bluuebunny/crossref_metadata_2025 huggingface dataset:
Patient safety culture among nurses
Authors: Ammouri A.A. , Tailakh A.K. , Muliira J.K. , Geethakrishnan R. , Al Kindi S.N.
Published: December 2014

Background

Patient safety is considered to be crucial to healthcare quality and is one of the major parameters monitored by all healthcare organizations around the world. Nurses play a vital role in maintaining and promoting patient safety due to the nature of their work.

Aims

The purpose of this study was to investigate nurses’ perceptions about patient safety culture and to identify the factors that need to be emphasized in order to develop and maintain the culture of safety among nurses in Oman.

Methods

A descriptive and cross‐sectional design was used. Patient safety culture was assessed by using the Hospital Survey on Patient Safety Culture among 414 registered nurses working in four major governmental hospitals in Oman. Descriptive statistics and general linear regression were employed to assess the association between patient safety culture and demographic variables.

Results

Nurses who perceived more supervisor or manager expectations, feedback and communications about errors, teamwork across hospital units, and hospital handoffs and transitions had more overall perception of patient safety. Nurses who perceived more teamwork within units and more feedback and communications about errors had more frequency of events reported. Furthermore, nurses who had more years of experience and were working in teaching hospitals had more perception of patient safety culture.

Conclusion

Learning and continuous improvement, hospital management support, supervisor/manager expectations, feedback and communications about error, teamwork, hospital handoffs and transitions were found to be major patient safety culture predictors. Investing in practices and systems that focus on improving these aspects is likely to enhance the culture of patient safety in Omani hospitals and others like them.

Implications for Nursing and Health Policy

Strategies to nurture patient safety culture in Omani hospitals should focus upon building leadership capacity that support open communication, blame free, team work and continuous organizational learning.
Hypoxia inhibits baroreflex vagal bradycardia via a central action in anaesthetized rats
Authors: Kongo Mariko , Yamamoto Rie , Kobayashi Masayoshi , Nosaka Shoichiro
Published: December 2014

It is known that arterial baroreflexes are suppressed in stressful conditions. The present study was designed to determine whether and how hypoxia affects arterial baroreflexes, especially the heart rate component, baroreflex vagal bradycardia. In chloralose‐urethane‐anaesthetized rats, baroreflex vagal bradycardia was evoked by electrical stimulation of the aortic depressor nerve, and the effect of 15 s inhalation of hypoxic gas (4% O2) was studied. Inhalation of hypoxic gas was found to inhibit baroreflex vagal bradycardia. The inhibition persisted after bilateral transection of the carotid sinus nerve. Cervical vagus nerves were cut bilaterally and their peripheral cut ends were stimulated to provoke vagal bradycardia of peripheral origin so as to determine whether hypoxia could inhibit vagal bradycardia by acting on a peripheral site. In contrast to baroreflex vagal bradycardia, the vagus‐induced bradycardia was not affected by hypoxic gas inhalation. It is concluded that baroreflex vagal bradycardia is inhibited by hypoxia and the inhibition is largely mediated by its direct central action.
Volumetric change of the lateral ventricles in the human brain following glucose loading
Authors: Puri B. K. , Lewis H. J. , Saeed N. , Davey N. J.
Published: December 2014

Lateral ventricular volumes were monitored and quantified using accurately registered magnetic resonance images (MRIs) in six healthy individuals 30 min before and up to 4 h after ingestion of a glucose drink. The volume of the lateral ventricles increased by an average (± S.E.M.) of 2.4 ± 0.4 % as blood glucose levels rose from 4.8 ± 0.2 mmol l−1 to 8.4 ± 0.4 mmol l−1. This was followed by a peak decrease of 5.99 ± 3.3 % below initial fasting volumes as blood glucose levels fell to 5.0 ± 0.3 mmol l−1. We suggest that the secondary volume decrease demonstrates a homeostatic process of brain volume regulation for which the mechanism remains uncertain.
Hypoxic regulation of ion channel function and expression
Authors: Peers Chris
Published: December 2014

Acute hypoxia regulates the activity of specific ion channels in a rapid and reversible manner. Such effects underlie appropriate cellular responses to hypoxia which are designed to initiate cardiorespiratory reflexes and contribute importantly to other tissue responses, all of which are designed to improve tissue O2 supply. These responses include excitation of chemoreceptors as well as pulmonary vasoconstriction and systemic vasodilatation. However, such responses may also contribute to the adverse responses to hypoxia, such as excitotoxicity in the central nervous system. Whilst numerous ion channel types are known to be modulated by acute hypoxia, the nature of the O2 sensor in most tissues remains to be identified. Prolonged (chronic) hypoxia regulates functional expression of ion channels, and so remodels excitability of various cell types. Whilst this may contribute to adaptive responses such as high‐altitude acclimatization, such altered channel expression may also contribute to the onset of pathological disorders, including Alzheimer's disease. Indeed, evidence is emerging that production of pathological peptides associated with Alzheimer's disease is increased during prolonged hypoxia. Such effects may account for the known increased incidence of this disease in patients who have previously endured hypoxic episodes, such as congestive heart failure and stroke. Identification of the mechanisms coupling hypoxia to the increased production of these peptides is likely to be of therapeutic benefit.
Bicarbonate‐induced alkalosis augments cellular acetyl group availability and isometric force during the rest‐to‐work transition in canine skeletal muscle
Authors: Roberts Paul A. , Loxham Susan J. G. , Poucher Simon M. , Constantin‐Teodosiu Dumitru , Greenhaff Paul L.
Published: December 2014

