bluuebunny/crossref_metadata_2025 huggingface dataset:
Mechanisms to explain purse seine bycatch mortality of coho salmon
Authors: Raby Graham D. , Hinch Scott G. , Patterson David A. , Hills Jayme A. , Thompson Lisa A. , Cooke Steven J.
Published: February 2015

Research on fisheries bycatch and discards frequently involves the assessment of reflex impairment,injury, or blood physiology as means of quantifying vitality and predicting post‐release mortality, but exceptionally few studies have used all three metrics concurrently. We conducted an experimental purse seine fishery for Pacific salmon in the Juan de Fuca Strait, with a focus on understanding the relationships between different sublethal indicators and whether mortality could be predicted in coho salmon (Oncorhynchus kisutch) bycatch. We monitored mortality using a ~24‐h net pen experiment (N = 118) and acoustic telemetry (N = 50), two approaches commonly used to assess bycatch mortality that have rarely been directly compared. Short‐term mortality was 21% in the net pen experiment (~24 h) and estimated at 20% for telemetry‐tagged fish (~48–96 h). Mortality was predicted by injury and reflex impairment, but only in the net pen experiment. Higher reflex impairment was mirrored by perturbations to plasma ions and lactate, supporting the notion that reflex impairment can be used as a proxy for departure from physiological homeostasis. Reflex impairment also significantly correlated with injury scores, while injury scores were significantly correlated with plasma ion concentrations. The higher time‐specific mortality rate in the net pen and the fact that reflexes and injury corresponded with mortality in that experiment, but not in the telemetry‐tagged fish released into the wild could be explained partly by confinement stress. While holding experiments offer the potential to provide insights into the underlying causes of mortality, chronic confinement stress can complicate the interpretation of patterns and ultimately affect mortality rates. Collectively, these results help refine our understanding of the different sublethal metrics used to assess bycatch and the mechanisms that can lead to mortality.
Comparison of traditional and optical grain-size field measurements with SNOWPACK simulations in a taiga snowpack
Authors: Leppänen L. , Kontu A. , Vehviläinen J. , Lemmetyinen J. , Pulliainen J.
Published: February 2015

Knowledge of snow microstructure is relevant for modelling the physical properties of snow cover and for simulating the propagation of electromagnetic waves in remote-sensing applications. Characterization of the microstructure in field conditions is, however, a challenging task due to the complex, sintered and variable nature of natural snow cover. A traditional measure applied as a proxy of snow microstructure, which can also be determined in field conditions, is the visually estimated snow grain size. Developing techniques also allow measurement, for example, of the specific surface area (SSA) of snow, from which the optical-equivalent grain size can be derived. The physical snow model SNOWPACK simulates evolution of snow parameters from meteorological forcing data. In this study we compare an extensive experimental dataset of measurements of traditional grain size and SSA-derived optical grain size with SNOWPACK simulations of grain-size parameters. On average, a scaling factor of 1.2 is required to match traditional grain-size observations with the corresponding SNOWPACK simulation; a scaling factor of 2.1 was required for the optical equivalent grain size. Standard deviations of scaling factors for the winters of 2011/12 and 2012/13 were 0.36 and 0.42, respectively. The largest scaling factor was needed in early winter and under melting conditions.
The effects of dating uncertainties on net accumulation estimates from firn cores
Authors: Rupper Summer , Christensen William F. , Bickmore Barry R. , Burgener Landon , Koenig Lora S. , Koutnik Michelle R. , Miège Clément , Forster Richard R.
Published: February 2015

The mean, trend and variability of net snow accumulation in firn cores are often used to validate model output, develop remote-sensing algorithms and quantify ice-sheet surface mass balance. Thus, accurately defining uncertainties associated with these in situ measurements is critical. In this study, we apply statistical simulation methods to quantify the uncertainty in firn-core accumulation data due to the uncertainty in depth–age scales. The methods are applied to a suite of firn cores from central West Antarctica. The results show that uncertainty in depth–age scales can give rise to spurious trends in accumulation that are the same order of magnitude as accumulation trends reported in West Antarctica. The depth–age scale uncertainties also significantly increase the apparent interannual accumulation variability, so these uncertainties must first be accounted for before using firn-core data to assess such processes as small-spatial-scale variability. Better quantification of error in accumulation will improve our ability to meaningfully compare firn-core data across different regions of the ice sheet, and provide appropriate targets for calibration and/or validation of model output and remote-sensing data.
Correspondence
Authors: Helanow Christian , Meierbachtol Toby , Jansson Peter
Published: February 2015

Recent efforts have been made to increase our understanding of the dynamics of ice-sheet hydrology. Notably, much work has focused on the southwest sector of the Greenland ice sheet (GrIS), with intense data collection on diurnal to interannual timescales (e.g. Bartholomew and others, 2012; Cowton and others, 2013; Doyle and others, 2013). Observations show a close correlation between surface meltwater production and the seasonal ice-sheet acceleration, and it is a well-accepted hypothesis that an increase in the former drives the latter via meltwater transfer through the subglacial drainage system (e.g. Zwally and others, 2002). However, due to the remote nature and complexity of the subglacial domain, a satisfactory description at the process level has remained elusive. Better understanding of the coupling of meltwater forcing on ice velocity through the subglacial component is therefore necessary to improve the physical integrity of ice-sheet models.
Cervicothoracic Arachnoid Cyst Causing Cervical Myelopathy: A Case Report
Authors: Kizilay Zahir , Yilmaz Ali , Ozkul Ayca , Ismailoglu Ozgur
Published: February 2015

