bluuebunny/crossref_metadata_2025 huggingface dataset:
Monitoring of tidal ventilation by electrical impedance tomography in anaesthetised horses
Authors: Mosing M. , Waldmann A. D. , Raisis A. , Böhm S. H. , Drynan E. , Wilson K.
Published: July 2018

Background

Electrical impedance tomography (EIT) is a method to measure regional impedance changes within the thorax. The total tidal impedance variation has been used to measure changes in tidal volumes in pigs, dogs and men.

Objectives

To assess the ability of EIT to quantify changes in tidal volume in anaesthetised mechanically ventilated horses.

Study design

In vivo experimental study.

Methods

Six horses (mean ± s.d.: age 11.5 ± 7.5 years and body weight 491 ± 40 kg) were anaesthetised using isoflurane in oxygen. The lungs were mechanically ventilated using a volume‐controlled mode. With an end‐tidal carbon dioxide tension in the physiological range, and a set tidal volume (VTvent) of 11–16 mL/kg (baseline volume), EIT data and VT measured by conventional spirometry were collected over 1 min. Thereafter, VTvent was changed in 1 L steps until reaching 10 L. After, VTvent was reduced to 1 L below the baseline volume and then further reduced in 1 L steps until 4 L. On each VT step data were recorded for 1 min after allowing 1 min of stabilisation. Impedance changes within the predefined two lung regions of interest (EITROI) and the whole image (EITthorax) were calculated. Linear regression analysis was used to assess the relationship between spirometry data and EITROI and EITthorax for individual horses and pooled data.

Results

Both EITROI and EITthorax significantly predicted spirometry data for individual horses with R2 ranging from 0.937 to 0.999 and from 0.954 to 0.997 respectively. This was similar for pooled data from all six horses with EITROI (R2 = 0.799; P<0.001) and EITthorax (R2 = 0.841; P<0.001).

Main limitations

The method was only tested in healthy mechanically ventilated horses.

Conclusions

The EIT can be used to quantify changes in tidal volume.
The Relational Mind in Couple Therapy: A Bateson‐Inspired View of Human Life as an Embodied Stream
Authors: Seikkula Jaakko , Karvonen Anu , Kykyri Virpi‐Liisa , Penttonen Markku , Nyman‐Salonen Petra
Published: July 2018

Research on human intersubjectivity has found that humans participate in a dialogue throughout their life, and that this is manifested not only via language, but also nonverbally, with the entire body. Such an understanding of human life has brought into focus some basic systemic ideas concerning the human relational mind. For Gregory Bateson, the mind works as a system, formed from components that are in continuous interaction with each other. In our Relational Mind research project, we followed twelve couple therapy processes involving two therapists per session, looking at the ways in which the four participants attuned to each other with their bodies, including their autonomic nervous system activity. Using observations from the project, we here describe the ways through which the relational and embodied mind can be realized in a couple therapy setting.
Creep of a Nextel™720/alumina ceramic composite containing an array of small holes at 1200°C in air and in steam
Authors: Ruggles‐Wrenn Marina B. , Minor Savannah N. , Przybyla Craig P. , Jones Eric L.
Published: July 2018

Tensile stress‐strain and tensile creep behaviors of an oxide‐oxide composite containing an array of small circular holes were evaluated at 1200°C. The composite consists of Nextel™720 alumina‐mullite fibers in a porous alumina matrix. Test specimens contained an array of 17 holes with 0.5‐mm diameter drilled using a CO2 laser. The presence of holes caused reduction in tensile strength and modulus. Tensile creep tests were conducted at 1200°C in air and in steam at creep stresses ranging from 38 to 140 MPa. Primary, secondary, and tertiary creep regimes were noted in air and in steam. The presence of the laser‐drilled holes accelerates the steady‐state creep rates. Creep run‐out, defined as 100 hours at creep stress, was attained for stress levels <60 MPa in air and for stresses <40 MPa in steam. The presence of the laser‐drilled holes significantly degrades creep resistance of the composite. The retained tensile properties of all specimens that attained run‐out were determined. Composite microstructure was examined; the damage and failure mechanisms were considered. The degradation of tensile properties and creep resistance are attributed to damage caused to composite microstructure by laser drilling.
Zirconium modified calcium‐silicate‐based nanoceramics: An in vivo evaluation in a rabbit tibial defect model
Authors: Doostmohammadi Ali , Karimzadeh Esfahani Zahra , Ardeshirylajimi Abdolreza , Rahmati Dehkordi Zahra
Published: July 2018

Over the past two decades calcium silicate (Ca–Si) based ceramics have been introduced as bioactive materials for bone tissue engineering applications and repairing bone defects. Recently, it is reported that zirconium modified calcium‐silicate‐based (Ca3ZrSi2O9, Baghdadite) ceramics stimulate cell proliferation and osteogenic differentiation of osteoblasts. The aim of this work was preparation, characterization, and evaluation of biological properties of Baghdadite in the nanoparticles form. These nanoparticles were synthesized by sol‐gel method and were annealed at 1150°C. Fabricated nanoparticles were investigated using XRD, FE‐SEM, EDX, and MTT in vitro, then implanted to the rabbit tibia as a bone animal model. The characterization results showed that nanoparticles with expected composition were successfully synthesized using sol‐gel method. According to MTT result, these nanoparticles were nontoxic. In addition, the proliferation of bone marrow derived mesenchymal stem cells was increased after 96 hours of culturing in the presence of nanoparticles compared to the control. Histopathological results also demonstrated that the defected bone was completely regenerated when implanted with nanoparticles after 6 weeks. Taking together, according to the results, Ca3ZrSi2O9 nanoparticles as a bioceramic with excellent biological properties can be applied for improvement of bone lesions healing process in the orthopedic and dental application.
Processing and properties of polycrystalline cubic boron nitride reinforced by SiC whiskers
Authors: Li Jian , Shao Gang , Ma Yao , Zhao Xiaotong , Wang Hailong , Zhang Rui
Published: July 2018

