bluuebunny/crossref_metadata_2025 huggingface dataset:
The use of evidenced‐based information by nurses and midwives to inform practice
Authors: Veeramah Ven
Published: January 2016

Aims and objectives

To examine the implementation of evidence‐based information by nurses and midwives to inform their practice.

Background

It is widely recognised that the main benefits of using evidence‐based information are to improve and update clinical practice and to enhance the quality of care and outcomes for patients. However, despite a large body of research showing that nurses and midwives have positive attitudes towards evidence‐based practice , its implementation remains a considerable and significant challenge.

Design

This was a cross‐sectional on‐line survey.

Methods

A self‐completed questionnaire was used to collect data from a convenience sample of 386 nursing and midwifery diplomates and graduates from June–December 2013. One hundred and seventy‐two participants completed the questionnaire, giving a response rate of 44·6%.

Results/Findings

The majority of respondents expressed very positive attitude towards evidence‐based practice and nearly everyone felt that this should become an important part of daily practice. A significant number stated that they have regular access to research through a number of relevant databases and the Internet at their place of work and evidence‐based guidelines relevant to their speciality were also available. The two top barriers perceived by respondents were lack of time to search for relevant evidence‐based information and being able to make time during working hours to look for new information. The most popular strategy suggested was to ensure evidence‐based information is readily available in a form which nurses and midwives can easily understand the implications for their practice.

Conclusion

Health services and government agencies should make a concerted effort to make time for nurses and midwives to access, appraise and use evidence‐based information to inform practice.

Relevance to clinical practice

More resources including protected time should be made available to support nurses and midwives to use evidence‐based information to improve the quality of care provided.
Illness perceptions of fatigue and the association with sense of coherence and stress in patients one year after myocardial infarction
Authors: Alsén Pia , Eriksson Monica
Published: January 2016

Aims and objectives

To explore the associations between illness perceptions of fatigue, sense of coherence and stress in patients one year after myocardial infarction.

Background

Post‐myocardial infarction fatigue is a stressful symptom that is difficult to cope with. Patients’ illness perceptions of fatigue guide professionals in predicting how individuals will respond emotionally and cognitively to symptoms. Individuals’ sense of coherence can be seen as a coping resource in managing stressors.

Design

A cross‐sectional study design was used.

Method

One year post‐myocardial infarction, a total of 74 patients still experiencing fatigue completed four questionnaires: the Multidimensional Fatigue Scale Inventory ‐20, the Brief Illness Perception Questionnaire, the Sense of Coherence scale (sense of coherence‐13) and a single‐item measure of stress symptoms. Descriptive statistics, correlations and stepwise regression analysis were carried out.

Results

Strong negative associations were found between illness perceptions of fatigue, sense of coherence and stress. Sense of coherence has an impact on illness perceptions of fatigue. Of the dimensions of sense of coherence, comprehensibility seemed to play the greatest role in explaining illness perceptions of fatigue one year after myocardial infarction.

Conclusion

To strengthen patients’ coping resources, health‐care professionals should create opportunities for patients to gain individual‐level knowledge that allows them to distinguish between common fatigue symptoms and warning signs for myocardial infarction.

Relevance to clinical practice

There is a need to improve strategies for coping with fatigue. It is also essential to identify patients with fatigue after myocardial infarction, as they need explanations for their symptoms and extra support.
Effects of a strengths‐based perspective support group among Taiwanese women who left a violent intimate partner relationship
Authors: Hou Wen‐Li , Ko Nai‐Ying , Shu Bih‐Ching
Published: January 2016

Aims and objectives

To examine the effects of an 8‐week strengths‐based perspective group intervention on hope, resilience and depression in Taiwanese women who left a violent intimate partner relationship.

Background

Studies on interventions for abused women have primarily focused on psychological problems. However, the effect of group intervention on the psychological strengths of abused women is still unknown.

Design

A two‐group, quasi‐experimental design using repeated measures was used in this study.

Methods

Twenty‐nine Taiwanese women who left violent intimate partner relationships were assigned to two groups and five participants did not complete the study. The experimental group (n = 8) underwent an 8‐week strengths‐based perspective group intervention developed by the investigators; the control group (n = 16) received no intervention. The effects of the intervention on the participants’ hope, resilience and depression levels were evaluated as a pretest, post‐test 1 (8th week) and post‐test 2 (12th week) and were compared. The Chinese version of the State Hope Scale, the 25‐item Resilience Scale, and the Taiwanese Depression Questionnaire were used in this study.

Results

On the eighth and twelfth weeks after the strengths‐based perspective group intervention, we found significantly lower scores on the depression scale in the experimental group. In the eighth week, participants in the experimental group had significantly lower scores on the pathway of hope subscales than those in the control group.

Conclusions

A strengths‐based perspective support group intervention designed specifically for women who left a violent intimate partner relationship significantly reduced the participants’ level of depressive symptoms and improved the pathway component of hope.

Relevance to clinical practice

This research highlights the importance of nurses not only focused on problems but also on the psychological strengths in practice of abused women survivors.
Comparison of two cohorts of women who expulsed either a copper‐intrauterine device or a levonorgestrel‐releasing intrauterine system
Authors: Simonatto Paula , Bahamondes Maria Valeria , Fernandes Arlete , Silveira Carolina , Bahamondes Luis
Published: January 2016

Aim

To assess if there is a difference in the characteristics of the women who expelled a copper‐intrauterine device (TCu‐IUD) or the levonorgestrel‐releasing intrauterine system (LNG‐IUS) and the frequency of expulsions over different periods of observation.

