bluuebunny/crossref_metadata_2025 huggingface dataset:
Type A aortic dissection presenting as superior vena cava syndrome
Authors: Raja Faisal S. , Islam Ali , Khan Mustafa , Abbasi Iram
Published: July 2016

A 51-year-old man presented with a 5-day history of progressive facial swelling, sensation of head fullness, increasing shortness of breath and paroxysmal nocturnal dyspnea. He denied chest pain, syncope or presyncope. Pastmedical history included mechanical aortic valve replacement 7 years prior and atrial fibrillation treated with warfarin. A clinical diagnosis of acute superior vena cava (SVC) syndrome was made. Portable chest radiograph showed a widened superior mediastinum. Computed tomography scan of the thorax demonstrated a large type A aortic dissection almost completely effacing the SVC. Acute type A aortic dissection (AD) is an emergency requiring prompt diagnosis and treatment. Patients typically present with acute onset of chest and/or back pain, classically described as “ripping” or “tearing.” SVC syndrome is rarely, if ever, mentioned as a presentation, as it is usually due to more chronic conditions. This case illustrates a rare incidence of type A AD actually presenting as SVC syndrome.
Frequent users of an inner-city emergency department
Authors: Geurts Jill , Palatnick Wes , Strome Trevor , Weldon Erin
Published: July 2016

Background:

Within the emergency department (ED) patient population there is a subset of patients who make frequent visits. This chart review sought to characterize this population and identify strategies to reduce frequent ED visits.

Methods:

Frequent use at an urban tertiary care centre was defined as 15 or more visits over 1 year. The details of each visit—demographics, entrance complaint, discharge diagnosis, arrival method, Canadian Triage and Acuity Scale (CTAS) score, and length of stay—were analyzed and compared to data from the entire ED population for the same period.

Results:

Ninety-two patients generated 2,390 ED visits (of 25,523 patients and 44,204 visits). This population was predominantly male (66%) and middle-aged (median 42 years), with no fixed address (27.2%). Patients arrived by ambulance in 59.3% of visits with less acute CTAS scores than the general population. Substance use accounted for 26.9% of entrance complaints. Increased lengths of stay were associated with female gender and abnormal vital signs, whereas shorter stays were associated with no fixed address and substance use (p< 0.05). Admissions were lower than the general population, and women were twice as likely as men to be admitted (p< 0.05). Patients left without being seen in 15.8% of visits.

Conclusions:

High-frequency ED users are more likely to be male, younger, and marginally housed and to present secondary to substance use. Although admissions among this population are low, the costs associated with these presentations are high. Interventions designed to decrease visits and improve the health of this population appear warranted.
Do injection drug users have more adverse events during procedural sedation and analgesia for incision and drainage of cutaneous abscesses?
Authors: Scheuermeyer Frank Xavier , Andolfatto Gary , Lange Lisa , Jong Danielle de , Qian Hong , Grafstein Eric
Published: July 2016

Objective:

Injection drug users (IDUs) often undergo procedural sedation and analgesia (PSA) in the emergency department (ED). We compared adverse events (AEs) for IDUs to those for non-IDUs receiving PSA for incision and drainage of cutaneous abscesses.

Methods:

This was a retrospective analysis of a PSA safety audit. IDU status was prospectively documented among consecutive patients undergoing PSA at two urban EDs. Structured data describing comorbidities, vital signs, sedation regimens, and adverse events were collected. Primary outcome was the proportion of patients in each group experiencing an AE, whereas the secondary outcomes included recovery times.

Results:

Of 525 consecutive patients receiving PSA for incision and drainage of an abscess, 244 were deemed IDUs and 281 non-IDUs. IDUs received higher doses of sedatives and analgesics, and 14 experienced AEs (5.7%), whereas 10 non-IDUs had AEs (3.6%), for a risk difference of 2.1% (95% CI -1.8, 6.5). Median recovery times were 18 minutes (interquartile range [IQR] 10-36) for IDUs and 12 minutes (IQR 7-19) for non-IDUs, for a difference of 6 minutes (95% CI 2-9 minutes). Median sedation times were also longer in IDUs, for a difference of 6 minutes (95% CI 5-10 minutes). Of 20 IDU patients and 1 non-IDU patient admitted to hospital, none had experienced an AE related to PSA.

Conclusions:

For ED patients requiring PSA for incision and drainage, IDUs had an AE rate similar to that of non-IDUs but longer sedation and recovery times. In experienced hands, PSA may be as safe in IDUs as in patients who do not use injection drugs.
Delayed pericardial effusion and cardiac tamponade following penetrating chest trauma
Authors: Donahoe Laura , Ouzounian Maral , MacDonald Scott , Field Simon
Published: July 2016

We present the case of a 20-year-old man who was stabbed in the left chest and was diagnosed with a large pericardial effusion by focused emergency department (ED) ultrasonography. After placement of a left chest tube for presumed tension pneumothorax, the pericardial effusion had resolved. The patient's postinjury course was complicated by pericarditis and recurrent tamponade, which required repeated pericardiocentesis for management. This case illustrates the role of focused ED ultrasonography for diagnosis of pericardial effusion in penetrating trauma and the potential for delayed pericardial effusion and tamponade in such patients. Although the pathophysiology of delayed pericardial effusion is unclear, autoimmune postpericardiotomy syndrome has been proposed as the cause of this rare condition. Our case underscores the importance of close monitoring of patients with known or suspected pericardial injuries due to their potential for the development of lifethreatening complications.
The Simulation Olympics: a resuscitation-based simulation competition as an educational intervention
Authors: Dagnone J. Damon , Takhar Amandeep , Lacroix Lauren
Published: July 2016