Dense polycrystalline cBN (PcBN)–SiCw composites were fabricated by a two‐step method: First, SiO2 was coated on the surface of cubic boron nitride (cBN) particles by the sol‐gel method. Then, silicon carbide whisker (SiCw)‐ coated cBN powder was prepared by carbon thermal reaction between SiO2 and carbon powders at 1500°C for 2 hour. Then, cBN–SiCw complex powders were sintered by high‐pressure and high‐temperature sintering technology using Al, B, and C as sintering additives. The phase compositions and microstructures of cBN–SiCw composites were investigated by X‐ray diffraction and scanning electron microscopy, respectively. It was found that the SiCw and Al3BC3 had been fabricated by in situ reaction, which cannot only promote densification but also improve mechanical properties. The relative density of PcBN composites increased from 96.3% to 99.4% with increasing SiCw contents from 5 to 20 wt%. Meanwhile, the Vickers hardness, fracture toughness and flexural strength of as‐obtained composites exhibited a similar trend as that of relative density. The composite contained 20 wt% of SiCw exhibited the highest Vickers hardness and fracture toughness of 42.7 ± 1.9 GPa and 6.52 ± 0.21 MPa•m1/2, respectively. At the same time, the flexural strength reached 406 ± 21 MPa.
Development of smoothies from dehydrated products of strawberry and banana pulps obtained through foam‐mat drying
Authors: Guazi Julaisa Scarpin , Lago‐Vanzela Ellen Silva , Conti‐Silva Ana Carolina
Published: July 2018

Dehydrated products from strawberry and banana pulps were obtained through foam‐mat drying and subsequently used for production and evaluation of smoothies. For that, six smoothies were prepared, with different proportions of dehydrated strawberry and banana products (40–60%, 50–50% and 60–40%, respectively), each reconstituted in whole milk or cold water (w/v). Smoothies with 50–50% and 60–40% of dehydrated strawberry and banana products, respectively, reconstituted in whole milk, stood out for their degree of liking of appearance and colour because of the lighter colour and instrumentally measured viscosity. The smoothie with 40% strawberry and 60% banana reconstituted in milk stood out by the degree of liking of its odour, viscosity and flavour, its overall acceptance, ideal intensity of sweetness and fruit flavour, as well by its colour hue. Our study shows the feasibility of using dehydrated products of strawberry and banana pulps through foam‐mat drying in smoothies, highlighting smoothies reconstituted in milk.
Evaluating the analytical performance of five new coagulation assays for the measurement of prothrombin time and activated thromboplastin time
Authors: Kitchen Steve , Geisen Ulrich , Kappelmayer Janos , Quehenberger Peter , Drieß Julia , Lowe Anna , Jones Robert , Boehm Jana G. , Miles Gabrielle , Rozsnyai Gergely
Published: July 2018

Introduction

New methods for coagulation tests require careful assessment before routine use. We evaluated the analytical performance of five new coagulation assays for measuring prothrombin time (PT) and activated partial thromboplastin time (aPTT).

Methods

PT Rec, PT Owren, aPTT, aPTT Lupus and aPTT Screen assays (Roche Diagnostics) were evaluated on cobas t 711 and cobas t 511 analysers (Roche Diagnostics) at four European centres. Analytical performance and method comparisons with relevant commercially available assays were performed to Clinical Laboratory Standards Institute guidelines using residual anonymized samples. Lot‐to‐lot comparison and equivalency of the cobas t analysers were also assessed; reference ranges were determined using samples from apparently healthy volunteers.

Results

Overall, coefficients of variation were ≤1.3% for within‐run precision and ≤6.3% for total reproducibility across all sites. Deming regression analyses showed good agreement between each assay (cobas t 711) and respective comparator method (Pearson's r: 0.964‐0.999, n > 120 samples/assay/site). Passing–Bablok regression analyses demonstrated equivalence of the two cobas t platforms for use with each assay (Pearson's r ≥ 0.995). Lot‐to‐lot consistency was high for all assays and comparisons (Pearson's r ≥ 0.998). Reference ranges (2.5th‐97.5th percentiles; n = 200 samples/assay) in seconds were 8.4‐10.6 (PT Rec), 18.2‐27.2 (PT Owren), 23.6‐30.6 (aPTT), 24.1‐31.7 (aPTT Lupus) and 23.9‐33.2 (aPTT Screen).

