bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of equations to estimate body composition in beef cattle using live, linear and standing-rib cut measurements
Authors: Fonseca M. A. , Tedeschi L. O. , Filho S. C. Valadares , De Paula N. F. , Silva L. D. , Sathler D. F. T.
Published: May 2016

Quick and reliable methods to estimate body and carcass composition of beef cattle are needed to predict the most profitable slaughter weight. This study evaluates body compositional equations using biometric measurements (BM), dissected fat (kg) at the 9–11th rib section and rib fat depth (cm). The present independent dataset used to evaluate the equations comprised of 48 F1 Nellore × Angus bulls (B) and steers (S); aged 12.5 ± 0.51 months with a mean shrunk BW (SBW) of 233 ± 23.5 and 238 ± 24.6 kg for B and S, respectively. Animals were fed a diet of 60% corn silage and 40% concentrate ad libitum. Eight animals were slaughtered at the beginning of the trial and the remaining animals were randomly assigned into a 2 (sex) × 3 (slaughter weights) factorial arrangement, and slaughtered when the average BW of the group reached 380 (6B and 5S), 440 (6B and 5S), 500 kg (5B and 5S). In addition, eight animals (4B and 4S) were fed at the maintenance level intake and slaughtered with the 500-kg group. Before slaughter, animals were led through a squeeze chute to collect BM, which included hook bone width, pin bone width, abdomen width, body length, rump height, height at withers, pelvic girdle length, rib depth, girth circumference, rump depth, body diagonal length, and thorax width. The following post-mortem measurements were included: total body surface, body volume (BV, m3), subcutaneous fat, internal fat, intermuscular fat, carcass physical fat (CF, kg), empty body fat (EBF, kg), carcass chemical fat (kg), empty body chemical fat (kg), fat thickness (cm) in the 12th rib, and 9–11th rib section fat. The predicted values were compared with the observed. Among all evaluated equations, only five were found to be adequate for F1 Nellore × Angus: Eqns (7): BV = 0.036 (±0.016) + 1.028 (±0.049) × BVcylinder (n = 28, RMSE = 0.016 m3, r2 = 0.942) and (8): BV = –0.011 (±0.004) + 9.8 × 10–4 (±1.84 × 10–5) × SBW (n = 27, RMSE = 0.003 m3, r2 = 0.997), to estimate BV; and Eqns (27): EBF = –16.8 (±2.68) + 0.142 (±0.008) × SBW (n = 36, RMSE = 4.17 kg, r2 = 0.897), (28): EBF = 0.011 (±0.002) × SBW + 1.22 (±0.024) × CF (n = 35, RMSE = 0.69 kg, r2 = 0.999), and (32): EBF = 1.445 (±0.010) × CF (n = 43, RMSE = 1.51 kg, r2 = 0.998), to estimate EBF. More research is needed to create a robust prediction of carcass and empty body fat using BM for animals of different breeds under diverse production conditions.
A regional model of sheep lice management practices to examine the impact of managing straying sheep combined with other management choices
Authors: Lucas Peri G. , Horton Brian J. , Parsons David , Carew Anna L.
Published: May 2016

A model of lice management systems was used to investigate the potential benefits of improved fencing against straying sheep, used in conjunction with other management options for lice control. The impact of combined strategies was simulated over a 20-year period. Management options included in the model were: lice eradication rate, lice detection, intervention level, improved fencing to reduce straying sheep, and biosecurity of purchased sheep. The modelling found it was cost-effective to improve fences for an initial average cost of $20 000/property if the number of properties from which strays could enter was reduced by ≥40%, but for average Australian properties this represents less than 20% of the boundary replaced. In order for fencing to be a cost-effective part of lice management, the fencing must target sections of boundary fence that will provide the greatest protection from contact with neighbouring flocks. The model showed that improved biosecurity against straying sheep combined well with improved eradication rates. However, biosecurity for purchased sheep may be the most cost-effective option.
Bioinspired Polymers: Antimicrobial Polymethacrylates
Authors: Locock Katherine E. S.
Published: May 2016

Naturally occurring antimicrobial peptides have been honed by evolution over millions of years to give highly safe and efficacious antimicrobials that form part of many organisms’ immune systems. By studying these peptides to identify key aspects of structure and composition, suitable synthetic polymer mimics can be designed that hold potential as anti-infective agents. This review focusses on an important aspect of peptide mimicry, that of replicating the chemical functionality provided by key amino acids present in antimicrobial peptides. These include polymethacrylate mimics of arginine-rich and tryptophan-rich peptides. Systematic investigation of the structure–activity relationships of these polymers identifies the guanidine based poly(methylmethacrylate-co-2-guanidinoethyl methacrylate) (pMMA-co-GEMA) copolymers with low molecular weight and low methyl content as having superior activity profiles when compared with all other combinations. Unique antibiofilm activity of these polymers is also revealed in in vitro testing against monomicrobial and polymicrobial biofilms of the bacteria Staphylococcus aureus and the fungus Candida albicans. This highlights Mother Nature as an important resource in drug development and identifies the arginine-mimicking polymethacrylates as important leads for the development of a new generation of antimicrobial agents to tackle resistance.
Partnerships and the past: reflections on 1940s community centre endeavours of the National Fitness Council
Authors: Madsen Wendy
Published: May 2016

Issue addressed

Multisectoral and multilevel partnerships have been used in Australia since the 1940s to promote health. Examination of historical partnerships can offer insights into current practice.

