bluuebunny/crossref_metadata_2025 huggingface dataset:
Severity of Pulmonary Hypertension and Obesity are Not Associated with Worse Functional Outcomes after Pulmonary Thromboendarterectomy
Authors: Matthews Daniel T. , Le Catherine N. , Robbins Ivan M. , Petracek Michael R. , Pugh Meredith E. , Brittain Evan L. , Hemnes Anna R.
Published: March 2016

Predictors of functional outcomes in patients with chronic thromboembolic pulmonary hypertension (CTEPH) undergoing pulmonary thromboendarterectomy (PTE) are important to identify preoperatively. We hypothesized that baseline severity of pulmonary hypertension and obesity would not be associated with 6‐month functional outcomes after PTE. Clinical and hemodynamic data were collected on consecutive patients undergoing PTE from 2008 to 2014. Patients were stratified according to baseline pulmonary vascular resistance (PVR) and body mass index (BMI). Six‐minute walk distance (6MWD), New York Heart Association functional class (FC), and echocardiography were assessed in each group at baseline and 6 months after PTE. Regression analyses were performed to evaluate for associations between functional outcomes and baseline PVR and BMI. Forty‐two patients underwent PTE and had 6‐month follow up data. In comparisons of patients with high and low baseline PVR, the baseline characteristics, distribution of disease, 6MWD, and FC were similar. Postoperative hemodynamics for both groups were similar. At 6 months, both groups achieved improvements in FC, and there were no between‐group differences in the change in 6MWD or FC. In comparisons of obese and nonobese patients, perioperative and FC improvement were similar; however, obese patients achieved a greater improvement in 6MWD than nonobese patients (P = 0.04). In conclusion, our data suggest that baseline severity of CTEPH and obesity were not associated with worse functional outcome. Further studies are needed to confirm these results, as these findings could have implications for patient selection for PTE.
Toroidal rotation induced by asymmetric cyclotron resonance absorption in minority ICRF-heated tokamak plasmas
Authors: Xu Y. , Wang S. , Zhang D.
Published: March 2016

A new mechanism of ion cyclotron range of frequency (ICRF)-induced rotation is proposed to explain the toroidal rotation with minority ICRF heating without net momentum injection. For ICRF waves launched with the symmetric spectrum, a nonlinear toroidal force can be generated through the asymmetric absorption of the toroidal wave momentum, which is due to the finite toroidal rotation of minority ions. This ICRF-induced toroidal force can drive a significant toroidal rotation of bulk ions.
Tritium retention measurements by accelerator mass spectrometry and full combustion of W-coated and uncoated CFC tiles from the JET divertor
Authors: Stan-Sion C. , Bekris N. , Kizane G. , Enachescu M. , Likonen J. , Halitovs M. , Petre A.
Published: March 2016

Accelerator mass spectrometry (AMS) and the full combustion method (FCM) followed by liquid scintillation counting were applied to quantitatively determine the tritium retention in the tungsten-coated carbon fibre composites (CFC), in comparison to uncoated CFC tiles from the JET divertor. The tiles were adjacent and exposed to plasma operations between 2007 and 2009. The tritium depth profiles are showing that the tritium retention on the W-coated tile was reduced by a factor of 13.5 in comparison to the uncoated tile whereas the bulk tritium concentration is approximately the same for both tiles.
Multiple testing procedures for adaptive enrichment designs: combining group sequential and reallocation approaches
Authors: Rosenblum Michael , Qian Tianchen , Du Yu , Qiu Huitong , Fisher Aaron
Published: March 2016

Adaptive enrichment designs involve preplanned rules for modifying enrollment criteria based on accrued data in an ongoing trial. For example, enrollment of a subpopulation where there is sufficient evidence of treatment efficacy, futility, or harm could be stopped, while enrollment for the remaining subpopulations is continued. We propose a new class of multiple testing procedures tailored to adaptive enrichment designs. The procedures synthesize ideas from two general approaches. As in the modified group sequential approach, the procedures gain power by leveraging the covariance among statistics for different stages and different hypotheses. As in the alpha reallocation approach, the procedures lower rejection thresholds for the remaining null hypotheses after others have been rejected. The proposed procedures are proved to have power greater than or equal to several existing methods, and to strongly control the familywise Type I error rate when statistics are normally distributed. The methods are illustrated through simulations of a trial for a surgical intervention for stroke, involving two subpopulations.
Mouse models for ROS1-fusion-positive lung cancers and their application to the analysis of multikinase inhibitor efficiency
Authors: Inoue Maki , Toki Hideaki , Matsui Junko , Togashi Yuki , Dobashi Akito , Fukumura Ryutaro , Gondo Yoichi , Minowa Osamu , Tanaka Norio , Mori Seiichi , Takeuchi Kengo , Noda Tetsuo
Published: March 2016

