bluuebunny/crossref_metadata_2025 huggingface dataset:
Balancing measures or a balanced accounting of improvement impact: a qualitative analysis of individual and focus group interviews with improvement experts in Scotland
Authors: Toma Madalina , Dreischulte Tobias , Gray Nicola M , Campbell Diane , Guthrie Bruce
Published: October 2017

Background

As quality improvement (QI) programmes have become progressively larger scale, the risks of implementation having unintended consequences are increasingly recognised. More routine use of balancing measures to monitor unintended consequences has been proposed to evaluate overall effectiveness, but in practice published improvement interventions hardly ever report identification or measurement of consequences other than intended goals of improvement.

Methods

We conducted 15 semistructured interviews and two focus groups with 24 improvement experts to explore the current understanding of balancing measures in QI and inform a more balanced accounting of the overall impact of improvement interventions. Data were analysed iteratively using the framework approach.

Results

Participants described the consequences of improvement in terms of desirability/undesirability and the extent to which they were expected/unexpected when planning improvement. Four types of consequences were defined: expected desirable consequences (goals); expected undesirable consequences (trade-offs); unexpected undesirable consequences (unpleasant surprises); and unexpected desirable consequences (pleasant surprises). Unexpected consequences were considered important but rarely measured in existing programmes, and an improvement pause to take stock after implementation would allow these to be more actively identified and managed. A balanced accounting of all consequences of improvement interventions can facilitate staff engagement and reduce resistance to change, but has to be offset against the cost of additional data collection.

Conclusion

Improvement measurement is usually focused on measuring intended goals, with minimal use of balancing measures which when used, typically monitor trade-offs expected before implementation. This paper proposes that improvers and leaders should seek a balanced accounting of all consequences of improvement across the life of an improvement programme, including deliberately pausing after implementation to identify and quantitatively or qualitatively evaluate any pleasant or unpleasant surprises.
British Thoracic Society Guideline for the management of non-tuberculous mycobacterial pulmonary disease (NTM-PD)
Authors: Haworth Charles S , Banks John , Capstick Toby , Fisher Andrew J , Gorsuch Thomas , Laurenson Ian F , Leitch Andrew , Loebinger Michael R , Milburn Heather J , Nightingale Mark , Ormerod Peter , Shingadia Delane , Smith David , Whitehead Nuala , Wilson Robert , Floto R Andres
Published: October 2017

The full guideline for the management of non-tuberculous mycobacterial pulmonary disease is published inThorax. The following is a summary of the recommendations and good practice points. The sections referred to in the summary refer to the full guideline.
Utility of prehospital electrocardiogram characteristics as prognostic markers in out-of-hospital pulseless electrical activity arrests
Authors: Ho Michael L , Gatien Mathieu , Vaillancourt Christian , Whitham Veronica , Stiell Ian G
Published: October 2017

Background

It is unclear if there are predictors of survival, including ECG characteristics, that can guide resuscitative efforts in pulseless electrical activity (PEA) cardiac arrests. We studied the predictive potential of presenting prehospital ECGs on survival for patients with out-of-hospital cardiac arrest (OHCA) with PEA.

Methods

We studied prehospital ECGs of patients with OHCA prospectively enrolled between June 2007 and November 2009 at the Ottawa/OPALS (Ontario Prehospital Advanced Life Support Study) site of the Resuscitation Outcomes Consortium PRIMED study (Prehospital Resuscitation using an IMpedance valve and Early versus Delayed analysis). We included adult non-traumatic OHCA with PEA rhythm where resuscitation was attempted. We measured HR, QRS interval and presence of P waves, and determined their impact on return of spontaneous circulation (ROSC) and survival to hospital discharge (SHD) using multivariate regression analysis.

Results

The demographic characteristics of the 332 included cases were the following: mean age 71.8, male 58.4%, SHD 5.4% and ROSC at ED arrival 26.5%. Survivors had similar HR (56.8 vs 52.0 beats per minute (bpm), p=0.53) and QRS intervals (128.7 vs 129.6 ms, p=0.95) compared with non-survivors. Prehospital ECG characteristics did not predict SHD or ROSC on multivariate analyses. Patients with initial HR <30 bpm had a 3.8% survival rate; those with both HR <30 bpm and QRS≥120 ms had a 3.7% survival rate. Location of arrest predicted SHD (adjusted OR (AdjOR)=1.49, 1.11 to 1.99; p=0.007). Atropine use negatively predicted SHD (AdjOR=0.06, 0.02 to 0.22; p<0.001). Predictors of ROSC ALS paramedic on scene (AdjOR=8.90, 1.11 to 71.41; p=0.04) and successful intubation (AdjOR=3.35, 1.75 to 6.39; p<0.001). Atropine use negatively predicted ROSC (AdjOR=0.27, 0.14 to 0.50; p<0.001).

Conclusions

Presenting prehospital ECG characteristics did not predict SHD or ROSC in OHCA PEA victims and should not be used to guide termination of resuscitation. Location of arrest was a positive predictor for SHD; atropine use was a negative predictor. ALS paramedic on scene and successful intubation were positive predictors of ROSC; atropine use was a negative predictor.

