bluuebunny/crossref_metadata_2025 huggingface dataset:
An exploration of the optimum dosage and number of cycles of itraconazole pulse therapy for severe onychomycosis
Authors: Zhang Li , Xu Hui , Shi Yuling , Yu Jing , Tao Yunjiao , Li Xiuli
Published: June 2018

Although standard itraconazole pulse therapy is a well‐established regimen for toenail onychomycosis, the cure rate for onychomycosis remains low. To evaluate the efficacy and safety of different cycles of itraconazole pulse therapy, determine the optimal dosage and number of cycles for onychomycosis. A total of 90 outpatients of our hospital with onychomycosis were randomised into three treatment groups: (1) standard itraconazole pulse therapy (200 mg twice per day, 1 week each month for three pulses); (2) long‐term pulse therapy (200 mg twice per day, 1 week each month for six pulses); (3) low‐dose and long‐term pulse therapy (200 mg/d, 1 week per month for six pulses) and were followed up for 15 months. Of the initial patients, the trial was completed by 81 patients. The complete cure rates were 32.43% for three cycles and 75% for six cycles (P < .001). For six cycles, despite the administration of half‐dose for patients weighing no more than 55 kg, there was no statistical difference in the complete cure rate (P = .862). Long‐term therapy is effective and safe for the treatment of toenail onychomycosis. For patients weighing no more than 55 kg, long‐term half‐dose itraconazole pulse therapy is recommended .
Evaluation of three MALDI‐TOF mass spectrometry libraries for the identification of filamentous fungi in three clinical microbiology laboratories in Manitoba, Canada
Authors: Stein Markus , Tran Vanessa , Nichol Kimberly A. , Lagacé‐Wiens Philippe , Pieroni Peter , Adam Heather J. , Turenne Christine , Walkty Andrew J. , Normand Anne‐Cécile , Hendrickx Marijke , Piarroux Renaud , Karlowsky James A.
Published: June 2018

Matrix‐assisted laser desorption ionisation‐time of flight mass spectrometry (MALDI‐TOF MS) is commonly used by clinical microbiology laboratories to identify bacterial pathogens and yeasts, but not for the identification of moulds. Recent progress in extraction protocols and the composition of comparative libraries support potential application of MALDI‐TOF MS for mould identification in clinical microbiology laboratories. We evaluated the performance of the Bruker Microflex™ MALDI‐TOF MS instrument (Billerica, MA, USA) to identify clinical isolates and reference strains of moulds using 3 libraries, the Bruker mould library, the National Institutes of Health (NIH) library and the Mass Spectrometry Identification (MSI) online library, and compared those results to conventional (morphological) and molecular (18S/ITS; gold standard) identification methods. All 3 libraries demonstrated greater accuracy in genus identification (≥94.9%) than conventional methods (86.4%). MALDI‐TOF MS identified 73.3% of isolates to species level compared to only 31.7% by conventional methods. The MSI library demonstrated the highest rate of species‐level identification (72.0%) compared to NIH (19.5%) and Bruker (13.6%) libraries. Greater than 20% of moulds remained unidentified to species level by all 3 MALDI‐TOF MS libraries primarily because of library limitations or imperfect spectra. The overall identification rate of each MALDI‐TOF MS library depended on the number of species and the number of spectra representing each species in the library.
Recurrent hybridisation events between Primula vulgaris, P. veris and P. elatior (Primulaceae, Ericales) challenge the species boundaries: using molecular markers to re‐evaluate morphological identifications
Authors: Tendal Kira , Ørgaard Marian , Larsen Bjarne , Pedersen Carsten
Published: June 2018

Three Primula species, Primula vulgaris, P. veris and P. elatior, have been objects of fascination for gardeners and botanists over several centuries. The species are able to hybridise, and where they co‐occur, hybrids are commonly found. In Denmark, Møns Klint on the island of Møn and Købelev Skov on Lolland are examples of localities where all three species occur and where the hybrids P. × digenea, the hybrid between P. vulgaris and P. elatior, and P. × polyantha, the hybrid between P. veris and P. vulgaris, can also be found. To investigate relationships between the species and their hybrids, we sampled 168 specimens from 10 geographical locations and subjected them to genetic analysis. The samples were also identified based on morphological traits: primarily inflorescense structure, the size, shape, colour and markings of corolla and leaf basis, leaf blade texture and hairiness. After identifying species‐specific SNPs in the Internal Transcribed Spacer sequence, these were used to resolve species and hybrid boundaries and status through a cleaved amplified polymorphic sequence assay. Polymorphisms in the chloroplast trnL sequence were used as a high‐throughput marker and used to determine the maternal parent of hybrids. Ten simple sequence repeat markers were applied to obtain further insight into the genetic makeup of the accessions using structure and Introgress, providing information of genetic variability within and between populations. Our results indicated that backcrossing of P. × digenea hybrids with parental species has occurred, and that many of the P. × digenea sampled were later‐generation hybrids rather than F1s. Analyses of P. × polyantha specimens show mostly the expected pattern for primary hybrids but indications of P. veris ancestry of a P. vulgaris plant was discovered. Our results further indicate that some of the specimens initially identified as P. elatior include P. vulgaris among their progenitors and thus challenge currently accepted species boundaries.
Chromosome number and karyotype of Phaenospermateae and Duthieeae (Poaceae), with reference to their systematic implications
Authors: Zhang Zhong‐Shuai , Li Ling‐Lu , Chen Wen‐Li
Published: June 2018

