bluuebunny/crossref_metadata_2025 huggingface dataset:
Remote control of North Atlantic Oscillation predictability via the stratosphere
Authors: Hansen F. , Greatbatch R. J. , Gollan G. , Jung T. , Weisheimer A.
Published: November 2016

The phase and amplitude of the North Atlantic Oscillation (NAO) are influenced by numerous factors, including sea‐surface temperature (SST) anomalies in both the Tropics and extratropics and stratospheric extreme events like stratospheric sudden warmings (SSWs). Analyzing seasonal forecast experiments, which cover the winters from 1979/1980–2013/2014, with the European Centre for Medium‐Range Weather Forecast model, we investigate how these factors affect NAO variability and predictability. Building on the idea that tropical influence might happen via the stratosphere, special emphasis is placed on the role of major SSWs. Relaxation experiments are performed, where different regions of the atmosphere are relaxed towards ERA‐Interim to obtain perfect forecasts in those regions. By comparing experiments with relaxation in the tropical atmosphere, performed with an atmosphere‐only model on the one hand and a coupled atmosphere–ocean model version on the other, the importance of extratropical atmosphere–ocean interaction is addressed.

Interannual variability of the NAO is best reproduced when perfect knowledge of the Northern Hemisphere (NH) stratosphere is available, together with perfect knowledge of SSTs and sea ice, in which case 64% of the variance of winter mean NAO is projected to be accounted for with a forecast ensemble of infinite size. The coupled experiment shows a strong bias in the stratospheric polar‐night jet (PNJ), which might be associated with a drift in the modelled SSTs resembling the North Atlantic cold bias and an underestimation of blockings in the North Atlantic/Europe sector. Consistent with the stronger PNJ, the lowest frequency of major SSWs is found in this experiment. However, after removing the bias statistically, a perfect forecast of the tropical atmosphere and allowing two‐way atmosphere–ocean coupling in the extratropics seem to be key ingredients for successful SSW predictions. In combination with SSW occurrence, a clear shift of the predicted NAO towards lower values occurs.
Neutral losses of sodium benzoate and benzoic acid in the fragmentation of the [M + Na]+ ions of methoxyfenozide and tebufenozide via intramolecular rearrangement in electrospray ionization tandem mass spectrometry
Authors: Chai Yunfeng , Gao Guanwei , Shen Shanshan , Liu Xin , Lu Chengyin
Published: November 2016

Rationale

Electrospray ionization (ESI) tandem mass spectrometry can be applied to determine structural information about organic compounds. The [M + Na]+ ion is one of the major precursor ions in ESI mass spectrometry, but its fragmentation mechanism study is still insufficient. This study reveals the interesting fragmentation reactions of the [M + Na]+ ions of methoxyfenozide and tebufenozide.

Methods

The fragmentations of the [M + Na]+, [M + Li]+, and [M + H]+ ions of methoxyfenozide and tebufenozide were studied using a hybrid quadrupole‐orbitrap mass spectrometer and an ion trap mass spectrometer. A hydrogen/deuterium (H/D)‐exchange experiment in the amide group of methoxyfenozide allowed for the confirmation of the fragmentation mechanism. Density functional theory (DFT) calculations were performed for a further understanding of the fragmentation mechanism of the [M + Na]+ ion of methoxyfenozide.

Results

Neutral losses of sodium benzoate and benzoic acid in the fragmentation of the [M + Na]+ ions of methoxyfenozide and tebufenozide were observed as the major fragmentation pathways. In contrast, similar fragmentations were not observed or minor pathways in the fragmentation of the [M + Li]+ and [M + H]+ ions of methoxyfenozide and tebufenozide. In addition, a minor product ion resulting from loss of NaOH was identified, which was the first reported example in the fragmentation of sodiated compounds in mass spectrometry.

Conclusions

Losses of sodium benzoate and benzoic acid in the fragmentation of the [M + Na]+ ions of methoxyfenozide and tebufenozide are proposed to be formed through an intramolecular rearrangement reaction, which is supported by DFT calculations. An H/D‐exchange experiment confirms that the carboxyl hydrogen of benzoic acid and the hydrogen of NaOH exclusively derive from the amide hydrogen of the precursor ion. This study enriches our knowledge on the Na+‐induced fragmentation reactions. Copyright © 2016 John Wiley & Sons, Ltd.
Trauma-Informed Care Is the Best Clinical Practice in Rehabilitation Nursing
Authors: Freeman Williamson Laneita , Kautz Donald D.
Published: November 2016

Purpose:

This clinical article explores how trauma-informed care (TIC) can be used by rehabilitation nurses with patients who have experienced pervasive adverse childhood experiences (ACEs).

Method (Intervention Strategies):

This clinical article gives suggestions for using the five guiding principles of TIC: safety, trustworthiness, choice, collaboration, and empowerment, as the best clinical practice.

Conclusion:

Implementing TIC promotes successful rehabilitation, improves patient outcomes, and reduces costs. For every $1 spent on TIC, $5 is saved in lifetime costs.

Clinical Relevance:

ACEs cause physiological changes in the brain, leading to antisocial and risky behaviors, which may result in head injuries, spinal cord injuries, amputations, and multiple traumas with subsequent rehabilitation admissions, as well as obesity, and chronic illnesses. TIC is a cultural shift: We as providers must ask ourselves “What happened to this person?” instead of “What is wrong with this person?” Nurses are beginning to develop our literature and practice of TIC.
Evaluation of an Exercise Program for Older Adults in a Residential Environment
Authors: Shin Juh Hyun
Published: November 2016

Purpose:

The aim of this study was to examine the effectiveness of an older adult exercise program in a senior-living complex campus.

