bluuebunny/crossref_metadata_2025 huggingface dataset:
The role of technology in Australian youth mental health reform
Authors: Burns Jane M. , Birrell Emma , Bismark Marie , Pirkis Jane , Davenport Tracey A. , Hickie Ian B. , Weinberg Melissa K. , Ellis Louise A.
Published: March 2016

This paper describes the extent and nature of Internet use by young people, with specific reference to psychological distress and help-seeking behaviour. It draws on data from an Australian cross-sectional study of 1400 young people aged 16 to 25 years. Nearly all of these young people used the Internet, both as a source of trusted information and as a means of connecting with their peers and discussing problems. A new model of e-mental health care is introduced that is directly informed by these findings. The model creates a system of mental health service delivery spanning the spectrum from general health and wellbeing (including mental health) promotion and prevention to recovery. It is designed to promote health and wellbeing and to complement face-to-face services to enhance clinical care. The model has the potential to improve reach and access to quality mental health care for young people, so that they can receive the right care, at the right time, in the right way. What is known about the topic? One in four young Australians experience mental health disorders, and these often emerge in adolescence and young adulthood. Young people are also prominent users of technology and the Internet. Effective mental health reform must recognise the opportunities that technology affords and leverage this medium to provide services to improve outcomes for young people. What does this paper add? Information regarding the nature of young people’s Internet use is deficient. This paper presents the findings of a national survey of 1400 young Australians to support the case for the role of technology in Australian mental health reform. What are the implications for practitioners? The Internet provides a way to engage young people and provide access to mental health services and resources to reduce traditional barriers to help-seeking and care. eMental health reform can be improved by greater attention toward the role of technology and its benefits for mental health outcomes.
Indicators of herbivorous fish biomass in community-based marine management areas in Fiji
Authors: Albert Simon , Tawake Alifereti , Vave Ron , Fisher Paul , Grinham Alistair
Published: March 2016

There has been a resurgence in community-based management of coral reef resources in the developing world over the last two decades. However, many of the threats to reef ecosystems are increasing at a rate beyond local knowledge acquisition. Consequently, there is a continuing need for management tools and monitoring to support community-based approaches. Using algal, fish and reef indicators we provide a rapid assessment method of herbivorous fishes in Locally Managed Marine Areas in Fiji. The algal indicator technique provided a time-integrated assessment of the process of herbivory within Locally Managed Marine Areas and could be used by untrained community members to quantify management responses. Generally, reefs with higher herbivore biomass had a diverse low biomass of algae typical of healthy reefs. Reefs with fewer herbivores had a higher biomass of turf or leathery algae typical of degraded reefs. These results show that simple ecological indicators can be a useful addition to the existing local knowledge that underpins community-based management.
The ability of winter grazing to reduce wildfire size and fire-induced plant mortality was not demonstrated: a comment on Davies et al. (2015)
Authors: Smith Alistair M. S. , Talhelm Alan F. , Kolden Crystal A. , Newingham Beth A. , Adams Henry D. , Cohen Jack D. , Yedinak Kara M. , Kremens Robert L.
Published: March 2016

A recent study by Davies et al. sought to test whether winter grazing could reduce wildfire size, fire behaviour and intensity metrics, and fire-induced plant mortality in shrub–grasslands. The authors concluded that ungrazed rangelands may experience fire-induced mortality of native perennial bunchgrasses. The authors also presented several statements regarding the benefits of winter grazing on post-fire plant community responses. However, we contend that the study by Davies et al. has underlying methodological errors, lacks data necessary to support their conclusions, and does not provide a thorough discussion on the effect of grazing on rangeland ecosystems. Importantly, Davies et al. presented no data on the post-fire mortality of the perennial bunchgrasses or on the changes in plant community composition following their experimental fires. Rather, Davies et al. inferred these conclusions based on their observed fire behaviour metrics of maximum temperature and a term described as the ‘heat load’. However, we contend that neither metric is appropriate for describing the heat flux impacts on plants. This lack of post-fire data, several methodological errors and the use of inappropriate thermal metrics limit the authors’ ability to support their stated conclusions.
Reforming the national core curriculum for bilingual education in Finland
Authors: Bergroth Mari
Published: March 2016

This article explores the discourses surrounding the act of writing Section 10 Bilingual education in the new Finnish national core curriculum, which will be implemented in 2016. This section will set the parameters for programs that integrate language and content learning, where a minimum of two languages are used for instruction in content subjects. The main research questions discussed in this article are how and why certain discourses are expressed, or left unexpressed, in the final draft version of the curriculum. The data for qualitative analysis consists of participatory observations and minutes of meetings in the working group assembled for writing the draft.
Whysuave movimientoisn’t ‘smooth movement’
Authors: Sullivan Karen
Published: March 2016

Spanishsuaveis sometimes translated as Englishsmoothorsoft. In cluster analyses of data from the British National Corpus and the Corpus del Español, senses ofsuaveare found to align in some ways withsmooth, in other respects withsoft, and sometimes with neither adjective. For instance, the ‘quiet’ sense ofsoftinsoft noiseis related to the ‘gentle’ sense insoft caress. The ‘quiet’ sense ofsuaveis similarly related to a ‘gentle’ sense. On the other hand, bothsmooth electionandsuave transición‘suavetransition’ indicate an easy process, butsmoothinsmooth electionclusters with the sense insmooth motion, whereassuaveinsuave transiciónclusters with the sense insuave velo‘suaveveil’. That is, asmooth electionis ‘easy’ in the manner of an unobstructed motion, whereas asuave transiciónis ‘easy’ to deal with, like a lightweight burden.
The devil is in the details of hand movement
Authors: Lin Yu-Cheng , Bangert Ashley S. , Schwartz Ana I.
Published: March 2016

