diphenhydramine after epidural administration of fentanyl. Within 14 minutes, the fetal heart rate increased from a baseline of 155 beats per minute (bpm) to more than 200 bpm while maintaining moderate variability. This was accompanied by an increase in uterine contractions occurring every 1.5 minutes. The fetal tachycardia lasted 51 minutes; several hours later, a healthy neonate was delivered.

CONCLUSION:

Diphenhydramine may produce transient fetal tachycardia as well as increased maternal uterine activity.
Repair of Bimalleolar Ankle Fracture
Authors: Fisher Nina , Atanda Abiola , Swensen Stephanie , Egol Kenneth A.
Published: July 2017

Purpose:

The incidence of ankle fractures is rapidly increasing in geriatric populations. Of the 4 fracture patterns described by the Lauge-Hansen classification system, supination-external rotation (SER) accounts for most ankle fractures. This video demonstrates surgical repair of a SER type 4 ankle fracture in a geriatric patient.

Methods:

SER type 4 ankle fractures are considered unstable and are generally treated with surgical fixation. After placement of plate and screws, intraoperative stress tests can be used to assess for syndesmotic widening. If necessary, the syndesmosis can be reduced open, with screw fixation placed parallel to the joint. Patients are kept non–weight-bearing for 6 weeks after surgery.

Results:

This video, shot on an iPhone 6S, shows the case of a 66-year-old female status after a fall with twisting mechanism resulting in an unstable SER type 4 fracture requiring operative repair. Intraoperative stress test revealed medial clear space widening requiring syndesmotic reduction.

Conclusions:

SER type 4 ankle fractures are a common injury that must be properly managed to return patients to baseline functional status. The surgical technique described in this video provides for good stabilization and allows for early range of motion with advancement to weight-bearing as tolerated at 6 weeks postoperatively.
Humeral Shaft Fracture: Intramedullary Nailing
Authors: Konda Sanjit R. , Saleh Hesham , Fisher Nina , Egol Kenneth A.
Published: July 2017

Introduction:

This video demonstrates the technique of intramedullary nailing for a humeral shaft fracture.

Methods:

The patient is a 30-year-old man who sustained a gunshot wound to his right arm. The patient was indicated for humeral nailing given the comminuted nature of the diaphysis and to allow for minimal skin incisions. Other relative indications include soft-tissue compromise about the arm precluding a large surgical exposure.

Results:

This video presents a case of a comminuted humeral shaft fracture treated with an intramedullary nail. Anatomic reduction and stable fixation was obtained with this technique.

Conclusion:

This case demonstrates a soft-tissue sparing technique of humeral shaft fixation using a humeral intramedullary nail. The technique is easy to perform and has significant benefits in minimizing surgical exposure, decreasing operative time, and decreasing blood loss. In the correct clinical setting, humeral nailing provides an expeditious form of fixation that restores length, alignment, and rotation of the fracture humeral diaphysis.
Intraarticular Distal Radius Fracture Open Reduction Internal Fixation
Authors: Nydick Jason A. , Streufert Benjamin D. , Stone Jeffrey D.
Published: July 2017

Purpose:

Intraarticular distal radius fractures are often treated with open reduction and internal fixation (ORIF) through a volar approach. This common approach, however, is technically demanding to restore the articular surface of the radiocarpal joint while respecting soft tissue integrity. The purpose of this video is to demonstrate the surgical technique of volar plate fixation of an intraarticular distal radius fracture.

Methods:

A 32-year-old patient who sustained multiple injuries including an intraarticular distal radius fracture was treated with ORIF by a volar approach.

Results:

Exposure is performed through a standard flexor carpi radialis approach. The intraarticular fracture of the distal radius is reduced, and a volar plate is applied. Careful measurement of screw length is described in detail to minimize postoperative tendon irritation. Closure of the soft tissues is completed and early postoperative rehabilitation is emphasized.