Several types of intraspinal cyst develop within the spinal canal from the craniovertebral junction to the sacrum. These lesions occur in both children and adults. Arachnoid cysts are one of them and are more frequent in the paediatric population, being a relatively uncommon lesion in adults. The arachnoid cyst may be located intradurally or extradurally. The intradural type may be congenital or from spinal trauma, infection or spondylosis. Although intradural arachnoid cysts are often asymptomatic, they may give early symptoms when they exist with synchronous pathologies constricting the spinal canal gradually as in cervical spondylosis.Â  In this report, a 60-year-old man with an arachnoid cyst of the cervicothoracic spine is presented. His cyst remained undiagnosed because of the nonspecific nature of the symptoms. It was only when he developed right hemiparesis that a posterior fluid collection compressing the spinal cord was found in Magnetic resonance imaginig. An intradural extramedullary cyst was removed with successful surgery and cord compression and symptoms were reversed. We discuss radiological diagnosis and surgical treatment of an arachnoid cyst in this report.
Symptomatic Pneumocephalus after Lumbar Disc Surgery: a Case Report
Authors: Kizilay Zahir , Yilmaz Ali , Ismailoglu Ozgur
Published: February 2015

Symptomatic pneumocephalus is frequently seen after traumatic fracture of the skull base bone. However, it has rarely been reported after spinal surgery and its mechanism has not been fully explained. In this paper, we present a 30 year old male patient who had lumbar discectomy due to a symptomatic midline lumbar disc herniation. He had developed symptomatic pneumocephalus after the lumbar disc surgery associated with application of a vacuum suction device. We present and discuss our patient in the light of the literatures.
S'arracher à sa condition d'ouvrier : de l'engagement syndical à l'encadrement intermédiaire
Authors: Giraud Baptiste
Published: February 2015

Cet article étudie les trajectoires militantes et professionnelles de deux ouvriers d’une petite et moyenne entreprise (PME) industrielle devenus agents de maîtrise après avoir occupé un mandat de représentant syndical. L’analyse de ces deux parcours biographiques permet de rendre compte des tensions et des contradictions qui opposent ces deux positions ouvrières, mais aussi ce que les modalités de leur engagement syndical et de leur promotion par la voie hiérarchique ont de commun dans la manière de s’accommoder de leur condition ouvrière. Ce faisant, cet article entend montrer l’intérêt de réintégrer l’analyse des ressorts de l’engagement et du désengagement syndical des salariés d’exécution, dans une perspective attentive à la diversité des voies de salut et des motifs de satisfaction qu’ils peuvent trouver dans l’exercice de leur activité professionnelle.
Quel régime salarial optimal pour la zone euro ?
Authors: Chagny Odile , Husson Michel
Published: February 2015

Cet article vise à définir une règle salariale optimale pour la zone euro qui permettrait de rendre compatibles les objectifs de cohésion sociale et de convergence et le respect des contraintes inhérentes à une zone monétaire. Dans la majorité des pays, à l’exception notable de l’Allemagne, les régimes salariaux assuraient avant la crise une progression des salaires relativement homogène entre secteurs abrité et exposé. Toutefois, les régimes salariaux étaient loin d’être optimaux, et depuis la crise, on tend à s’éloigner d’un régime salarial optimal et notamment de la norme de croissance relativement homogène des salaires qui prévalait auparavant. Un système européen de salaire minimum serait un instrument utile pour faire obstacle à une fragmentation accrue des marchés du travail, et il devrait être combiné avec des politiques coopératives assurant une meilleure convergence productive.
Improving the bowel habits of elderly residents in a nursing home using probiotic fermented milk
Authors: van den Nieuwboer M. , Klomp-Hogeterp A. , Verdoorn S. , Metsemakers-Brameijer L. , Vriend T.M. , Claassen E. , Larsen O.F.A.
Published: February 2015

Our aim was to determine whether a fermented milk drink containing probiotics could improve the bowel habits of frail elderly individuals living in a nursing home. A total of 135 participants were enrolled in this pilot study. The bowel habits (stool quality and bowel movements) were recorded by nursing staff during a baseline period of 3 weeks. After this period participants received daily a fermented milk drink containing minimally 6.5×109 colony forming units of Lactobacillus casei Shirota (LcS) for 6 weeks. During this period, bowel habits were recorded and compared to baseline period. Forty-four participants (74-99 years old) were compliant and used for analysis. Consumption of fermented milk containing LcS significantly increased the percentage of ideal stool types per week (P<0.01), lowered the percentage of constipation stool types per week (P<0.01) and significantly lowered the percentage of diarrhoea stool types per week (P=0.016) as compared to the baseline period. The study product had no significant effect on bowel movements. During the study, no changes in laxative usage or adverse events associated with the study product were reported. Our results suggest that a fermented milk containing LcS significantly improves the bowel habits of frail elderly residents in a nursing home. These promising results should be further substantiated by a confirmatory study.
Mycotoxin profile ofFusarium armeniacum isolated from natural grasses intended for cattle feed
Authors: Nichea M.J. , Cendoya E. , Zachetti V.G.L. , Chiacchiera S.M. , Sulyok M. , Krska R. , Torres A.M. , Chulze S.N. , Ramirez M.L.
Published: February 2015