Research with native-speaking monolinguals demonstrates that orthographic coding during lexical access is flexible in terms of letter positioning. Evidence for this comes in part from the observation of priming from transposed-letter (TL) non-words (jugde/judge), which is assumed to arise from spread of activation throughout an orthographically-defined neighborhood. The present study tested the hypothesis that, for bilinguals, orthographic coding of letter position is influenced by cross-language lexical activation. TL non-words were created from English-Spanish cognates that differed in their degree of orthographic overlap as well as from non-cognates. In Experiment 1, these served as primes in a masked lexical decision task. In Experiment 2, they were presented as targets in a mouse-tracking lexical decision task. In both experiments Spanish-­English bilinguals’ lexical decision performance reflected greater TL priming for cognates relative to non-cognates and for cognates with more orthographic overlap relative to cognates with less orthographic overlap.
Des saints et des insectes…
Authors: Perrin Hélène
Published: March 2016

Les saints sont parfois représentés avec des animaux, loups, cerfs, corbeaux ou même dragons; ils sont plus rarement accompagnés des plus petits d’entre eux, insectes, araignées. Cette iconographie est née de textes du Moyen Âge et principalement de la Légende dorée. Le rôle des insectes sensu lato n’est pas toujours le même: ils sont signes d’une destinée hors du commun, ils sont l’instrument d’une punition ou chantent la gloire de Dieu, ils montrent le pouvoir de celui qui a mis sa foi en Dieu. Ces récits traduisent de manière imagée un enseignement destiné aux chrétiens qui écoutent.*
Von Apollo bis Zeus
Authors: van Dijk Gert-Jan
Published: March 2016

Neben sprechenden Tieren, Pflanzen und Sachen begegnen in den antiken und mittelalterlichen Fabelsammlungen – und noch in den späteren, wie zum Beispiel der des Jean de La Fontaine – auch viele Geschichten mit Göttern und Menschen. Der vorliegende Beitrag will die Texte des griechischrömischen Fabel-Korpus, in welchen Götter – sowohl olympische als nicht olympische – Erwähnung finden, zusammenstellen. Ein abschliessender Ausblick deutet einige Richtungen für mögliche künftige Untersuchungen an.
Direccionales con con y Marcado Diferencial de Objeto
Authors: Fábregas Antonio
Published: March 2016

An understudied property of Spanish grammar is the possibility of obtaining a directional reading with a PP introduced by con ‘with’, as in Ven con papá ‘Come to daddy’. This work explores this construction taking into account both the properties of the verb and the prepositional phrase, identifying as one of the restrictions that the preposition must in such cases introduce an animate noun; this relates such cases to standard Differential Object Marking (DOM). The proposal, which closely follows the analyses of DOM based on animacy, is that con is able to grammaticalise the [person] property of an animate noun.
Los editoriales de la revista Antorcha de Paja
Authors: Rosal María
Published: March 2016

In the last years of the Spanish dictatorship and transition to democracy, the journal Antorcha de Paja developed an intense work on the Spanish culture from a position of rebelliousness and heterodoxy. Forty years after its appearance, we analyze in this article the references to the cultural conditions and the sociopolitical context where it is developed. The study starts from the editorials published in each number of the journal. A bibliographical review of the contributions of other experts in the topic is also carried out.
Physical activity estimated by the bone‐specific physical activity questionnaire is also associated with cardiovascular risk
Authors: Weeks Benjamin K. , Purvis Meredith , Beck Belinda R.
Published: March 2016

The nature of physical activity that benefits bone is traditionally thought to differ from that benefiting cardiovascular health. Accordingly, exercise recommendations for improving bone health and cardiovascular health are largely incongruent. Our aim was to determine the associations between high‐impact physical activity participation and both cardiovascular disease risk factors and bone mass. We recruited 94 men and women (age 34.0 ± 13.3 years) to undergo measures of cardiovascular disease risk (BMI, total cholesterol, fasting blood glucose, waist‐to‐hip ratio, and mean arterial pressure) and dual‐energy X‐ray absorptiometry (DXA XR‐800, Norland) measures of bone mass (femoral neck, lumbar spine, and whole body BMD) and body composition (whole body lean mass and fat mass). Physical activity participation was estimated using the bone‐specific physical activity questionnaire (BPAQ). Those in the upper tertile for current BPAQ score exhibited lower total cholesterol, waist‐to‐hip ratio, and mean arterial pressure than those in the lower tertiles (P < 0.05) with the relationship being mild‐to‐moderate (r = −0.49 to 0.29, P < 0.01). Those in the upper tertile for BPAQ score also had greater lumbar spine BMD than those in the lower tertile (P = 0.008), with BPAQ score predicting 6% of the variance in BMD (P = 0.02). We conclude that high‐impact physical activity as captured by the BPAQ may be beneficial for both bone health and for attenuating cardiovascular disease risk.
The evolving and interacting bases of EU environmental policy legitimacy
Authors: Brown M. Leann
Published: March 2016