Discussion:

Multiple, varied techniques for fixation of intraarticular distal radius fractures are described in the literature. As demonstrated in this video of ORIF with a volar plate, attention to articular reduction, soft-tissue protection, and postoperative rehabilitation are key components used to achieve good clinical outcomes.
Defining a Ventilation Strategy for Flexible Bronchoscopy on Mechanically Ventilated Patients in the Medical Intensive Care Unit
Authors: Greenstein Yonatan Y. , Shakespeare Eric , Doelken Peter , Mayo Paul H.
Published: July 2017

Background:

Flexible bronchoscopy (FB) in intubated patients on mechanical ventilation increases airway resistance. During FB, two ventilatory strategies are possible: maintaining tidal volume (V
T) while maintaining baseline CO2 or allowing reduction of V
T. The former strategy carries risk of hyperinflation due to expiratory flow limitation with FB. The aim of the authors was too study end expiratory lung volume (EELV) during FB of intubated subjects while limiting V
T.

Methods:

We studied 16 subjects who were intubated on mechanical ventilation and required FB. Changes in EELV were measured by respiratory inductance plethysmography. Ventilator mechanics, EELV, and arterial blood gases, were measured.

Results:

FB insertions decreased EELV in 64% of cases (−325±371 mL) and increased it in 32% of cases (65±59 mL). Suctioning decreased EELV in 76% of cases (−120±104 mL) and increased it in 16% of cases (29±33 mL). Respiratory mechanics were unchanged. Pre-FB and post-FB, PaO2 decreased by 61±96 mm Hg and PaCO2 increased by 15±7 mm Hg.

Conclusions:

There was no clinically significant increase in EELV in any subject during FB. Decreases in EELV coincided with FB-suctioning maneuvers. Peak pressure limiting ventilation protected the subject against hyperinflation with a consequent, well-tolerated reduction in V
T, and hypercapnea. Suctioning should be limited, especially in patients vulnerable to derecruitment effect.
Helicobacter pylori infection among patients with liver cirrhosis
Authors: Pogorzelska Joanna , Łapińska Magda , Kalinowska Alicja , Łapiński Tadeusz W. , Flisiak Robert
Published: July 2017

Background and aim

Inflammatory changes in the stomach caused by Helicobacter pylori indirectly and directly affect liver function. Moreover, the bacteria may worsen the course of the liver cirrhosis. The study aimed at evaluating the incidence of H. pylori infection among patients with liver cirrhosis, depending on the etiology and injury stage, scored according to Child–Pugh classification. Stage of esophageal varices and endoscopic inflammatory lesions in the stomach were evaluated, depending on the presence of H. pylori infection.

Patients and methods

The study included 147 patients with liver cirrhosis: 42 were infected with hepatitis C virus, 31 were infected with hepatitis B virus, 56 had alcoholic liver cirrhosis, and 18 had primary biliary cirrhosis. Diagnosis of H. pylori infection was performed based on the presence of immunoglobulin G antibodies in serum.

Results

H. pylori infection was found in 46.9% of patients. The incidence of H. pylori infection among patients with postinflammatory liver cirrhosis was significantly higher (P=0.001), as compared with patients with alcoholic liver cirrhosis. Ammonia concentration was significantly higher in patients infected with H. pylori, compared with noninfected individuals (129 vs. 112 μmol/l; P=0.002). Incidence of H. pylori infection in patients without esophageal varices was significantly lower compared with patients with esophageal varices (14 vs. 60%; P<0.001).

Conclusion

H. pylori infection is significantly more frequent among patients with postinflammatory liver cirrhosis (infected with hepatitis C virus or hepatitis B virus) than in patients with alcoholic liver cirrhosis or primary biliary cirrhosis. H. pylori infection correlates with elevated concentration of blood ammonia and the incidence of esophageal varices.
Reliability of Smartphone-Based Instant Messaging Application for Diagnosis, Classification, and Decision-making in Pediatric Orthopedic Trauma
Authors: Stahl Ido , Katsman Alexander , Zaidman Michael , Keshet Doron , Sigal Amit , Eidelman Mark
Published: July 2017

Objective

Smartphones have the ability to capture and send images, and their use has become common in the emergency setting for transmitting radiographic images with the intent to consult an off-site specialist. Our objective was to evaluate the reliability of smartphone-based instant messaging applications for the evaluation of various pediatric limb traumas, as compared with the standard method of viewing images of a workstation-based picture archiving and communication system (PACS).