ROS1-fusion genes, resulting from chromosomal rearrangement, have been reported in 1–2% of human non-small cell lung cancer cases. More than 10 distinct ROS1-fusion genes, including break-point variants, have been identified to date. In this study, to investigate the in vivo oncogenic activities of one of the most frequently detected fusions, CD74-ROS1, as well as another SDC4-ROS1 fusion that has also been reported in several studies, we generated transgenic (TG) mouse strains that express either of the two ROS1-fusion genes specifically in lung alveolar type II cells. Mice in all TG lines developed tumorigenic nodules in the lung, and a few strains of both TG mouse lines demonstrated early-onset nodule development (multiple tumor lesions present in the lung at 2–4 weeks after birth); therefore, these two strains were selected for further investigation. Tumors developed progressively in the untreated TG mice of both lines, whereas those receiving oral administration of an ALK/MET/ROS1 inhibitor, crizotinib, and an ALK/ROS1 inhibitor, ASP3026, showed marked reduction in the tumor burden. Collectively, these data suggest that each of these two ROS1-fusion genes acts as a driver for the pathogenesis of lung adenocarcinoma in vivo. The TG mice developed in this study are expected to serve as valuable tools for exploring novel therapeutic agents against ROS1-fusion-positive lung cancer.
Vaccine adjuvants as potential cancer immunotherapeutics
Authors: Temizoz Burcu , Kuroda Etsushi , Ishii Ken J.
Published: March 2016

Accumulated evidence obtained from various clinical trials and animal studies suggested that cancer vaccines need better adjuvants than those that are currently licensed, which include the most commonly used alum and incomplete Freund’s adjuvant, because of either a lack of potent anti-tumor immunity or the induction of undesired immunity. Several clinical trials using immunostimulatory adjuvants, particularly agonistic as well as non-agonistic ligands for TLRs, C-type lectin receptors, retinoic acid-inducible gene I-like receptors and stimulator of interferon genes, have revealed their therapeutic potential not only as vaccine adjuvants but also as anti-tumor agents. Recently, combinations of such immunostimulatory or immunomodulatory adjuvants have shown superior efficacy over their singular use, suggesting that seeking optimal combinations of the currently available or well-characterized adjuvants may provide a better chance for the development of novel adjuvants for cancer immunotherapy.
Brown hyena habitat selection varies among sites in a semi-arid region of southern Africa
Authors: Welch Rebecca J. , Tambling Craig J. , Bissett Charlene , Gaylard Angela , Müller Konrad , Slater Kerry , Strauss W. Maartin , Parker Daniel M.
Published: March 2016

Human/carnivore conflicts are common across the globe, and with a growing human population, this conflict is likely to increase as the space available to large carnivores is reduced. In South Africa, many small (< 400 km 2 ), fenced protected areas have reintroduced persecuted carnivores, such as brown hyenas ( Hyaena brunnea ). These reserves have great potential to conserve brown hyena populations; consequently, understanding the limitations that small, fenced reserves impose on space use patterns is needed. We investigated the home range (95% fixed kernel utilization distributions) and landscape determinants of habitat selection using resource selection functions for 10 brown hyenas in 3 separate fenced reserves. Home range sizes were consistently smaller in 2 of the reserves when compared to the third. Considerable variation in the selection of habitat features exists among individual brown hyenas and reserves. The most important landscape determinant driving brown hyena space use was distance to roads, with brown hyenas observed closer to roads when compared to random locations within their ranges. If this relationship with roads holds outside of protected areas, it could represent a considerable threat to the species. Thus, obtaining a better understanding of the influence of roads on brown hyenas represents an important focus for future research.
Paternity and male mating strategies of a ground squirrel (
Ictidomys parvidens
) with an extended mating season
Authors: Schwanz Lisa E. , Sherwin William B. , Ognenovska Katherine , Lacey Eileen A.
Published: March 2016

Animal mating systems are driven by the temporal and spatial distribution of sexually receptive females. In mammals, ground-dwelling squirrels represent an ideal clade for testing predictions regarding the effects of these parameters on male reproductive strategies. While the majority of ground squirrel species have a short, highly synchronous annual breeding season that occurs immediately after females emerge from hibernation, the Mexican or Rio Grande ground squirrel ( Ictidomys parvidens ) differs markedly in having an extended mating season (2 months) and a long delay between emergence from hibernation and female receptivity (1–2 months). Both traits are expected to favor polygyny by increasing the chances that a male can secure matings with multiple females (e.g., females that come into estrus on different days). To test this prediction, we used microsatellite markers to characterize the mating system of a population of Rio Grande ground squirrels from Carlsbad, New Mexico. Our analyses indicated a high frequency of multiple paternity of litters in this population. Paternity was not related to spatial overlap between known mothers and assigned fathers, suggesting that territory defense is unlikely to be an effective male reproductive strategy in the study population. Dominance interactions among males were frequent, with heavier males typically winning dyadic interactions. Surprisingly, however, males with lower dominance scores appeared to have higher reproductive success, as did males that were active over a greater extent of the study site. Collectively, these results suggest that the mating system of the Rio Grande ground squirrel is best described as scramble competition polygyny, with the primary male reproductive strategy consisting of searching for estrous females. Similar patterns of male–male competition have been reported for a few other ground squirrel species, providing potentially important opportunities for comparative studies of the factors favoring this form of male reproductive strategy.
Resource selection by southeastern fox squirrels in a fire-maintained forest system
Authors: Prince Annemarie , Chitwood M. Colter , Lashley Marcus A. , DePerno Christopher S. , Moorman Christopher E.
Published: March 2016

