bluuebunny/crossref_metadata_2025 huggingface dataset:
Trend analysis of emergency department malpractice claims in the Netherlands: a retrospective cohort analysis
Authors: Wansink Luuk , Kuypers Maybritt I. , Boeije Tom , van den brand Crispijn L. , de Waal Manon , Holkenborg Joris , Ter Avest Ewoud
Published: September 2018

Background

Over the past two decades, several quality improvement projects have been implemented in emergency departments (EDs) in the Netherlands, one of these being the training and deployment of emergency physicians. In this study we aim to perform a trend analysis of ED quality of care in Dutch hospitals, as measured by the incidence of medical malpractice claims.

Patients and methods

We performed a multicentre retrospective cohort study of malpractice claims in five Dutch EDs over the period 1998–2014. Incidence risk ratios were calculated to demonstrate any relation of specific quality improvement initiatives with the primary outcome, defined as the number of claims per 10 000 ED visits per year.

Results

During the study period, the cumulative number of ED visits increased significantly from 99 145 in 1998 to 162 490 in 2014 (P< 0.01). In total, 228 of 2 348 417 ED visits (0.97 per 10 000) resulted in a malpractice claim. At the same time, the yearly number of ED claims filed decreased with 0.07 (0.03–0.10) per 10 000 each year. The claim rate was higher in the period before emergency physicians were employed in the ED [1.18 (0.98–1.41) claims per 10 000 visits] compared with the period after they were employed [0.81 (0.67–0.97), incidence risk ratio 0.69 (0.53–0.89),P< 0.01].

Conclusion

Even though the number of ED visits increased significantly over the past two decades, the number of malpractice claims filed after an ED visit decreased. Various quality improvement initiatives, including the training and employment of emergency physicians, may have contributed to the observed decrease in claims.
Advancing a Culture of Clinical Nursing Research Through Collaborative Partnership Between Practice and Academia
Authors: Gullatte Mary Magee , Corwin Elizabeth J.
Published: September 2018

Engaging in clinical inquiry is a natural foundation for a nurse's critical thinking strategy and application to practice. Transforming clinical inquiry into a formal research question designed to improve patient care and/or the practice environment can, however, sometimes seem overwhelming to clinical nurses. It may even be seen as out of scope for their daily practice. As a result, aligning the trifold mission of service, education, and research at an Academic Health Sciences Center can be challenging unless there exists a purposeful strategy to achieve this goal. Since the publication of the Institute of Medicine “Future of Nursing Report” in 2010, Emory Healthcare Nursing and the Emory University Nell Hodgson Woodruff School of Nursing (SON) have sought to advance the vision and mission of strengthening and sustaining a culture of clinical inquiry to advance nursing science through nurse-led research. This vision also aligns with the American Association of Colleges of Nursing to identify paths for achieving enhanced partnerships between academic nursing and academic health centers. This goal has been conceptually important since then. In the last 2 years, there has been a renewed and invigorated commitment between Emory Healthcare Nursing and the Emory School of Nursing to forge a path for improving and sustaining a rigorous culture of collaborative and interprofessional research. This article describes the journey of the “One Emory Nursing” initiative, which spans from bedside/chairside to bench and back again. This work is built on a foundation of clinical nurses engaged in leading research that is designed to transform care in partnership with SON.
The Medicare Patient-Centered Partnership With Observation Units
Authors: McNamara Kiara , Wright Phyllis
Published: September 2018

With a goal of increasing transparency regarding the utilization of Observation Units (OUs) in relation to Medicare policies, a 2012-2014 retrospective analysis was performed on 108 009 de-identified records of patients admitted from emergency departments to OUs within an urban health system. A cost-benefit analysis of OUs from the patient-centered perspective provided the theoretical patient cost. Using a query search, data regarding encounter type, length of stay, insurance carrier, origin, disposition, and age were collected. The 2016 Health Care Cost and Utilization Report was used as a means to extrapolate cost. The results showed that Medicare patients with Part B coverage were expected to pay between $516.80 to $548.20 for the average OU stay. Patients needing care in a skilled nursing facility post-OU discharge, without a 3-day qualifying stay, incurred a charge of $6244 to $6402. There is reason to investigate the policies regarding patient education and notification surrounding OUs. In an effort to improve care delivery and patient satisfaction, health care clinicians must partner with patients to improve health education and empower patients to manage their own care.
International Nursing
Authors: Solbakken Rita , Bergdahl Elisabeth , Rudolfsson Gudrun , Bondas Terese
Published: September 2018

To explore and derive new conceptual understanding of nurse leaders' experiences and perceptions of caring in nursing. Research question: What is caring in nursing leadership from the nurse leaders' perspectives? There is a paucity of theoretical studies of caring in nursing leadership. Noblit and Hares interpretative meta-ethnography was chosen because of its interpretative potential for theory development.Caring in nursing leadership is a conscious movement between different “rooms” in the leader's “house” of leadership. This emerged as the metaphor that illustrates the core of caring in nursing leadership, presented in a tentative model. There are 5 relation-based rooms: The “patient room,” where nurse leaders try to avoid patient suffering through their clinical presence; the “staff room,” where nurse leaders trust and respect each other and facilitate dialogue; the “superior's room,” where nurse leaders confirm peer relationships; the “secret room,” where the leaders' strength to hang on and persist is nurtured; and the “organizational room,” where limited resources are continuously being balanced. Caring in nursing leadership means nurturing and growing relationships to safeguard the best nursing care. This presupposes that leaders possess a consciousness of the different “rooms.” If rooms are not given equal attention, movement stops, symbolizing that caring in leadership stops as well. One room cannot be given so much attention that others are neglected. Leaders need solid competence in nursing leadership to balance multiple demands in organizations; otherwise, their perceptiveness and the priority of “ministering to the patients” can be blurred.
Growing a Robust Academic Practice Partnership in an Academic Health System
Authors: Kelly Ursula , Abraham Corrine , Toney Sharlene , Muirhead Lisa , Shapiro Susan E.
Published: September 2018

