bluuebunny/crossref_metadata_2025 huggingface dataset:
The warm pool variability of the tropical northeast Pacific
Authors: Misra Vasubandhu , Groenen Danielle , Bhardwaj Amit , Mishra Akhilesh
Published: February 2016

The Eastern Pacific warm pool (EPWP) defined by the area enclosed within the 28.5 °C isotherm is examined for its seasonal cycle and interannual variability. The study characterizes the EPWP by its area and objectively defined onset, demise, and length of its seasonality. The onset of the EPWP season is defined by the day when the daily anomaly of the area of EPWP exceeds its climatological annual mean. Similarly, the demise of the EPWP season is defined when the daily anomaly of the area of the EPWP falls below its climatological annual mean, after the onset date is detected. We show that the seasonal evolution of the EPWP has a strong asymmetry, with the climatological peak of the EPWP area occurring approximately 41 days from the onset while the demise of the season occurs after nearly 106 days from the climatological peak. The EPWP is part of a larger Western Hemisphere warm pool (WHWP) that extends into the Intra‐Americas Seas and parts of the tropical northwest Atlantic Ocean. This study finds that the EPWP is weakly related to the Atlantic counterpart of the WHWP. This is partly due to the fact that the EPWP season precedes the seasonal peak of the warm pool in the Atlantic by several months and the size of the former is much smaller than the latter; therefore, the EPWP does not have a strong remote forcing on the Atlantic warm pool. The interannual variability of the area of EPWP is closely related to the El Niño and the Southern Oscillation (ENSO) variations in the equatorial Pacific with large (small) EPWP years associated with warm (cold) ENSO years.
Stair dimension affects knee kinematics and kinetics in patients with good outcome after TKA similarly as in healthy subjects
Authors: Trinler Ursula K. , Baty Florent , Mündermann Annegret , Fenner Verena , Behrend Henrik , Jost Bernhard , Wegener Regina
Published: February 2016

Joint biomechanics during stair walking may contain important information on functional deficits in patients with orthopaedic conditions but depend on the stair dimension. The goal of this study was to compare knee kinematics and kinetics between patients with good outcome 2 years after total knee arthroplasty (TKA) and age‐matched controls during stair ascent and descent at two different stair heights. Principal component analysis was used to detect differences in gait mechanics between 15 patients and 15 controls at different stair conditions. Linear mixed models showed differences in knee kinematic and kinetic patterns (in flexion/extension and abduction/adduction) between stair heights. The knee adduction angle was more affected by stair heights in stair ascending whereas knee adduction moment and knee power were more affected during stair descent. Some stair by height and subject effects were small but not significant. Overall, good outcome after TKA is reflected in close‐to‐normal knee biomechanics during stair walking. Specific stair configuration must be considered when comparing joint biomechanics between subject groups and studies. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:1753–1761, 2016.
Identification of breast cancer margins using intraoperative near‐infrared imaging
Authors: Keating Jane , Tchou Julia , Okusanya Olugbenga , Fisher Carla , Batiste Rebecca , Jiang Jack , Kennedy Gregory , Nie Shuming , Singhal Sunil
Published: February 2016

Background and Objectives

Current methods of intraoperative breast cancer margin assessment are labor intensive, not fully reliable, and time consuming; therefore novel strategies are necessary. We hypothesized that near infrared (NIR) intraoperative molecular imaging using systemic indocyanine green (ICG) would be helpful in discerning tumor margins.

Methods

A mammary cancer cell line, 4T1, was used to establish tumors in mouse flanks (n = 60). Tumors were excised 24 hr after intravenous ICG. Assessment of residual tumor in the wound bed was performed using a combination of NIR imaging and traditional method (by visual inspection and palpation) versus traditional method alone. Next we performed a clinical trial to evaluate the role of NIR imaging after systemic ICG for the margin assessment of 12 patients undergoing breast‐conserving surgery.

Results

Traditional margin assessment identified 30% of positive margins while NIR imaging identified 90% of positive margins. In our clinical trial, all tumors were detected by NIR imaging and there was fluorescent evidence of residual tumor in the tumor bed in 6 of the 12 patients. None of these patients had positive margins on pathology.

Conclusions

Systemic ICG reliably accumulates in breast cancers in murine models as well as human breast cancer. While NIR imaging is helpful for detection of retained tumor margins in our animal model, intraoperative imaging for precise margin detection will need further refinement before clinical value can be obtained. J. Surg. Oncol. 2016;113:508–514. © 2016 Wiley Periodicals, Inc.
Ionic liquid as a mobile phase additive in high‐performance liquid chromatography for the simultaneous determination of eleven fluorescent whitening agents in paper materials
Authors: Wang Qing , Chen Xianbo , Qiu Bin , Zhou Liang , Zhang Hui , Xie Juan , Luo Yan , Wang Bin
Published: February 2016