Recent molecular phylogenetic studies indicate that Phaenospermateae and Duthieeae are among the early diverging lineages of Pooideae and that they are closely related to each other. Here, we test this with cytotaxonomical data. The monotypic tribe Phaenospermateae, represented by Phaenosperma globosum, has a chromosome number of 2n = 2x = 24 and a fairly symmetric karyotype consisting of 22 median (m) and 2 submedian (sm) chromosomes varying in length between 1.8–3 μm. Duthieeae, represented by Duthiea brachypodium, Sinochasea trigyna, Stephanachne monandra and Stephanachne pappophorea, also share the chromosome number 2n = 2x = 24 and similar symmetric karyotypes with the chromosomes varying in length between 1.4–5 μm. Thus, the close relationship of Phaenospermateae and Duthieeae is corroborated.
Density and biotic interactions modify the combined effects of global and local stressors
Authors: Brooks Paul R. , Crowe Tasman P.
Published: June 2018

A key challenge in predicting the effects of global changes is determining how they may modify the influence of localised stressors, such that steps can be taken to minimise combined effects. Combined effects of global and local stressors can be difficult to predict as they are underpinned by influences on individual species and interactions between them, which in turn may be affected by absolute and relative densities. Here we tested experimentally the influence of increased temperature and/or nutrients on individual species, interactions between them and the consequences for ecosystem functioning. Elevated temperature had a more positive influence on functioning when species were combined in mixtures than when in monoculture. Responses to increased nutrients were positive irrespective of whether a species was in monoculture or in a mixture. Additionally, those effects were modified by changes in the relative density of the species, which in some cases resulted in shifts from negative interspecific interactions (competition) to positive interactions (facilitation) or vice versa.
Using ecological stoichiometry to understand and predict infectious diseases
Authors: Sanders Andrew J. , Taylor Brad W.
Published: June 2018

A key characteristic of host–parasite interactions is the theft of host nutrients by the parasite, yet we lack a general framework for understanding and predicting the interplay of host and parasite nutrition that applies across biological levels of organization. The elemental nutrients (C, N, P, Fe, etc.), and ecological stoichiometry provide a framework for understanding host–parasite interactions and their relation to ecosystem functioning. Here we use the ecological stoichiometry framework to develop hypotheses and predictions regarding the relationship between elemental nutrients and host–parasite interactions. We predict that a suite of host and parasite traits, stoichiometric homeostasis, host diet stoichiometry, and biogeochemical cycling are related to disease dynamics, host immunity and resistance, and bacterial growth form determination. We show that ecological stoichiometry is capable of expanding our understanding of host–parasite interactions, and complementing other approaches such as population and community ecology, and molecular biology, for studying infectious diseases.
Kimura disease in a patient of Arabic descent – a rare finding
Authors: Savla A. , Shah K. , Gormley M. , Sittampalam G.
Published: June 2018

This case reports a slow growing lesion in a 37‐year‐old male patient of Arabic descent in the left anterior parotid gland, which once excised was diagnosed as Kimura disease (KD). KD is a rare, chronic lymphoproliferative inflammatory disease, most commonly presenting in males of Asian descent, usually in their third and fourth decades. Given the frequently associated skin conditions, dermatologists were reported to have diagnosed most patients with KD. This case reminds us that the first presentation may be in an oral and maxillofacial setting. The disease develops in subcutaneous tissue, predominantly found in the head and neck region, and regional lymphadenopathy is common. Peripheral eosinophilia and raised serum IgE levels are also present. Although the disease is benign and remains largely asymptomatic, it could clinically be misdiagnosed as a neoplasm or angiolymphoid hyperplasia with eosinophilia (AHLE), which could affect treatment planning.
Clinical and electrophysiological properties of atrial tachycardia after pediatric heart transplantation
Authors: Drogalis‐Kim Diana E. , Gallotti Roberto G. , Blais Benjamin A. , Perens Greg , Moore Jeremy P.
Published: June 2018

Background

Pediatric heart transplant recipients are at an elevated risk for development of atrial tachycardia (AT); however, the underlying mechanisms and long‐term outcomes are unclear.

Objective

We hypothesized that occurrence of AT in pediatric heart transplant recipients would be associated with a higher frequency of adverse events during follow‐up.

Methods

A single‐center retrospective review of all pediatric heart transplant recipients with suspected AT between 1997 and 2017 was performed. Unaffected controls were matched with cases for age and transplant era. Clinical characteristics and long‐term outcomes were compared between groups.

Results

Of 294 heart transplant recipients, 13 with AT at electrophysiology study (4.4%) were identified and compared with 29 controls. The most common mechanism was focal (11), followed by atrial flutter (two), and electrical reconnection of a surgical atrial anastomosis (two). Focal AT was only observed in the right atrium or atrial septum, and was frequently found on or near the crista terminalis. Relative to controls, cases exhibited more frequent clinical evidence of rejection (9/13 vs 10/29, P  =  0.037). For patients with AT, there was a higher rate of death/retransplant among cases (log‐rank P  =  0.022), which remained significant in multivariate analysis.