Design:

A longitudinal one-group design was used.

Methods:

To supply residents with tools to maintain or improve general quality of life, balance, endurance, depression, and functional mobility, the Wellness and Fitness Center at the research setting provided a wide assortment of user-friendly equipment with many options. One fitness director in the selected setting evaluated participants every 6 months with 33 participants using the Senior Fitness Test (SFT).

Findings:

Repeated ANOVAs identified factors impacting the effects of the exercise program using PROC MIXED SAS 9.0. The improvement or deterioration rate of SFT scores was tested as a time effect in balance, upper body strength, and lower body flexibility. A statistically significant gender effect emerged on the 6-minute walk, which measured aerobic endurance and the chair sit-and-reach test, which measured lower body flexibility.

Conclusions:

The 8-foot up-and-go, arm curl, chair stand, and chair sit-and-reach tests showed statistically significant improvement over time, which means balance, upper body strength, lower body strength, and lower body flexibility improved.

Clinical Relevance:

Developing customized exercise protocols and using standardized measurement tools should be encouraged to enhance effective research and consistent measurement of exercise programs.
A Performant Dry Reforming Catalytic System Elaborated from the Reductive Decomposition of BaNi2V2O8
Authors: Guerrero‐Caballero Jesus , Löfberg Axel , Mentré Olivier , Kane Tanushree , Pussacq Tanguy , Roussel Pascal , Huvé Marielle , Trentesaux Martine , Gardoll Olivier , Kabbour Houria
Published: November 2016

The reductive decomposition of BaNi2V2O8 leads to a Ni‐supported catalyst composed by an intimate blend of Ba3(VO4)2/Ni/BaV10O15. High activity for the Dry Reforming of Methane (DRM) is attained with 85 % conversion for CH4 and CO2, as well as a very good stability in time and a high selectivity with H2/CO=0.9 and negligible carbon deposition. A rich redox and optimal oxide‐metal interactions provide a unique and promising catalytic system.
Organocatalytic Enantioselective Friedel‐Crafts Reaction of Sesamol and Electron–rich Phenols with Alkylideneindolenine Intermediates Generated from Arylsulfonyl Indoles
Authors: Chang Chia‐Hao , Han Jeng‐Liang
Published: November 2016

We have developed the organocatalyzed asymmetric Friedel‐Crafts reaction of sesamol and electron‐rich phenols with various alkylideneindolenine intermediates generated from arylsulfonyl Indoles by using cinchona alkaloid‐urea bifunctional organocatalysts. A broad range of enantioenriched Friedel‐Crafts adducts with a tertiary stereocenter could be smoothly synthesized in good to excellent yields with moderate to good enantioselectivities.
Quinolyl‐Amidinates Chelating Bimetallic Magnesium and Mononuclear Aluminum Complexes for ϵ‐Caprolactone Polymerization
Authors: Xi Yanxia , Rajendran Natesan Mannangatti , Zhang Wenjuan , Sun Yang , Lei Ming , Sun Wen‐Hua
Published: November 2016

A series of quinolyl‐amidinate compounds ((Ar–N=C(Ph)–N(H)–C9H5N–2–Me: Ar=2,6‐Me2C6H3 (L1), 2,6‐Et2C6H3 (L2), 2,6‐iPr2C6H3 (L3), 2,4,6‐Me3C6H2 (L4), 2,6‐Et2‐4‐MeC6H2 (L5)) was synthesized. These compounds in toluene reacted with C2H5MgBr forming the bimetallic bromomagnesium complexes (Mg1 ‐ Mg5) in high yields, and with AlMe3 producing dimethyl aluminum complexes (Al1 ‐ Al5) in high yields. All organic compounds and their corresponding magnesium and aluminum complexes were characterized by elemental and spectroscopic analyses. The ambiguous structures of complexes Mg2, Mg5 and Al1 were determined by the single crystal X‐ray diffraction analysis, reflecting bimetallic feature of complexes Mg2 and Mg5 with five‐coordination around magnesium atoms and mononuclear aluminum complex Al1 as a distorted trigonal‐bipyramidal geometry. All magnesium and aluminum complexes initiate the ring opening polymerization of ϵ‐caprolactone with good conversion yields. Aluminum complexes showed better activity with TOF up to 3678 h−1 at 80 °C in the presence of BnOH, while bromomagnesium complexes attained the good conversion of ϵ‐CL without of BnOH.
Synthesis of Sb2Se3 and Bi2Se3 Nanoparticles in Ionic Liquids at Low Temperatures and Solid State Structure of [C4C1Im]3[BiCl6]
Authors: Loor Manuel , Bendt Georg , Schaumann Julian , Hagemann Ulrich , Heidelmann Markus , Wölper Christoph , Schulz Stephan
Published: November 2016

Crystalline Sb2Se3 nanoparticles were prepared by reaction of SbCl3 with (Et3Si)2Se in the presence of oleylamine (OA) in the ionic liquid [C4C1Im]Cl, whereas the reaction of (Et3Si)2Se with [C4C1Im]3[BiCl6] (1), which was obtained from the reaction of BiCl3 with [C4C1Im]Cl and structurally characterized by single‐crystal X‐ray diffraction, yielded Bi‐rich Bi2Se3 nanoparticles. In contrast, the reaction of the reactive IL [C4C1Im]3[Bi3I12] with (Et3Si)2Se in the presence of oleylamine in [C4C1Im]I gave phase‐pure Bi2Se3 nanoparticles. The chemical composition of the nanoparticles was investigated by EDX, while possible surface contaminations were studied by XPS and IR spectroscopy. The morphology of the nanoparticles was studied by SEM and TEM.
Thermochemistry of Pyridinium Based Ionic Liquids with Tetrafluoroborate Anion
Authors: Zaitsau Dzmitry H. , Yermalayeu Andrei V. , Emel'yanenko Vladimir N. , Schulz Axel , Verevkin Sergey P.
Published: November 2016