Some recent scholarship has focused on concerns that implementation and compliance difficulties are undermining the legitimacy of European Union environmental policies and even the EU itself. Other officials and analysts, however, contend that environmental policy is one of the EU's most successful policy areas. While most discuss ‘legitimacy’ in unspecified or dichotomous terms, it is instead a more nuanced and contested concept. This study investigates several evolving and interacting bases of legitimacies associated with ‘permissive acceptance’ (based upon functional need, scientific and technical authority, and policy effectiveness), ‘appropriateness’ (based upon normative consensus, legalization, and adjudication), democracy (based upon representation, participation, and deliberation), and identity (based upon global leadership and ‘othering’). These legitimacies vary in terms of their strength, stability, and durability among the multiple European actors and institutions.
Projections in 𝐿¹(𝐺): the unimodular case
Authors: Alaghmandan Mahmood , Ghandehari Mahya , Spronk Nico , Taylor Keith
Published: March 2016

We consider the issue of describing all self-adjoint idempotents (projections) in

L
1

(
G
)

L^1(G)

when

G
G

is a unimodular locally compact group. The approach is to take advantage of known facts concerning subspaces of the Fourier-Stieltjes and Fourier algebras of

G
G

and the topology of the dual space of

G
G

. We obtain an explicit description of any projection in

L
1

(
G
)

L^1(G)

which happens to also lie in the coefficient space of a finite direct sum of irreducible representations. This leads to a complete description of all projections in

L
1

(
G
)

L^1(G)

for

G
G

belonging to a class of groups that includes

SL

2

(

R

)

\textrm {SL}_2({\mathbb R})

and all second countable almost connected nilpotent locally compact groups.
The isotropy constant and boundary properties of convex bodies
Authors: Meyer Mathieu , Reisner Shlomo
Published: March 2016

Let

K

n

\mathcal {K}^n

be the set of all convex bodies in

R

n

\mathbb {R}^n

endowed with the Hausdorff distance. We prove that if

K
∈

K

n

K\in \mathcal {K}^n

has positive generalized Gauss curvature at some point of its boundary, then

K
K

is not a local maximizer for the isotropy constant

L
K

L_K

.
The boundedness of the weighted Coxeter group with complete graph
Authors: Shi Jian-yi , Yang Gao
Published: March 2016

We prove that a weighted Coxeter group

(
W
,
S
,
L
)

(W,S,L)

is bounded with
<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" alttext="bold a left-parenthesis upper W right-parenthesis equals bold b prime left-parenthesis upper W right-parenthesis colon equals max left-brace right-brace comma comma comma comma of LL left-parenthesis right-parenthesis u comma bar bar of LL left-parenthesis right-parenthesis w comma s comma tu comma s comma element-of element-of tS comma greater-than greater-than vertical-bar vertical-bar upper W comma s comma t infinity">

a

(
W
)
=

b

′

(
W
)
:=
max
{
L
(
u
)
,
L
(

w

s
,
t

)
∣
u
,
s
,
t
∈
S
,

|

W

s
,
t

|

>
∞
}

\mathbf {a}(W)=\mathbf {b}’(W):=\max \{L(u),L(w_{s,t})\mid u,s,t\in S,|W_{s,t}|>\infty \}

if the Coxeter graph of

W
W

is complete and

b

′

(
W
)
>
∞

\mathbf {b}’(W)>\infty

, where

W

s
,
t

W_{s,t}

is the parabolic subgroup of

W
W

generated by

s
≠
t

s\ne t

in

S
S

and

w

s
,
t

w_{s,t}

is the longest element in

W

s
,
t

W_{s,t}

whenever

W

s
,
t

W_{s,t}

is finite.
Reflection group relations arising from cluster algebras
Authors: Seven Ahmet
Published: March 2016

There is a well-known analogy between cluster algebras and Kac-moody algebras: roughly speaking, Kac-Moody algebras are associated with symmetrizable generalized Cartan matrices while cluster algebras correspond to skew-symmetrizable matrices. In this paper, we study an interplay between these two classes of matrices. We obtain relations in the Weyl groups of Kac-Moody algebras that come from mutation classes of skew-symmetrizable matrices. More precisely, we establish a set of relations satisfied by the reflections of the so-called companion bases; these include c-vectors, which parametrize coefficients in a cluster algebra with principal coefficients. These relations generalize the relations obtained by Barot and Marsh for finite type. For affine type, we also show that the reflections of the companion bases satisfy the relations obtained by Felikson and Tumarkin. As an application, we obtain some combinatorial properties of the mutation classes of skew-symmetrizable matrices.
Convex separably rationally connected complete intersections
Authors: Furukawa Katsuhisa
Published: March 2016

We give a generalization of a result of R. Pandharipande to arbitrary characteristic: We prove that, if

X
X

is a convex, separably rationally connected, smooth complete intersection in

P

N

\mathbb {P}^N

over an algebraically closed field of arbitrary characteristic, then

X
X

is rational homogeneous.
Some remarks related to Maeda’s conjecture
Authors: Murty M. , Srinivas K.
Published: March 2016

In this article we deal with the problem of counting the number of pairs of normalized eigenforms

(
f
,
g
)