Fusarium armeniacum has been found as a saprophyte on natural grasses devoted to cattle feed in Argentina. This species has been reported as highly toxigenic due to the production of trichothecenes type A, but the information available about its toxigenic profile is incomplete. Thus, the aim of the present study was to determine the toxigenic ability of 50F. armeniacum isolates recovered from natural grasses using a multitoxin method based on LC-MS/MS. In addition, morphological identification of 15 selected isolates was confirmed by sequencing the translation elongation factor 1α. Out of the 327 metabolites analysed, only 10 were detected: T-2 toxin (T-2), T-2 triol, T-2 tetraol, HT-2 toxin (HT-2), diacetoxyscirpenol (DAS), monoacetoxyscirpenol (MAS), neosolaniol (NEO), aurofusarin (AUF), beauvericin (BEA) and zearalenone (ZEA). The most common group of mycotoxins produced by the isolates on rice under laboratory conditions was trichothecenes type A, and some minorFusarium mycotoxins, such as BEA and AUF. Some isolates were also able to produce ZEA. Among the trichothecene type A, HT-2, T-2, NEO were clearly synthesised at the highest levels and frequency, followed by DAS and MAS. HT-2, T-2, NEO and DAS production was detected in 48 (96%), 47 (94%), 47 (94%) and 38 (76%) isolates, respectively. The ability ofF. armeniacum, to produce ZEA and AUF has been demonstrated here for the first time. Given the new information provided about the toxigenic profile of this species, commonly associated with natural grasses in Argentina, the threat to animal health posed by this fungus should not be underestimated.
Healing through Self-Discovery and Artistic Design Journals
Authors: Brown Susannah
Published: February 2015

The author explores the process of healing through the use of artistic writing activities in a journal, which promote self-discovery. Techniques that involve art making and writing are shared, such as collaborative drawing and writing, ekphrasis, hand-made journals, mandala drawing, marble paper abstract drawing, and sensory printing. Through artistic design, the journey to better understand the self is addressed, emphasizing management of everyday stresses such as those stemming from relationships, roles, and change. Managing these stresses leads towards a healthy life by providing a balance between creative drive and daily obligations. Guided exercises using various media are explained. The process is emphasized, not the end product or artistic merit of the creation. It is through this creative process that tension and stress are released and the joy of discovery becomes a part of life. Individuality is valued through thoughtful reflection of the activities that are embedded in artistic design journals.
The Gift of Grief
Authors: Reed Marnie S.
Published: February 2015

My journey began with a call that brought me to “the edge”: the farthest reaches of what any mind can handle. I found every notion I had of myself was a fallacy, an illusion created so completely I'd fooled even myself. The days ahead found me by my father's side for the less than six weeks it took him to die from pancreatic cancer. The journey toward healing my mind, however, took far longer than I could've imagined. From the first days of wandering into the local Hospice building begging for help to a seemingly innocuous lunch with one of my third grade students that turned into a soul-soothing balm, I have sought more help than I once would've cared to admit. My story is an excursion to the deepest depths of grief and the extended passage back to a version of mental health I could've in no way imagined.
Curing Autoimmune Naturally
Authors: Karaba Donna J.
Published: February 2015

In September 2010, Donna, an active 49-year-old woman, experienced an autoimmune attack. After eight months of intense pain, she underwent a 10-day supervised fast at True North Health Center in Santa Rosa, CA. Her inflammation was eliminated and she has regained an optimal level of health and an active lifestyle including tennis, hiking, yoga, biking, and swimming. Donna also continues to practice and teach meditation. This chapter is intended to relay a case example of how one woman cured her symptoms of Polymyalgia Rheumatica (PMR) in the hopes of reducing unnecessary suffering and financial drain in the lives of others.
A Visual Approach to Business IT Alignment between Business Model and Enterprise Architecture
Authors: Fritscher Boris , Pigneur Yves
Published: February 2015

In this paper, the authors put forward an intermediary model that can support the transition between a business model and an IT infrastructure, then provide an example of how the approach can be used. The model is based on a combination of existing models: enterprise architecture and the Business Model Canvas. The authors show how the proposed intermediary model, which has a strong focus on a business model strategy, can help IT alignment. The intermediary model can help alignment from either a business model focus or an IT infrastructure focus because of the correspondence between the two paradigms. The focus on visualization within the intermediary model aids in quickly illustrating the common ground held by the parties involved in the alignment.
Klebsiella Pneumoniae in Septicemic Neonates with Special Reference to Extended Spectrum β-lactamase, AmpC, Metallo β-lactamase Production and Multiple Drug Resistance in Tertiary Care Hospital
Authors: Gajul Shivali V , Mohite Shivajirao T , Mangalgi Smita S , Wavare Sanjay M , Kakade Satish V
Published: February 2015

Background: β-lactamases viz., extended spectrum β-lactamase (ESBL), AmpC, and metallo β-lactamase (MBL) production in Klebsiella pneumoniae has led to a serious concern about septicemic neonates in Neonatal Intensive Care Units due to high resistance against commonly used antimicrobials

Purpose:To study the prevalence of ESBL, AmpC, and MBL production in K. pneumoniae isolates in neonatal septicemia, to check antimicrobial susceptibility to various drugs including tigecycline; and to assess burden of multiple drug resistance (MDR).

Materials and Methods: Total 24 clinical isolates of K. pneumoniae isolated from 318 blood samples of suspected cases of neonatal septicemia were studied. Isolates were screened for ESBL, AmpC, and MBL production by Clinical and Laboratory Standards Institute (CLSI) disk method, AmpC cefoxitin screen, and imipenem, meropenem, ceftazidime disk screen respectively; and confirmation was done by CLSI phenotypic disk confirmatory test, AmpC sterile disk method, and imipenem ethylenediamine tetracetic acid double disk synergy test respectively. Antimicrobial susceptibility was determined by Kirby-Bauer's disk diffusion method. Efficacy of tigecycline was evaluated using United States Food and Drug Administration guidelines.