Methods

We retrospectively analyzed 19 697 medical charts of women consulting between January 1980 and December 2013 who requested a TCu‐IUD or a LNG‐IUS.

Results

The medical records of 17 644 Cu‐IUD and 2053 LNG‐IUS users returning to the clinic for a follow‐up visit after insertion of an IUC were reviewed. Of these, 1532 Cu‐IUD and 254 LNG‐IUS parous users were found to have expelled the IUC for a first time. The mean age at insertion (± standard deviation) was 26.3 ± 6.6 years (range 16–49) for Cu‐IUD users and 31.7 ± 7.6 years (range 18–48) for LNG‐IUS users (P < 0.001). A total of 263 (13.4%) and 12 (4.3%) of the Cu‐IUD and the LNG‐IUS users were ≤19 years old, and 49.1% and 54.1% of the expulsions among the Cu‐IUD and LNG‐IUS users, respectively, were reported in the first six months after placement. A regression model showed that the variables significantly associated with an expulsion of either a Cu‐IUD or LNG‐IUS were age < 25 years, less than two deliveries and using a Cu‐IUD.

Conclusion

Our findings showed that the characteristics associated with IUC expulsion were age under 25 years, having had less than two deliveries and being users of Cu‐IUD.
Racial diversity in mortality and morbidity in urban patients with hepatitis C
Authors: Stubbs A. , Naylor P. , Ravindran K. , Benjaram S. , Reddy N. , Mutchnick S. , May E. , Ehrinpreis M. , Mutchnick M.
Published: January 2016

Defining mortality for Caucasians and African American patients with chronic hepatitis C with respect to racial diversity is critical for counselling patients on therapy options. The objective of this study was to define racial diversity influence on mortality and morbidity of 3724 consecutive hepatitis C virus (HCV)‐infected patients seen in an urban clinic between 1995 and 2008. Mortality, as of 2011, was defined using the SSA National Death Index and correlated with early visit medical information. The HCV chronically infected patient population consisted of 2879 African Americans (AA), 758 Caucasians and 87 other, and the majority were not treated for their infection prior to 2011. The average time to death from first visit was 5 years, the average age at death was 55 years, and despite racial diversity, AA were just as likely to be reported dead as Caucasians (23% AA vs 22% Caucasians). Cirrhosis and fibrosis (liver biopsy, AST Platelet Ratio Index or Fibrosis‐4) at first visit as well as low albumin, diabetes, renal impairment and cardiac symptoms were associated with increased mortality. Treated patients who cleared the virus (sustained viral response (SVR); AA = 59; Caucasians = 40) had lower mortality than patients who were not treated (AA: 5% vs 27%; Caucasians 5% vs 26%). Hence, we find that race is not a factor in the early mortality of patients with chronic HCV infection and achieving a SVR reduced mortality. Unexpectedly, nonresponding AA also benefited by a lower mortality. African American patients with kidney disease and low albumin were at highest risk and should be treated as soon as identified.
BsRADseq: screeningDNAmethylation in natural populations of non‐model species
Authors: Trucchi Emiliano , Mazzarella Anna B. , Gilfillan Gregor D. , Lorenzo Maria T. , Schönswetter Peter , Paun Ovidiu
Published: January 2016

Epigenetic modifications are expected to occur at a much faster rate than genetic mutations, potentially causing isolated populations to stochastically drift apart, or if they are subjected to different selective regimes, to directionally diverge. A high level of genome‐wide epigenetic divergence between individuals occupying distinct habitats is therefore predicted. Here, we introduce bisulfite‐converted restriction site associatedDNAsequencing (bsRADseq), an approach to quantify the level ofDNAmethylation differentiation across multiple individuals. This reduced representation method is flexible in the extent ofDNAsequence interrogated. We showcase its applicability in three natural systems, each comprising individuals adapted to divergent environments: a diploid plant (Heliosperma,Caryophyllaceae), a tetraploid plant (Dactylorhiza,Orchidaceae) and an animal (Gasterosteusaculeatus,Gasterosteidae). We present a robust bioinformatic pipeline, combining tools forRADlocus assembly,SNPcalling, bisulfite‐converted read mapping andDNAmethylation calling to analyse bsRADseq data with or without a reference genome. Importantly, our approach accurately distinguishes betweenSNPs and methylation polymorphism (SMPs). AlthoughDNAmethylation frequency between different positions of a genome varies widely, we find a surprisingly high consistency in the methylation profile between individuals thriving in divergent ecological conditions, particularly inHeliosperma. This constitutive stability points to significant molecular or developmental constraints acting onDNAmethylation variation. Altogether, by combining the flexibility ofRADseq with the accuracy of bisulfite sequencing in quantifyingDNAmethylation, the bsRADseq methodology and our bioinformatic pipeline open up the opportunity for genome‐wide epigenetic investigations of evolutionary and ecological relevance in non‐model species, independent of their genomic features.
Axonal TDP‐43 aggregates in sporadic amyotrophic lateral sclerosis
Authors: Onozato T. , Nakahara A. , Suzuki‐Kouyama E. , Hineno A. , Yasude T. , Nakamura T. , Yahikozawa H. , Watanabe M. , Kayanuma K. , Makishita H. , Ohara S. , Hashimoto T. , Higuchi K. , Sakai T. , Asano K. , Hashimoto T. , Kanno H. , Nakayama J. , Oyanagi K.
Published: January 2016

Aims

Axonal aggregates of phosphorylated (p‐) transactive response DNA‐binding protein 43 kDa (TDP‐43) in sporadic amyotrophic lateral sclerosis (sALS) were examined in relation to propagation of the protein in the nervous system.