Conclusion

In this cohort, the most common form of AT after pediatric heart transplantation was focal, with predilection for sites near the crista terminalis. Transplant patients with AT experienced a higher rate of clinical rejection and the composite end‐point of retransplantation or death relative to unaffected controls.
Effect of defibrillation threshold testing on effectiveness of the subcutaneous implantable cardioverter defibrillator
Authors: Peddareddy Lakshmi , Merchant Faisal M. , Leon Angel R. , Smith Paige , Patel Akshar , El‐Chami Mikhael F.
Published: June 2018

Background

Defibrillation threshold (DFT) testing is recommended with the subcutaneous implantable cardioverter defibrillator (SICD).

Objective

To describe first shock efficacy for appropriate SICD therapies stratified by the presence of implant DFT testing.

Methods

We reviewed all patients receiving SICDs at our institution and stratified them based on whether implant DFT testing was performed. Appropriate shocks were reviewed to see if ventricular tachycardia/ventricular fibrillation (VT/VF) terminated with a single shock. First shock efficacy was stratified by implant DFT status.

Results

178 patients implanted with SICDs and followed in our center were included in this study. Of these, 135 (76%) underwent DFT testing (DFT (+) group). In the DFT (+), 80 appropriate shocks were needed to treat 69 episodes of VT/VF. The first shock was effective in 61 out of 69 episodes (88.4%), whereas multiple shocks were required to terminate VT/VF in the remaining eight episodes. Among 43 patients without implant DFT testing (DFT (−) group), 20 appropriate shocks to treat 17 episodes of VT/VF occurred in seven patients. VT/VF was successfully terminated with the first shock in 16 out of 17 episodes (first shock efficacy 94.1 %). There was no significant difference in first shock effectiveness between those with and without implant DFT testing (P  =  0.97).

Conclusion

A strategy that omits DFT testing at implant did not appear to compromise the effectiveness of the SICD. These data suggest that routine DFT testing at SICD implant might not be necessary. Randomized trials are needed to confirm this finding.
Variability in school children's activity occurs in the recess and before‐school periods
Authors: Suzuki Iku , Okuda Masayuki , Tanaka Maki , Inoue Shigeru , Tanaka Shigeho , Tanaka Chiaki
Published: June 2018

Background

An accurate description of physical activity (PA) at school is required for appropriate health interventions. We examined PA patterns in children, and identified the time periods that influenced them.

Methods

Forty students in five Japanese primary schools were asked to wear triaxial accelerometers for ≥7 days. We obtained coefficients of variance (CV) at 15 min intervals, and conducted factor analysis of the school periods. A questionnaire was used to investigate where students spent time before school, and during recess.

Results

The amount of PA, and its CV were higher around 8 a.m. (before‐school period), 10 a.m. (morning recess), 1 p.m. (lunch recess), and 4 p.m. (commuting home from school). Moderate–vigorous PA (MVPA; ≥3.0 metabolic equivalent units [MET]) was highest during lunch recess and the after‐school period (12.9 ± 7.4 min and 12.6 ± 6.2 min, respectively). The percentage of MVPA time was high (>15%) in the before‐school period and morning and lunch recesses, but low (10%) in the after‐school period. On factor analysis there were differences in PA patterns between the school period and the after‐school period. The students who spent their time in the playground logged more MVPA time and less sedentary time (≤1.5 MET) than those who did not spend their time in the playground.

Conclusion

Activities before school, and in the morning and lunch recesses influenced daily PA, and were different from after‐school PA. Close attention to these periods may help in defining PA parameters during free time at school for PA interventions in children.
Factors associated with health and oral health–related quality of life of children and adolescents with cerebral palsy
Authors: Cardoso Andreia Medeiros Rodrigues , de Medeiros Mariana Marinho Davino , Gomes Lays Nóbrega , Martins Mariana Leonel , Padilha Wilton Wilney Nascimento , Cavalcanti Alessandro Leite
Published: June 2018

Aims

To verify factors associated with impact on Health‐Related Quality of Life (HRQoL) and Oral Health–Related Quality of Life (OHRQoL) of children and adolescents with cerebral palsy (CP).

Methods and results

Sample of 149 individuals with CP aged 2 to 18 years and their caregivers, who provided information regarding HRQoL (PedsQL 4.0), OHRQoL (PedsQL 3.0 Oral Health, and socioeconomic factors. A calibrated investigator performed dental examinations, with dental caries, traumatic dental injury, periodontal, and occlusal evaluation. HRQoL and OHRQoL scores were transformed into a 0 to 100 scale, dichotomized in absence or presence of impact (score < 50) and analyzed by Mann‐Whitney test and Poisson regression (α = .05). The mean HRQoL score was 50.3 ± 10.2. Impact on HRQoL was observed in 51.7% and associated with gender, general health perception, and communication skills. The mean OHRQoL score was 78.0 ± 24.6. The presence of impact on OHRQoL (12.1%) was associated with age, presence of gastroesophageal reflux, dental caries, and periodontal diseases.