In the present study, 11 4,4′‐diaminostilbene‐2,2′‐disulfonic acid based fluorescent whitening agents with different numbers of sulfonic acid groups were separated by using an ionic liquid as a mobile phase additive in high‐performance liquid chromatography with fluorescence detection. The effects of ionic liquid concentration, pH of mobile phase B, and composition of mobile phase A on the separation of fluorescent whitening agents were systematically investigated. The ionic liquid tetrabutylammonium tetrafluoroborate is superior to tetrabutylammomnium bromide for the separation of the fluorescent whitening agents. The optimal separation conditions were an ionic liquid concentration at 8 mM and the pH of mobile phase B at 8.5 with methanol as mobile phase A. The established method exhibited low limits of detection (0.04–0.07 ng/mL) and wide linearity ranges (0.30–20 ng/mL) with high linear correlation coefficients from 0.9994 to 0.9998. The optimized procedure was applied to analyze target analytes in paper samples with satisfactory results. Eleven target analytes were quantified, and the recoveries of spiked paper samples were in the range of 85–105% with the relative standard deviations from 2.1 to 5.1%. The obtained results indicated that the method was efficient for detection of 11 fluorescent whitening agents.
Tailor‐made ion‐imprinted polymer based on functionalized graphene oxide for the preconcentration and determination of trace copper in food samples
Authors: Liu Yan , Qiu Jian , Liu Zhanchao , Ni Liang , Jiang Yinhua , Gong Chongying , Meng Xiangguo , Liu Fangfang , Zhong Guoxing
Published: February 2016

A tailor‐made Cu(II) ion‐imprinted polymer based on large‐surface‐area graphene oxide sheets has been synthesized for the preconcentration and determination of trace copper from food samples by solid‐phase extraction. Attributed to the ultrahigh surface area and hydrophilicity of graphene oxide, the Cu(II) ion‐imprinted polymer prepared by the surface ion‐imprinting technique exhibited a high binding capacity and a fast adsorption rate under the optimized experimental conditions. In the static adsorption experiments, the maximum adsorption capacity of Cu(II) ion‐imprinted polymer is 109.38 mg/g at 25°C, which is much higher than that of the nonimprinted polymer (32.12 mg/g). Meanwhile, the adsorption is very rapid and equilibrium is reached after approximately 30 min. The adsorption mechanism is found to follow Langmuir adsorption model and the pseudo‐second‐order adsorption process. The Cu(II) ion‐imprinted polymer was used for extracting and detecting Cu(II) in food samples combined with graphite flame atomic adsorption spectrometry with high recoveries in the range of 97.6–103.3%. The relative standard deviation and limit of detection of the method were evaluated as 1.2% and 0.37 μg/L, respectively. The results showed that the novel absorbent can be utilized as an effective material for the selective enrichment and determination of Cu(II) from food samples.
Electrospun polystyrene nanofibers as a novel adsorbent to transfer an organic phase from an aqueous phase
Authors: Liu Feilong , Song Dandan , Huang Xueying , Xu Hui
Published: February 2016

The aim of this work is to develop a simple phase‐transfer method for dispersive liquid–liquid microextraction. For this purpose, a polystyrene nanofiber was prepared by a facile electrospinning strategy and used for the first time as an adsorbent to transfer the organic phase in dispersive liquid–liquid microextraction procedure. The fiber was characterized and its chemical stability and excellent hydrophobicity enable it to selectively adsorb the organic solvent in an aqueous sample. High porosity and specific surface area provide a large adsorption capacity. Under the optimal conditions, the developed dispersive liquid–liquid microextraction with high‐performance liquid chromatography method was successfully applied to the analysis of aldehydes in environmental water samples. The merits of this approach are that it is easy‐to‐operate, low‐cost, time‐saving, and has satisfactory sensitivity. It provides an alternative way for fast and convenient phase transfer of the hydrophobic organic solvent from the aqueous phase.
Experimental measuring set‐up and procedure for the traction coefficient on roller‐on‐disc contact
Authors: Gama A. , Cousseau T. , Graça B. , Castro J. , Seabra J.
Published: February 2016

A pin‐on‐disc machine was modified to measure traction coefficient and the potential of contact difference under controlled conditions of slide‐to‐roll ratio, temperature, contact pressure and entrainment speed; oil, grease, grease's base oil and bleed‐oil were tested. This new arrangement proved to be efficient to characterise lubricants traction behaviour, film separation and tribofilm generation. Copyright © 2016 John Wiley & Sons, Ltd.
A Novel Thermo‐Polymerizable Aromatic Diamine: Synthesis and Application in Enhancement of the Properties of Conventional Polyimides
Authors: Luo Yijie , Sun Jing , Wang Jiajia , Jin Kaikai , He Fengkai , Fang Qiang
Published: February 2016

Owing to their important application in the production of high performance materials, aromatic diamines have received interest in many areas for several years. However, most of the polymers derivated from diamines show poor processability due to their rigid backbone. Although much effort has been made, a balance between the solvent (or heat)‐resistance and processability of the polymers still needs to be achieved. In this contribution, a new aromatic diamine is reported, which has both reactive amine groups and thermo‐polymerizable benzocyclobutene moieties. Starting from the diamine can not only give the corresponding polymers, such as polyamides, polyimides, and polyurethanes, but can also provide new structural materials through the post‐polymerization of the polymers. It is found that adding diamine into a conventional polyimide system can greatly improve the properties of the polyimide, such as Tg, coefficient of thermal expansion, tensile strength, and storage modulus. When the content of the diamine is in the range ≈ 5–10 mol%, the tensile strength of the conventional polyimide is increased by up to 30%. The highest Tg (> 400 °C) is observed when the content of the diamine is 40 mol%.