The Department of Emergency Medicine at Queen's University developed, implemented, and evaluated an interprofessional simulation-based competition called the Simulation Olympics with the purpose of encouraging health care providers to practice resuscitation skills and foster strong team-based attitudes. Eleven teams (N= 45) participated in the competition. Teams completed three standardized resuscitation scenarios in a high-fidelity simulation laboratory with teams composed of nurses, respiratory therapists, and undergraduate and postgraduate medical trainees. Trained standardized actors and a dedicated technician were used for all scenarios. Judges evaluated team performance using standardized assessment tools. All participants (100%) completed an anonymous two-page questionnaire prior to the competition assessing baseline characteristics and evaluating participant attitudes, motivation, and barriers to participation. The majority of participants (71%) completed an evaluation form following the event focusing on highlights, barriers to participation, and desired future directions. Evaluations were uniformly positive in short-answer feedback and attitudinal scoring measures. To our knowledge, the Simulation Olympics competition is the first of its kind in Canada to be offered at an academic teaching hospital.
Colchicine overdose with coingestion of nonsteroidal antiinflammatory drugs
Authors: Little Anjuli , Tung David , Truong Christine , Lapinsky Stephen , Burry Lisa
Published: July 2016

Colchicine has a low therapeutic index. Its toxic effects generally occur at doses ≥ 0.5 mg/kg. We present the case of a 39-year-old female with toxicity following ingestion of 0.28 mg/kg. The patient presented to the emergency department (ED) with severe nausea, vomiting, and abdominal pain following an intentional multidrug ingestion that included colchicine, indomethacin, and zopiclone. Despite toxicologic management and supportive care, admission to the intensive care unit was required for clinical deterioration and symptom management. Shock and multiorgan failure resulted, with death occurring 52 hours postingestion. Although the toxic effects of colchicine are well documented, mortality caused by low doses is relatively uncommon. Management of toxicity consists of early diagnosis, decontamination, and supportive measures. Toxicity may be enhanced by drug interactions inhibiting metabolic enzymes or poor excretion due to renal failure. In this case, the ingestion of a nonsteroidal antiinflammatory drug and the associated volume depletion from the gastrointestinal effects of colchicine may have contributed to renal dysfunction, exacerbating the toxicity of colchicine. This ingestion of a relatively small dose of colchicine led to severe toxicity. Treatment options for colchicine toxicity are limited.
Management of hot tar burn using vitamin E ointment containing petroleum and polyoxyethylene sorbitan
Authors: Ng Karen , Dalen Dawn , Rhine David
Published: July 2016

Tar burns are primarily an occupational hazard associated with the road paving or roofing industry. Management of tar burns requires safe and effective removal of solidified tar from the skin using a dissolution or emulsifying agent to prevent inflicting further injury and pain. We report a case of a patient with tar burns on 10% of his body surface area involving the lower arms bilaterally and splashes to the facial area. The tar was efficiently removed with Webber Vitamin E Ointment without toxicity, irritation, or other complications.
The role of physician assistants in pediatric emergency medicine: the physician's view
Authors: Doan Quynh , Piteau Shalea , Sheps Sam , Singer Joel , Wong Hubert , Johnson David , Kissoon Niranjan
Published: July 2016

Objective:

To define the range of clinical conditions Canadian emergency pediatricians consider appropriate formanagement by physician assistants (PAs) and the degree of autonomy PAs should have in the pediatric emergency department (PED).

Methods:

We conducted a cross–sectional, pan-Canadian survey using electronic questionnaire technology: the Active Campaign Survey tool. We targeted PED physicians using the Pediatric Emergency Research Canada (PERC) network database (N = 297). Three outcome measures were assessed: demographic information, familiarity with PAs, and PA clinical roles in the PED. The level of PA involvement was assessed for 57 common nonemergent clinical conditions.

Results:

Of 297 physicians, 152 completed the survey, for a response rate of 51.2%. None of the 57 clinical categories achieved at least 85% agreement regarding PA management without direct physician involvement. Twenty-four clinical conditions had ≥ 15% agreement that any PA involvement would be inappropriate. For the remaining 33 clinical conditions, more than 85% of respondents felt that PA could appropriately manage but were divided between requiring direct and only indirect physician supervision. Respondents' selection of the number of conditions felt to be appropriate for PA involvement varied between the size of the emergency department (ED) in which they work (larger EDs 87.7–89.1% v. smaller EDs 74.2%) and familiarity with the clinical work of PAs in the ED (90.5–91.5% v. 82.2–84.7%).

Conclusion:

This national survey of Canadian PED physicians suggests that they feel PAs could help care for a large number of nonemergent clinical cases coming to the PED, but these clinical encounters would have to be directly supervised by a physician.
Cohort Study on the Prevalence and Risk Factors for Delayed Pulmonary Complications in Adults Following Minor Blunt Thoracic Trauma
Authors: Plourde Miville , Émond Marcel , Lavoie André , Guimont Chantal , Le Sage Natalie , Chauny Jean-Marc , Bergeron Éric , Vanier Laurent , Moore Lynne , Allain-Boulé Nadine , Fratu Ramona-Florina , Dufresne Maryline
Published: July 2016

Objectives:

The objectives of this study are to determine the prevalence, risk factors, and time to onset of delayed hemothorax and pneumothorax in adults who experienced a minor blunt thoracic trauma.

