bluuebunny/crossref_metadata_2025 huggingface dataset:
Abnormal head growth in children
Authors: Chitkara Monica , Ahmed Mas , Rafique Bushra , Dhillon Nimrit
Published: May 2016

Head size naturally differs between female and male infants, and it is age-dependent. The skull is filled with the brain, cerebrospinal fluid and vascular structures. The shape and size of the head is determined by the above components, as well as skull thickness, rate of the fusion of the cranial sutures, and the development of the frontal sinuses. This article aims to outline a best practice assessment of head circumference and discuss abnormalities that could be seen in general practice.
Proportional-derivative linear quadratic regulator controller design for improved longitudinal motion control of unmanned aerial vehicles
Authors: Yit Kok Kai , Rajendran Parvathy , Wee Lim Kah
Published: May 2016

This study investigates the longitudinal motion control of unmanned aerial vehicles through a simulation in MATLAB. The linear model of an unmanned aerial vehicle is applied to controllers to explicate the longitudinal motion of the unmanned aerial vehicle. The ideal performance for an unmanned aerial vehicle is to achieve the desired response instantly with 100% precision. However, currently available controllers need further improvements. Thus, a proportional-derivative linear quadratic regulator controller is developed and compared with a proportional-integral-derivative controller, a linear quadratic regulator controller, and a proportional linear quadratic regulator controller. The proportional-derivative linear quadratic regulator controller enhances the response of the system by reducing settling time by more than 95% compared with other available controllers. Additionally, the proportional-derivative linear quadratic regulator improves the root mean square error by almost 50% compared with the proportional linear quadratic regulator controller and improves rise time by almost 96% with reasonable overshoot.
Active filter driver for piezo-actuators for flapping-wing micro air vehicles
Authors: Chattaraj Nilanjan , Ganguli Ranjan
Published: May 2016

Piezoelectrically actuated flapping-wing micro air vehicle (MAV) is an emerging technology. This paper discusses limitations of presently used voltage drivers for the piezoelectric actuators used in such applications and suggests an active filter-based unipolar high-voltage driver. A Chebyshev polynomial has been used to extract a unipolar sinusoidal high voltage signal from a unipolar square wave signal for driving the piezoelectric actuators at low frequency in flapping-wing MAV applications. The filter is based on Sallen–Key topology and is suitable for connecting a piezo-bimorph in series or parallel electrical connection. We have considered an application-specific piezoelectric bimorph actuator of 40 Hz flapping frequency and 32 nF capacitance in each piezoelectric layer to design a driver. The driver circuit in verified by simulation results of OrCAD® software. The driver circuit can control the frequency of the sinusoidal driving voltage, which causes wing-flapping, by radio control communication.
Identification of the educational needs and feasible educational modalities for specialist nurses working with ophthalmic patients in a tertiary eye centre in Singapore
Authors: Aw Ai Tee , Drury Vicki
Published: May 2016

Aims:

We aim to identify the educational needs and feasible educational modalities for specialist nurses working with ophthalmic patients in a tertiary eye centre in Singapore.

Design:

This was a mixed-method study utilising paper-based surveys and focus groups with nurses working at a tertiary eye centre in Singapore.

Participants:

One hundred nurses were invited to respond to the survey, with a response rate of 91%. Two focus groups with a total of 19 nurses were facilitated.

Methods:

Participants completed a modified Hennessy–Hicks survey. Among these participants 19 were invited to participate in a focus group. Descriptive statistical analysis was performed on the survey results. Focus groups were analysed using the inductive thematic analysis procedure described by Braun and Clarke.

Findings:

The participants in this study reported a need for ophthalmic-specific education programmes, more training in patient education and a need to broaden clinical exposure and experience.

Conclusion:

For ophthalmic nursing, where the workforce and patient population are considered relatively small, and postgraduate programmes are limited, the need to develop local education strategies to meet workforce needs has emerged.
Hybrid Pulmonary Artery Stenting at the Bidirectional Glenn or Fontan Operation in Patients With Single Ventricle Congenital Heart Disease
Authors: Schwartz Matthew C. , DeCampli William M. , Pourmoghadam Kamal , Iacono Karen , Nykanen David
Published: May 2016

Background:

Stenosis of the retroaortic pulmonary artery is common in patients with single ventricle heart disease. Intraoperative hybrid stenting at the bidirectional Glenn or Fontan operation can treat this lesion and avoid a complex surgical arterioplasty.

Methods:

Patients who underwent intraoperative stent implantation to the retroaortic pulmonary artery during the bidirectional Glenn or Fontan operation at our center between January 2005 and July 2014 were retrospectively identified.

Results:

Thirteen patients were included with a median weight of 8 kg (5.6-14.4 kg) and age of 6 months (4 months-3.8 years). All had undergone Norwood operation, and eight (62%) had hypoplastic left heart syndrome. Eight (62%) underwent stent placement during bidirectional Glenn and five (38%) during Fontan operation. Ten patients had one stent placed, and three had two overlapping stents. The median diameter of the stenotic vessel was 3 mm (2.0-5.5 mm) and diameter of the balloon used for stent expansion was 7 mm (5-10 mm). Two complications occurred including pulmonary hemorrhage from presumed wire perforation and left main stem bronchus compression requiring stent removal. No patient required stent intervention in the postoperative period, and all were discharged from the hospital. At a median follow-up of 1.3 years (2 months-7.1 years), six patients underwent interval dilation to account for somatic growth.