Methods

Brains and spinal cords of Japanese patients with sALS and control subjects were examined immunohistochemically using formalin‐fixed paraffin‐embedded specimens with special reference to the topographical distribution, microscopic features, presynaptic aggregates, and correlation between the aggregates in axons and the clinical course.

Results

(i) Aggregates of p‐TDP‐43 were frequently present in axons of the hypoglossal and facial nerve fibres and the spinal anterior horn cells. (ii) Aggregates of p‐TDP‐43 in the axons showed two characteristic microscopic features – dash‐like granuloreticular aggregates (GRAs) and massive aggregates (MAs). (iii) MAs were surrounded by p‐neurofilaments, but p‐neurofilament immunnoreactivity decreased at the inside of axons with GRAs. (iv) Patients showing MAs and GRAs had a relatively shorter clinical course than patients without the aggregates. (v) Some neurones in the red nucleus in patients were surrounded by synapses containing p‐ and p‐independent (i)‐TDP‐43, and almost all neurones had lost their nuclear TDP‐43 immunoreactivity; 17% of those neurones in the red nucleus also had TDP‐43‐immunopositive neuronal cytoplasmic inclusions, but no postsynaptic p‐TDP‐43 deposition was evident.

Conclusions

There are two types of axonal p‐TDP‐43 aggregates, MAs and GRAs, located predominantly in the facial and hypoglossal nuclei and anterior horn cells. These aggregates may influence the function of neurones, and presynaptic aggregates of the protein induce loss of p‐i‐TDP‐43 in the nuclei of postsynaptic neurones.
Frontotemporal dementia and progressive supranuclear palsy‐like syndrome with a novel TARDBP mutation
Authors: Yabe Ichiro , Nakano Fumihito , Shirai Shinichi , Matsushima Masaaki , Takahashi Ikuko , Sasaki Hidenao
Published: January 2016

TARDBP mutation has been shown to cause frontotemporal dementia and progressive supranuclear palsy‐like disease. In this case study, we present the first reported Japanese case of frontotemporal dementia and progressive supranuclear palsy‐like syndrome caused by a novel TARDBP mutation. A 63‐year‐old man was diagnosed with frontotemporal dementia and progressive supranuclear palsy‐like disease. An older brother of the patient's deceased father showed similar symptoms. Genetic analysis showed a novel TARDBP heterozygous mutation (c.715 A > G, p.I239V). This mutation is not found in databases of the 1000 genome project and Human Genomic Variation, but is identified as a pathogenic mutation by Mutation Taster. Although the hot cross bun sign as a result of frontotemporal dementia and progressive supranuclear palsy has been reported only rarely, brain magnetic resonance imaging of this patient showed the hot cross bun sign and T2‐hyperintensity of the middle cerebellar peduncles along with frontotemporal and midbrain tegmentum atrophy.
Medication‐related osteonecrosis of the jaw associated with bisphosphonates and denosumab in osteoporosis
Authors: Bagan J , Peydró A , Calvo J , Leopoldo M , Jiménez Y , Bagan L
Published: January 2016

Objective

To describe the clinical characteristics and evolution of our series of medication‐related osteonecrosis of the jaws (MRONJ) associated with denosumab in osteoporotic patients.

Material and Methods

We present 10 new cases of MRONJ in patients receiving denosumab for osteoporosis. We describe the mean doses of denosumab, previous bisphosphonate intake, and the clinical characteristics associated with the osteonecrosis, such as local contributing factors, symptoms, and evolution after treatment.

Results

The mean number of denosumab doses was 3.4 ± 2.2. In 90% of patients, there was a prior history of oral bisphosphonate intake, with a mean duration of 46.78 ± 25.11 months. The most common local factor was dental extraction (6 cases; 60%), and most cases had necrotic bone exposure (9/10, 90%). Sclerosis of the bone was the most common radiographic finding. Stage 1 was the most common ONM stage, found in 80%. ‘Cure’ after conservative treatments was obtained in 71.4%.