Methods

X-ray images of 73 representative cases of pediatric limb trauma were captured and transmitted to 5 pediatric orthopedic surgeons by the Whatsapp instant messaging application on an iPhone 6 smartphone. Evaluators were asked to diagnose, classify, and determine the course of treatment for each case over their personal smartphones. Following a 4-week interval, revaluation was conducted using the PACS. Intraobserver agreement was calculated for overall agreement and per fracture site.

Results

The overall results indicate “near perfect agreement” between interpretations of the radiographs on smartphones compared with computer-based PACS, with κ of 0.84, 0.82, and 0.89 for diagnosis, classification, and treatment planning, respectively. Looking at the results per fracture site, we also found substantial to near perfect agreement.

Conclusions

Smartphone-based instant messaging applications are reliable for evaluation of a wide range of pediatric limb fractures. This method of obtaining an expert opinion from the off-site specialist is immediately accessible and inexpensive, making smartphones a powerful tool for doctors in the emergency department, primary care clinics, or remote medical centers, enabling timely and appropriate treatment for the injured child. This method is not a substitution for evaluation of the images in the standard method over computer-based PACS, which should be performed before final decision-making.
How Accurate Are Pediatric Emergency Tapes? A Comparison of 4 Emergency Tapes With Different Length-Based Weight Categorization
Authors: Both Christian P. , Schmitz Achim , Buehler Philipp K. , Weiss Markus , Schmidt Alexander R.
Published: July 2017

Objective

Pediatric emergency tapes have been developed to support paramedics and emergency physicians when dosing drugs and selecting medical equipment in pediatric emergency situations. The aim of this study was to compare the accuracy of 4 pediatric emergency tapes to correctly estimate patient's weight based on a large population of patients.

Methods

Patients undergoing general anesthesia between January 2012 and March 2015 with documented age, sex, body weight, and length were identified from the electronic anesthesia patient data management system of the Department of Anaesthesia, University Children's Hospital, Zurich, Switzerland. Weight estimation by means of the Broselow-Tape, the Pädiatrisches Notfalllineal, the Paulino System, and the Kinder-Sicher were compared with true patient's weight. Percentages of estimated body weight within a ±10% and ±20% interval were calculated. Data are median (interquartile range) or count (percent); statistical calculations were done with McNemar and Bonferroni correction.

Results

A total of 3307 patients were identified with complete data sets, 1930 (58.4%) were male, median age was 4.1 years (1.1–8.2 years), median length 101.0 cm (74.0–126.0 cm) and median patient weight 15.8 kg (9.2–25.0 kg). The proportion weight estimation within the ±10% and the ±20% interval was the highest in the Broselow-Tape with 54.0% and 81.5% (P < 0.001 and P = 0.003), followed by the Pädiatrisches Notfalllineal (50.5% and 79.8%), Paulino System (49.9% and 78.0%) and Kinder-Sicher (48.2% and 77.5%).

Conclusions

The overall accuracy of all 4 emergency tapes tested is poor and including a larger number of weight categories does not necessarily increase accuracy. Other strategies have to be developed to improve weight estimation in pediatric emergency situations.
The Use, Safety, and Efficacy of Olanzapine in a Level I Pediatric Trauma Center Emergency Department Over a 10-Year Period
Authors: Cole Jon B. , Klein Lauren R. , Strobel Ashley M. , Blanchard Stephane R. , Nahum Rebecca , Martel Marc L.
Published: July 2017

Objectives

Olanzapine is a second-generation antipsychotic increasingly used in emergency medicine for many indications. Literature on its use in children is sparse. Our objectives were to describe the use, safety, and efficacy of olanzapine in pediatric emergency patients.

