bluuebunny/crossref_metadata_2025 huggingface dataset:
P101: Quality of life in patients discharged from the emergency department with atrial fibrillation or flutter (AF/AFL): a prospective cohort study
Authors: Patrick S. , Duke P. , Lobay K. , Haager M. , Deane B. , Couperthwaite S. , Villa-Roel C. , Rowe B.H.
Published: May 2017

Introduction: Following an emergency department (ED) presentation for acute atrial fibrillation and/or flutter (AF/AFL), patients often experience anxiety, depression and impaired health-related quality of life (QoL). Emergency physicians may prescribe appropriate thrombo-embolic (TE) prophylaxis upon discharge; however, the QoL of these patients is unclear. This study measured the QoL of patients with AF/AFL following discharge to determine the factors associated with QoL. Methods: Patients ≥18 years of age identified by the attending physician as having a diagnosis of acute AF/AFL confirmed by ECG were prospectively enrolled from three Edmonton, AB EDs. Using standardized enrollment forms, trained research assistants collected data on patient demographics factors and management both in the ED and at discharge. Patients’ health-related QoL was assessed up to 20 days after their initial ED visit by a telephone interview based on six domains of the short-form 8 health survey. Results: From a total of 196 enrolled patients, 121 (62%) were male and the mean age was 63 years (standard deviation ±14). Most patients had previous history of AF/AFL (71%), and emergency physicians had the opportunity to treat or revise TE prevention therapy in 19% of the patients. The majority (89%) were discharged with prescriptions for antiplatelet or anticoagulant agents, and 188 (96%) were contacted by telephone at a median of 7 days. Most patients rated their overall health between good and excellent (70%); however, 30% assessed their health as fair or very poor. Many also reported having physical limitations (54%), difficulties completing their daily work (42%), bodily pain (32%) and limitations in social activities (32%). Finally, some patients reported having low energy (25%). At follow up, patients receiving adequate TE prevention rated their health to be similar to those without adequate TE prevention (30% vs 23%; p=0.534). Conclusion: Overall, patients with acute, symptomatic AF/AFL seen in the ED have impairments in health-related QoL following discharge from the ED. Many factors contribute to this impairment; however, providing patients with appropriate TE prophylaxis at discharge did not explain these findings. Further research is required to explore the impact of AF/AFL on patient’s health-related QoL after discharge from the ED.
P108: Fast track in Calgary hospitals: measures for quality improvement
Authors: Rogers P. , Oster A. , Wang D.
Published: May 2017

Introduction: Fast track (FT) implementation in emergency departments (ED) has shown a decrease in patient wait times, length of stay (LOS), left without being seen rates, and has increased patient satisfaction. The objective of this study was to analyze the demographics and presenting complaints of patients presenting to FT in Calgary EDs using local administrative databases to understand the current selection of FT patients, as well as to uncover potential throughput efficiencies through LOS analysis. Methods: Sunrise Clinical Manager data was pulled from the Foothills Medical Center (FMC), Peter Lougheed Center (PLC), and Rockyview General Hospital (RGH) EDs between October 2015 and September 2016. Based on consensus achieved by the Calgary FT-Minor Treatment Sub-committee, data was descriptively analyzed based on the following criteria: (1) triage profiles of the Calgary ED sites; (2) site admission rates by complaint, Canadian Triage and Acuity Scale (CTAS), vitals, and age; (3) LOS for orthopedic patients admitted from FT/Minor; and, (4) LOS in FT for non-admitted back pain patients. Results: A total of 53911 patients were triaged to FT, with 16224 patients triaged to FMC, 18299 to PLC, and 19388 to RGH. 6.9% of FT patients were admitted to hospital at FMC, 4.8% at PLC and 4.8% at RGH. 14.4% of patients at FMC, 18.3% at PLC and 17.6% at RGH were CTAS 2; 40.9% of patients at FMC, 46.2% at PLC and 37.9% at RGH were CTAS 3; 34.0% of patients at FMC, 27.8% at PLC and 33.3% at RGH were CTAS 4; 10.7% of patients at FMC, 7.7% from PLC and 11.2% for RGH were CTAS 5. For FT patients 80 years or older, 10.4% were admitted at FMC, 13.1% at PLC and 9.4% at RGH. The top FT presenting complaints at all sites were lower extremity injury, upper extremity injury, and laceration/puncture. The annual FT bed hours for patients admitted to orthopedic surgery (consultation request to time of orthopedic admission) was 802.3 hours at FMC, 441.1 PLC and 705.1 from RGH. The annual FT bed hours for patients with non-admitted back pain (FT bed to time of discharge) was 2144.3 hours from FMC, 3367.9 from PLC and 1134.9 from RGH. Conclusion: The efficiency of FT is based on streamlining low acuity patients with an expected rapid discharge from hospital. The results of this investigation will be presented to the FT-Minor Treatment Sub-committee in order to utilize current admission rates, patient profiles, and aggregate LOS to potentially improve throughput.
P122: Emergency department length of stay for alcohol intoxicated patients presenting with head injury
Authors: Varner C. , McLeod S.L. , Thompson C. , Borgundvaag B.
Published: May 2017