Schools of nursing located within academic health centers have embraced expanded opportunities to lead in this era of rapid change and considerable uncertainty in US health care. These schools bear a unique responsibility to work with their clinical nursing partners to advance the care of patients, improve the health of communities and populations, and help steward the nation's health care resources. This article describes how the Emory University Nell Hodgson Woodruff School of Nursing has formed and sustained academic-practice partnerships in response to these imperatives. The structures and processes that have supported the partnerships are shared, as are the keys to success in a true partnership. The authors describe the work required to achieve mutually agreed-upon goals, along with the challenges that faculty and health care leaders have faced in their journey to system partnerships.
Creating New Models of Care Through Academic-Clinical Partnership
Authors: Clevenger Carolyn K. , Cellar Janet
Published: September 2018

There are many documented instances of academic nurses creating faculty practice opportunities to support their faculty and students. Fewer articles have been published about the value of these shared models to clinical partners. Advanced practice nurses from the academic and clinical departments at Emory University and Emory Healthcare codesigned a new model of care that addresses the health system's need to achieve better experiences and health outcomes for patients living with dementia. The nurse-led clinical practice, called Integrated Memory Care Clinic, is an innovative example of joint planning and design by academic and clinical nurses to advance the teaching, practice, and research mission of the School of Nursing as well as help satisfy the health system's ability to achieve the Triple Aim.
Using Continuous Quality Improvement Tools to Promote Tobacco Cessation Among Primary Caregivers in a Home Visiting Program in Alabama
Authors: Fifolt Matthew , Preskitt Julie , Johnson Heather H. , Johns Elisabeth , Zeribi Karen Askov , Arbour MaryCatherine
Published: September 2018

Alabama's Maternal, Infant, and Early Childhood Home Visiting–funded program was one of 10 state teams accepted to participate in the first wave of the Federal Home Visiting Program State and Territory Continuous Quality Improvement Practicum. This article reports methods and results of Alabama's continuous quality improvement (CQI) project and lessons learned in developing CQI capabilities among state and local public health practitioners. The Alabama team tracked CQI data weekly for the duration of the practicum using an annotated run chart. Participants included 20 identified tobacco users in 2 participating LIAs. This article highlights specific CQI tools to achieve the project aim. On the basis of CQI interventions, Alabama reached its goal; 12 of 20 primary caregivers in 2 home visiting programs made quit attempts. Alabama utilized multiple CQI tools to reach an ambitious, behavior-based aim; these same concepts could be broadly applied to quality improvement initiatives in any federal or state public health program to guide process- and outcomes-based improvement efforts.
Examining the Role of Twitter in Response and Recovery During and After Historic Flooding in South Carolina
Authors: Brandt Heather M. , Turner-McGrievy Gabrielle , Friedman Daniela B. , Gentile Danielle , Schrock Courtney , Thomas Tracey , West Delia
Published: September 2018

Context:

Social media has played an increasing role in the response to emergency situations through information exchange and efforts to promote recovery. Understanding more about how social media users share and re-share information is particularly important to help emergency response entities determine best strategies for expanding reach and impact through social media in disseminating emergency messages.

Objective:

This study examined the role and use of Twitter as a response and recovery strategy before, during, and after historic rainfall and flooding in the Midlands region of the greater Columbia, South Carolina, area in October 2015.

Design:

A cross-sectional, thematic, and descriptive examination of Twitter data across 4 time periods (before the historic rainfall and flooding, during, immediately after a boil water advisory period, and 6 months later) was conducted.

Setting:

Twitter posts containing “#SCFlood” with a focus on the Midlands region were extracted and analyzed.

Results:

The most common themes of tweets across all 4 time periods were weather conditions, devastation description, resource distribution, volunteerism, actions to reduce threats to health, and appreciation. Tweets mostly originated from individual users, followed by media outlets, governmental agencies, and nonprofit agencies. Tweets from the first 3 time periods were largely focused on built and natural environment devastation and action to reduce threats to health, and tweets from the fourth time period were primarily focused on cleanup and repair.

Conclusions:

Twitter was utilized widely as a communication tool to provide time-sensitive and critical information before, during, and after the event. Ensuring that key social media users have developed disaster communication strategies inclusive of Twitter seems important in aiding response to and recovery from natural disasters.
Brief Report: Per Sex-Act Risk of HIV Transmission Under Antiretroviral Treatment: A Data-Driven Approach
Authors: Supervie Virginie , Breban Romulus
Published: September 2018

Background:

Before the completion of HPTN 052, PARTNER, and Opposites Attract studies, data were lacking to directly estimate HIV transmission risk under effective combined antiretroviral treatment (cART). Rather, estimates were obtained by extrapolating a dose–response relationship between viral load and risk of HIV transmission, observed among untreated individuals, to treated individuals. Presently, data have accumulated from 9 clinical studies for a direct validation of this extrapolation.