Increasing blood bicarbonate content has long been cited as a potential mechanism to improve contractile function. We investigated whether sodium bicarbonate‐induced metabolic alkalosis could positively affect force development during the rest‐to‐work transition in ischaemic skeletal muscle. Secondly, assuming it could, we investigated whether bicarbonate could augment acetyl group availability through the same equilibrium reaction as sodium acetate pre‐treatment and whether this underpins, at least in part, its ergogenic effect. Multiple biopsy samples were obtained from the canine gracilis muscle during 5 min of electrically evoked ischaemic contraction, which enabled the determination of the time course of acetyl group accumulation, substrate utilisation, pyruvate dehydrogenase complex activation and tension development in animals treated with saline (control; n = 6) or sodium bicarbonate (n = 5). Treatment with bicarbonate elevated acetylcarnitine content above the control level at rest (P < 0.05), but at no time point during subsequent contraction. The pyruvate dehydrogenase complex was activated following 40 s of contraction in both groups, with no differences existing between treatments at any time point. The requirement for ATP resynthesis from non‐oxygen‐dependent routes was no different between groups at any time point during contraction. No difference in peak twitch force production existed between groups. However, at 3 min of stimulation, tension development was better maintained in the bicarbonate group (P < 0.05), being ∼20% greater than control following 5 min of contraction (P < 0.05). The results demonstrate, for the first time, that bicarbonate can augment acetyl group availability prior to contraction, independent of pyruvate dehydrogenase complex activation, but cannot influence the requirement for non‐oxidative ATP re‐synthesis during subsequent contraction. It would appear, therefore, that the bicarbonate‐induced improvement in muscle tension development was probably mediated through the metabolic alkalosis and not via the increased availability of acetyl groups within the cell.
Changes in prevalence of periodontitis in two German population‐based studies
Authors: Schützhold Svenja , Kocher Thomas , Biffar Reiner , Hoffmann Thomas , Schmidt Carsten O. , Micheelis Wolfgang , Jordan Rainer , Holtfreter Birte
Published: December 2014

Aim

We aimed to assess changes of periodontal status in Germany.

Materials & Methods

The Studies of Health in Pomerania (SHIP) are two cross‐sectional population‐based studies conducted during 1997–2001 (SHIP‐0, 20–81 years,n = 3736) and 2008–2012 (SHIP‐Trend, 20–84 years,n = 3622) in northeast Germany. The German Oral Health Studies (DMS, 35–44 and 65–74 years) are national cross‐sectional population‐based surveys conducted in 1997 (DMS III,n = 1454) and 2005 (DMS IV,n = 1668), whose results were separately reported for West and East Germany. Prevalences, percentages and numbers of teeth affected were defined.

Results

InSHIP, prevalence of attachment loss (AL) ≥3 mm decreased from 89.7% (95% confidence interval (CI): 88.6–90.8) to 85.1% (95%CI: 83.9–86.3) (p < 0.05) and the mean extent reduced from 62.8% (95%CI: 61.7–63.8) to 55.9% (95%CI: 54.9–56.9) (p < 0.05). Probing depth (PD) ≥4 mm and the respective extent remained unchanged. In West Germany,AL≥3 mm decreased for 35–44‐year‐olds and increased for 65–74‐year‐olds (p < 0.05). InSHIPandDMS, the number of teeth in dentates increased significantly in all age groups.

Conclusions

Prevalences and extents ofALimproved almost in all age categories inSHIPand West German adults, whereasPDs remained unchanged. Nonetheless, the improvement of periodontal conditions implies an increase of treatment needs regarding moderately diseased teeth because of simultaneous increases of the number of present teeth.
Clinical use of conventional reference intervals in the frail elderly
Authors: Edvardsson Maria , Levander Märtha Sund , Ernerudh Jan , Theodorsson Elvar , Grodzinsky Ewa
Published: December 2014

Rationale, aims and objectives

Reference intervals provided by the laboratory are commonly established by measuring samples from apparently healthy subjects in the ages 18–65 years, excluding elderly individuals with chronic diseases and medication. The aim of our study was to establish whether current reference intervals for immune parameters and chemical biomarkers are valid for older individuals including those with chronic diseases, so‐called frail elderly.

Methods

Data from our cohort of 138 non‐infected nursing home residents (NHR), mean age 86.8 years, range 80–98, were compared with raw data, as basis for the development of reference intervals, obtained from reference populations, like blood donors (IgA, IgG, IgM, C3 and C4) and from the Nordic Reference Interval Project (NORIP) (alanine aminotransferase, albumin, aspartate aminotransferase, creatinine, gamma‐glutamyl transferase, lactate dehydrogenase, phosphate, sodium and urea). Immune parameters were measured by nephelometry and in NORIP the measurements were performed by means of different routine methods, in more than 100 laboratories.