(f,g)

of weight

k
k

and level

N
N

such that

a
p

(
f
)
=

a
p

(
g
)

a_p (f) = a_p (g)

where

a
p

(
f
)

a_p (f)

denotes the

p
p

-th Fourier coefficient of

f
f

. Here

p
p

is a fixed prime.
Nonhomogeneity of remainders
Authors: Arhangel’skii A. , van Mill J.
Published: March 2016

We present a cardinal inequality for the number of homeomorphisms of the remainders of compactifications of nowhere locally compact spaces. As a consequence, we obtain that if

X
X

is countable and dense in itself, then the remainder of any compactification of

X
X

has at most continuum many homeomorphisms.
Displaying updates in logic
Authors: Aucher Guillaume
Published: March 2016

We generalize the language of substructural logics interpreted over the ternary relational semantics. This is motivated by our intention to capture within the logical framework of substructural logics various logic-based formalisms dealing with common sense reasoning and logical dynamics. This initiative is based on the key observation that an update can be represented abstractly by the ternary relation of the substructural framework: the first argument of the ternary relation represents an initial situation, the second an informative event and the third the resulting situation after the occurrence of the informative event. Refining the language of substructural logics may allow us to account for the fine-grained reasoning present in common sense reasoning. Thus, we introduce three triples of connectives that are interconnected by means of cyclic permutations. The usual fusion, implication and co-implication connectives form one of these triples. We define a cut-free display calculus for our language that generalizes the display calculus for modal logic. We do not resort to structural connectives for truth constants and we show how we can obtain our display rules using Gaggle Theory. We prove the soundness and strong completeness of our display calculus via a Henkin-style construction. Using correspondence results from substructural logics, we also obtain sound and complete display calculi for a wide variety of classical and substructural logics. Then, we define dual substructural connectives and we provide a display calculus for our language extended with these dual connectives. Finally, we focus on the specific case of bi-intuitionistic logic for which we provide a novel sound and strongly complete display calculus. In a companion article (Aucher, 2016, J. Logic Comput.), we provide a sequent calculus for update logic that generalizes the non-associative Lambek calculus and a sequent calculus for dynamic epistemic logic that extends this sequent calculus for update logic.
Is There an Association Between Pain and Magnetic Resonance Imaging Parameters in Patients With Lumbar Spinal Stenosis?
Authors: Burgstaller Jakob M. , Schüffler Peter J. , Buhmann Joachim M. , Andreisek Gustav , Winklhofer Sebastian , Del Grande Filippo , Mattle Michèle , Brunner Florian , Karakoumis Georgios , Steurer Johann , Held Ulrike
Published: March 2016

Study Design.

A prospective multicenter cohort study.

Objective.

The aim of this study was to identify an association between pain and magnetic resonance imaging (MRI) parameters in patients with lumbar spinal stenosis (LSS).

Summary of Background Data.

At present, the relationship between abnormal MRI findings and pain in patients with LSS is still unclear.

Methods.

First, we conducted a systematic literature search. We identified relationships of relevant MRI parameters and pain in patients with LSS. Second, we addressed the study question with a thorough descriptive and graphical analysis to establish a relationship between MRI parameters and pain using data of the LSS outcome study (LSOS).

Results.

In the systematic review including four papers about the associations between radiological findings in the MRI and pain, the authors of two articles reported no association and two of them did. Of the latters, only one study found a moderate correlation between leg pain measured by Visual Analog Scale (VAS) and the degree of stenosis assessed by spine surgeons. In the data of the LSOS study, we could not identify a relevant association between any of the MRI parameters and buttock, leg, and back pain, quantified by the Spinal Stenosis Measure (SSM) and the Numeric Rating Scale (NRS). Even by restricting the analysis to the level of the lumbar spine with the most prominent radiological “stenosis,” no relevant association could be shown.

Conclusion.

Despite a thorough analysis of the data, we were not able to prove any correlation between radiological findings (MRI) and the severity of pain. There is a need for innovative “methods/techniques” to learn more about the causal relationship between radiological findings and the patients’ pain-related complaints.

Level of Evidence:2
Impact of Proactive Nurse Participation in ICU Family Conferences: A Mixed-Method Study
Authors: Garrouste-Orgeas Maité , Max Adeline , Lerin Talia , Grégoire Charles , Ruckly Stéphane , Kloeckner Martin , Brochon Sandie , Pichot Emmanuelle , Simons Clara , El-Mhadri Myriame , Bruel Cédric , Philippart François , Fournier Julien , Tiercelet Kelly , Timsit Jean-François , Misset Benoit
Published: March 2016

Objectives:

To investigate family perceptions of having a nurse participating in family conferences and to assess the psychologic well being of the same families after ICU discharge.

Design:

Mixed-method design with a qualitative study embedded in a single-center randomized study.

Setting:

Twelve-bed medical-surgical ICU in a 460-bed tertiary hospital.

Subjects:

One family member for each consecutive patient who received more than 48 hours of mechanical ventilation in the ICU.

Intervention:

Planned proactive participation of a nurse in family conferences led by a physician. In the control group, conferences were led by a physician without a nurse.