Methods

A structured chart review was performed of patients 18 years old or younger receiving olanzapine from 2007 to 2016 in the emergency department of a pediatric level I trauma center.

Results

A total of 285 children received olanzapine. Mean age was 16.4 years (range, 9–18 years); 121 were male (42.8%). Primary indications for olanzapine included agitation (n = 166, 58.3%), headache (n = 58, 20.4%), nausea/vomiting/abdominal pain (n = 37, 12.5%), unspecified pain (n = 20, 7%), and other (n = 4, 1.4%). Route of olanzapine administration was intramuscular (n = 160, 56%; median dose, 10 mg; range, 2.5–20), intravenous (n = 101, 36%; median dose, 5 mg; range, 1.25–5), and oral (n = 24, 8%; median dose, 10 mg; range, 5–10). For agitated patients, 28 (17%) received another sedative within 1 hour. For headache patients, 5 (8.6%) received another analgesic. For gastrointestinal complaints, 5 patients (13.5%) received another analgesic/antiemetic. Adverse respiratory events were hypoxia (pulse oximetry reading, in percentage, <92%; n = 7, 2.4%), supplemental oxygen placement (n = 9, 3.2%), and intubation (n = 2, 0.7%). No patient died or had a dysrhythmia. One patient experienced dystonia.

Conclusions

Olanzapine seems safe when used for a variety of conditions in pediatric emergency patients. It may be effective for acute agitation, primary headache, and gastrointestinal complaints.
Prospective Evaluation of Lymph Node Processing at Staging Surgery for High-grade Endometrial Cancer
Authors: Davidson Brittany A. , Ehrisman Jessie , Abbott Sara , Harmon Zach , Secord Angeles A. , Berchuck Andrew , Lee Paula S. , Valea Fidel A. , Li Xuechan , Havrilesky Laura J. , Hall Allison H.S.
Published: July 2017

To determine whether the processing of additional adipose tissue collected during lymph node (LN) dissection results in the identification of additional LNs during endometrial cancer (EC) staging and to determine if the division of LNs into nodal basin–specific specimens has an effect on the number of LNs identified during EC staging. A prospective randomized controlled trial was performed on women with high-grade EC undergoing surgical staging. Subjects were randomized to collection of LNs into nodal basin–specific containers on the randomized side versus simple labeling on the nonrandomized side. The total number of LNs and total number of LNs with metastases on the randomized versus the nonrandomized side were compared. The remaining adipose tissue from each LN specimen was submitted for histologic examination. We analyzed the number of LNs with and without metastases identified from additional adipose tissue. Of 120 consented subjects, 56 had sufficient data for analysis. The additional adipose tissue contained 7.5 additional LNs per patient on average (range: 0–26). In 2/54 total cases (3.7%) and 2/5 cases with nodal metastases (40%), the additional adipose contained LNs with metastases. In both cases, metastases were also detected in grossly identified LN candidates. The mean number of LNs identified was not significantly different based on method of collection (P=0.22). The mean number of LNs containing metastases per side was not significantly different (P=0.58). Processing of adipose tissue does increase the total number of LNs identified, however, it does not influence EC stage. No difference in LN counts was noted with basin-specific collection.
Experimental Models of Endotheliopathy: Impact of Shock Severity
Authors: Hofmann Nikolaus , Zipperle Johannes , Jafarmadar Mohammad , Ashmwe Mostafa , Keibl Claudia , Penzenstadler Carina , Ponschab Martin , Jafarmadar Behnaz , Redl Heinz , Bahrami Soheyl , Schöchl Herbert
Published: July 2017

Background:

Hemorrhagic shock (HS) followed by resuscitation is often associated with sympathoadrenal activation (SAA) and endothelial damage (ED).

Objective:

We aimed to evaluate the impact of HS alone on the magnitude of SAA and consecutive ED, and to characterize potential targets for a standardized and reproducible model of HS-induced endotheliopathy in rats.

