bluuebunny/crossref_metadata_2025 huggingface dataset:
A high mean arterial pressure target is associated with improved microcirculation in septic shock patients with previous hypertension: a prospective open label study
Authors: Xu Jing-Yuan , Ma Si-Qing , Pan Chun , He Hong-Li , Cai Shi-Xia , Hu Shu-Ling , Liu Ai-Ran , Liu Ling , Huang Ying-Zi , Guo Feng-Mei , Yang Yi , Qiu Hai-Bo
Published: March 2015

Introduction

The effect of mean arterial pressure titration to a higher level on microcirculation in septic shock patients with previous hypertension remains unknown. Our goal is to assess the effect of mean arterial pressure titration to a higher level on microcirculation in hypertensive septic shock patients.

Methods

This is a single-center, open-label study. Hypertensive patients with septic shock for less than 24 hours after adequate fluid resuscitation and requiring norepinephrine to maintain a mean arterial pressure of 65 mmHg were enrolled. Mean arterial pressure was then titrated by norepinephrine from 65 mmHg to the normal level of the patient. In addition to hemodynamic variables, sublingual microcirculation was evaluated by sidestream dark field imaging.

Results

Nineteen patients were enrolled in the study. Increasing mean arterial pressure from 65 mmHg to normal levels was associated with increased central venous pressure (from 11 ± 4 to 13 ± 4 mmHg, P = 0.002), cardiac output (from 5.4 ± 1.4 to 6.4 ± 2.1 l/minute, P = 0.001), and central venous oxygen saturation (from 81 ± 7 to 83 ± 7%, P = 0.001). There were significant increases in small perfused vessel density (from 10.96 ± 2.98 to 11.99 ± 2.55 vessels/mm2, P = 0.009), proportion of small perfused vessels (from 85 ± 18 to 92 ± 14%, P = 0.002), and small microvascular flow index (from 2.45 ± 0.61 to 2.80 ± 0.68, P = 0.009) when compared with a mean arterial pressure of 65 mmHg.

Conclusions

Increasing mean arterial pressure from 65 mmHg to normal levels is associated with improved microcirculation in hypertensive septic shock patients.

Trial registration

Clinicaltrials.gov: NCT01443494; registered 28 September 2011.
Fluid overload at start of continuous renal replacement therapy is associated with poorer clinical condition and outcome: a prospective observational study on the combined use of bioimpedance vector analysis and serum N-terminal pro-B-type natriuretic peptide measurement
Authors: Chen Haiyan , Wu Buyun , Gong Dehua , Liu Zhihong
Published: March 2015

Introduction

It is unclear whether the fluid status, as determined by bioimpedance vector analysis (BIVA) combined with serum N-terminal pro-B-type natriuretic peptides (NT-pro-BNP) measurement, is associated with treatment outcome among patients receiving continuous renal replacement therapy (CRRT). Our objective was to answer this question.

Methods

Patients who were in the intensive care units of a university teaching hospital and who required CRRT were screened for enrollment. For the enrolled patients, BIVA and serum NT-pro BNP measurement were performed just before the start of CRRT and 3 days afterward. According to the BIVA and NT-pro BNP measurement results, the patients were divided into four groups according to fluid status type: type 1, both normal; type 2, normal BIVA results and abnormal NT-pro BNP levels; type 3, abnormal BIVA results and normal NT-pro BNP levels; and type 4, both abnormal. The associations between fluid status and outcome were analyzed.

Results

Eighty-nine patients were enrolled, 58 were males, and the mean age was 49.0 ± 17.2 years. The mean score of Acute Physiology and Chronic Health Evaluation II (APACHE II) was 18.8 ± 8.6. The fluid status before CRRT start was as follows: type 1, 21.3% (19 out of 89); type 2, 16.9% (15 out of 89); type 3, 11.2% (10 out of 89); and type 4, 50.6% (45 out of 89). There were significant differences between fluid status types before starting CRRT on baseline values for APACHE II scores, serum creatinine, hemoglobin, platelet count, urine volume, and incidences of oliguria and acute kidney injury (P <0.05). There were significant differences between patients with different fluid status before CRRT start on hospital mortality—type 1, 26.3% (5 out of 19); type 2, 33.3% (5 out of 15); type 3, 40% (4 out of 10); and type 4, 64.4% (29 out of 45) (P = 0.019)—as well as renal function recovery rates: type 1, 57.1% (4 out of 7); type 2, 67.7% (6 out of 9); type 3, 50% (3 out of 6); and type 4, 23.7% (9 out of 38) (P = 0.051).

Conclusions

Fluid status abnormalities were common among patients receiving CRRT. Different types of fluid status distinguished by BIVA combined with serum NT-pro BNP measurements corresponded to different clinical conditions and treatment outcomes, which implies a value of this method for evaluation of fluid status among patients receiving CRRT.
Gender differences in outcome and use of resources do exist in Swedish intensive care, but to no advantage for women of premenopausal age
Authors: Samuelsson Carolina , Sjöberg Folke , Karlström Göran , Nolin Thomas , Walther Sten M
Published: March 2015

Introduction

Preclinical data indicate that oestrogen appears to play a beneficial role in the pathophysiology of and recovery from critical illness. In few previous epidemiologic studies, however, have researchers analysed premenopausal women as a separate group when addressing potential gender differences in critical care outcome. Our aim was to see if women of premenopausal age have a better outcome following critical care and to investigate the association between gender and use of intensive care unit (ICU) resources.