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A dose–response evaluation of freeze‐dried strawberries independent of fiber content on metabolic indices in abdominally obese individuals with insulin resistance in a randomized, single‐blinded, diet‐controlled crossover trial
Authors: Park Eunyoung , Edirisinghe Indika , Wei Hequn , Vijayakumar Lakshmi Prabha , Banaszewski Katarzyna , Cappozzo Jack C. , Burton‐Freeman Britt
Published: February 2016

Scope: This study evaluated the dose–response relationship of strawberries, an anthocyanin‐rich fruit, on postprandial glucose and insulin concentrations in individuals with insulin resistance (IR), including changes in plasma anthocyanins, markers of oxidative stress, and inflammation.

Methods and Results: In a randomized controlled, four‐arm, dose–response, crossover trial, 21 adults with IR consumed a high‐carbohydrate, high‐fat meal with one of four beverages containing 0 g freeze‐dried whole strawberry powder (0g FDS, control), 10, 20, or 40 g FDS, controlled for fiber. Blood was collected at 0 min and at 30 min intervals postmeal until 2 h, then hourly until 6 h. Postmeal insulin concentrations (6 h) were significantly reduced after the 40‐g FDS beverage compared to other beverages (p < 0.05). Postmeal 6 h glucose concentrations were not different, although mean insulin:glucose ratio was significantly different among beverages (p < 0.05). Pelargonidin‐glucuronide was inversely associated with mean insulin concentrations after the 20 and 40 g FDS (p < 0.05). Oxidized low‐density lipoprotein was reduced after 20 g FDS (p < 0.05) and IL‐6 was not different among treatments. Strawberry intake reduced the insulin demand to manage postmeal glucose in obese individuals with IR, which was related to plasma anthocyanin/pelargonidin concentrations.

Conclusion: The data support a role of strawberries in improving insulin sensitivity in people with IR.
Ginger augmented chemotherapy: A novel multitarget nontoxic approach for cancer management
Authors: Saxena Roopali , Rida Padmashree C. G. , Kucuk Omer , Aneja Ritu
Published: February 2016

Cancer, referred to as the ‘disease of civilization’, continues to haunt humanity due to its dreadful manifestations and limited success of therapeutic interventions such as chemotherapy in curing the disease. Although effective, chemotherapy has repeatedly demonstrated inadequacy in disease management due to its debilitating side effects arising from its deleterious nonspecific effects on normal healthy cells. In addition, development of chemoresistance due to mono‐targeting often results in cessation of chemotherapy. This urgently demands development and implementation of multitargeted alternative therapies with mild or no side effects. One extremely promising strategy that yet remains untapped in the clinic is augmenting chemotherapy with dietary phytochemicals or extracts. Ginger, depository of numerous bioactive molecules, not only targets cancer cells but can also mitigate chemotherapy‐associated side effects. Consequently, combination therapy involving ginger extract and chemotherapeutic agents may offer the advantage of being efficacious with reduced toxicity. Here we discuss the remarkable and often overlooked potential of ginger extract to manage cancer, the possibility of developing ginger‐based combinational therapies, and the major roadblocks along with strategies to overcome them in clinical translation of such inventions. We are optimistic that clinical implementation of such combination regimens would be a much sought after modality in cancer management.
Isolation and structure elucidation of unexpected in‐process impurities during tetrazole ring formation of an investigational drug substance
Authors: Silva Elipe Maria Victoria , Yoo Chul , Xia Fang , Simiens Jason , Crossley Kevin , Huckins John R. , Guo Hong‐Xun , Tedrow Jason , Wong‐Moon Kirby
Published: February 2016

During the formation of a tetrazole ring on an investigational drug, two in‐process impurities were detected and analyzed by LC–MS, which suggested that both impurities were drug‐related with the same mass‐to‐charge ratio. To understand and control their formation, both impurities were isolated from the mother liquor of the reaction using a multi‐step isolation procedure to obtain a sufficient amount for high‐resolution mass spectrometry (HRMS) and NMR structural analysis. HRMS suggested a protonated mass of 577.32 Da for both impurities; however, MS fragmentation patterns provided limited information on their structures. NMR analysis indicated the presence on an additional NH functional group in both isolates with similar spatial and bond correlations to one of the dimethylcarbamoyl moieties and the corresponding aromatic ring. A phenyldimethylcarbamoylamino moiety was supported by the NMR and HRMS data and could be explained based on the ‘Schmidt‐like’ reaction mechanism, which was an unexpected reaction pathway. Because the reaction conditions were fixed because of safety concerns, the crystallization protocol was redesigned to reduce the levels of these impurities significantly. Copyright © 2016 John Wiley & Sons, Ltd.
Boisterous Russia in emerging Europe
Authors: Aihonsu Matthew Olatubosun
Published: February 2016

Russia is permanently at a crossroads in its history, or standing in exasperation at a fork in the road but failing to resolve a geographical, historical and metaphysical dilemma: is Russia part of Europe or not? Russia holds a key but vulnerable strategic position in the heartland of Eurasia. Its geographical existence within a larger zone of Eurasian civilization meant that Russian culture had been shaped to a not insignificant extent by influences coming from Asia, that Russia was Eurasian and not European not only by virtue of its cultural patterns but also in terms of anthropological–racial considerations as well. The Eurasian Customs Union is clearly seen by Russia as a vehicle for reintegrating the post‐Soviet space, including the countries that fall within the sphere of the European Union's (EU)'s eastern neighbourhood.