Enthalpies of vaporization of five pyridinium based ionic liquids (ILs): 1‐R‐pyridinium (with R = ethyl, butyl‐, and hexyl), 1‐butyl‐3‐methyl‐pyridinium, and 1‐butyl‐4‐methyl‐pyridinium with tetrafluoroborate anion were studied using Quartz Crystal Microbalance (QCM). Enthalpies of solution of these ionic liquids were measured by high‐precision solution calorimetry. Gas‐phase enthalpies of formation of ILs were calculated by using the high‐level quantum‐chemical method G3MP2. From combination of experimental and theoretical results, enthalpies of formation of aqueous pyridinium based cations were derived for the first time.
Handcrafted Vacuum‐Assisted Device for Skin Ulcers Treatment Versus Traditional Therapy, Randomized Controlled Trial
Authors: Gonzalez Israel Gonzalez , Angel Medina Andrade Luis , Baez Maria Valeria Jimenez , Ruiz Flores Brenda , de los Angeles Martinez Ferretiz Maria , Woolf Stephanny Vanestty , López Israel , Sandoval‐Jurado Luis , Pat‐Espadas Fany Guadalupe , Cruz Alan Alejandro Reyes , Delgado Arsenio Torres
Published: November 2016

Background

Chronic lower limb ulcers constitute a public health problem, with important socioeconomic implications and high attention cost. This trial evaluates handcrafted vacuum‐assisted therapy versus traditional treatment effectiveness for lower limbs ulcers.

Materials and methods

It was a prospective randomized clinical trial conducted over 144 patients with lower limbs ulcers. Patients were randomized into two groups of 72 patients: Experimental group were treated with debridement, cure and a handcrafted vacuum‐assisted device that was changed every 72 h. Control group was treated with debridement and cure with soap every 24 h. Ulcers were evaluated every 72 h and on 10th day. The presence of systemic inflammatory response, pain, granulation tissue and viability for discharge was registered and analyzed.

Results

After exclusion of 18 patients, 126 were included, 65.1% were men with an average of 58 years. Sole region ulcer by diabetic foot was the more frequent in both groups (73%). Leukocytes count, systemic inflammatory response and pain were significantly lower in experimental group (p < 0.05). Discharge criteria and granulation tissue were present earlier in experimental group (p < 0.05).

Conclusion

Handcrafted vacuum‐assisted system is a feasible and safe method to treat chronic ulcers. This system would benefit patients favoring earlier infection control, faster granulation tissue appearance and earlier discharge.

Clinical trials registered in https://www.clinicaltrials.gov/ Number NCT02512159.
Portal Supply and Venous Drainage of the Caudate Lobe in the Healthy Human Liver: Virtual Three‐Dimensional Computed Tomography Volume Study
Authors: Benkö T. , Sgourakis G. , Molmenti E. P. , Peitgen H. O. , Paul A. , Nadalin S. , Schroeder T. , Radtke A.
Published: November 2016

Objective

The venous vascular anatomy of the caudate lobe is exceptional. The purpose of this study was to assess portal inflow and venous outflow volumes of the caudate lobe.

Methods

Extrahepatic (provided by the first‐order branches) versus intrahepatic (provided by the second‐ to third‐order branches) portal inflow, as well as direct (via Spieghel veins) versus indirect (via hepatic veins) venous drainage patterns were analyzed in virtual 3‐D liver maps in 140 potential live liver donors.

Results

The caudate lobe has a greater intrahepatic than extrahepatic portal inflow volume (mean 55 ± 26 vs. 45 ± 26%: p = 0.0763), and a greater extrahepatic than intrahepatic venous drainage (mean 54–61 vs. 39–46%). Intrahepatic drainage based on mean estimated values showed the following distribution: middle > inferior (accessory) > right > left hepatic vein.

Conclusions

Sacrifice of extrahepatic caudate portal branches can be compensated by the intrahepatic portal supply. The dominant outflow via Spieghel veins and the negligible role of left hepatic vein in caudate venous drainage may suggest reconstruction of caudate outflow via Spieghel veins in instances of extended left hemiliver live donation not inclusive of the middle hepatic vein. The anatomical data and the real implication for living donors must be further verified by clinical studies.
Comparative Validation of Abdominal CT Models that Predict Need for Surgery in Adhesion‐Related Small‐Bowel Obstruction
Authors: Yang Phillip F. , Rabinowitz Dean P. , Wong Shing W. , Khan Maroof A. , Gandy Robert C.
Published: November 2016

Introduction

Adhesion‐related small‐bowel obstruction (ASBO) can be managed without surgery in selected patients. The aim of this study was to validate three previously published computed tomography (CT) models that predict need for surgery.

Methods

A retrospective study of patients with ASBO admitted to a tertiary referral hospital between November 2009 and April 2015 was conducted. Data on clinical variables were extracted from medical records. CT signs were assessed by a radiologist who was blinded to whether or not the patients required surgery. Three previously published models were validated by testing their ability to predict need for surgery.