Conclusion

Individuals with CP had low HRQoL and OHRQoL scores. The impact on HRQoL was shown to be associated with gender, health perception. and communication skills. Regarding OHRQoL, the presence of impact was associated with age, gastroesophageal reflux, dental caries. and periodontal diseases.
Parenting beliefs and practices in toddlerhood as precursors to self‐regulatory, psychosocial, and academic outcomes in early and middle childhood in ethnically diverse low‐income families
Authors: Liew Jeffrey , Carlo Gustavo , Streit Cara , Ispa Jean M.
Published: June 2018

Ethnoracially diverse families living in poverty are vulnerable to stress, discrimination, and adversities that can be ‘toxic’ to parenting and to a wide range of psychosocial and academic outcomes in youth. Thus, there is high need to identify malleable protective and promotive factors that may lead to improved developmental trajectories and outcomes for at‐risk youth and families. In this study of 2,233 low‐income families with ethnoracially diverse children (49.5% girls; 42.5% European Americans, 38.4% African Americans, and 19.1% U.S. Latino/as), we tested a model positing that child‐rearing beliefs at 24 months and parenting practices at 36 months are precursors to the development of children’s self‐regulation at pre‐kindergarten, with self‐regulation as a mediating mechanism between parenting in toddlerhood and psychosocial and academic functioning at fifth grade. Results confirm that child‐rearing beliefs are precursors to parenting practices, and both parenting practices and self‐regulation are mediating mechanisms by which child‐rearing beliefs are linked to youths’ psychosocial and academic outcomes. The results have implications for early parent education and parenting interventions, including public health approaches that have the potential for positive impacts on vulnerable children, youth, and families.
Online virtual cases to teach resource stewardship
Authors: Zhou Linghong Linda , Tait Gordon , Sandhu Sharron , Steiman Amanda , Lake Shirley
Published: June 2018

Background

As health care costs rise, medical education must focus on high‐value clinical decision making. To teach and assess efficient resource use in rheumatology, online virtual interactive cases (VICs) were developed to simulate real patient encounters to increase price transparency and reinforce cost consciousness.

To teach and assess efficient resource use in rheumatology, online virtual interactive cases (VICs) were developed

Methods

The VIC modules were distributed to a sample of medical students and internal medicine residents, who were required to assess patients, order appropriate investigations, develop differential diagnoses and formulate management plans. Each action was associated with a time and price, with the totals compared against ideals. Trainees were evaluated not only on their diagnosis and patient management, but also on the total time, cost and value of their selected workup. Trainee responses were tracked anonymously, with opportunity to provide feedback at the end of each case.

Results

Seventeen medical trainees completed a total of 48 VIC modules. On average, trainees spent CAN $227.52 and 68 virtual minutes on each case, which was lower than expected. This may have been the result of a low management score of 52.4%, although on average 92.0% of participants in each case achieved the correct diagnosis. In addition, 85.7% felt more comfortable working up similar cases, and 57.1% believed that the modules increased their ability to appropriately order cost‐conscious rheumatology investigations.

Discussion

Our initial assessment of the VIC rheumatology modules was positive, supporting their role as an effective tool in teaching an approach to rheumatology patients, with an emphasis on resource stewardship. Future directions include the expansion of cases, based on feedback, wider dissemination and an evaluation of learning retention.
Long‐term outcome of permanent tracheostomy in 15 dogs with severe laryngeal collapse secondary to brachycephalic airway obstructive syndrome
Authors: Gobbetti Matteo , Romussi Stefano , Buracco Paolo , Bronzo Valerio , Gatti Samuele , Cantatore Matteo
Published: June 2018

Objective

To report the long‐term outcome of permanent tracheostomy for the management of severe laryngeal collapse secondary to brachycephalic airway obstructive syndrome.

Study design

Retrospective case series.

Animals

Fifteen brachycephalic dogs with severe laryngeal collapse treated with permanent tracheostomy.

Methods

Follow‐up data were obtained from medical records or via telephone conversation with the owners. The Kaplan‐Meier estimator was used to calculate median survival time. Death was classified as related or unrelated to tracheostomy surgery. Complications were classified as major when they were life‐threatening or required revision surgery. Owners were asked to classify the postoperative quality of life as improved, unchanged, or worse and the management of the stoma as simple or demanding.

Results

The median survival time was 100 days. Major complications were diagnosed in 12 of 15 (80%) dogs, resulting in death in 8 (median survival time 15 days) and revision surgery in 4 dogs. Seven of 15 (47%) dogs died of unrelated causes or were alive at the end of the study (median survival time 1982 days). The postoperative quality of life of 9 dogs was judged as markedly improved. Stoma management was defined as simple in 8 dogs and demanding in 4.

Conclusion

Permanent tracheostomy was associated with a high risk of complications and postoperative death in brachycephalic dogs. However, long‐term survival (exceeding 5 years) with a good quality of life was documented in 5 of 15 dogs.