Introduction: Excessive consumption of alcohol is associated with harm and responsible for up to 30% of emergency department (ED) visits. ED visits and length of stay (LOS) related to alcohol intoxication have increased over the last decade. The objective of this study was to compare the ED LOS of alcohol intoxicated and non-alcohol intoxicated patients presenting to the ED with acute head injury. Methods: This was a nested cohort analysis of patients screened for enrollment in a randomized controlled trial assessing minor traumatic brain injury (MTBI) discharge instructions in the ED of an academic tertiary care hospital (annual census 65,000). Patients aged 18 to 64 years presenting to the ED with a Canadian Emergency Department Information System (CEDIS) chief complaint of a head injury or suspected concussion occurring within 24 hours were eligible for study inclusion. Patients were identified as acutely intoxicated by their treating clinical providers. ED LOS for patients acutely intoxicated and those not intoxicated was compared using a Mann-Whitney U test using the Hodges-Lehmann method. Proportional differences were assessed using chi-square statistics. Results: A total of 164 patients were included in the analysis, 46 (28.0%) intoxicated and 118 (72.0%) not intoxicated. Median (IQR) ED LOS was 2.9 (1.5, 6.6) hours for intoxicated and 1.8 (1.3, 2.9) hours for non-intoxicated patients (Δ1.1 hours; 95% CI: 0.4, 1.8). Arrival by ambulance was higher in the intoxicated (73.9%) compared to the non-intoxicated (29.7%) group (Δ44.3%; 95% CI: 27.6, 57.1). Patients were more likely to have experienced assault in the intoxicated (34.8%) compared to the non-intoxicated (6.8%) group (Δ28.0%; 95% CI: 14.5, 42.8). There no difference in the proportion of patients who arrived after daytime hours, had a brain computed tomography, received analgesia in the ED, had another traumatic injury or had a history of psychiatric illness. Conclusion: One third of patients screened for a randomized controlled trial for MTBI were deemed ineligible for study inclusion due to acute alcohol intoxication. Alcohol intoxication was associated with prolonged ED LOS. Future studies specifically aimed at identifying factors that impact care on this frequent ED patient population are needed.
P125: Willingness of ED staff to implement a brief intimate partner violence case-finding tool
Authors: Vonkeman J. , Atkinson P.R. , Fraser J. , McCloskey R.
Published: May 2017

Introduction: Domestic violence (DV) rates in smaller cities have been reported to be some of the highest in Canada. It is highly likely that emergency department staff will come across victims of intimate partner violence (IPV) in their daily practice. However, elsewhere we have found a lack of knowledge of current tools as well as lack of training in ED staff. Furthermore, these findings may also be reflected by low rates of IPV documentation, especially in high-risk cases. The purpose of the current study is to determine if ED staff would be willing to implement a brief IPV screening tool, the Partner Violence Screen (PVS) in their daily practice. It consists of the 3 questions: Have you ever been hit, kicked, punched or otherwise hurt by someone within the past year, and if so, by whom? Do you feel safe in your current relationship? Is there a partner from a previous relationship that is making you feel unsafe now? Methods: A cross-sectional online survey was distributed to ED staff (LPNs, NPs, Physicians, Residents, RNs) via staff email lists three times between July and October 2016, with a response rate of 45.9% (n=55). The survey included a 5-question Likert scale. The primary outcome was whether ED staff are willing to implement a new case-finding tool in their daily practice. The secondary outcome was to assess whether staff would find this tool beneficial in case-finding for IPV. Results: 43.6% of staff responded that they are likely to use the tool routinely, 29.1% were unsure, and 2.7% very likely. 7.27% and 3.64% stated their predicted use as unlikely and very unlikely, respectively. In addition, 43.6% of staff thought that the PVS would be beneficial in case finding for IPV, 40% were unsure, 12.7% thought very likely, 1.82% unlikely, and 1.82% very unlikely. Conclusion: These findings suggest that emergency department staff may be receptive to and find the introduction of the PVS beneficial in identifying cases of IPV. Future directions will include the introduction of this tool through a knowledge translation education piece in order improve the identification process for and awareness of a high-risk condition in a vulnerable population group.
LO18: How big is emergency access block in Canadian hospitals?
Authors: Innes G. , Sivilotti M. , Ovens H.J. , Chochinov A. , McLelland K. , Sing C. Kim , MacKinnon D.J. , Chopra A. , Dukelow A. , Horak S. , Barclay N. , Kalla D. , Kwok E.S.
Published: May 2017