Methods:

Using estimates of per sex-act risk of HIV transmission on effective cART obtained by extrapolation, sexual behavior data, and a simple mathematical model, we estimated the number of seroconversions that should have been observed in HIV-serodiscordant couples where the HIV-positive partner was on cART across the 9 studies. We compared this with the number of seroconversions actually observed. Next, we directly estimated the risk of HIV transmission on effective cART, using Bayesian statistics to combine all available data.

Results:

We found that at least 4.7 (uncertainty bounds: 1.7–12.6) and 35.1 (uncertainty bounds: 13.2–92.0) seroconversions should have been observed among, respectively, heterosexual and men who have sex with men (MSM) serodiscordant couples. This is not validated by observations across the studies, which reported at most 1 seroconversion among heterosexual couples and 0 for MSM. Combining all available data, we found that the maximum per sex-act risk of HIV transmission under effective cART is 3.9:100,000 for heterosexuals and 4.4:100,000 for MSM.

Conclusions:

Data have accumulated to render obsolete estimates of the risk of HIV transmission on cART obtained by extrapolation. Direct estimates are substantially lower and should be used in practice.
18F-Fluoride Uptake in Soft Tissue Metastases of Medullary Thyroid Carcinoma as a Marker of Progressive Calcification
Authors: Duarte Paulo Schiavom , Marin José Flávio Gomes , Filho George Barberio Coura , Sapienza Marcelo Tatit , Buchpiguel Carlos Alberto
Published: September 2018

18F-fluoride (18F-NaF) uptake in soft tissue metastases of medullary thyroid carcinoma (MTC) has been reported. However, the evolution of these metastatic sites has rarely been assessed. We present a case of 18F-NaF uptake in multiple liver metastases of MTC initially without macroscopic calcification. The CT follow-up studies showed a progressive calcium deposition in the lesions. Therefore, this case suggests that the 18F-NaF uptake in MTC metastases could potentially be a marker of an ongoing calcification process instead of an inert deposit of calcium.
Neurosarcoidosis Mimics High-Grade Glioma in Dynamic 18F-FET PET Due to LAT Expression
Authors: Unterrainer Marcus , Diekmann Caroline , Dorostkar Mario , Vettermann Franziska Jill , Kümpfel Tania , Tonn Jörg-Christian , Bartenstein Peter , Albert Nathalie Lisa
Published: September 2018

We present a 45-year-old man with newly generalized tonic-clonic seizures due to a contrast-enhancing frontal lesion with perifocal edema suggestive for high-grade glioma (HGG). For further evaluation, a dynamic 18F-FET PET scan was performed, which showed high 18F-FET-uptake with early peak and constantly decreasing time-activity curves, a characteristic feature of HGG. Stereotactic biopsy and histological evaluation excluded a neoplastic lesion but confirmed a manifestation of neurosarcoidosis with strong expression of the L-amino-acid-transporter considered responsible for 18F-FET-uptake. Therefore, unknown manifestations of neurosarcoidosis represent a clinical pitfall in 18F-FET PET and can mimic HGG.
Pregnancy and Delivery After PRRT Without Sequelae
Authors: Zhang Jingjing , Kulkarni Harshad R. , Lehmann Coline , Singh Aviral , Baum Richard P.
Published: September 2018

Peptide receptor radionuclide therapy (PRRT) with radiolabeled somatostatin analogues has been proven to be very useful in the management of advanced, well-differentiated neuroendocrine neoplasms (NENs). We present here the pregnancy outcome in a NEN patient, who naturally conceived and gave birth to a healthy baby, after 4 cycles of PRRT administering a cumulative radioactivity of 27.1 GBq. This case underlines that pregnancy and birth without sequelae are possible in patients with NEN who have been treated with PRRT and offers a definitive prospect for patients of reproductive age group who plan conception despite having received or due to undergo PRRT.
Recurrence of Extramedullary Plasmacytomas Involving Lymph Nodes and Pancreas Revealed by 68Ga-DOTATATE and 18F-FDG PET/CT
Authors: Pan Qingqing , Luo Yaping , Li Jian , Zhang Shu , Li Fang
Published: September 2018

A 40-year-old man with history of extramedullary plasmacytoma in nasal cavity presented with right submandibular mass for 3 months. 18F-FDG PET/CT demonstrated mild radioactivity in the right submandibular mass, pancreatic mass, and lymph nodes in the abdomen and left hilum of the lung. To differentiate from pancreatic neuroendocrine tumor, 68Ga-DOTATATE PET/CT was performed. The above lesions were TATE avid, and additional lesions with intense radioactivity were also detected in the right internal mammary node and intrapericardial node. Finally, biopsy of the right submandibular mass confirmed recurrence of extramedullary plasmacytoma.
Bilateral Axillo-Breast Approach to Endoscopic Thyroidectomy in a Porcine Model
Authors: Yu Hyeong Won , Bae In Eui , Bae Dong Sik , Kim KyuHyung , Choi June Young , Lee Kyu Eun
Published: September 2018

Traditional surgical training methods to teach young doctors have changed because of the emergence of animal models. The present article summarizes a protocol for bilateral axillo-breast approach (BABA) endoscopic thyroidectomy in a pig model. All procedures were approved by the local ethics committee and the pigs were anesthetized by a veterinarian. Formation of the flap involved skin marking, hydrodissection, blunt dissection and, finally, trocar insertion. BABA endoscopic thyroidectomy is performed by midline division, identification of the thyroid, thyroidectomy and, finally, surveillance of bleeding. Four cases of endoscopic thyroidectomy using porcine models were performed using the BABA approach. The mean weight of the pigs was 60 kg, and the mean operation time was 74.3 minutes. All surgeries were completed without complications. Surgical training for BABA endoscopic thyroidectomy using a porcine model is a valuable education method for young surgeons who need practice before performing surgery on human patients.
Sling Plication for Failed Midurethral Sling Procedures: A Case Series
Authors: Maheshwari Deepali , Jones Keisha , Solomon Ellen , Harmanli Oz
Published: September 2018

Objectives

The aim of this article is to report the outcomes of sling plications performed on women who presented with persistent stress urinary incontinence after midurethral sling.

