bluuebunny/crossref_metadata_2025 huggingface dataset:
A modified varying‐stage adaptive phase II/III clinical trial design
Authors: Dong Gaohong , Vandemeulebroecke Marc
Published: June 2016

Conventionally, adaptive phase II/III clinical trials are carried out with a strict two‐stage design. Recently, a varying‐stage adaptive phase II/III clinical trial design has been developed. In this design, following the first stage, an intermediate stage can be adaptively added to obtain more data, so that a more informative decision can be made. Therefore, the number of further investigational stages is determined based upon data accumulated to the interim analysis. This design considers two plausible study endpoints, with one of them initially designated as the primary endpoint. Based on interim results, another endpoint can be switched as the primary endpoint. However, in many therapeutic areas, the primary study endpoint is well established. Therefore, we modify this design to consider one study endpoint only so that it may be more readily applicable in real clinical trial designs. Our simulations show that, the same as the original design, this modified design controls the Type I error rate, and the design parameters such as the threshold probability for the two‐stage setting and the alpha allocation ratio in the two‐stage setting versus the three‐stage setting have a great impact on the design characteristics. However, this modified design requires a larger sample size for the initial stage, and the probability of futility becomes much higher when the threshold probability for the two‐stage setting gets smaller. Copyright © 2016 John Wiley & Sons, Ltd.
Scanning electron microscopy combined with image processing technique: Analysis of microstructure, texture and tenderness in Semitendinous and Gluteus Medius bovine muscles
Authors: Pieniazek Facundo , Messina Valeria
Published: June 2016

In this study the effect of freeze drying on the microstructure, texture, and tenderness of Semitendinous and Gluteus Medius bovine muscles were analyzed applying Scanning Electron Microscopy combined with image analysis. Samples were analyzed by Scanning Electron Microscopy at different magnifications (250, 500, and 1,000×). Texture parameters were analyzed by Texture analyzer and by image analysis. Tenderness by Warner–Bratzler shear force. Significant differences (p < 0.05) were obtained for image and instrumental texture features. A linear trend with a linear correlation was applied for instrumental and image features. Image texture features calculated from Gray Level Co‐occurrence Matrix (homogeneity, contrast, entropy, correlation and energy) at 1,000× in both muscles had high correlations with instrumental features (chewiness, hardness, cohesiveness, and springiness). Tenderness showed a positive correlation in both muscles with image features (energy and homogeneity). Combing Scanning Electron Microscopy with image analysis can be a useful tool to analyze quality parameters in meat.Summary SCANNING 38:727–734, 2016. © 2016 Wiley Periodicals, Inc.
Correcting for binomial measurement error in predictors in regression with application to analysis of DNA methylation rates by bisulfite sequencing
Authors: Buonaccorsi John , Prochenka Agnieszka , Thoresen Magne , Ploski Rafal
Published: June 2016

Motivated by a genetic application, this paper addresses the problem of fitting regression models when the predictor is a proportion measured with error. While the problem of dealing with additive measurement error in fitting regression models has been extensively studied, the problem where the additive error is of a binomial nature has not been addressed. The measurement errors here are heteroscedastic for two reasons; dependence on the underlying true value and changing sampling effort over observations. While some of the previously developed methods for treating additive measurement error with heteroscedasticity can be used in this setting, other methods need modification. A new version of simulation extrapolation is developed, and we also explore a variation on the standard regression calibration method that uses a beta‐binomial model based on the fact that the true value is a proportion. Although most of the methods introduced here can be used for fitting non‐linear models, this paper will focus primarily on their use in fitting a linear model. While previous work has focused mainly on estimation of the coefficients, we will, with motivation from our example, also examine estimation of the variance around the regression line. In addressing these problems, we also discuss the appropriate manner in which to bootstrap for both inferences and bias assessment. The various methods are compared via simulation, and the results are illustrated using our motivating data, for which the goal is to relate the methylation rate of a blood sample to the age of the individual providing the sample. Copyright © 2016 John Wiley & Sons, Ltd.
Selection and Characterization of Malachite Green Aptamers for the Development of Light–up Probes
Authors: Wang Hongyan , Wang Jine , Sun Na , Cheng Hui , Chen Hongxia , Pei Renjun
Published: June 2016

The light‐up fluorogenic dyes exhibit excellent behavior that autofluorescence is very low but substantially increases when interacting with their ligands. Aptamers are single‐stranded oligonucleotides which are selected and are capable of binding certain targets tightly and specifically. Developing fluoreogenic dye‐aptamer light‐up fluoromodules will greatly prompt the development of label‐free probes for various detection purposes. A fluoregenic triphenylmethane dye, malachite green (MG) was found to have low quantum yield in fluid solutions, but restricting vibration was known to induce fluorescence enhancement. We used the modified in vitro selection method which is based on the target‐induced release of aptamers as the separation technique to isolate DNA aptamers for MG. 8 rounds of selection process was carried out, and the fluorescent intensity of MG was dramatically enhanced in the presence of a minimized 26‐mer DNA aptamer with low micromolar affinity. The MG‐aptamer pair could potentially be used as a novel light‐up fluorescent probe for various applications.
Visible Light‐Induced Photoeletrochemical and Antimicrobial Properties of Hierarchical CuBi2O4 by Facile Hydrothermal Synthesis
Authors: Zhu Lu , Basnet Pradip , Larson Steven R. , Jones Les P. , Howe Jane Y. , Tripp Ralph A. , Zhao Yiping
Published: June 2016