Results

Only nine individuals (7%) of NHR were found to be free from chronic disease. C3, C4 (P < 0.001) and IgG levels (P < 0.05) were higher, while IgM levels (P < 0.001) were lower in NHR compared with reference blood donors. Levels of alanine aminotransferase, phosphate (P < 0.001), albumin (P < 0.05) and sodium (P < 0.01) were lower while creatinine and urea levels were higher (P < 0.001) in NHR compared with NORIP subjects.

Conclusion

Comparing laboratory results from elderly people with conventional reference intervals can be misleading or even dangerous, as normal conditions may appear pathological, or vice versa and thus lead to unnecessary or even harmful treatment.
Pharmacological reactivation of p53 as a strategy to treat cancer
Authors: Zawacka‐Pankau J. , Selivanova G.
Published: December 2014

It has been confirmed through studies using the technique of unbiased sequencing that the TP53 tumour suppressor is the most frequently inactivated gene in cancer. This finding, together with results from earlier studies, provides compelling evidence for the idea that p53 ablation is required for the development and maintenance of tumours. Genetic reconstitution of the function of p53 leads to the suppression of established tumours as shown in mouse models. This strongly supports the notion that p53 reactivation by small molecules could provide an efficient strategy to treat cancer. In this review, we summarize recent advances in the development of small molecules that restore the function of mutant p53 by different mechanisms, including stabilization of its folding by Apr‐246, which is currently being tested in a Phase II clinical trial. We discuss several classes of compounds that reactivate wild‐type p53, such as Mdm2 inhibitors, which are currently undergoing clinical testing, MdmX inhibitors and molecules targeting factors upstream of Mdm2/X or p53 itself. Finally, we consider the clinical applications of compounds targeting p53 and the p53 pathway.
Rural Affordable Care Act Outreach and Enrollment: What We Learned During the First Marketplace Open Enrollment Period
Authors: Kwon Linda
Published: December 2014

As part of the Patient Protection and Affordable Care Act (Affordable Care Act) of 2010, 2 new opportunities for health care coverage were established for many uninsured individuals beginning on January 1, 2014. The first opportunity was through Medicaid expansion where states had the opportunity to expand Medicaid coverage to individuals with household incomes up to 133% of the federal poverty level. The second opportunity was through the establishment of Health Insurance Marketplaces where individuals could purchase private health plans and potentially qualify for financial assistance in paying for their plans.

The Office of Rural Health Policy (ORHP) provided supplemental grant awards to help stimulate Affordable Care Act outreach and education efforts in rural communities that were being served by the Rural Health Care Services Outreach (Outreach) Grant Program. As a result, Outreach grantees enrolled 9,300 rural Americans during the initial Open Enrollment period.

Valuable outreach and enrollment lessons were learned from rural communities based on discussions with the Outreach grantees who received the supplemental funding. These lessons will help rural communities prepare for the next Open Enrollment period.
Regulating Volunteering: Lessons from the Bingo Halls
Authors: Bedford Kate D.
Published: December 2014

This article uses charitable bingo to explore the sociolegal regulation of volunteers. Using case studies of two provincial bingo revitalization initiatives in Canada, I explore how charities and government officials manage the tension between regulating and incentivizing volunteers. I show that bingo revitalization plans in Alberta and Ontario increased surveillance of nonregularized workers and failed to protect charity service users from unpaid labor requirements. Moreover, revitalization initiatives reframe the volunteer role to focus on customer service and explaining how charities benefit the community. The potential for bingo volunteering to promote spaces of mutual aid with players will thus likely decline. I suggest that the allied power of charity and state over unpaid workers is increasing, giving charities better‐protected interests in volunteer labor and changing the tasks that volunteers do. The need for more research exploring the interests of volunteers as regulatory stakeholders in their own right is thus pressing.
Family Law and Social Change: Judicial Views of Joint Custody,
1998–2011
Authors: Artis Julie E. , Krebs Andrew V.
Published: December 2014

Rapid changes in family life over the last forty years have led to
substantial alterations in family law policy; specifically, most states now
endorse joint custody arrangements for divorcing families. However, we know
little about how lower court judges have embraced or resisted this change.
We conducted in‐depth interviews with judges in twenty‐five Indiana
jurisdictions in 1998 and 2011. Our findings suggest that judges' views of
joint custody dramatically changed. Judges in Wave II indicated a strong
preference for joint custody—a theme that was relatively absent in Wave I.
The observed change in judicial preferences did not seem to be related to
judicial replacement, gender, age, or political party affiliation. Although
our conclusions are exploratory, we speculate that shifts in judicial views
may be related to changing public mores of parenthood and, relatedly,
Indiana's adoption of Parenting Time Guidelines in 2001.
Superior orbital fissure syndrome caused by aspergillus infection from maxillary sinusitis
Authors: Matsuda Masazumi , Hanazono Akira , Kamada Sachiko , Okawa Satoshi , Kawasaki Youhei , Honda Kouhei , Ishikawa Kazuo , Sugawara Masashiro , Ohnishi Hirohide
Published: December 2014