Methods

All women who underwent sling plication for persistent stress urinary incontinence after placement of either retropubic or transobturator midurethral sling were included in this case series. For plication, first, the suburethral incision was opened. After mobilization of the mesh in the midline, the sling was plicated with absorbable sutures. Descriptive data were extracted from the electronic medical record. Postoperative stress urinary incontinence was diagnosed based on patients' response to the relevant question on the urinary distress inventory and compared this outcome with respect to the original sling placement approach.

Results

We identified 36 women who underwent sling plication between March 2013 and November 2016: 26 (72.2%) following a retropubic and 10 (27.7%) following a transobturator sling. Median time between midurethral sling and plication procedure was 6.8 weeks (range, 2–148 weeks). Median follow-up after sling plication was 17 weeks (range, 2–104 weeks). Overall, 24 women (66.6%) reported subjective resolution of stress incontinence. Success rate for plication of retropubic slings was 20 (76.9%) of 26 and significantly higher compared with 4 (40%) of 10 for transobturator slings (P = 0.034). There were no mesh erosions or persistent urinary retention after sling plication.

Conclusions

Sling shortening by plication is an effective low-risk option for the management of persistent stress urinary incontinence following a midurethral sling. This approach was found to be more successful after retropubic slings.
Sleep and Motor Control by a Basal Ganglia Circuit
Authors: Liu Danqian , Ma Chenyan , Zheng Weitong , Yao Yuanyuan , Dan Yang
Published: September 2018

From invertebrates to humans, a defining feature of sleep is behavioral immobility(Campbell and Tobler, 1984; Hendricks et al., 2000; Shaw et al., 2000). In mammals, diminished electromyographic (EMG) activity is a major criterion for both rapid eye movement (REM) and non-REM (NREM) sleep. However, the relationship between sleep and motor control at the neuronal level remains poorly understood. Here we show that regions of the basal ganglia long known to be essential for motor suppression also play a key role in sleep generation. Optogenetic or chemogenetic activation of GABAergic neurons in mouse substantia nigra pars reticulata (SNr) strongly increased both REM and NREM sleep, whereas their inactivation suppressed sleep and increased wakefulness. Analysis of natural home-cage behavior showed that mice transition sequentially through several behavioral states: locomotion, non-locomotor movement, quiet wakefulness, and sleep. Activation/inactivation of SNr neurons promoted/suppressed sleep by biasing the direction of progression through the natural behavioral sequence. Virus-mediated circuit tracing showed that SNr GABAergic neurons project to multiple wake-promoting monoaminergic cell groups in addition to the thalamus and mesencephalic locomotor region, and activating each projection promoted sleep. Within the thalamus, direct optogenetic inactivation of glutamatergic neurons is sufficient to enhance sleep, but the effect is largely restricted to the regions receiving SNr projection. Furthermore, a major source of excitatory inputs to the SNr is the subthalamic nucleus (STN), and activation of neurotensin-expressing glutamatergic neurons in the STN also promoted sleep. Together, these results demonstrate a key role of the STN-SNr basal ganglia pathway in sleep generation and reveal a novel circuit mechanism linking sleep and motor control.
The Arabidopsis autophagy cargo receptors ATI1 and ATI2 bind to ATG8 via intrinsically disordered regions and are post-translationally modified upon ATG8 interaction
Authors: Sjøgaard Ida Marie Zobbe , Bressendorff Simon , Prestel Andreas , Kausika Swathi , Oksbjerg Emilie , Kragelund Birthe B. , Brodersen Peter
Published: September 2018

Selective autophagy has emerged as an important mechanism by which eukaryotic cells control the abundance of specific proteins. This mechanism relies on cargo recruitment to autophagosomes by receptors that bind to both the ubiquitin-like AUTOPHAGY8 (ATG8) protein through ATG8 interacting motifs (AIMs) and to the cargo to be degraded. In plants, two autophagy cargo receptors, ATG8 Interacting Protein 1 (ATI1) and 2 (ATI2), were identified early on, but their molecular properties remain poorly understood. Here, we show that ATI1 and ATI2 are transmembrane proteins with long N-terminal intrinsically disordered regions (IDRs). The N-terminal IDRs contain the functional AIMs, and we use nuclear magnetic resonance spectroscopy to directly observe the disorder-order transition of the AIM upon ATG8 binding. Our analyses also show that the IDRs of ATI1 and ATI2 are not equivalent, because ATI2 has properties of a fully disordered polypeptide, while ATI1 has properties consistent with a collapsed pre-molten globule-like conformation Interestingly, wild type ATI1 and ATI2 exist as distinct post-translationally modified forms. Specifically, different forms are detectable upon mutation of the AIM, suggesting that interaction of ATI1 and ATI2 to ATG8 is coupled to a change in their post-translational modification.
Effects of enzymatic hydrolysis treatments on the physicochemical properties of beef bone extract using endo‐ and exoproteases
Authors: Chiang J. H. , Loveday S. M. , Hardacre A. K. , Parker M. E.
Published: September 2018