Trial registration number

NCT00394706; post-results.
BET 2: Should children with sport-related concussion observe strict physical rest until symptom-free?
Authors: Kline Andrew C
Published: October 2017

A short cut review was carried out to establish whether strict physical rest following sports related concussion in children is better than normal activity in reducing post-concussional symptoms. two recent systematic reviews presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are tabulated. It is concluded that children who present with a sport-related concussion should have a brief period of cognitive and physical rest followed by a gradual increase in activity. Further studies should examine the length of the brief rest period, however at this time 24–48 hours of rest should be recommended.
LGI1, CASPR2 and related antibodies: a molecular evolution of the phenotypes
Authors: Binks Sophie N M , Klein Christopher J , Waters Patrick , Pittock Sean J , Irani Sarosh R
Published: October 2017

Recent biochemical observations have helped redefine antigenic components within the voltage-gated potassium channel (VGKC) complex. The related autoantibodies may be now divided into likely pathogenic entities, which target the extracellular domains of leucine-rich glioma-inactivated 1 (LGI1) and contactin-associated protein-like 2 (CASPR2), and species that target intracellular neuronal components and are likely non-pathogenic. This distinction has enhanced clinical practice as direct determination of LGI1 and CASPR2 antibodies offers optimal sensitivity and specificity. In this review, we describe and compare the clinical features associated with pathogenic LGI1 and CASPR2 antibodies, illustrate emerging laboratory techniques for antibody determination and describe the immunological mechanisms that may mediate antibody-induced pathology. We highlight marked clinical overlaps between patients with either LGI1 or CASPR2 antibodies that include frequent focal seizures, prominent amnesia, dysautonomia, neuromyotonia and neuropathic pain. Although occurring at differing rates, these commonalities are striking and only faciobrachial dystonic seizures reliably differentiate these two conditions. Furthermore, the coexistence of both LGI1 and CASPR2 antibodies in an individual occurs surprisingly frequently. Patients with either antibody respond well to immunotherapies, although systematic studies are required to determine the magnitude of the effect beyond placebo. Finally, data have suggested that CASPR2 and LGI1 modulation via genetic or autoimmune mechanisms may share common intermediate molecules. Taken together, the biochemical distinction of antigenic targets has led to important clinical advances for patient care. However, the striking syndrome similarities, coexistence of two otherwise rare antibodies and molecular insights suggest the VGKC complex may yet be a common functional effector of antibody action. Hence, we argue for a molecular evolution alongside a clinical and phenotypic re-evaluation.
Prevalence of sleep apnoea and capnographic detection of nocturnal hypoventilation in amyotrophic lateral sclerosis
Authors: Boentert Matthias , Glatz Christian , Helmle Cornelia , Okegwo Angelika , Young Peter
Published: October 2017

Objective

This retrospective study aimed to investigate whether overnight oxymetry and early morning blood gas analysis predict nocturnal hypoventilation (NH) as reflected by night-time hypercapnia in patients with amyotrophic lateral sclerosis (ALS). In addition, prevalence and clinical determinants of sleep apnoea in ALS were evaluated.

Methods

In 250 patients with non-ventilated ALS, transcutaneous capnometry was performed along with polysomnography or polygraphy and early morning blood gases.

Results

123 patients were female, and 84 patients had bulbar-onset ALS. 40.0% showed NH, and an apnoea–hypopnoea index (AHI) >5/hour was found in 45.6%. In 22.3%, sleep apnoea and NH coincided. The obstructive apnoea index was significantly higher than the central apnoea index (p<0.0001). Both NH and sleep apnoea were significantly more common in male than in female patients. Sleep apnoea and AHI were associated with better bulbar function. Desaturation time (t<90%) and transcutaneous CO2 were negatively correlated with upright vital capacity. Early morning base excess (EMBE), bicarbonate and t<90% were independent predictors of NH. However, among 100 patients with NH, 31 were missed by t<90% >5 min and 17 were not identified when EMBE >3 mmol/L and t<90% >5 min were combined.

Conclusion

In ALS, sleep apnoea is common and often accompanies NH. It is mainly obstructive, and central apnoea appears to be clinically irrelevant. Polygraphy or oxymetry alone are not sufficient to uncover NH. Combination of EMBE and t<90% may increase sensitivity, but transcutaneous capnography is strongly recommended for reliable detection of NH in patients with ALS.
The pattern of paediatric blast injury in Afghanistan
Authors: Thompson Daniel C , Crooks R J , Clasper J C , Lupu A , Stapley S A , Cloke D J
Published: October 2017

Introduction

Between 2009 and 2015, 3746 children died, and 7904 were injured as a result of armed conflict within Afghanistan. Improvised explosive devices (IEDs) and explosive remnants of war accounted for 29% of child casualties in 2015. The aim of this study was to review the burden of paediatric blast injuries admitted to Camp Bastion, Afghanistan, and to investigate the hypothesis that children suffer proportionally more head injuries than adults.

Method

A retrospective analysis was undertaken of prospectively collected data derived from the UK Joint Theatre Trauma Registry of ambulant paediatric (aged 2–15 years) admissions with blast injuries at the Role 3 Field Hospital, Camp Bastion from June 2006 to March 2013. The data set included demographic information, injury profile and severity (New Injury Severity Score) and operative findings. The pattern of injuries were investigated by looking at trends in the number and severity of injuries sustained by each body region.