Results: Of the 24 K. pneumoniae isolates, co-production of AmpC + MBL was found in more number of isolates (67%) (P < 0.0001) compared to single enzyme production (ESBL and MBL 8% both, AmpC 12.5%). Rate of resistance for penicillins and cephalosporins was highest. Susceptibility was more for imipenem, co-trimoxazole, and meropenem. Nonsusceptibility to tigecycline was low (21%). A total of 23 (96%) isolates were MDR.

Conclusions: Routine detection of ESBL, AmpC, and MBL is required in laboratories. Carbapenems should be kept as a last resort drugs. Trend of tigecycline susceptibility has been noted in the study. Continued monitoring of susceptibility pattern is necessary to detect true burden of resistance for proper management.
Affine Actions of Uq(sl(2)) on Polynomial Rings
Authors: Bergen Jeffrey
Published: February 2015

We classify the affine actions of Uq(sl(2)) on commutative polynomial rings in m ≥ 1 variables. We show that, up to scalar multiplication, there are two possible actions. In addition, for each action, the subring of invariants is a polynomial ring in either m or m−1 variables, depending upon whether q is or is not a root of 1.
Phase partitioning and volatility of secondary organic aerosol components formed from α-pinene ozonolysis and OH oxidation: the importance of accretion products and other low volatility compounds
Authors: Lopez-Hilfiker F. D. , Mohr C. , Ehn M. , Rubach F. , Kleist E. , Wildt J. , Mentel Th. F. , Carrasquillo A. , Daumit K. , Hunter J. , Kroll J. H. , Worsnop D. , Thornton J. A.
Published: February 2015

Abstract. We measured a large suite of gas and particle phase multi-functional organic compounds with a Filter Inlet for Gases and AEROsols (FIGAERO) coupled to a high-resolution time-of-flight chemical ionization mass spectrometer (HR-ToF-CIMS) developed at the University of Washington. The instrument was deployed on environmental simulation chambers to study monoterpene oxidation as a secondary organic aerosol (SOA) source. We focus here on results from experiments utilizing an ionization method most selective towards acids (acetate negative ion proton transfer), but our conclusions are based on more general physical and chemical properties of the SOA. Hundreds of compounds were observed in both gas and particle phases, the latter being detected upon temperature programmed thermal desorption of collected particles. Particulate organic compounds detected by the FIGAERO HR-ToF-CIMS are highly correlated with, and explain at least 25–50% of, the organic aerosol mass measured by an Aerodyne Aerosol Mass Spectrometer (AMS). Reproducible multi-modal structures in the thermograms for individual compounds of a given elemental composition reveal a significant SOA mass contribution from large molecular weight organics and/or oligomers (i.e. multi-phase accretion reaction products). Approximately 50% of the HR-ToF-CIMS particle phase mass is associated with compounds having effective vapor pressures 4 or more orders of magnitude lower than commonly measured monoterpene oxidation products. The relative importance of these accretion-type and other extremely low volatility products appears to vary with photochemical conditions. We present a desorption temperature based framework for apportionment of thermogram signals into volatility bins. The volatility-based apportionment greatly improves agreement between measured and modeled gas–particle partitioning for select major and minor components of the SOA, consistent with thermal decomposition during desorption causing the conversion of lower volatility components into the detected higher volatility compounds.
Comparing TRMM 3B42, CFSR and ground-based rainfall estimates as input for hydrological models, in data scarce regions: the Upper Blue Nile Basin, Ethiopia
Authors: Worqlul A. W. , Collick A. S. , Tilahun S. A. , Langan S. , Rientjes T. H. M. , Steenhuis T. S.
Published: February 2015

Abstract. Accurate prediction of hydrological models requires accurate spatial and temporal distribution of rainfall observation network. In developing countries rainfall observation station network are sparse and unevenly distributed. Satellite-based products have the potential to overcome these shortcomings. The objective of this study is to compare the advantages and the limitation of commonly used high-resolution satellite rainfall products as input to hydrological models as compared to sparsely populated network of rain gauges. For this comparison we use two semi-distributed hydrological models Hydrologiska Byråns Vattenbalansavdelning (HBV) and Parameter Efficient Distributed (PED) that performed well in Ethiopian highlands in two watersheds: the Gilgel Abay with relatively dense network and Main Beles with relatively scarce rain gauge stations. Both are located in the Upper Blue Nile Basin. The two models are calibrated with the observed discharge from 1994 to 2003 and validated from 2004 to 2006. Satellite rainfall estimates used includes Climate Forecast System Reanalysis (CFSR), Tropical Rainfall Measuring Mission (TRMM) 3B42 version 7 and ground rainfall measurements. The results indicated that both the gauged and the CFSR precipitation estimates were able to reproduce the stream flow well for both models and both watershed. TRMM 3B42 performed poorly with Nash Sutcliffe values less than 0.1. As expected the HBV model performed slightly better than the PED model, because HBV divides the watershed into sub-basins resulting in a greater number of calibration parameters. The simulated discharge for the Gilgel Abay was better than for the less well endowed (rain gauge wise) Main Beles. Finally surprisingly, the ground based gauge performed better for both watersheds (with the exception of extreme events) than TRMM and CFSR satellite rainfall estimates. Undoubtedly in the future, when improved satellite products will become available, this will change.
Tomography-based monitoring of isothermal snow metamorphism under advective conditions
Authors: Ebner P. P. , Schneebeli M. , Steinfeld A.
Published: February 2015