Fire is essential to maintain the open forest structure required by the southeastern fox squirrel ( Sciurus niger niger ). In recent decades, managers of the longleaf pine ( Pinus palustris ) ecosystem have transitioned from dormant-season to growing-season burns, which more effectively limit midstory hardwood encroachment. Similarly, aggressive hardwood removal programs have been employed to further reduce hardwood midstory. However, fox squirrels are dependent on oaks ( Quercus spp.) for food and cover; thus, it is unclear how growing-season burns and hardwood removal may affect habitat quality for fox squirrels. We used compositional analysis to investigate selection of home ranges within the study area by 48 radiocollared fox squirrels on the Fort Bragg Military Installation, North Carolina. We used resource utilization functions with growing-season fire history and other habitat covariates as explanatory variables to test whether growing-season fires influenced the selection of habitat components within home ranges. Lastly, using a sample of fox squirrel relocations and paired random points, we performed binomial logistic regression to test whether habitat selection by fox squirrels was influenced by the availability of oaks and longleaf pines and select forest stand structural characteristics. When establishing home ranges, fox squirrels selected southern yellow pine over other cover types. Within home ranges, fox squirrel use increased with decreasing distance to a riparian area but was not affected by the application of growing-season fires. At the population level, fox squirrels selected for greater densities of reproductively mature oak stems. Fox squirrels likely benefit from growing-season fires that maintain expansive upland pine stands but are negatively affected by homogeneous fire application and mechanical hardwood removal that reduce the occurrence of reproductively mature oaks across the landscape. Managers should strive to maintain oaks in riparian areas, fire shadows, and naturally occurring patches within pine stands when managing for fox squirrels.
Resolving the planetesimal belt of HR 8799 with ALMA
Authors: Booth Mark , Jordán Andrés , Casassus Simon , Hales Antonio S. , Dent William R. F. , Faramaz Virginie , Matrà Luca , Barkats Denis , Brahm Rafael , Cuadra Jorge
Published: March 2016

The star HR 8799 hosts one of the largest known debris discs and at least four giant planets. Previous observations have found evidence for a warm belt within the orbits of the planets, a cold planetesimal belt beyond their orbits and a halo of small grains. With the infrared data, it is hard to distinguish the planetesimal belt emission from that of the grains in the halo. With this in mind, the system has been observed with ALMA in band 6 (1.34 mm) using a compact array format. These observations allow the inner edge of the planetesimal belt to be resolved for the first time. A radial distribution of dust grains is fitted to the data using an MCMC method. The disc is best fitted by a broad ring between $145^{+12}_{-12}$ au and $429^{+37}_{-32}$ au at an inclination of $40^{+5}_{-6}{^{\circ }}$ and a position angle of $51^{+8}_{-8}{^{\circ }}$. A disc edge at ∼145 au is too far out to be explained simply by interactions with planet b, requiring either a more complicated dynamical history or an extra planet beyond the orbit of planet b.
Flares from Galactic Centre pulsars: a new class of X-ray transients?
Authors: Giannios Dimitrios , Lorimer Duncan R.
Published: March 2016

Despite intensive searches, the only pulsar within 0.1 pc of the central black hole in our Galaxy, Sgr A*, is a radio-loud magnetar. Since magnetars are rare among the Galactic neutron star population, and a large number of massive stars are already known in this region, the Galactic Centre (GC) should harbour a large number of neutron stars. Population syntheses suggest several thousand neutron stars may be present in the GC. Many of these could be highly energetic millisecond pulsars which are also proposed to be responsible for the GC gamma-ray excess. We propose that the presence of a neutron star within 0.03 pc from Sgr A* can be revealed by the shock interactions with the disc around the central black hole. As we demonstrate, these interactions result in observable transient non-thermal X-ray and gamma-ray emission over time-scales of months, provided that the spin-down luminosity of the neutron star is Lsd ∼ 1035 erg s−1. Current limits on the population of normal and millisecond pulsars in the GC region suggest that a number of such pulsars are present with such luminosities.
A General Class of Social Distance Measures
Authors: Brown Graham K. , Langer Arnim
Published: March 2016

Measures of diversity and disparity within a population are used for investigating a range of developmental outcomes, but often by employing “off-the-shelf” indicators that may not be theoretically appropriate for the hypotheses under investigation. In this article, we proposed a general class of social distance measures that both enables us to see the conceptual relationship between different existing measures of heterogeneity more clearly and is sufficiently flexible to allow for the development of tailored hypothesis-specific measures. We show how a range of existing aggregate measures of diversity and disparity fit within the general class and demonstrate illustratively how the measure can be used to develop more precise hypothesis-specific measures.
Creating the Medical Schools of the Future
Authors: Skochelak Susan E. , Stack Steven J.
Published: March 2016