Measurements and Main Results:

Of the 172 eligible family members, 100 (60.2%) were randomized; among them, 88 underwent semistructured interviews at ICU discharge and 86 completed the Peritraumatic Dissociative Experiences Questionnaire at ICU discharge and then the Hospital Anxiety Depression Questionnaire and the Impact of Event Scale (for posttraumatic stress–related symptoms) 3 months later. The intervention and control groups were not significantly different regarding the prevalence of posttraumatic stress–related symptoms (52.3 vs 50%, respectively; p = 0.83). Anxiety and depression subscale scores were significantly lower in the intervention group. The qualitative data indicated that the families valued the principle of the conference itself. Perceptions of nurse participation clustered into four main themes: trust that ICU teamwork was effective (50/88; 56.8%), trust that care was centered on the patient (33/88; 37.5%), trust in effective dissemination of information (15/88; 17%), and trust that every effort was made to relieve anxiety in family members (12/88; 13.6%).

Conclusions:

Families valued the conferences themselves and valued the proactive participation of a nurse. These positive perceptions were associated with significant anxiety or depression subscale scores but not with changes in posttraumatic stress–related symptoms.
Variations in Case-Mix–Adjusted Duration of Mechanical Ventilation Among ICUs*
Authors: Kramer Andrew A. , Gershengorn Hayley B. , Wunsch Hannah , Zimmerman Jack E.
Published: March 2016

Objectives:

To develop a model that predicts the duration of mechanical ventilation and then to use this model to compare observed versus expected duration of mechanical ventilation across ICUs.

Design:

Retrospective cohort analysis.

Setting:

Eighty-six eligible ICUs at 48 U.S. hospitals.

Patients:

ICU patients receiving mechanical ventilation on day 1 (n = 56,336) admitted from January 2013 to September 2014.

Interventions:

None.

Measurements and Main Results:

We developed and validated a multivariable logistic regression model for predicting duration of mechanical ventilation using ICU day 1 patient characteristics. Mean observed minus expected duration of mechanical ventilation was then obtained across patients and for each ICU. The accuracy of the model was assessed using R
2. We defined better performing units as ICUs that had an observed minus expected duration of mechanical ventilation less than –0.5 days and a p value of less than 0.01; and poorer performing units as ICUs with an observed minus expected duration of mechanical ventilation greater than +0.5 days and a p value of less than 0.01. The factors accounting for the majority of the model’s explanatory power were diagnosis (71%) and physiologic abnormalities (24%). For individual patients, the difference between observed and mean predicted duration of mechanical ventilation was 3.3 hours (95% CI, 2.8–3.9) with R
2 equal to 21.6%. The mean observed minus expected duration of mechanical ventilation across ICUs was 3.8 hours (95% CI, 2.1–5.5), with R
2 equal to 69.9%. Among the 86 ICUs, 66 (76.7%) had an observed mean mechanical ventilation duration that was within 0.5 days of predicted. Five ICUs had significantly (p < 0.01) poorer performance (observed minus expected duration of mechanical ventilation, > 0.5 d) and 14 ICUs significantly (p < 0.01) better performance (observed minus expected duration of mechanical ventilation, < −0.5 d).

Conclusions:

Comparison of observed and case-mix–adjusted predicted duration of mechanical ventilation can accurately assess and compare duration of mechanical ventilation across ICUs, but cannot accurately predict an individual patient’s mechanical ventilation duration. There are substantial differences in duration of mechanical ventilation across ICU and their association with unit practices and processes of care warrants examination.
Beneficial Effects of Early Enteral Nutrition After Major Rectal Surgery: A Possible Role for Conditionally Essential Amino Acids? Results of a Randomized Clinical Trial
Authors: van Barneveld Kevin W. Y. , Smeets Boudewijn J. J. , Heesakkers Fanny F. B. M. , Bosmans Joanna W. A. M. , Luyer Misha D. , Wasowicz Dareczka , Bakker Jaap A. , Roos Arnout N. , Rutten Harm J. T. , Bouvy Nicole D. , Boelens Petra G.
Published: March 2016

Objectives:

To investigate direct postoperative outcome and plasma amino acid concentrations in a study comparing early enteral nutrition versus early parenteral nutrition after major rectal surgery. Previously, it was shown that a low plasma glutamine concentration represents poor prognosis in ICU patients.

Design:

A preplanned substudy of a previous prospective, randomized, open-label, single-centre study, comparing early enteral nutrition versus early parenteral nutrition in patients at high risk of postoperative ileus after surgery for locally advanced or locally recurrent rectal cancer. Early enteral nutrition reduced postoperative ileus, anastomotic leakage, and hospital stay.

Setting:

Tertiary referral centre for locally advanced and recurrent rectal cancer.

Patients:

A total of 123 patients with locally advanced or recurrent rectal carcinoma requiring major rectal surgery.

Interventions:

Patients were randomized (ALEA web-based external randomization) preoperatively into two groups: early enteral nutrition (early enteral nutrition, intervention) by nasojejunal tube (n = 61) or early parenteral nutrition (early parenteral nutrition, control) by jugular vein catheter (n = 62). Eight hours after the surgical procedure artificial nutrition was started in hemodynamically stable patients, stimulating oral intake in both groups. Blood samples were collected to measure plasma glutamine, citrulline, and arginine concentrations using a validated ultra performance liquid chromatography-tandem mass spectrometric method.

Measurements and Main Results:

Baseline concentrations were comparable for both groups. Directly after rectal surgery, a decrease in plasma amino acids was observed. Plasma glutamine concentrations were higher in the parenteral group than in the enteral group on postoperative day 1 (p = 0.027) and day 5 (p = 0.008). Arginine concentrations were also significantly increased in the parenteral group at day 1 (p < 0.001) and day 5 (p = 0.001).