Methods

Historical method was used to analyse archival material regarding the role of the National Fitness Council (NFC) and its partnerships under the Federal Government's program to establish community centres.

Results

Inadequate funding, messy organisational structures, a broadly defined goal and limited capacity within the NFC inhibited its work in regards to community centres.

Conclusions

Although the policy of establishing community centres was ultimately unsuccessful, this examination has analysed the partnerships between the NFC and various levels of governments, and the effect of the political and economic context on them.

So what?

Current health promotion practitioners can draw on the past to gain insight into potential problems and issues.
Isolation and characterisation of 12 polymorphic microsatellite loci for the threatened mound-building malleefowl, Leipoa ocellata (Aves : Megapodiidae)
Authors: Cope Taneal M. , Bertozzi Terry , Mulder Raoul A. , Donnellan Stephen C.
Published: May 2016

Using 454 pyrosequencing and genomic enrichment techniques we developed 12 polymorphic markers for the endangered megapode, the malleefowl (Leipoa ocellata). Pyrosequencing on a 454 instrument resulted in 65 536 reads, with 3469 containing microsatellite repeats. Of these, 232 contained unique flanking sequences and had more than 8 repeat motifs. We chose 13 loci based on reliability of amplification and, from these, 12 unlinked loci were selected for genotyping. In a single population (n = 19), the 12 markers were moderately polymorphic (number of alleles per locus range = 3–7) and showed moderate to high levels of heterozygosity (0.285–0.882). Nine microsatellite primer pairs developed from the brush turkey (Alectura lathami), the closest living relative of the malleefowl in the family, Megapodiidae, failed to reliably amplify malleefowl DNA.
Thy1+IL-7+lymphatic endothelial cells in iBALT provide a survival niche for memory T-helper cells in allergic airway inflammation
Authors: Shinoda Kenta , Hirahara Kiyoshi , Iinuma Tomohisa , Ichikawa Tomomi , Suzuki Akane S. , Sugaya Kaoru , Tumes Damon J. , Yamamoto Heizaburo , Hara Takahiro , Tani-ichi Shizue , Ikuta Koichi , Okamoto Yoshitaka , Nakayama Toshinori
Published: May 2016

Significance

A substantial proportion of people have intractable chronic allergic diseases for which no curative treatment exists. A clear understanding of how these allergic diseases develop and persist is lacking. Here, unique ectopic lymphoid-like structures called inducible bronchus-associated lymphoid tissue were found to be formed during chronic airway inflammation, and were critical in persistent inflammation. In addition, we identified a Thy1+IL-7+IL-33+subset of lymphatic endothelial cells (LECs) that support the maintenance of memory-type pathogenic T helper 2 (Tpath2) cells. A similar population of IL-7+IL-33+LECs was found in nasal polyps of patients with eosinophilic chronic rhinosinusitis. Thus, we revealed that Thy1+IL-7–producing LECs control chronic allergic airway inflammation by supporting memory-type Tpath2 cells in human and mouse systems.
Predicting the evolutionary dynamics of seasonal adaptation to novel climates in
Arabidopsis thaliana
Authors: Fournier-Level Alexandre , Perry Emily O. , Wang Jonathan A. , Braun Peter T. , Migneault Andrew , Cooper Martha D. , Metcalf C. Jessica E. , Schmitt Johanna
Published: May 2016

Significance

Anticipating the effect of climate change on plants requires understanding its evolutionary consequence on traits and genes in complex realistic environments. How seasonal variation has an impact on the dynamics of adaptation in natural populations remains unclear. We simulated adaptation to different climate change scenarios, grounding our analysis in experimental data and explicitly exploring seasonal variation. Seasonal variation dramatically affected the dynamics of adaptation: Marked seasonality led to genetic differentiation within the population to different seasonal periods, whereas low seasonality led to a single population with fast-evolving fitness. Our results suggest the prevalence of phenotypic plasticity across environmental conditions in determining how climate change will shift selection on traits and loci. In this unpredictable context, maintaining broad genomic diversity is critical.
Three-dimensionally preserved minute larva of a great-appendage arthropod from the early Cambrian Chengjiang biota
Authors: Liu Yu , Melzer Roland R. , Haug Joachim T. , Haug Carolin , Briggs Derek E. G. , Hörnig Marie K. , He Yu-yang , Hou Xian-guang
Published: May 2016

Significance

Understanding the nature of the Cambrian radiation involves knowing not only the morphologies of adult animals but also their developmental pathways. However, fossil evidence of early larvae is rare. Here we describe a well-preserved 2-mm-long larva of the short-great-appendage arthropodLeanchoilia illecebrosafrom the early Cambrian Chengjiang biota. The exceptional 3D preservation has allowed our microcomputed tomography analyses to resolve a series of rudimentary limb Anlagen in the posterior portion of the larva—an arrangement resembling that in late-stage eucrustacean metanauplii.L. illecebrosais considered as an early representative of either chelicerates or of euarthropods as a whole. Therefore, this discovery provides fossil evidence that posthatching segment addition is a feature rooted in the ancestor of Euarthropoda.
Riches of phenotype computationally extracted from microbial colonies
Authors: Liu Tzu-Yu , Dodson Anne E. , Terhorst Jonathan , Song Yun S. , Rine Jasper
Published: May 2016