Results

The cohort comprised 233 patients with ASBO (mean age 69.7 years, 47.6% male), of whom 73 (31.3%) required surgery. A predictive model using a combination of mesenteric oedema, free intraperitoneal fluid and absence of small‐bowel faecalisation had a sensitivity of 38% [95% CI 27–50%], specificity of 88% [81–92%], positive likelihood ratio (LR+) of 3.1 [1.6–5.1] and negative likelihood ratio (LR−) of 0.7 [0.6–0.8]. Only the results of one previously published model (which used a combination of obstipation, free intraperitoneal fluid and high‐grade or complete obstruction) could be reproduced. This model had a potentially clinically useful LR+ of 2.9 [1.1–7.4] and LR− of 0.9 [0.8–1.0]. The poor performances of the other two models may be partially explained by measurement bias.

Conclusion

The performances of the previously published predictive models in this validation study were varied. Future attempts to develop models should use clearly defined, standardised and reproducible predictors wherever possible.
3D Printed Surgical Instruments: The Design and Fabrication Process
Authors: George Mitchell , Aroom Kevin R. , Hawes Harvey G. , Gill Brijesh S. , Love Joseph
Published: November 2016

Background

3D printing is an additive manufacturing process allowing the creation of solid objects directly from a digital file. We believe recent advances in additive manufacturing may be applicable to surgical instrument design. This study investigates the feasibility, design and fabrication process of usable 3D printed surgical instruments.

Methods

The computer‐aided design package SolidWorks (Dassault Systemes SolidWorks Corp., Waltham MA) was used to design a surgical set including hemostats, needle driver, scalpel handle, retractors and forceps. These designs were then printed on a selective laser sintering (SLS) Sinterstation HiQ (3D Systems, Rock Hill SC) using DuraForm EX plastic. The final printed products were evaluated by practicing general surgeons for ergonomic functionality and performance, this included simulated surgery and inguinal hernia repairs on human cadavers. Improvements were identified and addressed by adjusting design and build metrics.

Results

Repeated manufacturing processes and redesigns led to the creation of multiple functional and fully reproducible surgical sets utilizing the user feedback of surgeons. Iterative cycles including design, production and testing took an average of 3 days. Each surgical set was built using the SLS Sinterstation HiQ with an average build time of 6 h per set.

Conclusions

Functional 3D printed surgical instruments are feasible. Advantages compared to traditional manufacturing methods include no increase in cost for increased complexity, accelerated design to production times and surgeon specific modifications.
Continued growth after fixation of slipped capital femoral epiphysis
Authors: Holmdahl Per , Backteman Torsten , Danielsson Aina , Kärrholm Johan , Riad Jacques
Published: November 2016

Purpose

When treating slipped capital femoral epiphysis (SCFE), a smooth pin with a hook or a short threaded screw can be used to allow further growth, which could be important to prevent the development of impingement and early arthritis. The purpose of this investigation was to measure growth in three dimensions after fixation of SCFE.

Methods

Sixteen participants with unilateral SCFE, nine girls and seven boys with a median age of 12.0 years (range 8.4–15.7 years), were included. The slipped hip was fixed with a smooth pin with a hook, and the non-slipped hip was prophylactically pinned. At the time of surgery, tantalum markers were installed bilaterally on each side of the growth plate through the drilled hole for the pin. Examination with radiostereometric analysis (RSA) was performed postoperatively and at 3, 6 and 12 months. The position of the epiphysis in relation to the metaphysis was calculated.

Results

At 12 months, the epiphysis moved caudally, median 0.16 mm and posteriorly 2.28 mm on the slipped side, in comparison to 2.28 cranially and 0.91 mm posteriorly on the non-slipped side, p = 0.003 and p = 0.030, respectively. Both slipped and non-slipped epiphysis moved medially, 1.52 and 1.74 mm, respectively. A marked variation in the movement was noted, especially on the slipped side.

Conclusions

The epiphysis moved in relation to the metaphysis after smooth pin fixation, both on the slipped side and on the prophylactically fixed non-slipped side, implying further growth. The RSA method can be used to understand remodelling after ‘growth-sparing’ fixation of SCFE.
Shallow Lithosphere-Asthenosphere Boundary beneath Cambay Rift Zone of India: Inferred Presence of Carbonated Partial Melt
Authors: Kumar Prakash , Sen Gautam , Mandal Prantik , Sen Mrinal K.
Published: November 2016

Cambay Rift Zone (CRZ) is an ancient rift that had last witnessed volcanism and rifting activity 68-65 million years ago, when the Indian plate migrated over the Deccan plume, potentially signifying the presence of a shallow LAB. Here we apply converted wave techniques to a teleseismic earthquake dataset to image the mantle below the CRZ. We place the Lithosphere-Asthenosphere Boundary (LAB) beneath this rift at a depth where a ∼10% drop occurs in shear wave velocity. The seismic velocity structure indicates that the lithosphere thickness varies from ∼60 km beneath the rift to ∼110 km beneath rift walls. Furthermore, the upper mantle discontinuities (410 and 660 km discontinuities) are found to be thinner by ∼2 sec (i.e. ∼20km) with delayed 410-km discontinuity and normal 660-km discontinuities. We infer this to be caused by a thermal anomaly in the upper mantle. The surface heat flow at CRZ is high. A geothermal gradient extrapolated from the surface heat flow intercepts CO2-bearing mantle peridotite solidus at 60 km, and thus could signal the presence of small amounts of carbonatite-type magma. We suggest that the CRZ might become reactivated by the generation of small pockets of melt at the LAB, which is being triggered by a thermal anomaly in the upper mantle beneath this currently inactive rift.
Biostratigraphy and Depositional Environments of Subsurface Sediments in Well Arani-A, Palar Basin, Tamil Nadu
Authors: Basavaraju M. H. , Jaiprakash B. C. , Chidambaram L. , Ayyadurai M.
Published: November 2016