Conclusions

Most of our cases were in the early stages of MRONJ, and the success rate after conservative treatment was high.
A new family ofCambrian rhynchonelliformean brachiopods (OrderNaukatida) with an aberrant coral‐like morphology
Authors: Streng Michael , Butler Aodhán D. , Peel John S. , Garwood Russell J. , Caron Jean‐Bernard
Published: January 2016

Tomteluva perturbatagen. et sp. nov. andNasakia thulensisgen. et sp. nov., two new rhynchonelliformean brachiopod taxa, are described from carbonate beds from the lower middleCambrian (Series 3,Stage 5) basinalStephenFormation,Canada, and the upper lowerCambrian (Series 2,Stage 4)HensonGletscherFormation,NorthGreenland, respectively. The two taxa are characterized by an unusual coral‐like morphology typified by a high conical ventral valve with an anteriorly curved umbo and a tube‐like structure inside the ventral valve, interpreted as pedicle tube. Both resemble the problematic late middleCambrian (Drumian) speciesAnomalocalyx cawoodiBrock fromAustralia, whose systematic affiliation is controversial. Together, the three genera are interpreted as representatives of a new family of rhynchonelliformean brachiopods, theTomteluvidae fam. nov., which is interpreted as an aberrant or derived taxon within theOrderNaukatida. Convergence between theTomteluvidae and the coralla of small solitaryCambrian coralimorphs, as well as the latePalaeozoic reef‐building richthofenioid brachiopods, might indicate adaptation to a similar life habits and environments. However, their small size (length 4 mm), well‐developed pedicle and perfect morphological symmetry make it more likely that tomteluvids lived attached to frondose algae or sponges, above the seafloor, in a similar fashion to the acrotretoid brachiopods with which they show a high degree of morphological convergence. Morphological features of the pedicle tube ofN. thulensissuggest that the tomteluvid pedicle is homologous to that in modern rhynchonelliformean brachiopods. This is the first evidence of the pedicle type within the Naukatida and represents the oldest confirmation of a rhynchonellate pedicle.
Ellis–van Creveld syndrome associated with chronic intestinal pseudo‐obstruction
Authors: Iwakura Hideo , Fujii Katsunori , Furutani Yoshiyuki , Takatani Tomozumi , Ebata Ryota , Nakanishi Toshio , Mitsunaga Tetsuya , Saito Takeshi , Kishimoto Takashi , Yoshida Hideo , Shimojo Naoki
Published: January 2016

Ellis–van Creveld (EVC) syndrome is a rare autosomal recessive disorder characterized by hypoplastic nails, polydactyly, and achondroplasia. Patients usually exhibit normal cognitive function and no remarkable developmental delay. We herein present an unusual case of EVC syndrome. A Japanese 2‐year‐old boy was born at term, but immediately developed severe respiratory failure due to thorax deformity, postaxial polydactyly and nail hypoplasia. We identified a novel pattern of germinal compound heterozygous nonsense EVC2 mutations of c.1814C > A (p. S605X) and c.2653C > T (p. R885X), leading to the diagnosis of EVC syndrome. Interestingly, he also had severe developmental delay, and suddenly developed excessive abdominal distension at the age of 2. On surgery, extensive necrotic bowel with chronic intestinal pseudo‐obstruction was noted. This is, to our knowledge, a most severe phenotype of EVC syndrome, illustrating that the specific pattern of EVC2 compound heterozygous mutations may cause severe developmental delay and intestinal malfunction.
Specificity of Chroomonas (Cryptophyceae) as a source of kleptochloroplast for Nusuttodinium aeruginosum (Dinophyceae)
Authors: Onuma Ryo , Horiguchi Takeo
Published: January 2016

The unarmoured dinoflagellate Nusuttodinium aeruginosum retains a kleptochloroplast, which is a transient chloroplast stolen from members of the cryptomonad genus, Chroomonas. Both N. aeruginosum and the closely related N. acidotum have been shown to restrict their diet to a limited number of species of this blue‐green genus of cryptophyte. However, it is still unclear how flexible the predators are with regard to the ingestion and utilization of Chroomonas spp. as a source of kleptochloroplast. To address specificity of cryptomonad in N. aeruginosum, we collected the cells of N. aeruginosum from several ponds in Japan, and analysed the phylogeny of the kleptochloroplasts based on their plastidial 16S rDNA sequences. All sequences obtained in this study were restricted to only one (the subclade 4) of four subclades known to comprise the Chroomonas/Hemiselmis clade. Therefore, N. aeruginosum is specific in its dietary requirements, selecting their prey within the subclade level.
Effectiveness of low‐dose pregabalin in three patients with Lewy body disease and central neuropathic pain
Authors: Ukai Katsuyuki , Fujishiro Hiroshige , Ozaki Norio
Published: January 2016

Many patients with Lewy body disease complain of pain, and their pain may be associated with this disease. Recently, pain has become a focus of attention in Parkinson's disease, but there is little information regarding pain in patients who have dementia with Lewy bodies. We used pregabalin to treat three Lewy body disease patients with chronic pain that may have been related to degeneration of central neurons. All three patients responded well to pregabalin at 25–50 mg/day. To our knowledge, there have been no previous reports of pregabalin showing efficacy for central neuropathic pain in Parkinson's disease or Lewy body disease.
Extensive and Intensive Margins of Exports and Labor Heterogeneity
Authors: Luong Tuan Anh , Chen Wei‐Chih
Published: January 2016

This paper investigates how changes in skilled and unskilled labor supply affect different margins of exports. Using bilateral trade data in manufacturing sectors of 34 countries from 1995 to 2010, we find that most of the impact of skilled labor on exports goes through the intensive margin, whereas most of the effect of unskilled labor works through the extensive margin. These outcomes result from the impact of labor skill composition on the productivity cut‐off of exporters. We also find that the impact of skilled and unskilled labor on trade margins depends on the income level of countries and on the type of products. The results indicate that the effect of skilled labor is greater for low‐income countries and differentiated products, while that of unskilled labor is greater for high‐income countries and homogeneous products.
Economic Integration, Monopoly Power and Productivity Growth without Scale Effects
Authors: Davis Colin , Hashimoto Ken‐ichi
Published: January 2016