Abstract. Time-lapse X-ray micro-tomography was used to investigate the structural dynamics of isothermal snow metamorphism exposed to an advective airflow. Diffusion and advection across the snow pores were analysed in controlled laboratory experiments. The 3-D digital geometry obtained by tomographic scans was used in direct pore-level numerical simulations to determine the effective transport properties. The results showed that isothermal advection with saturated air have no influence on the coarsening rate that is typical for isothermal snow metamorphism. Diffusion originating in the Kelvin effect between snow structures dominates and is the main transport process in isothermal snow packs.
Cloud effects on the surface energy and mass balance of Brewster Glacier, New Zealand
Authors: Conway J. P. , Cullen N. J.
Published: February 2015

Abstract. A thorough understanding of the influence of clouds on glacier surface energy balance (SEB) and surface mass balance (SMB) is critical for forward and backward modelling of glacier–climate interactions. A validated 22 month time series of SEB/SMB was constructed for the ablation zone of the Brewster Glacier, using high quality radiation data to carefully evaluate SEB terms and define clear-sky and overcast conditions. A fundamental change in glacier SEB in cloudy conditions was driven by increased effective sky emissivity and surface vapour pressure, rather than the minimal change in air temperature and wind speed. During overcast conditions, positive net longwave radiation and latent heat fluxes allowed melt to be maintained through a much greater length of time compared to clear-sky conditions, and led to similar melt in each sky condition. The sensitivity of SMB to changes in air temperature was greatly enhanced in overcast compared to clear-sky conditions due to more frequent melt and the occurrence of precipitation, which enabled a strong accumulation–albedo feedback. During the spring and autumn seasons, the sensitivity during overcast conditions was strongest. There is a need to include the effects of atmospheric moisture (vapour, cloud and precipitation) on melt processes when modelling glacier–climate interactions.
”ET GODT LOKALT LÆRINGSMILJØ?” Erfaringer med desentralisert bachelor i sykepleie, i tre kommunale studentgrupper 2001 -2004
Authors: Blix Siw , Eriksen Liss
Published: February 2015

Pilotprosjektet ” Et godt lokalt læringsmiljø” var finansiert av Høgskolen i Finnmark og gjennomført fra 2001 og avsluttet i 2007. Prosjektgruppen har jobbet med ulike tema i forhold til utprøving av ny desentralisert modell i tre kommunale studentgrupper.

Tidligere var de desentraliserte studietilbud lokalisert på ett studiested, mens den nye modellen hadde tre studiesteder. Det har vært viktig å evaluere erfaringene med modellen. Spesielt fokus har vært satt på hvordan det å studere i små fagmiljø i kommunene kontra et stort fagmiljø på Avdeling for Helsefag påvirket studieforløp og læringsprosessen til den enkelte student. Tema for prosjektet var ”et godt lokalt læringsmiljø”, som Avdeling for Helsefag prøvde å legge tilrette for i samarbeid med de involverte kommunene. Læringsmiljøet skulle skapes gjennom at studentgruppen skulle møtes daglig for å studere sammen, utenom samlingsukene på campus. Det å arbeide i grupper som læringsform så man på som et viktig fundament for å skape et godt læringsmiljø lokalt. Den lokale veilederen skulle være en erfaren sykepleier som skulle skape nettverk og samarbeid med det kommunale helsesentret og hjemmebasert omsorg. Praksisstudiet skulle gjennomføres hovedsakelig lokalt nettopp for å underbygge denne filosofien.

Erfaringene med desentralisert sykepleierutdanning er at det er et viktig tilbud for kommunene i Finnmark for å kunne opprettholde et forsvarlig helsetilbud til sine innbyggere. Det å satse på å utdanne sine ”egne” har vist seg å gi et bedre langsiktig resultat enn å tilby høyere lønn og lignende til sykepleiere for eksempel fra Sør- Norge. Av den grunn mener vi at merutgiftene til desentralisert utdanning en god investering.
Intramuscular Atypical Lipomatous Tumor/Well-Differentiated Liposarcoma of the Pectoralis Major Masquerading as a Breast Tumor: Management and Review of the Literature
Authors: Salemis Nikolaos S.
Published: February 2015

Atypical lipomatous tumor (ALT)/well-differentiated liposarcoma (WDL) of the pectoralis major muscle is an exceedingly rare clinical entity. We describe here a case of intramuscular ALT/WDL of the pectoralis major muscle in a female patient who presented with clinical manifestations of a rapidly growing breast tumor. Diagnostic evaluation and management of the patient are discussed along with a review of the relevant literature. We conclude that although the clinical examination may be inconclusive, the mammogram and especially the magnetic resonance imaging scan can precisely delineate the anatomic location and extent of the ALT/WDL of the pectoralis major muscle, thus allowing a correct preoperative diagnosis and adequate preoperative surgical planning. Complete resection is the treatment of choice for ALT/WDL. Long-term follow-up, however, remains mandatory because of the risk of local recurrence or delayed dedifferentiation.
Granular Cell Tumor of the Esophagus With Elevated Preoperative Serum Carbohydrate Antigen 19-9: A Case Report
Authors: Yanoma Toru , Fukuchi Minoru , Sakurai Shinji , Shoji Hisanori , Naitoh Hiroshi , Kuwano Hiroyuki
Published: February 2015