Method:

A prospective cohort of 450 consecutive patients was recruited. Eligible patients had to be over 16 years of age, consulted within 72 hours for a trauma, and available for outpatient follow-up at 2, 7, and 14 days posttrauma. The clinical outcome investigated was the presence of delayed pneumothorax or hemothorax on the follow-up chest x-ray.

Outcomes:

Delayed hemothorax occurred in 11.8% (95% CI 8.8–14.8), and delayed pneumothorax occurred in 0.9% (95% CI 0.2–2.3) of participants. During the 14-day follow-up period, 87.0% of these delayed complications developed in the first week. In the multivariate analysis, the only statistically significant risk factor for delayed complications was the location of fractures on the x-ray of the hemithorax. The adjusted odds ratio was 1.52 (95% CI 0.62–3.73) for the lower ribs (tenth to twelfth rib), 3.11 (95% CI 1.60–6.08) for the midline ribs (sixth to ninth rib), and 5.05 (95% CI 1.80–14.19) for the upper ribs (third to fifth rib) versus patients with no fractures.

Conclusion:

The presence of at least one rib fracture between the third and ninth rib on the x-ray of the hemithorax is a significant risk factor for delayed hemothorax and pneumothorax.
Lateral medullary syndrome: a diagnostic approach illustrated through case presentation and literature review
Authors: Day Gregory S. , Swartz Richard H. , Chenkin Jordan , Shamji Adil I. , Frost David W.
Published: July 2016

Patients with lateral medullary syndrome classically present with crossed hemisensory disturbance, ipsilateral Horner syndrome, and cerebellar signs, all of which are attributable to infarction of the lateral medulla. However, variability in the presentation of this syndrome is the rule, as illustrated in this case presentation and literature review. We propose an approach to diagnosis and management of the lateral medullary syndrome and illustrate the need to integrate clinical information with an understanding of brainstem anatomy with the goal of determining which patients require urgent neuroimaging and acute stroke therapies. The importance of recognition of this condition in the emergency department is underscored by the association between lateral medullary infarction and vertebral artery dissection. With optimal therapy, the prognosis for recovery from lateral medullary syndrome is good.
Diagnosis of occult scaphoid fractures: a randomized, controlled trial comparing bone scans to radiographs for diagnosis
Authors: Hiscox Christina , LaMothe Jeremy , White Neil , Bromley Mark , Paolucci Elizabeth Oddone , Hildebrand Kevin
Published: July 2016

Background:

Many patients with suspected scaphoid fractures but negative radiographs are immobilized for ≥ 2 weeks and are eventually found to have no fracture. Bone scans are reportedly 99% sensitive for these injuries if done ≥ 72 hours postinjury.

Objective:

The purpose of this study was to determine if early bone scans would allow for shorter cast immobilization periods in patients with suspected scaphoid fractures.

Methods:

Twenty-seven patients with clinically suspected scaphoid fractures and negative radiographs were randomized to early diagnosis (bone scan within 3–5 days; n 5 12) or traditional diagnosis (radiographs 10–14 days postinjury; n 5 15). The primary outcome was number of days immobilized in a cast.

Results:

The mean number of days immobilized was 26 in the traditional group and 29 in the bone scan group. Overall, 6 patients had scaphoid fractures (2 in the traditional diagnosis group and 4 in the bone scan group; p > 0.05), and 8 had other types of fractures. These other types of fractures included four distal radius fractures, two triquetral fractures, one trapezoid fracture, and one hamate fracture. There was no significant difference in the number of other types of fractures between groups. The Kaplan-Meier survival analysis using the log-rank test revealed that there was no statistically significant difference between days immobilized between the radiograph and bone scan groups (p 5 0.38).

Conclusions:

The current study suggests that the use of bone scans to help diagnose occult scaphoid fractures does not reduce the number of days immobilized and that the differential diagnosis of occult scaphoid fractures should remain broad because other injuries are common.
Reported practice variation in pediatric pain management: a survey of Canadian pediatric emergency physicians
Authors: Ali Samina , Chambers Andrea , Johnson David W. , Newton Amanda S. , Vandermeer Ben , Williamson Janie , Curtis Sarah J.
Published: July 2016

Objectives:

To describe pediatric emergency medicine (PEM) physicians' reported pain management practices across Canada and explore factors that facilitate or hinder pain management.

Methods:

This study was a prospective survey of Canadian pediatric emergency physicians. The Pediatric Emergency Research Canada physician database was used to identify participants, and a modified Dillman's Total Design Survey Method was used for recruitment.

Results:

The survey response rate was 68% (139 of 206). Most physicians were 31 to 50 years old (82%) with PEM training (56%) and had been in practice for less than 10 years (55%). Almost all pain screening in emergency departments (EDs) occurred at triage (97%). Twenty-four percent of physicians noted institutionally mandated pain score documentation. Ibuprofen and acetaminophen were commonly prescribed in the ED for mild to moderate pain (88% and 83%, respectively). Over half of urinary catheterizations (60%) and intravenous (53%) starts were performed without any analgesia. The most common nonpharmacologic interventions used for infants and children were pacifiers and distraction, respectively. Training background and gender of physicians affected the likelihood of using nonpharmacologic interventions. Physicians noted time restraints to be the greatest barrier to optimal pain management (55%) and desired improved access to pain medications (32%), better policies and procedures (30%), and further education (25%).