This paper considers how monopoly power affects the relationship between economic integration and economic growth that is not biased by a scale effect. In a two‐country model of trade, productivity growth is generated by firm‐level investment in process innovation, and the location of economic activity is determined by relative market size, trade costs and imperfect knowledge diffusion. Equilibrium features the partial concentration of manufacturing and the full concentration of innovation in the larger country. Increased economic integration raises the concentration of manufacturing in the larger country, and when monopoly power is strong, leads to decreased product variety, accelerated productivity growth and greater national welfare. With weak monopoly power, however, it raises product variety and dampens productivity growth, but may benefit or hurt welfare.
Intellectual Property Rights and the Quality of Transferred Technology in Developing Countries
Authors: Yang Lei , Tsai Yingyi , Mukherjee Arijit
Published: January 2016

This paper addresses the effects of a stronger patent system in developing countries on the quality of transferred technology and welfare. We show that a stronger patent system can reduce the quality of licensed technology. The presence of technology licensing may encourage the developing country to adopt a stronger patent system compared with the situation where licensing is not an option.
Capital Structure Premium in Multinational SOEs: Evidence from China
Authors: Zhang Rui , Zhang Xun
Published: January 2016

We investigate the relationship among multinational operations, ownership and capital structure using data from China's A‐share listed companies. We find that, in general, multinational enterprises (MNEs) have lower leverages than domestic enterprises (DEs). More importantly, we document a capital structure premium in China's multinational state‐owned enterprises (SOEs). Since the state supports multinational SOEs that promote overseas national strategy, these multinational SOEs will have higher credit availability and therefore higher debt–equity ratios. This study sheds light on the Chinese government's impact on firm's creditability.
Regionalism as Industrial Policy: Evidence from MERCOSUR
Authors: Moncarz Pedro , Olarreaga Marcelo , Vaillant Marcel
Published: January 2016

This paper empirically explores whether trade preferences can be used as a substitute for industrial policy and help countries achieve their industrialization objectives at the expense of other regional members. Results show that Mercado Común del Sur (MERCOSUR) preferences obtained by Brazilian exporters have led to an increase in exports of relatively sophisticated products in which Brazil does not enjoy a global comparative advantage. On the contrary, smaller members of MERCOSUR export to the region products in which they have strong comparative advantages and with relatively low levels of sophistication. This suggests that MERCOSUR has helped Brazil achieve its industrialization objectives, but has not contributed to the industrialization of its smaller members.
The first case of acute unilateral pan‐ureteritis caused by BK polyomavirus in an allogeneic stem cell transplant patient
Authors: Nigo M. , Marin D. , Mulanovich V.E.
Published: January 2016

Several cases of ureteral obstruction have been reported in stem cell transplant (SCT) patients; however, they were bilateral and concomitant with or preceded by hemorrhagic cystitis. We describe, to our knowledge, a first case of acute unilateral pan‐ureteritis caused by BK polyomavirus (BKPyV) in an SCT patient. This case may represent an early phase of BKPyV reactivation. BKPyV infection should be considered as a potential cause of acute unilateral ureteritis even among SCT recipients.
Decreasing child mortality, spatial clustering and decreasing disparity in North‐Western Burkina Faso
Authors: Becher Heiko , Müller Olaf , Dambach Peter , Gabrysch Sabine , Niamba Louis , Sankoh Osman , Simboro Seraphin , Schoeps Anja , Stieglbauer Gabriele , Yé Yazoume , Sié Ali
Published: January 2016

Within relatively small areas, there exist high spatial variations of mortality between villages. In rural Burkina Faso, with data from 1993 to 1998, clusters of particularly high child mortality were identified in the population of the Nouna Health and Demographic Surveillance System (HDSS), a member of the INDEPTH Network. In this paper, we report child mortality with respect to temporal trends, spatial clustering and disparity in this HDSS from 1993 to 2012. Poisson regression was used to describe village‐specific child mortality rates and time trends in mortality. The spatial scan statistic was used to identify villages or village clusters with higher child mortality. Clustering of mortality in the area is still present, but not as strong as before. The disparity of child mortality between villages has decreased. The decrease occurred in the context of an overall halving of child mortality in the rural area of Nouna HDSS between 1993 and 2012. Extrapolated to the Millennium Development Goals target period 1990–2015, this yields an estimated reduction of 54%, which is not too far off the aim of a two‐thirds reduction.
Biologics in pregnancy – for the obstetrician
Authors: Soh May Ching , MacKillop Lucy
Published: January 2016

Key content

The authors discuss commencing biologics in pregnancy and the potential side effects. Infection is a particular risk, which may be atypical or present atypically.

While there is no evidence of teratogenicity, these drugs cross the placenta and neonatal cord drug levels may exceed those of maternal drug levels.

If possible, anti‐tumour necrosis factor (TNF) agents should be discontinued midtrimester but the gestation to which each drug can be used is slightly different.

Neonates exposed in utero to anti‐TNF agents beyond the recommended gestation should not be given live attenuated vaccines for the first 6 months of life and any infections promptly treated.

Data are lacking on the long‐term effects of biologics on children exposed in utero. However, the benefits of controlling active autoimmune disease in the mother often outweigh the small risk to the exposed infants.

