bluuebunny/crossref_metadata_2025 huggingface dataset:
A novel noninstrumented surgical approach for foramen reconstruction for isthmic spondylolisthesis in patients with radiculopathy: preliminary clinical and radiographic outcomes
Authors: Spoor Jochem K. H. , Dallenga Alof H. G. , Gadjradj Pravesh S. , de Klerk Luuk , van Biezen Frans C. , Bijvoet Henk W. C. , Harhangi Biswadjiet S.
Published: January 2018

OBJECTIVE

The health care costs for instrumented spine surgery have increased dramatically in the last few decades. The authors present a novel noninstrumented surgical approach for patients with isthmic spondylolisthesis, with clinical and radiographic results.

METHODS

Charts of patients who underwent this technique were reviewed. The procedure consisted of nerve root decompression by reconstruction of the intervertebral foramen. This was achieved by removal of the pedicle followed by noninstrumented posterolateral fusion in which autologous bone graft from the right iliac crest was used. Outcomes regarding radicular complaints, bony fusion, progression of the slip, and complications were evaluated using patient history and radiographs obtained at follow-up intervals of 3–18 months after surgery.

RESULTS

A total of 58 patients with a mean age of 47 years were treated with this method. Partial removal of the pedicle was performed in 93.1% of the cases, whereas in 6.9% of the cases the entire pedicle was removed. The mean duration of surgery was 216.5 ± 54.5 minutes (range 91–340 minutes). The mean (± SD) duration of hospitalization was 10.1 ± 2.9 days (range 5–18 days).

After 3 months of follow-up, 86% of the patients reported no leg pain, and this dropped to 81% at last follow-up. Radiographic follow-up showed bony fusion in 87.7% of the patients. At 1 year, 5 patients showed progression of the slip, which in 1 patient prompted a second operation within 1 year. No major complications occurred.

CONCLUSIONS

Treatment of isthmic spondylolisthesis by reconstruction of the intervertebral neuroforamen and posterolateral fusion in situ is a safe procedure and has comparable results with the existing techniques. Cost-effectiveness research comparing this technique to conventional instrumented fusion techniques is necessary to evaluate the merits for both patients and society.
Minimally invasive anterior and lateral transpsoas approaches for closed reduction of grade II spondylolisthesis: initial clinical and radiographic experience
Authors: Xu David S. , Bach Konrad , Uribe Juan S.
Published: January 2018

OBJECTIVE

Minimally invasive anterior and lateral approaches to the lumbar spine are increasingly used to treat and reduce grade I spondylolisthesis, but concerns still exist for their usage in the management of higher-grade lesions. The authors report their experience with this strategy for grade II spondylolisthesis in a single-surgeon case series and provide early clinical and radiographic outcomes.

METHODS

A retrospective review of a single surgeon’s cases between 2012 and 2016 identified all patients with a Meyerding grade II lumbar spondylolisthesis who underwent minimally invasive lateral lumbar interbody fusion (LLIF) or anterior lumbar interbody fusion (ALIF) targeting the slipped level. Demographic, clinical, and radiographic data were collected and analyzed. Changes in radiographic measurements, Oswestry Disability Index (ODI), and visual analog scale (VAS) scores were compared using the paired t-test and Wilcoxon signed rank test for continuous and ordinal variables, respectively.

RESULTS

The average operative time was 199.1 minutes (with 60.6 ml of estimated blood loss) for LLIFs and 282.1 minutes (with 106.3 ml of estimated blood loss), for ALIFs. Three LLIF patients had transient unilateral anterior thigh numbness during the 1st week after surgery, and 1 ALIF patient had transient dorsiflexion weakness, which was resolved at postoperative week 1. The mean follow-up time was 17.6 months (SD 12.5 months) for LLIF patients and 10 months (SD 3.1 months) for ALIF patients. Complete reduction of the spondylolisthesis was achieved in 12 LLIF patients (75.0%) and 7 ALIF patients (87.5%). Across both procedures, there was an increase in both the segmental lordosis (LLIF 5.6°, p = 0.002; ALIF 15.0°, p = 0.002) and overall lumbar lordosis (LLIF 2.9°, p = 0.151; ALIF 5.1°, p = 0.006) after surgery. Statistically significant decreases in the mean VAS and the mean ODI measurements were seen in both treatment groups. The VAS and ODI scores fell by a mean value of 3.9 (p = 0.002) and 19.8 (p = 0.001), respectively, for LLIF patients and 3.8 (p = 0.02) and 21.0 (p = 0.03), respectively, for ALIF patients at last follow-up.

CONCLUSIONS

Early clinical and radiographic results from using minimally invasive LLIF and ALIF approaches to treat grade II spondylolisthesis appear to be good, with low operative blood loss and no neurological deficits. Complete reduction of the spondylolisthesis is frequently possible with a statistically significant reduction in pain scores.
A comparison of the techniques of direct pars interarticularis repairs for spondylolysis and low-grade spondylolisthesis: a meta-analysis
Authors: Mohammed Nasser , Patra Devi Prasad , Narayan Vinayak , Savardekar Amey R. , Dossani Rimal Hanif , Bollam Papireddy , Bir Shyamal , Nanda Anil
Published: January 2018

OBJECTIVE

Spondylosis with or without spondylolisthesis that does not respond to conservative management has an excellent outcome with direct pars interarticularis repair. Direct repair preserves the segmental spinal motion. A number of operative techniques for direct repair are practiced; however, the procedure of choice is not clearly defined. The present study aims to clarify the advantages and disadvantages of the different operative techniques and their outcomes.