Introduction: Emergency department (ED) access block is the #1 safety concern in Canadian EDs. Its main cause is hospital access block, manifested by prolonged boarding of inpatients in EDs. Hospital administrators often believe this problem is too big to be solved and would require large increases in hospital capacity. Our objective was to quantify ED access gap by estimating the cumulative hours that CTAS 1-3 patients are blocked in waiting areas. This value, expressed as a proportion of inpatient care capacity, is an estimate of the bed hours a hospital would have to find in order to resolve ED access. Methods: A convenience sample of urban Canadian ED directors were asked to provide data summarizing their CTAS 1-3 inflow, the proportion triaged to nursed stretchers vs. RAZ or Intake areas, and time to care space. Total ED access gap was calculated by multiplying the number of CTAS 1-3 patients by their average delay to care space. Time to stretcher was captured electronically at participating sites, but time to RAZ or intake spaces was often not. In such cases, respondents provided time from triage to first RN or MD assessment in these areas. The primary outcome was total annual ED access block hours for emergent-urgent patients, expressed as a proportion of funded inpatient bed hours. Results: Directors of 40 EDs were queried. Six sites did not gather the data elements required. Of 34 remaining, 29 (85.3%) provided data, including 15 tertiary (T), 10 community (C) and 2 pediatric (P) sites in 12 cities. Mean census for the 3 ED types was 72,308 (T), 58,849 C) and 61,050 (P) visits per year. CTAS 1-3 patients accounted for 73.4% (T), 67.7% (C) and 66.2% (P) of visits in the 3 groups, and 34% (T), 46% (C) and 44% (P) of these patients were treated in RAZ or intake areas rather than staffed ED stretchers. Mean time to stretcher/RAZ care was 50/71 min (T), 46/62 min (C), and 37/59 min (P). Average ED access gap was 47,564 hrs (T), 37,222 hrs (C) and 35,407 hrs (P), while average inpatient bed capacity was 599 beds (5,243,486 hrs), 291 beds (2,545,875 hrs) and 150 beds (1,314,000 hrs) respectively. ED access gap as a proportion of inpatient care capacity was 0.93% for tertiary, 1.46% for community and 2.69% for pediatric centres. Conclusion: ED access gap is very large in Canadian EDs, but small compared to hospital operating capacity. Hospital capacity or efficiency improvements in the range of 1-3% could profoundly mitigate ED access block.
LO24: Is prehospital care supported by evidence-based guidelines? An environmental scan and quality appraisal using AGREE II
Authors: Turner S. , Lang E. , Brown K. , Leyton C. , Bulger E. , Sayre M. , Kraus D. , Lee Robertson H.
Published: May 2017