Despite wide consensus on needed changes in medical education, experts agree that the gap continues to widen between how physicians are trained and the future needs of our health care system. A new model for medical education is needed to create the medical school of the future. The American Medical Association (AMA) is working to support innovative models through partnerships with medical schools, educators, professional organizations, and accreditors. In 2013, the AMA designed an initiative to support rapid innovation among medical schools and disseminate the ideas being tested to additional medical schools. Awards of $1 million were made to 11 medical schools to redesign curricula for flexible, individualized learning pathways, measure achievement of competencies, develop new assessment tools to test readiness for residency, and implement new models for clinical experiences within health care systems. The medical schools have partnered with the AMA to create the AMA Accelerating Change in Medical Education Consortium, working together to share prototypes and participate in a national evaluation plan. Most of the schools have embarked on major curriculum revisions, replacing as much as 25% of the curriculum with new content in health care delivery and health system science in all four years of training. Schools are developing new certification in quality and patient safety and population management. In 2015, the AMA invited 21 additional schools to join the 11 founding schools in testing and disseminating innovation through the consortium and beyond.
Ionizing Radiation Doses Detected at the Eye Level of the Primary Surgeon During Orthopaedic Procedures
Authors: Cheriachan Deepak , Hughes Adrian M. , du Moulin William S. M. , Williams Christopher , Molnar Robert
Published: March 2016

Objectives:

To evaluate the ionizing radiation dose received by the eyes of orthopaedic surgeons during various orthopaedic procedures. Secondary objective was to compare the ionizing radiation dose received between differing experience level.

Design:

Prospective comparative study between January 2013 and May 2014.

Setting:

Westmead Hospital, a Level 1 Trauma Centre for Greater Western Sydney.

Participants:

A total of 26 surgeons volunteered to participate within the study.

Intervention:

Experience level, procedure performed, fluoroscopy time, dose area product, total air kerma, and eye dose received was recorded. Participants were evaluated on procedure and experience level.

Main Outcome Measurements:

Radiation dose received at eye level by the primary surgeon during an orthopaedic procedure.

Results:

Data from a total of 131 cases was recorded and included for analysis. The mean radiation dose detected at the eye level of the primary surgeon was 0.02 mSv (SD = 0.05 mSv) per procedure. Radiation at eye level was only detected in 31 of the 131 cases. The highest registered dose for a single procedure was 0.31 mSv. Femoral nails and pelvic fixation procedures had a significantly higher mean dose received than other procedure groups (0.04 mSv (SD = 0.07 mSv) and 0.04 mSv (SD = 0.06 mSv), respectively). Comparing the eye doses received by orthopaedic consultants and trainees, there was no significant difference between the 2 groups.

Conclusions:

The risk of harmful levels of radiation exposure at eye level to orthopaedic surgeons is low. This risk is greatest during insertion of femoral intramedullary nails and pelvic fixation, and it is recommended that in these situations, surgeons take all reasonable precautions to minimize radiation dose. The orthopaedic trainees in this study were not subjected to higher doses of radiation than their consultant trainers. On the basis of these results, most of the orthopaedic surgeons remain well below the yearly radiation dose of 20 mSv as recommended by the International Commission on Radiological Protection.
Resolution of Cardiogenic Shock Using Echocardiography-Guided Pacing Optimization in Intensive Care: A Case Series*
Authors: Tavazzi Guido , Kontogeorgis Andy , Bergsland Niels P. , Price Susanna
Published: March 2016

Objective:

Inotropic and vasopressor drugs are routinely used in critically ill patients to maintain adequate blood pressure and cardiac output in patients with cardiogenic shock although potentially at the expense of increasing myocardial oxygen demand. Pacing optimization has been demonstrated as effective in reducing catecholamine requirements in patients with chronic heart failure by improving cardiac efficiency; however, there are no reports relating to the effectiveness of pacemaker optimization on cardiac output in critically ill patients with cardiogenic shock in the intensive care.

Data Sources:

Retrospective data analysis.

Study Selection:

Twenty-bed adult tertiary cardiothoracic ICU, university hospital.

Data Extraction:

Eight sequential patients receiving dual chamber pacemaker with DDD modality with cardiogenic shock and hemodynamic instability refractory to catecholamines underwent echocardiography-guided pacemaker optimization of cardiac output. An iterative method with Doppler echocardiography was used to assess changes in cardiac output, left ventricular filling time, ejection time, total isovolumic time, mitral regurgitation, ejection fraction, and blood pressure at different increments of heart rate, and atrioventricular and interventricular delay. All results are shown as median (minimum/maximum level) or mean ± sd.

Data Synthesis:

Using echocardiography-guided pacemaker optimization on cardiac output, the cardiac output increased from 3.2 (2.3/3.8) to 5.7 L/min (4.85/7.1) and cardiac index from 1.64 (1.1/1.9) to 2.68 L/min/m2 (2.1/3.2) and the total isovolumic time reduced from 22.8 to normal values (<14). In association, the glomerular filtration rate increased significantly except in one patient with stage IV chronic kidney disease. All inotropes and vasopressors were discontinued within 12 hours of pacemaker optimization on cardiac output, and all patients were discharged from the ICU within 1 week.