Methods

On the basis of our analysis of 127,254 consecutive Simplified Acute Physiology Score III–scored Swedish Intensive Care Registry ICU admissions from 2008 through 2012, we determined the risk-adjusted 30-day mortality, accumulated nurse workload score and ICU length of stay. To investigate associations with sex, we used logistic regression and multivariate analyses on the entire cohort as well as on two subgroups stratified by median age for menopause (up to and including 45 years and older than 45 years) and six selected diagnostic subgroups (sepsis, multiple trauma, chronic obstructive pulmonary disease, acute respiratory distress syndrome, pneumonia and cardiac arrest).

Results

There was no sex difference in risk-adjusted mortality for the cohort as a whole, and there was no sex difference in risk-adjusted mortality in the group 45 years of age and younger. For the group of patients older than 45 years of age, we found a reduced risk-adjusted mortality in men admitted for cardiac arrest. For the cohort as a whole, and for those admitted with multiple trauma, male sex was associated with a higher nurse workload score and a longer ICU stay.

Conclusions

Using information derived from a large multiple ICU register database, we found that premenopausal female sex was not associated with a survival advantage following intensive care in Sweden. When the data were adjusted for age and severity of illness, we found that men used more ICU resources per admission than women did.
Clinical effectiveness of a sedation protocol minimizing benzodiazepine infusions and favoring early dexmedetomidine: a before-after study
Authors: Skrupky Lee P , Drewry Anne M , Wessman Brian , Field R Ryan , Fagley Richard E , Varghese Linda , Lieu Angela , Olatunde Joshua , Micek Scott T , Kollef Marin H , Boyle Walter A
Published: March 2015

Introduction

Randomized controlled trials suggest clinical outcomes may be improved with dexmedetomidine as compared with benzodiazepines; however, further study and validation are needed. The objective of this study was to determine the clinical effectiveness of a sedation protocol minimizing benzodiazepine use in favor of early dexmedetomidine.

Methods

We conducted a before-after study including adult surgical and medical intensive care unit (ICU) patients requiring mechanical ventilation and continuous sedation for at least 24 hours. The before phase included consecutive patients admitted between 1 April 2011 and 31 August 31 2011. Subsequently, the protocol was modified to minimize use of benzodiazepines in favor of early dexmedetomidine through a multidisciplinary approach, and staff education was provided. The after phase included consecutive eligible patients between 1 May 2012 and 31 October 2012.

Results

A total of 199 patients were included, with 97 patients in the before phase and 102 in the after phase. Baseline characteristics were well balanced between groups. Use of midazolam as initial sedation (58% versus 27%, P <0.0001) or at any point during the ICU stay (76% versus 48%, P <0.0001) was significantly reduced in the after phase. Dexmedetomidine use as initial sedation (2% versus 39%, P <0.0001) or at any point during the ICU stay (39% versus 82%, P <0.0001) significantly increased. Both the prevalence (81% versus 93%, P =0.013) and median percentage of days with delirium (55% (interquartile range (IQR), 18 to 83) versus 71% (IQR, 45 to 100), P =0.001) were increased in the after phase. The median duration of mechanical ventilation was significantly reduced in the after phase (110 (IQR, 59 to 192) hours versus 74.5 (IQR, 42 to 148) hours, P =0.029), and significantly fewer patients required tracheostomy (20% versus 9%, P =0.040). The median ICU length of stay was 8 (IQR, 4 to 12) days in the before phase and 6 (IQR, 3 to 11) days in the after phase (P =0.252).

Conclusions

Implementing a sedation protocol that targeted light sedation and reduced benzodiazepine use led to significant improvements in the duration of mechanical ventilation and the requirement for tracheostomy, despite increases in the prevalence and duration of ICU delirium.
Meniscal extrusion promotes knee osteoarthritis structural progression: protective effect of strontium ranelate treatment in a phase III clinical trial
Authors: Roubille Camille , Martel-Pelletier Johanne , Raynauld Jean-Pierre , Abram François , Dorais Marc , Delorme Philippe , Pelletier Jean-Pierre
Published: March 2015

Introduction

To evaluate the impact of meniscal extrusion (Ext) on knee osteoarthritis (OA) structural progression and on response to strontium ranelate (SrRan) treatment at 36 months in patients with (+) or without (-) Ext, in association (+) or not (-) with bone marrow lesions (BML) in the medial compartment using X-rays (JSW) and qMRI.

Methods

Patients from the qMRI substudy of the SEKOIA trial (SrRan 1 g/day, n = 113; SrRan 2 g/day, n = 105; placebo, n = 112) were stratified based on whether meniscal extrusion and/or BML were present or not in the medial compartment.