Conclusion

Based on the excellent analytical performance and good agreement with relevant comparator methods, the five coagulation assays on the novel cobas t 711 and cobas t 511 analysers are suitable for routine use in core laboratories.
Are labour inspections effective when labour regulations vary according to the size of the firm? Evidence from Peru
Authors: VIOLLAZ Mariana
Published: July 2018

This article analyses the impact of enforcement of four labour standards (pension system enrolment, minimum wage, maximum weekly working hours and written employment contract) on compliance in Peru, where labour regulations and penalties vary according to firm size. The author uses household survey data to analyse a factor not previously studied – adjustment by firms through downsizing to benefit from lower fines and less stringent regulations. The empirical findings indicate that enforcement efforts have little effect on either the degree of compliance or the size of firms.
Repeat ablation of refractory ventricular arrhythmias in patients with nonischemic cardiomyopathy: Impact of midmyocardial substrate and role of adjunctive ablation techniques
Authors: Tzou Wendy S. , Rothstein Peter A. , Cowherd Michael , Zipse Matthew M. , Tompkins Christine , Marzec Lucas , Aleong Ryan G. , Schuller Joseph L. , Varosy Paul D. , Borne Ryan T. , Mathew Jehu , Tumolo Alexis , Sandhu Amneet , Nguyen Duy T. , Sauer William H.
Published: July 2018

Introduction

Multiple ablations are often necessary to manage ventricular arrhythmias (VAs) in nonischemic cardiomyopathy (NICM) patients. We assessed characteristics and outcomes and role of adjunctive, nonstandard ablation in repeat VA ablation (RAbl) in NICM.

Methods and results

Consecutive NICM patients undergoing RAbl were analyzed, with characteristics of the last VA ablations compared between those undergoing 1 versus multiple‐repeat ablations (1‐RAbl vs. >1RAbl), and between those with or without midmyocardial substrate (MMS). VA‐free survival was compared. Eighty‐eight patients underwent 124 RAbl, 26 with > 1RAbl, and 26 with MMS. 1‐RAbl and > 1‐RAbl groups were similar in age (57 ± 16 vs. 57 ± 17 years; P = 0.92), males (76% vs. 69%; P = 0.60), LVEF (40 ± 17% vs. 40 ± 18%; P = 0.96), and amiodarone use (31% vs. 46%, P = 0.22). One‐year VA freedom between 1‐RAbl vs. > 1RAbl was similar (82% vs. 80%; P = 0.81); adjunctive ablation was utilized more in >1RAbl (31% vs. 11%, P = 0.02), and complication rates were higher (27% vs. 7%, P = 0.01), most due to septal substrate and anticipated heart block. >1‐RAbl patients had more MMS (62% vs. 16%, P < 0.01). Although MMS was associated with worse VA‐free survival after 1‐RAbl (43% vs. 69%, P = 0.01), when >1RAbl was performed, more often with nonstandard ablation, VA‐free survival was comparable to non‐MMS patients (85% vs. 81%; P = 0.69). More RAbls were required in MMS versus non‐MMS patients (2.00 ± 0.98 vs. 1.16 ± 0.37; P < 0.001).

Conclusion

For NICM patients with recurrent, refractory VAs despite previous ablation, effective arrhythmia control can safely be achieved with subsequent ablation, although >1 repeat procedure with adjunctive ablation is often required, especially with MMS.
Ventricular wall stress and silent myocardial damage are associated with pulse pressure in the general population
Authors: Takahashi Tetsuya , Shishido Tetsuro , Watanabe Ken , Sugai Takayuki , Toshima Taku , Kinoshita Daisuke , Yokoyama Miyuki , Tamura Harutoshi , Nishiyama Satoshi , Takahashi Hiroki , Arimoto Takanori , Miyamoto Takuya , Watanabe Tetsu , Shibata Yoko , Konta Tsuneo , Ueno Yoshiyuki , Kato Takeo , Kayama Takamasa , Kubota Isao , Watanabe Masafumi
Published: July 2018

Pulse pressure (PP) is a risk factor for cardiovascular diseases and is associated with increased afterload and myocardial oxygen demand. Brain natriuretic peptide (BNP) and heart‐type fatty acid–binding protein (H‐FABP) are known as biomarkers indicating ventricular wall stress and silent myocardial damage. However, the association between PP and ventricular wall stress and silent myocardial damage in the general population is unclear. The authors enrolled 3504 patients who participated in a community‐based annual health check. Serum levels of BNP and H‐FABP were measured as markers of ventricular wall stress and silent myocardial damage. Patients were divided into four groups according to the quartiles of PP. Patients in the highest PP group showed higher serum BNP and H‐FABP levels than that of the other groups. Multivariate logistic analysis showed that high PP was independently associated with ventricular wall stress and silent myocardial damage on the basis of BNP and H‐FABP levels. Compared with systolic blood pressure, diastolic blood pressure, and mean blood pressure, PP was superior in predicting ventricular wall stress and silent myocardial damage evaluated according to BNP and H‐FABP levels, which was reflected by the receiver operating characteristic analysis. Screening of healthy patients revealed that high PP was related to high BNP and H‐FABP levels, suggesting that an asymptomatic general population with high PP may be exposed to ventricular wall stress and myocardial damage and might be susceptible to silent heart failure.
Acceptance of the Advanced Practice Nurse in Lung Cancer Role by Healthcare Professionals and Patients: A Qualitative Exploration
Authors: Serena Andrea , Dwyer Andrew A. , Peters Solange , Eicher Manuela
Published: July 2018

Purpose

The purpose of this study was to explore the acceptance of a novel role, the advanced practice nurse in lung cancer (APNLC), from the perspective of patients and healthcare professionals in a country lacking a regulatory oversight for advanced practice nursing (APN) roles.

Methods and Design

This study utilized a qualitative methodology using focus groups and semistructured interviews. Participants were purposively sampled in a Swiss academic medical center. Two focus groups were conducted: the first included nurses (n = 5) and the social worker, while the second targeted physicians (n = 6). The APNLC and patients (n = 4) were interviewed using semistructured interviews. Data were analyzed using thematic content analysis.