Conclusions:

Lower plasma glutamine and arginine concentrations were measured in the enteral group, whereas a better clinical outcome was observed. We conclude that plasma amino acids do not provide a causal explanation for the observed beneficial effects of early enteral feeding after major rectal surgery.
Eicosapentaenoic Acid Inhibits Oxidation of ApoB-containing Lipoprotein Particles of Different Size In Vitro When Administered Alone or in Combination With Atorvastatin Active Metabolite Compared With Other Triglyceride-lowering Agents
Authors: Mason R. Preston , Sherratt Samuel C.R. , Jacob Robert F.
Published: March 2016

Eicosapentaenoic acid (EPA) is a triglyceride-lowering agent that reduces circulating levels of the apolipoprotein B (apoB)-containing lipoprotein particles small dense low-density lipoprotein (sdLDL), very–low-density lipoprotein (VLDL), and oxidized low-density lipoprotein (LDL). These benefits may result from the direct antioxidant effects of EPA. To investigate this potential mechanism, these particles were isolated from human plasma, preincubated with EPA in the absence or presence of atorvastatin (active) metabolite, and subjected to copper-initiated oxidation. Lipid oxidation was measured as a function of thiobarbituric acid reactive substances formation. EPA inhibited sdLDL (IC50 ∼2.0 μM) and LDL oxidation (IC50 ∼2.5 μM) in a dose-dependent manner. Greater antioxidant potency was observed for EPA in VLDL. EPA inhibition was enhanced when combined with atorvastatin metabolite at low equimolar concentrations. Other triglyceride-lowering agents (fenofibrate, niacin, and gemfibrozil) and vitamin E did not significantly affect sdLDL, LDL, or VLDL oxidation compared with vehicle-treated controls. Docosahexaenoic acid was also found to inhibit oxidation in these particles but over a shorter time period than EPA. These data support recent clinical findings and suggest that EPA has direct antioxidant benefits in various apoB-containing subfractions that are more pronounced than those of other triglyceride-lowering agents and docosahexaenoic acid.
The Descending Thoracic Aorta: Forgotten Vascular Access for Endovascular Device Delivery
Authors: Allen Keith B. , Borkon A. Michael , Aggarwal Sanjeev , Davis J. Russell , Laster Steven , Cohen David J. , Chhatriwalla Adnan K. , Hart Anthony , Baron Suzanne J.
Published: March 2016

Vascular access for large endovascular devices has evolved as patients have become more complicated and device indications have expanded. As the benefits of catheter-based treatments for aortic aneurysm repair and aortic valve replacement become mainstream, there is a need to address difficult vascular access by developing not only smaller-diameter devices but also creative options for vascular access. We describe direct descending thoracic aortic access during endovascular aneurysm repair, transcatheter aortic valve replacement, and redo mesenteric revascularization in three patients who did not have traditional access options.
Augmented Reality System for Ultrasound Guidance of Transcatheter Aortic Valve Implantation
Authors: Currie Maria E. , McLeod A. Jonathan , Moore John T. , Chu Michael W. A. , Patel Rajni , Kiaii Bob , Peters Terry M.
Published: March 2016

Objective

Transcatheter aortic valve implantation (TAVI) relies on fluoroscopy and nephrotoxic contrast medium for valve deployment. We propose an alternative guidance system using augmented reality (AR) and transesophageal echocardiography (TEE) to guide TAVI deployment. The goals of this study were to determine how consistently the aortic valve annulus is defined from TEE using different aortic valve landmarks and to compare AR guidance with fluoroscopic guidance of TAVI deployment in an aortic root model.

Methods

Magnetic tracking sensors were integrated into the TAVI catheter and TEE probe, allowing these tools to be displayed in an AR environment. Variability in identifying aortic valve commissures and cuspal nadirs was assessed using TEE aortic root images. To compare AR guidance of TAVI deployment with fluoroscopic guidance, a TAVI stent was deployed 10 times in the aortic root model using each of the two guidance systems.

Results

Commissures and nadirs were both investigated as features for defining the valve annulus in the AR guidance system. The commissures were identified more consistently than the nadirs, with intraobserver variability of 2.2 and 3.8 mm, respectively, and interobserver variability of 3.3 and 4.7 mm, respectively. The precision of TAVI deployment using fluoroscopic guidance was 3.4 mm, whereas the precision of AR guidance was 2.9 mm, and its overall accuracy was 3.4 mm. This indicates that both have similar performance.

Conclusions

Aortic valve commissures can be identified more reliably than cuspal nadirs from TEE. The AR guidance system achieved similar deployment accuracy to that of fluoroscopy while eliminating the use and consequences of nephrotoxic contrast and radiation.
Effects of Stretching Exercise on Heart Rate Variability During Pregnancy
Authors: Logan Jeongok G. , Yeo SeonAe
Published: March 2016

Background:

Little evidence exists for effects of low-intensity exercises such as stretching on cardiovascular health in pregnant women.

Aim:

Our aim was to evaluate the effect of a 20-minute stretching exercise on heart rate variability (HRV), blood pressure (BP), and heart rate (HR) in healthy pregnant women.

Methods:

In 15 pregnant women with a mean (SD) age of 29.47 (4.07) years and mean (SD) gestational weeks of 26.53 (8.35), HRV, and BP were measured before and after the 20-minute stretching exercise.