A 62‐year‐old woman who was prescribed prednisolone and cyclosporine for uveitis developed right blepharoptosis, diplopia and hypesthesia of superficial sensation of the trigeminal nerve V1 domain. Preserved right visual acuity led to a diagnosis of superior orbital fissure syndrome. We could not find any abnormalities on computed tomography except for right maxillary sinusitis associated with calcification. No infectious agents were detected in the blood or cerebrospinal fluid. We concluded that maxillary aspergillus, which was proven histopathologically after surgery, caused superior orbital fissure syndrome through the ophthalmic veins. Surgical excision of the lesion and voriconazole administration resulted in complete remission. To the best of our knowledge, there have been no other reports of superior orbital fissure syndrome caused by maxillary aspergillus sinusitis. The calcified sinusitis suggested fungal infections, which allowed us to avoid using corticosteroids.
Dimensions of nurse work time: Progress in instrumentation
Authors: Jones Terry L. , Yoder Linda H.
Published: December 2014

Because the work of health care is embedded in time, understanding nursing time‐allocation practices is essential for identifying nurse staffing and workflow patterns that optimize healthcare cost and quality outcomes. The interdependent nature of nursing care requires that nurses share time with other members of their work group. Shared time, also known as social or organizational time, requires careful negotiation of workflows within healthcare teams. Evaluation of negotiated workflows is contingent upon valid and reliable measures of sociological nursing time. In this study, we evaluated the psychometric properties of a newly adapted instrument for measuring sociological nursing time and describe the experience of sociological time among hospital‐employed nurses. Using a cross‐sectional survey design with a convenience sample of nurses (n = 359), we identified nine reliable components of sociological nursing time: insufficient time allocation; strict adherence to schedules; increased time awareness; value of quality over speed; fast and unpredictable pace changes; predictable job duties punctuated with unpredictable job demands; expectations for a fast work pace; inconsistent work‐hour expectations across departments; and high expectations for punctuality.
A mechanism of deficient interregional neural communication in schizophrenia
Authors: Popov Tzvetan , Wienbruch Christian , Meissner Sarah , Miller Gregory A. , Rockstroh Brigitte
Published: December 2014

Cognitive interference control is disrupted in schizophrenia (SZ). Neuroimaging studies relate interference control to 4–7 Hz (theta) neural activity in a network spanning prefrontal, anterior cingulate (ACC), and parietal cortices. The mechanism of communication in this network and how it is disrupted in schizophrenia are unclear. Behavioral performance and EEG theta oscillations were examined in a Stroop color‐word interference task in 17 healthy controls (HC) and 14 SZ patients. Color‐word incongruence induced less theta power increase in SZ than in HC around 400 ms and 600–900 ms after word onset in ACC, left middle frontal gyrus (MFG), and inferior parietal regions. Coupling of ACC theta phase to MFG gamma amplitude, indexing interregional communication, was weaker in SZ than in HC. Results suggest ACC‐MFG theta power modulation as a mechanism of interference control that supports executive function and is disrupted in schizophrenia.
An empirical analysis on purposes, drivers and activities of technology opportunity discovery: the case of Korean SMEs in the manufacturing sector
Authors: Cho Chanwoo , Yoon Byungun , Coh Byoung‐Youl , Lee Sungjoo
Published: December 2014

Technology opportunity discovery (TOD) is becoming increasingly important for identifying technology opportunities so that they can be reflected in firms' strategy planning. However, understanding of TOD practices within firms is limited, and the diversity of TOD practices has not been fully reflected in previous studies, especially from the perspective of small and medium enterprises (SMEs), which typically lack diverse technology portfolios or plentiful innovation resources, so technology opportunities have seldom been defined and analyzed. This study aims to investigate SMEs' TOD practices and to identify their characteristics. Interviews were conducted with Korean SME executives to define a conceptual TOD model for SMEs, and 104 Korean SMEs' TOD drivers and activities were surveyed focusing business drivers, business models, and information gathering. The results were then analyzed to define six technology opportunity types and to derive similarities and differences among them, which are used to understand and further support SMEs' TOD practices. The research findings are expected to enhance understanding about TOD practices and to help establish SMEs' TOD strategies.
Sheep as vectors for branched broomrape (Orobanche ramosa subsp. mutelii [F.W. Schultz] Cout.) seed dispersal
Authors: Ginman Emma , Prider Jane , Matthews John , Virtue John , Watling Jennifer
Published: December 2014

Sheep can be vectors for the long‐distance dispersal of weeds when seed becomes attached and retained in wool or survives the gastrointestinal tract. This study aimed to determine an appropriate quarantine period for sheep that minimized the risk of the long‐distance dispersal of the seeds of branched broomrape (Orobanche ramosa L. subsp. mutelii [F.W. Shultz] Cout.), a parasitic weed. Experiments with penned sheep found that the seeds that were placed on the soil surface adhered to the wool on the thigh and belly of the sheep, with most of the seeds attaching to the feet. Most of the seeds that were applied to the belly and thigh wool detached within 2 days, although a small proportion was present after 7 days. The seeds that were introduced to the digestive tract via drenching had a peak voidance 2 days later and no seed was detected on Day 8. It is suggested that a 7 day quarantine period for sheep would be sufficient in order to reduce the risk of the internal transport of seed to acceptable levels, but a small risk of the external transport of seed on the fleece remains.
Feasibility Study on Thermoacoustic Cooling for Low-Power Handheld Electronic Devices
Authors: Kim Jangwoo , Ro Paul I.
Published: December 2014