Conclusions:

Hybrid stenting of the retroaortic pulmonary artery at the bidirectional Glenn or Fontan operation is an effective treatment of pulmonary artery stenosis and prevents the need for a complex surgical arterioplasty.
Paradox and power: A structurationist perspective on managers’ hesitation regarding people management
Authors: Bader Anna Katharina
Published: May 2016

Research has broadly investigated the role of line managers in human resource management. However, several studies have shown that line managers perceive there to be high pressure on their operational performance, often at the expense of their role as people managers. Combining Giddens’ theory of structuration and paradox lens as theoretical backgrounds, I aim to explain this phenomenon by accounting for the embeddedness of line managers in organizations as social and political systems. Therefore, I developed a circular structuration model displaying the process and dynamics that influence the development and change of norms for coping with paradoxical tensions. Implications for theory and practice are discussed.
Acquired von Willebrand syndrome associated with left ventricular assist device
Authors: Nascimbene Angelo , Neelamegham Sriram , Frazier O. H. , Moake Joel L. , Dong Jing-fei
Published: May 2016

Left ventricular assist devices (LVAD) provide cardiac support for patients with end-stage heart disease as either bridge or destination therapy, and have significantly improved the survival of these patients. Whereas earlier models were designed to mimic the human heart by producing a pulsatile flow in parallel with the patient’s heart, newer devices, which are smaller and more durable, provide continuous blood flow along an axial path using an internal rotor in the blood. However, device-related hemostatic complications remain common and have negatively affected patients’ recovery and quality of life. In most patients, the von Willebrand factor (VWF) rapidly loses large multimers and binds poorly to platelets and subendothelial collagen upon LVAD implantation, leading to the term acquired von Willebrand syndrome (AVWS). These changes in VWF structure and adhesive activity recover quickly upon LVAD explantation and are not observed in patients with heart transplant. The VWF defects are believed to be caused by excessive cleavage of large VWF multimers by the metalloprotease ADAMTS-13 in an LVAD-driven circulation. However, evidence that this mechanism could be the primary cause for the loss of large VWF multimers and LVAD-associated bleeding remains circumstantial. This review discusses changes in VWF reactivity found in patients on LVAD support. It specifically focuses on impacts of LVAD-related mechanical stress on VWF structural stability and adhesive reactivity in exploring multiple causes of AVWS and LVAD-associated hemostatic complications.
Is Middle-Upper Arm Circumference “normally” distributed? Secondary data analysis of 852 nutrition surveys
Authors: Frison Severine , Checchi Francesco , Kerac Marko , Nicholas Jennifer
Published: May 2016

Background

Wasting is a major public health issue throughout the developing world. Out of the 6.9 million estimated deaths among children under five annually, over 800,000 deaths (11.6 %) are attributed to wasting. Wasting is quantified as low Weight-For-Height (WFH) and/or low Mid-Upper Arm Circumference (MUAC) (since 2005). Many statistical procedures are based on the assumption that the data used are normally distributed. Analyses have been conducted on the distribution of WFH but there are no equivalent studies on the distribution of MUAC.

Methods

This secondary data analysis assesses the normality of the MUAC distributions of 852 nutrition cross-sectional survey datasets of children from 6 to 59 months old and examines different approaches to normalise “non-normal” distributions.

Results

The distribution of MUAC showed no departure from a normal distribution in 319 (37.7 %) distributions using the Shapiro–Wilk test. Out of the 533 surveys showing departure from a normal distribution, 183 (34.3 %) were skewed (D’Agostino test) and 196 (36.8 %) had a kurtosis different to the one observed in the normal distribution (Anscombe–Glynn test). Testing for normality can be sensitive to data quality, design effect and sample size. Out of the 533 surveys showing departure from a normal distribution, 294 (55.2 %) showed high digit preference, 164 (30.8 %) had a large design effect, and 204 (38.3 %) a large sample size. Spline and LOESS smoothing techniques were explored and both techniques work well. After Spline smoothing, 56.7 % of the MUAC distributions showing departure from normality were “normalised” and 59.7 % after LOESS. Box-Cox power transformation had similar results on distributions showing departure from normality with 57 % of distributions approximating “normal” after transformation. Applying Box-Cox transformation after Spline or Loess smoothing techniques increased that proportion to 82.4 and 82.7 % respectively.

Conclusion

This suggests that statistical approaches relying on the normal distribution assumption can be successfully applied to MUAC. In light of this promising finding, further research is ongoing to evaluate the performance of a normal distribution based approach to estimating the prevalence of wasting using MUAC.
On approximation of fixed points of multivalued pseudocontractive mappings in Hilbert spaces
Authors: Isiogugu Felicia Obiageli
Published: May 2016