Conclusions:

Echocardiography-guided pacemaker optimization of cardiac output is a feasible bedside therapeutic option, which should be considered when standard medical treatments are insufficient for the treatment of cardiogenic shock refractory to inotropic support, thereby minimizing the detrimental effect of catecholamines.
Awareness of human papillomavirus after introduction of HPV vaccination: a large population-based survey of Scandinavian women
Authors: Thomsen Louise T. , Nygård Mari , Stensen Signe , Terning Hansen Bo , Arnheim Dahlström Lisen , Liaw Kai-Li , Munk Christian , Kjaer Susanne K.
Published: March 2016

Using a large, population-based survey, we assessed the levels and correlates of human papillomavirus (HPV) awareness among Scandinavian women after introduction of HPV vaccination. In 2011–2012, a random sample of women aged between 18 and 45 years from Denmark, Sweden and Norway received a questionnaire on lifestyle, health and HPV awareness. We included 47 895 women (response rate 60.6%) in our study. Country-specific and age-specific proportions of women who had heard of HPV in 2011–2012 (postvaccination survey) were compared with corresponding proportions in an identical survey from 2004–2005 (prevaccination survey, n=54 079, response rate 71.3%). Correlates of HPV awareness in the postvaccination survey were assessed by logistic regression. In all countries and age groups, awareness of HPV increased from the prevaccination to the postvaccination survey. In the postvaccination survey, HPV awareness was higher in Denmark (75.8%) and Sweden (74.8%) compared with Norway (62.4%), with greatest discrepancy among women aged between 18 and 19 years (Denmark: 74.9%, Sweden: 70.4%, Norway: 39.6%). Variables associated with low HPV awareness included the following: low education [≤12 vs. >16 years of schooling: odds ratio (OR)=0.45, 95% confidence interval (CI): 0.42–0.48], being a virgin (vs. nonvirgins: OR=0.74, 95% CI: 0.66–0.83), never having used condoms (vs. ever: OR=0.62, 95% CI: 0.56–0.67), nonuse of contraception at first intercourse (vs. use: OR=0.83, 95% CI: 0.79–0.88) and daily smoking (vs. never: OR=0.86, 95% CI: 0.80–0.92). HPV awareness in Scandinavia has increased since the introduction of HPV vaccination. However, 24–38% of Scandinavian women still have never heard of HPV. Future information efforts should target groups with low HPV awareness.
Perioperative and Anesthesia Guidelines for Children with Autism: A Nationwide Survey from Sweden
Authors: Gimbler Berglund Ingalill , Huus Karina , Enskär Karin , Faresjö Maria , Björkman Berit
Published: March 2016

Objective:

The overall aim of this study was to describe the current set of guidelines for the preparation and care for children with autism spectrum disorder (ASD) in the perioperative setting across Sweden and explore the content of these guidelines in detail.

Method:

An online questionnaire was distributed to the chairpersons of all anesthesia departments (n = 68) and pediatric departments (n = 38) throughout Sweden. Follow-up phone calls were made to those departments that did not return the questionnaire. The presence of guidelines was analyzed through descriptive statistics. These guidelines and comments on routines used in these departments were analyzed inspired by conventional content analysis.

Results:

Seven of the 68 anesthesia departments and none of the 38 pediatric departments across Sweden have guidelines for preparing and/or administering care to children with ASD within the perioperative setting. From the guidelines and routines used, 3 categories emerge: “lacking the necessary conditions,” “no extra considerations needed,” and “care with specific consideration for children with ASD.” These 3 categories span a continuum in the care. In the first category, the anesthesia induction could result in the child with ASD being physically restrained. In the last category, the entire encounter with the health care service would be adapted to the specific needs of the child.

Conclusion:

There is a lack of evidence-based guidelines specifically designed to meet the needs of children with ASD in the preoperative period in Sweden. Further research is needed to understand if children with ASD would benefit from evidence-based guidelines.
Evidence for a central mode of action for etoricoxib (COX-2 inhibitor) in patients with painful knee osteoarthritis
Authors: Arendt-Nielsen Lars , Egsgaard Line Lindhardt , Petersen Kristian Kjær
Published: March 2016

The COX-2 inhibitor etoricoxib modulates the peripheral and central nociceptive mechanisms in animals. This interaction has not been studied in patients with pain. This randomized, double-blind, placebo-controlled, 2-way crossover, 4-week treatment study investigated the pain mechanisms modulated by etoricoxib in patients with painful knee osteoarthritis. Patients were randomized to group A (60 mg/d etoricoxib followed by placebo) or B (placebo followed by 60 mg/d etoricoxib). The quantitative, mechanistic pain biomarkers were pressure pain thresholds, temporal summation (TS), and conditioning pain modulation. Clinical readouts were Brief Pain Inventory, WOMAC, painDETECT questionnaire (PD-Q), and time and pain intensity during walking and stair climbing. Etoricoxib as compared with placebo significantly modulated the pressure pain thresholds (P = 0.012, localized sensitization) at the knee and leg (control site) (P = 0.025, spreading sensitization) and TS assessed from the knee (P = 0.038) and leg (P = 0.045). Conditioning pain modulation was not modulated. The Brief Pain Inventory (pain scores), PD-Q, WOMAC, and walking and stair climbing tests were all significantly improved by etoricoxib. Based on a minimum of 30% or 50% pain alleviation (day 0-day 28), responders and nonresponders were defined. The nonresponders showed a significant association between increased facilitation of TS and increased pain alleviation. None of the other parameters predicted the degree of pain alleviation. Generally, a responder to etoricoxib has the most facilitated TS. In conclusion, etoricoxib (1) modulated central pain modulatory mechanisms and (2) improved pain and function in painful osteoarthritis. Stronger facilitation of TS may indicate a better response to etoricoxib, supporting the central mode-of-action of the drug.
Addition of posttraumatic stress and sensory hypersensitivity more accurately estimates disability and pain than fear avoidance measures alone after whiplash injury
Authors: Pedler Ashley , Kamper Steven J. , Sterling Michele
Published: March 2016