Results:

Compared with before the stretching exercise, standard deviation of the normal-to-normal intervals, total variability of heart rate, increased by 7.40 milliseconds (t = −2.31, P = .04) and root mean square of successive differences, a surrogate measure of parasympathetic outflow, also increased by 11.68 milliseconds (Z = −2.04, P = .04) after the stretching exercise. Diastolic BP and HR decreased by 2.13 mm Hg (t = 1.93, P = .07) and 3.31 bpm (t = 2.17, P = .05), respectively, but they did not reach statistical significance.

Discussion:

These preliminary data suggest that 20 minutes of stretching exercise may promote cardiovascular health by attenuating the loss of parasympathetic tone associated with pregnancy.
A retrospective analysis of the occurrence of accidents during 20 years of neonatal transport in Liguria region, Italy
Authors: Bellini Carlo , Risso Francesco M. , Sannia Andrea , Campone Francesco , Traggiai Cristina , Ramenghi Luca A.
Published: March 2016

Our article focuses on a retrospective analysis of the occurrence of accidents relating to 20 years of activity of Neonatal Emergency Transport Service (NETS) in Liguria region, Italy. The objective of this study is to determine the vehicle accident rate for a specialized emergency medical services-NETS transport system between 1995 and 2015. We reviewed 5035 medical records related to the activity of our NETS from its beginning, in February 1995 to June 2015. We identified the occurrence of three road accidents (rate ∼1 : 1600 transports; 1 : 170 000 driven km), no helicopter accidents and only one technical problem during helicopter use; our service was not involved in any crashes resulting in injury. We discussed some reasons possibly explaining these good results.
Investigation of Sacral Needle Depth in Minimally Invasive Sacrocolpopexy
Authors: Graham Edith , Akl Ahmed , Brubaker Linda , Dhaher Yasin , Fitzgerald Colleen , Mueller Elizabeth Rose
Published: March 2016

Purpose

The aims of the study were to optimize surgical safety and to minimize vertebral disc puncture during sacral needle placement at the time of minimally invasive sacrocolpopexy. Cadaveric studies report that the anterior longitudinal ligament (ALL), which covers the vertebral disc and vertebrae, has a reported thickness of only 1.4 to 2.3 mm at L5-S1. Intervertebral disc puncture can accelerate disc degeneration, disc herniation, and loss of disc height, a risk that may be avoidable.

Materials and Methods

After institutional review board approval, research consent was obtained from women undergoing primary laparoscopic sacrocolpopexy. Intraoperatively, sacral sutures were placed in the ALL with a 1.5 cm diameter CV-2 needle using Gore-Tex suture. Depth measurements were collected using a laparoscopic ultrasound transducer positioned on the sacral promontory (SP) between the 2 ends of the needle visible through the ALL. Two still-frame US images of the single needle were taken using the BK Medical software. Needle depth was calculated by measuring the distance from the top of the ALL to the needle.

Results

Two satisfactory intraoperative images were obtained for all 9 participants. The mean needle depth at the SP was 3.96 mm. The interpatient needle depth varied from 2.07 to 9.04 mm.

Conclusions

In most participants (78%), the sacral needle depth exceeded 2.3 mm, suggesting that there may be risk to sacral suture placement without depth guidance at the promontory. During minimally invasive sacrocolpopexy, the depth of the ALL and the placement of the needle at the SP may result in inadvertent disc penetration. Surgeons should be conscious of the minimal depth of the ALL and consider placing the suture below the promontory to avoid the disc.
Factors Influencing Selection of Vaginal, Open Abdominal, or Robotic Surgery to Treat Apical Vaginal Vault Prolapse
Authors: Anand Mallika , Weaver Amy L. , Fruth Kristin M. , Gebhart John B.
Published: March 2016

Objectives

This study aimed to determine factors influencing the selection of Mayo-McCall culdoplasty (MMC), open abdominal sacrocolpopexy (ASC), or robotic sacrocolpopexy (RSC) for posthysterectomy vaginal vault prolapse.

Methods

We retrospectively searched for the records of patients undergoing posthysterectomy apical vaginal prolapse surgery between January 1, 2000, and June 30, 2012, at our institution. Baseline characteristics and explicit selection factors were abstracted from the electronic medical records. Factors were compared between groups using χ2 tests for categorical variables, analysis of variance for continuous variables, and Kruskal-Wallis tests for ordinal variables.

Results

Among the 512 patients identified who met inclusion criteria, the MMC group (n = 174) had more patients who were older, had American Society of Anesthesiologists class 3+ or greater, had anterior vaginal prolapse grade 3+, desired to avoid abdominal surgery, and did not desire a functional vagina. Patients in the ASC (n = 237) and RSC (n = 101) groups had more failed prolapse surgeries, suspected abdominopelvic pathologic processes, and chronic pain. Advanced prolapse was more frequently cited as an explicit selection factor for ASC than for either MMC or RSC.