METHODS

A meta-analysis was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The following databases were searched: PubMed, Cochrane Library, Web of Science, and CINAHL (Cumulative Index to Nursing and Allied Health Literature). Studies of patients with spondylolysis with or without low-grade spondylolisthesis who underwent direct repair were included. The patients were divided into 4 groups based on the operative technique used: the Buck repair group, Scott repair group, Morscher repair group, and pedicle screw–based repair group. The pooled data were analyzed using the DerSimonian and Laird random-effects model. Tests for bias and heterogeneity were performed. The I2 statistic was calculated, and the results were analyzed. Statistical analysis was performed using StatsDirect version 2.

RESULTS

Forty-six studies consisting of 900 patients were included in the study. The majority of the patients were in their 2nd decade of life. The Buck group included 19 studies with 305 patients; the Scott group had 8 studies with 162 patients. The Morscher method included 5 studies with 193 patients, and the pedicle group included 14 studies with 240 patients. The overall pooled fusion, complication, and outcome rates were calculated. The pooled rates for fusion for the Buck, Scott, Morscher, and pedicle screw groups were 83.53%, 81.57%, 77.72%, and 90.21%, respectively. The pooled complication rates for the Buck, Scott, Morscher, and pedicle screw groups were 13.41%, 22.35%, 27.42%, and 12.8%, respectively, and the pooled positive outcome rates for the Buck, Scott, Morscher, and pedicle screw groups were 84.33%, 82.49%, 80.30%, and 80.1%, respectively. The pedicle group had the best fusion rate and lowest complication rate.

CONCLUSIONS

The pedicle screw–based direct pars repair for spondylolysis and low-grade spondylolisthesis is the best choice of procedure, with the highest fusion and lowest complication rates, followed by the Buck repair. The Morscher and Scott repairs were associated with a high rate of complication and lower rates of fusion.
Radial to axillary nerve transfer
Authors: Vanaclocha Vicente , Herrera Juan Manuel , Rivera-Paz Marlon , Martínez-Gómez Deborah , Vanaclocha Leyre
Published: January 2018

Axillary nerve injury is common after brachial plexus injuries, particularly with shoulder luxation. Nerve grafting is the traditional procedure for postganglionic injuries. Nerve transfer is emerging as a viable option particularly in late referrals. At the proximal arm the radial and axillary nerves lie close by. Sacrificing one of the triceps muscle nerve branches induces little negative consequences. Transferring the long head of the triceps nerve branch is a good option to recover axillary nerve function. The surgical technique is presented in a video, stressing the steps to achieve a successful result.

The video can be found here: https://youtu.be/WbVbpMuPxIE.
Neurofibroma of the peroneal nerve
Authors: Haldeman Clayton , Hanna Amgad
Published: January 2018

Neurofibromas are benign tumors composed of different cell types from the peripheral nervous system. Neurofibromas infiltrate between nerve fascicles and do not have a discrete capsule. On MRI, they are T1 hypointense or isointense, T2 hyperintense, often with a “target sign,” and contrast enhancing. The video shows gross-total resection of a peroneal nerve neurofibroma presenting as a painful mass in the popliteal fossa. Incisions across a skin crease can be either oblique or zigzag, but never perpendicular to it. It is also key to expose normal nerve proximal and distal to the tumor. The patient had a good functional outcome.

The video can be found here: https://youtu.be/G74Zoa1Y2JM.
Surgical repair of sciatic nerve traumatic rupture: technical considerations and approaches
Authors: Abou-Al-Shaar Hussam , Yoon Nam , Mahan Mark A.
Published: January 2018

Traumatic proximal sciatic nerve rupture poses surgical repair dilemmas. Disruption often causes a large nerve gap after proximal neuroma and distal scar removal. Also, autologous graft material to bridge the segmental defect may be insufficient, given the sciatic nerve diameter. The authors utilized knee flexion to allow single neurorrhaphy repair of a large sciatic nerve defect, bringing healthy proximal stump to healthy distal segment. To avoid aberrant regeneration, the authors split the sciatic nerve into common peroneal and tibial divisions. After 3 months, the patient can fully extend the knee and has evidence of distal regeneration and nerve continuity without substantial injury.

The video can be found here: https://youtu.be/lsezRT5I8MU.
Acute repair of traumatic pan–brachial plexus injury: technical considerations and approaches
Authors: Abou-Al-Shaar Hussam , Karsy Michael , Ravindra Vijay , Joyce Evan , Mahan Mark A.
Published: January 2018

Particularly challenging after complete brachial plexus avulsion is reestablishing effective hand function, due to limited neurological donors to reanimate the arm. Acute repair of avulsion injuries may enable reinnervation strategies for achieving hand function. This patient presented with pan–brachial plexus injury. Given its irreparable nature, the authors recommended multistage reconstruction, including contralateral C-7 transfer for hand function, multiple intercostal nerves for shoulder/triceps function, shoulder fusion, and spinal accessory nerve–to–musculocutaneous nerve transfer for elbow flexion. The video demonstrates distal contraction from electrical stimulation of the avulsed roots. Single neurorrhaphy of the contralateral C-7 transfer was performed along with a retrosternocleidomastoid approach.