It is proved that if a multivalued k-strictly pseudocontractive mapping S of Chidume et al. (Abstr. Appl. Anal. 2013:629468, 2013) is of type one, then $I-S$
I
−
S
is demiclosed at zero. Also, under this condition, the Mann (respectively, Ishikawa) sequence weakly (respectively, strongly) converges to a fixed point of a multivalued k-strictly pseudocontractive (respectively, pseudocontractive) mapping S without the condition that the fixed point set of S is strict, where S is of type one if for any pair $r,g \in D(S)$
r
,
g
∈
D
(
S
)
, $$\|u-v\|\leq\Phi(Sr,Sg) \quad\mbox{for all } u\in P_{S}r, v\in P_{S}g, $$
∥
u
−
v
∥
≤
Φ
(
S
r
,
S
g
)

for all 
u
∈

P
S

r
,
v
∈

P
S

g
,
and Φ denotes the Hausdorff metric. The results obtained give a partial answer to the problem of the removal of the strict fixed point set condition, which is usually imposed on multivalued mappings. Thus, the results extend, complement, and improve the results on multivalued and single-valued mappings in the contemporary literature.
The role of transoral robotic surgery, transoral laser microsurgery, and lingual tonsillectomy in the identification of head and neck squamous cell carcinoma of unknown primary origin: A systematic review
Authors: Fu Terence S. , Foreman Andrew , Goldstein David P. , de Almeida John R.
Published: May 2016

Background

Squamous cell carcinoma of the head and neck can present as a cervical metastasis from an unknown primary site. Recently, transoral robotic surgery (TORS) and transoral laser microsurgery (TLM) have been incorporated in the workup of unknown primary tumors.

Methods

We searched MEDLINE, EMBASE, Cochrane, and CINAHL from inception to June 2015 for all English-language studies that utilized TORS, TLM, or lingual tonsillectomy in the approach to an unknown primary.

Results

Of 217 identified studies, eight were reviewed. TORS/TLM identified the primary tumor in 111/139 (80 %) patients overall, and 36/54 (67 %) patients with no remarkable findings following physical exam, radiologic imaging, and panendoscopy with directed biopsies. Lingual tonsillectomy identified the primary tumor in 18/25 (72 %) patients with no findings. Hemorrhage (5 %) was the most common perioperative complication.

Conclusion

Lingual tonsillectomy using new approaches such as TORS/TLM may improve the identification of occult primary tumors.
Detecting iron-based pigments on ruthenium-coated ancestral Pueblo pottery using variable pressure scanning electron microscopy
Authors: Pendleton M. W. , Washburn D. K. , Ellis E. A. , Pendleton B. B.
Published: May 2016

Background

Ancestral Puebloan black-on-white ceramics of the American Southwest can be classified as containing pigments within their painted designs containing high levels of organic-based elements such as potassium, or mineral-based elements such as iron, or a mixture of these elements. The identification of pigment elements of the pottery of a site is fundamental in determining the site’s cultural and temporal context. This paper will concentrate only on the analysis of mineral based pigment which was shown by previous researchers to exhibit greater concentrations of iron than organic based pigment. Although the visual discrimination of these pigments can be difficult if the pigment is a mixture of both pigment types or if the pigment is worn, this paper will describe a sherd sample previously shown to contain only mineral pigment. For the present study, a Tescan variable pressure scanning electron microscope, a JEOL 6400 scanning electron microscope, and a Hitachi S-3400 N scanning electron microscope were used with the same sherd. This sherd was coated with ruthenium to reduce charging without the visual color change associated with sputtered metal coatings. A reduction in microscope chamber vacuum also greatly reduced charging of unpainted areas. An energy dispersive spectrometry detector produced a map of the iron present in the sherd. Areas of iron in the sherd were identified using a backscatter electron detector. Iron as well as other elements present in the paint pigment was also detected using micro-X-ray fluorescence on the same sherd.

Results

The images and maps produced by the Tescan variable pressure scanning electron microscope did not always show well-defined iron-based pigmented areas on the sherd. Although the secondary image taken with a high vacuum did not show clear boundaries of the pigment on the sherd, a secondary image taken at a low vacuum of the same area showed well defined pigment boundaries. Other images taken with this microscope such as the backscatter image showed boundaries of sections of the pigment and the energy dispersive spectroscopic map showed a green colored pattern corresponding in general to the pigment area of the sherd containing iron. Using micro-X-ray fluorescence, the Hitachi S-3400 N scanning electron microscope mapped the following elements: iron, aluminum, potassium, calcium, sulfur, and silicon at a high vacuum with excellent resolution primarily for iron in the paint pigment on the sherd.

Conclusions

The best resolved image of iron-based pigment for the ruthenium coated sherd was obtained using the low vacuum secondary detector in the Tescan Vega 3 XMU. Excellent resolution for the energy dispersive spectrometry maps for iron was obtained by the micro-X-ray fluorescence detector on the Hitachi S-3400 N scanning electron microscope.
On the role of the gas environment, electron-dose-rate, and sample on the image resolution in transmission electron microscopy
Authors: Ek Martin , Jespersen Sebastian P. F. , Damsgaard Christian D. , Helveg Stig
Published: May 2016

The introduction of gaseous atmospheres in transmission electron microscopy offers the possibility of studying materials in situ under chemically relevant environments. The presence of a gas environment can degrade the resolution. Surprisingly, this phenomenon has been shown to depend on the electron-dose-rate. In this article, we demonstrate that both the total and areal electron-dose-rates work as descriptors for the dose-rate-dependent resolution and are related through the illumination area. Furthermore, the resolution degradation was observed to occur gradually over time after initializing the illumination of the sample and gas by the electron beam. The resolution was also observed to be sensitive to the electrical conductivity of the sample. These observations can be explained by a charge buildup over the electron-illuminated sample area, caused by the beam–gas–sample interaction, and by a subsequent sample motion induced by electrical capacitance in the sample.
Complete genome sequence of an agr-dysfunctional variant of the ST239 lineage of the methicillin-resistant Staphylococcus aureus strain GV69 from Brazil
Authors: Botelho Ana M. N. , Costa Maiana O. C. , Beltrame Cristiana O. , Ferreira Fabienne A. , Côrtes Marina F. , Bandeira Paula T. , Lima Nicholas C. B. , Souza Rangel C. , Almeida Luiz G. P. , Vasconcelos Ana T. R. , Nicolás Marisa F. , Figueiredo Agnes M. S.
Published: May 2016