Methods:

Rats were subjected either to a volume-controlled HS (40% of total blood volume: v-HS group) or to a laboratory-guided HS (l-HS) targeting base deficit (BD) more than 5.5 mmol/L and/or lactate more than 2.2 mmol/L using a pressure-controlled volume loss.

Results:

At the end of shock, mean arterial pressure was significantly higher in the v-HS than the l-HS group (36 ± 5.6 vs. 30 ± 3.0 mmHg; P < 0.01). Base deficit and lactate were higher in l-HS than the v-HS group (BD: 9.5 ± 2.5 vs. 3.0 ± 1.0 mmol/L; P < 0.001; lactate: 4.1 ± 1.3 vs. 1.6 ± 0.6 mmol/L; P < 0.001). sVEGFR-1 and syndecan-1 were approximately 50% higher in the l-HS than the v-HS group (% changes vs. baseline: 160 ± 10 vs. 116 ± 36; P < 0.01; 170 ± 37 vs. 113 ± 27; P < 0.001). Adrenaline was 2-fold higher in l-HS than the v-HS group (1964 ± 961% vs. 855 ± 451%; P < 0.02, respectively). Moreover, linear regression analysis revealed an independent association of shock severity BD with syndecan-1 (rho = 0.55, P = 0.0005), sVEGFR1 (rho = 0.25, P < 0.05), and adrenaline (rho = 0.31, P = 0.021).

Conclusions:

Our findings indicate that ED has already occurred during HS without reperfusion; intensity is strongly related to the severity of HS and consecutive SAA; and severity may appropriately be targeted and standardized in a HS model controlled by biological endpoints such as BD and/or lactate.
Science Game Lab: tool for the unification of biomedical games with a purpose
Authors: Good Benjamin M. , Santini Sarah , Wallace Margaret , Fortugno Nicholas , Szeder John , Mooney Patrick , Waldispuhl Jerome , Tsueng Ginger , Su Andrew I
Published: July 2017

Games with a purpose and other kinds of citizen science initiatives demonstrate great potential for advancing biomedical science and improving STEM education. Articles documenting the success of projects such as Fold.it and Eyewire in high impact journals have raised wide interest in new applications of the distributed human intelligence that these systems have tapped into. However, the path from a good idea to a successful citizen science game remains highly challenging. Apart from the scientific difficulties of identifying suitable problems and appropriate human-powered solutions, the games still need to be created, need to be fun, and need to reach a large audience that remain engaged for the long-term. Here, we describe Science Game Lab (SGL) (https://sciencegamelab.org), a platform for bootstrapping the production, facilitating the publication, and boosting both the fun and the value of the user experience for scientific games with a purpose.
Developmental constraints on genome evolution in four bilaterian model species
Authors: Liu Jialin , Robinson-Rechavi Marc
Published: July 2017

Developmental constraints on genome evolution have been suggested to follow either an early conservation model or an “hourglass” model. Both models agree that late development strongly diverges between species, but debate on which developmental period is the most conserved. Here, based on a modified “Transcriptome Age Index” approach, i.e. weighting trait measures by expression level, we analyzed the constraints acting on three evolutionary traits of protein coding genes (strength of purifying selection on protein sequences, phyletic age, and duplicability) in four species: nematode wormCaenorhabditis elegans, flyDrosophila melanogaster, zebrafishDanio rerio, and mouseMus musculus. In general, we found that both models can be supported by different genomic properties. Sequence evolution follows an hourglass model, but the evolution of phyletic age and of duplicability follow an early conservation model. Further analyses indicate that stronger purifying selection on sequences in the middle development are driven by temporal pleiotropy of these genes. In addition, we report evidence that expression in late development is enriched with retrogenes, which usually lack efficient regulatory elements. This implies that expression in late development could facilitate transcription of new genes, and provide opportunities for acquisition of function. Finally, inC. elegans, we suggest that dosage imbalance could be one of the main factors that cause depleted expression of high duplicability genes in early development.
Institutional drivers of land mobility
Authors: Geoghegan Cathal , Kinsella Anne , O’Donoghue Catahl
Published: July 2017

Purpose

The purpose of this paper is to examine the role of institutional factors in agricultural structural change in the European Union (EU) using the case study of land mobility in Ireland. A range of agricultural land use options are compared in order to examine the effect of domestic and EU policy instruments on land mobility.