The video can be found here: https://youtu.be/GMPfno8sK0U.
Minimally invasive approach to resection of paraspinal schwannoma
Authors: Paullus Patrick , Wilson Taylor A. , Lee Paul , Gunasekaran Arunprasad , Kazemi Noojan
Published: January 2018

In this video, the authors demonstrate a minimally invasive approach and resection of a paraspinal schwannoma. Using an expandable retractor, the authors were able to identify important adjacent bony landmarks and hence visualize and remove this peripheral nerve sheath tumor. While a tubular retractor is commonly used for interbody fusion procedures, the location of the tumor allowed this minimally invasive approach resulting in excellent access, minimal soft-tissue injury, and a short hospital stay. The authors present this approach as a less invasive and yet effective technique for resection of otherwise difficult-to-access nerve lesions.

The video can be found here: https://youtu.be/89OY5wdMB_k.
Peroneal nerve decompression
Authors: Corriveau Mark , Lescher Jacob D. , Hanna Amgad S.
Published: January 2018

Peroneal neuropathy is a common pathology encountered by neurosurgeons. Symptoms include pain, numbness, and foot drop. When secondary to compression of the nerve at the fibular head, peroneal (fibular) nerve release is a low-risk procedure that can provide excellent results with pain relief and return of function. In this video, the authors highlight key operative techniques to ensure adequate decompression of the nerve while protecting the 3 major branches, including the superficial peroneal nerve, deep peroneal nerve, and recurrent genicular (articular) branches. Key steps include positioning, circumferential nerve dissection, fascial opening, isolation of the major branches, and closure.

The video can be found here: https://youtu.be/0y9oE8w1FIU.
Targeted fascicular biopsy in a patient with prostate cancer
Authors: Stone Jonathan J. , Kaszuba Megan C. , Spinner Robert J.
Published: January 2018

Patients who present with a history of cancer and the new onset of lumbosacral or peripheral neuropathy should be evaluated for the potential of metastasis. Targeted fascicular biopsy can be useful to diagnose atypical lesions within peripheral nerves in patients with major or progressive neurological deficits. In this video, the authors demonstrate the technique of targeted fascicular biopsy of the sciatic nerve in a 63-year-old man with a history of prostate cancer.

The video can be found here: https://youtu.be/PTOX9XxNBDU.
Introduction: the value of peripheral nerve surgery
Authors: Spinner Robert J. , Gilmer Holly S. , Trost Gregory R.
Published: January 2018

If a single picture is worth a thousand words, then a video, by logical extension, would be priceless. This edition showcases peripheral nerve surgery in all its grandeur and preserves it for posterity. Classic and novel surgical techniques are shown related to tumor biopsy or resection; nerve decompression for entrapment; and nerve reconstruction with direct repair or nerve transfer. Akin to a nautical chart filled with detailed maps for sailors, this Neurosurgical Focus Video Atlas provides navigational tools for neurosurgeons. The shared underlying message is that a sound knowledge of anatomy can lead to innovation (i.e., creative approaches or solutions) and excellence (i.e., improved patient outcomes).
Quantitative Estimation of Cr and Pd in Heteropneustes Fossilis Fish due to Absorption from Tannery Waste Water
Authors: Bhowmick A. C. , Bhowmick R. R. , Moim M. I.
Published: January 2018

The objective of this research is to reveal the pollution level and its impact on fresh water fish and finally, to estimate the concentration (ppm) of toxic metals chromium (Cr) (53.9 ppm) and lead (Pb) (13.2 ppm) in raw waste water (100%) and in fish (heteropneustes fossilis) (Cr 3.4 ppm, and Pb 2.0 ppm) by Atomic Absorption Spectrometry (AAS). Fresh tannery effluent is collected from Hazaribag-Dhaka and as early as possible some physico-chemical parameters of that effluent such as Electrical Conductivity (EC) (535 ms/cm) and pH (6.1), Total Dissolved Solids (TDS) (30336 ppm), Dissolved Oxygen (DO) (2.0 ppm), Chemical Oxygen Demand (COD) (9480 ppm) are determined. Pisi-culture is done by constructing some pilot base fresh water systems in the laboratory and it has been found that in raw waste water (100%), the fish survival rate is only a few hours (5h), where in rest of others such as 75%, 50%, 25% and 5% waste water systems, the survival rate of fishes is longer than a week after increasing the amount of DO artificially. So, if fishes are eaten from nearby fresh water bodies of Hazaribag-Dhaka, ultimately it may harm the normal physiology of human.
Some Features of Intuitionistic L- R1 Spaces
Authors: Islam R. , Hossain M. S.
Published: January 2018

In this paper, we have introduced four notions of R1 space in intuitionistic L-topological spaces and established some implications among them. We have also proved that all of these definitions satisfy “good extension” and “hereditary” property. Finally, it has been shown that all concepts are preserved under one-one, onto and continuous mapping.
Effect of Sodium Starch Glycolate on Formulation of Fexofenadine Hydrochloride Immediate Release Tablets by Direct Compression Method
Authors: Karim S. , Biswas A. , Bosu A. , Laboni F. R. , Julie A. S. , Rashid M. H. O.
Published: January 2018