This study reported the effects of enzymatic hydrolysis treatments on the physiochemical properties of beef bone extract using endo‐ and exoproteases. Each enzyme hydrolysis kinetics were studied using Michaelis–Menten model, and the ideal E/S ratio obtained for Protamex® (P), bromelain (B) and Flavourzyme® (F) was found to be 1.10%, 1.60% and 4.70% w/w, respectively. Seven hydrolysates were produced from single (P, B, F), simultaneous (P + F, B + F) and sequential (P > F, B > F) treatments, where bone extract hydrolysed by Flavourzyme® exhibited highest DH and proportion of low molecular weight (Mw) peptides (<5000 Da) in single treatment. When Flavourzyme® was used with Protamex® or bromelain in simultaneous or sequential treatments, no significant differences in Mw distribution, exposed SH content, SS content and viscosity were evident compared with Flavourzyme® only. This indicated that without the addition of other enzymes, Flavourzyme® was capable of increasing the proportion of low Mw peptides and reduce viscosity.
Characterisation of dominant autochthonous strains for nitrite degradation of Chinese traditional fermented fish
Authors: Liao E , Xu Yanshun , Jiang Qixing , Xia Wenshui
Published: September 2018

In this study, three previously isolated dominant autochthonous strains from Chinese traditional fermented fish products (CTFPs), namely Lactobacillus plantarum 120, Saccharomyces cerevisiae 2018 and Staphylococcus xylosus 135, were used to evaluate their nitrite degradation abilities. The highest nitrite degradation rate (NDR) was observed in L. plantarum 120 (90.70%), followed by S. cerevisiae 2018 (78.75%) and S. xylosus 135 (13.09%). The nitrite reductase activities of L. plantarum 120 and S. cerevisiae 2018 could be promoted by appropriate sodium chloride contents (4%–6%). Meanwhile, nitrite could be degraded in soluble grass carp proteins, and the NDR was positively associated with the protein concentration. Inoculation with L. plantarum 120, S. cerevisiae 2018 and S. xylosus 135 significantly (P < 0.05) decreased the nitrite and nitrate concentrations in CTFPs. Therefore, dominant autochthonous strains, especially L. plantarum 120 and S. cerevisiae 2018, could be used as promising starter cultures to inhibit nitrite accumulation in CTFPs.
Tannase improves gallic acid bioaccessibility and maintains the quality of mango juice
Authors: Sirven Maritza A. , Negrete Marcos , Talcott Stephen T.
Published: September 2018

The effect of tannase on gallic acid (GA) bioaccessibility and auto‐oxidative browning of mango juice was investigated. After 2 h of simulated gastric digestion, the concentration of bioaccessible GA increased (P < 0.05) 94.3 ± 7.0% in juice treated with 0.5 U mL−1 tannase while juice not treated with tannase had only a 6.3 ± 3.4% increase in GA. During 2–10 h of simulated intestinal digestion, tannase treated juice continued to have a higher concentration (P < 0.05) of bioaccessible GA in comparison to juice that was not treated with tannase. The use of 167 U 100 mL−1 tannase while processing mango juice did not result in any differences (P < 0.05) in browning measured at 420 nm, yet there was significantly higher (P < 0.05) GA in mango juice post‐storage. Processing mango juice with tannase can help improve the bioaccessibility of mango polyphenols without hindering the quality of juice during storage.
The authenticity identification of teas (Camellia sinensis L.) of different seasons according to their multi‐elemental fingerprints
Authors: Zhao Haiyan , Zhao Fangyuan
Published: September 2018

The objective of this study was to investigate the feasibility of discriminating harvest seasons of tea by the multi‐elemental fingerprinting technique. A total of 162 tea leaf samples were collected in spring, summer and autumn of 2015 and 2016 respectively. The concentrations of 25 elements were determined by inductively coupled plasma mass spectrometry. Analysis of variance and linear discriminant analysis were performed to analyse the differences of tea leaves of different harvest seasons and years and identify the seasons and years of tea leaves. The results showed that tea leaves of different harvest seasons and years had their own elemental profiles. For tea leaves of 2015 and 2016, using the established discriminant models, the total accuracy of season‐based identification reached 95.1% and 87.7% respectively. The classifications of tea leaves of different years were 100% accurate. Therefore, the multi‐elemental fingerprinting technique can be used to identify harvest seasons of tea.
Propagation and Molecular Characterization of Bioreactor Adapted Very Virulent Infectious Bursal Disease Virus Isolates of Malaysia
Authors: Lawal Nafi’u , Hair-Bejo Mohd , Arshad Siti Suri , Omar Abdul Rahman , Ideris Aini
Published: September 2018