Design/methodology/approach

Using socio-economic data from the Teagasc National Farm Survey, three hypothetical farms are created using a microsimulation approach to compare incomes across farm systems and land use options. Tax and subsidy policies are applied to derive returns for the hypothetical farms under a variety of land use scenarios.

Findings

The analysis finds that in comparing four hypothetical scenarios, leasing out agricultural land on a long-term basis can prove more profitable for cattle and tillage farmers than farming the land. Only dairy farmers derive consistently higher disposable incomes from farming their land as opposed to leasing it out. Changes in CAP rules can also negatively affect farmers taking advantage of Ireland’s tax-based leasing incentives.

Originality/value

A gap in the literature exists in terms of how institutional factors may act to prevent either land supply or demand channels from functioning properly. This paper addresses that gap, using Ireland as a case study.
Circumventing the predatory state
Authors: C. Besenhard Petra , G. Wenzel Nikolai
Published: July 2017

Purpose

The purpose of this paper is to study the decline of the Tuareg, and explore the emergence of traditional elements of Tuareg culture to circumvent formal barriers to trade.

Design/methodology/approach

This paper examines the history of the Tuareg through the lens of the New Development Economics.

Findings

This paper examines three elements of past Tuareg wealth: the caravan trade as spontaneous order; the unintended consequences of forced modernization policies under colonization and post-colonial states; and contemporary problems from hindered freedom of trade. The bad news is that the Tuareg are facing impediments from failed states with low economic and political freedom. The good news is that traditional elements in the Tuareg’s entrepreneurial culture are re-emerging to circumvent formal barriers.

Research limitations/implications

The literature on the Tuareg is largely pessimistic, as the Tuareg’s traditions have largely been quashed by post-colonial boundaries and failed states. The New Development Economics offers a new perspective, with two implications. First, there is hope for the Tuareg, and a possible win-win, if the local states adopt a policy of laissez faire and international trade, rather than assimilation or repression. Second, this theoretical lens can be used in other cases throughout Africa (and the world) involving post-colonial borders.

Originality/value

There already exists a rich literature on the Tuareg. This paper uses the New Development Economics to examine the history of the Tuareg’s decline – and to find hope in traditional elements of Tuareg entrepreneurship emerging to circumvent local failed (and predatory) states.
Evaluating health service quality: using importance performance analysis
Authors: Izadi Azar , Jahani Younes , Rafiei Sima , Masoud Ali , Vali Leila
Published: July 2017

Purpose

Measuring healthcare service quality provides an objective guide for managers and policy makers to improve their services and patient satisfaction. Consequently, the purpose of this paper is to measure service quality provided to surgical and medical inpatients at Kerman Medical Sciences University (KUMS) in 2015.

Design/methodology/approach

A descriptive-analytic study, using a cross-sectional method in the KUMS training hospitals, was implemented between October 2 and March 15, 2015. Using stratified random sampling, 268 patients were selected. Data were collected using an importance-performance analysis (IPA) questionnaire, which measures current performance and determines each item’s importance from the patients’ perspectives. These data indicate overall satisfaction and appropriate practical strategies for managers to plan accordingly.

Findings

Findings revealed a significant gap between service importance and performance. From the patients’ viewpoint, tangibility was the highest priority (mean=3.54), while reliability was given the highest performance (mean=3.02). The least important and lowest performance level was social accountability (mean=1.91 and 1.98, respectively).

Practical implications

Healthcare managers should focus on patient viewpoints and apply patient comments to solve problems, improve service quality and patient satisfaction.