Learning objectives

To know the biologics most commonly used in pregnancy.

To understand the literature regarding safety of the common biologics in pregnancy.

To be able to counsel a woman taking a biologic about the potential benefits and risks of taking it at different gestations.

To be able to counsel a woman receiving biologics in pregnancy about vaccinations for her baby after birth.

Ethical issues

Biologic agents are relatively new drugs that are being increasingly used in young women because of their perceived ‘fertility sparing’ benefits despite a lack of high quality evidence.

Most women who have been prescribed biologics are often refractory to other treatments, and therefore these agents are required for disease control. The decision to continue or discontinue these drugs in pregnancy, especially late pregnancy, is particularly contentious.

The long‐term effect of biologics on infants exposed in utero is not known and the decision to use these drugs has to be balanced against the risk of severe maternal flares.
For real: land as capital and commodity
Authors: Christophers Brett
Published: January 2016

With the aim of helping to revivify a stalled geographical literature on the place of land in capitalist political economies, this article presents a critique of the popular idea that land can be usefully conceptualised as a ‘fictitious’ form of capital or commodity. The critique is based primarily on a close and critical consideration of the grounds on which the identifiers and theorists of such fictitiousness – Marx/Harvey in the case of capital, Polanyi in the case of the commodity – distinguished it from ‘real’ variants. Those grounds, the article argues, are tenuous. And, far from disabling us, treating land as no more or less real than other forms of capital and commodity can empower us in productively revisiting and centring the question of land's political economy – a crucial undertaking in a world where the materiality of land to social relations is writ increasingly large.
Large-Eddy Simulation of Plasma-Based Active Control on Imperfectly Expanded Jets
Authors: Goparaju Kalyan , Gaitonde Datta V.
Published: January 2016

Jet flow control is important for mixing enhancement and noise mitigation. In previous efforts, we have used validated simulations to examine the effect of localized arc filament plasma actuators (LAFPA) on perfectly expanded Mach 1.3 jets. Here, we extend the analysis to an underexpanded jet at the same Mach number to examine the effect of shocks and expansions on control authority. After validation of the baseline flow, it is shown that the downstream evolution is relatively independent of Reynolds number. Simulations performed at different values of upstream pressure indicate that the higher stagnation pressure yields shock cells that are quantitatively stronger but qualitatively similar to those observed for the lower upstream stagnation pressure condition. For control simulations, axisymmetric mode pulsing is considered at two different Strouhal numbers of St = 0.3 and St = 0.9. These simulations show that the response of the jet to flow control is a strong function of the actuation frequency. Relative to the no-control case, actuating at the column-mode instability frequency (St = 0.3) results in an increase in the rate of spreading of the shear layer. Phase-averaged results indicate the formation of large toroidal vortices formed as a result of amplification of the column-mode instabilities that are excited at this frequency. On the other hand, the higher frequency actuation affects the initial shear-layer instability and interferes with the formation of the large-scale structures. Detailed integral azimuthal length scale analyses reveal that despite the absence of the axisymmetric toroids, the St = 0.9 case shows the dominance of the axisymmetric mode even at large distances from the nozzle exit. This indicates that flow control methods need not always have a visual signature of their influence on the system.
Designing the Same, but in Different Ways: Determinism in Graph-Rewriting Systems for Function-Based Design Synthesis
Authors: Eichhoff Julian R. , Roller Dieter
Published: January 2016

This paper compares methods for identifying determinism within graph-rewriting systems. From the viewpoint of functional decomposition, these methods can be implemented to search efficiently for distinct function structures. An additional requirement is imposed on this comparison that stems from a cooperative design application where different organizations contribute to a distributed graph-rewriting system: Inspecting the definitions of production rules is not allowed for identifying determinism because production rules are considered to be confidential corporate knowledge. Under this assumption, two approaches were selected and empirically compared with respect to random search and guided search scenarios. The results suggest that the herein proposed dynamic rule independence analysis outperforms traditional approaches in light of the above restriction.
A New Dynamic Model of Ball-Bearing Rotor Systems Based on Rigid Body Element
Authors: Cao Hongrui , Li Yamin , Chen Xuefeng
Published: January 2016

Ball-bearing rotor systems are key components of rotating machinery. In this work, a new dynamic modeling method for ball-bearing rotor systems is proposed based on rigid body element (RBE). First, the concept of RBE is given, and then the rotor is divided into several discrete RBEs. Every two adjacent RBEs are connected by imaginary springs, whose stiffness is calculated according to properties of the RBEs. Second, all the parts of rolling ball bearings (i.e., outer ring, inner ring, ball, and cage) are considered as RBEs, and Gupta's model is employed to model bearings which include radial clearance, waviness, pedestal effect, etc. Finally, the rotor and all the rolling ball bearings are coupled to develop a dynamic model of the ball-bearing rotor system. The vibration responses of the ball-bearing rotor system can be calculated by solving dynamic equations of each RBE. The proposed method is verified with both simulation and experiment. The RBE model of the rotor is compared with its finite element (FE) model first, and numerical simulation shows the validity of the RBE model. Then, experiments are conducted on a rotor test rig which is supported with two rolling ball bearings as well. Good agreements between measurement and simulation show the ability of the model to predict the dynamic behavior of ball-bearing rotor systems.
Analysis and Modeling of Burr Formation During the Plane Milling of Cast Aluminum Alloy Using Polycrystalline Diamond Tools
Authors: Bourlet Clément , Fromentin Guillaume , Harika Elias , Crolet Arnaud
Published: January 2016