Present study aspires at the design of an immediate release formulation with prospective use of fexofenadine hydrochloride by exploring the effect of sodium starch glycolate as super disintegrant. Fexofenadine hydrochloride immediate release tablets (Formulations F-1, F-2, F-3, F-4 and F-5) using different ratios of sodium starch glycolate as a disintegrant were prepared by direct compression method. Standard physicochemical tests were performed for all the formulations. Dissolution studies of the formulations were done in phosphate buffer, pH 6.8 using USP apparatus II (paddle apparatus) at 50 rpm. Percent release of fexofenadine hydrochloride of formulations F-1, F-2, F-3, F-4 and F-5 were 89.98%, 90.98%, 92.95, 96.92% and 99.85%, respectively after 1 h and the release pattern followed the zero order kinetics. The release rate in the formulation F-5 was higher compared to other formulations and the studied market products. Sodium starch glycolate speed up the release of the drug from the core tablets, and the release of fexofenadine hydrochloride from tablets was directly proportional to the amount of sodium starch glycolate present in the formulations and there by produced immediate action.
Environmentally Benign Synthesis of Tetra-Substituted Imidazoles through 4-Components Strategy Mediated by (S)-3-Methyl-1, 1-Diphenylbutane-1, 2-Diamine
Authors: Rana M. , Rahman A. , Roy P. K. , Roy H. N.
Published: January 2018

(S)-3-Methyl-1, 1-diphenylbutane-1, 2-diamine has been found to be a mild and effective organocatalyst for one-pot 4-components synthesis of 1, 2, 4, 5-tetra-substituted imidazoles. The key benefits of this protocol is high yielding, cost effectiveness, easy purification and above all, environmentally benign.
Desalination Technologies for Developing Countries: A Review
Authors: Islam M. S. , Sultana A. , Saadat A. H. M. , Islam M. S. , Shammi M. , Uddin M. K.
Published: January 2018

Fresh water is rapidly being exhausted due to natural and anthropogenic activities. The more and more interest is being paid to desalination of seawater and brackish water in order to provide fresh water. The suitability of these desalination technologies is based on several criteria including the level of feed water quality, source of energy, removal efficiency, energy requirement etc. In this paper, we presented a review of different desalination methods, a comparative study between different desalination methods, with emphasis on technologies and economics. The real problem in these technologies is the optimum economic design and evaluation of the combined plants in order to be economically viable for the developing countries. Distillation plants normally have higher energy requirements and unit capital cost than membrane plants and produces huge waste heat. Corrosion, scaling and fouling problems are more serious in thermal processes compare to the membrane processes. On the other hand, membrane processes required pretreatment of the feed water in order to remove particulates so that the membranes last longer. With the continuing advancement to reduce the total energy consumption and lower the cost of water production, membrane processes are becoming the technology of choice for desalination in developing countries.
Effect of Salmonella on Decomposition of Poultry Litter
Authors: Mushtaq M. , Kasur H. , Khan R. A. , Khalid A. , Iqbal M. K.
Published: January 2018

Chicken litter is a significant source of nutrients for production of crops and to reduce the impact of human pathogens on environment. The physicochemical properties of poultry litter mixture compost was assessed against the maturity and stability indices such as carbon nitrogen ratio (C/N), nitrate (NO3), ammonia (NH3), ash, Cation Exchange Capacity (CEC), Humification Index (HI), Humification Rate (HR) and Degree of Polymerization (DP). The use of Salmonella significantly improves the humification process and physicochemical properties of final compost product are better in comparison to control trial. The most prominent effects was the fast rise in temperature from mesophilic to thermophilic stage was accompanied by an increase in NH4+-N that gradually decrease near the maturation phase. Moreover, the decrease in carbon and nitrogen ratio and increase in DP, CEC, HI, HR, phosphorous and potassium was also observed. A significant correlation was found between the maturity and stability parameters like C: N ratio, cation exchange capacity, humification index, degree of polymerization, humification rate and nitrate. Therefore, it is acclaimed that isolated microorganisms Salmonella from poultry litter promote the stable compost formation.
Protein Profiling of Thiobacillus ferrooxidans and Pseudomonas fluorescens Mutants during Metal Extraction
Authors: Shaikh S. M. , Shaikh R. U. , Ade A. B.
Published: January 2018

Proteins are specific for the specific task associated with the cell. The metal extracting bacteria, Thiobacillus ferrooxidans and Pseudomonas fluorescens have two different mechanisms for the metal extraction. One extracts the metals by donating electrons and by doing self-oxidation and another is accumulating the metals onto its cell surface which is negatively charged. Therefore to differentiate the task of metal extraction protein profiling was done and compared. The water soluble proteins were analyzed through SDS-PAGE. There was no significant difference in the profiles of both.
Analysis of Natural Convection Flow in a Trapezoidal Cavity Containing a Rectangular Heated Body in Presence of External Oriented Magnetic Field
Authors: Akter A. , Parvin S.
Published: January 2018

The laminar natural convection flow and heat transfer inside a trapezoidal cavity filled with air and containing a rectangular block is investigated numerically. The left and right walls of the cavity are cold, the top and bottom walls are adiabatic and the rectangular body is heated uniformly. Finite Element Method of Galerkin’s weighted residual scheme is used to solve the transport equations with appropriate boundary conditions. The main objective of this study is to explore the influence of pertinent parameters such as Rayleigh number, Hartmann number and orientation of the magnetic field on the flow and heat transfer performance of the fluid while the Prandtl number is considered fixed. Results indicate that the heat transfer rate is significantly affected by increasing the mentioned parameters.
Antibacterial and Antifungal Evaluation of Chloroflavones
Authors: Rahim M. A. , Bhuiyan M. M. H. , Matin M. M. , Alam M. R.
Published: January 2018