Results

In the placebo group, Ext+ patients (n = 26) had more JSW loss (p = 0.002) and cartilage volume loss in the global knee (p = 0.034) and plateau (p = 0.005), and medial compartment (p = 0.0005) than Ext- patients (n = 86). Ext-BML+ patients (n = 18) demonstrated more JSW loss (p = 0.003) and cartilage volume loss in the global (p = 0.020) and medial femur (p = 0.055) than Ext-BML- (n = 68). Compared to Ext+ BML- (n = 14), Ext+ BML+ patients (n = 12) had more cartilage volume loss in the global femur (p = 0.028), with no change in JSW. The JSW loss (p = 0.0004) and cartilage volume loss (global knee, p = 0.033, medial compartment, p = 0.0005) were greater when Ext and BML were simultaneously present in the medial compartment. SrRan 2 g/day treatment demonstrated a reduction in OA knee structural progression with qMRI, but not with JSW, in which less cartilage volume loss was found in the plateaus (p = 0.007) in Ext+ patients (n = 15), and in the medial plateau (p = 0.046) in patients in whom both Ext and BML were co-localized.

Conclusion

The findings of this study are novel and could have an impact on future strategies regarding clinical trials. Indeed, data first argue for a combined, cumulative effect of meniscal extrusion and bone marrow lesions on cartilage loss and, secondly, they showed that SrRan may have protective effects in OA patients with meniscal extrusion as well as when both meniscal extrusion and BML are co-localized.
Sequence stratigraphy of a mixed siliciclastic-carbonate setting, Scotian Shelf, Canada
Authors: Qayyum Farrukh , Catuneanu Octavian , Bouanga Crépin Eric
Published: March 2015

During the Jurassic Period, a large-scale carbonate bank (Abenaki Formation) and a siliciclastic (Sable) delta coexisted in North America. Conventionally, carbonate systems (in situ) are separated from siliciclastic systems (transported) because of their contrasting origin. However, we developed a case study to show that the basic principles of sequence stratigraphy remain applicable. We integrated the results obtained from a regional 2D study and a detailed follow-up study using 3D seismic data of the Scotian Shelf, Canada. The results were integrated with the prepared Wheeler diagrams, and a unified sequence stratigraphic framework was proposed. We determined that two second-order sequences were developed on a larger scale during the Jurassic Period. The first sequence developed during the transition from a ramp to rimmed margin. The second sequence developed during the evolution from a rimmed to ramp margin. These sequences formed a distinct stratigraphic style throughout the Scotian Shelf. The siliciclastic supply varied from the northeast to the southwest depending on the studied site; however, the regions close to the siliciclastic supply contained well-defined clinoform patterns. The topsets of such clinoforms were mostly eroded. Their directions were also found to be different than the carbonate-related clinoform geometries. Most of the carbonates were developed; as such, they kept up and prograded toward a backreef margin during the rimming stages. The second-order sequences were further subdivided into four third-order sequences. These were studied using the 3D seismic data and were found to contain several barrier reefs that could have stratigraphic exploration potential in the Penobscot area.
4D seismic interpretation in a Nigerian deepwater field
Authors: Effiom Oghogho , Maskall Robert , Quadt Edwin , Lawal Kazeem A. , Afolabi Raphael , Emakpor Jake , Mbah Reginald
Published: March 2015

To improve the management of a Nigerian deep water field, two vintages of 4D data have been acquired since field start up in 2005. The first Nigerian 4D seismic (monitor-I) in water depths greater than 1000 m was taken in this field in 2008, and the second monitor (monitor-II) was acquired in 2012. Compared to monitor-I, better geometric repeatability was achieved in monitor-II as the lessons learned from monitor-I were incorporated to achieve better results. The final normalized root mean square of monitor-II fast-track volume was 12% compared to 25% for monitor-I. The improved quality is attributed to improvements in the acquisition methodology and prediction of the effects of currents. Seismic interpretation of the field revealed two distinct turbidite depositional settings: (1) An unconfined amalgamated lobe system with low relief, high net-to-gross reservoir sands that exhibit fairly homogeneous water flooding patterns on 4D and (2) an erosional canyon setting, filled with meander belts having a more complex 3D connectivity within and between the channels resulting in a challenging 4D interpretation. The time lapse data were instrumental for better understanding the reservoir architecture, enabling improved wells and reservoir management practices, the identification of infill opportunities, and more mature subsurface models. We evaluated the seismic acquisition and the 4D interpretation of the deepwater 4D seismic data, highlighting the merits of a multidisciplinary collaborative understanding to time-lapse seismic. At present, the value of information of the 4D monitor-II is conservatively estimated at 101 million United States dollars, equivalent to the cost of a well in this deepwater operating environment.
Human factors in seismic uncertainty — Restoring a realistic uncertainty range
Authors: Chellingsworth Liz , Bentley Mark , Wynn Tim
Published: March 2015

Seismic data play a prominent part in the quantification of the subsurface. Improved imaging and calibration give us a better starting point for interpretation and uncertainty analysis. However, aside from the technical aspects of evaluating seismic data, there are human factors that play a role in the way we use and analyze the data, and these tend to work against attempts to quantify realistic uncertainty ranges. We used a case study to reveal some common pitfalls and assumptions that can compromise our ability to produce sufficiently wide uncertainty ranges in our evaluations. The example highlighted three human factors that affected the decision-making process: anchoring, availability, and overconfidence. Interpreters should avoid anchoring on a base case and focus on alternative possibilities. They should be wary of judging which methodology is best only by the ease with which it comes to mind. Technical specialists should guard against overconfidence in their data, interpretation, and ability to describe the full uncertainty space. We suggested alternative methods that allow us to restore that uncertainty range using a multideterministic approach incorporating multiple data sets, interpretations, and methodologies.
The descent of ant: field-measured performance of gliding ants
Authors: Munk Yonatan , Yanoviak Stephen P. , Koehl M. A. R. , Dudley Robert
Published: March 2015