The fear avoidance model (FAM) has been proposed to explain the development of chronic disability in a variety of conditions including whiplash-associated disorders (WADs). The FAM does not account for symptoms of posttraumatic stress and sensory hypersensitivity, which are associated with poor recovery from whiplash injury. The aim of this study was to explore a model for the maintenance of pain and related disability in people with WAD including symptoms of PTSD, sensory hypersensitivity, and FAM components. The relationship between individual components in the model and disability and how these relationships changed over the first 12 weeks after injury were investigated. We performed a longitudinal study of 103 (74 female) patients with WAD. Measures of pain intensity, cold and mechanical pain thresholds, symptoms of posttraumatic stress, pain catastrophising, kinesiophobia, and fear of cervical spine movement were collected within 6 weeks of injury and at 12 weeks after injury. Mixed-model analysis using Neck Disability Index (NDI) scores and average 24-hour pain intensity as the dependent variables revealed that overall model fit was greatest when measures of fear of movement, posttraumatic stress, and sensory hypersensitivity were included. The interactive effects of time with catastrophising and time with fear of activity of the cervical spine were also included in the best model for disability. These results provide preliminary support for the addition of neurobiological and stress system components to the FAM to explain poor outcome in patients with WAD.
Clinical utility of double-balloon enteroscopy in suspected Crohn’s disease: a single-centre experience
Authors: Tun Gloria S.Z. , Rattehalli Deepa , Sanders David S. , McAlindon Mark E. , Drew Kaye , Sidhu Reena
Published: March 2016

Background

Small bowel Crohn’s disease has a heterogeneous presentation leading to a delay in diagnosis. Capsule endoscopy is now a well-established diagnostic tool; however, few studies have evaluated the role of double-balloon enteroscopy (DBE) in patients with suspected Crohn’s disease. Histology obtained at DBE is useful in addition to clinical symptoms, blood parameters and capsule endoscopy findings to aid diagnosis and further management.

Objective

The aim of this study was to evaluate the impact of DBE and histology on the management of patients with suspected small bowel Crohn’s disease.

Methods

DBE procedures including histology for suspected Crohn’s disease from 2006 to 2014 were retrospectively reviewed. Follow-up data for all patients were collected.

Results

In our series of 399 double-balloon enteroscopies, 122 procedures were performed in 100 patients for suspected Crohn’s disease. Positive DBE findings were found in 60% of patients. Forty-five per cent of patients were treated as Crohn’s disease on the basis of a combination of histology, endoscopic appearance, clinical symptoms and blood parameters. Histology was diagnostic of Crohn’s disease in 8% and supportive of it in 15%. In 12%, an alternative diagnosis was made, of whom two patients were diagnosed with small bowel malignancy on histology.

After a median follow-up period of 27 months, the actual prevalence for a new diagnosis of Crohn’s disease in our study was 38%.

Conclusion

DBE has a useful place in clarifying the diagnosis in patients with suspected Crohn’s disease. Although histology can be nondiagnostic, the combination of the macroscopic appearance with clinical correlation is useful in the diagnosis and management.
Mothers' Psychological Distress and Feeding of Their Preterm Infants
Authors: Park Jinhee , Thoyre Suzanne , Estrem Hayley , Pados Britt F. , Knafl George J. , Brandon Debra
Published: March 2016

Purpose:

To examine the change in psychological distress of mothers of preterm infants and its association with maternal feeding behaviors as the infant transitions to full oral feeding.

Study Design and Methods:

This descriptive exploratory study used a subset of data from a study of the effects of a coregulated feeding intervention for 34 mothers and hospitalized preterm infants in a Level-III neonatal intensive care unit (NICU). Maternal psychological distress was measured by maternal worry (Child Health Worry Scale), depression (Center for Epidemiology-Depression Scale), and role stress (Parental Stress Scale: NICU-Role Alteration) at three time points: within 1 week prior to the first oral feeding (T1), and at achievement of half (T2) and full oral feeding (T3). Feedings were videotaped at T2 and T3. An observational coding system measured maternal feeding behaviors. Linear mixed modeling evaluated the change in maternal psychological distress and its association with mothers' feeding behaviors as the infant transitioned to full oral feeding.

Results:

Maternal depressive symptoms were highest at T1 and declined over time. Maternal worry and role stress were also highest at T1 but remained stable from T2 to T3. Increased maternal psychological distress, particularly depressive symptoms and role stress, were associated with less use of developmentally supportive feeding behaviors, that is, minimizing tactile stimulation, providing steady touch to contain or stabilize the infant, and regulating milk flow.