Findings

Three main themes were identified: APNLC role identification, APNLC role‐specific contributions, and APNLC flexible service. Physicians and patients clearly recognized the APNLC role, noting contributions to continuity of care, psychosocial support, and enabling symptom self‐management. Nurses perceived the APNLC role as overlapping with the oncology nurse role. Flexibility in providing care was seen as the strength of the APNLC role, yet this also posed organizational challenges.

Conclusions

The new role appears to be well accepted by patients and physicians, yet barriers posed by nursing colleagues remain challenging.

Clinical Relevance

Based on existing literature and the present findings, we propose a model to guide future implementation and enhance acceptance of the APNLC role. This model comprises three actions: (a) formalizing nursing role expectations, (b) providing appropriate support and resources, and (c) promoting a national plan for APN regulation.
Forest seedling community response to understorey filtering by tree ferns
Authors: Brock James M. R. , Perry George L. W. , Burkhardt Tynan , Burns Bruce R.
Published: July 2018

Questions

Large pteridophytes frequently co‐occur with conifers and angiosperms in the understorey of temperate broad‐leaved podocarp forests but interactions between them are poorly understood. We evaluated the impact of tree ferns on the regeneration niche of vascular woody species to determine whether tree ferns function as biotic filters and influence seedling occurrence. We asked the following questions: (i) do understorey tree ferns influence the woody seedling bank, and (ii) which potential mechanisms drive any such influence?

Location

Auckland and Waikato regions, northern New Zealand.

Methods

We measured woody seedlings in 164 1‐m2 plots in northern New Zealand temperate broad‐leaved podocarp forest and used multivariate analyses and modelling to assess the relative contributions of abiotic and biotic effects on community composition and seedling abundance. We manipulated the environments beneath 160 tree fern individuals by removing fronds and/or macro‐litter in a balanced factorial design, and recorded the response of the seedling community over 1 year. We then assessed the relative influences of shading and litter depth on the seedling community response.

Results

Distance to the nearest tree fern was the best predictor of understorey seedling abundance; seedling abundance decreased beneath tree ferns. There was no strong evidence, however, that tree ferns influence seedling community composition; although the palm Rhopalostylis sapida, was consistently present away from tree fern micro‐sites. Removal of tree fern shading and macro‐litter both influenced the local seedling community; conifers responded positively, and most consistently to frond removal. Frond‐shading and deep litter reduced seedling species richness and seedling abundance.

Conclusions

Tree ferns influence the woody seedling bank in temperate broad‐leaved podocarp forest through increased shading and macro‐litter accumulation, both of which reduce the abundance of angiosperm and conifer seedlings. A tree fern‐dominated understorey is likely to reduce conifer establishment and may limit direct competition among woody plants by reducing densities and regeneration opportunities immediately beneath tree fern canopies.
On selection of an appropriate logistic model to determine the risk factors of childhood stunting in Bangladesh
Authors: Bhowmik Kakoli Rani , Das Sumonkanti
Published: July 2018

Stunting is the core measure of child health inequalities as it reveals multiple dimensions of child health and development status. The main focus of this study is to show the procedure of selecting the most appropriate logistic regression model for stunting by developing and comparing several plausible models, which ultimately helps to identify the predictors of childhood stunting in Bangladesh. This study utilizes child anthropometric data collected in the 2014 Bangladesh Demographic and Health Survey. Valid height‐for‐age anthropometric indices were available for a total of 6,931 children aged 0–59 months, of which about 36% were stunted. Ordinary logistic, survey logistic, marginal logistic, and random intercept logistic regression models were developed assuming independence, sampling design, cluster effect, and hierarchy of the data. Based on a number of model selection criteria, random intercept logistic model is found the most appropriate for the studied children. A number of child, mother, household, regional, and community‐level variables were included in the model specification. The factors that increased the odds of stunting are children older than 11 months, short birth interval, recent morbidity of children, lower maternal education, young maternity, lower maternal body mass index, poor household wealth, urban residential place, and living in Sylhet division. Findings of this study recommend to utilize an appropriate logistic model considering the issues relevant to the data, particularly sampling design and clustering for determining the risk factors of childhood stunting in Bangladesh.
Differences Between Short‐ and Long‐Term Risk Aversion: An Optimal Asset Allocation Perspective
Authors: Gonzalo Jesus , Olmo Jose
Published: July 2018

This paper studies the long‐term asset allocation problem of an investor with different risk aversion attitudes to the short and the long term. We characterize investor's preferences with a utility function exhibiting a regime shift in risk aversion at some point of the multiperiod investment horizon that is estimated using threshold nonlinearity methods. Our empirical results for a portfolio of cash, bonds and stocks suggest that long‐term risk aversion is higher than short‐term risk aversion and increases with the investment horizon. The exposure of the investment portfolio from stocks to bonds and cash increases with the degree of risk aversion.
Does the Media Help the General Public in Understanding Inflation?
Authors: Jansen David‐Jan , Neuenkirch Matthias
Published: July 2018

This paper studies whether media information helps the general public in understanding inflation. We combine detailed Dutch household survey data on media usage, inflation perceptions, and inflation expectations. We find no evidence that more‐often informed members of the general public do better in understanding inflation. In fact, more frequent readership of popular newspapers is associated with slightly less accurate inflation perceptions. There is also no evidence that usage of non‐print media leads to more accurate of views on inflation. One implication of these results is that central banks might need to consider more direct ways of engaging with the general public.
Correlation between minute carbon dioxide elimination and pulmonary blood flow in single‐ventricle patients after stage 1 palliation and 2‐ventricle patients with intracardiac shunts: A pilot study
Authors: Al‐Subu Awni , Jooste Edmund , Hornik Christoph P. , Fleming Gregory A. , Cheifetz Ira M. , Ofori‐Amanfo George
Published: July 2018

Background

Assessment of pulmonary blood flow and cardiac output is critical in the postoperative management of patients with single‐ventricle physiology or 2‐ventricle physiology with intracardiac shunting. Currently, such hemodynamic data are only obtainable by invasive procedures, such as cardiac catheterization or the use of a pulmonary artery catheter. Ready availability of such information, especially if attainable noninvasively, could be a valuable addition to postoperative management.