Two chloroflavones, 6 and 7 along with their corresponding chalcones, 4 and 5 have been tested for antibacterial and antifungal activities against six human pathogenic bacteria viz. Bacillus cereus (G+), Staphylococcus aureus (G+), Escherichia coli (G-), Vibrio choloriae (G-), Pseudomonas aeruginosa (G-), and Salmonella typhi (G-), and four plant as well as mold fungi viz. Aspergillus flavus, Aspergillus ochraceus, Aspergillus niger and Rhizopus spp.. The antibacterial and antifungal screens of the synthesized compounds were performed in vitro by the filter paper disc diffusion method and the poisoned food technique, respectively. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of these synthesized compounds in comparison to ampicillin were also determined by broth micro-dilution method. Some of them were found to possess significant activity, when compared to standard drugs.
Transition from silicene monolayer to thin Si films on Ag(111): comparison between experimental data and Monte Carlo simulation
Authors: Curcella Alberto , Bernard Romain , Borensztein Yves , Pandolfi Silvia , Prévot Geoffroy
Published: January 2018

Scanning tunneling microscopy (STM), Auger electron spectroscopy (AES) and low energy electron diffraction have been used to follow the growth of Si films on Ag(111) at various temperatures. Using a simple growth model, we have simulated the distribution of film thickness as a function of coverage during evaporation, for the different temperatures. In the temperature regime where multilayer silicene has been claimed to form (470–500 K), a good agreement is found with AES intensity variations and STM measurements within a Ag surfactant mediated growth, whereas a model with multilayer silicene growth fails to reproduce the AES measurements.
Effectiveness in the performance of organ transplants in the State of Paraná, Brazil
Authors: De Oliveira Iria Barbara , De Souza Carla Moretti , Galdino Maria José Quina , Pissinati Paloma S. Cavalcante , Silva Larissa Gutierrez de Carvalho , Vannuchi Marli Terezinha Oliveira , Haddad Maria do Carmo Fernandez Lourenço
Published: January 2018

Objective: To analyze the effectiveness of organ transplants in the state of Paraná, Brazil.

Methods: A cross-sectional quantitative study was conducted with data from 2,036 solid organ transplants performed in the state between 2011 and 2015. Three indicators were calculated, per capita transplants, meeting the demands of the population and the demand for transplants, which demonstrated the effectiveness and the disparities in the process. The association between the variables was verified by Pearson's Chi-Square test and Fisher's exact test.

Results: Most transplants were performed in philanthropic hospitals, male, funded by public funding, and there was an annual increase in the number of transplants per capita and in the productivity of kidney, liver and heart transplantation teams. Although renal transplantation is the most performed in absolute numbers, it served a maximum of 2.2% of its demand.

Conclusion: It is necessary to devise strategies to meet the demand for organ transplants, above all, to consolidate the process of donating organs in the state under study.
Measurement of Physiological Monitor Alarm Accuracy and Clinical Relevance in Intensive Care Units
Authors: Ruppel Halley , Funk Marjorie , Whittemore Robin
Published: January 2018

Background

Alarm fatigue threatens patient safety by delaying or reducing clinician response to alarms, which can lead to missed critical events. Interventions to reduce alarms without jeopardizing patient safety target either inaccurate or clinically irrelevant alarms, so assessment of alarm accuracy and clinical relevance may enhance the rigor of alarm intervention studies done in clinical units.

Objectives

To (1) examine approaches used to measure accuracy and/or clinical relevance of physiological monitor alarms in intensive care units and (2) compare the proportions of inaccurate and clinically irrelevant alarms.

Methods

An integrative review was used to systematically search the literature and synthesize resulting articles.

Results

Twelve studies explicitly measuring alarm accuracy and/or clinical relevance on a clinical unit were identified. In the most rigorous studies, alarms were annotated retrospectively by obtaining alarm data and parameter waveforms rather than being annotated in real time. More than half of arrhythmia alarms in recent studies were inaccurate. However, contextual data were needed to determine alarms’ clinical relevance. Proportions of clinically irrelevant alarms were high, but definitions of clinically irrelevant alarms often included inaccurate alarms.

Conclusions

Future studies testing interventions on clinical units should include alarm accuracy and/or clinical relevance as outcome measures. Arrhythmia alarm accuracy should improve with advances in technology. Clinical interventions should focus on reducing clinically irrelevant alarms, with careful consideration of how clinical relevance is defined and measured.
Rectal and Bladder Temperatures vs Forehead Core Temperatures Measured With SpotOn Monitoring System
Authors: Schell-Chaple Hildy M. , Liu Kathleen D. , Matthay Michael A. , Puntillo Kathleen A.
Published: January 2018

Background

Methods and frequency of temperature monitoring in intensive care unit patients vary widely. The recently available SpotOn system uses zero-heat-flux technology and offers a noninvasive method for continuous monitoring of core temperature of critical care patients at risk for alterations in body temperature.

Objective

To evaluate agreement between and precision of a zero-heat-flux thermometry system (SpotOn) and continuous rectal and urinary bladder thermometry during fever and defervescence in adult patients in intensive care units.