The Eurasian Customs Union is the vehicle through which Russia increasingly engages in ‘normative rivalry’ with the EU in the so‐called ‘shared neighbourhood’. These geopolitical and economic contraptions underpin the strategic calculations that have influenced largely the crisis of Russian Lebensraum escapade in Ukraine and EU's reaction. Copyright © 2016 John Wiley & Sons, Ltd.
Boosting or Hindering Aid Effectiveness? An Assessment of Systems for Measuring Donor Agency Results
Authors: Holzapfel Sarah
Published: February 2016

Amid rising criticism of aid effectiveness coupled with tight budgets in many donor countries at a time of economic crisis, donor agencies are under pressure to deliver value for money and to demonstrate development results. In response to these pressures, more and more donor agencies are adopting standard indicators, which allow for results to be aggregated across interventions and countries, in order to report agency‐wide results. This article analyses the reporting practices of eleven bilateral and multilateral donor agencies and assesses the implications of agency‐wide results measurement systems for aid effectiveness. The analysis shows that the data on aggregate results provided by donor agencies is only of limited informational value and does not provide an adequate basis for holding donor agencies to account. Moreover, reporting on agency‐wide results may have a number of adverse effects. Given the various limitations and risks identified in this article, I suggest that donor agencies should explore complementary options or alternatives to standard indicators in order to meet their reporting requirements. Donor agencies are advised to invest more in rigorous impact evaluations and to raise the transparency of individual interventions. © 2016 The Authors. Public Administration and Development published by John Wiley & Sons Ltd.
Effect of covering filaments on the compression performance and failure mechanism of unidirectional fiber‐reinforced plastic
Authors: Ruan Fangtao , Bao Limin
Published: February 2016

The effects of covering ultra‐high molecular weight polyethylene (UHMWPE) fibers with different types and spacings of filaments on the longitudinal compression properties of unidirectional UHMWPE fiber‐reinforced epoxy resin samples were investigated. UHMWPE fiber bundles covered with fiber filaments were prepared using a custom winding machine, and composites were subsequently fabricated by vacuum‐assisted resin transfer molding. Covering filament spacing was controlled by the warp speed. Compression testing of the resulting samples was performed and the fracture surfaces were examined by an optical microscope. The results showed that the compression strength and modulus of the unidirectional composites reinforced with filament‐covered bundles depended strongly on the compressive failure mechanism, which was decided by the type and spacing of the covering filament. Four kinds of filaments have positive effect for compressive properties of composites, for the basalt filament, the effect for improving compressive strength is best, the improving percentage is 18.4%. For the UHMWP and PBO filament‐covered UFRPs displayed considerable increases of compressive modulus, with improvements of about 36% and 45%. POLYM. COMPOS., 39:247–253, 2018. © 2016 Society of Plastics Engineers
Accelerated development of CuSbS2 thin film photovoltaic device prototypes
Authors: Welch Adam W. , Baranowski Lauryn L. , Zawadzki Pawel , DeHart Clay , Johnston Steve , Lany Stephan , Wolden Colin A. , Zakutayev Andriy
Published: February 2016

Development of alternative thin film photovoltaic technologies is an important research topic because of the potential of low‐cost, high‐efficiency solar cells to produce terawatt levels of clean power. However, this development of unexplored yet promising absorbers can be hindered by complications that arise during solar cell fabrication. Here, a high‐throughput combinatorial method is applied to accelerate development of photovoltaic devices, in this case, using the novel CuSbS2 absorber via a newly developed three‐stage self‐regulated growth process to control absorber purity and orientation. Photovoltaic performance of the absorber, using the typical substrate CuInxGa1 − xSe2 (CIGS) device architecture, is explored as a function of absorber quality and thickness using a variety of back contacts. This study yields CuSbS2 device prototypes with ~1% conversion efficiency, suggesting that the optimal CuSbS2 device fabrication parameters and contact selection criteria are quite different than for CIGS, despite the similarity of these two absorbers. The CuSbS2 device efficiency is at present limited by low short‐circuit current because of bulk recombination related to defects, and a small open‐circuit voltage because of a theoretically predicted cliff‐type conduction band offset between CuSbS2 and CdS. Overall, these results illustrate both the potential and limits of combinatorial methods to accelerate the development of thin film photovoltaic devices using novel absorbers. Copyright © 2016 John Wiley & Sons, Ltd.
On the application of the vibrating Kelvin probe method for quality control of Cu(In,Ga)(Se,S)2 thin‐film solar modules
Authors: Lavrenko Tetiana , Marzinzig Kerstin , Walter Thomas , Plesz Balázs , Ress Sándor
Published: February 2016

