bluuebunny/crossref_metadata_2025 huggingface dataset:
What do patients know? Education from the European Lung Foundation perspective
Authors: Powell Pippa , Smyth Dan , Saraiva Isabel , Lisspers Karin , Hardavella Georgia , Fuertes Juan , Hill Kate
Published: March 2018

The European Lung Foundation (ELF) is an organisation whose mission is to bring together the public and patients with respiratory professionals to improve lung health. A core part of all its activities focus on education: the education of patients on their condition, including how to prevent, treat and manage it; the education of healthcare professionals on how to improve work with patients and awareness about the issues that are important to patients; and education of the public and policy makers of the importance of lung health at a European level. ELF was founded and works in a unique partnership with the European Respiratory Society (ERS).

This article has been written by the recent past Chairs and the new Chairs of three ELF committees (Council (D. Smyth and I. Saraiva), Professional Advisory Committee (K. Lisspers and G. Hardavella) and Patient Advisory Committee (J. Fuertes and K. Hill)) in order to reflect on ELF’s journey in this regard over recent years. In particular, it seems a good moment to assess the success and impact of the first patient Chair of ELF, Dan Smyth, and reflect on what this has meant for ELF’s educational activities, and what the future now looks like.

Educational aims

To understand the importance of educated patients (patients that are knowledgeable on their condition and how healthcare processes work).

To understand the importance of guiding patients to quality reliable sources of information and education.

To establish ways to ensure that healthcare professionals are prepared to work with educated patients.

To outline the initiatives that ELF has driven forward in the field of education.

To see the value in patients advocating at the European level for raising standards of education for patients and physicians.
Treatment outcomes in depression: reducing drop-out rates in cognitive therapy
Authors: Pentaraki Alexandra D.
Published: March 2018

Although cognitive therapy is a promising treatment for depression, high drop-out rates and, conversely, the specific elements that make the intervention effective continue to puzzle practising clinicians. This article discusses both therapist-related factors (including competence and competencies) and patient-related factors (such as engagement in therapy and external logistical problems with attendance) that are related to drop-out and suggests practical ways to address them and improve outcomes. It examines cognitive and behavioural elements of manualised cognitive therapy and discusses findings relating to cognitive–behavioural therapy (CBT) in particular.

LEARNING OBJECTIVES

•

Understand factors associated with high drop-out rates in the cognitive therapy of depression and ways to reduce them

•

Learn about treatment integrity in cognitive therapy of depression and its relationship to the clinical outcome

•

Identify specific cognitive therapy techniques associated with patients' improvement in depression

DECLARATION OF INTEREST

None.
Serum Sclerostin and Bone Turnover in Latent Autoimmune Diabetes in Adults
Authors: Napoli Nicola , Strollo Rocky , Defeudis Giuseppe , Leto Gaetano , Moretti Chiara , Zampetti Simona , D’Onofrio Luca , Campagna Giuseppe , Palermo Andrea , Greto Valentina , Manfrini Silvia , Hawa Mohammed I , Leslie R David , Pozzilli Paolo , Buzzetti Raffaella ,   NIRAD (NIRAD 10) and Action LADA Study Groups
Published: March 2018

Purpose

Bone formation is impaired in both type 1 diabetes and type 2 diabetes (T2D), whereas sclerostin, an antagonist of bone formation, is increased in T2D only. No data are available on latent autoimmune diabetes in adults (LADA), an autoimmune type of diabetes that may clinically resemble T2D at diagnosis. We evaluated serum sclerostin and bone turnover markers in LADA compared with those in T2D and whether metabolic syndrome (MetS) affects sclerostin in T2D or LADA.

Methods

This cross-sectional study included 98 patients with T2D and 89 with LADA from the Action LADA and Non Insulin Requiring Autoimmune Diabetes cohorts. Patients were further divided according to MetS status. Nondiabetic participants (n = 53) were used as controls. Serum sclerostin, bone formation (pro-collagen type 1 N-terminal propeptide [P1NP]), and bone resorption (C-terminal telopeptide of type I collagen [CTX]) were analyzed.

Results

Patients with T2D had higher sclerostin than did those with LADA [P = 0.0008, adjusted for sex and body mass index (BMI)], even when analysis was restricted to patients with MetS (adjusted P = 0.03). Analysis of T2D and LADA groups separately showed that sclerostin was similar between those with and those without MetS. However, a positive trend between sclerostin and number of MetS features was seen with T2D (P for trend = 0.001) but not with LADA. Patients with T2D or LADA had lower CTX than did controls (P = 0.0003) and did not have significantly reduced P1NP. Sclerostin was unrelated to age or hemoglobin A1c but was correlated with BMI (ρ = 0.29; P = 0.0001), high-density lipoprotein (ρ = −0.23; P = 0.003), triglycerides (ρ = 0.19; P = 0.002), and time since diagnosis (ρ = 0.32; P < 0.0001).

Conclusions

Patients with LADA presented lower bone resorption than did controls, similar to patients with T2D. Sclerostin is increased in T2D but not in LADA, suggesting possible roles on bone metabolism in T2D only.
Diagnostic yield of 90-kVp low-tube-voltage carotid and intracerebral CT-angiography: effects on radiation dose, image quality and diagnostic performance for the detection of carotid stenosis
Authors: Leithner Doris , Wichmann Julian L , Mahmoudi Scherwin , Martin Simon S , Albrecht Moritz H , Vogl Thomas J , Scholtz Jan-Erik
Published: March 2018

Objective:

To investigate the impact of low-tube-voltage 90-kVp acquisition combined with advanced modeled iterative reconstruction algorithm (Admire) on radiation exposure, image quality, artifacts, and assessment of stenosis in carotid and intracranial CT angiography (CTA).