Significance

The genome and physiology of a cell can undergo complex changes among the many cells that make up a growing microbial colony. Genetic and physiological dynamics can be revealed by measuring reporter-gene expression, but rigorous quantitative analysis of colony-wide patterns has been underexplored. Here, we developed a suite of automated image processing, feature extraction, visualization, and classification algorithms to facilitate the analysis of sectoring patterns in
Saccharomyces
colonies. Classification results for various mutants and for colonies grown under different environmental conditions revealed significant differences in sectoring that were not apparent by visual inspection.
Bacteriocin from epidemicListeriastrains alters the host intestinal microbiota to favor infection
Authors: Quereda Juan J. , Dussurget Olivier , Nahori Marie-Anne , Ghozlane Amine , Volant Stevenn , Dillies Marie-Agnès , Regnault Béatrice , Kennedy Sean , Mondot Stanislas , Villoing Barbara , Cossart Pascale , Pizarro-Cerda Javier
Published: May 2016

Significance

Listeria monocytogenesis a bacterial pathogen responsible for listeriosis, a foodborne disease characterized by septicemia and abortion in pregnant women. The most severe listeriosis outbreaks are associated with a subset of bacterial epidemic clones, although the underlying virulence mechanisms of these clones remain elusive. Here, we demonstrate, to our knowledge for the first time, that these epidemic strains secrete a bacteriocin specifically in the gut and alter host intestinal microbiota, allowingL. monocytogenescolonization of the intestine and, consequently, invasion of deeper organs. Therefore, our work shows that epidemic listeriosis implicates not only interactions betweenL. monocytogenesand host cells, but also interactions betweenL. monocytogenesand the host intestinal microbiota that are critical for the establishment of infection.
Dopamine pathway is highly diverged in primate species that differ markedly in social behavior
Authors: Bergey Christina M. , Phillips-Conroy Jane E. , Disotell Todd R. , Jolly Clifford J.
Published: May 2016

Significance

Our study provides insight into the genetic factors underpinning complex behaviors via comparative study of wild primates differing in social system. This research is among the first investigations of social behavior through population genomic scans for adaptive divergence in wild primate groups using an unparalleled sample set that spans decades. Our main conclusion, that a dopamine pathway underlies the social behavioral differences seen, offers comparative insight into the evolution of human behavioral and psychiatric phenotypes. We suggest that variation in impulsivity or boldness has played a major role in the evolution of socially complex species such as primates.
Regulation of genetic flux between bacteria by restriction–modification systems
Authors: Oliveira Pedro H. , Touchon Marie , Rocha Eduardo P. C.
Published: May 2016

Significance

The role of restriction–modification (R-M) as bacteria's innate immune system, and a barrier to sexual exchange, has often been challenged. Recent works suggested that the diversification of these systems might have driven the evolution of highly virulent bacterial lineages. Here, we showed that R-M systems were more abundant in species enduring more DNA exchanges and that within-species flux of genetic material was higher when cognate systems were present. Presumably, bacteria enduring frequent infections by mobile elements select for the presence of more numerous R-M systems, but rapid diversification of R-M systems leads to varying patterns of sexual exchanges between bacterial lineages.
Selective expression of mutant huntingtin during development recapitulates characteristic features of Huntington’s disease
Authors: Molero Aldrin E. , Arteaga-Bracho Eduardo E. , Chen Christopher H. , Gulinello Maria , Winchester Michael L. , Pichamoorthy Nandini , Gokhan Solen , Khodakhah Kamran , Mehler Mark F.
Published: May 2016

Significance

Research initiatives in Huntington’s disease (HD) have traditionally focused on defining the biological processes mediating neuronal dysfunction and death during adult life. In contrast to these classical approaches, we have shown that selective exposure to the pathogenic protein during development recapitulates characteristic features of HD. These findings support the hypothesis that putative HD-associated developmental impairments in neurogenesis contribute to regional cellular vulnerabilities to late-life stressors leading to dysfunction culminating in cell death. An implication of our findings is that the spectrum of developmental alterations can be held in check for many decades after the birth of these vulnerable neuronal subtypes, thus defining a previously unidentified window for therapeutic interventions at a time when irreversible neural degeneration has not yet occurred.
Transcription factors Mix1 and VegT, relocalization of
vegt
mRNA, and conserved endoderm and dorsal specification in frogs
Authors: Sudou Norihiro , Garcés-Vásconez Andrés , López-Latorre María A. , Taira Masanori , del Pino Eugenia M.
Published: May 2016

Significance

The transcription factors VegT and Mix1 are markers of the future gut (presumptive endoderm) of the frog
Xenopus laevis.
VegT and Mix1 proteins localized to the embryo vegetal hemisphere, providing an equivalent identity to the presumptive endoderm in the five frog species that were analyzed. Moreover, VegT protein localized to the animal hemisphere in embryos of all frogs. Similarly,
vegt
transcripts relocalized to the dorso-animal region of the egg after fertilization in
X. laevis
, suggesting that
vegt
may participate in dorsal development. In addition,
vegt
transcripts relocalized around vegetal nuclei of
X. laevis
embryos. This relocalization may provide endodermal identity to the large vegetal cells. The results suggest conservation of the developmental strategies for endoderm and dorsal specification in frogs.
Preseason changes in markers of lower body fatigue and performance in young professional rugby union players
Authors: Roe Gregory A. B. , Darrall‐Jones Joshua D. , Till Kevin , Jones Ben
Published: May 2016