Two Malaysian very virulent infectious bursal disease virus (vvIBDV) strains UPM0081 (also known as B00/81) and UPM190 (also known as UPM04/190) isolated from local IBD outbreaks in 2000 and 2004, respectively, were separately passaged for 12 consecutive times in 11-day-old specific pathogen free (SPF) chicken embryonated eggs (CEE) via the chorioallantoic membrane (CAM) route. The CEE passage 8 (EP8) isolates were passaged once in BGM-70 cell line yielding UPM0081EP8BGMP1 and UPM190EP8BGMP1, while the EP12 isolates were passaged 15 times in BGM-70 cell line yielding UPM0081EP12BGMP15 and UPM190EP12BGMP15 using T25 tissue culture flask. These isolates were all propagated once in bioreactor using cytodex 1 as microcarrier at 3 g per liter (3 g/L) yielding UPM0081EP8BGMP1BP1, UPM190EP8BGMP1BP1, UPM0081EP12BGMP15BP1, and UPM190EP12BGMP15BP1 isolates. The viruses were harvested at 3 days after inoculation, following the appearance of cytopathic effects (CPE) characterized by detachment from the microcarrier using standard protocol and filtered using 0.2 μm syringe filter. The filtrates were positive for IBDV by RT-PCR and immunofluorescence. Sequence and phylogenetic tree analysis indicated that the isolates were of the vvIBDV strains and were not different from the flask propagated parental viruses.
An Investigation of Dynamic Responses and Head Injuries of Standing Subway Passengers during Collisions
Authors: Peng Yong , Xu Tuo , Hou Lin , Fan Chaojie , Zhou Wei
Published: September 2018

With the development of the subway and the pressing demand of environmentally friendly transportation, more and more people travel by subway. In recent decades, the issues about passenger passive safety on the train have received extensive attention. In this research, the head injury of a standing passenger in the subway is investigated. Three MADYMO models of the different standing passenger postures, defined as baseline scenarios, are numerically set up. HIC15values of passengers with different postures are gained by systematic parametric studies. The injury numerical simulation results of various scenarios with different friction coefficients, collision acceleration, standing angle, horizontal handrail height, and ring handrail height are analyzed. Results show that the horizontal handrail provides better protection in the three different standing passenger postures. Different friction coefficients and the standing angle have great impact on the head injuries of passengers in three different scenarios. The handrail height also has some effects on head injury of passengers with different standing postures, so it is necessary to be considered when designing the interior layout of the subway. This study may provide guidance for the safety design of the subway and some advices for standing subway passengers.
Acute Pancreatitis Secondary to Hemobilia after Percutaneous Liver Biopsy: A Rare Complication of a Common Procedure, Presenting in an Atypical Fashion
Authors: Mansour Ramy , Miller Justin
Published: September 2018

Percutaneous Liver Biopsy is an often-required procedure for the evaluation of multiple liver diseases. The complications are rare but well reported. Here we present a case of a 60-year-old overweight female who underwent liver biopsy for elevated alkaline phosphatase. She developed acute pancreatitis secondary to hemobilia, with atypical signs and symptoms, following the biopsy. She never had the classic triad of RUQ pain, jaundice, and upper GI hemorrhage. There were also multiple negative imaging studies, thus complicating the presentation. She was successfully treated with ERCP, sphincterotomy, balloon sweep, and stent placement. Angiography and transcatheter embolization were not required.
Experimental Study of Al2O3 Nanofluids on the Thermal Efficiency of Curved Heat Pipe at Different Tilt Angle
Authors: Razvarz S. , Jafari R.
Published: September 2018

This paper represents an experimental study about the effect of curves related to thermosyphons and heat pipes with different active fluids and inclination angle at the thermal efficiency. The nanofluid utilized in this work is an aqueous soluble of Al2O3 nanoparticles with 35 nm diameter in pure water. The test saturation level of nanoparticles is 0%, 1%, and 3%wt. All the experiments were conducted and repeated at inclination angle of 30°, 60°, and 90° (vertical). The article presents the gravity impacts on the heat transfer characteristics in different angles and the effects of working fluids and tilt angle of heat pipe tube by the addition of nanoparticles and weight fractions on the thermal efficiency of heat pipe at different inclination. According to the experimental results, the heat pipe at the tilt angle of 60° generates the superior results. At a particle volume concentration of 1%, the use of Al2O3/water nanofluid gives significantly higher heat transfer.
Optimal Form for Compliance of Membrane Boundary Shift in Nonlinear Case
Authors: Yousfi Y. , Hadi I. , Benbrik A.
Published: September 2018

In this work, we search the existence shifting compliance optimal form of some boundary membrane, which is not elastic and not isotropic, generating nonlinear PDE. An optimal form of the elastic membrane described by the p-Laplacian is investigated. The boundary perturbation method due to Hadamard is applied in Sobolev spaces.
Preliminary Selection of Device Materials to Locally Transform Thermal into SFR Neutron Spectrum
Authors: Chrysanthopoulou N. , Savva P. , Varvayanni M. , Colin C. , Huot-Marchand C. , Catsaros N.
Published: September 2018