The first exploratory well Arani – A was drilled in the Palar basin to a depth of 2400m and terminated within the granitic basement. This well offered the first ever opportunity to understand biostratigraphy, sedimentation history and depositional environment of the entire sedimentary column based on arenaceous foraminifera, spores, pollen and dinoflagellate cyst assemblages. Previous studies on few scattered outcrops around Sriperumbudur, Chengalpattu and Sathyavedu areas have documented palynofossil assemblage of Neocomian – Aptian age. The present study reveals the presence of middle Jurassic (Bajocian-Callovian) sediments (2360-1725 m) resting on the granitic basement. The sediments are interpreted to have deposited under lacustrine/estuarine conditions with high tides providing occasional marine influence. The middle Jurassic sediments are conformably overlain by late Jurassic (Oxfordian–Tithonian) sediments (1725 - 950 m). The late Jurassic sediments have been inferred to have got deposited under fluctuating near shore-marginal marine conditions. There is a 55m thick boulder bed (950 - 895 m) separating the overlying Valanginian sediments. Early Cretaceous (Valanginian-Early Albian) sediments are developed in the interval from 895-50m. The boulder bed possibly corresponds to the missing Berriasian stage of the earliest Cretaceous representing an unconformity of the order of ∽5 Ma across Jurassic-Cretaceous boundary. These sediments are inferred to have deposited under shallow inner neritic conditions. The sediments from 50m to surface consist mainly of lateritic sandstone and alluvium. The sedimentary history of Palar basin began in Bajocian stage of middle Jurassic (170 -168 Ma) and ended in early Albian stage of early Cretaceous (113-105 Ma). The late Albian marine transgression which facilitated huge sedimentation in Cauvery and Krishna-Godavari basins has bypassed the Palar basin thus adversely affecting the hydrocarbon potential.
Reactivation and Strain Localisation in Bhavani Shear Zone, South India
Authors: Prasannakumar V. , Mccaig Andrew
Published: November 2016

Shear markers and shear sense indicators from the Bhavani shear zone, a member of the shear system separating the northern Archaean and southern Pan African granulite terranes of the South Indian shield, with differently exhumed crustal blocks, suggest multiphase reactivation. This is revealed by textural and geochemical characteristics of mylonites which indicate an event of prograde epidote-amphibolite facies metamorphism of the previously retrograded protolith of shear zone rocks. The amphibole varies progressively from an initial magnesio-hornblende to ferrotschermakitic hornblende with increasing Al and K while the plagioclase maintains oligoclase composition (An21-25). P-T estimates suggest metamorphic conditions of 634°C - 720°C at 3.6±0.5 to 5.8±0.5 kbar. Strain partitioning during the reactivation of the shear zone prior to the Pan African event, is responsible for the gradation in the intensity of mylonitic fabric as well as some of the opposing shear sense indicators.
Physical and occupational therapy outcomes: Adolescents’ change in functional abilities using objective measures and self-report
Authors: Kempert Heidi , Benore Ethan , Heines Rachel
Published: November 2016

Purpose

This study evaluates the clinical usefulness of patient-rated and objective measures to identify physically-oriented functional changes after an intensive chronic pain program in a pediatric setting. Past studies have demonstrated the importance of adolescents’ perception of their abilities and measurement tools used for rehabilitation outcomes within physical and occupational therapy; however, these tools used are not often easily utilized or have not been examined with a pediatric chronic pain population. In chronic pain rehabilitation, it is important to have a primary focus on functional improvement not on pain reduction as a leading outcome. This study examines how both self-report and objective physical activity measures can be meaningful constructs and can be used as reliable outcome measures. It was hypothesized that adolescents completing an interdisciplinary pain rehabilitation program would report functional gains from admission to discharge, and that perceived gains in physical ability would be associated with objective physical activities. Further, it was hypothesized that gains in functioning would be associated with mild pain reduction.

Methods

Data from 78 children and adolescents with chronic pain that participated in an intensive multidisciplinary treatment program completed self-report measures including the Lower Extremity Functional Scale (LEFS), Upper Extremity Functional Index (UEFI). In addition, adolescents were objectively monitored for repetitions of selected physical activities for 1 min intervals.

Results

Data demonstrated significant gains in all measures of functioning during the program. Correlations between self-report and objective outcomes suggest they are measuring similar yet distinct factors.

Conclusions

The LEFS, UEFI, and objective exercises provide a meaningful way to track progress in pediatric chronic pain rehabilitation. Despite similarities, they appear to track separate but related aspects of rehabilitation and capture important short-term response to rehabilitation. Both measures appear distinct from pain as an outcome. These findings increase our understanding of rehabilitation practices provide opportunities to promote clinical improvement in pediatric pain.

Implications

The use of self-report measures along with objective measures can help therapists gain understanding in regards to a patient’s insight and how that may impact their overall outcome compared to the use of a single outcome measure. Viewing these rated measures at any point in the rehabilitation process can be useful to facilitate discussion about challenges they can identify and how therapies can facilitate improvement and functional gains.
Slow or swift, your patients’ experience won’t drift: absence of correlation between physician productivity and the patient experience
Authors: Lenz Kasia , McRae Andrew , Wang Dongmei , Higgins Benjamin , Innes Grant , Cook Timothy , Lang Eddy
Published: November 2016

Absract

Objectives

To evaluate the relationship between Emergency Physician (EP) productivity and patient satisfaction with Emergency Department (ED) care.