In this contribution, the application possibilities of Kelvin probe mapping on Cu(In,Ga)(Se,S)2 thin‐film modules was explored and compared with dark lock‐in thermography and electroluminescence imaging techniques. It has been shown that unlike any imaging technique, Kelvin probe measurements are able to detect spatial potential variations in both reverse and forward biases applied to a module and therefore to localize electrical defects and material inhomogeneities of a module, which are not visible to other characterization techniques. Moreover, Kelvin probe measurements under reverse bias conditions demonstrated a high sensitivity to variations of the reverse currents of the single diodes connected in series even under conditions where open‐circuit voltage is not severely affected by inhomogeneities. Therefore, this mapping technique can be a valuable tool in a quality assessment process especially as an early warning tool in production. Copyright © 2016 John Wiley & Sons, Ltd.
New drug treatments for cancer: what the future holds
Authors: Buckland Danny
Published: February 2016

Cancer drug research is a rapidly expanding field, with thousands of new products in active development. Danny Buckland discusses how innovative new cancer treatments coming to the market and the associated financial pressures will impact on the NHS and patients in the UK.
NICE guideline: diagnosis and management of the menopause
Authors: Chaplin Steve
Published: February 2016

The new NICE guideline on the menopause published in November provides information on diagnosis and the risks and benefits of HRT to enable shared decision making between women and healthcare professionals. Steve Chaplin provides an overview of the guidance.
Equatorial superrotation in Held and Suarez like flows with weak equator‐to‐pole surface temperature gradient
Authors: Polichtchouk I. , Cho J. Y‐K.
Published: February 2016

Equatorial superrotation under zonally symmetric thermal forcing is investigated in a set‐up close to that of the classic Held and Suarez set‐up. In contrast to the behaviour in the classic set‐up, a transition to equatorial superrotation occurs when the equator‐to‐pole surface equilibrium entropy gradient is weakened. Two factors contribute to this transition: (i) the reduction of breaking Rossby waves from the midlatitudes that decelerate the equatorial flow and (ii) the presence of barotropic instability in the equatorial region, providing stirring to accelerate the equatorial flow. In the latter, Kelvin waves excited by instability near the Equator generate and maintain the superrotation. However, the superrotation is unphysically enhanced if simulations are underresolved and/or overdissipated. On leave from Queen Mary University of London.
Hydrogeomorphology—Ecology Interactions in River Systems
Authors: Grabowski R. C. , Gurnell A. M.
Published: February 2016

The European Union‐funded REFORM (REstoring rivers FOR effective catchment Management) project has developed guidance and tools aimed at making river restoration and mitigation measures more effective. A major component of this work has been to investigate functional linkages between the hydrogeomorphology and ecology of rivers. This special collection presents some of the outputs from this work concerning interactions between hydrological, geomorphological and ecological processes in naturally functioning river systems. Together, this set of five papers reviews some of the existing knowledge on interactions and feedbacks between hydrogeomorphology and ecology in river systems and outlines how hydrogeomorphological processes, ecological processes and plant traits contribute to driving river corridor dynamics that create and sustain a diversity of aquatic and wetland habitats that support fish communities.
A comparative study of functional and structural properties of starch extracted from Dioscorea rotundata and Colocasiaesculenta
Authors: Ogunmolasuyi Adewoyin Martin , Egwim Evans C. , Adewoyin Mary A. , Awoyinka Oluwapemi
Published: February 2016

This study was designed to compare some functional and structural properties of yam (Dioscorea rotundata) and cocoyam (Colocasia esculenta) starches. The yield, swelling power, amylose content, paste clarity, and viscosity of yam and cocoyam starches were determined. Likewise, the structural conformation of the starches was evaluated using optical and scanning electron microscopy as well as FTIR spectroscopy. The result showed that, the yield, swelling power, amylose content, and paste clarity of yam and cocoyam starches were 33.38% (217 ± 0.88 g) and 25% (108.75 ± 0.88 g); 38.4 ± 0.2 g/g and 33.4 ± 0.1 g/g; 25.96 ± 0.16 and 22.99 ± 0.04 and 44 ± 2% 34 ± 1% and 350 ± 15.28 and 210 ± 10 mPa.s, respectively. The yield, swelling power, amylose content, paste clarity, and viscosity of yam starch were significantly higher (p < 0.05) than from cocoyam starch. The result of FTIR spectroscopy of yam and cocoyam starches at OH stretch was 3176.45 and 3251.60 cm−1, respectively. At OH stretch cocoyam starch gives higher absorption intensity and broader shape than yam starch, which could be attributed to higher crystallinity of cocoyam starch granules compared to yam starch. The optical and scanning electron microscopy indicated that the granular shape of yam starch was oval whereas cocoyam starch was polygonal with fissures and cavities. In conclusion, from the various functional and structural properties of yam and cocoyam starches evaluated, both could be a cheap and good sources starch, which could be worked for industrial application.
Office Hysteroscopy. An operative gold standard technique and an important contribution to Patient Safety
Authors: Mairos J. , Di Martino P.
Published: February 2016

According to World Health Organization (WHO), about 1 out of 10 hospitalized patients suffers an adverse event, in developed countries, being an adverse event an injury related to medical management, in contrast to complications of disease. These events cause both unnecessary suffering and huge cost to health systems. This issue is so important that WHO has defined it as a global health problem and in 2004 launched the World Alliance for Patient Safety, with the aim to coordinate, disseminate and accelerate improvements in Patient Safety. Office Hysteroscopy (OH), as an independent technique of the hospital circuit, has the ideal conditions to be qualified as the gold standard technique for the surgical treatment of intracavitary uterine pathology. It does not require the use of an operating room, hospital admission and general or locoregional anaesthesia. The appropriate surgical techniques, allied to pain control, allow OH to resolve much more than 90 % of the surgical needs of the intracavitary uterine pathology, thus being an important contribution for Patient Safety.
Money, Peers and Parents: Social and Economic Aspects of Inequality in Youth Wellbeing
Authors: Plenty Stephanie , Mood Carina
Published: February 2016