Results

During this period, 295 admissions were identified, 76% of whom were male, with an overall mortality rate of 18.5%. The most common blast mechanism was an IED (68%) causing 80% of fatalities. The lower extremities were the most commonly injured body region, accounting for 31% of total injuries and occurring in 62% of cases. 24.3% of children between 2 and 7 years suffered severe head or neck injuries compared with 19.8% of children aged between 8 and 15 years. 34% of head injuries were rated unsurvivable and accounted for 88% of fatalities. 77% of cases required an operation with a mean operating time of 125 min. The most common first operations were debridement of soft tissues (50%), laparotomy (16%) and lower limb amputation (11%).

Conclusion

Although paediatric blast casualties represented a small percentage of the overall workload at Camp Bastion Role 3 Medical Facility, the pattern of injuries seen suggests that children are more likely to sustain severe head, face and neck injuries than adults.
Objections still fail: a response to Faria
Authors: Arnason Gardar
Published: October 2017

In her reply to my critical assessment of objections to the Weatherall report’s justification of non-human primate (NHP) research, Catia Faria focuses on three objections which she entitles ‘the disanalogy’, ‘the utilitarian calculus’ and ‘species overlap’. Faria finds my assessment unconvincing, butI argue that the objections still fail.
Prenatal exposure to glycol ethers and cryptorchidism and hypospadias: a nested case–control study
Authors: Warembourg Charline , Botton Jérémie , Lelong Nathalie , Rouget Florence , Khoshnood Babak , Le Gléau Florent , Monfort Christine , Labat Laurence , Pierre Fabrice , Heude Barbara , Slama Rémy , Multigner Luc , Charles Marie-Aline , Cordier Sylvaine , Garlantézec Ronan
Published: October 2017

Objectives

Glycol ethers (GE) are oxygenated solvents frequently found in occupational and consumer products. Some of them are well-known testicular and developmental animal toxicants. This study aims to evaluate the risk of male genital anomalies in association with prenatal exposure to GE using urinary biomarkers of exposure.

Methods

We conducted a case–control study nested in two joint mother–child cohorts (5303 pregnant women). Cases of cryptorchidism and hypospadias were identified at birth and confirmed during a 2-year follow-up period (n=14 cryptorchidism and n=15 hypospadias). Each case was matched to three randomly selected controls within the cohorts for region of inclusion and gestational age at urine sampling. Concentrations of five GE acidic metabolites were measured in spot maternal urine samples collected during pregnancy. ORs were estimated with multivariate conditional logistic regressions including a Firth’s penalisation.

Results

Detection rates of urinary GE metabolites ranged from 8% to 93% and only two were sufficiently detected (>33%) in each cohort to be studied: methoxyacetic acid (MAA) and phenoxyacetic acid (PhAA). A significantly higher risk of hypospadias was associated with the highest tertile of exposure to MAA: OR (95% CI) 4.5(1.4 to 23.4). No association were observed with urinary concentration of PhAA, nor with the risk of cryptorchidism.

Conclusions

In view of the toxicological plausibility of our results, this study, despite its small sample size, raises concern about the potential developmental toxicity of MAA on the male genital system and calls for thorough identification of current sources of exposure to MAA.
Long-term follow-up for cancer incidence in a cohort of Danish firefighters
Authors: Kirstine Ugelvig Petersen Kajsa , Pedersen Julie Elbaek , Bonde Jens Peter , Ebbehoej Niels Erik , Hansen Johnni
Published: October 2017

Objectives

To examine cancer incidence among Danish firefighters using several employment-related exposure subgroups.

Methods

A historical cohort of 9061 male Danish firefighters was established from collected personnel and membership records from employers and trade unions. Using the unique Danish personal identification number, information on additional previous employment, cancer and vital status was linked to members of the cohort from the Supplementary Pension Fund Register, the Danish Cancer Registry and the Danish Civil Registration System. SIRs were calculated for specific cancer types using rates for the general population, a sample of the working population and military employees, respectively.

Results

Compared with the selected reference groups, the overall observed incidence of cancer among the firefighters was at level with the expected (SIR 1.02, 95% CI 0.96 to 1.09 vs the general population). The SIR for colon cancer was consistently significantly reduced, while the slight excess seen for melanoma of the skin, prostate and testicular cancer compared with the general population was not reproduced using the military as reference.

Conclusions

Previous associations with melanoma of the skin, prostate and testicular cancer are supported by our main results. However, the increase in incidence of these cancers is not reproduced using the military as reference. Similarities in cancer profile for the firefighters and the military point to shared risk factors in either lifestyle or work environment.
Association of QT interval with mortality by kidney function: results from the National Health and Nutrition Examination Survey (NHANES)
Authors: Malik Rehan , Waheed Sehrish , Parashara Deepak , Perez Jorge , Waheed Salman
Published: October 2017

Objective

Prolonged QT interval predisposes to ventricular arrhythmias and sudden cardiac death. However, the association between QT interval and mortality by the level of pre-existing kidney function has not been investigated.

Methods

We followed 6565 participants from the National Health and Nutrition Examination Survey III for a median of 13.3 years. Sample divided according to corrected QT (QTc) interval was as follows: normal (QTc <450 ms for men and <460 ms for women) or prolonged. It was further categorised as follows: (1) no chronic kidney disease (CKD), that is, albumin to creatinine ratio (ACR) <30 mg/g and estimated glomerular filtration rate (eGFR)>60 mL/min/1.73 m2; (2) CKD by eGFR only (eGFR <60 mL/min/1.73 m2, ACR <30 mg/g); (3) CKD by ACR only (ACR >30 mg/g, eGFR >60 mL/min/1.73 m2) and (4) CKD by both. Cox proportional hazards models were used.