Narrow bandgap semiconductor CuBi2O4 microstructures such as three dimensional hierarchical microspheres, micro‐flowers, one dimensional microrods and nanorods were fabricated through a facile hydrothermal synthesis approach by systematically changing the synthesis conditions. Their optical properties and photocatalytical performances under visible light illumination were characterized. The hierarchical micro‐flower shaped CuBi2O4 sample showed a high photodecay rate of 0.114 ± 0.002 h−1 with 1 mg/ml CuBi2O4 concentration for methylene blue (30 μM). Under the illumination of an AM 1.5G solar simulator, a 0.02 mA/cm2 stable cathodic photocurrent density was observed at a low negative bias voltage (‐0.25 V vs (Ag/AgCl)). The micro‐flower shaped CuBi2O4 sample also showed a high antibacterial effect against Escherichia coli, with ∼ 93 % bacteria reduction after 6 h illumination by a commercial white LED light (10 mW/cm2). These results indicate that CuBi2O4 can be a promising candidate for visible light driven energy conversion and antimicrobial applications.
Synthesis and Relaxometric Characterization of a New Mn(II)‐EDTA‐Deoxycholic Acid Conjugate Complex as a Potential MRI Blood Pool Agent
Authors: Baroni S. , Colombo Serra Sonia , Fringuello Mingo Alberto , Lux G. , Giovenzana G. B. , Lattuada L.
Published: June 2016

Gd(III)‐complexes have been employed for more than twentyfive years as MRI contrast agents. In the last decade, considerations about potential toxicity of residual gadolinium in patients suffering from severe kidney diseases have moved researchers to evaluate alternative solutions, among them Mn(II)‐complexes, to shorten T1 and achieve good image contrast. In this article we report on the synthesis of a new Mn(II)‐chelate, endowed with a deoxycholic acid residue designed to interact reversibly with serum albumin and to boost the usually low relaxivity associated with Mn(II)‐complexes. Its detailed relaxometric characterization and the analysis of albumin binding behaviour showed remarkable properties, suggesting its potential use as MRI blood pool agent.
A Model Study on the Carbon‐Halogen Activation in Perhalonated Arenes with Isonitrile Under Photoirradiation
Authors: Su Ming‐Der
Published: June 2016

The mechanisms of the photochemical carbon‐halogen bond activation reactions were investigated theoretically using a model system of hexahalobenzene C6X6 (X=F, Cl, and Br) and phenyl isonitrile (PhN=C:), with the M06‐2X method and the 6–311G(d) basis set. The theoretical findings suggest the photoactivation mechanism should proceed as follows: Rea‐X‐S0 + hν → FC‐X‐T1 → PhNC‐T1 + C6X6 → Int‐X‐T1 → TS‐X‐T1 → T1/S0‐X → Pro‐X‐S0. The present theoretical evidence confirms the reported results by Studer and co‐workers that using UV irradiation, a simple and efficient transition‐metal‐free C‐F activation in various perfluoroarenes with aryl and alkyl isonitriles obtain imidoyl fluorides. Nevertheless, due to the highly vertical Frank‐Condon excitation energy, our theoretical study demonstrates N‐heterocyclic carbene cannot undergo the C‐F bond activation reaction with hexafluorobenzene under photoirradiation, which closely agrees with the available experimental observations. The present theoretical research reveals the spin crossover processes, which lead to a concerted reaction pathway, play a key role in the regioselecitivities of the final photoinsertion products.
Mononuclear Transition Metal Complexes of 7‐Nitro‐1,3,5‐Triazaadamantane
Authors: Wagner Gabriele , Horton Peter N. , Coles Simon J.
Published: June 2016

Complexes of the type [MCl2(7‐nitro‐1,3,5‐triaza‐adamantane)2] (M = Zn(II), Pd(II), Pt(II)) and [MCl2(H2O)2(7‐nitro‐1,3,5‐triazaadamantane)2] (M = Mn (II), Co(II), Ni(II)) have been prepared and their structures have been analysed by X‐ray crystallography, elemental analysis, IR and solid state 13C and 15N NMR spectroscopy, supported by density functional theory/gauge independent atomic orbital (DFT/GIAO) calculations. In each case, 7‐nitro‐1,3,5‐triazaadamantane acts as a mono‐dentate ligand and binds to one metal centre only, in spite of the presence of three equivalent amino nitrogens. In the Co(II) and Ni(II) complexes, a two‐dimensional intermolecular hydrogen bonding network between the aqua‐ and the chloro ligands is established. The uncoordinated amines of the 7‐nitro‐1,3,5‐triaza‐adamantane are not involved in any H‐bonding, as a result of the exceptionally low basicity of this compound.
Fast Numerical Simulation of Symmetric Flat Rolling Processes for Inhomogeneous Materials Using a Layer Model − Part I: Basic Theory
Authors: Schmidtchen Matthias , Kawalla Rudolf
Published: June 2016