Methods

This retrospective observational study linked administrative and patient experience databases to measure correlations between the patient experience and EP productivity. The study was performed across three Calgary EDs (from June 2010 to July 2013). Patients>16 years old with completed Health Quality Council of Alberta (HQCA) ED Patient Experience Surveys were included. EP productivity was measured at the individual physician level and defined as the average number of patients seen per hour. The association between physician productivity and patient experience scores from six composite domains of the HQCA ED Patient Experience Survey were examined using Pearson correlation coefficients, linear regression modelling, and a path analysis.

Results

We correlated 3,794 patient experience surveys with productivity data for 130 EPs. Very weak non-significant negative correlations existed between productivity and survey composites: “Staff Care and Communication” (r=-0.057, p=0.521), “Discharge Communication” (r=-0.144, p=0.102), and “Respect” (r=-0.027, p=0.760). Very weak, non-significant positive correlations existed between productivity and the composite domains: “Medication Communication” (r=0.003, p=0.974) and “Pain management” (r=0.020, p=0.824). A univariate general linear model yielded no statistically significant correlations between EP productivity and patient experience, and the path analysis failed to show a relationship between the variables.

Conclusion

We found no correlation between EP productivity and the patient experience.
Concealed resuscitation-related injuries as reversible cause of recurrent arrest following extracorporeal cardiopulmonary resuscitation
Authors: Han Kap Su , Lee Sung Woo , Park Kwang Hoon , Park Jong Su , Jung Jae Seung , Yu Cheol Woong , Kim Su Jin
Published: November 2016

A life-threatening cardiopulmonary resuscitation (CPR)-related injury can cause recurrent arrest after return of circulation. Such injuries are difficult to identify during resuscitation, and their contribution to failed resuscitation can be missed given the limitations of conventional CPR. Extracorporeal cardiopulmonary resuscitation (ECPR), increasingly being considered for selected patients with potentially reversible etiology of arrest, may identify previously occult CPR-related injuries by restoring arterial pressure and flow. Herein, we describe two cases of severe CPR-related injuries contributing to recurrent arrest. Each case had ECPR implemented within 60 minutes of the start of CPR. After the presumed cardiac etiology had been addressed with percutaneous coronary intervention, life-threatening cardiovascular injuries with recurrent arrest were noted, and resuscitative thoracotomy was performed under ECPR. One patient survived to hospital discharge.

ECPR may provide an opportunity to identify and correct severe resuscitation-related injuries causing recurrent arrest. Chest compression depth >6 cm, especially in older women, may contribute to these injuries.
Supplementary Educational Models in Canadian Neurosurgery Residency Programs
Authors: Ryu Won Hyung A. , Chan Sonny , Sutherland Garnette R.
Published: November 2016

Background: The proposed implementation of work hour restrictions has presented a significant challenge of maintaining the quality of resident education and ensuring adequate hands-on experience that is essential for novice surgeons. To maintain the level of resident surgical competency, revision of the apprentice model of surgical education to include supplementary educational methods, such as laboratory and virtual reality (VR) simulations, have become frequent topics of discussion. We aimed to better understand the role of supplementary educational methods in Canadian neurosurgery residency training. Methods: An online survey was sent to program directors of all 14 Canadian neurosurgical residency programs and active resident members of the Canadian Neurosurgical Society (N=85). We asked 16 questions focusing on topics of surgeon perception, current implementation and barriers to supplementary educational models. Results: Of the 99 surveys sent, 8 out of 14 (57%) program directors and 37 out of 85 (44%) residents completed the survey. Of the 14 neurosurgery residency programs across Canada, 7 reported utilizing laboratory-based teaching within their educational plan, while only 3 programs reported using VR simulation as a supplementary teaching method. The biggest barriers to implementing supplementary educational methods were resident availability, lack of resources, and cost. Conclusions: Work-hour restrictions threaten to compromise the traditional apprentice model of surgical training. The potential value of supplementary educational methods for surgical education is evident, as reported by both program directors and residents across Canada. However, availability and utilization of laboratory and VR simulations are limited by numerous factors such as time constrains and lack of resources.
A Japanese diet with low glycaemic index and glycaemic load is associated with both favourable and unfavourable aspects of dietary intake patterns in three generations of women
Authors: Inomaki Ryoko , Murakami Kentaro , Livingstone M Barbara E , Okubo Hitomi , Kobayashi Satomi , Suga Hitomi , Sasaki Satoshi ,   the Three-generation Study of Women on Diets and Health Study Group
Published: November 2016

Objective

Western studies have suggested cultural differences in food and nutrient intake patterns associated with dietary glycaemic index (GI) and glycaemic load (GL). Here, we conducted a cross-sectional study to examine the GI and GL of Japanese diets in relation to food and nutrient intakes.

Design

Dietary intake was assessed using a validated, self-administered, diet history questionnaire.

Setting

A total of thirty-five of forty-seven prefectures in Japan.

Subjects

Young (age 18 years), middle-aged (mean age 48 years) and older (mean age 74 years) Japanese women (n 3961, 3800 and 2202, respectively).

Results

Irrespective of age, a positive association with dietary GI was seen for white rice only, which contributed most (37–42 %) to the variation in dietary GI. Conversely, all other food groups (such as fruit and vegetable juice, dairy products, noodles and fruit) were negative predictors of dietary GI. For dietary GL, 95–96 % of variation was explained by carbohydrate-rich food groups, all of which were positive predictors of GL. After adjustment for potential confounding factors, only carbohydrate intake was positively associated with dietary GI and GL, irrespective of age. Conversely, dietary GI and GL were inversely associated with intakes of all other nutrients examined (including SFA and Na).