Results

CKD group had prolonged QTc than those without CKD (20.5%vs12.9%, p<0.0001). Both prolonged QTc and CKD are independently associated with increased risk of mortality. When combined, risk of mortality is higher in those with CKD by eGFR with prolonged QTc than normal QTc (HR 2.6 (1.7–3.9) and 3.1 (1.7–5.4) vs 1.4 (1.1–1.7) and 1.7 (1.3–2.1) for all-cause and CV mortality). There is no significant difference in risk in those with CKD by ACR when QTc is prolonged. There is significant improvement in risk prediction for all-cause and CV mortality when QTc is added to CKD beyond established CV risk factors (net reclassification index p<0.00001).

Conclusion

A screening ECG in those with CKD may help in finer risk stratification and may be considered.
Improving paediatric residents’ knowledge and perspectives regarding the insulin pump using a novel educational workshop
Authors: Bansal Shipra , Marwa Albara , Kasturi Kannan , Perez-Colon Sheila
Published: October 2017

Objectives

As a pilot study, we aimed to investigate the knowledge and perceptions of categorical paediatric residents (RES) at our institution regarding insulin pumps (IPs) and the impact following a targeted workshop.

Methods

All RES at our institution in attendance at a routine noon conference participated in a workshop, completing an anonymous survey before and right after the intervention to evaluate knowledge, attitudes and self-reported comfort regarding IPs. The workshop consisted of a didactic lecture followed by an insulin pump (IP) device demonstration of three commonly available brands. Knowledge score (KS) was calculated for each RES based on the total correct responses. Attitudes were assessed via 5-point Likert scale. Frequencies, t-test and McNemar tests were used to analyse data.

Results

Thirty four completed surveys were analysed out of 49 RES (69.3%) who attended the workshop. Among them, there were 19 first-year, 8 second-year and 7 third-year residents. Following the intervention, KS increased significantly (p<0.001) with progression in residents’ attitudes. Overall, more RES reported being comfortable with handling the IP, including looking up and changing the settings (p<0.001).

Conclusion

There is scope for improvement in the knowledge and perceptions of RES regarding IPs. Educational interventions like ours are needed to familiarise our future physicians with IPs to allow hospitals to provide their systematic and safe inpatient use.
Reference values for oxygen saturation from sea level to the highest human habitation in the Andes in acclimatised persons
Authors: Rojas-Camayo Jose , Mejia Christian Richard , Callacondo David , Dawson Jennifer A , Posso Margarita , Galvan Cesar Alberto , Davila-Arango Nadia , Bravo Erick Anibal , Loescher Viky Yanina , Padilla-Deza Magaly Milagros , Rojas-Valero Nora , Velasquez-Chavez Gary , Clemente Jose , Alva-Lozada Guisela , Quispe-Mauricio Angel , Bardalez Silvana , Subhi Rami
Published: October 2017

Oxygen saturation, measured by pulse oximetry (SpO2), is a vital clinical measure. Our descriptive, cross-sectional study describes SpO2 measurements from 6289 healthy subjects from age 1 to 80 years at 15 locations from sea level up to the highest permanent human habitation. Oxygen saturation measurements are illustrated as percentiles. As altitude increased, SpO2 decreased, especially at altitudes above 2500 m. The increase in altitude had a significant impact on SpO2 measurements for all age groups. Our data provide a reference range for expected SpO2 measurements in people from 1 to 80 years from sea level to the highest city in the world.
Healthfulness and nutritional composition of Canadian prepackaged foods with and without sugar claims
Authors: Bernstein Jodi T. , Franco-Arellano Beatriz , Schermel Alyssa , Labonté Marie-Ève , L’Abbé Mary R.
Published: October 2017

The objective of this study was to evaluate differences in calories, nutrient content, overall healthfulness, and use of sweetener ingredients between products with and without sugar claims. Consumers assume products with sugar claims are healthier and lower in calories. It is therefore important claims be found on comparatively healthier items. This study is a cross-sectional analysis of the University of Toronto’s 2013 Food Label Database. Subcategories where at least 5% of products (and n ≥ 5) carried a sugar claim were included (n = 3048). Differences in median calorie content, nutrient content, and overall healthfulness, using the Food Standards Australia/New Zealand Nutrient Profiling Scoring criterion, between products with and without sugar claims, were determined. Proportion of products with and without claims that had excess free sugar levels (≥10% of calories from free sugar) and that contained sweeteners was also determined. Almost half (48%) of products with sugar claims contained excess free sugar, and a greater proportion contained sweeteners than products without such claims (30% vs 5%, χ2 = 338.6, p < 0.0001). Overall, products with sugar claims were “healthier” and had lower median calorie, free sugar, total sugar, and sodium contents than products without claims. At the subcategory level, reductions in free sugar contents were not always met with similar reductions in calorie contents. This study highlights concerns with regards to the nutritional composition of products bearing sugar claims. Findings can support educational messaging to assist consumer interpretation of sugar claims and can inform changes in nutrition policies, for example, permitting sugar claims only on products with calorie reductions and without excess free sugar.
Inflammation status of healthy young men: initial and specific responses to resistance training
Authors: Ihalainen Johanna K. , Peltonen Heikki , Paulsen Göran , Ahtiainen Juha P. , Taipale Ritva S. , Hämäläinen Mari , Moilanen Eeva , Mero Antti A.
Published: October 2017