In the first part, a brief introduction to a general non‐isothermal layer model for symmetric but inhomogeneous rolling conditions is presented. The model is based on an extended slab theory. Additional to conventional approaches, a phenomenological layer thickness model for NS‐layers and its application to several rolling conditions is briefly described in part I. Within the course of computation for the stress and strain state internal stresses at the entrance and exit of the roll gap are predicted as a closing condition for the derived set of kinematic and kinetic equations. They transform elastically outside the roll gap to residual stresses. In this part, first comparisons are given to finite element solutions and experimental investigations. The results of an extensive case study will be given in part II. Due to the used coupling between kinematics and kinetics, a significant improvement of the slab theory in relation to a local description of an inhomogeneous plane strain deformation and stress state is found.
Situating Paradigms in Student Development Theory
Authors: Abes Elisa S.
Published: June 2016

This chapter reviews paradigms in which student development theory is situated, encouraging the use of critical and poststructural paradigms.
Evolution of Student Development Theory
Authors: Jones Susan R. , Stewart Dafina‐Lazarus
Published: June 2016

The authors situate critical perspectives in the larger context of the evolution of theory and discuss a “third wave” of theory development.
Critical and Poststructural Perspectives on Self‐Authorship
Authors: Abes Elisa S. , Hernández Ebelia
Published: June 2016

This chapter explores how critical and poststructural perspectives on self‐authorship challenge the nature of development and the meaning of self‐authorship.
A phase I clinical study to evaluate safety of orally administered, genetically engineeredSalmonella entericaserovarTyphimuriumfor canine osteosarcoma
Authors: Fritz Sara E. , Henson Michael S. , Greengard Emily , Winter Amber L. , Stuebner Kathleen M. , Yoon Una , Wilk Vicki L. , Borgatti Antonella , Augustin Lance B. , Modiano Jaime F. , Saltzman Daniel A.
Published: June 2016

We conducted a prospective phase I study to evaluate safety of an orally administeredSalmonellaencodingIL‐2 (SalpIL2) in combination with amputation and adjuvant doxorubicin for canine appendicular osteosarcoma. Efficacy was assessed as a secondary measure. The first dose of SalpIL2 was administered to 19 dogs on Day 0; amputation was done after 10 days with chemotherapy following 2 weeks later. SalpIL2 was administered concurrent with chemotherapy, for a total of five doses of doxorubicin and six doses of SalpIL2. There were six reportable events prior to chemotherapy, but none appeared due to SalpIL2. Dogs receiving SalpIL2 had significantly longer disease‐free interval (DFI) than a comparison group of dogs treated with doxorubicin alone. Dogs treated using lower doses of SalpIL2 also had longerDFIthan dogs treated using the highest SalpIL2 dose. The data indicate that SalpIL2 is safe and well tolerated, which supports additional testing to establish the potential for SalpIL2 as a novel form of adjuvant therapy for dogs with osteosarcoma.
Diabetes mellitus in people with schizophrenia, bipolar disorder and major depressive disorder: a systematic review and large scale meta‐analysis
Authors: Vancampfort Davy , Correll Christoph U. , Galling Britta , Probst Michel , De Hert Marc , Ward Philip B. , Rosenbaum Simon , Gaughran Fiona , Lally John , Stubbs Brendon
Published: June 2016

Type 2 diabetes mellitus (T2DM) is highly predictive of cardiovascular diseases and can have particularly deleterious health impacts in people with severe mental illness (SMI), i.e. schizophrenia, bipolar disorder or major depressive disorder. This meta‐analysis aimed: a) to describe pooled frequencies of T2DM in people with SMI; b) to analyze the influence of demographic, illness and treatment variables as well as T2DM assessment methods; and c) to describe T2DM prevalence in studies directly comparing persons with each specific SMI diagnosis to general population samples. The trim and fill adjusted pooled T2DM prevalence among 438,245 people with SMI was 11.3% (95% CI: 10.0%‐12.6%). In antipsychotic‐naïve participants, the prevalence of T2DM was 2.9% (95% CI: 1.7%‐4.8%). There were no significant diagnostic subgroup differences. A comparative meta‐analysis established that multi‐episode persons with SMI (N=133,470) were significantly more likely to have T2DM than matched controls (N=5,622,664): relative risk, RR=1.85, 95% CI: 1.45‐2.37, p<0.001. The T2DM prevalence was consistently elevated in each of the three major diagnostic subgroups compared to matched controls. Higher T2DM prevalences were observed in women with SMI compared to men (RR=1.43, 95% CI: 1.20‐1.69, p<0.001). Multi‐episode (versus first‐episode) status was the only significant predictor for T2DM in a multivariable meta‐regression analysis (r2=0.52, p<0.001). The T2DM prevalence was higher in patients prescribed antipsychotics, except for aripriprazole and amisulpride. Routine screening and multidisciplinary management of T2DM is needed. T2DM risks of individual antipsychotic medications should be considered when making treatment choices.
Understanding the burnout experience: recent research and its implications for psychiatry
Authors: Maslach Christina , Leiter Michael P.
Published: June 2016