Conclusions:

When analgesia was reported as provided, ibuprofen and acetaminophen were most commonly used. Both procedural and presenting pain remained suboptimally managed. There is a substantial evidence practice gap in children's ED pain management, highlighting the need for further knowledge translation strategies and policies to support optimal treatment.
Administration and leadership competencies: establishment of a national consensus for emergency medicine
Authors: Thoma Brent , Poitras Julien , Penciner Rick , Sherbino Jonathan , Holroyd Brian R. , Woods Robert A.
Published: July 2016

Introduction: The Royal College of Physicians and Surgeons of Canada requires emergency medicine (EM) residency programs to meet training objectives relating to administration and leadership. The purpose of this study was to establish a national consensus on the competencies for inclusion in an EM administration and leadership curriculum.

Methods: A modified Delphi process involving two iterative rounds of an electronic survey was used to achieve consensus on competencies for inclusion in an EM administration and leadership curriculum. An initial list of competencies was compiled using peer-reviewed and grey literature. The participants included 14 EM residency program directors and 43 leadership and administration experts from across Canada who were recruited using a snowball technique. The proposed competencies were organized using the CanMEDS Physician Competency Framework and presented in English or French. Consensus was defined a priori as >70% agreement.

Results: Nearly all (13 of 14) of the institutions with an FRCPC EM program had at least one participant complete both surveys. Thirty-five of 57 (61%) participants completed round 1, and 30 (53%) participants completed both rounds. Participants suggested an additional 16 competencies in round 1. The results of round 1 informed the decisions in round 2. Fifty-nine of 109 (54.1%) competencies achieved consensus for inclusion.

Conclusions: Based on a national modified Delphi process, we describe 59 competencies for inclusion in an EM administration and leadership curriculum that was arranged by CanMEDS Role. EM educators may consider these competencies when designing local curricula.
An exploration of Canadian emergency physicians' and residents' knowledge of computed tomography radiation dosing and risk
Authors: Barbic David , Barbic Skye , Dankoff Jerrald
Published: July 2016

Objective: The objective of this study was to measure the current knowledge of Canadian emergency physicians and emergency medicine residents regarding computed tomography (CT) radiation dosing and its associated risks.

Methods: Three focus groups were conducted as the qualitative element of this study. Cognitive debriefing was carried out to ensure the validity and reliability of the focus group findings and to aid with survey development. A 26-item electronic survey was developed and pilot tested for distribution to the membership of the Canadian Association of Emergency Physicians.

Results: Eighteen emergency medicine physicians and three emergency medicine residents participated in the focus groups. Four major themes emerged: 1) physician knowledge of risks associated with CT, 2) risk management strategies, 3) communication, and 4) knowledge translation. The survey response rate was 49.8% (638 of 1,281). The mean respondent age was 40.9±9.9 years, and 70.7% were male. Of all respondents, 82.5% were actively practicing attending physicians, 56.4% of all respondents practiced in urban academic emergency departments, and the average time practicing was 10.7±9.6 years. Radiography and CT were correctly identified by 92.2% and 95.1% of respondents, respectively, as sources of ionizing radiation, whereas magnetic resonance imaging and ultrasonography were selected by 1.0% and 0.5%, respectively. With respect to the lifetime attributable risk (LAR) of malignancy due to CT, 82.2% of participants correctly identified that abdominal CT increases the risk of cancer by 0.2 to 2%, whereas 51.3% correctly identified that the LAR increases twofold in a 7- year-old boy. When asked to identify populations at risk for potential harm due to ionizing radiation, 92.2% of respondents identified children, 80.3% identified pregnant women, and 71.4% identified women of reproductive age. A minority (37.2%) reported communicating the potential risks of CT to a majority of their patients. Electronic platforms were identified by 74.8% of respondents as their preferred method of knowledge translation on this topic.

Conclusions: Canadian emergency medicine physicians and emergency medicine residents demonstrated identifiable gaps in knowledge surrounding CT radiation dose and risk.
Studying with the cloud: the use of online Web-based resources to augment a traditional study group format
Authors: Chan Teresa , Sennik Serena , Zaki Amna , Trotter Brendon
Published: July 2016

Cloud-based applications such as Google Docs, Skype, Dropbox, and SugarSync are revolutionizing the way that we interact with the world. Members of the millennial generation (those born after 1980) are now becoming senior residents and junior attending physicians. We describe a novel technique combining Internet- and cloud-based methods to digitally augment the classic study group used by final-year residents studying for the Royal College of Physicians and Surgeons of Canada examination. This material was developed by residents and improved over the course of 18 months. This is an innovation report about a process for enhanced communication and collaboration as there has been little research to date regarding the augmentation of learner-driven initiatives with virtual resources.
Registration of Five Short‐Season Stiff Stalk (SS) EarlyGEM Maize Germplasms
Authors: Carena M. J. , Sharma S.
Published: July 2016