Our primary aim was to study the effects of a 4-week preparatory resistance-training (RT) period followed by 12 weeks of 2 specific RT protocols (either hypertrophic-strength (HS) or strength-hypertrophy-power training) on inflammation markers and the possible relationship of the changes in abdominal fat and lean mass to the changes in inflammation status. A total of 82 healthy men were included in the study. Maximal concentric leg press strength (1-repetition maximum), total body lean mass, total body and abdominal fat mass, circulating high-sensitivity C-reactive protein, interleukin-6, interleukin-1 receptor antagonist (IL-1ra), monocyte chemoattractant protein 1 (MCP-1), and selected adipocytokines (resistin, adiponectin, and leptin) concentrations were measured before and after 4 (wk4) and 16 weeks (wk16) of RT. After the initial phase of RT, on wk4, abdominal and total fat mass as well as plasma leptin concentrations were significantly reduced (p < 0.05), whereas muscle mass, IL-1ra, resistin, and MCP-1 concentrations were significantly increased (p < 0.05). During specialized training phase, at wk16, only HS led to further reduction in abdominal and total fat mass, resistin, and leptin (p < 0.05), whereas both training modes led to lower MCP-1 concentrations (p < 0.05). Abdominal fat mass and circulating leptin were reduced already after 4 weeks of RT. Simultaneously, circulating MCP-1 and resistin concentrations increased, possibly as markers of muscle adaptation and regeneration. The present findings also suggest that RT with hypertrophic focus is beneficial for further reductions in abdominal fat mass and to decrease circulating inflammatory markers.
Geosynthetic reinforced column supported embankments and the role of ground improvement installation effects
Authors: King Daniel J. , Bouazza Abdelmalek , Gniel Joel R. , Rowe R. Kerry , Bui Ha H.
Published: October 2017

For geosynthetic reinforced column supported embankments (GRCSE) supporting a high embankment, lateral forces associated with lateral sliding and embankment stability often govern the acceptability of a given design under serviceability conditions. Frequently, the complex soil–structure–geosynthetic interaction, the size, and the three-dimensional nature of a GRCSE necessitate the use of numerical analysis to assess embankment performance relative to serviceability criteria. However, traditional finite element method techniques used to model serviceability behaviour are limited in their ability to model the geotechnical mechanisms associated with column installation, equilibration, and group installation effects. These installation effects are examined herein based on a GRCSE field case study located in Melbourne, Australia, that has been extensively instrumented. The role that these installation effects have on the performance of the GRCSE is highlighted and the behaviour of the columns supporting the embankment is emphasized. It is shown that cracking of the unreinforced columns supporting the embankment is likely inevitable and that the reduction of lateral resistance provided by the columns should be accounted for in design. The suitability of various numerical approaches currently used in design to model the columns supporting the GRCSE, and the embankment itself, are discussed and recommendations are made.
Site-directed mutagenesis to deactivate two nitrogenase isozymes of Kosakonia radicincitans DSM16656T
Authors: Ekandjo Lempie K. , Ruppel Silke , Remus Rainer , Witzel Katja , Patz Sascha , Becker Yvonne
Published: October 2017

Biological nitrogen fixation (BNF) is considered one of the key plant-growth-promoting (PGP) factors for diazotrophic organisms. Whether the iron and iron–molybdenum nitrogenases of Kosakonia radicincitans contribute to its PGP effect is yet to be proven. Hence, for the first time, we conducted site-directed mutagenesis in K. radicincitans to knock out anfH and (or) nifH as a mean to deactivate BNF in this strain. We used 15N2-labeled air to trace BNF activities in ΔanfH, ΔnifH, and ΔanfHΔnifH mutants. Assessing bacterial growth, nitrogen content, and 15N incorporation revealed that BNF is impaired in K. radicincitans DSM16656T ΔnifH and ΔanfHΔnifH. However, we detected no significant contribution of the Fe nitrogenase to biological dinitrogen assimilation under our pure bacterial culture experimental conditions. Such nondiazotrophic K. radicincitans DSM16656T mutants represent excellent tools for investigating nitrogen nutrition in K. radicincitans-inoculated plants.
Quantum mechanix plus Newtonian gravity violates the universality of free fall
Authors: Visser Matt
Published: October 2017

Classical point particles in Newtonian gravity obey, as they do in general relativity, the universality of free fall. However, classical structured particles, (for instance with a mass quadrupole moment), need not obey the universality of free fall. Quantum mechanically, an elementary “point” particle (in the particle physics sense) can be described by a localized wave packet, for which we can define a probability quadrupole moment. This probability quadrupole can, under plausible hypotheses, affect the universality of free fall. (So point-like elementary particles, in the particle physics sense, can and indeed must nevertheless have structure in the general relativistic sense once wave packet effects are included.) This raises an important issue of principle, as possible quantum violations of the universality of free fall would fundamentally impact on our ideas of what “quantum gravity” might look like. I will present an estimate of the size of the effect, and discuss where if at all it might be measured.
INVESTIGATING ANTECEDENTS AND STAGE-SPECIFIC EFFECTS OF CUSTOMER INTEGRATION INTENSITY ON NEW PRODUCT SUCCESS
Authors: SCHUHMACHER MONIKA C. , KUESTER SABINE , HANKER ANNA-LENA
Published: October 2017