The experience of burnout has been the focus of much research during the past few decades. Measures have been developed, as have various theoretical models, and research studies from many countries have contributed to a better understanding of the causes and consequences of this occupationally‐specific dysphoria. The majority of this work has focused on human service occupations, and particularly health care. Research on the burnout experience for psychiatrists mirrors much of the broader literature, in terms of both sources and outcomes of burnout. But it has also identified some of the unique stressors that mental health professionals face when they are dealing with especially difficult or violent clients. Current issues of particular relevance for psychiatry include the links between burnout and mental illness, the attempts to redefine burnout as simply exhaustion, and the relative dearth of evaluative research on potential interventions to treat and/or prevent burnout. Given that the treatment goal for burnout is usually to enable people to return to their job, and to be successful in their work, psychiatry could make an important contribution by identifying the treatment strategies that would be most effective in achieving that goal.
The CHANGE trial: no superiority of lifestyle coaching plus care coordination plus treatment as usual compared to treatment as usual alone in reducing risk of cardiovascular disease in adults with schizophrenia spectrum disorders and abdominal obesity
Authors: Speyer Helene , Christian Brix Nørgaard Hans , Birk Merete , Karlsen Mette , Storch Jakobsen Ane , Pedersen Kamilla , Hjorthøj Carsten , Pisinger Charlotta , Gluud Christian , Mors Ole , Krogh Jesper , Nordentoft Merete
Published: June 2016

Life expectancy in patients with schizophrenia is reduced by 20 years for men and 15 years for women compared to the general population. About 60% of the excess mortality is due to physical illnesses, with cardiovascular disease being dominant. CHANGE was a randomized, parallel‐group, superiority, multi‐centre trial with blinded outcome assessment, testing the efficacy of an intervention aimed to improve cardiovascular risk profile and hereby potentially reduce mortality. A total of 428 patients with schizophrenia spectrum disorders and abdominal obesity were recruited and centrally randomized 1:1:1 to 12 months of lifestyle coaching plus care coordination plus treatment as usual (N=138), or care coordination plus treatment as usual (N=142), or treatment as usual alone (N=148). The primary outcome was 10‐year risk of cardiovascular disease assessed post‐treatment and standardized to age 60. At follow‐up, the mean 10‐year risk of cardiovascular disease was 8.4 ± 6.7% in the group receiving lifestyle coaching, 8.5 ± 7.5% in the care coordination group, and 8.0 ± 6.5% in the treatment as usual group (p=0.41). We found no intervention effects for any secondary or exploratory outcomes, including cardiorespiratory fitness, physical activity, weight, diet and smoking. In conclusion, the CHANGE trial did not support superiority of individual lifestyle coaching or care coordination compared to treatment as usual in reducing cardiovascular risk in patients with schizophrenia spectrum disorders and abdominal obesity.
Central Hepatectomy versus Extended Hepatectomy for Malignant Tumors: A Propensity Score Analysis of Postoperative Complications
Authors: de’Angelis Nicola , Pascal Gérard , Salloum Chady , Lahat Eylon , Ichai Philippe , Saliba Faouzi , Adam René , Castaing Denis , Azoulay Daniel
Published: June 2016

Background

The specific definition of central hepatectomy (CH) (i.e., resection of segments 4‐5‐8 ± 1) is not uniformly used, resulting in conflicting comparisons with the more commonly performed extended hepatectomy (EH). The study aimed to compare, using propensity score matching (PSM) analysis, the incidence of postoperative complications between CH and EH for centrally located liver tumors (CLLT).

Methods

All consecutive CH and EH procedures for CLLT performed from 1980 to 2011 were retrospectively reviewed. Independent predictors of postoperative complications were identified. CH was compared to EH after PSM.

Results

The study population consisted of 373 patients, 44 (11.8 %) of whom underwent CH and 329 (88.2 %) of whom underwent EH. Before PSM, the overall 90‐day mortality was 7.2 % (27 patients) without a group difference (2 (4.5 %) for CH vs. 25 (7.6 %) for EH, p = 0.756). The CH and EH groups had similar postoperative morbidity rates (43.2 vs. 55.3 %; p = 0.108). Blood transfusion was the only independent predictor of postoperative complications (Hazard Ratio: 1.73; 95 % confidence interval: 1.11–2.68; p = 0.014). After PSM, 43 CH patients were matched with 43 EH patients. No group difference was observed for the postoperative mortality, morbidity, or duration of hospital stay. A higher number of EH patients (30.2 vs. 9.3 %, p = 0.028) presented with more than one postoperative complication.

Conclusions

CH and EH yield similar mortality and morbidity. For CLLT, CH may be an attractive procedure with the advantage of sparing the liver parenchyma compared with EH.
Should Gastric Decompression be a Routine Procedure in Patients Who Undergo Pylorus‐Preserving Pancreatoduodenectomy?
Authors: Park Joon Seong , Kim Jae Young , Kim Jae Keun , Yoon Dong Sup
Published: June 2016

Background

Nasogastric tube placement after abdominal surgery has been a standard procedure for many decades. In pancreatoduodenectomy, delayed gastric emptying (DGE) is still a leading postoperative complication, often resulting in patient anxiety or depression and prolonged hospital stays. Such complications have led many surgeons to prefer postoperative nasogastric decompression because of the greater risk of DGE. Therefore, the goal of this study was to evaluate the DGE and perioperative outcomes after pylorus‐preserving pancreatoduodenectomy (PPPD) with or without routine gastrostomy.

Methods

From May 2009 to December 2014, 228 patients underwent PPPD at the Department of Surgery, Gangnam Severance Hospital, Yonsei University. The first cohort of 116 patients underwent surgery before June 2012 and uniformly underwent gastric decompression as a part of postoperative management. The second cohort of 112 patients underwent operation after July 2012, and gastric decompression was selectively used to facilitate exposure during operation and was removed in the operating room at the end of surgery. We evaluated DGE incidence, time to dietary tolerance, length of hospital stay, and postoperative gastric tube reinsertion rates.