A feasibility study on developing a small-scale thermoacoustic cooler based on form and size factors for a typical cell phone is presented. First, an approximate analytical model for the temperature difference was derived using the linear theory of thermoacoustics. Cooling performance could be reasonably predicted with the analytical model proposed in this study. Air and helium as the working gases and the operating frequencies of 3 kHz for air and 9.2 kHz for helium are considered within the scope of typical cell phone configurations. A stack as a core of thermoacoustic cooler is designed to accomplish the most effective performance based on normalized parameters. For the 57 mm thermoacoustic cooler operating at 3 kHz with air, the maximum temperature difference of 23.13 °C across the stack in the resonance cavity is achieved with a drive ratio of 2% with air as the medium and Mylar as a stack material. This temperature difference varies depending on the stack placement along the length of the resonance cavity, but the maximum difference was achieved when the center of stack is placed at around 7 mm away from the driver end. The drive ratio, which is proportional to the power required to produce the thermoacoustic effect, is shown to be directly related to the cooling performance achieved by thermoacoustic drivers. For example, while a drive ratio of 2% results in a temperature difference of over 20 °C at its maximum, a drive ratio of 0.2% causes a temperature difference less than 1 °C. This will be one of hardware issues to be considered in making commercially viable products. The possibility of omitting heat exchangers in the thermoacoustic cooler is investigated considering their manufacturing cost and the relatively minute improvement they bring to overall cooling for small-scale systems. The numerical result of the thermoacoustic cooling system based on design environment for low-amplitude thermoacoustic energy conversion (DeltaEC) is compared to the theoretical result. Discrepancies between the two results exist in the range of 10–15% mainly due to the limitation imposed by short stack considerations and the linear theory of thermoacoustics.
Characterization of Interfacial Mass Transfer Rate of Stored Liquids
Authors: Rakshit Dibakar , Narayanaswamy R. , Thiagarajan K. P.
Published: December 2014

A thermodynamic analysis of the two-phase physics involving a liquid–vapor combination has been studied under the regime of conjugate heat and mass transfer phenomena. An experiment has been designed and performed to estimate the interfacial mass transfer characteristics of a liquid–vapor system by varying the liquid temperature. The experimental setup consists of an instrumented tank partially filled with water and maintained at different temperatures. The evaporation of liquid from the interface and the gaseous condensation has been quantified by calculating the interfacial mass transfer rate for both covered and uncovered tanks. The dependence of interfacial mass transfer rate on the liquid–vapor interfacial temperature, fractional concentration of the evaporating liquid, the surface area of the liquid vapor interface, and the fill level of the liquid has been established through the present experimental study. An estimation of the overall mass transfer rate from the interface due to a concentration gradient shows an analogy with the multiphase heat transfer that takes place across the interface due to temperature gradient. It was seen that at low fill levels and with a temperature difference of about 30 °C between liquid and ullage, the mass transfer rate of a closed system was nearly doubled when compared to its open system counterpart.
Fabrication of Gallium Nitride Films in a Chemical Vapor Deposition Reactor
Authors: Meng J. , Wong S. , Jaluria Y.
Published: December 2014

A numerical study has been carried out on the metalorganic chemical vapor deposition (MOCVD) process for the fabrication of gallium nitride (GaN) thin films, which range from a few nanometers to micrometers in thickness. The numerical study is also coupled with an experimental study on the flow and thermal transport processes in the system. Of particular interest in this study is the dependence of the growth rate of GaN and of the uniformity of the film on the flow, resulting from the choice of various design and operating parameters involved in the MOCVD process. Based on an impingement type rotating-disk reactor, three-dimensional simulations have been preformed to indicate the deposition rate increases with reactor pressure, inlet velocity, and wafer rotating speed, while decreases with the precursor concentration ratio. Additionally, a better film uniformity is caused by reducing the reactor pressure, inlet velocity and wafer rotating speed, and increasing precursor concentration ratio. With the impact of wafer temperature included in this study as well, these results are expected to provide a quantitative basis for the prediction, design, and optimization of the process for the fabrication of GaN devices. The flow and the associated transport processes are discussed in detail on the basis of the results obtained to suggest approaches to improve the uniformity of thin film, minimize fluid loss, and reduce flow recirculation that could affect growth rate and uniformity.
Piezoelectric Vibration Energy Harvesting From a Two-Dimensional Coupled Acoustic-Structure System With a Dynamic Magnifier
Authors: Aladwani A. , Aldraihem O. , Baz A.
Published: December 2014