Indicators of social and economic status are important health determinants. However, evidence for the influence of family socioeconomic status in adolescent wellbeing is inconsistent and during this period of development youth may begin to develop their own status positions. This study examined social and economic health inequalities by applying a multidimensional and youth-orientated approach. Using a recent (2010–2011) and representative sample of Swedish 14-year olds (n = 4456, 51 % females), the impact of family socioeconomic status, youth economic resources and peer status on internalizing symptoms and self-rated health were examined. Data was based on population register, sociometric and self-report information. Aspects of family socioeconomic status, youth’s own economy and peer status each showed independent associations, with poorer wellbeing observed with lower status. However, there were equally strong or even stronger effects of peer status and youth’s own economy than family socioeconomic status. Lower household income and occupational status were more predictive of poor self-rated health than of internalizing symptoms. The findings suggest that youth’s own economy and peer status are as important as family socioeconomic status for understanding inequalities in wellbeing. Thus, a focus on youth-orientated conceptualizations of social and economic disadvantage during adolescence is warranted.
Reduced Mitochondrial Function in Human Huntington Disease Lymphoblasts is Not Due to Alterations in Cardiolipin Metabolism or Mitochondrial Supercomplex Assembly
Authors: Mejia Edgard M. , Chau Sarah , Sparagna Genevieve C. , Sipione Simonetta , Hatch Grant M.
Published: February 2016

Huntington's Disease (HD) is an autosomal dominant disease that occurs as a result of expansion of the trinucleotide repeat CAG (glutamine) on the HTT gene. HD patients exhibit various forms of mitochondrial dysfunction within neurons and peripheral tissues. Cardiolipin (Ptd2Gro) is a polyglycerophospholipid found exclusively in mitochondria and is important for maintaining mitochondrial function. We examined if altered Ptd2Gro metabolism was involved in the mitochondrial dysfunction associated with HD. Mitochondrial basal respiration, spare respiratory capacity, ATP coupling efficiency and rate of glycolysis were markedly diminished in Epstein‐Barr virus transformed HD lymphoblasts compared to controls (CTRL). Mitochondrial supercomplex formation and Complex I activity within these supercomplexes did not vary between HD patients with different length of CAG repeats and appeared unaltered compared to CTRL. In contrast, in vitro Complex I enzyme activity in mitochondrial enriched samples was reduced in HD lymphoblasts compared to CTRL. The total cellular pool size of Ptd2Gro and its synthesis/remodeling from [3H]acetate/[14C]oleate were unaltered in HD lymphoblasts compared to CTRL. In addition, the molecular species of Ptd2Gro were essentially unaltered in HD lymphoblasts compared to CTRL. We conclude that compared to CTRL lymphoblasts, HD lymphoblasts display impaired mitochondrial basal respiration, spare respiratory capacity, ATP coupling efficiency and rate of glycolysis with any pathological CAG repeat length, but this is not due to alterations in Ptd2Gro metabolism. We suggest that HD patient lymphoblasts may be a useful model to study defective energy metabolism that does not involve alterations in Ptd2Gro metabolism.
Daily Enteral DHA Supplementation Alleviates Deficiency in Premature Infants
Authors: Baack Michelle L. , Puumala Susan E. , Messier Stephen E. , Pritchett Deborah K. , Harris William S.
Published: February 2016

Docosahexaenoic acid (DHA) is an essential fatty acid (FA) important for health and neurodevelopment. Premature infants are at risk of DHA deficiency and circulating levels directly correlate with health outcomes. Most supplementation strategies have focused on increasing DHA content in mother's milk or infant formula. However, extremely premature infants may not reach full feedings for weeks and commercially available parenteral lipid emulsions do not contain preformed DHA, so blood levels decline rapidly after birth. Our objective was to develop a DHA supplementation strategy to overcome these barriers. This double‐blind, randomized, controlled trial determined feasibility, tolerability and efficacy of daily enteral DHA supplementation (50 mg/day) in addition to standard nutrition for preterm infants (24–34 weeks gestational age) beginning in the first week of life. Blood FA levels were analyzed at baseline, full feedings and near discharge in DHA (n = 31) or placebo supplemented (n = 29) preterm infants. Term peers (n = 30) were analyzed for comparison. Preterm infants had lower baseline DHA levels (p < 0.0001). Those receiving DHA had a progressive increase in circulating DHA over time (from 3.33 to 4.09 wt% or 2.88 to 3.55 mol%, p < 0.0001) while placebo‐supplemented infants (receiving standard neonatal nutrition) had no increase over time (from 3.35 to 3.32 wt% or 2.91 to 2.87 mol%). Although levels increased with additional DHA supplementation, preterm infants still had lower blood DHA levels than term peers (4.97 wt% or 4.31 mol%) at discharge (p = 0.0002). No differences in adverse events were observed between the groups. Overall, daily enteral DHA supplementation is feasible and alleviates deficiency in premature infants.
Localized rotors and focal impulse sources within the left atrium in human atrial fibrillation: A phase analysis of contact basket catheter electrograms
Authors: Sasaki Naoko , Okumura Yasuo , Watanabe Ichiro , Madry Andrew , Hamano Yuki , Nikaido Mizuki , Kogawa Rikitake , Nagashima Koichi , Takahashi Keiko , Iso Kazuki , Ohkubo Kimie , Nakai Toshiko , Hirayama Atsushi
Published: February 2016

Background

Consistent detection of rotor(s) and/or focal impulse(s) of atrial fibrillation can using a 64‐pole basket catheter remain unclear.