Staphylococcus aureus is a versatile Gram-positive coccus frequently found colonizing the skin and nasal membranes of humans. The acquisition of the staphylococcal cassette chromosome mec was a major milestone in the evolutionary path of methicillin-resistant S. aureus. This genetic element carries the mecA gene, the main determinant of methicillin resistance. MRSA is involved in a plethora of opportunistic infectious diseases. The accessory gene regulator is the major S. aureus quorum sensing system, playing an important role in staphylococcal virulence, including the development of biofilms. We report the complete genome sequence (NCBI BioProject ID: PRJNA264181) of the methicillin-resistant S. aureus strain GV69 (= CMVRS P4521), a variant of the ST239 lineage that presents with a natural attenuation of agr-RNAIII transcription and a moderate accumulation of biofilm.
President's Page
Authors: Detomo Rocky
Published: May 2016

A number of years ago, I had the good fortune to listen to a lecture on leadership given by retired General Colin Powell. Powell was the first African-American to serve as chairman of the United States' Joint Chiefs of Staff and was U. S. secretary of state under President George W. Bush. I found his talk refreshing because it challenged the status quo and the “accommodating” mindset of the times. He was talking about responsible leadership during difficult times — times when the road has become nearly impassable, when the path forward is not clear, and when the outlook for the future doesn't look very appealing.
Reviews
Authors: Green William R. , Taylor Patrick
Published: May 2016

The Early Earth: Accretion and Differentiation, AGU Geophysical Monograph Series vol. 212, edited by James Badro and Michael Walter, ISBN 978-1-118-86057-1, 2015, Wiley, 198 p., US$149.95. Acquisition and Analysis of Terrestrial Gravity Data, by L. T. Long and R. D. Kaufmann, ISBN 978-1-107-02413-7, 2013, Cambridge University Press, 179 p., US$74.99 (print), US$60 (eBook).
Is sleep disruption a trigger for postpartum
psychosis?
Authors: Lewis Katie J. S. , Foster Russell G. , Jones Ian R.
Published: May 2016

An episode of postpartum psychosis can be devastating for a woman and her
family, and it is vital we understand the factors involved in the aetiology
of this condition. Sleep and circadian rhythm disruption is a plausible
candidate but further research is needed that builds on the latest advances
in chronobiology and neuroscience.
Caloric Restriction Paradoxically Increases Adiposity in Mice With Genetically Reduced Insulin
Authors: Dionne Derek A. , Skovsø Søs , Templeman Nicole M. , Clee Susanne M. , Johnson James D.
Published: May 2016

Antiadiposity effects of caloric restriction (CR) are associated with reduced insulin/IGF-1 signaling, but it is unclear whether the effects of CR would be additive to genetically reducing circulating insulin. To address this question, we examined female Ins1+/−:Ins2−/− mice and Ins1+/+:Ins2−/− littermate controls on either an ad libitum or 60% CR diet. Although Igf1 levels declined as expected, CR was unable to reduce plasma insulin levels in either genotype below their ad libitum-fed littermate controls. In fact, 53-week-old Ins1+/−:Ins2−/− mice exhibited a paradoxical increase in circulating insulin in the CR group compared with the ad libitum-fed Ins1+/−:Ins2−/− mice. Regardless of insulin gene dosage, CR mice had lower fasting glucose and improved glucose tolerance. Although body mass and lean mass predictably fell after CR initiation, we observed a significant and unexpected increase in fat mass in the CR Ins1+/−:Ins2−/− mice. Specifically, inguinal fat was significantly increased by CR at 66 weeks and 106 weeks. By 106 weeks, brown adipose tissue mass was also significantly increased by CR in both Ins1+/−:Ins2−/− and Ins1+/+:Ins2−/− mice. Interestingly, we observed a clear whitening of brown adipose tissue in the CR groups. Mice in the CR group had altered daily energy expenditure and respiratory exchange ratio circadian rhythms in both genotypes. Multiplexed analysis of circulating hormones revealed that CR was associated with increased fasting and fed levels of the obesogenic hormone, glucose-dependent insulinotropic polypeptide. Collectively these data demonstrate CR has paradoxical effects on adipose tissue growth in the context of genetically reduced insulin.
Sertoli Cells Modulate Testicular Vascular Network Development, Structure, and Function to Influence Circulating Testosterone Concentrations in Adult Male Mice
Authors: Rebourcet Diane , Wu Junxi , Cruickshanks Lyndsey , Smith Sarah E. , Milne Laura , Fernando Anuruddika , Wallace Robert J. , Gray Calum D. , Hadoke Patrick W. F. , Mitchell Rod T. , O'Shaughnessy Peter J. , Smith Lee B.
Published: May 2016