Methods:

Dual-energy CTA studies of 43 patients performed on a third-generation 192-slice dual-source CT were retrospectively evaluated. Intraindividual comparison of 90-kVp and linearly blended 120-kVp equivalent image series (M_0.6, 60% 90-kVp, 40% Sn-150-kVp) was performed. Contrast-to-noise and signal-to-noise ratios of common carotid artery, internal carotid artery, middle cerebral artery, and basilar artery were calculated. Qualitative image analysis included evaluation of artifacts and suitability for angiographical assessment at shoulder level, carotid bifurcation, siphon, and intracranial by three independent radiologists. Detection and quantification of carotid stenosis were performed. Radiation dose was expressed as dose–length product (DLP).

Results:

Contrast-to-noise values of all arteries were significantly increased in 90-kVp compared to M_0.6 (p < 0.001). Suitability for angiographical evaluation was rated excellent with low artifacts for all levels in both image series. Both 90-kVp and M_0.6 showed excellent accordance for detection and grading of carotid stenosis with almost perfect interobserver agreement (carotid stenoses in 32 of 129 segments; intraclass correlation coefficient, 0.94). dose–length product was reduced by 40.3% in 90-kVp (110.6 ± 32.1 vs 185.4 ± 47.5 mGy·cm, p < 0.001).

Conclusion:

90-kVp carotid and intracranial CTA with Admire provides increased quantitative and similarly good qualitative image quality, while reducing radiation exposure substantially compared to M_0.6. Diagnostic performance for arterial stenosis detection and quantification remained excellent.

Advances in knowledge:

90-kVp carotid and intracranial CTA with an advanced iterative reconstruction algorithm results in excellent image quality and reduction of radiation exposure without limiting diagnostic performance.
Response heterogeneity: Challenges for personalised medicine and big data approaches in psychiatry and chronic pain
Authors: Norbury Agnes , Seymour Ben
Published: March 2018

Response rates to available treatments for psychological and chronic pain disorders are poor, and there is a substantial burden of suffering and disability for patients, who often cycle through several rounds of ineffective treatment. As individuals presenting to the clinic with symptoms of these disorders are likely to be heterogeneous, there is considerable interest in the possibility that different constellations of signs could be used to identify subgroups of patients that might preferentially benefit from particular kinds of treatment. To this end, there has been a recent focus on the application of machine learning methods to attempt to identify sets of predictor variables (demographic, genetic, etc.) that could be used to target individuals towards treatments that are more likely to work for them in the first instance.

Importantly, the training of such models generally relies on datasets where groups of individual predictor variables are labelled with a binary outcome category − usually ‘responder’ or ‘non-responder’ (to a particular treatment). However, as previously highlighted in other areas of medicine, there is a basic statistical problem in classifying individuals as ‘responding’ to a particular treatment on the basis of data from conventional randomized controlled trials. Specifically, insufficient information on the partition of variance components in individual symptom changes mean that it is inappropriate to consider data from the active treatment arm alone in this way. This may be particularly problematic in the case of psychiatric and chronic pain symptom data, where both within-subject variability and measurement error are likely to be high.

Here, we outline some possible solutions to this problem in terms of dataset design and machine learning methodology, and conclude that it is important to carefully consider the kind of inferences that particular training data are able to afford, especially in arenas where the potential clinical benefit is so large.
Evaluation of portal pressure by doppler ultrasound in patients with cirrhosis before and after simvastatin administration – a randomized controlled trial
Authors: Elwan Nadia , Salah Raafat , Hamisa Manal , Shady Ebtsam , Hawash Nehad , Abd-Elsalam Sherief
Published: March 2018

Background: Portal hypertension is one of the most frequent complications of cirrhosis. β-adrenergic blockers, with or without organic nitrates, are currently used as hypotensive agents. Statins such as simvastatin seem to be safe for patients with chronic liver diseases and exert multiple pleiotropic actions. This study aimed to assess PTH using Doppler ultrasound in patients with cirrhosis before and after simvastatin administration.

Methods: This randomized controlled clinical trial was conducted on 40 patients with cirrhosis who were randomized into 2 groups: group I included 20 patients with cirrhosis who were administered 20 mg of simvastatin daily for 2 weeks and then 40 mg daily for another 2 weeks, and group II included 20 patients with cirrhosis who did not receive simvastatin as a control group. All patients underwent full clinical examination, laboratory investigations, and abdominal Doppler ultrasound at baseline and after 30 days to evaluate portal vein diameter, blood flow volume, direction and velocity of portal vein blood flow, hepatic artery resistance and pulsatility indices, splenic artery resistance index, portal hypertension index (PHI), liver vascular index, and modified liver vascular index (MLVI).