Gliding ants avoid predatory attacks and potentially mortal consequences of dislodgement from rainforest canopy substrates by directing their aerial descent towards nearby tree trunks. The ecologically relevant measure of performance for gliding ants is the ratio of net horizontal to vertical distance traveled over the course of a gliding trajectory, or glide index. To study variation in glide index, we measured three-dimensional trajectories of Cephalotes atratus ants gliding in natural rain forest habitats. We determined that righting phase duration, glide angle, and path directness all significantly influence variation in glide index. Unsuccessful landing attempts result in the ant bouncing off of its target and being forced to make a second landing attempt. Our results indicate that ants are not passive gliders, and that they exert active control over the aerodynamic forces they experience during their descent despite their apparent lack of specialized control surfaces.
The Forecast of Phytoplankton Spring Blossoming in the Uchinsky Reservoir
Authors: Юсупова  , Yusupova K. , Корсак  , Korsak M. , Мошаров  , Mosharov Sergey , Кроленко  , Krolenko M.
Published: March 2015

Increase of water treatment efficiency in water supply systems during the spring period directly depends on the forecast

accuracy related to mass blossoming of phytoplankton in drinking reservoirs. Object of research is the Uchinsky reservoir – the

drinking reservoir having insignificant its own water collection area, and fed by water of Moscow Canal. The data on seasonal

phytoplankton dynamics received in Akulovsky Hydrosite Laboratory of the MCUE "Mosvodokanal" for two stations: Pestovo

(reservoir’s headwater) and Listvyanka (reservoir’s lower part), and also actinometric data of continuous supervision from 1998

to 2003 performed by Lomonosov Moscow State University’s Geographical faculty Meteorological Observatory (MOMGU) have

been used in this work. Results of mathematical modeling for dependence of start date and peak values of phytoplankton’s

spring blossoming in the Uchinsky reservoir depending on intensity of total solar radiation during the period preceding the

phytoplankton blossoming have been presented. It has been established that the more solar energy streams’ values in the

range of photosynthetic active radiation (PhAR) will be received by the reservoir surface in the middle of February, the later

peaks of phytoplankton’s spring blossoming will be observed. Research results represent undoubted interest for the analysis of

reservoir’s light factor influence on phytoplankton’s seasonal dynamics, and also for the exact forecast related to beginning of

phytoplankton’s spring blossoming in drinking reservoirs when planning water treatment actions.
Construction of Heterogeneous Conjoint Choice Designs: A New Approach
Authors: Liu Qing , Tang Yihui (Elina)
Published: March 2015

Extant research on choice designs in marketing focuses on the construction of efficient homogeneous designs where all respondents get the same design. Recently marketing scholars proposed the construction of efficient heterogeneous designs where different respondents or groups of respondents get different subdesigns, and demonstrated substantial efficiency gain when such heterogeneous designs are employed. A significant hurdle in the widespread adoption of heterogeneous designs is the high computation cost, even when the number of subdesigns contained in the heterogeneous design is restricted to be small. In this paper we propose a new approach for the construction of efficient heterogeneous choice designs. In contrast to extant approaches that are based on an exact design framework where it is computationally prohibitive to do an exhaustive search to find a globally optimal design, our proposed approach is based on the continuous design framework where well-established mathematical theories can be leveraged for quick identification of a globally optimal design. The proposed approach makes it feasible to generate a highly efficient choice design that is completely heterogeneous—a unique subdesign for each individual respondent in the choice experiment. The proposed approach is the first in the marketing literature to find a completely heterogeneous choice design with assured high global design efficiency using the continuous design framework. Results from simulation and empirical studies demonstrate superior performance of the proposed approach over extant approaches in constructing efficient heterogeneous choice designs.

Data, as supplemental material, are available at http://dx.doi.org/10.1287/mksc.2014.0897 .
Large Neighborhoods with Implicit Customer Selection for Vehicle Routing Problems with Profits
Authors: Vidal Thibaut , Maculan Nelson , Ochi Luiz Satoru , Vaz Penna Puca Huachi
Published: March 2015

We consider several vehicle routing problems (VRP) with profits, which seek to select a subset of customers, each one being associated with a profit, and to design service itineraries. When the sum of profits is maximized under distance constraints, the problem is usually called the team orienteering problem. The capacitated profitable tour problem seeks to maximize profits minus travel costs under capacity constraints. Finally, in the VRP with a private fleet and common carrier, some customers can be delegated to an external carrier subject to a cost. Three families of combined decisions must be taken: customer’s selection, assignment to vehicles, and sequencing of deliveries for each route.