This study investigated the changes in measures of neuromuscular fatigue and physical performance in young professional rugby union players during a preseason training period. Fourteen young (age: 19.1 ± 1.2 years) professional rugby union players participated in the study. Changes in measures of lower body neuromuscular fatigue (countermovement jump (CMJ) mean power, mean force, flight‐time) and physical performance (lower body strength, 40 m sprint velocity) were assessed during an 11‐week preseason period using magnitude‐based inferences. CMJ mean power was likely to very likely decreased during week 2 (−8.1 ± 5.5% to −12.5 ± 6.8%), and likely to almost certainly decreased from weeks 5 to 11 (−10 ± 4.3% to −14.7 ± 6.9%), while CMJ flight‐time demonstrated likely to very likely decreases during weeks 2, and weeks 4–6 (−2.41 ± 1% to −3.3 ± 1.3%), and weeks 9–10 (−1.9 ± 0.9% to −2.2 ± 1.5%). Despite this, possible improvements in lower body strength (5.8 ± 2.7%) and very likely improvements in 40 m velocity (5.5 ± 3.6%) were made. Relationships between changes in CMJ metrics and lower body strength or 40 m sprint velocity were trivial or small (<0.22). Increases in lower body strength and 40 m velocity occurred over the course of an 11‐week preseason despite the presence of neuromuscular fatigue (as measured by CMJ). The findings of this study question the usefulness of CMJ for monitoring fatigue in the context of strength and sprint velocity development. Future research is needed to ascertain the consequences of negative changes in CMJ in the context of rugby‐specific activities to determine the usefulness of this test as a measure of fatigue in this population.
The Medical Science DMZ
Authors: Peisert Sean , Barnett William , Dart Eli , Cuff James , Grossman Robert L , Balas Edward , Berman Ari , Shankar Anurag , Tierney Brian
Published: May 2016

Objective We describe use cases and an institutional reference architecture for maintaining high-capacity, data-intensive network flows (e.g., 10, 40, 100 Gbps+) in a scientific, medical context while still adhering to security and privacy laws and regulations.

Materials and Methods High-end networking, packet filter firewalls, network intrusion detection systems.

Results We describe a “Medical Science DMZ” concept as an option for secure, high-volume transport of large, sensitive data sets between research institutions over national research networks.

Discussion The exponentially increasing amounts of “omics” data, the rapid increase of high-quality imaging, and other rapidly growing clinical data sets have resulted in the rise of biomedical research “big data.” The storage, analysis, and network resources required to process these data and integrate them into patient diagnoses and treatments have grown to scales that strain the capabilities of academic health centers. Some data are not generated locally and cannot be sustained locally, and shared data repositories such as those provided by the National Library of Medicine, the National Cancer Institute, and international partners such as the European Bioinformatics Institute are rapidly growing. The ability to store and compute using these data must therefore be addressed by a combination of local, national, and industry resources that exchange large data sets. Maintaining data-intensive flows that comply with HIPAA and other regulations presents a new challenge for biomedical research. Recognizing this, we describe a strategy that marries performance and security by borrowing from and redefining the concept of a “Science DMZ”—a framework that is used in physical sciences and engineering research to manage high-capacity data flows.

Conclusion By implementing a Medical Science DMZ architecture, biomedical researchers can leverage the scale provided by high-performance computer and cloud storage facilities and national high-speed research networks while preserving privacy and meeting regulatory requirements.
CLABSI Reduction Strategy
Authors: Wilder Kerry A. , Wall Brittany , Haggard David , Epperson Tiffany
Published: May 2016

Background:

Central line–associated bloodstream infections (CLABSIs) are the most common hospital-acquired infections costing hospitals millions of dollars annually. An evidence-based practice literature review revealed that utilizing a systematic team approach for proper line maintenance is effective in reducing CLABSI rates.

Purpose:

The purpose of this quality improvement initiative was to reduce the CLABSI rate in the neonatal intensive care unit from 3.9 per 1000 line days in 2011 by at least 50% in 2014. Policies, protocols, team members utilized, competencies, and techniques were created and a formal line-rounding and dressing change competency was established. The competency included specific criteria for performing daily line rounds and a 2-person sterile technique for dressing changes.

Findings/Results:

Central line–associated bloodstream infection rate was effectively reduced from 3.9 in 2011 to 0.3 per 1000 line days in 2014, with an overall 92% improvement.

Implications for Practice:

Introduction of a dedicated CLABSI team has been shown to be effective in the reduction of CLABSI rates in the neonatal intensive care unit.

Implications for Research:

Further research is needed to evaluate how a team approach could be used to reduce other hospital-acquired conditions; catheter-associated urinary tract infection, and hospital-acquired pressure ulcers.
Developmental Care in North American Pediatric Cardiac Intensive Care Units
Authors: Sood Erica , Berends Wilma M. , Butcher Jennifer L. , Lisanti Amy J. , Medoff-Cooper Barbara , Singer Jayne , Willen Elizabeth , Butler Samantha
Published: May 2016

Background:

Developmental care practices across pediatric cardiac intensive care units (CICUs) have not previously been described.