The testicular vasculature forms a complex network, providing oxygenation, micronutrients, and waste clearance from the testis. The vasculature is also instrumental to testis function because it is both the route by which gonadotropins are delivered to the testis and by which T is transported away to target organs. Whether Sertoli cells play a role in regulating the testicular vasculature in postnatal life has never been unequivocally demonstrated. In this study we used models of acute Sertoli cell ablation and acute germ cell ablation to address whether Sertoli cells actively influence vascular structure and function in the adult testis. Our findings suggest that Sertoli cells play a key role in supporting the structure of the testicular vasculature. Ablating Sertoli cells (and germ cells) or germ cells alone results in a similar reduction in testis size, yet only the specific loss of Sertoli cells leads to a reduction in total intratesticular vascular volume, the number of vascular branches, and the numbers of small microvessels; loss of germ cells alone has no effect on the testicular vasculature. These perturbations to the testicular vasculature leads to a reduction in fluid exchange between the vasculature and testicular interstitium, which reduces gonadotropin-stimulated circulating T concentrations, indicative of reduced Leydig cell stimulation and/or reduced secretion of T into the vasculature. These findings describe a new paradigm by which the transport of hormones and other factors into and out of the testis may be influenced by Sertoli cells and highlights these cells as potential targets for enhancing this endocrine relationship.
Contribution of Heritability and Epigenetic Factors to Skeletal Muscle Mass Variation in United Kingdom Twins
Authors: Livshits Gregory , Gao Fei , Malkin Ida , Needhamsen Maria , Xia Yudong , Yuan Wei , Bell Christopher G. , Ward Kirsten , Liu Yuan , Wang Jun , Bell Jordana T. , Spector Tim D.
Published: May 2016

Context:

Skeletal muscle mass (SMM) is one of the major components of human body composition, with deviations from normal values often leading to sarcopenia.

Objective:

Our major aim was to conduct a genome-wide DNA methylation study in an attempt to identify potential genomic regions associated with SMM.

Design:

This was a mixed cross-sectional and longitudinal study.

Setting:

Community-based study.

Participants:

A total of 1550 middle-aged United Kingdom twins (monozygotic [MZ] and dizygotic [DZ]), 297 of which were repeatedly measured participated in the study.

Main Outcome Measure:

Appendicular lean mass assessed using dual-energy X-ray absorptiometry technology, and methylated DNA immunoprecipitation sequencing DNA methylation profiling genome-wide were obtained from each individual.

Results:

Heritability estimate of SMM, with simultaneous adjustment for covariates obtained using variance decomposition analysis, was h2 = 0.809 ± 0.050. After quality control and analysis of longitudinal stability, the DNA methylation data comprised of 723 029 genomic sites, with positive correlations between repeated measurements (Rrepeated = 0.114–0.905). Correlations between MZ and DZ twins were 0.51 and 0.38 at a genome-wide average, respectively, and clearly increased with Rrepeated. Testing for DNA methylation association with SMM in 50 discordant MZ twins revealed 36 081 nominally significant results, of which the top-ranked 134 signals (P < .01 and Rrepeated > 0.40) were subjected to replication in the sample of 1196 individuals. Seven SMM methylation association signals replicated at a false discovery rate less than 0.1, and these were located in or near genes DNAH12, CAND1, CYP4F29P, and ZFP64, which have previously been highlighted in muscle-related studies. Adjusting for age, smoking, and blood cell heterogeneity did not alter significance of these associations.

Conclusion:

This epigenome-wide study, testing longitudinally stable methylation sites, discovered and replicated a number of associations between DNA methylation at CpG loci and SMM. Four replicated signals were related to genes with potential muscle functions, suggesting that the methylome of whole blood may be informative of SMM variation.
The Myth of Rescue Reversal in “Can’t Intubate, Can’t Ventilate” Scenarios
Authors: Naguib Mohamed , Brewer Lara , LaPierre Cristen , Kopman Aaron F. , Johnson Ken B.
Published: May 2016

BACKGROUND:

An unanticipated difficult airway during induction of anesthesia can be a vexing problem. In the setting of can’t intubate, can’t ventilate (CICV), rapid recovery of spontaneous ventilation is a reasonable goal. The urgency of restoring ventilation is a function of how quickly a patient’s hemoglobin oxygen saturation decreases versus how much time is required for the effects of induction drugs to dissipate, namely the duration of unresponsiveness, ventilatory depression, and neuromuscular blockade. It has been suggested that prompt reversal of rocuronium-induced neuromuscular blockade with sugammadex will allow respiratory activity to recover before significant arterial desaturation. Using pharmacologic simulation, we compared the duration of unresponsiveness, ventilatory depression, and neuromuscular blockade in normal, obese, and morbidly obese body sizes in this life-threatening CICV scenario. We hypothesized that although neuromuscular function could be rapidly restored with sugammadex, significant arterial desaturation will occur before the recovery from unresponsiveness and/or central ventilatory depression in obese and morbidly obese body sizes.

METHODS:

We used published models to simulate the duration of unresponsiveness and ventilatory depression using a common induction technique with predicted rates of oxygen desaturation in various size patients and explored to what degree rapid reversal of rocuronium-induced neuromuscular blockade with sugammadex might improve the return of spontaneous ventilation in CICV situations.