Results: There was a highly significant decrease in the hepatic artery resistance index  in group I, from 0.785 ± 0.088 to 0.717 ± 0.086 (P < 0.001). There was a significant decrease in the PHI in group I , from 3.915 ± 0.973 m/sec to 3.605 ± 1.168 m/sec (P = 0.024). Additionally, there was a significant increase in the MLVI in group I from 11.540 ± 3.266 cm/sec to 13.305 ± 3.222 cm/sec, an increase of 15.3% from baseline (P = 0.009). No significant adverse effects were detected.

Conclusions: Simvastatin is safe and effective in lowering portal hypertension.

[ClinicalTrials.gov Identifier: NCT02994485]
Mechanism of natural acid-formation of shungite rocks and its role in industrial introduction
Authors: Рафиенко Владимир , Rafienko Vladimir
Published: March 2018

For the first time the mechanism of natural acid-formation of shungite rocks in preliminary grinding processes is studied and substantiated explicitly.
Acid-formation of shungite headings in the technical processing is the major drawback constraining broad application of finely-dispersed shungite rocks.
The application sphere of neutralized shungite products will be essentially broaden and high-technology branches of industrial production will get qualitative product with unique properties that shungite rocks possess.
The book would be interesting for specialists in the sphere of mineral raw material processing technology, geochemists, as well as it can be useful for PhD students, researches and those working in the industry connected with matters of rational management of natural resources.
Commodity science and examination of meat products. Laboratory workshop
Authors: Данильчук Юлия , Danilchuk YUliya
Published: March 2018

In this workshop the work on the study of the classification, assortment and expertise of the quality of meat and meat products.
Each Chapter provides an overview of the relevant types of products and a list of the main regulatory documents required for their examination. The latest changes in the regulatory framework have been taken into account. Laboratory work on the examination of products include tasks for the study of defects, acceptance rules and methods of sampling, marking analysis, evaluation of the quality of goods by organoleptic and physical and chemical parameters.
For students of higher educational institutions studying in the direction of preparation 38.03.07 "commodity science".
Implementing a sustainable clinical supervision model for Isles nurses in Orkney
Authors: Hall Ian
Published: March 2018

The Isles Network of Care (INOC) community nurses work at the extreme of the remote and rural continuum, working mostly as lone practitioners. Following the development of sustainable clinical supervision model for Isles nurses in Orkney, clinical supervision was found to improve both peer support and governance for this group of isolated staff. A literature overview identified the transition of clinical supervision in general nursing over 24 years from ‘carrot’ to ‘stick’. The study included a questionnaire survey that was sent to the 2017 Queen's Nursing Institute Scotland cohort to elicit information about the nurses' experience of clinical supervision. The survey found that 55% provide supervision and 40% receive it. Health board encouragement of its use was found to be disappointingly low at 40%. The INOC nurses were surveyed about the new peer-support (restorative) model, which relies on video-conference contact to allow face to face interaction between isolated isles nurses. Feedback prompted a review of clinical supervision pairings, and the frequency and methods of meeting. The need for supervisor training led to agreement with the Remote and Rural Health Education Alliance to provide relevant support. The perceived benefits of supervision included increased support and reflection, and improved relationships with isolated colleagues.
A standardised pathway for the surveillance of stable vestibular schwannoma
Authors: Shapey J , Barkas K , Connor S , Hitchings A , Cheetham H , Thomson S , U-King-Im JM , Beaney R , Jiang D , Barazi S , Obholzer R , Thomas NWM
Published: March 2018

Introduction

Conservative management of patients with a stable vestibular schwannoma (VS) places a significant burden on National Health Service (NHS) resources and yet patients’ surveillance management is often inconsistent. Our unit has developed a standardised pathway to guide surveillance imaging of patients with stable VS. In this article, we provide the basis for our imaging protocol by reviewing the measurement, natural history and growth patterns of VS, and we present a cost analysis of implementing the pathway both regionally and nationally.

Methods

Patients with an extrameatal VS measuring ≤20mm in maximal diameter receive magnetic resonance imaging (MRI) six months after their index imaging, followed by three annual MRI scans, two two-year interval MRI scans, a single three-year interval MRI scan and then five-yearly MRI scans to be continued lifelong. Patients with purely intrameatal tumours follow the same protocol but the initial six-month imaging is omitted. A cost analysis of the new pathway was modelled on our unit’s retrospective data for 2015 and extrapolated to reflect the cost of VS surveillance nationally.

Results

Based on an estimation that imaging surveillance would last approximately 25 years (+/- 10 years), the cost of implementing our regional surveillance programme would be £151,011 per year (for 99 new referrals per year) and it would cost the NHS £1,982,968 per year if implemented nationally.

Conclusions

A standardised surveillance pathway promotes safe practice in the conservative management of VS. The estimated cost of a national surveillance programme compares favourably with other tumour surveillance initiatives, and would enable the NHS to provide a safe and economical service to patients with VS.
Establishment and evaluation of the goose embryo epithelial (GEE) cell line as a new model for propagation of avian viruses
Authors: Wang Wenxiu , Said Abdelrahman , Wang Baoqin , Qu Guanggang , Xu Qingqing , Liu Bo , Shen Zhiqiang
Published: March 2018