Purpose:

To characterize current developmental care practices in North American CICUs.

Methods:

A 47-item online survey of developmental care practices was developed and sent to 35 dedicated pediatric CICUs. Staff members who were knowledgeable about developmental care practices in the CICU completed the survey.

Findings/Results:

Completed surveys were received from 28 CICUs (80% response rate). Eighty-nine percent reported targeted efforts to promote developmental care, but only 50% and 43% reported having a developmental care committee and holding developmental rounds, respectively. Many CICUs provide darkness for sleep (86%) and indirect lighting for alertness (71%), but fewer provide low levels of sound (43%), television restrictions (43%), or designated quiet times (21%). Attempts to cluster care (82%) and support self-soothing during difficult procedures (86%) were commonly reported, but parental involvement in these activities is not consistently encouraged. All CICUs engage in infant holding, but practices vary on the basis of medical status and only 46% have formal holding policies.

Implications for Practice:

Implementation of developmental care in the CICU requires a well-planned process to ensure successful adoption of practice changes, beginning with a strong commitment from leadership and a focus on staff education, family support, value of parents as the primary caregivers, and policies to increase consistency of practice.

Implications for Research:

Future studies should examine the short- and long-term effects of developmental care practices on infants born with congenital heart disease and cared for in a pediatric CICU.
Neonatal Resuscitation Training
Authors: Jnah Amy J. , Newberry Desi M. , Trembath Andrea N. , Robertson Tracey , Downing April , Greene Miriam , Sewell Kerry
Published: May 2016

Background:

The Neonatal Resuscitation Program's (NRP's) Sixth Edition introduced simulation-based training (SBT) into neonatal life support training. SBT offers neonatal emergency response teams a safe, secure environment to rehearse coordinated neonatal resuscitations. Teamwork and communication training can reduce tension and anxiety during neonatal medical emergencies.

Purpose:

To discuss the implications of variability in number and type of simulation scenario, number and type of learners who comprise a course, and their influence upon scope of practice, role confusion, and role ambiguity.

Methods:

Relevant articles from MEDLINE, CINAHL, EMBASE, Google Scholar, the World Health Organization, the American Heart Association, and NRP were included in this integrative review of the literature.

Findings/Results:

Purposeful synergy of optimal SBT course construct with teamwork and communication can resist discipline compartmentalization, role confusion, and role ambiguity. Five key themes were identified and coined the “5 Rights” of NRP SBT. These “5 Rights” can guide healthcare institutions with planning, implementation, and evaluation of NRP SBT courses.

Implications for Practice:

NRP SBT can facilitate optimal team function and reduce errors when teams of learners and varied scenarios are woven into the course construct. The simulated environment must be realistic and fully equipped to encourage knowledge transfer and attainment of the NRP's key behavioral outcomes.

Implications for Research:

Investigation of teamwork and communication training with NRP SBT, course construct, discipline compartmentalization, and behavioral and clinical outcomes is indicated. Investigation of outcomes of SBT using a team-teaching model, combining basic and advanced practice NRP instructors, is indicated.
Perceptions of Palliative Care in the NICU
Authors: Falck Alison J. , Moorthy Sheela , Hussey-Gardner Brenda
Published: May 2016

Background and Purpose:

The American Academy of Pediatrics supports palliative care (PC) for all children with life-threatening illnesses. Thus, many neonatal intensive care unit (NICU) patients and their families could benefit from PC. Our study objective was to examine provision of PC as experienced by mothers and healthcare providers (HCPs) of NICU patients with life-threatening illnesses. Palliative care components explored included communication, choices, comfort, psychosocial and spiritual needs, and coordination of care.

Methods:

In this qualitative, descriptive study, we conducted semistructured interviews with mothers of infants with life-threatening illnesses and NICU HCPs who cared for these infants. Mothers selected HCPs who were key figures during their infant's NICU stay to participate. Interviews were transcribed and manually coded until themes emerged and theoretical saturation was achieved. Researchers reviewed charts for demographics and notes pertaining to PC. Triangulation of maternal interviews, HCP interviews, and chart notes was performed.

Results:

Theoretical saturation was achieved after 12 interviews. Mothers identified 5 nurses and 1 physician to be interviewed. Five themes were identified following data analysis and triangulation: (1) communication, (2) privacy, (3) continuity of care and relationship building, (4) maternal knowledge seeking, and (5) emotional turmoil.

Implications for Practice and Research:

Of domains of pediatric PC explored, participants emphasized transparent communication, family meetings as a venue for collaboration and shared decision making, the significance of psychosocial support for maternal emotional distress, and the importance of continuity of care across an often long and stressful hospitalization. Although mothers desired privacy, participants valued the security of the open-room NICU design. Future research should address components of PC that predominate in this specialized population.
Clavicle Fracture Is Not Predictive of the Need for Microsurgery in Brachial Plexus Birth Palsy
Authors: Leshikar Holly B. , Bauer Andrea S. , Lightdale-Miric Nina , Molitor Fred , Waters Peter M.
Published: May 2016

Background:

Brachial plexus birth palsy (BPBP) and clavicle fractures occur concurrently as well as in isolation during difficult deliveries. The concept that concurrent clavicle fracture may spare nerve injury has been advocated. Our aim was to compare those children with BPBP presenting to a tertiary care center with and without concurrent clavicle fractures and assess the utility of the presence of a clavicle fracture as a predictor of injury severity in children with BPBP.