A class of piezoelectric energy harvester is presented to harness the vibration energy from coupled acoustic-structure systems such as those existing, for example, in aircraft acoustic cabin/flexible fuselage systems. Generic idealization of any of these systems involves the interaction between the dynamics of an acoustic cavity coupled with a flexible structure. Pressure oscillations inside the acoustic cavity induce vibration in the flexible structure and vice versa. Harnessing the associated vibration energy can be utilized to potentially power various vibration, noise, and health monitoring instrumentation. In this paper, the emphasis is placed on harnessing this energy using a special class of piezoelectric energy harvesters coupled with a dynamic magnifier in order to amplify its power output as compared to conventional harvesters. A finite element model (FEM) is developed to predict the performance of this class of harvesters in terms of the mechanical displacements of the flexible structure, the pressure inside the acoustic cavity, and the output electric voltage of the piezoelectric harvester. The FEM is formulated here to analyze a two-dimensional (2D) energy harvesting system which is composed of a rigid acoustic cavity coupled, at one end, with a vibrating base structure to which is attached the piezoelectric energy harvester. The developed FEM is exercised to predict the output electric power for broad interior pressure excitation frequencies. Numerical examples are presented to illustrate the behavior of the harvester and extract the conditions for maximum electric power output of the harvester. The obtained results demonstrate the feasibility of the dynamic magnifier concept as an effective means for enhancing the energy harvesting as compared to conventional harvesters. The presented model can be easily extended and applied to more complex fluid–structure systems such as aircraft and vehicle cabins.
Ultrafast feedback-controlled electromigration using a field-programmable gate array
Authors: Kanamaru Yuma , Ando Masazumi , Shirakashi Jun-ichi
Published: December 2014

Feedback-controlled electromigration (FCE) has been a useful technique for creating nanoscale gaps between metal electrodes. In general, it is considered that the fabrication of nanogaps by the conventional FCE method using a microprocessor-based control system is a very time consuming and slow process. Here, the authors propose an ultrafast FCE method using a field-programmable gate array (FPGA) to immediately and precisely control the channel resistance of metal nanowires at room temperature. Using the ultrafast FCE method based on an FPGA, the channel resistance of Au micrometer wires was precisely controlled from 102 to 104 Ω within 1 s at room temperature, and without catastrophic breaks of the Au micrometer wires. Furthermore, the total process time of the FPGA-based ultrafast FCE procedure was considerably shortened without degradation of the controllability of the channel resistance of the Au micrometer wires, and is 103 to 104 times shorter than that of conventional FCE. These results imply that ultrafast FCE using an FPGA can precisely and stably control the channel resistance of Au micrometer wires with a shortened process time.
Accurate information transmission through dynamic biochemical signaling networks
Authors: Selimkhanov Jangir , Taylor Brooks , Yao Jason , Pilko Anna , Albeck John , Hoffmann Alexander , Tsimring Lev , Wollman Roy
Published: December 2014

Stochasticity inherent to biochemical reactions (intrinsic noise) and variability in cellular states (extrinsic noise) degrade information transmitted through signaling networks. We analyzed the ability of temporal signal modulation—that is, dynamics—to reduce noise-induced information loss. In the extracellular signal–regulated kinase (ERK), calcium (Ca
2+
), and nuclear factor kappa-B (NF-κB) pathways, response dynamics resulted in significantly greater information transmission capacities compared to nondynamic responses. Theoretical analysis demonstrated that signaling dynamics has a key role in overcoming extrinsic noise. Experimental measurements of information transmission in the ERK network under varying signal-to-noise levels confirmed our predictions and showed that signaling dynamics mitigate, and can potentially eliminate, extrinsic noise–induced information loss. By curbing the information-degrading effects of cell-to-cell variability, dynamic responses substantially increase the accuracy of biochemical signaling networks.
Bird genomes give new perches to old friends
Authors: Pennisi Elizabeth
Published: December 2014

Comparing genomes clarifies family relations and pinpoints genes for song learning.
Tossed out to save the masses
Authors: Calegari Federico
Published: December 2014

Dead stem cells are expelled from the vertebrate brain
Genetic Analysis of the Localization of APOBEC3F to Human Immunodeficiency Virus Type 1 Virion Cores
Authors: Donahue John P. , Levinson Rebecca T. , Sheehan Jonathan H. , Sutton Lorraine , Taylor Harry E. , Meiler Jens , D'Aquila Richard T. , Song Chisu
Published: December 2014

Members of the APOBEC3 family of cytidine deaminases vary in their proportions of a virion-incorporated enzyme that is localized to mature retrovirus cores. We reported previously that APOBEC3F (A3F) was highly localized into mature human immunodeficiency virus type 1 (HIV-1) cores and identified that L306 in the C-terminal cytidine deaminase (CD) domain contributed to its core localization (C. Song, L. Sutton, M. Johnson, R. D'Aquila, J. Donahue, J Biol Chem
287:
16965–16974, 2012,
http://dx.doi.org/10.1074/jbc.M111.310839
). We have now determined an additional genetic determinant(s) for A3F localization to HIV-1 cores. We found that one pair of leucines in each of A3F's C-terminal and N-terminal CD domains jointly determined the degree of localization of A3F into HIV-1 virion cores. These are A3F L306/L368 (C-terminal domain) and A3F L122/L184 (N-terminal domain). Alterations to one of these specific leucine residues in either of the two A3F CD domains (A3F L368A, L122A, and L184A) decreased core localization and diminished HIV restriction without changing virion packaging. Furthermore, double mutants in these leucine residues in each of A3F's two CD domains (A3F L368A plus L184A or A3F L368A plus L122A) still were packaged into virions but completely lost core localization and anti-HIV activity. HIV virion core localization of A3F is genetically separable from its virion packaging, and anti-HIV activity requires some core localization.