Clinical significance

Permanent tracheostomy is a suitable salvage option in brachycephalic dogs with severe laryngeal collapse that did not improve following more conservative surgeries.
Contribution of allelopathic effects to the overall weed suppression by different cover crops
Authors: Sturm D J , Peteinatos G , Gerhards R
Published: June 2018

Cover crops can suppress weeds within agricultural fields due to competitive and allelopathic effects. Glasshouse experiments were conducted to evaluate the relative proportions of allelopathic effects to the total weed inhibition. Six different cover crop species were combined with three weed species in the presence or absence of active carbon over a period of four weeks. Active carbon was used as an adsorbent for allelopathic substances in the soil. Our study revealed that the competition between cover crops and weeds shifted, possibly due to the minimisation of allelopathic effects by active carbon in the soil. We assume that the degree of cover crops allelopathic effects on weeds is species‐specific, both on the side of cover crops and on the weed side. The cover crops Raphanus sativus, Fagopyrum esculentum and Avena strigosa showed the highest allelopathic weed suppression with up to 28%. Additionally, Stellaria media turned out to be the most sensitive weed against allelopathic effects induced by all cover crops, except for Linum usitatissimum and Guizotia abyssinica. The knowledge about the contribution of competitive and allelopathic effects by cover crops would help to create cover crop mixtures with high weed suppressive ability.
Effectiveness of interventions for preventing occupational irritant hand dermatitis: a quantitative systematic review
Authors: Papadatou Zoi , Williams Hector , Cooper Kay
Published: June 2018

Objective:

The aim of this review was to identify, appraise and synthesize the best available evidence on the effectiveness of moisturizers, barrier creams, protective gloves, skin protection education and complex interventions (a combination of two or more of the interventions listed here) in preventing occupational irritant hand dermatitis (OIHD) in wet workers, comparing each intervention to an alternative intervention or to usual care (workers’ regular skin care regimen).

Introduction:

The most significant occupational skin problem potentially encountered in wet work occupations is occupational dermatitis. When the skin comes into contact with hazardous substances at work, this can cause occupational dermatitis. Substances which may cause occupational dermatitis include cleaning products, organic solvents, metalworking fluids, cement, flour, adhesives, other chemicals and even certain plants. Occupational skin disease has adverse effects on quality of life and the long term prognosis for skin health is poor unless workplace exposures are addressed. To date, no systematic review has been undertaken to determine the effectiveness of interventions for the primary prevention of OIHD in wet workers.

Inclusion criteria:

The review included any workers from healthcare (e.g. nurses, doctors and allied health professionals) and also people in different wet work occupations (e.g. hairdressers, florists, catering workers, metal workers) at similar risk of OIHD. Studies that assessed the following interventions in the primary prevention of OIHD in wet workers at the workplace and at home (before and after work) were included:

Use of moisturizers, for example, high and low lipid content moisturizers.

Barrier creams, for example, barrier creams which may contain substances such as liquid paraffin lotion, lanolin oil, silicone or hydrocarbon.

Gloves (rubber and/or cotton).

Education, for example, seminars and training courses (face-to-face or online).

Types of studies considered were experimental study designs including randomized controlled trials, non-randomized controlled trials, quasi-experimental, and before and after studies. Primary outcome measures were OIHD incidence, and secondary outcome measures were product evaluation and change of occupation because of OIHD versus staying in the occupation.

Methods:

Published and unpublished literature in the English language was sought between 2004 and 2017. The databases searched included: COCHRANE CENTRAL, MEDLINE, CINAHL, AMED and Embase. The search for unpublished studies included: Google Scholar, Open DOAR and Robert Gordon University's thesis database, “OPEN AIR”.

Results:

There were no studies located that met the inclusion requirements of this review.

Conclusion:

There is currently no evidence available to determine the effectiveness of interventions to prevent OIHD amongst wet workers that met this review's inclusion criteria.
Integration of Indigenous healing practices with western biomedicine in Australia, Canada, New Zealand and the United States of America: a scoping review protocol
Authors: Blignault Ilse , Hunter Jennifer , Mumford Janette
Published: June 2018

Review questions

This scoping review aims to explore the following questions:

What types of Indigenous healing practices have been integrated with western biomedicine in Australia, Canada, New Zealand and the USA, and for what conditions or purpose have they been used?

How has this integration been achieved, i.e. what are the key features of the service models implemented?
Allied health and nursing pre-registration student tracking studies: a scoping review protocol
Authors: Khalil Hanan , Sutton Keith , Waller Susan
Published: June 2018

Review question

The objective of this scoping review is to examine the study designs and outcomes of allied health and nursing student and graduate tracking studies. Specifically the review questions are:

i) What are the study designs of placement tracking studies for allied health and nursing students and graduates, as described in the literature?

ii) What are the outcomes reported in studies addressing allied health and nursing student and graduate tracking studies?
Effectiveness of diaphragmatic breathing on physiological and psychological stress in adults: a quantitative systematic review protocol
Authors: Hopper Susan I. , Murray Sherrie L. , Ferrara Lucille R. , Singleton Joanne K.
Published: June 2018

Review question:

What is the effectiveness of diaphragmatic breathing on physiological and psychological stress in adults?
Association between emergency department length of stay and patient outcomes: a systematic review protocol
Authors: Burgess Luke , Hines Sonia , Kynoch Kathryn
Published: June 2018

Review question:

The question of this review is: what is the association between emergency department length of stay and patient outcomes?