Results

Gastric re‐decompression was necessary in 38 patients (16.7 %), and there was a significant difference between the two groups (p = 0.006). Eleven (9.8 %) patients in the no‐tube gastrostomy group required nasogastric tube reinsertion, and 27 (23.3 %) in the routine gastrostomy group required that the gastrostomy tube be re‐drainage. There were no statistically significant differences in the frequency or severity of complications such as delayed gastric emptying or pancreatic leakage.

Conclusions

Our study demonstrates that routine postoperative gastric decompression can be safely avoided in patients who undergo PPPD.
Riboflavin transport and metabolism in humans
Authors: Barile Maria , Giancaspero Teresa Anna , Leone Piero , Galluccio Michele , Indiveri Cesare
Published: June 2016

Recent studies elucidated how riboflavin transporters and FAD forming enzymes work in humans and create a coordinated flavin network ensuring the maintenance of cellular flavoproteome. Alteration of this network may be causative of severe metabolic disorders such as multiple acyl‐CoA dehydrogenase deficiency (MADD) or Brown‐Vialetto‐van Laere syndrome. A crucial step in the maintenance of FAD homeostasis is riboflavin uptake by plasma and mitochondrial membranes. Therefore, studies on recently identified human plasma membrane riboflavin transporters are presented, together with those in which still unidentified mitochondrial riboflavin transporter(s) have been described. A main goal of future research is to fill the gaps still existing as for some transcriptional, functional and structural details of human FAD synthases (FADS) encoded by FLAD1 gene, a novel “redox sensing” enzyme. In the frame of the hypothesis that FADS, acting as a “FAD chaperone”, could play a crucial role in the biogenesis of mitochondrial flavo‐proteome, several basic functional aspects of flavin cofactor delivery to cognate apo‐flavoenzyme are also briefly dealt with. The establishment of model organisms performing altered FAD homeostasis will improve the molecular description of human pathologies. The molecular and functional studies of transporters and enzymes herereported, provide guidelines for improving therapies which may have beneficial effects on the altered metabolism.
A Retrospective Exploration of the Impact of the ‘Angelina Jolie Effect’ on the Single State‐Wide Familial Cancer Program in Perth, Western Australia
Authors: Freedman Rebecca , Mountain Helen , Karina Dian , Schofield Lyn
Published: June 2016

Global media has the power to influence the ways the public engage with health services. On May 14th 2013, Angelina Jolie published an article in the New York Times magazine, outlining her decision to undergo BRCA mutation testing due to a family history of cancer; then proceed with a mastectomy. The article evoked significant interest from the media and the public. During the months that followed, the Familial Cancer Program (FCP) at Genetic Services of Western Australia (GSWA) experienced a significant increase in referrals and enquiries. Resources were overstretched and it became clear we needed to adjust work practices to manage the escalating numbers. New strategies were devised to cope with the influx of enquiries, albeit without the benefit of additional resources. We conducted an audit of referrals to the FCP made between January 2012 and December 2014. This included a comparison of the months prior to and following the New York Times article. The aim of the audit was to quantify the impact of the “Angelina Jolie effect” on referrals to the FCP. Whilst the increased awareness of the role of genetic services in risk assessment and testing for familial breast and ovarian cancer was considered positive, pre‐referral risk assessment at the primary health level to evaluate the appropriateness of their patients for referral could have been helpful. Potentially, many inappropriate referrals to FCP may have been avoided with primary health evaluation thus lessening the burden on our service and preventing unnecessary worry in well women who possessed minimal family history or risk factors. It is important to understand the factors driving the uptake of risk reduction activities, particularly if engagement with a genetics service is considered part of that pathway. Continued education about cancer risk due to family history, individual features and awareness surrounding genetic testing criteria, costs and availability is required for both the public and health professionals.
Routine radiographs at time of pin removal after closed reduction and percutaneous pinning for type 2 supracondylar humerus fractures do not change management: A retrospective cohort study
Authors: Garg Sumeet , Bloch Nikki , Cyr Micaela , Carry Patrick
Published: June 2016

Purpose

Radiographs are usually taken on day of pin removal for children treated with closed reduction and percutaneous pinning (CRPP) of type 2 supracondylar humerus fractures. The purpose of this study was to determine whether radiographs taken at time of pin removal for patients recovering uneventfully alter management.

Methods

After IRB approval, billing records identified 1213 patients aged 1–10 years who underwent elbow surgery between 2007 and 2013 at our institution for a supracondylar humerus fracture. Of these patients, 389 met inclusion criteria. Clinical charts were reviewed for demographics, operative details, and clinical follow-up, focusing on clinical symptoms present at pin removal. Radiographs taken at time of pin removal and subsequent visits were assessed for healing and fracture alignment.

Results

In no case was pin removal delayed based on radiographs. One hundred and nineteen (31 %) patients had radiographs taken following pin removal; in no case was loss of reduction found among these patients. No cases of neurologic or vascular injury, re-fracture, or loss of reduction occurred. Infection occurred in 12 patients (3 %). Pins were kept in place for 23.8 ± 4.4 days. Eighty-six patients (22 %) had additional intervention after pin removal (cast application in all cases). Of 389 patients, 75 (19 %) had no documented reason for extended casting, four (1 %) were extended based on physician evaluation of radiographs, and seven (2 %) were extended for other reasons.