Methods:

Records of all patients belonging to a large prospective multicenter cohort study of infants with BPBP (Treatment and Outcomes of Brachial Plexus Injuries study) were analyzed for demographic information and birth information including risk factors, comorbidity, presence of clavicle fracture, and injury severity.

Results:

The records of 639 children with BPBP were examined. Thirteen patients were excluded for incomplete data. Ninety-six children who sustained concurrent birth fracture and BPBP were identified (15%). Of these, 57 sustained clavicle fractures (9%), 44 sustained humerus fractures, and 4 sustained other fractures. Of the demographic factors analyzed, only the presence of gestational diabetes was found to be significantly higher in those children with fractures versus those without. The presence of a clavicle fracture did not change the rate of microsurgical intervention, nor did clavicle fracture rates differ by Toronto score, suggesting that there was no difference in injury severity between the 2 groups.

Conclusions:

In a large multicenter prospective study, 9% of children presenting with BPBP also sustained a clavicle fracture at birth. The presence of a clavicle fracture did not correlate with the severity of brachial plexus injury. We suggest that in study populations of children with severe enough BPBP to present to a tertiary care center, compared with studies collected in the obstetric population, the presence of a clavicle fracture is neither protective from nerve injury nor predictive of injury severity.

Level of Evidence:

Level 2—prognostic.
The surgical management of cephalalgia
Authors: Osborn Timothy M.
Published: May 2016

Purpose of review

Management of headache disorders is not part of most craniomaxillofacial surgery practices; however there are certain indications for surgical management of headaches by the craniomaxillofacial surgeon.

Recent findings

Migraine headaches are the most amenable to surgical management and while the exact mechanism of migraine is unknown, a central or peripheral trigger such as compressive neuropathy of trigeminal nerve branches leading to neurogenic inflammation has been suggested. The primary management for episodic migraine headache should be lifestyle modification and medication, whereas for chronic migraine (>15 headache days/month) use of medication and botulinum neurotoxin is effective, whereas some patients may choose to explore surgical options. Trigger site decompression for chronic migraine surgically relieves anatomic impingement at various sites and has been shown to reduce by at least 50% the frequency, intensity, and duration of headaches in over 85% and elimination of headaches in almost 60%. Trigger points may also lead to exacerbation of cluster headaches and treatment with botulinum neurotoxin may reduce attacks.

Trigger site decompression is an effective treatment for chronic migraine, as are botulinum neurotoxin injections in reducing attacks in cluster headaches. The craniomaxillofacial surgeon is uniquely qualified to treat these primary headache disorders.
Redesign of chronic illness care in children and adolescents: evidence for the chronic care model
Authors: Adams John S. , Woods Elizabeth R.
Published: May 2016

Purpose of review

This article provides an overview of the chronic care model (CCM), examines the evidence for its utility in pediatric and adolescent chronic illness, and discusses practical steps for improving chronic illness care in the pediatric medical home.

Recent findings

Few studies have used the CCM as an improvement framework in pediatrics. However, in recent years, several quality improvement efforts based on the CCM have demonstrated improvement in important process measures or clinical outcomes in pediatric or adolescent obesity, inflammatory bowel disease, attention-deficit/hyperactivity disorder, depression, and asthma.

The CCM is an improvement framework that has demonstrated success in improving the care of children and adolescents with chronic disease. More research is needed to identify priority conditions for improvement efforts, to better understand the mediators of health outcomes in pediatric chronic disease, and to rigorously demonstrate the effectiveness of new models of chronic illness care. The evidence to date suggests that the CCM may be useful in guiding the redesign of care delivery systems to improve the health outcomes of young people with chronic disease.
Predictors of Patient Satisfaction With Pain Management in the Emergency Department
Authors: Fallon Echo , Fung Sierra , Rubal-Peace Georgina , Patanwala Asad E.
Published: May 2016

To identify predictors of patient satisfaction with pain control measured after emergency department (ED) discharge. This was a prospective, cross-sectional study conducted in an academic, urban ED in the United States. Adult patients with a pain-related complaint were interviewed via telephone within 72 hr of discharge from the ED. A standardized questionnaire was used to obtain demographic and clinical information. The primary outcome of interest was patient satisfaction with pain management in the ED measured using the following question: “How often was your pain well controlled in the ED?” (0–10 scale; 0 = never, 10 = always). Linear regression analyses were used to identify predictors of pain satisfaction. The study included 75 patients. The mean age of patients was 43 ± 18 years, and the majority of patients were female (n = 47; 63%). There were 24 patients (32%) who had chronic pain conditions, 23 (31%) with depression, and 2 patients who admitted to using heroin. In the multivariate regression analysis, patient perception of enough pain medication provision (coefficient = 2.81; 95% CI [1.35, 4.26]; p < 0.001), staff helpfulness (coefficient = 0.35; 95% CI [0.10, 0.59]; p = 0.006), report of generalized pain (coefficient = −1.62; 95% CI [−2.87, −0.36]; p = 0.013), and lowest pain score achieved in the ED (coefficient = −0.30; 95% CI [−0.53, −0.04]; p = 0.021) was significantly associated with patient satisfaction (model R
2 = 0.57). Patient perception of enough pain medication provision, staff helpfulness, lowest pain scores achieved, and patient report of generalized pain were associated with satisfaction with pain management in the ED.
Complements Are Not Always a Good Thing
Authors: Bailey Abby Mynatt , Reed Brittany S. , Weant Kyle A. , Justice Stephanie Baker
Published: May 2016