Conclusions

The most common factors that influenced the type of apical vaginal vault prolapse surgery overlapped with characteristics that differed at baseline. In general, MMC was chosen for advanced anterior vaginal prolapse and baseline characteristics that increased surgical risks, ASC for advanced apical prolapse, and ASC or RSC for recurrent prolapse, suspected abdominal pathology, and patients with chronic pain or lifestyles including heavy lifting. Thus, efforts should be made to attempt to control for selection bias when comparing these procedures.
Times to Key Events in the Course of Zika Infection and their Implications for Surveillance: A Systematic Review and Pooled Analysis
Authors: Lessler Justin , Ott Cassandra T. , Carcelen Andrea C. , Konikoff Jacob M. , Williamson Joe , Bi Qifang , Reich Nicholas G. , Cummings Derek A. T. , Kucirka Lauren M. , Chaisson Lelia H.
Published: March 2016

Background

Evidence suggests that Zika virus has driven a 10-fold increase in babies born with microcephaly in Brazil, prompting the WHO to declare a Public Health Emergency of International Concern. However, little is known about the natural history of infection. These data are critical for implementing surveillance and control measures such as protecting the blood supply.

Methods

We conducted a systematic review and pooled analysis to estimate the distribution of times from Zika infection to symptom onset, seroconversion, and viral clearance, and analyzed their implications for surveillance and blood supply safety.

Results

Based on 25 cases, we estimate the median incubation period of Zika virus infection is 5.9 days (95% CI: 4.4-7.6), and that 95% of those who do develop symptoms will do so by 11.1 days post-infection (95% CI: 7.6-18.0). On average seroconversion occurs 9.0 days (95% CI, 7.0-11.6) after infection, and virus is detectable in blood for 9.9 days (95% CI: 6.8-21.4). In 5% of cases detectable virus persists for over 18.9 days (95% CI: 12.6-79.5). The baseline (no screening) risk of a Zika infected blood donation increases by approximately 1 in 10,000 for every 1 per 100,000 person-days increase in Zika incidence. Symptom based screening reduces this by 7% (RR 0.93, 95% CI 0.86-0.99), and antibody screening by 29% (RR 0.71, 95% CI: 0.28-0.88).

Conclusions

Symptom or antibody-based surveillance can do little to reduce the risk of Zika contaminated blood donations. High incidence areas may consider PCR testing to identify lots safe for use in pregnant women.
Demographic inference under the coalescent in a spatial continuum
Authors: Guindon Stéphane , Guo Hongbin , Welch David
Published: March 2016

Understanding population dynamics from the analysis of molecular and spatial data requires sound statistical modeling. Current approaches assume that populations are naturally partitioned into discrete demes, thereby failing to be relevant in cases where individuals are scattered on a spatial continuum. Other models predict the formation of increasingly tight clusters of individuals in space, which, again, conflicts with biological evidence. Building on recent theoretical work, we introduce a new genealogy-based inference framework that alleviates these issues. This approach effectively implements a stochastic model in which the distribution of individuals is homogeneous and stationary, thereby providing a relevant null model for the fluctuation of genetic diversity in time and space. Importantly, the spatial density of individuals in a population and their range of dispersal during the course of evolution are two parameters that can be inferred separately with this method. The validity of the new inference framework is confirmed with extensive simulations and the analysis of influenza sequences collected over five seasons in the USA.
Exact length distribution of filamentous structures assembled from a finite pool of subunits
Authors: Harbage David , Kondev Jané
Published: March 2016

Self-assembling filamentous structures made of protein subunits are ubiquitous in cell biology. These structures are often highly dynamic, with subunits in a continuous state of flux, binding to and falling off of filaments. In spite of this constant turnover of their molecular parts, many cellular structures seem to maintain a well-defined size over time, which is often required for their proper functioning. One widely discussed mechanism of size regulation involves the cell maintaining a finite pool of protein subunits available for assembly. This finite pool mechanism can control the length of a single filament by having assembly proceed until the pool of free subunits is depleted to the point when assembly and disassembly are balanced. Still, this leaves open the question whether the same mechanism can provide size control for multiple filamentous structures that are assembled from a common pool of protein subunits, as is often the case in cells. We address this question by solving the steady-state master equation governing the stochastic assembly and disassembly of multi-filament structures made from a shared finite pool of subunits. We find that while the total number of subunits within a multi-filament structure is well defined, individual filaments within the structure have a wide, power-law distribution of lengths. We also compute the phase diagram for two multi-filament structures competing for the same pool of subunits and identify conditions for coexistence when both have a well-defined size. These predictions can be tested in cell experiments in which the size of the subunit pool or the number of filament nucleators is tuned.
An impact evaluation of a fund to finance innovation in SMEs
Authors: Monge-González Ricardo , Rodríguez-Alvarez Juan Antonio , Leiva Juan Carlos
Published: March 2016

Purpose

The purpose of this paper is to estimate the impact of one productive development program (PROPYME) in a developing nation like Costa Rica. This program seeks to increase the capacity of small and medium-sized firms (SMEs) to innovate.

Design/methodology/approach

Impacts have been estimated assuming that beneficiary firms are trying to maximize their profits and that PROPYME aims to increase these firms productivity. The impacts were measured in terms of three result variables real average wages employment demand and the probability of exporting. A combination of fixed effects and propensity score matching techniques was used in estimations to correct for any selection bias. The authors worked with panel data companies treated and untreated for the period 2001-2011.

Findings

PROPYME’s beneficiaries performed better than other firms in terms of labor demand and their probability of exporting. In addition, the dose and the duration of the effects of the treatment (timing effects) are important.

Originality/value

The authors study the impact in ways that go beyond the average treatment effects on the treated (ATT) usually estimated in the existing literature. Specifically, the research focusses on the identification of the timing or dynamic effects (i.e. how long should we wait to see results?) and treatment intensity (dosage effects).