Conclusions

Elimination of radiographs at time of pin removal should be considered. If continuing to obtain radiographs at pin removal, we recommend removing pins before taking radiographs to reduce patient fear and anxiety from visualizing percutaneous pins.
Zukunft der deutschen Energiegenossenschaften
Authors: Klagge Britta , Schmole Hanna , Seidl Irmi , Schön Susanne
Published: June 2016

Energy co-operatives have played an important role in the development of decentralized renewable electricity production in Germany in the new millennium. They collect capital from individuals and thus open up another source of funding to promote the ”Energiewende“ in Germany. Their regional orientation and the co-operative participation model are regarded as success factors which help to increase local acceptance. With the amendment of the German Renewable Energy Sources Act (EEG) in 2014, the so far very favorable funding conditions gradually fall away, which were central to the business models of many, especially regional energy co-operatives. The boom phase of energy co-operatives has thus come to an end and the increasing market orientation of support policies requires adaptations and innovations. Against this background the paper explores energy cooperatives and their development from an innovation perspective. It specifically asks how they need to position, if they are to make a significant contribution to a decentralized energy transition in the future.

In the empirical part of this paper, we examine the structures and developments in the German energy co-operative sector based on existing data and an online survey, with a focus on energy cooperatives of different sizes and geographical orientation, complemented by an analysis of two case studies. We conclude that economies of scale and geographical diversification can offer benefits, but that there are also promising development opportunities for regional energy co-operatives. Diversification of business fields, which can include not only energy-related services, but also other local general interest services, as well as cooperation at the regional level and with other energy co-operatives and their umbrella associations, could be starting points for successful regional strategies. In general, direct marketing can become a potentially important element of innovative development of business models, because – in accordance with the co-operative core principles of member orientation and the principle of identity – it links the focus on specific target groups with a regional or ideological surplus value.
Evaluating a surgeon led training program: Targeting kidney disease in Vietnam
Authors: Slakey Douglas P. , Reily Robert , Davidson Ingemar , Korndorffer James R.
Published: June 2016

ABSTRACT

Background:

An educational program consisted of lectures and simulation training designed to provide knowledge and skills to improve the delivery of care to patients with kidney disease was delivered in Hue, Vietnam. A follow-up study to validate the efficacy and durability of the education and training was done one year later.

Methods:

The course was validated using Kirkpatrick's four levels of evaluation: (i) pre- and post-course interviews reflecting initial reaction; (ii) training quality assessment on simulated scenarios; and (iii) follow-up questionnaires, interviews, and on-site observation of clinical care delivery.

Results:

Reaction to the course was uniformly positive. Multidisciplinary design and emphasis was rated highly. The combination of evidence-based didactics and simulation training provided an assessment of application of learned material. Structured debriefing demonstrated a high degree of understanding. Predicted language and cultural barriers were reduced using simulation. Follow-up identified that course material had been put into practice, including communication, crew resource management, and a systems approach to the management of complications. Observation of clinical care identified systems changes that improved ability to deliver care in a cost-effective manner.

Conclusions:

The curriculum improved multidisciplinary team performance in the short and long term. Course design provided a structured training framework, and enhanced the learning. The methods used to deliver the educational material and simulation training overcame potential language and cultural barriers. Follow-up demonstrated a sustained acceptance and application of the training in the care of complex kidney disease patients. The Kirkpatrick evaluation method assisted in determining the effectiveness of this training methodology. Using this platform for education and training can foster improvements in patient outcomes effectiveness.

Highlights
Simulation and system identification of helicopter dynamics using support vector regression - ERRATUM
Authors: Manso S.
Published: June 2016

The article by Manso(1) was published online with a number of errors. The errors are shown below, along with the corrected article.
Consumers' Motivations Driving Organic Demand: Between Self-interest and Sustainability
Authors: Monier-Dilhan Sylvette , Bergès Fabian
Published: June 2016

We study consumers’ motivations for buying organic food by analyzing their shopping baskets. Buying organic can be motivated by concern about sustainable development and/or self-interest (considerations related to health or product quality). Pro-social motivation is inferred from the presence of fair trade products in the consumer's basket; consumer self-interest is deduced from the presence of healthy and higher-quality products bearing special quality labels or certifications. Our results indicate that environmental motivation predicts organic food purchases better than health or quality considerations: the complementarity between organic and fair trade products is strongest. In addition, the household's socioeconomic background influences secondary motivations.
Private Ordering and the Chinese in Nineteenth Century Straits Settlements
Authors: TAN Cheng Han
Published: June 2016

The Straits Settlements comprised a group of British territories located in the Malay Peninsula in Southeast Asia. It initially comprised Penang, Singapore, and Malacca, and was formed in 1826. Unlike Malacca which was a thriving city with a substantial Chinese community, Penang and Singapore were relatively uninhabited when the British arrived, but Chinese immigration to both territories swiftly took place and on a large scale. For much of the nineteenth century, British policy towards the Chinese community in the Straits was one of minimal governance. They were largely left to order their affairs privately and this suited the Chinese, who tended to be aloof from the machinery of government and were also unfamiliar with English law. While there were many positive aspects of such private ordering, some negative features included the manner in which secret societies evolved and the treatment of coolies. It was only when the colonial government introduced strong measures that these negative aspects were ameliorated.
Dravet Syndrome: Diagnosis and Long-Term Course
Authors: Connolly Mary B.
Published: June 2016