Methods and results

Intracardiac left atrial electrograms were recorded, prior to ablation, in 20 patients with atrial fibrillation. Unipolar electrograms, filtered at 0.1–300 Hz, were recorded and exported for an offline phase analysis. From the cohort, 8 of the 20 patients had analyzable data. Localized rotors were identified in 3 of these patients, with focal impulses detected in 4 patients.

Conclusion

Localized rotors and focal impulses can be identified on phase maps of atrial fibrillation in a small number of patients.
Design of a Bayesian adaptive phase 2 proof‐of‐concept trial for BAN2401, a putative disease‐modifying monoclonal antibody for the treatment of Alzheimer's disease
Authors: Satlin Andrew , Wang Jinping , Logovinsky Veronika , Berry Scott , Swanson Chad , Dhadda Shobha , Berry Donald A.
Published: February 2016

Introduction

Recent failures in phase 3 clinical trials in Alzheimer's disease (AD) suggest that novel approaches to drug development are urgently needed. Phase 3 risk can be mitigated by ensuring that clinical efficacy is established before initiating confirmatory trials, but traditional phase 2 trials in AD can be lengthy and costly.

Methods

We designed a Bayesian adaptive phase 2, proof‐of‐concept trial with a clinical endpoint to evaluate BAN2401, a monoclonal antibody targeting amyloid protofibrils. The study design used dose response and longitudinal modeling. Simulations were used to refine study design features to achieve optimal operating characteristics.

Results

The study design includes five active treatment arms plus placebo, a clinical outcome, 12‐month primary endpoint, and a maximum sample size of 800. The average overall probability of success is ≥80% when at least one dose shows a treatment effect that would be considered clinically meaningful. Using frequent interim analyses, the randomization ratios are adapted based on the clinical endpoint, and the trial can be stopped for success or futility before full enrollment.

Discussion

Bayesian statistics can enhance the efficiency of analyzing the study data. The adaptive randomization generates more data on doses that appear to be more efficacious, which can improve dose selection for phase 3. The interim analyses permit stopping as soon as a predefined signal is detected, which can accelerate decision making. Both features can reduce the size and duration of the trial. This study design can mitigate some of the risks associated with advancing to phase 3 in the absence of data demonstrating clinical efficacy. Limitations to the approach are discussed.
We All Stand Together: The Role of the Association of Asian Constitutional Courts and Equivalent Institutions in Promoting Constitutionalism
Authors: DE VISSER Maartje
Published: February 2016

This article critically evaluates the interplay among courts with constitutional jurisdiction in Asia. This is done in the specific context of the Association of Asian Constitutional Courts and Equivalent Institutions (AACC). The article finds that the AACC has to date made only a nominal contribution to cultivating inter-court relations in furtherance of common goals and advances the claim that its members ought to rectify this state of affairs. On the one hand, transnational judicial alliances have instrumental value for participating courts in the discharge of their mandate. On the other hand, the AACC can be a useful conduit in nurturing an Asian perspective to the global judicial discourse on constitutional issues. In that vein, the article identifies the most suitable means to enable the AACC to optimally discharge its role to help advance respect for democracy, the rule of law, and human rights in the region.
Health & Economic Burden of Traumatic Brain Injury in the Emergency Department
Authors: Fu Terence S. , Jing Rowan , McFaull Steven R. , Cusimano Michael D.
Published: February 2016

Objective:To evaluate epidemiological patterns and lifetime costs of traumatic brain injury (TBI) identified in the emergency department (ED) within a publicly insured population in Ontario, Canada, in 2009.Methods:A nationally representative, population-based database was used to identify TBI cases presenting to Ontario EDs between April 2009 and March 2010. We calculated unit costs for medical treatment and productivity loss, and multiplied these by corresponding incidence estimates to determine the lifetime costs of identified TBI cases across age group, sex, and mechanism of injury.Results:In 2009, there were more than 133,000 ED visits for TBI in Ontario, resulting in a conservative estimate of $945 million in lifetime costs. Lifetime cost estimates ranged from $279 million to $1.22 billion depending on the diagnostic criteria used to define TBI. Peak rates of TBI occurred among young children (ages 0-4 year) and the elderly (ages 85+ years). Males experienced a 53% greater rate of TBI and incurred two-fold higher costs compared with females. Falls, sports/bicyclist-related injuries, and motor vehicle crashes represented 47%, 12%, and 10% of TBI presenting to ED, respectively, and accounted for a significant proportion of costs.Conclusions:This study revealed an enormous health and economic burden associated with TBI identified in the ED setting. Our findings underscore the importance of ongoing surveillance and prevention efforts targeted to vulnerable populations. More research is needed to fully appreciate the burden of TBI across a variety of health care settings.
Depressive Symptoms Negatively Impact Montreal Cognitive Assessment Performance: A Memory Clinic Experience
Authors: Blair Mervin , Coleman Kristy , Jesso Sarah , Desbeaumes Jodoin Véronique , Smolewska Kathy , Warriner Erin , Finger Elizabeth , Pasternak Stephen H.
Published: February 2016