RESULTS:

Our simulations showed that the duration of neuromuscular blockade was longer with 1.0 mg/kg succinylcholine than with 1.2 mg/kg rocuronium followed 3 minutes later by 16 mg/kg sugammadex (10.0 vs 4.5 minutes). Once rocuronium neuromuscular blockade was completely reversed with sugammadex, the duration of hemoglobin oxygen saturation >90%, loss of responsiveness, and intolerable ventilatory depression (a respiratory rate of ≤4 breaths/min) were dependent on the body habitus and duration of oxygen administration. There is a high probability of intolerable ventilatory depression that extends well beyond the time when oxygen saturation decreases <90%, especially in obese and morbidly obese patients. If ventilatory rescue is inadequate, oxygen desaturation will persist in the latter groups, despite full reversal of neuromuscular blockade. Depending on body habitus, the duration of intolerable ventilatory depression after sugammadex reversal may be as long as 15 minutes in 5% of individuals.

CONCLUSIONS:

The clinical management of CICV should focus primarily on restoration of airway patency, oxygenation, and ventilation consistent with the American Society of Anesthesiologist’s practice guidelines for management of the difficult airway. Pharmacologic intervention cannot be relied upon to rescue patients in a CICV crisis.
Semaphorin 3A is a retrograde cell death signal in developing sympathetic neurons
Authors: Wehner Amanda B. , Abdesselem Houari , Dickendesher Travis L. , Imai Fumiyasu , Yoshida Yutaka , Giger Roman J. , Pierchala Brian A.
Published: May 2016

During development of the peripheral nervous system, excess neurons are generated, most of which will be lost by programmed cell death due to a limited supply of neurotrophic factors from their targets. Other environmental factors, such as ‘competition factors' produced by neurons themselves, and axon guidance molecules have also been implicated in developmental cell death. Semaphorin 3A (Sema3A), in addition to its function as a chemorepulsive guidance cue, can also induce death of sensory neurons in vitro. The extent to which Sema3A regulates developmental cell death in vivo, however, is debated. We show that in compartmentalized cultures of rat sympathetic neurons, a Sema3A-initiated apoptosis signal is retrogradely transported from axon terminals to cell bodies to induce cell death. Sema3A-mediated apoptosis utilizes the extrinsic pathway and requires both neuropilin 1 and plexin A3. Sema3A is not retrogradely transported in older, survival factor-independent sympathetic neurons, and is much less effective at inducing apoptosis in these neurons. Importantly, deletion of either neuropilin 1 or plexin A3 significantly reduces developmental cell death in the superior cervical ganglia. Taken together, a Sema3A-initiated apoptotic signaling complex regulates the apoptosis of sympathetic neurons during the period of naturally occurring cell death.
Plant regeneration: cellular origins and molecular mechanisms
Authors: Ikeuchi Momoko , Ogawa Yoichi , Iwase Akira , Sugimoto Keiko
Published: May 2016

Compared with animals, plants generally possess a high degree of developmental plasticity and display various types of tissue or organ regeneration. This regenerative capacity can be enhanced by exogenously supplied plant hormones in vitro, wherein the balance between auxin and cytokinin determines the developmental fate of regenerating organs. Accumulating evidence suggests that some forms of plant regeneration involve reprogramming of differentiated somatic cells, whereas others are induced through the activation of relatively undifferentiated cells in somatic tissues. We summarize the current understanding of how plants control various types of regeneration and discuss how developmental and environmental constraints influence these regulatory mechanisms.
Comparative genomic analysis of upstream miRNA regulatory motifs in Caenorhabditis
Authors: Jovelin Richard , Krizus Aldis , Taghizada Bakhtiyar , Gray Jeremy C. , Phillips Patrick C. , Claycomb Julie M. , Cutter Asher D.
Published: May 2016

MicroRNAs (miRNAs) comprise a class of short noncoding RNA molecules that play diverse developmental and physiological roles by controlling mRNA abundance and protein output of the vast majority of transcripts. Despite the importance of miRNAs in regulating gene function, we still lack a complete understanding of how miRNAs themselves are transcriptionally regulated. To fill this gap, we predicted regulatory sequences by searching for abundant short motifs located upstream of miRNAs in eight species of Caenorhabditis nematodes. We identified three conserved motifs across the Caenorhabditis phylogeny that show clear signatures of purifying selection from comparative genomics, patterns of nucleotide changes in motifs of orthologous miRNAs, and correlation between motif incidence and miRNA expression. We then validated our predictions with transgenic green fluorescent protein reporters and site-directed mutagenesis for a subset of motifs located in an enhancer region upstream of let-7. We demonstrate that a CT-dinucleotide motif is sufficient for proper expression of GFP in the seam cells of adult C. elegans, and that two other motifs play incremental roles in combination with the CT-rich motif. Thus, functional tests of sequence motifs identified through analysis of molecular evolutionary signatures provide a powerful path for efficiently characterizing the transcriptional regulation of miRNA genes.
Formation of Integrated Legal Entities in Legal System: Tribute to Fashion or Necessity?
Authors: Сидорова Елена , Sidorova Elena
Published: May 2016

Today integrated legal entities are again in the focus of attention of the scientific community. Addressing this problem is so topical and popular that one can safely acknowledge persistent urge to consider any question of legal character mainly through the lens of determining the integrated nature of law. What’s to be done in this situation when it is necessary to determine the status of a relevant legal entity? Therefore, with a certain degree of objectivity the article notes important issues related to integrated legal entities, their formation within the legal framework, provides definition to the method of an integrated branch of law, demonstrates differences between the main branches of law and integrated legal entities. The article also identifies and sets forth possible ways to resolve the issues at the theoretical level. Taking into account considerable advantages provided by integral regulation, the author assumes that there will be a further surge in the interest towards these topics.
Improvement of Criminal Legislation on Liability for Fraud
Authors: Кошаева Татьяна , Koshayeva Tatyana
Published: May 2016