In 2000, the North Dakota (ND) maize (Zea mays L.) breeding project initiated the long‐term EarlyGEM program to increase the genetic diversity of northern US maize hybrids. The goal was to expand Germplasm Enhancement Maize (GEM) efforts. NDEarlyGEM3 (Reg. No. GP‐594, PI 675374), NDEarlyGEM10 (Reg. No. GP‐595, PI 675377), NDEarlyGEM21a (Reg. No. GP‐ 596, PI 675378), NDEarlyGEM21b (Reg. No. GP‐ 597, PI 675379), and NDEarlyGEM21c (Reg. No. GP‐598, PI 675380) are new maize populations carrying diverse genetics for short‐season environments. These populations belong to the Stiff Stalk (SS) heterotic group as per their original GEM pedigree validated by combining ability data. A modified pedigree selection program including elite GEM and ND lines was utilized to move GEM germplasm northward and westward. Early‐ and late‐generation hybrid trials, including EarlyGEM BC1‐derived lines were conducted from 2006 to 2010. The bulk‐entry method allowed top progenies not only to be recombined to create new populations but also to initiate the development of new elite lines and hybrids. New EarlyGEM populations provide a unique option to expand the gene pool of breeding programs. Four new EarlyGEM lines (ND2014, ND2015, ND2016, and ND2035) derived from released NDEarlyGEM SS populations have recently been released to industry exclusively after being tested across 51 to 64 northern US environments. In this paper, however, only EarlyGEM populations are registered due to the fact that elite EarlyGEM inbred lines have intellectual property exclusive restrictions set up by the North Dakota State University Research Foundation. Adaptation and improvement programs carrying unique and diverse germplasm will be essential in the development of new cultivars tolerant to climate changes.
Modulation of adipogenesis-related gene expression by ethanol extracts of Detam 1 soybean and Jati belanda leaf in 3T3-L1 cells
Authors: Hidayat Meilinah , Prahastuti Sijani , Fauziah Nurul , Maesaroh Maesaroh , Balqis Balqis , Widowati Wahyu
Published: July 2016

In this study, we evaluated the effects of ethanol extracts of Detam 1 soybean, Jati belanda leaf, and the combination toward expression of peroxisome proliferator-activated receptor gamma (PPARγ), CCAAT/enhancer-binding protein alpha (C/EBPα), and stearoyl-CoA desaturase 1 (SCD1) genes in 3T3-L1 cells as anti-adipogenesis and anti-obesity. The differentiation of 3T3-L1 cells into adipocyte was conducted using induction medium consist of Dulbecco's Modified Eagle's Medium, 3-isobutyl-1-methylxanthine, insulin, dexamethasone, and fetal bovine serum. The expression of PPARγ, C/EBPα, and SCD1 gene was measured using real-time quantitative polymerase chain reaction (qPCR). Ethanol extract of Jati belanda at a concentration of 50 μg/mL was most effective to reduce PPARγ, C/EBPα, and SCD1 gene expression in 3T3-L1 cells. Ethanol extract of Detam 1 soybean failed to reduce PPARγ gene expression, whilst in the concentration of 50 μg/mL it was able to significantly reduce the C/EBPα and SCD1 gene expression. Both ethanol extracts of Detam 1 soybean and Jati belanda have potential as anti-adipogenesis and anti-obesity by suppressing adipogenesis-related gene expression, particularly C/EBPα and SCD1.

Video Clip:

Maintaining 3T3-L1 cell culture: 5 min 15 sec
Affinity Propagation Clustering Using Path Based Similarity
Authors: Jiang Yuan , Liao Yuliang , Yu Guoxian
Published: July 2016

Clustering is a fundamental task in data mining. Affinity propagation clustering (APC) is an effective and efficient clustering technique that has been applied in various domains. APC iteratively propagates information between affinity samples, updates the responsibility matrix and availability matrix, and employs these matrices to choose cluster centers (or exemplars) of respective clusters. However, since it mainly uses negative Euclidean distance between exemplars and samples as the similarity between them, it is difficult to identify clusters with complex structure. Therefore, the performance of APC deteriorates on samples distributed with complex structure. To mitigate this problem, we propose an improved APC based on a path-based similarity (APC-PS). APC-PS firstly utilizes negative Euclidean distance to find exemplars of clusters. Then, it employs the path-based similarity to measure the similarity between exemplars and samples, and to explore the underlying structure of clusters. Next, it assigns non-exemplar samples to their respective clusters via that similarity. Our empirical study on synthetic and UCI datasets shows that the proposed APC-PS significantly outperforms original APC and other related approaches.
A Novel Technique for the Deposition of Bismuth Tungstate onto Titania Nanoparticulates for Enhancing the Visible Light Photocatalytic Activity
Authors: Ratova Marina , Kelly Peter , West Glen , Tosheva Lubomira
Published: July 2016