Methods

Prospective comparison of SpotOn vs rectal and urinary bladder thermometry in eligible patients enrolled in a randomized clinical trial on the effect of acetaminophen on core body temperature and hemodynamic status.

Results

A total of 748 paired temperature measurements from 38 patients who had both SpotOn monitoring and either continuous rectal or continuous bladder thermometry were analyzed. Temperatures during the study were from 36.6°C to 39.9°C. The mean difference for SpotOn compared with bladder thermometry was −0.07°C (SD, 0.24°C; 95% limits of agreement, ± 0.47°C [−0.54°C, 0.40°C]). The mean difference for SpotOn compared with rectal thermometry was −0.24°C (SD, 0.29°C; 95% limits of agreement, ± 0.57°C [−0.81°C, 0.33°C]). Most differences in temperature between methods were within ± 0.5°C in both groups (96% bladder and 85% rectal).

Conclusions

The SpotOn thermometry system has excellent agreement and good precision and is a potential alternative for noninvasive continuous monitoring of core temperature in critical care patients, especially when alternative methods are contraindicated or not available.
Predictors of Moral Distress in a US Sample of Critical Care Nurses
Authors: Hiler Catherine A. , Hickman Ronald L. , Reimer Andrew P. , Wilson Kimberly
Published: January 2018

Background

Moral distress in registered nurses causes decreased job satisfaction, turnover in staffing, burnout, and heightened states of psychological distress. To date, investigation of modifiable factors, such as perceptions of the practice environment and patient safety, among a diverse sample of critical care nurses has been limited.

Objective

To explore the relationships among the severity of moral distress, the practice environment, and patient safety in a national sample of critical care nurses.

Methods

Critical care nurses experienced in working with adults (> 1 year of intensive care unit experience) and who were subscribers to the American Association of Critical-Care Nurses’ e-mail listserv and social media sites anonymously participated in this descriptive study. Participants completed a demographic questionnaire, the Moral Distress Scale–Revised, and the Practice Environment Scale of the Nursing Work Index. Descriptive statistics, bivariate correlation coefficients, and a hierarchical regression analysis were used to describe the sample characteristics and to assess relationships among the study variables.

Results

Of a national sample of 328 critical care nurses, 56% had less than 20 years of experience as a registered nurse. Moral distress was modestly associated with negative perceptions of the practice environment and patient safety. Job satisfaction, practice environment, and the participant’s age were statistically significant predictors of moral distress in this sample.

Conclusions

Modifications of organizational factors such as the development of healthy work environments that promote collegial relationships could reduce moral distress among critical care nurses.
Incidence of Sinusitis Associated With Endotracheal and Nasogastric Tubes: NIS Database
Authors: Metheny Norma A. , Hinyard Leslie J. , Mohammed Kahee A.
Published: January 2018

Background

Endotracheal and nasogastric tubes are recognized risk factors for nosocomial sinusitis. The extent to which these tubes affect the overall incidence of nosocomial sinusitis in acute care hospitals is unknown.

Objective

To use data for 2008 through 2013 from the Nationwide Inpatient Sample database to compare the incidence of sinusitis in patients with nasogastric tubes with that in patients with an endotracheal tube alone or with both an endotracheal tube and a nasogastric tube.

Methods

Patients’ data with any of the following International Classification of Disease, Ninth Revision, Clinical Modification codes were abstracted from the database: (1) 96.6, enteral infusion of concentrated nutritional substances; (2) 96.07, insertion of other (naso-)gastric tube; or (3) 96.04, insertion of an endotracheal tube. Sinusitis was defined by the appropriate codes. Weighted and unweighted frequencies and weighted percentages were calculated, categorical comparisons were made by χ2 test, and logistic regression was used to examine odds of sinusitis development by tube type.

Results

Of 1 141 632 included cases, most (68.57%) had an endotracheal tube only, 23.02% had a nasogastric tube only, and 8.41% had both types of tubes. Sinusitis was present in 0.15% of the sample. Compared with patients with only a nasogastric tube, the risk for sinusitis was 41% greater in patients with an endotracheal tube and 200% greater in patients with both tubes.

Conclusion

Despite the low incidence of sinusitis, a significant association exists between sinusitis and the presence of an endotracheal tube, especially when a nasogastric tube is also present.
Insecticidal and synergistic activity of two monoterpenes against diamondback moth (Lepidoptera: Plutellidae)
Authors: Webster A.E. , Manning P. , Sproule J.M. , Faraone N. , Cutler G.C.
Published: January 2018

We examined the insecticidal activity of linalool and thymol, against diamondback moth,Plutella xylostella(Linnaeus) (Lepidoptera: Plutellidae), and whether they would synergise the activity of spinosad against this pest. Both linalool and thymol were toxic to diamondback moth larvae by topical and oral exposure, but orders of magnitude less so than spinosad. We found that low concentrations of linalool weakly synergised spinosad, increasing its toxicity more than twofold. An interaction between spinosad, and acetone meant it was not possible to identify any potential synergisms between thymol and spinosad. Our results demonstrate limited potential for thymol and linalool to act as biopesticides or synergists for managing diamondback moth.
177Lu-DOTATATE peptide receptor radionuclide therapy in patients with borderline low and discordant renal parameters: Treatment feasibility assessment by sequential estimation of triple parameters and filtration fraction
Authors: Naik Chinna , Basu Sandip
Published: January 2018