In this study, we report the establishment and characterization of a new epithelial cell line, goose embryonated epithelial cell line (GEE), derived from embryonic goose tissue. The purified GEE cell line can efficiently grow over 65 passages in the M199 medium supplemented with 10% fetal bovine serum at 37°C. Immunofluorescence assay was used to identify purified GEE cells as epithelial cell line by detecting expression of the Keratin-18 and -19. Further characterizations demonstrated that the GEE cell line can be continuously subcultured with (i) a high capacity to replicate for over 65 passages, (ii) a spontaneous epithelial-like morphology, (iii) constant chromosomal features and (iv) without an evidence of converting to tumorigenic cells either in vitro or in vivo study. Moreover, the GEE cell line can be effectively transfected with plasmids expressing reporter genes of different avian viruses, such as VP3, VP1 and F of goose parvo virus (GPV), duck hepatitis virus (DHV), and Newcastle disease virus (NDV), respectively. Finally, the established GEE cell line was evaluated for avian viruses infection susceptibility. Our results showed that the tested GPV, DHAV and NDV were capable to replicate in the new cell line with titers a comparatively higher to the ones detected in the traditional culture system. Accordingly, our established GEE cell line is apparently a suitable in vitro model for transgenic, and infection manipulation studies.
Julgar quem mata: A decisão judicial em processos-crime de homicídio
Authors: Botelho Mónica , Gonçalves Rui Abrunhosa
Published: March 2018

O que é apreciado pelos juízes num processo crime de homicídio em Portugal ainda carece de um longo percurso investigativo no âmbito da psicologia da justiça. A presente investigação de carácter exploratório objetiva analisar diferenças na medida da pena aplicada em função de elementos identificados nos acórdãos. Procura igualmente conhecer se existem diferenças decisórias entre a primeira e a segunda instâncias. Salientam-se os seguintes resultados: os juízes tendem a aplicar penas mais elevadas quando as vítimas são do sexo feminino; sentenciam os agentes a penas superiores quando estes se remetem ao silêncio, consubstanciando estes dois fatores, elementos extralegais. Constatou-se igualmente que a medida da pena é inferior quando o ofensor se diz arrependido. Verifica-se que nenhuma variável relativa às características do ofensor resultou estatisticamente significativa. Os resultados são discutidos, salientando-se a participação de fatores extralegais na decisão judicial.
Experimental Fracture Analysis of Individual Sand Particles at High Loading Rates
Authors: Druckrey Andrew M. , Alshibli Khalid , Casem Daniel T. , Huskins Emily
Published: March 2018

High strain rate loading conditions such as blast, impact, or projectile penetration cause major damages to infrastructure and soils. Sand particles will likely fracture if they are exposed to such loading conditions. Modeling the constitutive behavior of sand deposits when they are subjected to dynamic loading requires a high-fidelity particle-scale analysis, calibration, and validation using experimental measurements. In this paper, natural sand particles with complex morphology, mineralogy, and grain size were randomly selected from the bulk material and were separated based on particle size and mineralogy. Intact particles were first imaged using a desktop X-ray computed tomography (CT) scanner to calculate morphology and provide further input to the mineralogy and internal structure. Each particle was placed between incident and transmitter bars of a Kolsky bar setup, and two optical images (side and top views) were collected to visualize the loading geometry and direction. Each particle was then dynamically loaded to failure, at which load and compressive displacement were measured. Some of recovered particle fragments were imaged using synchrotron microcomputed tomography (SMT) to determine the fracture mode and fracture surface. Weibull statistical analyses were performed and multivariable nonlinear regression was implemented, using particle characteristics as predictors. The paper discusses the influence of morphology, mineralogy, internal structure, and size of particles on dynamic particle failure strength.
Theta Oscillations Organize Spiking Activity in Higher-Order Visual Thalamus during Sustained Attention
Authors: Yu Chunxiu , Li Yuhui , Stitt Iain M. , Zhou Zhe Charles , Sellers Kristin K. , Frohlich Flavio
Published: March 2018

Higher-order visual thalamus plays a fundamental but poorly understood role in attention-demanding tasks. To investigate how neuronal dynamics in higher-order visual thalamus are modulated by sustained attention, we performed multichannel electrophysiological recordings in the lateral posterior-pulvinar complex (LP/pulvinar) in the ferret (Mustela putorius furo). We recorded single unit activity and local field potential (LFP) during the performance of the five-choice serial reaction time task (5-CSRTT), which is used in both humans and animals as an assay of sustained attention. We found that half of the units exhibited an increasing firing rate during the delay period before stimulus onset (attention-modulated units). In contrast, the non-attention-modulated units responded to the stimulus, but not during the delay period. Spike-field coherence (SFC) of only the attention-modulated neurons significantly increased from the start of the delay period until screen touch, predominantly in the θ frequency band. In addition, θ power and θ/γ phase amplitude coupling (PAC) were elevated throughout the delay period. Our findings suggest that the θ oscillation plays a central role in orchestrating thalamic signaling during sustained attention.
The Limits to Parapatric Speciation II: Strengthening a Preexisting Genetic Barrier to Gene Flow in Parapatry
Authors: Blanckaert Alexandre , Hermisson Joachim
Published: March 2018