Objective:The Montreal Cognitive Assessment (MoCA) is a general cognitive screening tool that has shown sensitivity in detecting mild levels of cognitive impairment in various clinical populations. Although mood dysfunction is common in referrals to memory clinics, the influence of mood on the MoCA has to date been largely unexplored.Method:In this study, we examined the impact of mood dysfunction on the MoCA using a memory clinic sample of individuals with depressive symptoms who did not meet criteria for a neurodegenerative disease.Results:Half of the group with depressive symptoms scored below the MoCA-suggested cutoff for cognitive impairment. As a group, they scored below healthy controls, but above individuals with Alzheimer’s disease and frontotemporal dementia. A MoCA subtask analysis revealed a pattern of executive/attentional dysfunction in those with depressive symptoms.Conclusions:This observed negative impact of depressive symptomatology on the MoCA has interpretative implications for its utility as a cognitive screening tool in a memory clinic setting.
Challenge or Consent? Understanding Losers’ Reactions in Mass Elections
Authors: Lago Ignacio , Martinez i Coma Ferran
Published: February 2016

The conditions under which losers are willing to challenge the results of elections remain an open question. Using data from the Electoral Integrity Project for 66 democratic and non-democratic countries in 2012 and 2013, we measure how parties or candidates react once votes have been cast and one of them is declared the winner. Do they accept or challenge the results? This measure allows us to examine the causal mechanisms that account for the self-enforcing nature of democracies. Our findings show that losers’ consent increases with free and fair elections and in more economically developed countries, while income inequality is not relevant. Additionally, the impact of free and fair elections is particularly important in more economically developed countries.
Entrainment by turbulent fountains
Authors: Burridge H. C. , Hunt G. R.
Published: February 2016

Experimental measurements of entrainment by turbulent fountains from circular sources in quiescent uniform environments are presented. Our results span almost four orders of magnitude in the source Froude number ($0.004\leqslant \mathit{Fr}_{0}\leqslant 25$) and thereby encompass the entrainment across all classes of fountain behaviour identified to date. We identify scalings for the entrained volume flux $Q_{E}$, in terms of $\mathit{Fr}_{0}$ and the source volume flux $Q_{0}$, within a number of distinct Froude-number bands corresponding to each class of fountain. Additionally we identify a distinct class of new behaviour, as yet unreported, for $\mathit{Fr}_{0}\lesssim 0.1$.
It Hurts To Be Lonely! Loneliness and Positive Mental Wellbeing in Australian Rural and Urban Adolescents
Authors: Houghton Stephen , Hattie John , Carroll Annemaree , Wood Lisa , Baffour Bernard
Published: February 2016

This study examined associations between loneliness, a construct associated with serious adverse mental health outcomes, and positive mental wellbeing. Validated measures of loneliness (represented by friendship-related loneliness, isolation, positive attitude to solitude, and negative attitude to solitude) and positive mental wellbeing were administered to 1,143 adolescents from urban and rural schools. Confirmatory factor analyses revealed satisfactory model fit for both measures. A structural equation model confirmed significant positive associations between positive mental wellbeing and friendship-related loneliness and positive attitude to solitude; a significant negative association was found for isolation. Regression analyses provided support for significant differences in these associations according to gender, age, and geographical location (although only marginally). The implications of these findings during adolescence are reviewed.
Trajectory estimation based on extended state observer with Fal-filter
Authors: Lin C-L , Hsieh S-L , Lin Y-P
Published: February 2016

This paper intends to develop a target trajectory estimation algorithm with application to the ballistic target estimation in the terminal phase. The proposed design is based on the application of a second-order extended state observer (ESO) technique using target information acquired from the seeker to estimate the trajectory of manoeuverable ballistic targets. Satisfactory results have been received while applying the design in estimation of either two-dimenional or three-dimentional target evasive acceleration via computer simulation.
Aero-propulsive modelling for climb and descent trajectory prediction of transport aircraft using genetic algorithms
Authors: Baklacioglu T. , Cavcar M.
Published: February 2016

In this study, a new aero-propulsive model (APM) was derived from the flight manual data of a transport aircraft using Genetic Algorithms (GAs) to perform accurate trajectory predictions. This new GA-based APM provided several improvements to the existing models. The use of GAs enhanced the accuracy of both propulsive and aerodynamic modelling. The effect of compressible drag rise above the critical Mach number, which was not included in previous models, was considered along with the effects of compressibility and profile camber in the aerodynamic model. Consideration of the thrust dependency with respect to Mach number and the altitude in the propulsive model expression was observed to be a more practical approach. The proposed GA model successfully predicted the trajectory for the descent phase, as well, which was not possible in previous models. Close agreement was observed when comparing the time to climb and time to descent values obtained from the model with the flight manual data.