Burr formation is a significant problem during manufacturing and leads to a lack of geometrical quality through the appearance of undesired and undefined shapes on the workpiece. Thus, understanding the burr formation and elaborating of predictive models are helpful for process design in order to avoid or to reduce burrs and to optimize the strategies for eventual deburring. This study presents both an experimental approach and a model for the plane milling of openwork parts, where burrs are a significant factor. A large-scale analysis of relevant geometrical parameters and their interactions are performed. A phenomenological burr size model is established considering local parameters and the specificities of 3D cutting in milling. Based on local parameters, this article proposes a new methodology to simulate burr height along any part edge and for most face-milling trajectories. Simulations and validations during tool path exits, with changing local parameters, are presented. In addition to the quantitative approach, new 3D aspects of face milling in relation with exit order sequence (EOS) are developed.
Synthesis and Analysis of a Parallel-Type Independently Controllable Transmission Mechanism
Authors: Hwang Guan-Shong , Liao Wei-Hsiang , Tsay Der-Min , Lin Bor-Jeng
Published: January 2016

This study proposes an innovative transmission mechanism, called parallel-type independently controllable transmission (ICT). The proposed mechanism can provide functions similar to those of infinitely variable transmission (IVT) or continuously variable transmission (CVT) mechanisms. The parallel-type ICT can transmit rotational output speed that can be independently regulated using a controller and is unaffected by the speed variation of the input shaft. Thus, a variable speed wind turbine can generate electricity with a constant frequency and improved quality. The kinematic characteristics, torque distribution, and power flow of this transmission mechanism were verified using a prototype of the ICT to demonstrate the feasibility of its application.
Estimating Tool–Tissue Forces Using a 3-Degree-of-Freedom Robotic Surgical Tool
Authors: Zhao Baoliang , Nelson Carl A.
Published: January 2016

Robot-assisted minimally invasive surgery (MIS) has gained popularity due to its high dexterity and reduced invasiveness to the patient; however, due to the loss of direct touch of the surgical site, surgeons may be prone to exert larger forces and cause tissue damage. To quantify tool–tissue interaction forces, researchers have tried to attach different kinds of sensors on the surgical tools. This sensor attachment generally makes the tools bulky and/or unduly expensive and may hinder the normal function of the tools; it is also unlikely that these sensors can survive harsh sterilization processes. This paper investigates an alternative method by estimating tool–tissue interaction forces using driving motors' current, and validates this sensorless force estimation method on a 3-degree-of-freedom (DOF) robotic surgical grasper prototype. The results show that the performance of this method is acceptable with regard to latency and accuracy. With this tool–tissue interaction force estimation method, it is possible to implement force feedback on existing robotic surgical systems without any sensors. This may allow a haptic surgical robot which is compatible with existing sterilization methods and surgical procedures, so that the surgeon can obtain tool–tissue interaction forces in real time, thereby increasing surgical efficiency and safety.
Extended Static Modeling and Analysis of Compliant Compound Parallelogram Mechanisms Considering the Initial Internal Axial Force*
Authors: Hao Guangbo , Li Haiyang
Published: January 2016

Extended nonlinear analytical modeling and analysis of compound parallelogram mechanisms are conducted in this paper to consider the effect of the initial internal axial force. The nonlinear analytical model of a compound basic parallelogram mechanism (CBPM) is first derived incorporating the initial internal axial force. The stiffness equations of compound multibeam parallelogram mechanisms (CMPMs) are then followed. The analytical maximal stress under the primary actuation force only is also derived to determine the maximal primary motion (motion range). The influence of initial internal axial forces on the primary motion/stiffness is further quantitatively analyzed by considering different slenderness ratios, which can be employed to consider active displacement preloading control and/or thermal effects. The criterion that the primary stiffness may be considered “constant” is defined and the initial internal axial force driven by a temperature change is also formulated. A physical preloading system to control the initial internal axial force is presented and testing results of the object CBPM are compared with theoretical ones.
Two-Pronged Jet Formation Caused by Droplet Impact on Anisotropic Superhydrophobic Surfaces
Authors: Pearson J. T. , Bilodeau D. , Maynes D.
Published: January 2016

When a liquid droplet impacts a superhydrophobic surface with anisotropic surface patterning in the form of alternating ribs and cavities, the rebounding droplet may exhibit a unique two-pronged jet emission. Droplet impact experiments with 11 different fluids of viscosity that varied by more than three orders of magnitude were conducted, and this paper quantifies the Capillary number, Ca, and Ohnesorge number, Oh, ranges over which the two-pronged phenomenon occurs. For Oh > 0.0154, the behavior was never observed, while at lower values of Oh, the behavior occurs for an intermediate range of Ca that depends on Oh.
ToF-SIMS analysis of amyloid beta aggregation on different lipid membranes
Authors: Yokoyama Yuta , Aoyagi Satoka , Shimanouchi Toshinori , Iwamura Miki , Iwai Hideo
Published: January 2016