A novel powder handling technique was used to allow the deposition of bismuth tungstate coatings onto commercial titanium dioxide photocatalytic nanoparticles. The coatings were deposited by reactive pulsed DC magnetron sputtering in an argon/oxygen atmosphere. The use of an oscillating bowl with rotary particle propagation, positioned beneath two closed-field planar magnetrons, provided uniform coverage of the titania particle surfaces. The bismuth/tungsten atomic ratio of the coatings was controlled by varying the power applied to each target. The resulting materials were characterized by X-ray diffraction, energy-dispersive X-ray spectroscopy (EDX), Brunauer–Emmett–Teller (BET) surface area measurements, transmission electron microscopy (TEM), and UV-visible diffuse reflectance spectroscopy. Photocatalytic properties under visible light irradiation were assessed using an acetone degradation test. It was found that deposition of bismuth tungstate onto titania nanoparticles resulted in significant increases in visible light photocatalytic activity, compared to uncoated titania. Of the coatings studied, the highest photocatalytic activity was measured for the sample with a Bi/W atomic ratio of 2/1.
A WebGIS Decision Support System for Management of Abandoned Mines
Authors: Stanković Ranka , Vulović Nikola , Lilić Nikola , Obradović Ivan , Tošović Radule , Pešić-Georgiadis Milica
Published: July 2016

This paper presents the development of a WebGIS application aimed at providing safe and reliable data needed for reclamation of abandoned mines in national parks and other protected areas in Vojvodina in compliance with existing legal regulations. The geodatabase model for this application has been developed using UML and the CASE tool Microsoft Visio featuring an interface with ArcGIS. The WebGIS application was developed using GeoServer, an open source tool in the Java programming language, with integrated PostgreSQL DB and the possibility of generating and publishing WMS, WFS and KML services. The WebGIS application is publicly available, based on an appropriate central database, which for the first time encompasses all available data on abandoned mines in Vojvodina, and as such may serve as a model for similar databases on the territory of the Republic of Serbia.
Multislot Simultaneous Spectrum Sensing and Energy Harvesting in Cognitive Radio
Authors: Liu Xin , Na Zhenyu , Jia Min , Gu Xuemai , Li Xiaotong
Published: July 2016

In cognitive radio (CR), the spectrum sensing of the primary user (PU) may consume some electrical power from the battery capacity of the secondary user (SU), resulting in a decrease in the transmission power of the SU. In this paper, a multislot simultaneous spectrum sensing and energy harvesting model is proposed, which uses the harvested radio frequency (RF) energy of the PU signal to supply the spectrum sensing. In the proposed model, the sensing duration is divided into multiple sensing slots consisting of one local-sensing subslot and one energy-harvesting subslot. If the PU is detected to be present in the local-sensing subslot, the SU will harvest RF energy of the PU signal in the energy-harvesting slot, otherwise, the SU will continue spectrum sensing. The global decision on the presence of the PU is obtained through combining local sensing results from all the sensing slots by adopting “Or-logic Rule”. A joint optimization problem of sensing time and time splitter factor is proposed to maximize the throughput of the SU under the constraints of probabilities of false alarm and detection and energy harvesting. The simulation results have shown that the proposed model can clearly improve the maximal throughput of the SU compared to the traditional sensing-throughput tradeoff model.
Broadband PLC for Clustered Advanced Metering Infrastructure (AMI) Architecture
Authors: Ikpehai Augustine , Adebisi Bamidele , Rabie Khaled
Published: July 2016

Advanced metering infrastructure (AMI) subsystems monitor and control energy distribution through exchange of information between smart meters and utility networks. A key challenge is how to select a cost-effective communication system without compromising the performance of the applications. Current communication technologies were developed for conventional data networks with different requirements. It is therefore necessary to investigate how much of existing communication technologies can be retrofitted into the new energy infrastructure to cost-effectively deliver acceptable level of service. This paper investigates broadband power line communications (BPLC) as a backhaul solution in AMI. By applying the disparate traffic characteristics of selected AMI applications, the network performance is evaluated. This study also examines the communication network response to changes in application configurations in terms of packet sizes. In each case, the network is stress-tested and performance is assessed against acceptable thresholds documented in the literature. Results show that, like every other communication technology, BPLC has certain limitations; however, with some modifications in the network topology, it indeed can fulfill most AMI traffic requirements for flexible and time-bounded applications. These opportunities, if tapped, can significantly improve fiscal and operational efficiencies in AMI services. Simulation results also reveal that BPLC as a backhaul can support flat and clustered AMI structures with cluster size ranging from 1 to 150 smart meters.
Removal of PM10 by Forests as a Nature-Based Solution for Air Quality Improvement in the Metropolitan City of Rome
Authors: Marando Federica , Salvatori Elisabetta , Fusaro Lina , Manes Fausto
Published: July 2016

Nature-based solutions have been identified by the European Union as being critical for the enhancement of environmental qualities in cities, where urban and peri-urban forests play a key role in air quality amelioration through pollutant removal. A remote sensing and geographic information system (GIS) approach was applied to the Metropolitan City (MC) of Rome to assess the seasonal particulate matter (PM10) removal capacity of evergreen (broadleaves and conifers) and deciduous species. Moreover, a monetary evaluation of PM10 removal was performed on the basis of pollution externalities calculated for Europe. Deciduous broadleaves represent the most abundant tree functional group and also yielded the highest total annual PM10 deposition values (1769 Mg). By contrast, PM10 removal efficiency (Mg·ha−1) was 15%–22% higher in evergreen than in deciduous species. To assess the different removal capacity of the three functional groups in an area with homogeneous environmental conditions, a study case was performed in a peri-urban forest protected natural reserve (Castelporziano Presidential Estate). This study case highlighted the importance of deciduous species in summer and of evergreen communities as regards the annual PM10 removal balance. The monetary evaluation indicated that the overall PM10 removal value of the MC of Rome amounted to 161.78 million Euros. Our study lends further support to the crucial role played by nature-based solutions for human well-being in urban areas.
Extraction of High Quality RNA from Cannabis sativa Bast Fibres: A Vademecum for Molecular Biologists
Authors: Guerriero Gea , Mangeot-Peter Lauralie , Hausman Jean-Francois , Legay Sylvain
Published: July 2016