More specifically, what is the association between the length of time a patient spends in the emergency department and outcomes, including, but not limited to: mortality, omitted episodes of care (e.g. non-administration of prescribed medication), adverse events, time to treatment (e.g. time to analgesia or time to operating theater), inpatient length of stay, leave without being seen rate and patient satisfaction?
A Proposal for the Numerical and Experimental Evaluation of Temperature Rise in Synthetic and Hybrid Ropes Used in AHC Systems and Methods of Lessening the Effect
Authors: Pourladian Bamdad , Groce John
Published: June 2018

Recent commercial activities in the deeper regions of seas and oceans have placed increasing demands for higher strength-to-weight ratio tension members with certain improved mechanical properties. Activities such as heavy lifting in subsea regions can impose extreme dynamic loading conditions as well as other environmental factors on ropes used as tension members for those applications. In this paper, some recently developed synthetic fiber and hybrid tension member technologies that may provide solutions for some of these challenging needs are presented. A proposal for a hybrid rope concept is presented which is envisioned to provide for more effective cooling of the rope in high cycle bending applications such as active heave compensated winches. A proposal for numerical modeling and experimental evaluation of heat transfer rates in such a hybrid rope is briefly presented. A short overview of the current ASME B30 standard volumes for land-based crane rope usage and inspection, as well as ISO 4309 and the API 2D standards will also be presented.

Paper published with permission.
Developing Performance-Based Classification Rules/Regulatory Guidelines to Improve Effectiveness of Incident Management and Outcome of Disasters
Authors: Ghosh Amit
Published: June 2018

What was common between the capsizing of the cruise liner Costa Concordia, engine fire on the Carnival Triumph and the sinking of the Deepwater Horizon rig?

In all cases, the people impacted did not believe or find that the authorities, whether public or private, were capable of meeting their immediate needs. Consequently, such biases led to collective behavior or ‘herding’ with devastating outcomes.

Holding true to its mission of marine safety, the United States Coast Guard (USCG) finds itself in roles of maritime incident management and provider of training for examination of foreign ships carrying U.S. passengers.

Also, following land-based costal events such as Hurricane Harvey, the USCG is called upon to perform rescue operations in which risk assessment through effective communication between stakeholders becomes extremely important.

Accordingly, this paper proposes a performance-based approach to occupant safety, occupant circulation, and hazard communication so that both classification rules can be developed and guidelines can be proposed for inclusion in the USCG Incident Management Handbook.

Advances in the analysis and modelling of the movement of people, especially in building fires, have established the decision-making processes that individuals or groups undergo before reacting to an imminent danger. When a large number of people have a high commitment either to activity or to inactivity, it becomes important that an equilibrium solution is adopted and the resources are allocated accordingly.

The author proposes evaluating incident management as a dynamic system. Like any dynamic system, incident management for any disaster, evolves with time in terms of scale, needed inputs and desired outputs. Engineers today have the capability to influence the outputs by establishing protocols for sharing of information and resources among the stakeholders. The author presented a paper on a similar topic at ASME’s Dynamic Systems and Controls Conference (DSCC 2015)3.

Paper published with permission.
Slitted leading edge profiles for the reduction of turbulence-aerofoil interaction noise
Authors: Chaitanya P. , Joseph P.
Published: June 2018

Aerofoils operating in a turbulent flow are an efficient source of noise radiation by scattering vorticity into sound at the leading edge (LE). Much work has now been undertaken demonstrating the effectiveness of serrations, or undulations, introduced onto the LE can substantially reduce broadband LE interaction noise. However, all of this work is focused on sinusoidal LE serration profiles. In this paper, an alternative profile is proposed that is capable of providing significantly greater noise reductions than the maximum noise reductions that can be achieved by single-wavelength serrations of the same peak-to-root amplitude. In its most general realization, the LE serration profiles simply comprise of a sawtooth or single wavelength serration for which every root has a single narrow slit. This simple geometry, upon interaction with a turbulent flow, produces compact source regions at either end of the slit, which then destructively interfere, leading to considerably less efficient noise radiation than conventional single-wavelength geometries. The paper will demonstrate experimentally that even slits by themselves can provide greater levels of noise reduction than conventional profiles of the same peak-to-root amplitude.
Model-scale jet noise analysis with a single-point, frequency-domain nonlinearity indicator
Authors: Miller Kyle G. , Gee Kent L.
Published: June 2018

A single-point, frequency-domain nonlinearity indicator is calculated and analyzed for noise from a model-scale jet at Mach 0.85, Mach 1.8, and Mach 2.0. The nonlinearity indicator, νN, has been previously derived from an ensemble-averaged, frequency-domain version of the generalized Burgers equation (GBE) from Reichman, Gee, Neilsen, and Miller [J. Acoust. Soc. Am. 139, 2505–2513 (2016)]. The indicator gives the spatial rate of change due to nonlinear processes in sound pressure level (SPL) spectrum, and two other indicators from the GBE—νS and να—give the same quantity due to geometric spreading and absorption, respectively. Trends with frequency, angle, distance, and jet condition—supported both by spectral analysis and by calculation of the GBE-derived indicators—reveal a concentration of nonlinear effects along radials close to the plume with large overall SPLs. The calculated indicators for nonlinearity and absorption effects far from the source combine to give the same decay predicted by nonlinear theory for monofrequency sources. Trends in the νN indicator are compared with trends observed for other indicators such as pressure-derivative skewness and bicoherence, revealing both the qualitative and quantitative advantages of the νN indicator.
Sucrose and Sodium but not Caffeine Content Influence the Retention of Beverages in Humans Under Euhydrated Conditions
Authors: Maughan Ronald J. , Watson Phillip , Cordery Philip A.A. , Walsh Neil P. , Oliver Samuel J. , Dolci Alberto , Rodriguez-Sanchez Nidia , Galloway Stuart D.R.
Published: June 2018