Aims

The aim of this study was to assess the correlation between volume of CO2 elimination obtained by volumetric capnography and pulmonary blood flow in pediatric patients with single‐ventricle physiology after stage 1 palliation as well as in patients with other cardiac lesions associated with intracardiac shunting.

Methods

This prospective cohort study included children with congenital or acquired heart disease who underwent cardiac catheterization as part of clinical care. Cardiac output, pulmonary blood flow, and volume of CO2 elimination were simultaneously collected. Spearman's rank correlation coefficients were used to assess correlation between measurements after controlling for minute ventilation.

Results

Thirty‐five patients were enrolled and divided into 3 groups. Group 1 (n = 8) included single‐ventricle patients after stage 1 palliation. Group 2 (n = 10) patients had structural heart disease with 2 ventricles and intracardiac shunting. Group 3 (n = 17) had structurally normal hearts. Among Group 1 patients, the correlation coefficients (R2) between volume of CO2 elimination and pulmonary blood flow and volume of CO2 elimination and cardiac output were 0.60 (P = .02) 95% CI [0.01‐0.79] and 0.29 (P = .74) 95% CI [−0.91 ‐ 0.86], respectively. In patients with 2 ventricles associated with intracardiac shunts (Group 2), the correlation coefficients between volume of CO2 elimination and pulmonary blood flow and volume of CO2 elimination and cardiac output were 0.86 (P = .001) 95% CI [0.53 ‐ 0.97] and 0.73 (P = .001) 95% CI [0.29 ‐ 0.95], respectively. Among Group 3 patients, the correlation coefficient between volume of CO2 elimination and pulmonary blood flow was 0.66 (P = .038) 95% CI [0.29 ‐ 0.87].

Conclusion

Volume of CO2 elimination may be a surrogate marker of pulmonary blood flow in single‐ventricle patients and patients with biventricular physiology with intracardiac shunting. Also, among patients with normal cardiac anatomy, volume of CO2 elimination may be a marker of cardiac output.
Dorsal penile nerve block for circumcision in pediatric patients: A prospective, observer‐blinded, randomized controlled clinical trial for the comparison of ultrasound‐guided vs landmark technique
Authors: Teunkens An , Van de Velde Marc , Vermeulen Kristien , Van Loon Philippe , Bogaert Guy , Fieuws Steffen , Rex Steffen
Published: July 2018

Background and aims

Circumcision is a frequently performed procedure in day case pediatric surgery. Dorsal penile nerve block has proven its effectiveness for the management of acute postoperative pain after circumcision. We investigated if the ultrasound‐guided placement of a dorsal penile nerve block could reduce opioid requirement as compared to a landmark‐based technique.

Methods

Three hundred and ten prepubertal children, aged between 52 weeks postconception and 11 years, were included in this prospective, observer‐blinded, randomized controlled trial and received either a landmark‐ or an ultrasound‐guided dorsal penile nerve block, using a caudal needle and injecting 0.1 mL/kg levobupivacaine 0.5% bilaterally. A single, experienced investigator performed all blocks. The primary endpoint was the number of patients in need of piritramide postoperatively as triggered by the Objective Pain Scale. Secondary outcome parameters included the cumulative dose of postoperatively administered opioids, the requirement to administer fentanyl intraoperatively, the need for paracetamol and ibuprofen during the first 24 postoperative hours, postoperative pain scores, the incidence of postoperative nausea and vomiting, the anesthesia induction time, and the time to discharge.

Results

The proportion of patients requiring postoperative piritramide did not differ significantly between both groups (Landmark: 38% vs Ultrasound: 47%, with a difference in proportion between both conditions (95% CI): 0.09 (0.2 to 0.02); P = .135). In addition, the cumulative doses of postoperative piritramide and intraoperative fentanyl, the postoperative need for paracetamol or ibuprofen, pain scores, the incidence of postoperative nausea and vomiting, and the time to discharge were not different either. However, the anesthesia induction time was significantly longer in the ultrasound‐guided dorsal penile nerve block (median time [IQR]: Landmark: 11[9; 13] min vs Ultrasound: 13[11; 15] min, P < .001).