The aim was to assess the effect of standard fixed-dose protocol of 177Lu-DOTATATE peptide receptor radionuclide therapy (PRRT) in patients with borderline low renal function of one parameter (glomerular filtration rate [GFR], effective renal plasma flow [ERPF] or serum creatinine), that was discordant with the remaining parameters and determine the feasibility of this procedure in this group of patients. Renal toxicity of PRRT is a routine issue or concern for such cases. We compared different renal parameters used for pretherapy assessment in patients with borderline low single parameter at baseline and their potential significance with regards to deterioration of renal function subsequently. A retrospective analysis was performed in patients of metastatic neuroendocrine tumors who received therapeutic 177Lu-DOTATATE (using standard fixed-dose protocol) and had borderline compromised renal parameter values (either of GFR/ERPF/serum creatinine). Filtration fraction (FF) was also estimated in each case and all renal parameters were correlated using kappa statistics. The characteristics of cases showing progressive worsening of renal function in the follow-ups were also studied. A total of 15 patients (11 males, 4 females; age range: 32–75 years) were selected among a population of 450 patients. The follow-up duration ranged from 10 to 48 months and administered cumulative activity ranged 9.9–31.3 GBq (2–5 cycles). Based on the parameter characteristics, the study population was divided into following four groups: (a) patients with reduced GFR and maintained ERPF and normal serum creatinine (n = 3); (b) patients with reduced ERPF with maintained GFR and borderline elevated/normal serum creatinine (n = 3); (c) patients with both reduced GFR and ERPF and maintained serum creatinine (n = 1); (d) patients with compromised single kidney function (n = 5). A total of four patients were found who had normal baseline renal function values but showed progressive worsening in the subsequent period. There was no significant change in renal parameters during the follow-up in both Groups a and c. Two patients of Group b demonstrated well-maintained other renal parameters, whereas in 1 patient, there was the evidence of renal toxicity with gradual fall of GFR and ERPF and progressive increase in serum creatinine level. In patients with compromised single kidney function at baseline (Group d), there was overall maintained normal renal parameters, whereas 3 of 5 (60%) showed the increase of FF of the affected kidney. Interestingly, a compensatory hyperfunction was noted in the contralateral kidney. PRRT with 177Lu-DOTATATE is feasible and can be considered in patients with reduced GFR and with maintained ERPF and normal serum creatinine and also in the presence of single compromised parameter if the other two are normal; however, these patients need critical monitoring.
-adic -functions for
Authors: Barrera Salazar Daniel , Williams Chris
Published: January 2018

Since Rob Pollack and Glenn Stevens used overconvergent modular symbols to construct$p$-adic$L$-functions for non-critical slope rational modular forms, the theory has been extended to construct$p$-adic$L$-functions for non-critical slope automorphic forms over totally real and imaginary quadratic fields by the first and second authors, respectively. In this paper, we give an analogous construction over a general number field. In particular, we start by proving a control theorem stating that the specialisation map from overconvergent to classical modular symbols is an isomorphism on the small slope subspace. We then show that if one takes the modular symbol attached to a small slope cuspidal eigenform, then one can construct a ray class distribution from the corresponding overconvergent symbol, which moreover interpolates critical values of the$L$-function of the eigenform. We prove that this distribution is independent of the choices made in its construction. We define the$p$-adic$L$-function of the eigenform to be this distribution.
Tolerance of jenipapo seeds to cryoprotectants and thawing after immersion in liquid nitrogen
Authors: Sobrinho Severino De Paiva , Albuquerque Maria Cristina De Figueiredo e , Luz Petterson Baptista da , Neves Leonarda Grillo , Camili Elisangela Clarete
Published: January 2018

The objective of this study was to evaluate the effects of two cryoprotectants followed by thawing on the physiological potential of Genipa americana L. seeds. Two experiments testing 12 treatments were conducted, one for each cryoprotectant, both in a factorial scheme of 6 × 2 (cryoprotectant concentrations × thawing methods). We tested 0, 5, 10, 15, 20, and 25% for dimethyl sulfoxide, and 0, 0.25, 0.5, 0.75, 1.0, and 1.25 M for sucrose. The thawing methods were fast (38 °C for 30 min) and slow (25 °C for 4 h). The seeds were immersed in the cryoprotectant solution for 3 h, stored for 120 h, and then thawed. The seeds were then sown in substrate (sand and vermiculite, 1:1). Emergence percentage along with speed index, length, fresh and dry matter mass of seedlings were evaluated. Dimethyl sulfoxide and sucrose can be used as cryoprotectants in G. americana seeds. Thawing should be slow when treating seeds with dimethyl sulfoxide.
Efeito da antraquinona na curva de cozimento kraft para madeira do híbrido Eucalyptus grandis x Eucalyptus urophylla
Authors: Vivian Magnos Alan , Da Silva Júnior Francides Gomes
Published: January 2018