Originality/value

The authors applied an IPA questionnaire to measure service quality provided to surgical and medical ward patients. This method identifies and corrects service quality shortcomings and improving service recipient perceptions.
The nursing quality indicator framework tool
Authors: Connolly Dawn , Wright Fiona
Published: July 2017

Purpose

The purpose of this paper is to develop a nursing quality indicator (NQI) framework and provide a comprehensive reporting mechanism for nursing care.

Design/methodology/approach

Mixed method, including patient records audit, patient experience questionnaire, nurse self-report questionnaire and collecting ward-level information. The sample was 53 patients and 22 nurses.

Findings

Outputs from the NQI framework domains offer a more comprehensive understanding of nursing quality compared to when domains are analysed separately. The NQI framework also provides a more inclusive mechanism for assuring nursing care.

Research limitations/implications

Sample size was limited to 53 English-speaking patients who consented to participating in the study.

Originality/value

One design strength was the ability to describe individual patient care across the four domains and subsequently show relationships between nursing knowledge, nursing interventions and patient outcomes/experiences. Additionally, corroborated information from three sources (documentation review, patient and nurse responses) strengthened the conclusion that the NQI framework could provide more comprehensive assurances on nursing quality and identify care improvements.
State space approach with FEM for the determination of structural behaviour of composite plates
Authors: Albostami Asad Shukri , Wu Zhangjian , Zou Zhenmin
Published: July 2017

Purpose

An analytical investigation has been carried out for a simply supported rectangular plate with two different loading conditions by using 3D state space approach (SSA). Also, the accurate location of the neutral plane (N.P.) through the thickness of the plate can be identified: the N.P. is shifted away from the middle plane according to the loading condition. The paper aims to discuss these issues.

Design/methodology/approach

SSA and finite element method are used for the determination of structural behaviour of simply supported orthotropic composite plates under different types of loading. The numerical results from a finite element model developed in ABAQUS.

Findings

The effect of the plate thickness on displacements and stresses is described quantitatively. It is found that the N.P. of the plate, identified according to the values of the in-plane stresses through the thickness direction, is shifted away from the middle plane. Further investigation shows that the position of the N.P. is loading dependant.

Originality/value

This paper describe the effect of the plate thickness on displacements and stresses quantitatively by using an exact solution called SSA. Also, it is found that the N.P. of the plate, identified according to the values of the in-plane stresses through the thickness direction, is shifted away from the middle plane. Further investigation shows that the position of the N.P. is loading dependant.
The study of terrorist leadership: where do we go from here?
Authors: Hofmann David C.
Published: July 2017

Purpose

Despite the recognition of the importance of leaders for the formation and ongoing success of social and political movements, the study of leadership in terrorist groups remains underdeveloped. The purpose of this paper, therefore, is to stimulate additional research into terrorist leadership in three main ways: by providing a broad overview of the theoretical perspectives that scholars have used to examine terrorist leadership, by critically reviewing the current state of the academic literature on terrorist leadership, and by presenting various ways in which future research on terrorist leadership can be improved.

Design/methodology/approach

This paper takes a conceptual and critical approach to reviewing the scholarly literature on terrorist leadership, and draws upon the author’s expertise with the wider multidisciplinary literature on leadership to make methodological and conceptual recommendations to improve related future research.

Findings

There is a paucity of empirical and theoretical research devoted to understanding important social and strategic aspects of terrorist leadership, and existing scholarly research is largely conducted in isolation with differing methodological and epistemological starting points. This has hampered efforts to measure, operationalize, and understand key concepts involving leadership in terrorist groups.

Practical implications

This paper provides several methodological and conceptual recommendations by which future research on terrorist leadership can be improved from insights taken from the wider scholarly literature on leadership. By virtue of being published in a criminology journal, this paper helps disseminate and expose key concepts in the study of terrorism to related disciplines.

Originality/value

This paper provides a general overview of the strengths and weaknesses of the study of terrorist leadership to scholars and students interested in the topic. It provides a foundational discussion of how the current literature on terrorist conceives of and utilizes the concept of leadership. It also provides methodological and conceptual recommendations to improve future research on terrorist leadership.