Clinical Implications:

Supporting maternal psychological well-being while infants are learning to feed orally may be an appropriate target for interventions to support mother–infant early feeding interactions.
Concept of Pediatric Feeding Problems From the Parent Perspective
Authors: Estrem Hayley Henrikson , Pados Britt Frisk , Thoyre Suzanne , Knafl Kathleen , McComish Cara , Park Jinhee
Published: March 2016

Purpose:

Feeding difficulties in early childhood are common, affecting approximately 25% of typically developing children and up to 80% of children with developmental disabilities. There is no interdisciplinary consensus on the definition of a feeding problem and there is no input from families in the conceptualization. Lack of common language is a barrier to effective communication between clinicians, researchers, and caregivers, and inhibits collaboration. The purpose of this study was to examine the conceptualization of pediatric feeding problems by family caregivers (parents).

Study Design and Methods:

This study reports an empirical phase of a concept analysis. Data from interviews with 12 parents of children with feeding problems were coded for related concepts, attributes, antecedents, and consequences of feeding problems, and then analyzed for themes within conceptual categories.

Results:

Conceptual elements across interviews are presented with an emphasis on shared perspectives. Parents related pediatric feeding problems to be a process or journey on which they found themselves for an unknown duration. Common themes of attributes were problematic feeding behaviors of the child, restrictive or selective intake, and child weight or growth concerns.

Clinical Implications:

Parents conceptualize feeding problems as a condition with symptoms experienced by the child and family that need to be incorporated into family life. In contrast, prior literature coming from providers' point of view presents this problem to be of the child. Nurses can improve care of families with children who have feeding problems by coordinating interdisciplinary, family-centered care.
Representations of ECT in English-Language Film and Television in the New Millennium
Authors: Matthews Avery Madeleine , Rosenquist Peter B. , McCall William Vaughn
Published: March 2016

Objective

The aim of the study was to survey the media landscape to determine whether visual depictions of electroconvulsive therapy (ECT) are becoming more or less medically accurate in the new millennium.

Method

English-language film and television shows depicting ECT were analyzed for patient demographics, administrator roles, indication, consent, anesthesia, paralytics, bite block, lead placement, electroencephalogram, and outcome.

Results

Thirty-nine ECT scenes were viewed, and just 3 included all 5 essential tools of modern ECT: anesthesia, paralytic, electrodes, electroencephalogram, and a bite block.

Conclusions

Media depictions of ECT do not reflect current practice. Too often, ECT is portrayed as a torture technique rather than an evidenced-based therapy, and even in a therapeutic setting, it is too often shown with outdated techniques.
Micro-CT scan reveals an unexpected high-volume and interconnected pore network in a Cretaceous Sanagasta dinosaur eggshell
Authors: Hechenleitner E. Martín , Grellet-Tinner Gerald , Foley Matthew , Fiorelli Lucas E. , Thompson Michael B.
Published: March 2016

The Cretaceous Sanagasta neosauropod nesting site (La Rioja, Argentina) was the first confirmed instance of extinct dinosaurs using geothermal-generated heat to incubate their eggs. The nesting strategy and hydrothermal activities at this site led to the conclusion that the surprisingly 7 mm thick-shelled eggs were adapted to harsh hydrothermal microenvironments. We used micro-CT scans in this study to obtain the first three-dimensional microcharacterization of these eggshells. Micro-CT-based analyses provide a robust assessment of gas conductance in fossil dinosaur eggshells with complex pore canal systems, allowing calculation, for the first time, of the shell conductance through its thickness. This novel approach suggests that the shell conductance could have risen during incubation to seven times more than previously estimated as the eggshell erodes. In addition, micro-CT observations reveal that the constant widening and branching of pore canals form a complex funnel-like pore canal system. Furthermore, the high density of pore canals and the presence of a lateral canal network in the shell reduce the risks of pore obstruction during the extended incubation of these eggs in a relatively highly humid and muddy nesting environment.
Fish larvae exploit edge vortices along their dorsal and ventral fin folds to propel themselves
Authors: Li Gen , Müller Ulrike K. , van Leeuwen Johan L. , Liu Hao
Published: March 2016

Larvae of bony fish swim in the intermediate Reynolds number (Re) regime, using body- and caudal-fin undulation to propel themselves. They share a median fin fold that transforms into separate median fins as they grow into juveniles. The fin fold was suggested to be an adaption for locomotion in the intermediate Reynolds regime, but its fluid-dynamic role is still enigmatic. Using three-dimensional fluid-dynamic computations, we quantified the swimming trajectory from body-shape changes during cyclic swimming of larval fish. We predicted unsteady vortices around the upper and lower edges of the fin fold, and identified similar vortices around real larvae with particle image velocimetry. We show that thrust contributions on the body peak adjacent to the upper and lower edges of the fin fold where large left–right pressure differences occur in concert with the periodical generation and shedding of edge vortices. The fin fold enhances effective flow separation and drag-based thrust. Along the body, net thrust is generated in multiple zones posterior to the centre of mass. Counterfactual simulations exploring the effect of having a fin fold across a range of Reynolds numbers show that the fin fold helps larvae achieve high swimming speeds, yet requires high power. We conclude that propulsion in larval fish partly relies on unsteady high-intensity vortices along the upper and lower edges of the fin fold, providing a functional explanation for the omnipresence of the fin fold in bony-fish larvae.
Engineering a more sustainable world through catalysis and green chemistry
Authors: Sheldon Roger A.
Published: March 2016