IMPORTANCE
Specific leucine-leucine interactions are identified as necessary for A3F's core localization and anti-HIV activity but not for its packaging into virions. Understanding these signals may lead to novel strategies to enhance core localization that may augment effects of A3F against HIV and perhaps of other A3s against retroviruses, parvoviruses, and hepatitis B virus.
Lentiviral Nef Proteins Manipulate T Cells in a Subset-Specific Manner
Authors: Yu Hangxing , Khalid Mohammad , Heigele Anke , Schmökel Jan , M. Usmani Shariq , van der Merwe Johannes , Münch Jan , Silvestri Guido , Kirchhoff Frank
Published: December 2014

The role of the accessory viral Nef protein as a multifunctional manipulator of the host cell that is required for effective replication of human immunodeficiency virus (HIV) and simian immunodeficiency virus (SIV)
in vivo
is well established. It is unknown, however, whether Nef manipulates all or just specific subsets of CD4
+
T cells, which are the main targets of virus infection and differ substantially in their state of activation and importance for a functional immune system. Here, we analyzed the effect of Nef proteins differing in their T cell receptor (TCR)-CD3 downmodulation function in HIV-infected human lymphoid aggregate cultures and peripheral blood mononuclear cells. We found that Nef efficiently downmodulates TCR-CD3 in naive and memory CD4
+
T cells and protects the latter against apoptosis. In contrast, highly proliferative CD45RA
+
CD45RO
+
CD4
+
T cells were main producers of infectious virus but largely refractory to TCR-CD3 downmodulation. Such T cell subset-specific differences were also observed for Nef-mediated modulation of CD4 but not for enhancement of virion infectivity. Our results indicate that Nef predominantly modulates surface receptors on CD4
+
T cell subsets that are not already fully permissive for viral replication. As a consequence, Nef-mediated downmodulation of TCR-CD3, which distinguishes most primate lentiviruses from HIV type 1 (HIV-1) and its
vpu
-containing simian precursors, may promote a selective preservation of central memory CD4
+
T cells, which are critical for the maintenance of a functional immune system.

IMPORTANCE
The Nef proteins of human and simian immunodeficiency viruses manipulate infected CD4
+
T cells in multiple ways to promote viral replication and immune evasion
in vivo
. Here, we show that some effects of Nef are subset specific. Downmodulation of CD4 and TCR-CD3 is highly effective in central memory CD4
+
T cells, and the latter Nef function protects this T cell subset against apoptosis. In contrast, highly activated/proliferating CD4
+
T cells are largely refractory to receptor downmodulation but are main producers of infectious HIV-1. Nef-mediated enhancement of virion infectivity, however, was observed in all T cell subsets examined. Our results provide new insights into how primate lentiviruses manipulate their target cells and suggest that the TCR-CD3 downmodulation function of Nef may promote a selective preservation of memory CD4
+
T cells, which are critical for immune function, but has little effect on activated/proliferating CD4
+
T cells, which are the main targets for viral replication.
Improving the surgical hot clinic
Authors: Hubbard Thomas , Thomas Rhys
Published: December 2014

Ambulatory care is an underdeveloped concept in the setting of emergency surgery, however it is recognised that many institutions will need to develop this service to cope with increased time and financial pressures.[1] There is increased emphasis on ambulatory care pathways for a variety of medical conditions.[2] Risk management is important in managing patients with acute abdominal pain in an outpatient setting and senior doctor support is essential. While the patient remains in the community, effective communication with the patient’s primary care provider improves patient safety and satisfaction.[3]

This quality improvement project identified current service provision of ambulatory care for surgical patients in the hot clinic at Croydon University Hospital with subsequent consultation with the surgical department to identify problems arising from the throughput of patients. Guidelines were then updated incorporating solutions to the identified issues which were then validated by the department of general surgery. Post intervention measurement identified a decrease in patients whose principal assessment and management was made by a senior house officer level doctor through the hot clinic patient journey from 26% to 9% (64% decrease), indicating an increase in registrar and/or consultant involvement in managing the hot clinic. The number of patients attending hot clinic that had effective discharge liaison (in the form of a formal letter) to the GP increased from 18% to 68% (250% increase). In conclusion, the introduction of updated guidelines effected a safer and more effective ambulatory hot clinic to perform closer to full capacity, providing improved patient care for the local population.
EARLY CHILDHOOD IS OVERRATED—A LIFE COURSE PERSPECTIVE USING SIBLINGS AND POPULATIONS
Authors: Wall-Wieler E , Roos LL , Chateau D
Published: December 2014

Purpose/Rationale for the project

How important are early childhood predictors in the presence of later childhood and early adolescent predictors when examining several late adolescent health and education outcomes? How well do the models work? A sibling design examines a set of time-varying predictors on two health outcomes (ADHD/Conduct Disorders, asthma) between ages 14 and 18 and one education outcome (failure to graduate high school), controlling for a variety measures.