Conclusion

Compared with the landmark‐guided, the ultrasound‐guided dorsal penile nerve block did not reduce the need for postoperative analgesia after circumcision in children, but was associated with an increase in the procedural time.
Intraoperative anesthetic management of an infant with a bridging bronchus: A case report
Authors: Shakuo Tomoharu , Oe Katsunori , Shimura Yuko , Awakura Hanae , Yamada Arata
Published: July 2018

A newborn infant was diagnosed with an imperforate anus, and colostomy was performed one day after birth. He exhibited repeated episodes of poor oxygenation during intubation, and a CT scan revealed a bridging bronchus. He was scheduled to undergo sacroperineal repair in the prone position 8 months later. A tracheal tube, with its tip modified to widen the opening, was inserted through the nose. This led to normal oxygenation, even while in the prone position. The surgery was completed without any complications.
Market effects of farmer field schools in Sub‐Saharan Africa: The case for cocoa
Authors: Tsiboe Francis , Luckstead Jeff , Nalley Lawton L. , Popp Jennie S. , Dixon Bruce L.
Published: July 2018

Billions of dollars are invested in development programs, all of which have a monitoring and evaluation component and consider only the programs’ intended effects while ignoring their market effects on prices. This study analyzes the market effects of the Cocoa Livelihood Program (CLP) in Ghana. To evaluate both the benefits to cocoa farmers and market outcomes of CLP on cocoa and other noncocoa markets, this study simulates a partial‐equilibrium farm household model. The analysis shows that CLP participating households benefit by U.S.$154 per household, while nonparticipating households benefit (through market outcome) by only U.S.$21 per household, at the 2016 participation rate of 6 percent. The net welfare changes in staple food markets (maize, rice, cassava, and yam) attributable to CLP, is estimated at U.S.$850 per household. A rise in the CLP participation rate leads to a decline in the Ghanaian cocoa price. However, net gains from the program become negative at participation rates of more than 60 percent, as supply increases and the cocoa price falls. This result suggests that CLP participation could be expanded up to 60 percent of Ghana's cocoa producing households. However, expanding cocoa demand is equally as important as expanding production if participation rates exceed 60 percent.
Firm heterogeneity and international trade in services
Authors: Morikawa Masayuki
Published: July 2018

This study, using panel data on Japanese firms, analyses the relationship between services trade and firm heterogeneity. It finds that the number of firms engaged in services trade is far less than that engaged in goods trade. Further, the productivity of services traders is higher than that of domestic firms and goods trading firms, whereas the productivity of firms that export services beyond the boundary of their firm groups is higher than that of those that export services only to their affiliate firms. These results suggest that only productive firms can engage in services trade by incurring the relatively large fixed costs.
Firm strategies in expanding and diversifying exports
Authors: Lawless Martina , Siedschlag Iulia , Studnicka Zuzanna
Published: July 2018

This paper provides novel empirical evidence on the patterns and dynamics of exports by Irish firms over the past two decades from a highly detailed data set of export records at the firm‐product‐destination level. We identify patterns of export concentration and specialisation and how these evolved over time. Firms’ strategies for export growth along product and destination markets mixes are then examined and the contributions of intensive (average sales) and extensive (number of products or markets) margins to overall exports and to export growth are calculated. We find that most exporting firms are quite small, selling a few products to a small number of destinations while export values are dominated by a relatively small group of highly globalised large firms selling many products to many destinations. Continuing exporters frequently introduce new products, drop products and enter and exit markets. Export growth in the case of Irish‐owned exporters appears largely driven by the extensive margin of product and destination changes. However, the opposite pattern holds for foreign‐owned firms with growth mainly coming from the intensive margin.
WORKABILITY AND RHEOLOGICAL PROPERTIES OF EVA-MODIFIED BITUMEN COMPARED WITH PG 76 BINDER
Authors: Oluwasola Ebenezer Akin , Hainin Mohd Rosli , Idham Mohd Khairul , Abayomi Modupe
Published: July 2018

The failures of the flexible pavements are not only caused by harsh climatic conditions prevailing in most of the tropical countries but also due to increase in traffic. The ethylene vinyl acetate (EVA) modification of the bitumen can strengthen the properties of binders and also improve the quality of bitumen used for pavements construction. This paper reports the changes in physical and rheological properties of unaged 80-100 grade bitumen modified with different percentages of EVA and compared with the properties of PG 76 binder. The penetration, softening point and viscosity properties were studied. The rheological properties were measured using dynamic shear rheometer and the test was performed at temperatures ranging from 46 to 76 ⁰C at intervals of 6 ⁰C. It was noted that, after modification, the properties of binders had improved. The results show that 5% EVA content by weight in modified binder is adequate in terms of physical and rheological properties studied. In addition, the properties of 5% EVA modified 80-100 grade bitumen are similar to PG 76 binder.
THE ACOUSTIC EFFECTS OF THE AUDIENCE IN THE MODERN USE THE OF ANCIENT THEATRES
Authors: Iannace Gino , Trematerra Amelia
Published: July 2018

The ancient theatres are used in modern age for different kinds of shows. Today the ancient theatres have been returned to be the center of cultural activities during the summer seasons. Although many shows do not achieve the success of the critics and of the audience due to the weak acoustics of the theatres. Often the audience criticizes the acoustics, because they consider them lacking for the spoken comprehension and for the weakness of the music. An important aspect is the presence of the audience in the cavea, so it is important to understand whether this has a negative role in the overall acoustics of the theatre. The presence of the audience in the cavea involves variations of the room’s acoustics characteristics. The acoustic measurements are very difficult to carry out when there are people in the theatre. So it is possible to simulate the presence of the audience, in a virtual way, by using a software for architectural acoustics, in which the presence of the audience is simulated changing the value of the absorption coefficient of the surfaces of the cavea.
Beyond the Sticking Point
Authors: Nosonovsky Michael
Published: July 2018