This study systematically examined the influence of carbohydrate (sucrose), sodium, and caffeine on the fluid retention potential of beverages under euhydrated conditions, using the beverage hydration index method. Three cohorts, each of 12 young, healthy, active men, ingested 1 L of beverages containing four different concentrations of a single component (sucrose, sodium, or caffeine) in a double-blind, crossover manner. Urine output was collected for the subsequent 4 hr. Cumulative urine output was lower and net fluid balance was higher after 10 and 20% sucrose beverages than 0 and 5% sucrose beverages (p < .05), and after 27 and 52 mmol/L sodium beverages than 7 and 15 mmol/L sodium beverages (p < .05). No difference in urine output or net fluid balance was apparent following ingestion of caffeine at concentrations of 0–400 mg/L (p = .83). Consequently, the calculated beverage hydration index was greater in beverages with higher sucrose or sodium content, but caffeine had no effect. No difference was observed in arginine vasopressin or aldosterone between any trials. These data highlight that the key drivers promoting differences in the fluid retention potential of beverages when euhydrated are energy density, likely through slowed fluid delivery to the circulation (carbohydrate content effect), or electrolyte content through improved fluid retention (sodium content effect). These data demonstrate that beverage carbohydrate and sodium content influence fluid delivery and retention in the 4 hr after ingestion, but caffeine up to 400 mg/L does not. Athletes and others can use this information to guide their daily hydration practices.
Bone Broth Unlikely to Provide Reliable Concentrations of Collagen Precursors Compared With Supplemental Sources of Collagen Used in Collagen Research
Authors: Alcock Rebekah D. , Shaw Gregory C. , Burke Louise M.
Published: June 2018

Intake of dietary sources of collagen may support the synthesis of collagen in varying tissues, with the availability of key amino acids being a likely contributor to its effectiveness. This study analyzed commonly consumed preparations of bone broth (BB) to assess the amount and consistency of its amino acid content. Commercial and laboratory-prepared samples, made with standardized and variable (nonstandardized) protocols, were analyzed for key amino acids (glycine, lysine, proline, leucine, hydroxyproline, and hydroxylysine). The main finding of this study was that amino acid concentrations in BB made to a standardized recipe were significantly lower for hydroxyproline, glycine, and proline (p = .003) and hydroxylysine, leucine, and lysine (p = .004) than those provided by a potentially therapeutic dose (20 g) of reference collagen supplements (p > .05). There was a large variability in the amino acid content of BB made to nonstandardized recipes, with the highest levels of all amino acids found within the café-prepared varieties. For standardized preparations, commercial BBs were lower in all amino acids than the self-prepared varieties. There were no differences (p > .05) in the amino acid content of different batches of BB when prepared according to a standardized recipe. If the intake of collagen precursors is proven to support the synthesis of new collagen in vivo, it is unlikely that BB can provide a consistently reliable source of key amino acids. Research on the provision of key amino acids from dietary sources should continue to focus on the standard sources currently being researched.
Physical Performance in Elite Male and Female Team-Handball Players
Authors: Wagner Herbert , Fuchs Patrick , Fusco Andrea , Fuchs Philip , Bell Jeffrey W. , von Duvillard Serge P.
Published: June 2018

Purpose: Biological differences between men and women are well known; however, literature addressing knowledge about the influence of sex on specific and general performance in team handball is almost nonexistent. Consequently, the aim of the study was to assess and compare specific and general physical performance in male and female elite team-handball players, to determine if the differences are consequential for general compared with specific physical performance characteristics and the relationship between general and specific physical performance. Methods: Twelve male and 10 female elite team-handball players performed a game-based performance test, upper- and lower-body strength and power tests, a sprinting test, and an incremental treadmill running test. Results: Significant differences (P < .05) between male and female players were found for peak oxygen uptake and total running time during the treadmill test, 30-m sprinting time, leg-extension strength, trunk- and shoulder-rotation torque, and countermovement-jump height, as well as offense and defense time, ball velocity, and jump height in the game-based performance test. An interaction (sex × test) was found for time and oxygen uptake, and except shoulder-rotation torque and ball velocity in women, the authors found only a low relationship between specific and general physical performance. Conclusion: The results of the study revealed that male players are heavier, taller, faster, and stronger; jump higher; and have better aerobic performance. However, female players performed relatively better in the team-handball-specific tests than in the general tests. The findings also suggest that female players should focus more on strength training.
Muscle Glycogen Utilization During an Australian Rules Football Game
Authors: Routledge Harry E. , Leckey Jill J. , Lee Matt J. , Garnham Andrew , Graham Stuart , Burgess Darren , Burke Louise M. , Erskine Robert M. , Close Graeme L. , Morton James P.
Published: June 2018