Hereditary angioedema attacks are rare, but emergency care providers must be aware of the clinical presentation and treatment of these patients because the emergency department remains the most common setting where these patients seek treatment. If providers are not aware of the past medical history of these patients, they are likely to receive standard therapies for respiratory distress and anaphylaxis including antihistamines, corticosteroids, and epinephrine. However, these medications may not work in these patients, given the pathophysiology of their underlying disease. Since 2009, several new therapies have been approved for the treatment of acute hereditary angioedema attacks. This article discusses pathophysiology, clinical presentation, and use of novel therapies for the management of angioedema.
Association of Blood Component Ratio With Clinical Outcomes in Patients After Trauma and Massive Transfusion
Authors: Jones Allison R. , Frazier Susan K.
Published: May 2016

Component ratios that mimic whole blood may produce survival benefit in patients massively transfused after trauma; other outcomes have not been reviewed. The purpose of this review was to systematically analyze studies where clinical outcomes were compared on the basis of the component ratios administered during massive transfusion in adult patients after trauma. PubMed, CINAHL, and MEDLINE (Ovid) were searched for studies published in English between 2007 and 2015, performed at Level I or major trauma centers. Twenty-one studies were included in the analysis. We used an adapted 9-item instrument to assess bias risk. The average bias score for the studies was 2.86 ± 1.39 out of 16, indicating a low bias risk. The most common bias sources were lack of data about primary outcomes and adverse events. Those who received high ratios experienced not only greater survival benefit but also higher rates of multiple-organ failure; all other clinical outcomes findings were equivocal.
The Presence of Pretransplant Antiphospholipid Antibodies IgA Anti-β-2-Glycoprotein I as a Predictor of Graft Thrombosis After Renal Transplantation
Authors: Morales Jose Maria , Serrano Manuel , Martínez-Flores Jose Angel , Pérez Dolores , Castro Maria José , Sánchez Elena , García Florencio , Rodríguez-Antolín Alfredo , Alonso Marina , Gutierrez Eduardo , Morales Enrique , Praga Manuel , González Esther , Andrés Amado , Paz-Artal Estela , Martínez Miguel Angel , Serrano Antonio
Published: May 2016

Background

Vessel thrombosis is a severe complication after renal transplantation. Antibodies anti-β-2 glycoprotein-I of IgA isotype (IgA-aB2GP1) have been linked to thrombotic events and mortality in hemodialysis patients.

Methods

All kidney transplanted patients from 2000 to 2011 (n = 1375) in our hospital were followed up for 2 years, evaluating 3 time periods.

Results

At transplantation, 401 patients were positive for IgA-aB2GPI (29.2%, group 1), and the remaining patients were negative (group 2). Graft loss at 6 months posttransplantation was higher in group 1 (18% vs 7.2%; P < 0.001). The most frequent cause of early graft loss was vessel thrombosis, especially in group 1 (12.2% vs 2.6% of patients; P < 0.001). In fact, vessel thrombosis was the most important cause of graft loss in the 3 time periods, irrespective of demographic changes and introduction of transplantation with asystolic donors.

Notably, IgA-aB2GP1 was an independent risk factor for graft thrombosis (odds ratio, 5.047; P < 0.001). Furthermore, the presence of IgA-aB2GP1 was associated with early graft loss and delayed graft function. Mortality at 24 months was also higher in group 1.

Conclusions

In conclusion, pretransplant IgA-aB2GP1 was the main risk factor for graft thrombosis and early graft loss. Further research should be made on whether anticoagulation in antibody-positive patients could ameliorate this catastrophic complication.
Applications of fidelity measures to complex quantum systems
Authors: Wimberger Sandro
Published: May 2016

We revisit fidelity as a measure for the stability and the complexity of the quantum motion of single-and many-body systems. Within the context of cold atoms, we present an overview of applications of two fidelities, which we call static and dynamical fidelity, respectively. The static fidelity applies to quantum problems which can be diagonalized since it is defined via the eigenfunctions. In particular, we show that the static fidelity is a highly effective practical detector of avoided crossings characterizing the complexity of the systems and their evolutions. The dynamical fidelity is defined via the time-dependent wave functions. Focusing on the quantum kicked rotor system, we highlight a few practical applications of fidelity measurements in order to better understand the large variety of dynamical regimes of this paradigm of a low-dimensional system with mixed regular–chaotic phase space.
Quantum dynamics of excitations and decoherence in many-spin systems detected with Loschmidt echoes: its relation to their spreading through the Hilbert space
Authors: Sánchez C. M. , Levstein P. R. , Buljubasich L. , Pastawski H. M. , Chattah A. K.
Published: May 2016