This cross-sectional study specifically examines the antecedents and performance consequences of customer integration intensity for B2C industries. In line with this focus, we extend the notion of market-oriented management by explicitly considering the role of customers and retailers as two distinct facets of the market intelligence perspective. Moreover, for new product development in B2C industries, research says little about when customers should be integrated during the new product development process. First, data from 205 firms and evidence from a validation study of 175 firms indicate that customer integration intensity in new goods development positively affects overall new product success. Further, the results show that companies can foster the intensity of customer integration by emphasising both retailer and customer orientation and by establishing an incentive system that comprises new product development-specific components. Second, additional cross-sectional data from 171 firms show that managers need to integrate customers intensively in the development and launch stage and less in the ideation stage for the successful development of new goods.
Forced Vibration Analysis of Functionally Graded Nanobeams
Authors: Akbaş Şeref Doğuşcan
Published: October 2017

In this paper, forced vibration responses of functionally graded (FG) nanobeams are presented for modified couple stress theory (MCST) with damping effect. The FG nanobeam is excited by a transverse triangular force impulse modulated by a harmonic motion. Mechanical properties of FG beam depends on the position. The Kelvin–Voigt model is considered in the damping effect. In solution of the dynamic problem, finite element method is used within Timoshenko beam theory. The obtained system of differential equations is reduced to a linear algebraic equation system and solved in the time domain by using Newmark average acceleration method. Influences of the geometry and material parameters on forced vibration responses of FG nanobeams are examined and discussed.
Bandgap Structures of SH-Wave in a One-Dimensional Phononic Crystal with Viscoelastic Interfaces
Authors: Li Yuhang , Zhou Xiaoliang , Bian Zuguang , Xing Yufeng , Song Jizhou
Published: October 2017

Phononic crystal is an artificial periodic structure with the ability to regulate and control the wave propagation of particular frequencies and has been widely used in many applications. The adhesive layer bonding different constituents in the periodic structure of phononic crystals is usually a viscoelastic material, which has frequency-dependent material properties. In this paper, an analytical model based on the transfer matrix method is developed to study the bandgap structures of SH-wave (a shear wave with the propagation direction normal to the motion plane) in a one-dimensional phononic crystal consisting of two different elastic constituents bonded by the viscoelastic adhesive layer. The results show that the viscosity of the adhesive layer has a significant influence on the bandgap structure at the region of high frequency. The effects of various material parameters of the viscoelastic adhesive layer such as the relaxation time, the final-state modulus and the initial-state modulus are systematically studied. These results are very helpful in the practical design of phononic crystals involving the viscoelastic adhesive layers.
A Combined Analytical–Numerical Investigation on Photosensitive Hydrogel Micro-Valves
Authors: Kargar-Estahbanaty Arash , Baghani Mostafa , Shahsavari Hamid , Faraji Ghader
Published: October 2017

In this paper, employing photo-thermal sensitive (PTS) hydrogels, a photosensitive bio-compatible micro-valve is investigated. In this regard, the energy representation and governing equations of PTS hydrogels are described. Two benchmark problems common in micro-fluidic designs are solved using the presented theory, and the deformation and stress distributions are calculated. The theory is implemented into a finite element (FE) framework by developing a user-defined subroutine. To properly validate the FE model, the FE results are compared with the proposed analytical results. The confirmed numerical method is then employed to investigate two different realistic micro-valve structures. The constructions are composed of three jacket-pillar structures arranged in two different patterns. In this step, the nonlinear contact between the components of structures and presumptive rigid walls are added to the thermo-mechanical deformation of the photosensitive micro-jackets. The contact length and contact pressure are investigated. By calculating all necessary mechanical parameters, the analysis results can be utilized in the design procedure of a photosensitive micro-valve and pave the way for the industrial production of the next generation micro-fluidic devices.
Comprehensive study of electronic polarizability and band gap of B2O3–Bi2O3–ZnO–SiO2 glass network
Authors: Mustafa Iskandar Shahrim , Razali Nur Ain Nabilah , Azman Nurul Zahirah Noor , Yahaya Nor Zakiah , Zaini Muhammad Zulhafiz Mohamad , Rusli Nur Lina , Nizamani Muhammad Bakhsh , Kamari Halimah Mohamed
Published: October 2017

Quaternary glasses were successfully fabricated using melt quenching technique based on the chemical compound composition ([Formula: see text])Bi2O3–([Formula: see text]) ZnO–(0.2)B2O3–(0.3)SiO2, where ([Formula: see text], 0.2, 0.3, 0.4, 0.45) mole. The sources of SiO2 was produced from rice husk ash (RHA) at 99.36% of SiO2. The Urbach energy was increased from 0.16[Formula: see text]eV to the 0.29[Formula: see text]eV as the mole of Bi2O3 increased in the glass structure. The indirect energy band gap is indicated in decrement pattern with 3.15[Formula: see text]eV towards 2.51[Formula: see text]eV. The results of Urbach energy and band gap energy that were obtained are due to the increment of Bi[Formula: see text] ion in the glass network. The refractive indexes for the prepared glasses were evaluated at 2.36 to 2.54 based on the Lorentz–Lorentz formulation which correlated to the energy band gap. The calculated of molar polarizability, electronic polarizability and optical basicity exemplify fine complement to the Bi2O3 addition in the glass network. The glass sample was indicated in amorphous state.
SPACE-TA
Authors: Wang Leye , Zhang Daqing , Yang Dingqi , Pathak Animesh , Chen Chao , Han Xiao , Xiong Haoyi , Wang Yasha
Published: October 2017