The grand challenge facing the chemical and allied industries in the twenty-first century is the transition to greener, more sustainable manufacturing processes that efficiently use raw materials, eliminate waste and avoid the use of toxic and hazardous materials. It requires a paradigm shift from traditional concepts of process efficiency, focusing on chemical yield, to one that assigns economic value to replacing fossil resources with renewable raw materials, eliminating waste and avoiding the use of toxic and/or hazardous substances. The need for a greening of chemicals manufacture is readily apparent from a consideration of the amounts of waste generated per kilogram of product (the E factors) in various segments of the chemical industry. A primary source of this waste is the use of antiquated ‘stoichiometric’ technologies and a major challenge is to develop green, catalytic alternatives. Another grand challenge for the twenty-first century, driven by the pressing need for climate change mitigation, is the transition from an unsustainable economy based on fossil resources—oil, coal and natural gas—to a sustainable one based on renewable biomass. In this context, the valorization of waste biomass, which is currently incinerated or goes to landfill, is particularly attractive. The bio-based economy involves cross-disciplinary research at the interface of biotechnology and chemical engineering, focusing on the development of green, chemo- and biocatalytic technologies for waste biomass conversion to biofuels, chemicals and bio-based materials. Biocatalysis has many benefits to offer in this respect. The catalyst is derived from renewable biomass and is biodegradable. Processes are performed under mild conditions and generally produce less waste and are more energy efficient than conventional ones. Thanks to modern advances in biotechnology ‘tailor-made’ enzymes can be economically produced on a large scale. However, for economic viability it is generally necessary to recover and re-use the enzyme and this can be achieved by immobilization, e.g. as solid cross-linked enzyme aggregates (CLEAs), enabling separation by filtration or centrifugation. A recent advance is the use of ‘smart’, magnetic CLEAs, which can be separated magnetically from reaction mixtures containing suspensions of solids; truly an example of cross-disciplinary research at the interface of physical and life sciences, which is particularly relevant to biomass conversion processes.
Functions of innate and acquired immune system are reduced in domestic pigeons (Columba livia domestica) given a low protein diet
Authors: Mabuchi Yuko , Frankel Theresa L.
Published: March 2016

Racing pigeons are exposed to and act as carriers of diseases. Dietary protein requirement for their maintenance has not been determined experimentally despite their being domesticated for over 7000 years. A maintenance nitrogen (protein) requirement (MNR) for pigeons was determined in a balance study using diets containing 6, 10 and 14% crude protein (CP). Then, the effects of feeding the diets were investigated to determine whether they were adequate to sustain innate and acquired immune functions. Nitrogen intake from the 6% CP diet was sufficient to maintain nitrogen balance and body weight in pigeons. However, the immune functions of phagocytosis, oxidative burst and lymphocyte proliferation in pigeons fed this diet were reduced compared with those fed 10 and 14% CP diets. Pigeons given the 6 and 10% CP diets had lower antibody titres following inoculation against Newcastle disease (ND) than those on the 14% CP diet. A confounding factor found on autopsy was the presence of intestinal parasites in some of the pigeons given the 6 and 10% CP diets; however, none of the pigeons used to measure MNR or acquired immunity to ND were infested with parasites. In conclusion, neither the 6 nor 10% CP diets adequately sustained acquired immune function of pigeons.
Hybridization generates a hopeful monster: a hermaphroditic selfing cichlid
Authors: Svensson Ola , Smith Alan , García-Alonso Javier , van Oosterhout Cock
Published: March 2016

Compared with other phylogenetic groups, self-fertilization (selfing) is exceedingly rare in vertebrates and is known to occur only in one small clade of fishes. Here we report observing one F1-hybrid individual that developed into a functional hermaphrodite after crossing two closely-related sexually reproducing species of cichlids. Microsatellite alleles segregated consistent with selfing and Mendelian inheritance and we could rule out different modes of parthenogenesis including automixis. We discuss why selfing is not more commonly observed in vertebrates in nature, and the role of hybridization in the evolution of novel traits.
Chatty maps: constructing sound maps of urban areas from social media data
Authors: Aiello Luca Maria , Schifanella Rossano , Quercia Daniele , Aletta Francesco
Published: March 2016

Urban sound has a huge influence over how we perceive places. Yet, city planning is concerned mainly with noise, simply because annoying sounds come to the attention of city officials in the form of complaints, whereas general urban sounds do not come to the attention as they cannot be easily captured at city scale. To capture both unpleasant and pleasant sounds, we applied a new methodology that relies on tagging information of georeferenced pictures to the cities of London and Barcelona. To begin with, we compiled the first urban sound dictionary and compared it with the one produced by collating insights from the literature: ours was experimentally more valid (if correlated with official noise pollution levels) and offered a wider geographical coverage. From picture tags, we then studied the relationship between soundscapes and emotions. We learned that streets with music sounds were associated with strong emotions of joy or sadness, whereas those with human sounds were associated with joy or surprise. Finally, we studied the relationship between soundscapes and people's perceptions and, in so doing, we were able to map which areas are chaotic, monotonous, calm and exciting. Those insights promise to inform the creation of restorative experiences in our increasingly urbanized world.