A 59-year-old Japanese man was admitted to our hospital for treatment of a submucosal tumor of the esophagus detected by upper gastrointestinal endoscopy and computed tomography (CT). Endoscopic examination revealed a submucosal tumor in the esophagus 35 cm from the incisor teeth. Biopsy of the lesions identified granular cell tumor. CT indicated a projecting and slightly enhanced homogenous mass measuring 2.0 × 1.5 cm in the esophagus below the tracheal bifurcation. Serum tumor marker studies revealed elevated carbohydrate antigen (CA) 19-9. Therefore, the tumor was considered to have malignant potential, and surgical resection was performed. The final pathologic diagnosis was a benign granular cell tumor, positive for S-100 protein. The patient was doing well with normal CA 19-9 levels and no recurrence more than 5 years after surgery. To the best of our knowledge, this is the first report of a granular cell tumor with elevated serum CA 19-9.
Pneumatosis Cystoides Intestinalis: An Unusual Cause of Intestinal Ischemia and Pneumoperitoneum
Authors: Ogul Hayri , Pirimoglu Berhan , Kisaoglu Abdullah , Karaca Leyla , Havan Nuri , Ozogul Bunyami , Kantarci Mecit
Published: February 2015

Pneumatosis cystoides intestinalis (PCI), with an unknown etiology, is an uncommon disease characterized by the presence of multiple gas-filled cysts within the submucosa or subserosa of the intestinal wall. Intestinal obstruction and/or perforation are relatively uncommon complications associated with PCI. The patients are often prone to misdiagnosis or mistreatment. The diagnosis of PCI is based on plain radiography or endoscopy. Multidetector computed tomography (MDCT) provides data on other intra-abdominal pathologies. Therefore, it is an important modality for the diagnosis of PCI. We present a case of PCI in a 58-year-old man affected by peritoneal free air with multidetector computed tomography imaging findings. We performed the plain film of the abdomen, and MDCT studies that showed numerous, diffuse, bubble-like intramural gas collections into the jejunum, ileum, and colon walls at the left-upper quadrant of the abdomen. MDCT findings were confirmed by surgical exploration.
Strict Selection Criteria During Surgical Training Ensures Good Outcomes in Laparoscopic Omental Patch Repair (LOPR) for Perforated Peptic Ulcer (PPU)
Authors: Shelat Vishal G. , Ahmed Saleem , Chia Clement L. K. , Cheah Yee Lee
Published: February 2015

Application of minimal access surgery in acute care surgery is limited due to various reasons. Laparoscopic omental patch repair (LOPR) for perforated peptic ulcer (PPU) surgery is safe and feasible but not widely implemented. We report our early experience of LOPR with emphasis on strict selection criteria. This is a descriptive study of all patients operated on for PPU at academic university-affiliated institutes from December 2010 to February 2012. All the patients who were operated on for LOPR were included as the study population and their records were studied. Perioperative outcomes, Boey score, Mannheim Peritonitis Index (MPI), and physiologic and operative severity scores for enumeration of mortality and morbidity (POSSUM) scores were calculated. All the data were tabulated in a Microsoft Excel spreadsheet and analyzed using Stata Version 8.x. (StataCorp, College Station, TX, USA). Fourteen patients had LOPR out of a total of 45 patients operated for the PPU. Mean age was 46 years (range 22−87 years). Twelve patients (86%) had a Boey score of 0 and all patients had MPI < 21 (mean MPI = 14). The predicted POSSUM morbidity and mortality were 36% and 7%, respectively. Mean ulcer size was 5 mm (range 2−10 mm), mean operating time was 100 minutes (range 70−123 minutes) and mean length of hospital stay was 4 days (range 3−6 days). There was no morbidity or mortality pertaining to LOPR. LOPR should be offered by acute care surgical teams when local expertise is available. This can optimize patient outcomes when strict selection criteria are applied.
Results of Surgery in General Surgical Patients Receiving Warfarin: Retrospective Analysis of 61 Patients
Authors: Belli Sedat , Aytac Huseyin Ozgur , Yabanoglu Hakan , Karagulle Erdal , Parlakgumus Alper , Nursal Tarik Zafer , Yildirim Sedat
Published: February 2015

The aim of this study is to investigate postoperative complications, mortality rates, and to determine the factors affecting mortality on the patients receiving warfarin therapy preoperatively, as well as comparing the results obtained from emergency and elective surgeries. Surgical outcomes of 61 patients on long-term oral anticoagulation with warfarin who underwent surgery in our center were retrospectively reviewed over an 8-year period. Thirty-three (54.1%) patients were female, with a mean age of 53 years. Mitral valve replacement (62.3%) was the most frequent indication for chronic anticoagulation therapy. Twelve out of 61 (19.2%) patients underwent emergency surgery; 59 (96.7%) operations were classified as major surgery. We did not observe any thromboembolic events on patients receiving our bridging therapy protocol. Cardiopulmonary dysfunction (CPD; 19.7%) and hemorrhage (16.4%) were the most encountered postoperative complications. Presence of CPD, bleeding, endocarditis, and mortality were statistically significant for emergency surgeries when compared with the results obtained from elective surgeries. There were 5 (8.2%) deaths observed during follow-up. It was found that advanced age, prolonged duration of operations, and presence of CPD had a statistically significant effect on mortality (P < 0.05). The patients receiving oral anticoagulant had high postoperative complication and mortality rates. This case was more evident in emergency surgeries. It is recommendable that as mortality is more apparent in the patients who undergo emergency surgeries—being older, having long duration of operations as well as CPD. Therefore during the postoperative follow-up process, the patients should be closely monitored.
Anterolateral Intermuscular Approach for Type A2 Intertrochanteric Fractures: A Cadaveric Study
Authors: Li Binhua , Zhang Bin , Ding Zhihui , Liu Yuan , Dai Min
Published: February 2015