This article discusses that new friction theories can help engineers not only avoid costly blunders but also come up with elegant novel solutions to longstanding challenges. The article also highlights that conventional design tools such as the computer-aided design or computer-aided engineering software, deal with friction by assuming a constant value of the coefficient of friction. Engineers would be better off defining that parameter themselves to capture the dynamic nature of friction. Frictional effects are increasingly important with miniaturization. This is because small devices have high surface-to-volume ratios, with surface forces such as friction and adhesion dominating over the volume forces. Relying on the old-fashioned models of friction provides insufficient precision for micron- or submicron-size devices. The examples described in the article suggest that proper incorporation of dynamic friction into engineering design models and software can be beneficial for practical engineers.
Eyes on the Prize
Authors: Kelly Lassie
Published: July 2018

This article emphasizes on the role and the importance of engineering competitive events for engineering students. More and more universities are encouraging competitions and integrating them with course curricula. This is because hands-on, competitive engineering lets students do what they came to school to do: innovate and build. In surveys and on internet chatrooms, students complain about the drudgery of learning engineering fundamentals. They learn the same concepts in a competition, but applying them to real challenges makes all the difference. Through competitions, students are fusing together disciplines to navigate a faster and more interconnected future. They are learning to rise to technical challenges, and discovering how to turn people with different skills into an effective team. They have helped commercialize manned spaceflight, launch the autonomous car revolution, design fuel-miser sports cars, and plumb the ocean depths. They are developing new combinations of skills, and laying the foundations for modern technologies and start-ups.
No Resistance to Tenofovir Alafenamide Detected through 96 Weeks of Treatment in Patients with Chronic Hepatitis B Infection
Authors: Cathcart Andrea L. , Chan Henry Lik-Yuen , Bhardwaj Neeru , Liu Yang , Marcellin Patrick , Pan Calvin Q. , Shalimar  , Buti Maria , Cox Stephanie , Parhy Bandita , Zhou Eric , Martin Ross , Chang Silvia , Lin Lanjia , Flaherty John F. , Kitrinos Kathryn M. , Gaggar Anuj , Izumi Namiki , Lim Young-Suk
Published: July 2018

Tenofovir alafenamide (TAF) has shown equivalent efficacy and improved safety profiles for patients with chronic hepatitis B (CHB) compared to tenofovir disoproxil fumarate (TDF). However, limited data are available for its resistance profiles.
Antimicrobial Susceptibility Testing and Tentative Epidemiological Cutoff Values for Five Bacillus Species Relevant for Use as Animal Feed Additives or for Plant Protection
Authors: Agersø Yvonne , Stuer-Lauridsen Birgitte , Bjerre Karin , Jensen Michelle Geervliet , Johansen Eric , Bennedsen Mads , Brockmann Elke , Nielsen Bea
Published: July 2018

When commercializing bacterial strains, like
Bacillus
spp., for feed applications or plant bioprotection, it is required that the strains are free of acquired antimicrobial resistance genes that could potentially spread to pathogenic bacteria, thereby adding to the pool of resistance genes that may cause treatment failures in humans or animals. Conversely, if antimicrobial resistance is intrinsic to a bacterial species, the risk of spreading horizontally to other bacteria is considered very low. Reliable susceptibility test methods and interpretation criteria at the species level are needed to accurately assess antimicrobial resistance levels. In the present study, tentative ECOFFs for five
Bacillus
species were determined, and the results showed that the variation in MICs followed the respective species. Moreover, putative resistance genes, which were detected by whole-genome sequencing and suggested to be intrinsic rather that acquired, could explain the resistance phenotypes in most cases.
Sera from Individuals with Narrowly Focused Influenza Virus Antibodies Rapidly Select Viral Escape Mutations
In Ovo
Authors: Davis Amy K. F. , McCormick Kevin , Gumina Megan E. , Petrie Joshua G. , Martin Emily T. , Xue Katherine S. , Bloom Jesse D. , Monto Arnold S. , Bushman Frederic D. , Hensley Scott E.
Published: July 2018

Influenza vaccine strains must be updated frequently since circulating viral strains continuously change in antigenically important epitopes. Our previous studies have demonstrated that some individuals possess antibody responses that are narrowly focused on epitopes that were present in viral strains that they encountered during childhood. Here, we show that influenza viruses rapidly escape this type of polyclonal antibody response when grown
in ovo
by acquiring single mutations that directly prevent antibody binding. These studies improve our understanding of how influenza viruses evolve when confronted with narrowly focused polyclonal human antibodies.
MicroRNA hsa-miR-324-5p Suppresses H5N1 Virus Replication by Targeting the Viral PB1 and Host CUEDC2
Authors: Kumar Ashish , Kumar Akhilesh , Ingle Harshad , Kumar Sushil , Mishra Richa , Verma Mahendra Kumar , Biswas Debasis , Kumar Nachimuthu Senthil , Mishra Anamika , Raut Ashwin Ashok , Takaoka Akinori , Kumar Himanshu
Published: July 2018

Highly pathogenic influenza A virus (HPAIV) continues to pose a pandemic threat globally. From 2003 to 2017, H5N1 HPAIV caused 453 human deaths, giving it a high mortality rate (52.74%). This work shows that miR-324-5p suppresses H5N1 HPAIV replication by directly targeting the viral genome (thereby inhibiting viral gene expression) and cellular CUEDC2 gene, the negative regulator of the interferon pathway (thereby enhancing antiviral genes). Our study enhances the knowledge of the role of microRNAs in the cellular response to viral infection. Also, the study provides help in understanding how the host cells utilize small RNAs in controlling the viral burden.
Strategy of Human Cytomegalovirus To Escape Interferon Beta-Induced APOBEC3G Editing Activity
Authors: Pautasso Sara , Galitska Ganna , Dell'Oste Valentina , Biolatti Matteo , Cagliani Rachele , Forni Diego , De Andrea Marco , Gariglio Marisa , Sironi Manuela , Landolfo Santo
Published: July 2018