We propose a new neighborhood search for these problems, which explores an exponential number of solutions in pseudo-polynomial time. The search is conducted with standard VRP neighborhoods on an exhaustive solution representation, visiting all customers. Since visiting all customers is usually infeasible or suboptimal, an efficient select algorithm, based on resource constrained shortest paths, is repeatedly used on any new route to find the optimal subsequence of visits to customers. The good performance of these neighborhood structures is demonstrated by extensive computational experiments with a local search, an iterated local search, and a hybrid genetic algorithm. Intriguingly, even a local-improvement method to the first local optimum of this neighborhood achieves an average gap of 0.09% on classic team orienteering benchmark instances, rivaling with the current state-of-the-art metaheuristics. Promising research avenues on hybridizations with more standard routing neighborhoods are also open.
Risk Factors for Androgen Deficiency with Daily Opioid Use; Co-trimoxazole and Sudden Cardiac Death in Patients Receiving ACE Inhibitors; Clindamycin-Induced Myelosuppression; Apixaban-Induced Diffuse Alveolar Hemorrhage; DRESS Syndrome Induced by Allopurinol
Authors: Mancano Michael A.
Published: March 2015

The purpose of this feature is to heighten awareness of specific adverse drug reactions (ADRs), discuss methods of prevention, and promote reporting of ADRs to the US Food and Drug Administration's (FDA's) MEDWATCH program (800-FDA-1088). If you have reported an interesting, preventable ADR to MEDWATCH, please consider sharing the account with our readers.
Doxorubicin and Dacarbazine (AD) Regimen for Soft Tissue Sarcomas
Authors: Adkins Kyle E. , Solimando Dominic A. , Waddell J. Aubrey
Published: March 2015

The complexity of cancer chemotherapy requires pharmacists be familiar with the complicated regimens and highly toxic agents used. This column reviews various issues related to preparation, dispensing, and administration of antineoplastic therapy, and the agents, both commercially available and investigational, used to treat malignant diseases.
Intraluminal Volume Dose Alteplase for the Clearance of Occluded Peripherally Inserted Central Catheter Lines at a Long-Term Acute Care Hospital: Efficacy and Economic Impact
Authors: Sapienza Stephen P. , Ciaschini Darrin R.
Published: March 2015

Purpose

To evaluate the efficacy and economic impact of a maximum of 2 doses of intraluminal volume 1 mg/1 mL dose alteplase for the clearance of occluded peripherally inserted central catheter (PICC) lines at a long-term acute care hospital (LTACH).

Methods

Open-label, nonrandomized quasi-experimental trial taking place over a 3-month period from December 2013 to March 2014. Patients had a standing order of either standard (2 mg/2 mL) or intraluminal volume (1 mg/1 mL) dose alteplase entered for any potential occlusions. The primary efficacy outcome was restored line patency after a maximum of 2 doses of alteplase. Secondary efficacy outcomes included restored patency after 1 dose of alteplase, reocclusion rate, mean time to reocclusion, and mean number of occlusions per patient.

Results

A total of 168 patients were enrolled into the study (intraluminal volume, n = 54; standard, n = 114) and a total of 270 occlusions were recorded; 90 received intraluminal volume dose alteplase and 180 received the standard dose. The primary efficacy endpoint was 93.3% for the intraluminal volume dose group and 94.4% for the standard dose group. Secondary outcomes were similar between groups. The average cost per dose was $123.77 and $60.62 for the standard and intraluminal volume dose alteplase groups, respectively.

Conclusion

For the clearance of occluded PICC lines at our LTACH, there was no statistical difference in the efficacy of a maximum of 2 doses of intraluminal volume dose alteplase versus the standard dose. Use of intraluminal volume dose alteplase was found to be significantly more cost-effective.
Fosaprepitant for the Treatment of Refractory Postoperative Nausea and Vomiting
Authors: Tran Linh H. , Cudny Magdalena , Ngo Dat , Patel Samit , Lam Manuel Y.
Published: March 2015

Postoperative nausea and vomiting (PONV) is a debilitating condition that occurs in approximately 30% of patients undergoing general anesthesia. Premedication with 5-HT3 receptor antagonists and glucocorticoids is effective in clinical practice; however, 10% to 20% of patients still develop PONV. Currently, little is known about the treatment of refractory PONV. We present a case that illustrates the use of fosaprepitant for the treatment of refractory postoperative nausea and vomiting.
Ledipasvir/Sofosbuvir
Authors: Cada Dennis J. , Baker Danial E. , Bindler Ross Jason
Published: March 2015

Each month, subscribers to The Formulary Monograph Service receive 5 to 6 well-documented monographs on drugs that are newly released or are in late phase 3 trials. The monographs are targeted to Pharmacy & Therapeutics Committees. Subscribers also receive monthly 1-page summary monographs on agents that are useful for agendas and pharmacy/nursing in-services. A comprehensive target drug utilization evaluation/medication use evaluation (DUE/MUE) is also provided each month. With a subscription, the monographs are sent in print and are also available on-line. Monographs can be customized to meet the needs of a facility. A drug class review is now published monthly with The Formulary Monograph Service. Through the cooperation of The Formulary, Hospital Pharmacy publishes selected reviews in this column. For more information about The Formulary Monograph Service, call The Formulary at 800-322-4349. The March 2015 monograph topics are paritaprevir, ritonavir, ombitasvir, and dasabuvir; meningococcal B bivalent recombinant vaccine; alemtuzumab; ceftolozane/tazobactam; and peramivir solution. The Safety MUE is on peramivir solution.
Approvals, Submission, and Important Labeling Changes for US Marketed Pharmaceuticals
Authors: Baker Danial E.
Published: March 2015

This monthly feature will help readers keep current on new drugs, new indications, dosage forms, and safety-related changes in labeling or use. Efforts have been made to ensure the accuracy of this information; however, if there are any questions, please let me know at danial.baker@wsu.edu .
“Desastres naturais”. Algumas considerações: vulnerabilidade, risco e resiliência
Authors: Gonçalves Carmen Diego
Published: March 2015