In plants there is no universal protocol for RNA extraction, since optimizations are required depending on the species, tissues and developmental stages. Some plants/tissues are rich in secondary metabolites or synthesize thick cell walls, which hinder an efficient RNA extraction. One such example is bast fibres, long extraxylary cells characterized by a thick cellulosic cell wall. Given the economic importance of bast fibres, which are used in the textile sector, as well as in biocomposites as green substitutes of glass fibres, it is desirable to better understand their development from a molecular point of view. This knowledge favours the development of biotechnological strategies aimed at improving specific properties of bast fibres. To be able to perform high-throughput analyses, such as, for instance, transcriptomics of bast fibres, RNA extraction is a crucial and limiting step. We here detail a protocol enabling the rapid extraction of high quality RNA from the bast fibres of textile hemp, Cannabis sativa L., a multi-purpose fibre crop standing in the spotlight of research.
Infection Rates by Dengue Virus in Mosquitoes and the Influence of Temperature May Be Related to Different Endemicity Patterns in Three Colombian Cities
Authors: Peña-García Víctor , Triana-Chávez Omar , Mejía-Jaramillo Ana , Díaz Francisco , Gómez-Palacio Andrés , Arboleda-Sánchez Sair
Published: July 2016

Colombia is an endemic country for dengue fever where the four serotypes of virus dengue (DENV1–4) circulate simultaneously, and all types are responsible for dengue cases in the country. The control strategies are guided by entomological surveillance. However, heterogeneity in aedic indices is not well correlated with the incidence of the disease in cities such as Riohacha, Bello and Villavicencio. As an alternative, molecular detection of dengue virus in mosquitoes has been proposed as a useful tool for epidemiological surveillance and identification of serotypes circulating in field. We conducted a spatiotemporal fieldwork in these cities to capture adult mosquitoes to assess vector infection and explain the differences between Breteau indices and disease incidence. DENV infection in females and DENV serotype identification were evaluated and infection rates (IR) were estimated. The relationship between density, dengue cases and vector index was also estimated with logistic regression modeling and Pearson’s correlation coefficient. The lack of association between aedic indices and dengue incidence is in agreement with the weak associations between the density of the mosquitoes and their infection with DENV in the three cities. However, association was evident between the IR and dengue cases in Villavicencio. Furthermore, we found important negative associations between temperature and lag time from two to six weeks in Riohacha. We conclude that density of mosquitoes is not a good predictor of dengue cases. Instead, IR and temperature might explain better such heterogeneity.
How Does the Severity of Injury Vary between Motorcycle and Automobile Accident Victims Who Sustain High-Grade Blunt Hepatic and/or Splenic Injuries? Results of a Retrospective Analysis
Authors: Hsieh Ting-Min , Tsai Tsung-Cheng , Liu Yueh-Wei , Hsieh Ching-Hua
Published: July 2016

Background: High-grade blunt hepatic and/or splenic injuries (BHSI) remain a great challenge for trauma surgeons. The main aim of this study was to investigate the characteristics, mortality rates, and outcomes of high-grade BHSI in motorcyclists and car occupants hospitalized for treatment of traumatic injuries in a Level I trauma center in southern Taiwan. Methods: High-grade BHSI are defined as grade III-VI blunt hepatic injuries and grade III-V blunt splenic injuries. This retrospective study reviewed the data of 101 motorcyclists and 32 car occupants who experienced a high-grade BHSI from 1 January 2011 to 31 December 2013. Two-sided Fisher’s exact or Pearson’s chi-square tests were used to compare categorical data, unpaired Student’s t-test was used to analyze normally distributed continuous data, and Mann–Whitney’s U test was used to compare non-normally distributed data. Results: In this study, the majority (76%, 101/133) of high-grade BHSI were due to motorcycle crashes. Car occupants had a significantly higher injury severity score (ISS; 26.8 ± 10.9 vs. 20.7 ± 10.4, respectively, p = 0.005) and organ injured score (OIS; 3.8 ± 1.0 vs. 3.4 ± 0.6, respectively, p = 0.033), as well as a significantly longer hospital length of stay (LOS; 21.2 days vs. 14.6 days, respectively, p = 0.038) than did motorcyclists. Car occupants with high-grade BHSI also had worse clinical presentations than their motorcyclist counterparts, including a significantly higher incidence of hypotension, hyperpnea, tube thoracostomy, blood transfusion >4 units, LOS in intensive care unit >5 days, and complications. However, there were no differences in the percentage of angiography or laparotomy performed or mortality rate between these two groups of patients. Conclusions: This study demonstrated that car occupants with high-grade BHSI were injured more severely, had a higher incidence of worse clinical presentation, had a longer hospital LOS, and had a higher incidence of complications than motorcyclists. The results also implied that specific attention should be paid to those car occupants with high-grade BHSI, whose critical condition should not be underestimated because of the concept that the patients within in a car are much safer.
Psychopathological Variables and Sleep Quality in Psoriatic Patients
Authors: Luca Maria , Luca Antonina , Musumeci Maria , Fiorentini Federica , Micali Giuseppe , Calandra Carmela
Published: July 2016