Dravet syndrome is one of the most severe epilepsy syndromes of early childhood, and it comes with very high morbidity and mortality. The typical presentation is characterized by hemiclonic or generalized clonic seizures triggered by fever during the first year of life, followed by myoclonic, absence, focal and generalized tonic-clonic seizures. Non-convulsive status epilepticus and epileptic encephalopathy are common. Development is normal in the first year of life, but most individuals eventually suffer from intellectual impairment. Dravet syndrome is associated with mutations in the sodium channel alpha1 subunit gene (SCN1A) in 70-80% of individuals. SCN1A mutation results in inhibition of the GABAergic inhibitory interneurons, leading to excessive neuronal excitation. The “interneuron hypothesis” is the current most accepted pathophysiological mechanism of Dravet syndrome. The mortality rate is increased significantly in Dravet syndrome. Ataxia, a characteristic crouched gait and Parkinson’s symptoms may develop in some individuals. It is likely that Dravet syndrome is underdiagnosed in adults with treatment-resistant epilepsy. Early diagnosis is important to avoid anti-seizure medications that exacerbate seizures.
Dravet Syndrome: Addressing the Needs of Patients and Families: Introduction
Authors: Dravet Charlotte
Published: June 2016

Dravet syndrome is not one of the most frequent severe epilepsies affecting infants during the first year of life. In the most recent epidemiological study, in Sweden, its estimated incidence was 1 in 33,000 live births. On December 31, 2011, its prevalence was 1 in 45,700 children aged less than 18 years. Nonetheless, it is now well known by many child neurologists for several reasons. First, its genetic aetiology was demonstrated almost 15 years ago, and an animal model was created shortly thereafter, allowing experimental work focused on the underlying mechanisms of the disease. Second, the clinical characteristics of the typical form of Dravet syndrome are well defined, enough to allow early diagnosis. Third, although the epileptic seizures are highly pharmacoresistant, we now have at our disposal a specific therapeutic strategy that allows one to avoid the most severe seizures in a number of patients due to the new drug stiripentol, used in different associations. Nevertheless, this therapeutic strategy should not be limited to seizure control and needs to take into account all other aspects of the disease. The aim of this symposium is to present a synthesis of the diagnosis and treatment of Dravet syndrome with a focus on family needs.
Promoting Health for All Kansans Through Mass Media: Lessons Learned From a Pilot Assessment of Student Ebola Perceptions
Authors: Chesser Amy K. , Keene Woods Nikki , Mattar Jennifer , Craig Timothy
Published: June 2016

Objective

We aimed to assess student knowledge of Ebola virus disease (EVD) and opinions about media coverage of EVD.

Methods

We conducted a pilot study with a cross-sectional survey and a convenience sample.

Results

Sixty-five college students participated in the survey and reported a low level of basic knowledge of EVD, high health literacy levels, and Internet and health professionals as sources for health information.

Conclusion

This pilot study was an important first step to understanding students’ knowledge of Ebola, common sources of health information, and health literacy levels. Results from this study highlight the need to improve health communication training and further evaluate the quality of health information dissemination via all communication sources. (Disaster Med Public Health Preparedness. 2016;10:641–643)
Evaluating a Hospitalist-Based Intervention to Decrease Unnecessary Antimicrobial Use in Patients With Asymptomatic Bacteriuria
Authors: Hartley Sarah E. , Kuhn Latoya , Valley Staci , Washer Laraine L. , Gandhi Tejal , Meddings Jennifer , Robida Michelle , Sabnis Salas , Chenoweth Carol , Malani Anurag N. , Saint Sanjay , Flanders Scott A.
Published: June 2016

OBJECTIVE

Inappropriate treatment of asymptomatic bacteriuria (ASB) in the hospital setting is common. We sought to evaluate the treatment rate of ASB at the 3 hospitals and assess the impact of a hospitalist-focused improvement intervention.

DESIGN

Prospective, interventional trial.

SETTING

Two community hospitals and a tertiary-care academic center.

PATIENTS

Adult patients with a positive urine culture admitted to hospitalist services were included in this study. Exclusions included pregnancy, intensive care unit admission, history of a major urinary procedure, and actively being treated for a urinary tract infection (UTI) at the time of admission or >48 hours prior to urine collection.

INTERVENTIONS

An educational intervention using a pocket card was implemented at all sites followed by a pharmacist-based intervention at the academic center. Medical records of the first 50 eligible patients at each site were reviewed at baseline and after each intervention for signs and symptoms of UTI, microbiological results, antimicrobials used, and duration of treatment for positive urine cultures. Diagnosis of ASB was determined through adjudication by 2 hospitalists and 2 infectious diseases physicians.

RESULTS

Treatment rates of ASB decreased (23.5%; P=.001) after the educational intervention. Reductions in treatment rates for ASB differed by site and were greatest in patients without classic signs and symptoms of UTI (34.1%; P<.001) or urinary catheters (31.2%; P<.001). The pharmacist-based intervention was most effective at reducing ASB treatment rates in catheterized patients.

CONCLUSIONS

A hospitalist-focused educational intervention significantly reduced ASB treatment rates. The impact varied across sites and by patient characteristics, suggesting that a tailored approach may be useful.