Introduction: The Institute of Medicine (IOM) has recommended that high-quality, evidence-based guidelines be developed for emergency medical services (EMS). The National Association of EMS Physicians (NAEMSP) has outlined a strategy that will see this task fulfilled, consisting of multiple working groups focused on all aspects of guideline development and implementation. A first step, and our objective, was a cataloguing and appraisal of the current guidelines targeting EMS providers. Methods: A systematic search of the literature was conducted in MEDLINE (1175), EMBASE (519), PubMed (14), Trip (416), and guidelines.gov (64) through May 1, 2016. Two independent reviewers screened titles for relevance to prehospital care, and then abstracts for essential guideline features, including a systematic review, a grading system, and an association between level of evidence and strength of recommendation. All disagreements were moderated by a third party. Citations meeting inclusion criteria were appraised with the AGREE II tool, which looks at six different domains of guideline quality, containing a total of 23 items rated from 1 to 7. Each guideline was appraised by three separate reviewers, and composite scores were calculated by averaging the scaled domain totals. Results: After primary (kappa 97%) and secondary (kappa 93%) screening, 49 guidelines were retained for full review. Only three guidelines obtained a score of >90%, the topics of which included aeromedical transport, analgesia in trauma, and resuscitation of avalanche victims. Only two guidelines scored between 80% and 90%, the topics of which included stroke and pediatric seizure management. One guideline, splinting in an austere environment, scored between 70% and 80%. Nine guidelines scored between 60% and 70%, the topics of which included ischemic stroke, cardiovascular life support, hemorrhage control, intubation, triage, hypothermia, and fibrinolytic use. Of the remaining guidelines, 14 scored between 50% and 60%, and 20 obtained a score of <50%. Conclusion: There are few high-quality, evidence-based guidelines in EMS. Of those that are published, the majority fail to meet established quality measures. Although a lack of randomized controlled trials (RCTs) conducted in the prehospital field continues to limit guideline development, suboptimal methodology is also commonplace within the existing literature.
LO26: The efficacy of high dose cephalexin in the outpatient management of moderate cellulitis for pediatric patients
Authors: Farley St-Amand B. , Trottier E. D. , Autmizguine J. , Vincent M. , Tremblay S. , Chevalier I. , Gouin S.
Published: May 2017

Introduction: Children with moderate cellulitis are often treated with IV antibiotics in the hospital setting, as per recommendations. Previously in our hospital, a protocol using daily IV ceftriaxone with follow-up at the day treatment center (DTC) was used to avoid admission. In 2013, a new protocol was implanted and suggested the use of high dose (HD) oral cephalexin with follow-up at the DTC for those patients. The aim of this study was to evaluate the safety and efficacy of the HD cephalexin protocol to treat moderate cellulitis in children as outpatient. Methods: A retrospective chart review was conducted. Children were included if they presented to the ED between January 2014 and 2016 and were diagnosed with a moderate cellulitis sufficiently severe to request a follow up at DTC and who were treated according to the standard of care with the HD oral cephalexin (100 mg/kg/day) protocol. Descriptive statistics for clinical characteristics of patients upon presentation, as well as for treatment characteristics in the ED and DTC were analyzed. Treatment failure was defined as: need for admission at the time of DTC evaluation, change for IV treatment in DTC or return visit to the ED. Outcomes were compared to historic controls treated with IV ceftriaxone at the DTC, where admission was avoided in 80% of cases. Results: During the study period, 682 children with cellulitis were diagnosed in our ED. Of these, 117 patients were treated using the oral HD cephalexin outpatient protocol. Success rate was 89.5% (102/114); 3 patients had an alternative diagnosis at DTC. Treatment failure was reported in 12 cases; 10 patients (8.8%) required admission, one (0.9%) received IV antibiotics at DTC, and one (0.9%) had a return visit to the ED without admission or change to the treatment. This compares favorably with the previous study using IV ceftriaxone (success rate of 80%). No severe deep infections were reported or missed; 4 patients required drainage. The mean number of visits per patient required at the DTC was 1.6. Conclusion: Treatment of moderate cellulitis requiring a follow-up in a DTC, using an oral outpatient protocol with HD cephalexin is a secure and effective option. By reducing hospitalization rate and avoiding the need for painful IV insertion, HD cephalexin is a favourable option in the management of moderate cellulitis for pediatric patients, when no criteria of toxicity are present.
Analytical Prediction of Stability Lobes for Passively Damped Boring Bars
Authors: Fallah M. , Moetakef-Imani B.
Published: May 2017