APOBEC3 family of proteins plays a pivotal role in intrinsic immunity defense mechanisms against multiple viral infections, including retroviruses, through the deamination activity. However, the currently available data on APOBEC3 editing mechanisms upon HCMV infection remain unclear. In the present study, we show that particularly the APOBEC3G (A3G) member of the deaminase family is strongly induced upon infection with HCMV in fibroblasts and that its upregulation is mediated by IFN-β. Furthermore, we were able to demonstrate that neither A3G knockout nor A3G overexpression appears to modulate HCMV replication, indicating that A3G does not inhibit HCMV replication. This may be explained by HCMV escape strategy from A3G activity through depletion of the preferred nucleotide motifs (hot spots) from its genome. The results may shed light on antiviral potential of APOBEC3 activity during HCMV infection, as well as the viral counteracting mechanisms under A3G-mediated selective pressure.
Transposon Insertion Sequencing Elucidates Novel Gene Involvement in Susceptibility and Resistance to Phages T4 and T7 in
Escherichia coli
O157
Authors: Cowley Lauren A. , Low Alison S. , Pickard Derek , Boinett Christine J. , Dallman Timothy J. , Day Martin , Perry Neil , Gally David L. , Parkhill Julian , Jenkins Claire , Cain Amy K.
Published: July 2018

Experiments using bacteriophage (phage) to infect bacterial strains have helped define some basic genetic concepts in microbiology, but our understanding of the complexity of bacterium-phage interactions is still limited. As the global threat of antibiotic resistance continues to increase, phage therapy has reemerged as an attractive alternative or supplement to treating antibiotic-resistant bacterial infections. Further, the long-used method of phage typing to classify bacterial strains is being replaced by molecular genetic techniques. Thus, there is a growing need for a complete understanding of the precise molecular mechanisms underpinning phage-bacterium interactions to optimize phage therapy for the clinic as well as for retrospectively interpreting phage typing data on the molecular level. In this study, a genomics-based fitness assay (TraDIS) was used to identify all host genes involved in phage susceptibility and resistance for a T4 phage infecting Shiga-toxigenic
Escherichia coli
O157. The TraDIS results identified both established and previously unidentified genes involved in phage infection, and a subset were confirmed by site-directed mutagenesis and phenotypic testing of 14 T4 and 2 T7 phages. For the first time, the entire
sap
operon was implicated in phage susceptibility and, conversely, the stringent starvation protein A gene (
sspA
) was shown to provide phage resistance. Identifying genes involved in phage infection and replication should facilitate the selection of bespoke phage combinations to target specific bacterial pathogens.

IMPORTANCE
Antibiotic resistance has diminished treatment options for many common bacterial infections. Phage therapy is an alternative option that was once popularly used across Europe to kill bacteria within humans. Phage therapy acts by using highly specific viruses (called phages) that infect and lyse certain bacterial species to treat the infection. Whole-genome sequencing has allowed modernization of the investigations into phage-bacterium interactions. Here, using
E. coli
O157 and T4 bacteriophage as a model, we have exploited a genome-wide fitness assay to investigate all genes involved in defining phage resistance or susceptibility. This knowledge of the genetic determinants of phage resistance and susceptibility can be used to design bespoke phage combinations targeted to specific bacterial infections for successful infection eradication.
Are low levels of serum bicarbonate associated with risk of progressing to impaired fasting glucose/diabetes? A single-centre prospective cohort study in Beijing, China
Authors: Li Sen , Wang Ying-Ying , Cui Jing , Chen Dong-Ning , Li Yu , Xin Zhong , Xie Rong-Rong , Cao Xi , Lu Jing , Yang Fang-Yuan , Yang Jin-Kui
Published: July 2018

Aims

Bicarbonate is involved in many human essential metabolic processes, but little is known about the association between serum bicarbonate and glucose metabolism. This study aims to investigate the association between serum bicarbonate and the risk of progressing to impaired fasting glucose (IFG)/diabetes mellitus (DM).

Setting

The data were obtained from a large-scale prospective cohort study in a single health centre in Beijing.

Participants

A total of 5318 participants aged 18–70 years who underwent health examinations annually with baseline fasting plasma glucose (FPG) ranging from 3.9 to 5.5 mmol/L, without a history of either diabetes or concomitant chronic diseases, were enrolled in this 6-year observational study.

Primary outcome measures

A logistic regression analysis was used to calculate ORs for progressing to IFG/DM by the category of baseline serum bicarbonate. In addition, an analysis of the receiver operating characteristic (ROC) curve for predicting IFG was performed.

Results

Of the 5318 participants, 210 developed IFG after a median 2.2 years of follow-up. After adjusting for sex, age, FPG, body mass index, systolic blood pressure, serum creatinine, serum alanine aminotransferase and low-density lipoprotein cholesterol at baseline, the participants in the first (OR 4.18, 95% CI 2.42 to 7.21; p<0.001), second (OR 3.02, 95% CI 1.71 to 5.33; p<0.001) and third (OR 2.12, 95% CI 1.15 to 3.89; p=0.015) quartiles of serum bicarbonate had higher odds for progressing to IFG/DM compared with those in the highest quartile. The area under the ROC curve for predicting IFG/DM was 0.69 (95% CI 0.65 to 0.72; p<0.001).

Conclusions

Lower serum bicarbonate is associated with higher risk of the development of IFG/DM.