Os denominados desastres naturais afetam não só a infraestrutura económica dos países como a sua estrutura social (comunidades e populações), mas também a saúde física e psicológica dos seus membros. A avaliação do risco deverá incluir a avaliação da vulnerabilidade e a previsão do impacto tendo em conta os limiares de risco aceitável para uma dada sociedade. Um outro conceito deverá ser tido em linha de conta: a resiliência - a capacidade positiva dos indivíduos e grupos em contexto para lidarem com situações potencialmente causadoras de stress e trauma.
Mapeamento de riscos ambientais e planejamento participativo de bacias hidrográficas: o caso do Manancial Rio Santo Anastácio, SP-Brasil
Authors: Carpi Jr Salvador , Leal Antonio Cezar , Dibieso Eduardo Pizzolim
Published: March 2015

O objetivo desta pesquisa consiste no mapeamento dos riscos ambientais no Manancial Rio Santo Anastácio, apoiando atividades de planejamento e mobilização participativa relacionadas à criação de uma Área de Proteção e Recuperação de Manancial nessa área. Através de reuniões públicas de mapeamento de riscos ambientais, trabalhos de campo e pesquisa bibliográfica, foi possível notar a grande variedade de situações de riscos nesse setor da bacia, que podem ter sua situação ainda mais agravada, caso não sejam realizadas ações preventivas e corretivas.
Riscos para a saúde das populações – estudo de caso do electromagnetismo no município de Guimarães
Authors: Azevedo Bruno , Remoaldo Paula Cristina , Nogueira Helena
Published: March 2015

No presente artigo os autores realizam uma primeira aproximação de uma investigação em curso relacionada com o tipo de impacto dos postes e das linhas de alta e muito alta tensão na saúde da população, centrando-se na freguesia de Serzedelo (município de Guimarães), devido à elevada densidade deste tipo de postes e linhas e porque a freguesia foi estudada sumariamente ao nível da mortalidade pela Autoridade Regional de Saúde do Norte. Na presente investigação é ensaiada uma nova metodologia (estudo de expostos e não expostos), apresentando as respectivas limitações e vantagens.
A importância da análise dos riscos de contaminação na reabilitação de brownfields urbanos)
Authors: Lombardo Magda Adelaide , Volpe Larissa Lucciane , Vasques Amanda Ramalho
Published: March 2015

Esta pesquisa objetivou analisar os riscos de contaminação em locais brownfields, uma vez que muitas indústrias desenvolveram atividades potencialmente contaminadoras, tornando os imóveis e terrenos impróprios ou restritos para um novo uso. Foram analisadas propostas de reabilitação e diretrizes para nortear planos de reocupação do imóvel, fazendo-se necessário o estudo das legislações ambientais que determinam a qualidade dos solos e os riscos a serem minimizados no processo de reabilitação, que está intimamente relacionado aos riscos de saúde pública que uma área contaminada pode trazer para a comunidade vizinha a estes locais.
Áreas de risco: um problema social urbano. Estudo de caso em Manaus
Authors: Ribeiro Alberto Augusto Amazonas , Correa Costa Reinaldo
Published: March 2015

O processo de ocupação da cidade de Manaus foi constituído de inúmeras ocupações irregulares da reprodução socioeconômica fruto do capitalismo. Estas ocupações irregulares resultaram no surgimento de áreas de risco. Destacasse neste trabalho o caso da comunidade João Paulo II, na cidade de Manaus, onde há grande número de ocorrências de alagações e deslizamentos de terra.
A segurança rodoviária e os acidentes – estudo de caso
Authors: Talaia Mário , Amaro Nuno
Published: March 2015

A segurança rodoviária deve interessar a todos os cidadãos. Todos podem contribuir para tornar as estradas mais seguras. Neste trabalho aborda-se um estudo de caso de um acidente, numa estrada plana e horizontal, envolvendo duas viaturas. O estudo mostra como a partir da localização da posição final das viaturas e das linhas de travagem é possível avaliar a velocidade na fase de percepção. Um algoritmo foi construído para simular variáveis de entrada no modelo. Foram também criados diferentes diagramas de resposta rápida.
Relación clima-vegetación: adaptaciones de la comunidad del jarillal al clima semiárido, Parque Nacional Lihué Calel, provincia de La Pampa, Argentina
Authors: Duval Valeria Soledad , Benedetti Graciela María , Campo Alicia María
Published: March 2015

El estudio de la vegetación desde la Geografía se centra en el análisis de su distribución espacial y los factores que inciden en la misma. Uno de ellos es el clima que determina las características de las formaciones vegetales y en una escala más grande, a las comunidades. El objetivo de este trabajo fue analizar la relación clima-vegetación mediante las adaptaciones de la comunidad del jarillal con respecto al clima semiárido en el Parque Nacional Lihué Calel, provincia de La Pampa, Argentina. Para ello se realizó el balance hídrico de Thornthwaite y Mather para el área de estudio utilizando datos de la estación meteorológica del parque pertenecientes al período 1995-2010. Se aplicaron los índices bioclimáticos de Lang, Emberger, De Martonne y  Currey y se realizaron los cuadrados o stands correspondientes para conocer la composición florística y su fisonomía. Finalmente se analizaron las respuestas adaptativas identificadas en los individuos vegetales relevados y se comprobó que el clima semiárido condiciona la morfología y fisonomía del jarillal. Para el área de estudio se definió la presencia de vegetación xerófila con predominio de arbustos y un patrón de distribución abierta. El déficit hídrico da lugar a adaptaciones como por ejemplo la: pérdida de hojas en la estación desfavorable, el reemplazo de espinas por hojas, hojas pequeñas y resinosas, inclinación de la hoja y raíces extensas.
Post menopause and Osteoporosis - Unfolding the link
Authors: Sahithi Dathar , Reddy Sudhakara , Rajesh N. , Priyadarshini Sheela , Krishnan Meenakshi , Upendra Gurugubelli
Published: March 2015