Conclusions

A low-GI and -GL diet, which was characterized principally by a low intake of white rice, was associated with both favourable (higher intakes of dietary fibre and key vitamins and minerals) and unfavourable (higher intakes of SFA and Na) aspects of dietary intake patterns in three generations of Japanese women.
Enhancing psychosocial and spiritual palliative care: Four-year results of the program of comprehensive care for people with advanced illnesses and their families in Spain
Authors: Gómez-Batiste Xavier , Mateo-Ortega Dolors , Lasmarías Cristina , Novellas Anna , Espinosa Jose , Beas Elba , Ela Sara , Barbero Javier ,   FOR THE “LA CAIXA” FOUNDATION
Published: November 2016

Objective:

We aimed to describe the overall quantitative and qualitative results of a “La Caixa” Foundation and World Health Organization Collaborating Center Program entitled “Comprehensive Care for Patients with Advanced Illnesses and their Families” after four years of experience.

Method:

Qualitative and quantitative methods were employed to assess the program. Quasiexperimental, prospective, multicenter, single-group, and pretest/posttest methods were utilized to assess the quantitative data. The effectiveness of psychosocial interventions was assessed at baseline (visit 1) and after four follow-up visits. The following dimensions were assessed: mood state, discomfort, anxiety, degree of adjustment or adaptation to disease, and suffering. We also assessed the four dimensions of the spiritual pain scale: faith or spiritual beliefs, valuable faith or spiritual beliefs, meaning in life, and peace of mind/forgiveness. Qualitative analyses were performed via surveys to evaluate stakeholder satisfaction.

Results:

We built 29 psychosocial support teams involving 133 professionals—mainly psychologists and social workers. During the study period, 8,964 patients and 11,810 family members attended. Significant improvements were observed in the psychosocial and spiritual dimensions assessed. Patients, family members, and stakeholders all showed high levels of satisfaction.

Significance of Results:

This model of psychosocial care could serve as an example for other countries that wish to improve psychosocial and spiritual support. Our results confirm that specific psychosocial interventions delivered by well-trained experts can help to ease suffering and discomfort in end-of-life and palliative care patients, particularly those with high levels of pain or emotional distress.
New NASA Science Head Foresees Progress in Search for Alien Life
Authors: Showstack Randy
Published: November 2016

Thomas Zurbuchen said other top goals for science and the agency include understanding and protecting life on Earth and probing fundamental aspects of the universe like dark matter and dark energy.
Landmark Paris Climate Accord Comes into Force
Authors: Showstack Randy
Published: November 2016

Still, much work remains to limit emissions and damage from climate change, said top United Nations and World Bank officials, scientists, and leaders of organizations combating the climate threat.
Electron-beam lithography for polymer bioMEMS with submicron features
Authors: Scholten Kee , Meng Ellis
Published: November 2016

We present a method for submicron fabrication of flexible, thin-film structures fully encapsulated in biocompatible polymer poly(chloro-p-xylylene) (Parylene C) that improves feature size and resolution by an order of magnitude compared with prior work. We achieved critical dimensions as small as 250 nm by adapting electron beam lithography for use on vapor deposited Parylene-coated substrates and fabricated encapsulated metal structures, including conducting traces, serpentine resistors, and nano-patterned electrodes. Structures were probed electrically and mechanically demonstrating robust performance even under flexion or torsion. The developed fabrication process for electron beam lithography on Parylene-coated substrates and characterization of the resulting structures are presented in addition to a discussion of the challenges of applying electron beam lithography to polymers. As an application of the technique, a Parylene-based neural probe prototype was fabricated with 32 recording sites patterned along a 2 mm long shank, an electrode density surpassing any prior polymer probe.
Structural basis of GM-CSF and IL-2 sequestration by the viral decoy receptor GIF
Authors: Felix Jan , Kandiah Eaazhisai , De Munck Steven , Bloch Yehudi , van Zundert Gydo C.P. , Pauwels Kris , Dansercoer Ann , Novanska Katka , Read Randy J. , Bonvin Alexandre M.J.J. , Vergauwen Bjorn , Verstraete Kenneth , Gutsche Irina , Savvides Savvas N.
Published: November 2016

Subversion of the host immune system by viruses is often mediated by molecular decoys that sequester host proteins pivotal to mounting effective immune responses. The widespread mammalian pathogen parapox Orf virus deploys GIF, a member of the poxvirus immune evasion superfamily, to antagonize GM-CSF (granulocyte macrophage colony-stimulating factor) and IL-2 (interleukin-2), two pleiotropic cytokines of the mammalian immune system. However, structural and mechanistic insights into the unprecedented functional duality of GIF have remained elusive. Here we reveal that GIF employs a dimeric binding platform that sequesters two copies of its target cytokines with high affinity and slow dissociation kinetics to yield distinct complexes featuring mutually exclusive interaction footprints. We illustrate how GIF serves as a competitive decoy receptor by leveraging binding hotspots underlying the cognate receptor interactions of GM-CSF and IL-2, without sharing any structural similarity with the cytokine receptors. Our findings contribute to the tracing of novel molecular mimicry mechanisms employed by pathogenic viruses.
Saponin-based adjuvants induce cross-presentation in dendritic cells by intracellular lipid body formation
Authors: den Brok Martijn H. , Büll Christian , Wassink Melissa , de Graaf Annemarie M. , Wagenaars Jori A. , Minderman Marthe , Thakur Mayank , Amigorena Sebastian , Rijke Eric O. , Schrier Carla C. , Adema Gosse J.
Published: November 2016