O presente estudo teve por objetivo avaliar os efeitos da adição da antraquinona em uma curva de cozimento, com diferentes cargas de reagentes, por meio do processo kraft de polpação, para a madeira de híbrido de Eucalyptus grandis x Eucalyptus urophylla, visando inferir sobre os parâmetros do processo. A madeira foi transformada em cavacos e classificada para condução das curvas de cozimento kraft. As cargas aplicadas foram de 10% a 24% de álcali ativo e 25% de sulfidez, com uma carga de antraquinona de 0,05% (sobre a massa seca de madeira). Avaliou-se o rendimento bruto e depurado, o teor de rejeitos, o número kappa (nível de deslignificação) e o álcali ativo residual. Observou-se que a adição da antraquinona não afetou o rendimento bruto do processo, porém aumentou o rendimento depurado através da redução do teor de rejeitos, em especial para as baixas cargas de álcali ativo (10% e 12%). Outro efeito observado foi a redução do número kappa com a adição da antraquinona, o que indica o aumento da taxa de deslignificação da madeira. Esse aumento é reforçado pelo menor álcali ativo residual, o que se subentende maior aproveitamento dos reagentes no processo.
Avaliação dos focos de calor e da fórmula de Monte Alegre no parque Nacional da Chapada dos Guimarães
Authors: Machado Neto Arlindo De Paula , Batista Antonio Carlos , Soares Ronaldo Viana , Biondi Daniela , De Morais Riubi Lopes
Published: January 2018

O presente estudo teve por objetivo analisar o comportamento da Fórmula de Monte Alegre (FMA) e quantificar os focos de calor detectados por satélites de referência, comparando os mesmos com os incêndios ocorridos no Parque Nacional da Chapada dos Guimarães de 2007 a 2015. O monitoramento dos focos de calor foi realizado através de imagens dos satélites AQUA, TERRA e NOAA, cujos dados diários de focos detectados foram usados para compor a série temporal ao longo dos anos, permitindo a análise de tendências dos números de focos para o parque. Os dados foram adquiridos na plataforma do Instituto Nacional de Pesquisas Espaciais, na base de dados históricos do Instituto Nacional de Meteorologia e junto à gerência do parque. Na maioria dos anos houve uma superestimação do número de focos de calor em relação ao número de ocorrência dos incêndios. O satélite TERRA apresentou valores que mais se aproximaram do número de registros de fogo no parque. Observou-se que 87,69% dos incêndios foram validados em relação a FMA, onde 60% estavam na classe de perigo muito alto e 27,69% enquadraram-se na classe de perigo alto, demonstrando a efetividade da FMA em relação aos registros de incêndios ocorridos no parque.
Estratégia de implantação de aplicativo para prescrição de enfermagem
Authors: Alencar Isabele Gouveia Muniz de , Nunes Vanicleide Sá , Alves Audimar Souza , Cruz Renato Di Paula Gomes
Published: January 2018

RESUMOObjetivo: relatar a experiência do COIISAE na implantação do módulo “Prescrição de Enfermagem”, cujas potencialidades qualificam a práxis de Enfermagem nos serviços geridos pela empresa. Método: estudo descritivo, tipo relato de experiência, realizado em um hospital universitário. Resultados: a implantação ocorreu por meio das seguintes fases: 1) Diagnóstico estratégico (visão dos cenários presentes e futuros); 2) Plano estratégico (objetivos estratégicos); 3) Iniciativa estratégica (desdobramentos de objetivos estratégicos); 4) Priorização das iniciativas 2015/2016; 5) Execução e acompanhamento. Conclusão: a acessibilidade da ferramenta demonstrou-se favorável para realizar as prescrições de Enfermagem, entretanto, cumpre ressaltar a responsabilidade do enfermeiro ao manter atualizada a prescrição. Descritores: Estratégias; Planejamento de Instituições de Saúde; Informática em Enfermagem; Processos de Enfermagem; Cuidados de Enfermagem; Tecnologia da Informação.ABSTRACTObjective: to report the experience of COIISAE in the implementation of the module "Prescription of Nursing", whose potential qualifies Nursing praxis in the services managed by the company. Method: descriptive study, type of experience report, carried out in a university hospital. Results: the implementation took place through the following phases: 1) Strategic diagnosis (vision of present and future scenarios); 2) Strategic plan (strategic objectives); 3) Strategic initiative (unfolding of strategic objectives); 4) Prioritization of 2015-2016 initiatives; 5) Implementation and monitoring. Conclusion: the accessibility of the tool was favorable to perform the Nursing prescriptions, however, it should be emphasized the responsibility of the nurse in keeping the prescription updated. Descriptors: Strategies; Health Facility Planning; Nursing Informatics; Nursing Processes; Nursing Care; Information Technology.RESUMEN Objetivo: relatar la experiencia del COIISAE en la implantación del módulo "Prescripción de Enfermería", cuyas potencialidades califica la praxis de Enfermería en los servicios gestionados por la empresa. Método: estudio descriptivo, tipo relato de experiencia, realizado en un hospital universitario. Resultados: la implantación ocurrió por medio de las siguientes fases: 1) Diagnóstico estratégico (visión de los escenarios presentes y futuros); 2) Plan estratégico (objetivos estratégicos); 3) Iniciativa estratégica (desdoblamientos de objetivos estratégicos); 4) Priorización de las iniciativas 2015/2016; 5) Ejecución y acompañamiento. Conclusión: la accesibilidad de la herramienta se demostró favorable para realizar las prescripciones de Enfermería, sin embargo, debe resaltar la responsabilidad del enfermero al mantener actualizada la prescripción. Descriptores: Estrategias; Planificación de Instituciones de Salud; Informática Aplicada a la Enfermería; Proceso de enfermería; Atención de Enfermería; Tecnología de la información.