By encompassing the whole continuum between allopatric and sympatric scenarios, parapatric speciation includes many potential scenarios for the evolution of new species. Here, we investigate how a genetic barrier to gene flow, that relies on a single postzygotic genetic incompatibility, may further evolve under ongoing migration. We consider a continent island model with three loci involved in pairwise Dobzhansky–Muller incompatibilities (DMIs). Using an analytic approach, we derive the conditions for invasion of a new mutation and its consequences for the strength and stability of the initial genetic barrier. Our results show that the accumulation of genetic incompatibilities in the presence of gene flow is under strong selective constraints. In particular, preexisting incompatibilities do not always facilitate the invasion of further barrier genes. If new mutations do invade, they will often weaken or destroy the barrier rather than strengthening it. We conclude that migration is highly effective at disrupting the so-called “snowball effect”, the accelerated accumulation of DMIs that has been described for allopatric populations en route to reproductive isolation.
Mito-Nuclear Interactions Affecting Lifespan and Neurodegeneration in aDrosophilaModel of Leigh Syndrome
Authors: Loewen Carin A , Ganetzky Barry
Published: March 2018

Mitochondrial function requires coordinated activities of interacting proteins encoded in both the nuclear and mitochondrial genomes. Nuclear mutations cause human mitochondrial disorders that commonly exhibit unexplained clinical variability (e.g. age of onset and severity)...

Proper mitochondrial activity depends upon proteins encoded by genes in the nuclear and mitochondrial genomes that must interact functionally and physically in a precisely coordinated manner. Consequently, mito-nuclear allelic interactions are thought to be of crucial importance on an evolutionary scale, as well as for manifestation of essential biological phenotypes, including those directly relevant to human disease. Nonetheless, detailed molecular understanding of mito-nuclear interactions is still lacking, and definitive examples of such interactions in vivo are sparse. Here we describe the characterization of a mutation in Drosophila ND23, a nuclear gene encoding a highly conserved subunit of mitochondrial complex 1. This characterization led to the discovery of a mito-nuclear interaction that affects the ND23 mutant phenotype. ND23 mutants exhibit reduced lifespan, neurodegeneration, abnormal mitochondrial morphology, and decreased ATP levels. These phenotypes are similar to those observed in patients with Leigh syndrome, which is caused by mutations in a number of nuclear genes that encode mitochondrial proteins, including the human ortholog of ND23. A key feature of Leigh syndrome, and other mitochondrial disorders, is unexpected and unexplained phenotypic variability. We discovered that the phenotypic severity of ND23 mutations varies depending on the maternally inherited mitochondrial background. Sequence analysis of the relevant mitochondrial genomes identified several variants that are likely candidates for the phenotypic interaction with mutant ND23, including a variant affecting a mitochondrially encoded component of complex I. Thus, our work provides an in vivo demonstration of the phenotypic importance of mito-nuclear interactions in the context of mitochondrial disease.
Evaluation of risk factors in patients with breast cancer in stages III and IV: comparison of Cox and Fine-Grey competing risk regression models
Authors: Arani Monireh Dehghani , Abadi Alireza , Yavari Aarvin , Bashiri Yousef , Mahmudi Liley , Bajdik Chris
Published: March 2018

Introduction: The aim of this study is to fit Fine-Grey competing risk model and compare its results with stratified Cox model and to examine its application in breast cancer data.
Methods: The study was conducted on 15830 women diagnosed with breast cancer in British Columbia, Canada. They were divided into four groups according to patients' stage of disease then for patients with stage III and IV breast cancer was fitted Cox's model and Fine-Grey competing risk flexible models to each group.
Results: The data show that Out of 1888 patients, 578 lied in the age group of below 50 years old, while 1310 were above 50 years of age. The results obtained from fitting stratified Cox regression model indicate that the variables of age and surgery are significant. The patients in the age group of below 50 years old have 70% less hazard in comparison with people older than 50 years of age (HR=0.83). Further, the patients receiving surgery have 38% less hazard in comparison with the patients not receiving surgery (HR=0.62). Then we fit Fine-Grey competing risk models. the variable of chemotherapy is significant in both parametric and semi-parametric competing risk models, and its hazard ratio is HR=1.15 and HR=1.14 in the two models, respectively. On the other hand, the variable of age has not become significant in any of the models, and its hazard ratio is HR=0.92 and HR=0.93, respectively. The variable of surgery in the competing risk parametric model is significant with an HR of 0.67. In Cox model, the variable of surgery is also significant with HR=0.62. Moreover, the variable of age in the competing risk parametric model has not become significant (HR=0.92), and in contrast the variable of age in the Cox model is significant (HR=0.83).
Conclusion: The results of this study show that Considering the comparison of the two models, it is observed that regardless of the properties of competing risk data, estimations of hazard ratio and the extent of significance resulting from Cox models are different from those of competing risk models.
Associations Between Pediatric Palliative Care Consultation and End-of-Life Preparation at an Academic Medical Center: A Retrospective EHR Analysis
Authors: Stutz Matthew , Kao Roy L. , Huard Leanna , Grotts Jonathan , Sanz Javier , Ross Mindy K.
Published: March 2018

OBJECTIVES:

Our aim in this study was to understand usage patterns of pediatric palliative care (PPC) consultation and associations with end-of-life preparation among pediatric patients who are deceased.

METHODS:

We reviewed 233 pediatric mortalities. Data extraction from the electronic health record included determination of PPC consultation by using Current Procedural Terminology codes. Diagnoses were identified by International Classification of Disease codes and were classified into categories of life-threatening complex chronic conditions (LT-CCCs). Data analysis included Student’s t test, Wilcoxon rank test, Fisher’s exact test, χ2 test, and multivariable logistic regression.