Purpose: To better understand the carbohydrate (CHO) requirement of Australian Football (AF) match play by quantifying muscle glycogen utilization during an in-season AF match. Methods: After a 24-h CHO-loading protocol of 8 and 2 g/kg in the prematch meal, 2 elite male forward players had biopsies sampled from m. vastus lateralis before and after participation in a South Australian Football League game. Player A (87.2 kg) consumed water only during match play, whereas player B (87.6 kg) consumed 88 g CHO via CHO gels. External load was quantified using global positioning system technology. Results: Player A completed more minutes on the ground (115 vs 98 min) and covered greater total distance (12.2 vs 11.2 km) than player B, although with similar high-speed running (837 vs 1070 m) and sprinting (135 vs 138 m). Muscle glycogen decreased by 66% in player A (pre: 656 mmol/kg dry weight [dw], post: 223 mmol/kg dw) and 24% in player B (pre: 544 mmol/kg dw, post: 416 mmol/kg dw). Conclusion: Prematch CHO loading elevated muscle glycogen concentrations (ie, >500 mmol/kg dw), the magnitude of which appears sufficient to meet the metabolic demands of elite AF match play. The glycogen cost of AF match play may be greater than in soccer and rugby, and CHO feeding may also spare muscle glycogen use. Further studies using larger sample sizes are now required to quantify the interindividual variability of glycogen cost of match play (including muscle and fiber-type-specific responses), as well examining potential metabolic and ergogenic effects of CHO feeding.
Enhancing Grit Through Functional Imagery Training in Professional Soccer
Authors: Rhodes Jonathan , May Jon , Andrade Jackie , Kavanagh David
Published: June 2018

Functional imagery training (FIT) extends multisensory imagery training by involving athletes with goal setting and appraisal. The authors measured the effect of FIT on 24 professional soccer players’ grit, a personality trait associated with perseverance for a long-term goal. In a stepped-wedge design, an immediate (n = 9) and a delayed (n = 10) group received FIT at Week 1 or 6 and were measured at Week 12. A self-selected control group (n = 5) received no intervention. The delayed group was also measured at Week 6 just before their intervention, and at Week 18. Grit scores in both intervention groups increased after the intervention, but the control group’s did not. The delayed group increased in grit between Weeks 6 and 12, showing the effectiveness of the intervention over a relatively short time, and continued to improve to Week 18. In the intervention groups, vividness of goal imagery also increased and players perceived that FIT improved sport performance.
The Development of Leadership in Model Youth Football Coaches
Authors: Pankow Kurtis , Mosewich Amber D. , Holt Nicholas L.
Published: June 2018

The purpose of this study was to examine perceptions of leadership styles in model youth football coaches. Six award-winning youth football coaches participated, and each was interviewed twice. Within a qualitative descriptive framework, deductive analysis was completed to identify the coaches’ leadership styles, using the charismatic, ideological, and pragmatic model of outstanding leadership. Whereas pragmatic leadership behaviors were most frequently identified, all coaches appeared to have mixed leadership styles. Inductive analysis was then used to examine factors that influenced the coaches’ leadership development. Identified themes were role models, networks of coaches, experience and reflection, and formal, nonformal, and informal learning. These were consistent across all the coaches, regardless of leadership style. This study therefore provides new insights into the perceived use of pragmatic behaviors in mixed leadership styles in model youth sport coaches and indicates that similar factors contributed to their leadership development.
Francisella marina sp. nov., Etiologic Agent of Systemic Disease in Cultured Spotted Rose Snapper (Lutjanus guttatus) in Central America
Authors: Soto Esteban , Griffin Matt J. , Morales Juan Alberto , Calvo Elías Barquero , de Alexandre Sebastião Fernanda , Porras Adrián Lopez , Víquez-Rodríguez Xindy , Reichley Stephen R. , Rosser Thomas G. , Ware Cynthia , Byrne Barbara A. , García Julio C. , LaFrentz Benjamin R. , Camus Alvin C.
Published: June 2018

Finfish aquaculture is the fastest growing global food production sector. Infectious disease, particularly emergent pathogens, pose a significant threat to established and nascent aquaculture industries worldwide. Herein, we characterize a novel pathogen isolated from mortality events in cultured spotted rose snapper in Central America. The bacteria recovered from these outbreaks were genetically and phenotypically dissimilar from other known
Francisella
spp. from fish, representing a previously unrecognized member of the genus
Francisella
, for which the name
Francisella marina
sp. nov. is proposed.
Phenotypic Divergence along Geographic Gradients Reveals Potential for Rapid Adaptation of the White-Nose Syndrome Pathogen, Pseudogymnoascus destructans, in North America
Authors: Forsythe Adrian , Giglio Victoria , Asa Jonathan , Xu Jianping
Published: June 2018

The causal agent of white-nose syndrome in bats isPseudogymnoascus destructans, a filamentous fungus recently introduced from its native range in Europe. Infections caused byP. destructanshave progressed across the eastern parts of Canada and the United States over the last 10 years. It is not clear how the disease is spread, as the pathogen is unable to grow above 23°C and ambient temperature can act as a barrier when hosts disperse. Here, we explore the patterns of phenotypic diversity and the germination of the fungal asexual spores, arthroconidia, from strains across a sizeable area of the epizootic range. Our analyses revealed evidence of adaptation along geographic gradients during its expansion. The results have implications for understanding the diversification ofP. destructansand the limits of WNS spread in North America. Given the rapidly expanding distribution of WNS, a detailed understanding of the genetic bases for phenotypic variations in growth, reproduction, and dispersal ofP. destructansis urgently needed to help control this disease.