In this work, we overview time-reversal nuclear magnetic resonance (NMR) experiments in many-spin systems evolving under the dipolar Hamiltonian. The Loschmidt echo (LE) in NMR is the signal of excitations which, after evolving with a forward Hamiltonian, is recovered by means of a backward evolution. The presence of non-diagonal terms in the non-equilibrium density matrix of the many-body state is directly monitored experimentally by encoding the multiple quantum coherences. This enables a spin counting procedure, giving information on the spreading of an excitation through the Hilbert space and the formation of clusters of correlated spins. Two samples representing different spin systems with coupled networks were used in the experiments. Protons in polycrystalline ferrocene correspond to an ‘infinite’ network. By contrast, the liquid crystalN-(4-methoxybenzylidene)-4-butylaniline in the nematic mesophase represents a finite proton system with a hierarchical set of couplings. A close connection was established between the LE decay and the spin counting measurements, confirming the hypothesis that the complexity of the system is driven by the coherent dynamics.
From Loschmidt daemons to time-reversed waves
Authors: Fink Mathias
Published: May 2016

Time-reversal invariance can be exploited in wave physics to control wave propagation in complex media. Because time and space play a similar role in wave propagation, time-reversed waves can be obtained by manipulating spatial boundaries or by manipulating time boundaries. The two dual approaches will be discussed in this paper. The first approach uses ‘time-reversal mirrors’ with a wave manipulation along a spatial boundary sampled by a finite number of antennas. Related to this method, the role of the spatio-temporal degrees of freedom of the wavefield will be emphasized. In a second approach, waves are manipulated from a time boundary and we show that ‘instantaneous time mirrors’, mimicking the Loschmidt point of view, simultaneously acting in the entire space at once can also radiate time-reversed waves.
Lyapunov decay in quantum irreversibility
Authors: García-Mata Ignacio , Roncaglia Augusto J. , Wisniacki Diego A.
Published: May 2016

The Loschmidt echo—also known as fidelity—is a very useful tool to study irreversibility in quantum mechanics due to perturbations or imperfections. Many different regimes, as a function of time and strength of the perturbation, have been identified. For chaotic systems, there is a range of perturbation strengths where the decay of the Loschmidt echo is perturbation independent, and given by the classical Lyapunov exponent. But observation of the Lyapunov decay depends strongly on the type of initial state upon which an average is carried out. This dependence can be removed by averaging the fidelity over the Haar measure, and the Lyapunov regime is recovered, as has been shown for quantum maps. In this work, we introduce an analogous quantity for systems with infinite dimensional Hilbert space, in particular the quantum stadium billiard, and we show clearly the universality of the Lyapunov regime.
The semiclassical propagator in Fock space: dynamical echo and many-body interference
Authors: Engl Thomas , Urbina Juan Diego , Richter Klaus
Published: May 2016

We present a semiclassical approach to many-body quantum propagation in terms of coherent sums over quantum amplitudes associated with the solutions of corresponding classical nonlinear wave equations. This approach adequately describes interference effects in the many-body space of interacting bosonic systems. The main quantity of interest, the transition amplitude between Fock states when the dynamics is driven by both single-particle contributions and many-body interactions of similar magnitude, is non-perturbatively constructed in the spirit of Gutzwiller’s derivation of the van Vleck propagator from the path integral representation of the time evolution operator, but lifted to the space of symmetrized many-body states. Effects beyond mean-field, here representing the classical limit of the theory, are semiclassically described by means of interfering amplitudes where the action and stability of the classical solutions enter. In this way, a genuinely many-body echo phenomenon, coherent backscattering in Fock space, is presented arising due to coherent quantum interference between classical solutions related by time reversal.
Dynamical phase transitions and Loschmidt echo in the infinite-range XY model
Authors: Žunkovič Bojan , Silva Alessandro , Fabrizio Michele
Published: May 2016

We compare two different notions of dynamical phase transitions in closed quantum systems. The first is identified through the time-averaged value of the equilibrium-order parameter, whereas the second corresponds to non-analyticities in the time behaviour of the Loschmidt echo. By exactly solving the dynamics of the infinite-range XY model, we show that in this model non-analyticities of the Loschmidt echo are not connected to standard dynamical phase transitions and are not robust against quantum fluctuations. Furthermore, we show that the existence of either of the two dynamical transitions is not necessarily connected to the equilibrium quantum phase transition.
A semiclassical reversibility paradox in simple chaotic systems
Authors: Tomsovic Steven
Published: May 2016

Using semiclassical methods, it is possible to construct very accurate approximations in the short-wavelength limit of quantum dynamics that rely exclusively on classical dynamical input. For systems whose classical realization is strongly chaotic, there is an exceedingly short logarithmic Ehrenfest time scale, beyond which the quantum and classical dynamics of a system necessarily diverge, and yet the semiclassical construction remains valid far beyond that time. This fact leads to a paradox if one ponders the reversibility and predictability properties of quantum and classical mechanics. They behave very differently relative to each other, with classical dynamics being essentially irreversible/unpredictable, whereas quantum dynamics is reversible/stable. This begs the question: ‘How can an accurate approximation to a reversible/stable dynamics be constructed from an irreversible/unpredictable one?’ The resolution of this incongruity depends on a couple of key ingredients: a well-known, inherent, one-way structural stability of chaotic systems; and an overlap integral not being amenable to the saddle point method.