RESULTS:

The overall PPC consultation rate for pediatric patients who subsequently died was 24%. A PPC consultation for patients admitted to the pediatric ward and PICU was more likely than for patients cared for in the NICU (31% vs 12%, P < .01) and was more likely for those with an LT-CCC (40% vs 10%, P < .01), particularly malignancy (65% vs 35%, P < .01). Also noted were increased completion of Physician Orders for Life-Sustaining Treatment forms (8 vs 0, P < .01) and increased documentation of mental health disorders (60% vs 40%, P = .02).

CONCLUSIONS:

Our findings suggest that PPC consultation for patients in the pediatric ward and PICU is more likely among patients with a greater number of LT-CCCs, and is associated with increased Physician Orders for Life-Sustaining Treatment preparation and documentation of mental health disorders. Patients at risk to not receive PPC consultation are those with acute illness and patients in the NICU.
Understanding the Limitations of Fetal Cardiac Imaging
Authors: Schneider Patrick D. , Groner Abraham
Published: March 2018

Congenital heart defects are among the most common fetal structural malformations, with a prevalence of 8 in 1,000 live births, and are a significant source of infant mortality. Women with low-risk pregnancies are screened for fetal cardiac disease by anatomical ultrasonographic surveys. Fetal echocardiography is typically reserved for pregnant women with a suspected fetal cardiac lesion based on fetal survey and pregnancies at high risk for fetal congenital heart defects. Prenatal diagnosis allows for collaboration and consultation with multiple services, improved recognition of associated extracardiac anomalies, and early detection of underlying genetic anomalies. Theoretically, prenatal diagnosis should offer opportunities to improve postnatal management and long-term outcomes. However, the evidence to suggest benefit to prenatal diagnosis is mixed and the benefit seems to be dependent on the specific cardiac lesion. To facilitate the appropriate utilization of fetal echocardiography, it is necessary to understand how the study is currently being performed, its cost considerations, and how clinicians and sonographers can use it effectively to ensure appropriate image acquisition and interpretation.
Selective Serotonin Reuptake Inhibitor Use in Pregnancy: Repercussions on the Oblivious Passenger
Authors: Rodriguez-Kovacs Javier , Tien Shelly H. , Plunkett Beth A.
Published: March 2018

Depression is one of the most common comorbidities in pregnancy, and use of selective serotonin reuptake inhibitors (SSRIs) has become increasingly more common during this period. For this reason it is essential to understand the implications of SSRI use on fetal development and neonatal complications. As reviewed here, the preponderance of evidence suggests that the risk of teratogenicity with SSRI use is low. Poor neonatal adaptation or withdrawal syndrome is common among neonates exposed to SSRIs in the third trimester of pregnancy. However, the risk of severe neonatal adaptation syndrome, which would require neonatal intensive care, is low. The association between SSRI exposure and persistent pulmonary hypertension of the newborn remains controversial, but the evidence suggests a weak relationship with this rare outcome. The decision to initiate an SSRI in pregnancy should be individualized. Providers caring for pregnant women using SSRIs should feel comfortable discussing possible neonatal adaptation syndrome associated with the antenatal use of SSRIs, with a primary focus on appropriate treatment of maternal depression after discussion of risks and benefits.
Hypothyroidism and Iodine Deficiency in Children on Chronic Parenteral Nutrition
Authors: Ikomi Chijioke , Cole Conrad R. , Vale Emily , Golekoh Marjorie , Khoury Jane C. , Jones Nana-Hawa Yayah
Published: March 2018

BACKGROUND AND OBJECTIVES:

Iodine is an essential trace element for maintenance of normal thyroid function. Normal thyroid function is a prerequisite for neurocognitive development and growth in children. In the United States, iodine is not routinely added as a trace element in parenteral nutrition (PN). Our objective was to determine the prevalence of iodine deficiency and hypothyroidism in children on chronic PN.

METHODS:

This was a cross-sectional study of children <17 years of age and using PN for >6 months at a tertiary children’s hospital. Primary outcomes were spot urine iodine concentration (UIC), serum thyrotropin, and free thyroxine levels.

RESULTS:

Twenty-seven patients were identified (74% male). The median age at screening was 48 months (range: 7–213 months). The median duration on PN was 27 months (range: 11–77 months). Seventeen out of 20 patients (85%) were iodine deficient (spot UIC <100 μg/L), whereas 11 out of 20 patients (55%) were severely iodine deficient (spot UIC <20 μg/L). The prevalence of acquired hypothyroidism (elevated thyrotropin, low free thyroxine, and UIC <100 μg/L) was 33% (n = 8). None of the children with hypothyroidism screened for autoimmune thyroiditis had positive test results. There was no statistically significant association between duration of PN use and development of iodine deficiency (P = .08) or hypothyroidism (P = .96).