This cadaveric study was designed to clarify the anatomic basis of using an anterolateral intermuscular approach to repair type A2 intertrochanteric fractures (ITF). The conventional lateral approach to surgery that is used for ITF has several disadvantages that can result in both intraoperative and postoperative complications, especially for type A2 ITF. Previous studies have suggested using minimally-invasive total hip arthroplasty (THA) with an anterolateral approach. The legs of 10 formalin-fixed Asian cadavers were dissected, simulating an anterolateral surgical approach. The distances from the superior gluteal nerve and the lateral femoral circumflex artery branches to the lateral protrusive point of the greater trochanter were measured. The anterolateral intermuscular approach provided excellent exposure of the GT, the lesser trochanter and the femoral neck. The gluteus medius branch of the ascending branch of the lateral femoral circumflex artery (GMB-LFCA) and the most inferior branch of the superior gluteal nerve (MIB-SGN) were found to cross the spatium intermusculare between the gluteus medius and the tensor fasciae latae. The distance from the GMB-LFCA, in the intermuscular plane, to the lateral protrusive point of the GT was (4.04 ± 1.00 cm, range 2.96–6.62 cm); and the distance from the MIB-SGN to the lateral protrusive point of the GT was (5.47 ± 1.61 cm, range 3.68–9.56 cm). The anterolateral intermuscular approach is relatively safe, provides excellent exposure, and causes less soft-tissue damage than the traditional approach, and it represents a promising new method to surgically treat type A2 ITF.
Enhancing Postmarketing Surveillance of Medical Products With Large Language Models
Authors: Matheny Michael E. , Yang Jie , Smith Joshua C. , Walsh Colin G. , Al-Garadi Mohammed A. , Davis Sharon E. , Marsolo Keith A. , Fabbri Daniel , Reeves Ruth R. , Johnson Kevin B. , Dal Pan Gerald J. , Ball Robert , Desai Rishi J.
Published: August 2024

Importance

The Sentinel System is a key component of the US Food and Drug Administration (FDA) postmarketing safety surveillance commitment and uses clinical health care data to conduct analyses to inform drug labeling and safety communications, FDA advisory committee meetings, and other regulatory decisions. However, observational data are frequently deemed insufficient for reliable evaluation of safety concerns owing to limitations in underlying data or methodology. Advances in large language models (LLMs) provide new opportunities to address some of these limitations. However, careful consideration is necessary for how and where LLMs can be effectively deployed for these purposes.

Observations

LLMs may provide new avenues to support signal-identification activities to identify novel adverse event signals from narrative text of electronic health records. These algorithms may be used to support epidemiologic investigations examining the causal relationship between exposure to a medical product and an adverse event through development of probabilistic phenotyping of health outcomes of interest and extraction of information related to important confounding factors. LLMs may perform like traditional natural language processing tools by annotating text with controlled vocabularies with additional tailored training activities. LLMs offer opportunities for enhancing information extraction from adverse event reports, medical literature, and other biomedical knowledge sources. There are several challenges that must be considered when leveraging LLMs for postmarket surveillance. Prompt engineering is needed to ensure that LLM-extracted associations are accurate and specific. LLMs require extensive infrastructure to use, which many health care systems lack, and this can impact diversity, equity, and inclusion, and result in obscuring significant adverse event patterns in some populations. LLMs are known to generate nonfactual statements, which could lead to false positive signals and downstream evaluation activities by the FDA and other entities, incurring substantial cost.

Conclusions and Relevance

LLMs represent a novel paradigm that may facilitate generation of information to support medical product postmarket surveillance activities that have not been possible. However, additional work is required to ensure LLMs can be used in a fair and equitable manner, minimize false positive findings, and support the necessary rigor of signal detection needed for regulatory activities.
Study: Facilitated training improves alcohol screening in primary care
Authors: Enos Gary
Published: August 2024

Primary care practices at which clinicians received facilitator‐led training in addressing unhealthy alcohol use in their patients saw a major jump in the use of screening and brief counseling services that can lead to reduced drinking, a new study has found.
Anti‐stigma sites selected by Addiction Policy Forum
Authors: Knopf Alison
Published: August 2024

Last week, the Addiction Policy Forum announced the 117 nationwide Anti‐Stigma Initiative sites, meant to minimize stigma surrounding addiction. The initiative measures the levels of stigma and identifies stereotypes and prejudice held by the participating sites or within their communities. There are 117 sites in 34 U.S. states and three international locations.
Role of Tailoring Exciplex‐Forming Cohosts in the Longevity of Blue Phosphorescent Organic Light‐Emitting Diodes
Authors: Lee Kyung Hyung , Jo Unhyeok , Kim Jae‐Min , Lee Jun Yeob
Published: August 2024