Fraud is a widely-spread offence against property. The article studies issues on improving criminal and legal law on liability for fraud for the purpose of enhancing efficiency in crime prevention. Problems of implementation of new laws on fraud (cl.cl. 159—1596 of the Criminal Code of the Russian Federation) remain unsolved. The author analyzes characteristics of common and special fraud components, and provides different judgments on the issue, published in legal literature. The author puts forward proposals on optimization of criminal legislation in this area.
ISSUES OF INTERNATIONAL-LEGAL AND NATIONAL-LEGAL REGULATION IN THE ARCTIC (COMPARATIVE LAW ANALYSIS)
Authors: Курбанов Рашад , Kurbanov Rashad
Published: May 2016

It is not only the eight Arctic countries who have been recently showing their interest in the Arctic areas. Other countries in Europe, Asia, and America claim their presence in the Arctic, even those who are geographically located in a different hemisphere and could hardly be called circumpolar. For example, Germany, Japan, India, South Korea, China, Brazil and about 20 other countries have declared their determination to develop fields in the Arctic shelf areas. Moreover, China, India, Singapore and some other countries have already been developing strategies to use the Northern Sea Route in the Arctic. It is necessary to note that at the constitutional level all Arctic countries regulate issues related to the Arctic in different ways (both directly and indirectly). In particular, most of the constitutions contain provisions on the rights of indigenous peoples which are equally applicable to the Arctic region, as the number of indigenous peoples in the Arctic amounts to about 400 000 people. Besides, at the national level all Arctic countries have basic programs like “Arctic Documents” or a special “Arctic legislation” (except for Finland and Sweden). In this study we analyze the main basic program documents and legal regulations governing this sector in the Arctic countries, define optimal balance between the national and international legal regulation in determining the legal regime in the Arctic region.
JUDICIAL COMPLIANCE ASSESSMENT AS A KEY FACTOR OF ENFORCEMENT OF THE EURASIAN LAW AND ORDER
Authors: Федорцов Александр , Fedortsov Aleksandr
Published: May 2016

The article presents the development of the Eurasian integration processes and the role of the Court of the Eurasian Economic Union in ensuring the uniform application of the Eurasian Economic Union law. Basing on the generally accepted approaches to understanding the importance of the international judicial body for international relations, the author reveals the organizational structure of the Court of the Eurasian Economic Union, the key aspects of the competence of the Eurasian institute of judicial protection. The author compares the missions of the international court and the national body of the constitutional control. The author draws attention to the procedural requirements for the implementation of the Court’s jurisdiction: procedures for dispute considering, and also to the importance of high-quality execution of the Court decisions in order to ensure efficient compliance assessment. The conducted analysis takes into account the statistics of the Court’s performance during its first year of functioning (2015). The author expresses his point of view on the need to create mechanisms of cooperation between the Court of the Eurasian Economic Union and the supreme judicial authorities of the States, including constitutional courts and councils, for proper implementation of judicial compliance assessment within the framework of the Eurasian Economic Union.
Development Tendencies in Legislation on Plant World
Authors: Минина Елена , Minina Elena
Published: May 2016

In the modern context the necessity of comprehensive protection of flora increases. Meanwhile, the Russian legislation fragmentarily regulates the use and protection of vegetation outside forest lands. The legal regime of greenery in cities and other settlements is regulated by local laws, which are not always optimal. It is necessary to draft a federal law on the plant world containing a definition of species of flora, as well as differentiation between the scope of the legislation on flora and related branches, the forest legislation, in the first place. The article analyzes other countries’ experience in dealing with these issues which will enable to develop optimal approaches to the formation of legislation in this sphere of public relations.
Readmission following caesarean section: Outcomes for women in an Irish maternity hospital
Authors: Panda Sunita , Begley Cecily , Daly Deirdre
Published: May 2016

Background:

Women who give birth by caesarean section are more likely to require readmission to hospital following birth compared to women who give birth vaginally.

Aims:

To examine the reasons, management and outcomes for women readmitted to hospital following birth by caesarean section (CS).

Methods:

A retrospective audit of maternity records was undertaken.

Findings:

The total number of births for the period of data extraction was 8580, of which 2470 (28.79%) women gave birth by CS. A total of 107 women (4.33% of those who gave birth by CS) were readmitted to hospital between 1 August 2014 and 31 July 2015, of which 46 women (1.86%) were readmitted following elective CS and 61 (2.47%) following emergency CS. The average length of hospital stay was 2.64 and 4.61 nights, respectively, and the average timeline for readmission was 14.6 days following elective CS and 15.7 following emergency CS. The most common reason for readmission was wound infection, with the majority of women requiring analgesics (n=29, 63.05% following elective CS and n=51, 83.61% following emergency CS) and intravenous antibiotics (n=23, 50% following elective CS and n=34, 55.74% following emergency CS).