CONCLUSIONS:

Children on chronic PN are at risk for developing iodine deficiency and resultant hypothyroidism; hence, these children should be screened for these outcomes. Further studies are needed to define the temporal onset of iodine deficiency and timing to thyroid dysfunction related to PN.
Soil seed bank and its importance in the natural regeneration of degraded areas
Authors: Dos Santos Danielle Melo , Da Silva Kleber Andrade , Dos Santos Josiene Maria Falcão Fraga , Araújo Elcida de Lima
Published: March 2018

As florestas tropicais secas sofreram uma grande degradação por atividades antrópicas, e muitas foram convertidas em pastagens ou áreas agrícolas. Conseqüentemente, as características do banco de sementes do solo dessas áreas foram modificadas, e é necessário uma melhor compreensão das implicações para a regeneração natural das florestas. Nesta revisão, o objetivo foi reunir o conhecimento atual sobre a influência das práticas humanas sobre o banco de sementes de solo restante dos ambientes secos, para destacar as implicações da resiliência e da dinâmica da floresta. Realizou-se levantamento bibliográfico, das seguintes palavras-chave: banco de sementes, floresta semi-árida e seca. Em resumo, estudos mostram que o banco de sementes do solo é fortemente afetado por ações antropogênicas. Em geral, o banco de solo de áreas agro-pastorais sofre perda de espécies, E tem uma menor quantidade de sementes quando comparada com áreas não perturbadas pela ação antrópica. Portanto, entender a dinâmica espaço-temporal do banco de sementes na terra pós-uso é essencial para propor estratégias para o manejo sustentável e conservação da vegetação, especialmente considerando o cenário preditivo de mudança climática que deve aumentar a gravidade das secas e, talvez, Naturalmente, reduza o montante da semente que anualmente reabastece o estoque de sementes do solo.
Mathematical modeling of the frequencies of words of different lengths in written Hindi language corpora and examination of the role of texts’ stylistic factor in model’s parameters
Authors: Pande Hemlata , Dhami Hoshiyar S.
Published: March 2018

In quantitative research related to the areas of language and linguistics, first the linguistic features are specified and counted, and then statistical models are constructed in order to explicate these observed facts. In the present paper, an attempt has been made to represent the pattern of occurrence of words of different lengths in various corpora of Hindi language in the form of a mathematical model and an inspection has been made to check the dependency of the parameters of investigated model for a particular text in the type of text by selection of texts under categories media/essay and creative writing; or in other words we have attempted to test the applications of the parameters of the model in text classification process.
Encapsulation of metallic iron magnetic nanoparticles by polyacrylamide in water suspensions
Authors: Shankar A. , Safronov A. P. , Beketov I.
Published: March 2018

Theoretical consideration of the factors of the stability of metallic iron magnetic nanoparticles (MNPs) in water suspensions was done using extended DLVO (Derjaguin-Landau-Verwey-Overbeek) approach based on the balance among Van der Waals, electrostatic, magnetic and steric interactions.  Magnetic and steric interactions dominate over other in suspensions of Fe MNPs. To test the theory Fe MNPs with average diameter 84 nm were synthesized by electrical explosion of wire and encapsulated by polyacrylamide in water suspension to provide steric repulsion. It was shown that encapsulation resulted in the efficient diminishing of the aggregation of metallic iron MNPs in water.
Resistance of industrial nickel-containing methanation catalysts to the poisoning by organic carbon dioxide absorbents
Authors: Efremov V. N. , Golosman E. Z. , Kashinskaya A. V. , Mugenov T. I. , Zolotareva V. E. , Polivanov B. I. , Polushin A. P.
Published: March 2018

We report the results of studies on the influences of the organic carbon dioxide absorbent – aqueous solution of activated methyldiethanolamine (MDEA) – on the physico-chemical and mechanical characteristics of nickel-alumina catalyst NIAP-07-01 (NKM-1) and cement-containing catalysts NIAP-07-07 (NKM-7), Meth-134 and Meth-135 for the hydrogenation of carbon oxide (methanation). It is established that for the nickel-alumina and nickel-cement-containing catalysts subjected to activated methyldiethanolamine (MDEA) it’s possible to restore their strength and catalytic properties. In order to increase the time of operation of the methanator it is recommended to apply a new Nickel cement-containing catalyst NIAP-07-07 (NKM-7), which can be produced as tablets, rings or extrudates.
Study and optimization of the synthesis routine of the single phase YBaCo2O6-δ double perovskite
Authors: Sednev A. L. , Tsvetkov D. S.
Published: March 2018

The chemical interaction of YCoO3-δ and BaCoO3-δ with formation of double perovskite was studied depending on temperature and oxygen partial pressure. The stability of YCoO3 was shown to have а crucial influence on the kinetics and mechanism of YBaCo2O6-δ formation. It was found that at 1000 °C in air, i.e. under conditions when YCoO3 is unstable, the double perovskite YBaCo2O6-δ is formed much slower compared to the pure oxygen atmosphere where YCoO3 is stable at the same temperature. Thus controlling YCoO3 stability was shown to be the factor of key importance for optimal preparation of the YBaCo2O6-δ single phase.
Solubility and phase equilibria in the Na, Са || СО3, НСО3–H2O system at 0 °С
Authors: Soliev L. , Dzhumaev M. T. , Dzhabborov B. B.
Published: March 2018

The information on phase equilibria in the Na, Ca || CO3, HCO3-H2O system at 0 °С, predicted earlier by the translation method, has been obtained experimentally. Dependences of the concentration parameters reflecting phase equilibria are presented in the form of geometric patterns on the solubility diagram for the system studied. The diagram of solubility of the investigated system at 0 °С is constructed for the first time, in which the contours of the crystallization fields of individual phases are outlined, the conditions for their сo-crystallization in the form of curves and points are determined.
Why Words Matter: How the Common Mis-use of the Term Music Therapy May Both Hinder and Help Music Therapists
Authors: Pearson Sarah
Published: March 2018