The safe introduction of Generation IV (Gen IV) reactor concepts into operation will require extensive testing of their components. This must be performed under neutronic conditions representative of those expected to prevail inside the new reactor cores when in operation. In a thermal Material Testing Reactor (MTR) such neutronic conditions can be achieved by tailoring the prevailing neutron spectrum with the utilization of a device containing appropriate materials. In this work various materials are investigated as candidate components of a device that will be required in case that a thermal MTR neutron energy spectrum must be locally transformed, so as to imitate Sodium cooled Fast Reactor (SFR). Many nuclides have been examined with respect to only their neutronic behavior, providing thus a pool of neutronically appropriate materials for consideration in further investigation, such as regarding reactor safety and fabrication issues. The nuclides have been studied using the neutronics code TRIPOLI-4.8 while the reflector of the Jules Horowitz Reactor (JHR) was considered as the hosting environment of the transforming device. The results obtained suggest that elements with important inelastic neutron scattering could be chosen at a first level as being able to modify the prevailing neutron spectrum towards the desired direction. The factors which are important for an effective inelastic scatterer comprise density and inelastic microscopic cross section, as well as the energy ranges where inelastic scattering occurs. All the above factors have been separately examined in order to suggest potential device materials, able to locally produce SFR neutron spectrum imitation in a thermal MTR.
A Practical Perspective on 5G‐Ready Highly Dynamic Spectrum Management with LSA
Authors: Masek Pavel , Mokrov Evgeny , Zeman Krystof , Ponomarenko-Timofeev Aleksey , Pyattaev Alexander , Nesterov Sergey , Andreev Sergey , Hosek Jiri , Samouylov Konstantin , Koucheryavy Yevgeni
Published: September 2018

A diversity of wireless technologies will collaborate to support the fifth‐generation (5G) communication networks with their demanding applications and services. Despite decisive progress in many enabling solutions, next‐generation cellular deployments may still suffer from a glaring lack of bandwidth due to inefficient utilization of radio spectrum, which calls for immediate action. To this end, several capable frameworks have recently emerged to all help the mobile network operators (MNOs) leverage the abundant frequency bands that are utilized lightly by other incumbents. Along these lines, the recent Licensed Shared Access (LSA) regulatory framework allows for controlled sharing of spectrum between an incumbent and a licensee, such as the MNO, which coexist geographically. This powerful concept has been subject to several early technology demonstrations that confirm its implementation feasibility. However, the full potential of LSA‐based spectrum management can only become available if it is empowered to operate dynamically and at high space‐time‐frequency granularity. Complementing the prior efforts, we in this work outline the functionality that is required by the LSA system to achieve the much needed flexible operation as well as report on the results of our respective live trial that employs a full‐fledged commercial‐grade cellular network deployment. Our practical results become instrumental to facilitate more dynamic bandwidth sharing and thus promise to advance on the degrees of spectrum utilization in future 5G systems without compromising the service quality of their users.
Can Obstetric Risk Factors Predict Fetal Acidaemia at Birth? A Retrospective Case-Control Study
Authors: Kapaya Habiba , Williams Roslyn , Elton Grace , Anumba Dilly
Published: September 2018

Background. Despite major advances in perinatal medicine, intrapartum asphyxia remains a leading and potentially preventable cause of perinatal mortality and long-term morbidity. The umbilical cord pH is considered an essential criteria for the diagnosis of acute intrapartum hypoxic events. The purpose of this study was to evaluate whether obstetric risk factors are associated with fetal acidaemia at delivery. Methodology. In a case-control study, 294 women with term singleton pregnancies complicated by an umbilical artery cord pH < 7.20 at birth were individually matched by controls with umbilical artery cord pH > 7.20. Groups were compared for differences in maternal, obstetric, and fetal characteristics using logistic regression models presented as odds ratio (OR) with 95% confidence intervals (CI). Results. The study showed pregestational diabetes (PGDM) [OR: 5.31, 95% CI: 1.15- 24.58, P = 0.018], urinary tract infection (UTI) [OR: 3.21, 95% CI: 1.61- 6.43, P < 0.001], and low Apgar scores to be significantly associated with acidaemia, whereas low maternal BMI [OR: 0.19, 95% CI: 0.04-0.87, P = 0.032], pyrexia in labour [OR 0.23; 95% CI 0.12-0.53; P < 0.001], electronic fetal monitoring (EFM) [OR 0.65; 95% CI 0.43-0.99; P = 0.042), and emergency caesarean section [OR 0.42; 95% CI 0.26-0.66; P < 0.001] were found to be protective of acidaemia. Conclusion. Certain obstetric risk factors before and during labour can identify newborns at risk of developing acidaemia. Further research is needed to gain quantitative insight into the predictive capacity of these risks that can inform obstetric clinical management for improved outcomes.
Risk Factors Associated with Dengue Transmission and Spatial Distribution of High Seroprevalence in Schoolchildren from the Urban Area of Medellin, Colombia
Authors: Piedrahita Leidy Diana , Agudelo Salas Ivony Y. , Marin Katherine , Trujillo Andrea I. , Osorio Jorge E. , Arboleda-Sanchez Sair Orieta , Restrepo Berta Nelly
Published: September 2018

Dengue fever is an increasing health problem in tropical and subtropical regions. During 2010 in Medellin, the younger population presented a particularly high dengue incidence rate. This study estimated dengue virus (DENV) transmission in schoolchildren (aged 5–19 years) in Medellin from 2010 to 2012. A longitudinal serological survey (IgG) and spatial analysis were conducted to determine the distribution of DENV seroprevalence. A total of 4,385 schoolchildren participated for at least one year. Dengue seroprevalence significantly increased during the studied period (53.8% to 64.6%; p<0.001). A significantly higher seroconversion rate was observed in 2010-2011 (16.8%) compared to 2011-2012 (7.8%). Multivariate regression analysis showed that the main factor associated with the seroprevalence was the aging. Furthermore, in 2010, patients with high socioeconomic status presented a lower risk. Predominant multitypic and DENV4 monotypic antibody responses were demonstrated. Geostatistical analysis evidenced a temporal clustering distribution of DENV seroprevalence in 2010. Population density and Ae. aegypti House Index were significantly correlated with the observed pattern. This study revealed high DENV transmission in schoolchildren determined as “sentinel population.” High DENV risk was found in districts with combined poorly socioeconomic conditions and densest human and mosquito populations. These findings may allow to target population for effective prevention and vaccination campaigns.
An Iterative Method for Time-Fractional Swift-Hohenberg Equation
Authors: Li Wenjin , Pang Yanni
Published: September 2018