Data quality and budget are two primary concerns in urban-scale mobile crowdsensing. Traditional research on mobile crowdsensing mainly takes sensing coverage ratio as the data quality metric rather than the overall sensed data error in the target-sensing area. In this article, we propose to leverage spatiotemporal correlations among the sensed data in the target-sensing area to significantly reduce the number of sensing task assignments. In particular, we exploit both intradata correlations within the same type of sensed data and interdata correlations among different types of sensed data in the sensing task. We propose a novel crowdsensing task allocation framework called
SPACE-TA (SPArse Cost-Effective Task Allocation)
, combining compressive sensing, statistical analysis, active learning, and transfer learning, to dynamically select a small set of subareas for sensing in each timeslot (cycle), while inferring the data of unsensed subareas under a probabilistic data quality guarantee. Evaluations on real-life temperature, humidity, air quality, and traffic monitoring datasets verify the effectiveness of SPACE-TA. In the temperature-monitoring task leveraging intradata correlations, SPACE-TA requires data from only 15.5% of the subareas while keeping the inference error below 0.25°C in 95% of the cycles, reducing the number of sensed subareas by 18.0% to 26.5% compared to baselines. When multiple tasks run simultaneously, for example, for temperature and humidity monitoring, SPACE-TA can further reduce ∼10% of the sensed subareas by exploiting interdata correlations.
Consuming DNA: The Good Citizen in the Age of Precision Medicine
Authors: Lee Sandra Soo-Jin
Published: October 2017

The convergence of increasingly efficient high-throughput genetic sequencing technology and ubiquitous Internet use has fueled the proliferation of companies that provide direct-to-consumer (DTC) personal genetic information. The emergence of consumer genetics reflects several shifts in the governance of genetic testing and management of human genetic data. This article discusses DTC genetics as a case study of neoliberalism and contemporary transformations in medicine that construe disease and its management through economic rationalities. At stake are shifts in subjectivities from “patient” to “consumer” and the meaning of being a “good citizen” in the context of precision medicine. Engaging concepts of biopower, biosociality, and biovalue in the public consumption of genetic information, this article analyzes DTC genetics and its effect on social connection, identity, and modes of participation in the production of biomedical knowledge and the management of health and risk.
Brain Plasticity and Human Evolution
Authors: Sherwood Chet C. , Gómez-Robles Aida
Published: October 2017

Human behavior is shaped by social learning to an extent that is unrivaled in the natural world. What neurobiological changes have occurred in human evolutionary history that have enabled this remarkable cultural capacity? Human brain anatomy and function have evolved to be highly responsive to experience from the environment, especially the milieu of social interactions. Numerous aspects of human brain development show evidence of specialization leading to increased plasticity. These include the timing of brain growth relative to birth, rates of synaptogenesis and myelination, and shifts in gene expression and epigenetic modifications. Some of these evolutionary changes in human brain plasticity are also evident in fossil hominins and from analyses of ancient DNA.
Active and Passive Microrheology: Theory and Simulation
Authors: Zia Roseanna N.
Published: October 2017

Microrheological study of complex fluids traces its roots to the work of the botanist Robert Brown in the early nineteenth century. Indeed, passive microrheology and Brownian motion are one and the same. Once thought to reveal a fundamental life force, the phenomenon was ultimately leveraged by Einstein in proof of the atomic nature of matter ( Haw 2006 ). His work simultaneously paved the way for modern-day passive microrheology by connecting observable particle motion—diffusion—to solvent properties—the viscosity—via the well-known Stokes–Einstein relation. Advances in microscopy techniques in the last two decades have prompted extensions of the original model to generalized forms for passive probing of complex fluids. In the last decade, active microrheology has emerged as a means by which to interrogate the nonequilibrium behavior of complex fluids, in particular, the non-Newtonian rheology of dynamically heterogeneous and microscopically small systems. Here we review theoretical and computational approaches and advances in both passive and active microrheology, with a focus on the extent to which these techniques preserve the connection between single-particle motion and flow properties, as well as the rather surprising recovery of non-Newtonian flow behavior observed in bulk rheology.
Linguistic Aspects of Primary Progressive Aphasia
Authors: Grossman Murray
Published: October 2017

Primary progressive aphasia (PPA) refers to a disorder of declining language associated with neurodegenerative diseases such as frontotemporal degeneration and Alzheimer disease. Variants of PPA are important to recognize from a medical perspective because these syndromes are clinical markers suggesting specific underlying pathology. In this review, I discuss linguistic aspects of PPA syndromes that may prove informative for parsing our language mechanism and identifying the neural representation of fundamental elements of language. I focus on the representation of word meaning in a discussion of semantic variant PPA, grammatical comprehension and expression in a discussion of nonfluent/agrammatic variant PPA, the supporting role of short-term memory in a discussion of logopenic variant PPA, and components of language associated with discourse in a discussion of behavioral variant frontotemporal dementia. PPA provides a novel perspective that uniquely addresses facets of language and its disorders while complementing traditional aphasia syndromes that follow stroke.
Stem Cell Pathology
Authors: Fu Dah-Jiun , Miller Andrew D. , Southard Teresa L. , Flesken-Nikitin Andrea , Ellenson Lora H. , Nikitin Alexander Yu.
Published: October 2017