This reflective paper examines occasions where medical studies refer to music therapy as a practice that can be used by non-music therapists. This common use of the term music therapy to describe any use of music for wellbeing, is an area of professional frustration and ethical concern for music therapists. The author explores reasons why the term music therapy is so commonly used to describe something other than the scope of practice; the impact on music therapists of this common misconception are discussed; and opportunities for music therapists to respond positively to these misconceptions are explored.
A cone surface in three-dimensional analyses of slopes with tension cut-off
Authors: Park Dowon , Michalowski Radoslaw L
Published: March 2018

A three-dimensional limit analysis of slopes is presented in this paper, based on a right circular cone failure surface. The associated translational mechanism appears to yield better assessment of the safety in isotropic rock than the traditional wedge-type mechanism. The strength of a bonded geomaterial was described using a linear strength envelope truncated in the tensile regime. The tensile strength cut-off so introduced constitutes a non-linear portion of the strength envelope, and it allows constructing failure mechanisms that include rupture modes, in addition to the shear deformation mode. Consequently, the mechanisms in materials with tension cut-off are more critical than those in materials with a traditional linear strength envelope. It is also demonstrated that the failure mechanism based on the right circular cone failure surface in vertical slopes yields results as good as or better than the more complex rotational mechanisms, although the difference is not very significant.
Design Of Dry Cask Storage For Serpong Multipurpose Reactor Spent Nuclear Fuel
Authors: Rahayu Dyah Sulistyani , Purwanto Yuli , Salimin Zainus
Published: March 2018

DESIGN OF DRY CASK STORAGE FOR SERPONG MULTI PURPOSE REACTOR SPENT NUCLEAR FUEL. The spent nuclear fuel (SNF) from Serpong Multipurpose Reactor, after 100 days storing in the reactor pond, is transferred to water pool interim storage for spent fuel (ISFSF). At present there are a remaining of 245 elements of SNF on the ISSF,198 element of which have been re-exported to the USA. The dry-cask storage allows the SNF, which has already been cooled in the ISSF, to lower its radiation exposure and heat decayat a very low level. Design of the dry cask storage for SNF has been done. Dual purpose of unventilated vertical dry cask was selected among other choices of metal cask, horizontal concrete modules, and modular vaults by taking into account of technical and economical advantages. The designed structure of cask consists of SNF rack canister, inner steel liner, concrete shielding of cask, and outer steel liner. To avoid bimetallic corrosion, the construction material for canister and inner steel liner follows the same material construction of fuel cladding, i.e. the alloy of AlMg2. The construction material of outer steel liner is copper to facilitate the heat transfer from the cask to the atmosphere. The total decay heat is transferred from SNF elements bundle to the atmosphere by a serial of heat transfer resistance for canister wall, inner steel liner, concrete shielding, and outer steel liner respectedly. The rack canister optimum capacity of 34 fuel elements was designed by geometric similarity method basedon SNF position arrangement of 7 x 6 triangular pitch array of fuel elements for prohibiting criticality by spontaneous neutron. The SNF elements are stored vertically on the rack canister.  The thickness of concrete wall shielding was calculated by trial and error to give air temperature of 30 oC and radiation dose on the wall surface of outer liner of 200 mrem/h. The SNF elements bundles originate from the existing racks of wet storage, i.e. rack canister no 3, 8 and 10. The value of I0 from the rack no 3, 8 and 10 are 434.307; 446.344; and 442.375 mrem/h respectively. The total heat decay from rack canister no 3,8 and 10 are 179.640 ; 335.2; and 298.551 watts. The result of the trial and error calculation indicates that the rack canister no 3, 8 and 10 need the thickness of concrete shielding of 0.1912, 0.1954 and 0.1940 m respectively.Keywords: heat and radiation decay, spent fuel , storage cask.
Die wegbeweeg vanaf gematigdheid na 'n radikale grondherverdelingsbenadering as transformasieprioriteit in Suid-Afrika
Authors: Van Der Elst H
Published: March 2018

'n Prioriteitskonsep wat deesdae gereeld gekoppel word aan radikale sosio-ekonomiese transformasie in Suid-Afrika (SA) is die oproep om versnelde grondherverdeling. In hierdie verband is daar konsensus onder akademici en meningsvormers dat grondhervorming in SA, met 'n spesifieke fokus op herverdeling, uiters traag plaasvind, en nie noodwendig die voorheen benadeelde massas bevoordeel nie. Vanuit verskillende oorde word geargumenteer dat die regering tot op hede 'n baie gematigde benadering tot grondherverdeling gevolg het. Dit is juis hierdie gematigde benadering wat bygedra het tot die trae pas van grondherverdeling. Teen die agtergrond van oproepe om radikale sosio-ekonomiese transformasie word daar toenemend gesinspeel dat daar wegbeweeg gaan word van 'n gematigde na 'n meer radikale grondherverdelingsbenadering. Dit is dan ook die doel van hierdie artikel om die regering se gematigde benadering tot grondherverdeling in oënskou te neem en te kontrasteer met die elemente van die ontvouende meer radikale beleids- en implementeringsbenadering. Die vraag word gestel: Wat is/was die rasionaal agter die huidige gematigde regeringsbenadering tot grondherverdeling, en watter faktore en beleidselemente gaan moontlik rigtinggewend wees vir die ontvouende meer radikale benadering?