Background: Osteoporosis is one of the most systemic diseases prevalent among the postmenopausal women attributing to the increased risk of occurrence of fractures. Hence, early detection of this disease is of utmost importance which can be determined by concentration of calcium in saliva and radiographically by quantitative radiomorphometric indices like panoramic mandibular Index (PMI).Objectives: The purpose of this study is to evaluate and compare the salivary calcium levels and PMI in order to identify the risk group of osteoporosis in postmenopausal women.Methods: A case-control study was carried out among 60 female subjects who were equally categorized into two groups. Salivary Â Â Â calcium levels were calorimetrically assessed by spectrophotometry and PMI index was calculated using Digora software from the Digital Panoramic image obtained for individual patient.Results: The results had shown that salivary calcium among the case group was significantly higher than the control group (p value = 0.001) and PMI values among the case group were significantly lower than the control group (p value = 0.001).With the advancing duration of menopause, the salivary calcium levels were increasing and PMI values were found to be decreasing and both were statistically significant.Conclusion: The results of this study suggest that both salivary calcium and PMI can certainly be used as screening tools to identify the risk of osteoporosis among postmenopausal women.
Data integration of cost materials needs through a service oriented architecture (study case: pt x garment ungaran)
Authors: Christianto Erwien , Utomo Wiranto , Sulistyo Wiwin
Published: March 2015

Data processing is an important part of a garment company. With increasingly complex and developing a garment company, data processing and integration became a very important requirement. The need for data integration in determining the cost of materials becomes a very important part in the garment industry. Data distribution or dissemination from one to another section gives results in data duplication, so that it may cause the data to be inconsistent. In addition, the efficiency of the process in determining the cost of materials is highly needed to achieve the selling price determination target. Nowadays, there is web-based technology, which is capable of handle data integration service, called SOA (Service Oriented Architecture). Business processes (work flows) involving the supplier need to go back to the supplier with the output price that has been determined by the system, can be integrated with Web service with concentration of BPELSOA. By utilizing the SOA technology then data processing and integration problems that occurred in the garment industry could be made into an integrated information system, so that the problems in the garment industry can be solved.
Visualizing onomasiological change: Diachronic variation in metonymic patterns for woman in Chinese
Authors: Zhang Weiwei , Geeraerts Dirk , Speelman Dirk
Published: March 2015

This paper introduces an innovative method to aid the study of conceptual onomasiological research, with a specific emphasis on diachronic variation in the metonymic patterns with which a target concept is expressed. We illustrate how the method is applied to explore and visualize such diachronic changes by means of a case study on the metonymic patterns forwomanin the history of Chinese. Visualization is done with the help of a Multidimensional Scaling solution based on the profile-based distance calculation (Geeraerts et al. 1999; Speelman et al. 2003) and by drawing diachronic trajectories in a set of MDS maps, corresponding to different metonymic targets. This method proves to be effective and feasible in detecting changes in the distribution of metonymic patterns in authentic historical corpus data. On the basis of this method, we can show that different targets exhibit different degrees of diachronic variation in their metonymic patterns. We find diachronically more stable targets (e.g.imperial woman), targets with a dominant trend in diachronic variation (e.g.a woman), and targets with highly fluctuating historical variation (e.g.beautiful woman). Importantly, we can identify the cultural and social changes that may lie behind some of these changes. Examining the results uncovered by the method offers us a better understanding of the dynamicity of metonymic conceptualizations.
Nursing Students’ Experiences with High-Fidelity Simulation
Authors: Najjar Rana Halabi , Lyman Bret , Miehl Nick
Published: March 2015

Research has revealed the effectiveness of simulation for facilitating student development of self-efficacy, knowledge, clinical judgment, and proficiency in technical skills. This grounded theory study was conducted to describe the experience of nursing students in high-fidelity simulation and develop a model which explicates the experience of nursing students in simulation. Focus group interviews were conducted with three cohorts of students enrolled in a baccalaureate nursing program who experienced simulation four to twelve times per academic year. Five prominent themes emerged during analysis Emotional Processing; Anxiety; Making Connections; Fidelity; and Learning. The Simulation Learning Model – Student Experience (SLM-SE) was developed to illustrate the student’s multi-dimensional experience of learning through high-fidelity simulation. Findings from this study suggest that students are better equipped to learn through increasing confidence and experience, continued reflection-on action and enhanced peer-to-peer interaction. Recommendations for future research include developing strategies to optimize students’ experiences for learning in simulation.
Disaster and Protection of Tenants in Japanese Law: General Principles in Time of Emergencies
Authors: Koyanagi Shunichiro
Published: March 2015