Rapid advances in stem cell biology and regenerative medicine have opened new opportunities for better understanding disease pathogenesis and the development of new diagnostic, prognostic, and treatment approaches. Many stem cell niches are well defined anatomically, thereby allowing their routine pathological evaluation during disease initiation and progression. Evaluation of the consequences of genetic manipulations in stem cells and investigation of the roles of stem cells in regenerative medicine and pathogenesis of various diseases such as cancer require significant expertise in pathology for accurate interpretation of novel findings. Therefore, there is an urgent need for developing stem cell pathology as a discipline to facilitate stem cell research and regenerative medicine. This review provides examples of anatomically defined niches suitable for evaluation by diagnostic pathologists, describes neoplastic lesions associated with them, and discusses further directions of stem cell pathology.
Endothelial function is impaired in the cutaneous microcirculation of adults with psoriasis through reductions in nitric oxide-dependent vasodilation
Authors: Alba Billie K. , Greaney Jody L. , Ferguson Sara B. , Alexander Lacy M.
Published: October 2017

Psoriasis is an independent risk factor for cardiovascular disease; however, the underlying mechanisms are not fully understood. Deficits in conduit arterial function are evident in patients with psoriasis, but potential impairments in microcirculatory endothelial function remain unclear. We hypothesized that cutaneous microvascular dysfunction would be detectable in otherwise healthy individuals with psoriasis. Two intradermal microdialysis fibers were placed in (nonlesional) forearm skin of nine patients (3 men and 6 women, 39 ± 5 yr) with moderate (16 ± 2% of body surface area) plaque psoriasis and nine healthy (nonpsoriatic) control subjects (3 men and 6 women, 38 ± 5 yr) for local delivery of 1) lactated Ringer solution (control) and 2) 10 mM l-ascorbate (a nonspecific antioxidant). An index of skin blood flow was measured using laser-Doppler flowmetry during local heating (42°C). Nitric oxide (NO)-dependent vasodilation was directly quantified after perfusion of the nonspecific NO synthase inhibitor NG-nitro-l-arginine methyl ester (15 mM). A third fiber was perfused with increasing concentrations (10−10– 10−2M) of norepinephrine to elicit adrenoreceptor-mediated cutaneous vasoconstriction. NO-dependent vasodilation was attenuated in patients with psoriasis (57 ± 5% and 39 ± 7% maximum cutaneous vascular conductance in control subjects and adults with psoriasis, respectively, P < 0.01). l-Ascorbate did not improve NO-dependent vasodilation ( P > 0.05). There was no group difference in maximal vasoconstriction or microvascular sensitivity to norepinephrine ( P > 0.05). These data suggest that NO bioavailability is reduced in otherwise healthy individuals with psoriasis, which contributes to systemic microvascular dysfunction.

NEW & NOTEWORTHY In adults with psoriasis, reduced nitric oxide bioavailability mediates impaired endothelium-dependent vasodilation, independent of increases in oxidative stress. Furthermore, the degree of psoriatic symptomology is directly related to greater reductions in nitric oxide-dependent vasodilation.
Chronic femoral artery ligation exaggerates the pressor and sympathetic nerve responses during dynamic skeletal muscle stretch in decerebrate rats
Authors: Kempf Evan A. , Rollins Korynne S. , Hopkins Tyler D. , Butenas Alec L. , Santin Joseph M. , Smith Joshua R. , Copp Steven W.
Published: October 2017

Mechanical and metabolic signals arising during skeletal muscle contraction reflexly increase sympathetic nerve activity and blood pressure (i.e., the exercise pressor reflex). In a rat model of simulated peripheral artery disease in which a femoral artery is chronically (~72 h) ligated, the mechanically sensitive component of the exercise pressor reflex during 1-Hz dynamic contraction is exaggerated compared with that found in normal rats. Whether this is due to an enhanced acute sensitization of mechanoreceptors by metabolites produced during contraction or involves a chronic sensitization of mechanoreceptors is unknown. To investigate this issue, in decerebrate, unanesthetized rats, we tested the hypothesis that the increases in mean arterial blood pressure and renal sympathetic nerve activity during 1-Hz dynamic stretch are larger when evoked from a previously “ligated” hindlimb compared with those evoked from the contralateral “freely perfused” hindlimb. Dynamic stretch provided a mechanical stimulus in the absence of contraction-induced metabolite production that closely replicated the pattern of the mechanical stimulus present during dynamic contraction. We found that the increases in mean arterial blood pressure (freely perfused: 14 ± 1 and ligated: 23 ± 3 mmHg, P = 0.02) and renal sympathetic nerve activity were significantly greater during dynamic stretch of the ligated hindlimb compared with the increases during dynamic stretch of the freely perfused hindlimb. These findings suggest that the exaggerated mechanically sensitive component of the exercise pressor reflex found during dynamic muscle contraction in this rat model of simulated peripheral artery disease involves a chronic sensitizing effect of ligation on muscle mechanoreceptors and cannot be attributed solely to acute contraction-induced metabolite sensitization.

NEW & NOTEWORTHY We found that the pressor and sympathetic nerve responses during dynamic stretch were exaggerated in rats with a ligated femoral artery (a model of peripheral artery disease). Our findings provide mechanistic insights into the exaggerated exercise pressor reflex in this model and may have important implications for peripheral artery disease patients.