Psoriasis is an inflammatory disease frequently associated with psychiatric disturbances and sleep disorders. The aim of the study was to assess the prevalence of depression, interaction anxiety, audience anxiety, and sleep quality in psoriatic patients. One hundred and two psoriatic patients were enrolled and underwent the following questionnaires: Zung Self-Rating Depression Scale (SDS), Interaction Anxiousness Scale (IAS), Audience Anxiousness Scale (AAS), Pittsburgh Sleep Quality Index (PSQI). The severity of skin lesions was assessed by Psoriasis Area Severity Index (PASI). The presence of a link between clinical variables and with demographic data has been investigated. Psoriasis was linked to depression, interaction and audience anxiety, as well as to poor sleep quality; 37.5% of patients were depressed, 46.1% scored above 37 at the IAS, 47.1% scored above 33 at the AAS. Thirty-nine subjects (38.2%) presented a PSQI ≥ 5. An association between interaction anxiety and lower limbs psoriasis-related erythema as well as between PSQI and head psoriasis-related erythema was found, particularly among male patients. Hence, psoriatic patients should be assessed from a holistic point of view, in order to identify associated disorders that could benefit from targeted treatments.
Assessment of Dextran Antigenicity of Intravenous Iron Preparations with Enzyme-Linked Immunosorbent Assay (ELISA)
Authors: Neiser Susann , Koskenkorva Taija , Schwarz Katrin , Wilhelm Maria , Burckhardt Susanna
Published: July 2016

Intravenous iron preparations are typically classified as non-dextran-based or dextran/dextran-based complexes. The carbohydrate shell for each of these preparations is unique and is key in determining the various physicochemical properties, the metabolic pathway, and the immunogenicity of the iron-carbohydrate complex. As intravenous dextran can cause severe, antibody-mediated dextran-induced anaphylactic reactions (DIAR), the purpose of this study was to explore the potential of various intravenous iron preparations, non-dextran-based or dextran/dextran-based, to induce these reactions. An IgG-isotype mouse monoclonal anti-dextran antibody (5E7H3) and an enzyme-linked immunosorbent assay (ELISA) were developed to investigate the dextran antigenicity of low molecular weight iron dextran, ferumoxytol, iron isomaltoside 1000, ferric gluconate, iron sucrose and ferric carboxymaltose, as well as isomaltoside 1000, the isolated carbohydrate component of iron isomaltoside 1000. Low molecular weight iron dextran, as well as dextran-based ferumoxytol and iron isomaltoside 1000, reacted with 5E7H3, whereas ferric carboxymaltose, iron sucrose, sodium ferric gluconate, and isolated isomaltoside 1000 did not. Consistent results were obtained with reverse single radial immunodiffusion assay. The results strongly support the hypothesis that, while the carbohydrate alone (isomaltoside 1000) does not form immune complexes with anti-dextran antibodies, iron isomaltoside 1000 complex reacts with anti-dextran antibodies by forming multivalent immune complexes. Moreover, non-dextran based preparations, such as iron sucrose and ferric carboxymaltose, do not react with anti-dextran antibodies. This assay allows to assess the theoretical possibility of a substance to induce antibody-mediated DIARs. Nevertheless, as this is only one possible mechanism that may cause a hypersensitivity reaction, a broader set of assays will be required to get an understanding of the mechanisms that may lead to intravenous iron-induced hypersensitivity reactions.
Guided Wave Based Crack Detection in the Rivet Hole Using Global Analytical with Local FEM Approach
Authors: Bhuiyan Md , Shen Yanfeng , Giurgiutiu Victor
Published: July 2016

In this article, ultrasonic guided wave propagation and interaction with the rivet hole cracks has been formulated using closed-form analytical solution while the local damage interaction, scattering, and mode conversion have been obtained from finite element analysis. The rivet hole cracks (damage) in the plate structure gives rise to the non-axisymmetric scattering of Lamb wave, as well as shear horizontal (SH) wave, although the incident Lamb wave source (primary source) is axisymmetric. The damage in the plate acts as a non-axisymmetric secondary source of Lamb wave and SH wave. The scattering of Lamb and SH waves are captured using wave damage interaction coefficient (WDIC). The scatter cubes of complex-valued WDIC are formed that can describe the 3D interaction (frequency, incident direction, and azimuth direction) of Lamb waves with the damage. The scatter cubes are fed into the exact analytical framework to produce the time domain signal. This analysis enables us to obtain the optimum design parameters for better detection of the cracks in a multiple-rivet-hole problem. The optimum parameters provide the guideline of the design of the sensor installation to obtain the most noticeable signals that represent the presence of cracks in the rivet hole.
Analytic Properties of the Sum B1(h, k)
Authors: Cetin Elif
Published: July 2016

In this paper, with the help of the Hardy and Dedekind sums we will give many properties of the sum B 1 ( h , k ) , which was defined by Cetin et al. Then we will give the connections of this sum with the other well-known finite sums such as the Dedekind sums, the Hardy sums, the Simsek sums Y ( h , k ) and the sum C 1 ( h , k ) . By using the Fibonacci numbers and two-term polynomial relation, we will also give a new property of the sum B 1 ( h , k ) .