This article examines the legal protection of ex-tenants after disasters in Japan. The “Act Providing Temporary Measures concerning Land Lease and Building Lease in the Cities Damaged by War” of 1946 conferred not only the right to lease rebuilt buildings, but also the right of ex-tenants to lease the land of destroyed buildings. Therefore, many victims of the war disaster were entitled to construct and keep self-made shelters on the site of destroyed buildings. Thus, emergencies created exceptions to general rules or principles. The implementation of the Lease Act of 1946 was initially limited to the war disaster, but the government later issued the implementation Cabinet Orders of the Lease Act of 1946 to major disasters until 2004. However, in the case of the Great East Japan Earthquake of 2011, the local communities and local bar associations raised strong oppositions against the Lease Act of 1946 on the motif that the implementation of the Lease Act of 1946 would cause complicated legal and social problems. The Ministry of Justice decided not to enact an implementation Cabinet Order of the Lease Act of 1946. The Japanese Diet adopted a new Act regarding the lease in time of disaster in June 2013 to abolish the right to lease land and to lease newly rebuilt buildings as well. In a highly developed modern society, it is difficult to justify exceptions to general principles even in the case of emergencies caused by large-scale disasters.
Highly Organic Fill for Levee Stability Berms
Authors: VandenBerge D. R. , Brandon T. L. , Wielputz M. P.
Published: March 2015

Earth berms constructed of cohesive fill are often used to improve the stability of levees. In some parts of the United States, many of the locally available cohesive soils contain high organic content (>9 %), which has historically prevented their use for stability berms. This study investigated the compaction characteristics, undrained strength, and erodibility of eight samples of clay from Louisiana with organic content ranging from 1.7 % to 29 % to evaluate their potential use for stability berms. The target total unit weight of 15.7 kN/m3 was found to be difficult to attain for soils with organic content above about 9 %. The desired minimum undrained strength of 19.2 kPa was easily attained for all of the organic content at water content up to 6 % wet of optimum. The erosion resistance, measured using the jet erosion test, stayed the same or increased as the organic content of the fill increased. Based on these test results, soils with organic content in excess of 9 % are suitable for use as stability berm fill, provided that a lower total unit weight can be used in design.
Effect of Electrical Surface Charge on Seal Coat Curing and Aggregate Loss Performance
Authors: Lee Jusang , Ahn Hyungjun
Published: March 2015

This study presents quantifications of the electrical interactions between aggregates and emulsions using zeta potentials and evaluates the interaction influence on seal coat curing and aggregate loss performances. Three emulsions and seven aggregates consisting of CRS-2P, RS-2P, and AE-90S for emulsions and Trap Rock, Sandstone, Blast Furnace Slag, Steel Slag, Limestone, Dolomite, and Crushed Gravel were used for the zeta potential for electrostatic interaction, the water content test for the curing performance, and the sweep test for aggregate loss performance. All aggregates and emulsions showed positive zeta potentials at a low pH and negative zeta potentials at high pH with the exception of Blast Furnace Slag, which exhibited negative zeta potential values regardless of pH levels. This observation confirms that the zeta potential sensitively varies with the pH of solution. Conclusively, the electrical surface charge of an aggregate in emulsions varies with the type of emulsion. CRS-2P presented the fastest water evaporation among the three emulsions, which confirms that cationic emulsions show fast curing due to a negatively charged existing pavement surface, in general, like a felt disk used in this study. Another observation made from the water content test is that Limestone aggregate can slow down the water evaporation rate in CRS-2P. RS-2P and AE-90S show similar retardations, but they are statistically insignificant. It should be noted that there was no electrostatic attraction among the emulsions and Limestone based on the zeta potential test results. However, the electrostatic interaction between CRS-2P and Limestone has the smallest repulsion among Limestone with the emulsions. This study also showed that the electrostatic interaction and aggregate loss performance had a poor correlation (R2 = 0.3212), which may lead to a conclusion that repulsion and attraction between emulsion particle and aggregate particle does not significantly affect the aggregate loss performance of seal coat.
Applying FQFD and Utility Representative Functions Under Fuzzy Environment for FMCDM
Authors: Wang Yu-Jie
Published: March 2015

In this paper, we apply fuzzy quality function deployment (FQFD) and utility representative functions under fuzzy environment for fuzzy multi-criteria decision-making (FMCDM). In the FMCDM, criteria weights can present both consumers’ opinions and experts’ opinions. Consumers’ opinions are expressed by fuzzy importance levels of customer needs, experts’ opinions are presented by fuzzy relationship strength ratings for customer needs on skill needs, and the two opinions are integrated by FQFD. In addition to importance levels of customer needs and relationship strength ratings for customer needs on skill needs being fuzzy numbers, performance criteria ratings of alternatives are also displayed by fuzzy numbers in FMCDM. Thus, multiplying fuzzy numbers and aggregating several pooled fuzzy numbers formed by multiplying fuzzy numbers are critical on computation. Practically, the fuzzy computations are hard. In this paper, we use utility representative functions of multiplication and aggregation on fuzzy numbers to resolve the computation ties, especially for multiplying three fuzzy numbers. In addition, we compare the proposed method with other FMCDM methods to demonstrate our method’s feasibility and rationality. Therefore, FMCDM can be finished easily and efficiently through associating FQFD with the utility representative functions of fuzzy numbers applied.