Saponin-based adjuvants (SBAs) are being used in animal and human (cancer) vaccines, as they induce protective cellular immunity. Their adjuvant potency is a factor of inflammasome activation and enhanced antigen cross-presentation by dendritic cells (DCs), but how antigen cross-presentation is induced is not clear. Here we show that SBAs uniquely induce intracellular lipid bodies (LBs) in the CD11b+ DC subset in vitro and in vivo. Using genetic and pharmacological interference in models for vaccination and in situ tumour ablation, we demonstrate that LB induction is causally related to the saponin-dependent increase in cross-presentation and T-cell activation. These findings link adjuvant activity to LB formation, aid the application of SBAs as a cancer vaccine component, and will stimulate development of new adjuvants enhancing T-cell-mediated immunity.
Several posttranslational modifications act in concert to regulate gephyrin scaffolding and GABAergic transmission
Authors: Ghosh Himanish , Auguadri Luca , Battaglia Sereina , Simone Thirouin Zahra , Zemoura Khaled , Messner Simon , Acuña Mario A. , Wildner Hendrik , Yévenes Gonzalo E. , Dieter Andrea , Kawasaki Hiroshi , O. Hottiger Michael , Zeilhofer Hanns Ulrich , Fritschy Jean-Marc , Tyagarajan Shiva K.
Published: November 2016

GABAA receptors (GABAARs) mediate the majority of fast inhibitory neurotransmission in the brain via synergistic association with the postsynaptic scaffolding protein gephyrin and its interaction partners. However, unlike their counterparts at glutamatergic synapses, gephyrin and its binding partners lack canonical protein interaction motifs; hence, the molecular basis for gephyrin scaffolding has remained unclear. In this study, we identify and characterize two new posttranslational modifications of gephyrin, SUMOylation and acetylation. We demonstrate that crosstalk between SUMOylation, acetylation and phosphorylation pathways regulates gephyrin scaffolding. Pharmacological intervention of SUMO pathway or transgenic expression of SUMOylation-deficient gephyrin variants rescued gephyrin clustering in CA1 or neocortical neurons of Gabra2-null mice, which otherwise lack gephyrin clusters, indicating that gephyrin SUMO modification is an essential determinant for scaffolding at GABAergic synapses. Together, our results demonstrate that concerted modifications on a protein scaffold by evolutionarily conserved yet functionally diverse signalling pathways facilitate GABAergic transmission.
Practical challenges in quantum key distribution
Authors: Diamanti Eleni , Lo Hoi-Kwong , Qi Bing , Yuan Zhiliang
Published: November 2016

Quantum key distribution (QKD) promises unconditional security in data communication and is currently being deployed in commercial applications. Nonetheless, before QKD can be widely adopted, it faces a number of important challenges such as secret key rate, distance, size, cost and practical security. Here, we survey those key challenges and the approaches that are currently being taken to address them.
SALL4 promotes gastric cancer progression through activating CD44 expression
Authors: Yuan X , Zhang X , Zhang W , Liang W , Zhang P , Shi H , Zhang B , Shao M , Yan Y , Qian H , Xu W
Published: November 2016

The stem cell factor SALL4 (Sal-like protein 4) plays important roles in the development and progression of cancer. SALL4 is critically involved in tumour growth, metastasis and therapy resistance. However, the underlying mechanisms responsible for the oncogenic roles of SALL4 have not been well characterized. In this study, we demonstrated that SALL4 knockdown by short hairpin RNA greatly inhibited the proliferation, migration and invasion of gastric cancer cells. We further confirmed the inhibitory effects of SALL4 knockdown on gastric cancer cells by using a tetracycline-inducible system. Mechanistically, SALL4 knockdown downregulated the expression of CD44. The results of luciferase assay and chromatin immunoprecipitation study showed that SALL4 bound to CD44 promoter region and transcriptionally activated CD44. The results of rescue study revealed that CD44 overexpression antagonized SALL4 knockdown-mediated inhibition of gastric cancer cell proliferation, migration, and invasion in vitro and gastric cancer growth in vivo. Collectively, our findings indicate that SALL4 promotes gastric cancer progression through directly activating CD44 expression, which suggests a novel mechanism for the oncogenic roles of SALL4 in gastric cancer and represents a new target for gastric cancer therapy.
3-dimensional electron microscopic imaging of the zebrafish olfactory bulb and dense reconstruction of neurons
Authors: Wanner Adrian A. , Genoud Christel , Friedrich Rainer W.
Published: November 2016

Large-scale reconstructions of neuronal populations are critical for structural analyses of neuronal cell types and circuits. Dense reconstructions of neurons from image data require ultrastructural resolution throughout large volumes, which can be achieved by automated volumetric electron microscopy (EM) techniques. We used serial block face scanning EM (SBEM) and conductive sample embedding to acquire an image stack from an olfactory bulb (OB) of a zebrafish larva at a voxel resolution of 9.25×9.25×25 nm3. Skeletons of 1,022 neurons, 98% of all neurons in the OB, were reconstructed by manual tracing and efficient error correction procedures. An ergonomic software package, PyKNOSSOS, was created in Python for data browsing, neuron tracing, synapse annotation, and visualization. The reconstructions allow for detailed analyses of morphology, projections and subcellular features of different neuron types. The high density of reconstructions enables geometrical and topological analyses of the OB circuitry. Image data can be accessed and viewed through the neurodata web services (http://www.neurodata.io). Raw data and reconstructions can be visualized in PyKNOSSOS.
Correction: Corrigendum: Fish oil supplements in New Zealand are highly oxidised and do not meet label content of n-3 PUFA
Authors: Albert Benjamin B. , Derraik José G. B. , Cameron-Smith David , Hofman Paul L. , Tumanov Sergey , Villas-Boas Silas G. , Garg Manohar L. , Cutfield Wayne S.
Published: November 2016

Scientific Reports 5: Article number: 7928; published online: 21 January 2015; updated: 07 November 2016