We study a type of iterative method and apply it to time-fractional Swift-Hohenberg equation with initial value. Using this iterative method, we obtain the approximate analytic solutions with numerical figures to initial value problems, which indicates that such iterative method is effective and simple in constructing approximate solutions to Cauchy problems of time-fractional differential equations.
Effect of Normal and Shear Interaction Stiffnesses on Three‐Dimensional Viscoplastic Creep Behaviour of a CFR Dam
Authors: Karalar Memduh , Çavuşli Murat
Published: September 2018

Rockfill materials and foundation continuously interact with each other during lifetime of the rockfill dams. This interaction condition alters the viscoplastic behaviour of these dams in time. For this reason, examination of the time‐dependent viscoplastic interaction analyses is vital important for monitoring and evaluating of the future and safety of the rockfill dams. In this study, it is observed how the time‐dependent displacement and stress behaviour of a concrete‐faced rockfill (CFR) dam change by the effect of the normal and shear interaction spring stiffness parameters. Ilısu Dam that is the longest concrete‐faced rockfill dam in the world now and has been completed in the year 2017 is selected for the three‐dimensional (3D) creep analyses. The 3D finite difference model of this dam is modelled using FLAC3D software that is based on the finite difference method. The concrete slab, rockfill materials, foundation, and reservoir water are separately created for the 3D interaction analyses. A WIPP‐creep viscoplastic material model and a burger‐creep viscoplastic material model that are special material models for the creep analyses of rockfill dams are used for concrete slab and for rockfill materials and foundation, respectively. Totally 20 different interaction parameters (normal and shear stiffnesses) are separately defined between the rockfill materials and the foundation to represent the interaction condition. According to numerical analyses, the effect of these various interaction parameters on the viscoplastic behaviour of the Ilısu Dam is evaluated for the empty and full reservoir conditions. As a consequence, the most critical normal and shear stiffnesses’ range for creep analyses of the rockfill dams is determined. Afterwards, the long‐term viscoplastic interaction behaviour of Ilısu Dam is examined during 35 years considering this important stiffness values. Settlements, horizontal displacements, and principal stresses are evaluated for both reservoir conditions, and these results are compared with each other in detail.
Dynamic Reduction-Expansion Operator to Improve Performance of Genetic Algorithms for the Traveling Salesman Problem
Authors: Caballero-Morales Santiago-Omar , Martinez-Flores Jose-Luis , Sanchez-Partida Diana
Published: September 2018

The Traveling Salesman Problem (TSP) is an important routing problem within the transportation industry. However, finding optimal solutions for this problem is not easy due to its computational complexity. In this work, a novel operator based on dynamic reduction-expansion of minimum distance is presented as an initial population strategy to improve the search mechanisms of Genetic Algorithms (GA) for the TSP. This operator, termed as RedExp, consists of four stages: (a) clustering to identify candidate supply/demand locations to be reduced, (b) coding of clustered and nonclustered locations to obtain the set of reduced locations, (c) sequencing of minimum distances for the set of reduced locations (nearest neighbor strategy), and (d) decoding (expansion) of the reduced set of locations. Experiments performed on TSP instances with more than 150 nodes provided evidence that RedExp can improve convergence of the GA and provide more suitable solutions than other approaches focused on the GA’s initial population.
Equivalent Property of a Hilbert-Type Integral Inequality Related to the Beta Function in the Whole Plane
Authors: Xin Dongmei , Yang Bicheng , Wang Aizhen
Published: September 2018

By means of the technique of real analysis and the weight functions, a few equivalent statements of a Hilbert-type integral inequality with the nonhomogeneous kernel in the whole plane are obtained. The constant factor related to the beta function is proved to be the best possible. As applications, the case of the homogeneous kernel, the operator expressions, and a few corollaries are considered.
Existence Results for Generalized Bagley-Torvik Type Fractional Differential Inclusions with Nonlocal Initial Conditions
Authors: Chen Lizhen , Li Gang
Published: September 2018

In this article, we prove the existence of solutions for the generalized Bagley-Torvik type fractional order differential inclusions with nonlocal conditions. It allows applying the noncompactness measure of Hausdorff, fractional calculus theory, and the nonlinear alternative for Kakutani maps fixed point theorem to obtain the existence results under the assumptions that the nonlocal item is compact continuous and Lipschitz continuous and multifunction is compact and Lipschitz, respectively. Our results extend the existence theorems for the classical Bagley-Torvik inclusion and some related models.
Measurement Error of a Coupled AFM Probe-Elastic Membrane System
Authors: Lin Shueei-Muh , Tsai Che-Lun , Lee Hung-Chang
Published: September 2018

The characteristic of an AFM probe scanning the topography on an elastic substrate is investigated. It is different to the conventional rigid substrate. The analytical solution of the novel system is presented. For an elastic substrate the errors of frequency shift determined by using the force gradient methods and the perturbation method are satisfactory only for larger tip-surface distances. The smaller the interacting distance is, the larger the measurement error due to the amplitude of membrane is.