Conclusions:

Abdominal wound infection is one of the most common reasons for readmission of women to hospital following birth by CS. These findings will make it easier to understand and identify women at risk of postpartum morbidity following birth by CS.
Is the introduction of a named midwife for teenagers associated with improved outcomes? A service development project
Authors: Butcher Alison , Williams Peter , Jones Felicity
Published: May 2016

Background:

The role of named midwife for teenagers was implemented in Royal Surrey County Hospital NHS Foundation Trust in order to improve outcomes for teenage mothers and their babies. The role comprised a dedicated midwife-led teenage antenatal clinic, antenatal and postnatal home visits and tailored antenatal education.

Aims:

This project monitored the outcomes of teenage mothers following implementation of the role, to assess improvements in outcomes.

Methods:

During this service development project, 31 teenage mothers aged ≤ 19 years received midwifery care and their obstetric outcomes were monitored. These outcomes were compared with 52 teenage mothers who had previously given birth.

Findings:

Comparing teenagers who gave birth in February–August 2014 with those who gave birth in the same period in 2013, there was an increase in the rate of spontaneous vaginal deliveries, a decrease in instrumental deliveries and increase in induction of labour; however, induction of labour for intrauterine growth restriction decreased. The rate of caesarean section increased but remained lower than in the general population. An increase in birth weight and intention to breastfeed were also observed.

Conclusions:

This project indicates that the role of a dedicated midwife for teenagers has a place in the care of teenage mothers.
Coded rhetoric: The reality of midwifery practice
Authors:   Birth Project Group, Mander Rosemary
Published: May 2016

In the light of certain failings in NHS provision of care, the Nursing and Midwifery Council's ( NMC, 2015 ) Code requires staff to engage more effectively with patients and service users. An online survey was undertaken by the Birth Project Group to assess how economic stringencies affecting health care have an impact on midwives' perceptions of their practice. Midwives were less positive about their employers' desire for quality care provision than the Code might suggest. Midwives found difficulty engaging effectively due to staff shortages and lack of time for basic activities. Evidence-based practice tended not to be a priority. Some midwives were content with their practice environment, but many reported a range of serious interpersonal difficulties. Midwives were seriously concerned about the safety of women and their babies, as well as about their own welfare. It is argued that the NMC should recognise the reality of midwives' practice environment.
Case report: calcaneal fractures in a cat
Authors: Longley Mark , Bergmann Hannes , Langley-Hobbs Sorrel
Published: May 2016

A one-year-four-month-old male neutered domestic shorthair cat was presented for suddenonset left pelvic limb lameness. Upon clinical examination, pain was localised to the hock region and the cat was found to have persistent deciduous teeth. No evidence of trauma was apparent. Radiographs revealed a transverse fracture at the base of the calcaneus. The fracture was stabilised with a Steinmann pin and tension band wire. Eleven weeks after fixation of the fracture, the cat presented with lameness of the contralateral limb and again no evidence of trauma was identified. Radiographs revealed a transverse fracture at the base of the right calcaneus. Fracture repair was performed as for the left. Fourteen months following the initial surgery, the cat was ambulating normally with no signs of pain or lameness in either pelvic limb. This case supports the association between persistent deciduous teeth and spontaneous fractures in cats.
Gastrointestinal biopsies from the pathologist's point of view
Authors: Dobromylskyj Melanie
Published: May 2016

Both full-thickness and endoscopic biopsies of the gastrointestinal (GI) tract may be presented to the pathologist for the diagnosis of GI disease. This article discusses the role of gastrointestinal biopsies in the diagnosis of alimentary tract disease, as well as highlighting certain conditions that may be missed by endoscopic biopsies as opposed to surgical (fullthickness) biopsies. It outlines the World Small Animal Veterinary Association guidelines used by pathologists to assess inflammatory diseases present, discussing some of the key points of these guidelines and also some of their pitfalls.
Rabbit Awareness Week: advising owners on rabbit care
Authors: Speight Claire
Published: May 2016

Rabbits are the third most commonly kept pet in the UK and yet their welfare needs are still greatly misunderstood, even at times by well-meaning owners. Rabbit Awareness Week aims to highlight some of the problems rabbits face, but what as practicing veterinary surgeons can you do to help during Rabbit Awareness Week and for the rest of the year?
The coronal hypomochlion
Authors: Heijens E. , Kornherr P. , Meister C.
Published: May 2016

Aims

In patients undergoing medial opening wedge high tibial osteotomy (MOWHTO), soft tissue opening on the medial side of the knee is difficult to predict. When the load bearing axis is corrected beyond a certain point, the knee joint tilts open on the medial side. We therefore hypothesised that there is a tipping point and defined this as the coronal hypomochlion.

Patients and Methods

In this prospective study of 150 navigated MOWHTOs (144 consecutive patients), data were collected before surgery and at three months post-operatively. In order to calculate the hypomochlion, we compared the respective changes to the joint line convergence angle (JLCA) with the post-operative axis of the leg. The change to the medial proximal tibial angle accounts for only about 80% of the change to the femorotibial angle; 20% of the correction can therefore be attributed to non-osseous, soft-tissue changes.

Results

We were able to demonstrate a linear change of JLCA in a range of 0° to 5° of valgus which started when the post-operative long-leg axis was corrected beyond 2° of valgus.

Conclusion

We found that the coronal hypomochlion occurs at 2° of valgus. Take home message: It is recommended to plan realignment for medial open wedge high tibial osteotomy at a maximum of 2° valgus. Cite this article: Bone Joint J 2016;98-B:628–33.