Amyloid beta (Aβ) peptides are considered to be strongly related to Alzheimer's disease. Aβ peptides form a β-sheet structure on hard lipid membranes and it would aggregate to form amyloid fibrils, which are toxic to cells. However, the aggregation mechanism of Aβ is not fully understood. To evaluate the influence of the lipid membrane condition for Aβ aggregation, the adsorption forms of Aβ (1–40) on mixture membranes of lipid 1,2-dimyristoyl-sn-glycero-3-phosphocholine (DMPC) and cholesterol β-d-glucoside (β-CG) were investigated by time-of-flight secondary ion mass spectrometry. As a result, Aβ adsorbed along the localized DMPC lipid on the mixture lipid membranes, whereas it was adsorbed homogeneously on the pure DMPC and β-CG membranes. Moreover, amino acid fragments that mainly existed in the n-terminal of Aβ (1–40) peptide were strongly detected on the localized DMPC region. These results suggested that the Aβ was adsorbed along the localized DMPC lipid with a characteristic orientation. These findings suggest that the hardness of the membrane is very sensitive to coexisting materials and that surface hardness is important for aggregation of Aβ.
An online x‐ray based position validation system for prostate hypofractionated radiotherapy
Authors: Arumugam Sankar , Sidhom Mark , Xing Aitang , Holloway Lois
Published: January 2016

Purpose:

Accurate positioning of the target volume during treatment is paramount for stereotactic body radiation therapy (SBRT). In this work, the authors present the development of an in‐house software tool to verify target position with an Elekta‐Synergy linear accelerator using kV planar images acquired during treatment delivery.

Methods:

In‐house software, SeedTracker, was developed in matlab to perform the following three functions: 1. predict intended seed positions in a planar view perpendicular to any gantry angle, simulating a portal imaging device, from the 3D seed co‐ordinates derived from the treatment planning system; 2. autosegment seed positions in kV planar images; and 3. report the position shift based on the seed positions in the projection images. The performance of SeedTracker was verified using a CIRS humanoid phantom (CIRS, VA, USA) implanted with three Civco gold seed markers (Civco, IA, USA) in the prostate. The true positive rate of autosegmentation (TPRseg) and the accuracy of the software in alerting the user when the isocenter position was outside the tolerance (TPRtrig) were studied. Two‐dimensional and 3D static position offsets introduced to the humanoid phantom and 3D dynamic offsets introduced to a gel phantom containing gold seeds were used for evaluation of the system.

Results:

SeedTracker showed a TPRseg of 100% in the humanoid phantom for projection images acquired at all angles except in the ranges of 80°–100° and 260°–280° where seeds are obscured by anatomy. This resulted in a TPRtrig of 88% over the entire treatment range for considered 3D static offsets introduced to the phantom. For 2D static offsets where the position offsets were only introduced in the anterior–posterior and lateral directions, the TPRtrig of SeedTracker was limited by both seed detectability and positional offset. SeedTracker showed a false positive trigger in the projection angle range between 130°–170° and 310°–350° (a maximum of 24% of treatment time) due to limited information that can be derived from monoscopic images. The system accurately determined the dynamic trajectory of the isocenter position in the superior and inferior direction for the studied dynamic offset scenarios based on the seed position in monoscopic images.

Conclusions:

The developed software has been shown to accurately autosegment the seed positions in kV planar images except for two 20° arcs where seeds are obscured by anatomical structures. The isocenter trajectories determined by the system, based on the monoscopic images, provide useful information for monitoring the prostate position. The developed system has potential application for monitoring prostate position during treatment delivery in linear accelerator based SBRT.
Rare isotopes offer clues to the chemistry of the planet
Authors: Hand Eric
Published: January 2016

New lab tools bring exotic isotopic signatures into view.
Researchers claim to find HIV sanctuaries
Authors: Cohen Jon
Published: January 2016

The most powerful antiretrovirals may not reach virus lurking in some tissues.
How can higher-yield farming help to spare nature?
Authors: Phalan Ben , Green Rhys E. , Dicks Lynn V. , Dotta Graziela , Feniuk Claire , Lamb Anthony , Strassburg Bernardo B. N. , Williams David R. , Ermgassen Erasmus K. H. J. zu , Balmford Andrew
Published: January 2016

Mechanisms to link yield increases with conservation
A zebrafish melanoma model reveals emergence of neural crest identity during melanoma initiation
Authors: Kaufman Charles K. , Mosimann Christian , Fan Zi Peng , Yang Song , Thomas Andrew J. , Ablain Julien , Tan Justin L. , Fogley Rachel D. , van Rooijen Ellen , Hagedorn Elliott J. , Ciarlo Christie , White Richard M. , Matos Dominick A. , Puller Ann-Christin , Santoriello Cristina , Liao Eric C. , Young Richard A. , Zon Leonard I.
Published: January 2016

Visualizing the beginnings of melanoma

In cancer biology, a tumor begins from a single cell within a group of precancerous cells that share genetic mutations. Kaufman
et al.
used a zebrafish melanoma model to visualize cancer initiation (see the Perspective by Boumahdi and Blanpain). They used a fluorescent reporter that specifically lit up neural crest progenitors that are only present during embryogenesis or during adult melanoma tumor formation. The appearance of this tumor correlated with a set of gene regulatory elements, called super-enhancers, whose identification and manipulation may prove beneficial in detecting and preventing melanoma initiation.

Science
, this issue p.
10.1126/science.aad2197
; see also p.
453