Infect Control Hosp Epidemiol 2016;37:1044–1051
Drag reduction in numerical two-phase Taylor–Couette turbulence using an Euler–Lagrange approach
Authors: Spandan Vamsi , Ostilla-Mónico Rodolfo , Verzicco Roberto , Lohse Detlef
Published: June 2016

Two-phase turbulent Taylor–Couette (TC) flow is simulated using an Euler–Lagrange approach to study the effects of a secondary phase dispersed into a turbulent carrier phase (here bubbles dispersed into water). The dynamics of the carrier phase is computed using direct numerical simulations (DNS) in an Eulerian framework, while the bubbles are tracked in a Lagrangian manner by modelling the effective drag, lift, added mass and buoyancy force acting on them. Two-way coupling is implemented between the dispersed phase and the carrier phase which allows for momentum exchange among both phases and to study the effect of the dispersed phase on the carrier phase dynamics. The radius ratio of the TC setup is fixed to ${\it\eta}=0.833$, and a maximum inner cylinder Reynolds number of $Re_{i}=8000$ is reached. We vary the Froude number ($Fr$), which is the ratio of the centripetal to the gravitational acceleration of the dispersed phase and study its effect on the net torque required to drive the TC system. For the two-phase TC system, we observe drag reduction, i.e. the torque required to drive the inner cylinder is lower compared with that of the single-phase system. The net drag reduction decreases with increasing Reynolds number $Re_{i}$, which is consistent with previous experimental findings (Murai et al., J. Phys.: Conf. Ser., vol. 14, 2005, pp. 143–156; Phys. Fluids, vol. 20(3), 2008, 034101). The drag reduction is strongly related to the Froude number: for fixed Reynolds number we observe higher drag reduction when $Fr<1$ than for with $Fr>1$. This buoyancy effect is more prominent in low $Re_{i}$ systems and decreases with increasing Reynolds number $Re_{i}$. We trace the drag reduction back to the weakening of the angular momentum carrying Taylor rolls by the rising bubbles. We also investigate how the motion of the dispersed phase depends on $Re_{i}$ and $Fr$, by studying the individual trajectories and mean dispersion of bubbles in the radial and axial directions. Indeed, the less buoyant bubbles (large $Fr$) tend to get trapped by the Taylor rolls, while the more buoyant bubbles (small $Fr$) rise through and weaken them.
Conditions for validity of mean flow stability analysis
Authors: Beneddine Samir , Sipp Denis , Arnault Anthony , Dandois Julien , Lesshafft Lutz
Published: June 2016

This article provides theoretical conditions for the use and meaning of a stability analysis around a mean flow. As such, it may be considered as an extension of the works by McKeon & Sharma (J. Fluid Mech., vol. 658, 2010, pp. 336–382) to non-parallel flows and by Turton et al. (Phys. Rev. E, vol. 91 (4), 2015, 043009) to broadband flows. Considering a Reynolds decomposition of the flow field, the spectral (or temporal Fourier) mode of the fluctuation field is found to be equal to the action on a turbulent forcing term by the resolvent operator arising from linearisation about the mean flow. The main result of the article states that if, at a particular frequency, the dominant singular value of the resolvent is much larger than all others and if the turbulent forcing at this frequency does not display any preferential direction toward one of the suboptimal forcings, then the spectral mode is directly proportional to the dominant optimal response mode of the resolvent at this frequency. Such conditions are generally met in the case of weakly non-parallel open flows exhibiting a convectively unstable mean flow. The spatial structure of the singular mode may in these cases be approximated by a local spatial stability analysis based on parabolised stability equations (PSE). We have also shown that the frequency spectrum of the flow field at any arbitrary location of the domain may be predicted from the frequency evolution of the dominant optimal response mode and the knowledge of the frequency spectrum at one or more points. Results are illustrated in the case of a high Reynolds number turbulent backward facing step flow.
Turbulence laws in natural bed flows
Authors: Ferraro Domenico , Servidio Sergio , Carbone Vincenzo , Dey Subhasish , Gaudio Roberto
Published: June 2016

Characterization of turbulence in natural bed streams is one of the most fascinating problems of fluid dynamics. In this study, a statistical description of turbulence in a natural pebble bed flow is presented applying the laws of turbulence. A laboratory experiment was conducted to measure the three-dimensional instantaneous velocity components in a flow over heterogeneous coarse sediments that simulated a natural bed. The analysis reveals that the spectra (in Fourier space) show a power-law scaling,$E(k)\sim k^{{\it\alpha}}$, suggesting the presence of inertial range turbulence. The exponent${\it\alpha}$is slightly shallower than the Kolmogorov$5/3$scaling law, with this deviation possibly due to the bed roughness heterogeneity and to fluctuation anisotropy. The Taylor frozen-in approximation is broken at smaller scales towards the roughness crest level; therefore, a new statistical tool for the validation of this approximation is proposed. The Kolmogorov$4/5$-law for the longitudinal increments and simultaneously the Monin–Yaglom$4/3$-law for the nonlinear normal fluxes (both in physical space) are preserved, providing an accurate estimation of the turbulent kinetic energy dissipation rate. The heterogeneity of the bed acts to induce the transport of finite kinetic helicity to the outer layer through persistently prolonged vortices. An associated$2/15$-law for the cascade of helicity has been locally found. These findings open a new direction in turbulence research for flows over highly rough beds.