Methods

Multi-level modeling of a sample of randomly selected consecutive siblings and twins (n=29,444) born in Manitoba, Canada between 1984 and 1989 allowed comparing family and individual level characteristics. Extensive sensitivity testing involved comparison with a population sample (n=62,820). This analysis uses files from the Population Health Research Data Repository at the Manitoba Centre for Health Policy (MCHP), linked across ministries, which include information on individual level health and education. Census data on neighborhood household income, education and so forth, were also incorporated.

Results/Next steps

Although several 0–3 variables were significant for the education outcome, very few were significant for the health outcomes indicating that early childhood variables are not particularly important in predicting late adolescent health and education outcomes. Time-varying predictors in early childhood were markedly less important when including later childhood (4–8) and early adolescent (9–13) health predictor; however, events in early childhood might be important in embedding specific outcomes in later life. Using a life course approach provided an excellent fit for the externalizing mental conditions model (c-statistic=0.826) and a reasonable fit for failure to graduate high school (c-statistic=0.793) and asthma (c-statistic=0.798) models. This paper adds to the growing literature that suggests a stronger focus be put on adolescence as a “second sensitive developmental period” when examining late adolescent and adult outcomes. Future research should be less concerned with birth and early childhood predictors and put a stronger focus on the late childhood and early adolescent time periods, as they bring with them a period of rapid brain maturation that can significantly modify childhood trajectories.
DEVELOPING A SHELTER EVALUATION INSTRUMENT THAT PROMOTES POST-DISASTER POPULATION HEALTH
Authors: Nath R , Shannon H , Kabali C , Oremus M
Published: December 2014

Introduction

Absence of shelter may adversely affect the health of post-disaster populations. When shelters are inadequate or not provided, overcrowded ad hoc communities may form and encourage the spread of infectious disease. Shelter evaluation is therefore necessary to promote post-disaster population health. Even in cases where evaluations are carried out, standardized evaluation indicators do not exist.

Objectives

To determine what indicators are being used and which should be used to evaluate shelter assistance following natural disasters.

Methodology

 1. Review: Using systematic review methods, electronic databases and the grey literature were searched for publications that evaluated shelter assistance following natural disasters in developing countries. Indicators used to evaluate shelter assistance were extracted and the most common indicators were identified.

 2. Interviews: Based on the indicators extracted, a preliminary evaluation instrument was designed to evaluate shelter assistance. Six shelter experts were interviewed to establish validity of the indicators and evaluation questions. The transcripts from the interviews were analyzed using rigorous qualitative research methodology.

Results

 1. Review: A total of 1480 indicators were extracted from 181 publications. Indicators most commonly evaluated in the field were: community involvement in shelter planning (n=108), quality and labour of construction (n=107), and scale of assistance provided (n=99).

 2. Interviews: Shelter experts felt that the correct indicators had been extracted; however, they expressed the need for more health related indicators. They also felt that the questions evaluating the indicators measured output and should be rephrased to evaluate outcome and impact.

Conclusions

This evaluation instrument, directly based on the most important indicators in the literature and validated by shelter experts, will enable aid agencies to better assess and meet the shelter and health needs of populations impacted by disasters.
THE EFFECTIVENESS OF PHARMACOLOGICAL AND NON-PHARMACOLOGICAL INTERVENTIONS IN IMPROVING RESTLESS LEGS SYNDROME SEVERITY AMONG PATIENTS ON DIALYSIS: A SYSTEMATIC REVIEW
Authors: Quach K , Gandhi M , Brimble KS , Walsh M
Published: December 2014

Background and objectives

Restless legs syndrome (RLS) is common amongst patients receiving dialysis. It is unclear how to optimally treat RLS in dialysis patients. We conducted a systematic review to identify therapies to reduce the severity of RLS.

Methods

We systematically searched MEDLINE and EMBASE and hand searched narrative reviews for randomized controlled trials that assessed the use of pharmacological or non-pharmacological interventions to reduce the severity of RLS among patients receiving dialysis. The primary outcome was RLS symptoms.

Results

Of 621 abstracts identified, 12 studies that included 13 interventions met the inclusion and exclusion criteria. All trials reported interventions that significantly improved RLS severity. The interventions included dopamine agonists (n=6), gabapentin (n=2), intradialytic exercise (n=2) intravenous iron (n=1), vitamins C and E (n=1), and clonidine (n=1). In studies that compared two interventions, ropinirole gabapentin, and intradialytic exercise with resistance were all more effective than L-dopa in comparisons. However, all studies were at high risk of bias with the most common causes due to lack of allocation concealment, high losses to follow-up, and missing data. Further, follow-up for these studies was short-term ranging from 3 days to 24 weeks.

Conclusions

Ropinirole, gabapentin, and intradialytic exercise appear promising to reduce RLS in dialysis patients. However, methodologically rigorous, appropriately powered, longer term RCTs are required to determine the optimal treatment strategy for RLS among dialysis patients.