Although exciplex hosts have been used to enhance the operational lifetime of blue phosphorescent organic light‐emitting diodes, their detailed design rule has not been established because of their unresolved degradation. In this work, the underlying mechanisms involved in device degradation are investigated, focusing on the tailor‐tuning effect of the exciplex host to maximize the device's lifetime with a given phosphorescent dopant. Analysis of trap dynamics shows that the stability improvement caused by adding an electron‐donating unit to the N‐type host does not originate from the stable positive polaron state. It is found that the exciplex host modified with minor substituents opens extra pathways for polaron transport and exciton generation rather than chemical stability, resulting in the spatial dispersion of polarons and excitons. The dispersion of excitons and polarons, in turn, enhances the recombination coefficient and suppresses exciton–exciton and exciton–polaron bimolecular interactions, enabling further improved device stability. With comprehensive analysis, a perspective on the role of the host in the degradation mechanism is presented.
Efficient Deep‐Red Perovskite Light‐Emitting Diodes Based on a Vertical 3D/2D Perovskite Heterojunction
Authors: Zhang Dengliang , Liu Jiacheng , Duan Xingxing , Chen Kaiwang , Yu Bufan , Liang Yue , Xing Zhaohui , Wang Lei , Chen Jiangshan , Ma Dongge
Published: August 2024

Metal halide perovskites hold a great promise for the development of electroluminescent and down‐conversion light‐emitting diodes (LEDs) owing to their easily tunable optical bandgaps, high photoluminescence quantum yields (PLQYs) and excellent color purity. 3D structural perovskites, valued for their high charge carrier transport capacity, have garnered much attention for high‐performance electroluminescent LEDs with low operating voltages. However, solution‐processed 3D perovskite films always suffer from the generation of defect‐induced trap states on the surfaces and at the grain boundaries, resulting in nonradiative recombination that detracts from the electroluminescence performance. Herein, a 3D/2D heterostructure is constructed to reduce the surface defects of CsPbIxBr3‐x based 3D perovskites by reconfiguring the surface of the 3D perovskite film with fluorine para‐substituted phenethylammonium iodine (p‐FPEAI). The analysis of charge carrier dynamics indicates a decrease in trap‐assisted nonradiative recombination and a notable increase in radiative recombination in the red 3D/2D perovskite films. Consequently, the cutting‐edge deep‐red LEDs with the resultant 3D/2D heterostructure perovskite as the emissive layer demonstrate a high external quantum efficiency of 22.2% and a very stable electroluminescence peak at 674 nm. The proposed p‐FPEAI‐assisted surface engineering is considered a resultful approach for advancing the development of high‐performance LEDs with perovskite heterojunction.
Smart Tattoos of Intradermally Implanted Photochromic Nanosensors for Personal UV Sensing and Dosimetry
Authors: Butterfield Jesse L. , Quigley Jennifer R. , Bruns Carson J.
Published: August 2024

Monitoring personal ultraviolet (UV) exposure facilitates risk mitigation against UV‐induced skin aging and skin cancer, the most common malignancy in North America, Europe, and Australia. UV radiometers convey real‐time information on local UV irradiance, while UV dosimeters count accumulated UV exposure over time. These devices can help users manage exposure levels in order to reach a healthy daily dose of UV light required for vitamin D production without exceeding erythemal limits that would increase skin cancer risk. However, personal UV detectors still suffer from several limitations. Wearable electronic UV sensors are relatively bulky, heavy, and expensive, while the more commonly used on‐skin disposable colorimetric UV sensors suffer from short service life, skin discomfort, and high accumulated costs when used daily as recommended. Intradermal colorimetric UV nanosensors can overcome these limitations, offering long‐term, comfortable, and inexpensive naked‐eye colorimetric indication of intradermal UV irradiance. Now, a new generation of UV‐sensing intradermal pigments with an improved design offers better tunability, stability, and biocompatibility. These UV‐photochromic nanosensors may be operated as UV dosimeters or simple sunscreen efficacy monitors, depending on the formulation, and can remain functional and re‐usable in the dermis for years.
Unraveling Electronic Microenviroment of Iron Single Atom Modulated by Nitrogen‐Bridged Ligands in MBene Toward Bilateral Sulfur Redox Chemistry
Authors: Zhang Xinlu , Bai Xuexiu , Wei Chuanliang , Xi Baojuan , Xiong Shenglin , Feng Jinkui
Published: August 2024

Exploring functional substrates for single‐atom electrocatalysts and precisely modulating their electronic microenvironments are of significant importance for sulfur redox chemistry in lithium‐sulfur batteries (LSBs) with unsatisfactory shuttle effects and sluggish redox kinetic. Herein, the electronic microenvironment of atomic ion (Fe) is rationally unraveled and modulated by nitrogen (N)‐bridged ligands that are engineered by metallic vacancies in MoB spontaneously trapping atomic Fe by fluorine‐free organic molten salt in situ etching and self‐reduction strategy. Intriguingly, these atomic Fe can be coordinated with adjacent in‐plane boron (B), lattice oxygen (O) and axial bridged N‐doped carbon (NC) to construct the distinctive Fe configuration (FeB4‐O‐NC‐MoB). Theorical calculations and experimental investigations unveil the electronic microenvironment of Fe disturbed from axial bridged N to construct octahedra configuration that can reinforce adsorption energy and lower energy barrier by Fe‐S and N‐Li bonds to suppress shuttle effect and expedite bidirectional redox kinetics. Thus, FeB4‐O‐NC‐MoB modified separator in LSBs delivers impressive reversible capacities (765 mAh g−1 at 0.5 C after 500 cycles and 541.9 mAh g−1 at 2 C after 5000 cycles). This work affords a feasible strategy for modulating electronic microenvironment by manipulating coordination configuration of single‐atom electrocatalyst to boost the bilateral sulfur redox chemistry.