The present article proposes the closed-form solution for analytical prediction of stability lobes in internal turning process. The passively damped boring bar is modeled as a cantilevered Euler-Bernoulli beam with constant cross sectional properties in which a Tuned Mass Damper (TMD) is embedded for the purpose of chatter suppression. The non-dimensional equations of motion are derived, assuming that the boring bar dynamics is well-represented by the fundamental mode of vibration. The stability of equivalent two-DOF dynamic model, i.e. boring bar with TMD, is analyzed in frequency domain. The closed- form expressions for critical depth of cut and spindle speed are presented in terms of boring bar and TMD characteristics. The proposed solution considers the effects of boring bar's structural damping and cutting geometry of insert on the stability behavior of passively damped cutting tool. An unconstrained optimization method is utilized to compute the most optimal set of tuning parameters for anti-chatter TMD. In order to improve the boundary of stability in a global sense, maximization of minimum critical depth of cut is selected as the objective of optimization. The superior performance of anti-chatter TMD is compared to H∞and H2TMDs for a wide range of applications. Moreover, the achieved results show a remarkable improvement of stability boundary compared to recent research works.
THE PRINCIPLE OF SYSTEMIC INTEGRATION IN HUMAN RIGHTS LAW
Authors: Rachovitsa Adamantia
Published: May 2017

International lawyers and courts consider the principle of systemic integration to be a potential answer to difficulties arising from the fragmentation of public international law. This article questions the application of this approach in the context of human rights treaties. It is argued, first, that in many instances, systemic integration raises serious interpretational and jurisdictional concerns and, second, that systemic integration may give rise to a less diverse international law.
Dactylogyrids (Platyhelminthes, Monogenoidea) from the gills of Hoplias malabaricus (Characiformes: Erythrinidae) from coastal rivers of the Oriental Amazon Basin: species of Urocleidoides and Constrictoanchoratus n. gen.
Authors: Ferreira K.D.C. , Rodrigues A.R.O. , Cunha J.-M. , Domingues M.V.
Published: May 2017

Five species of Urocleidoides (one new) and two new species of Constrictoanchoratus n. gen. are described in this study. All were collected from the gills of Hoplias malabaricus (Characiformes: Erythrinidae) captured in six localities of coastal rivers of the north-eastern sector the State of Pará (Oriental Amazon): Urocleidoides brasiliensis Rosim, Mendoza-Franco & Luque, 2011; Urocleidoides bulbophallus n. sp.; Urocleidoides cuiabai Rosim, Mendoza-Franco & Luque, 2011; Urocleidoides eremitus Kritsky, Thatcher & Boeger, 1986; Urocleidoides malabaricusi Rosim, Mendoza-Franco & Luque, 2011; Constrictoanchoratus lemmyi n. gen. n. sp.; and Constrictoanchoratus ptilonophallus n. gen. n. sp. This is the first reported occurrence of the four previously described species of Urocleidoides parasitizing H. malabaricus from streams in the Oriental Amazon Basin. The analysis of voucher specimens of U. eremitus parasitizing the gills of H. malabaricus from the Upper Paraná River floodplain in the limits of States of Paraná and Mato Grosso do Sul, Brazil, indicates that these specimens are members of a new species of Urocleidoides, described here as Urocleidoides paranae n. sp. Constrictoanchoratus n. gen. is proposed for the species with a male copulatory organ sclerotized, coiled, clockwise; ventral anchor with elongate superficial root, inconspicuous deep root; dorsal anchor with inconspicuous roots, and a constriction at the intersection between the shaft and the point. The host–parasite diversity scenario and host specificity of the species of Constrictoanchoratus n. gen. and Urocleidoides from the gills of H. malabaricus are also discussed in this study.
Infection, specificity and host manipulation ofAustralapatemonsp. (Trematoda, Strigeidae) in two sympatric species of leeches (Hirudinea)
Authors: KARVONEN ANSSI , FALTÝNKOVÁ ANNA , CHOO JOCELYN MAH , VALTONEN E. TELLERVO
Published: May 2017

Factors that drive parasite specificity and differences in infection dynamics among alternative host species are important for ecology and evolution of host–parasite interactions, but still often poorly known in natural systems. Here, we investigated spatiotemporal dynamics of infection, host susceptibility and parasite-induced changes in host phenotype in a rarely explored host–parasite system, theAustralapatemonsp. trematode infecting two sympatric species of freshwater leeches,Erpobdella octoculataandHelobdella stagnalis. We show significant variation in infection abundance between the host species in both space and time. Using experimental infections, we also show that most of this variation likely comes from interspecific differences in exposure rather than susceptibility. Moreover, we demonstrate that the hiding behaviour ofE. octoculata, but not that ofH. stagnalis, was impaired by the infection irrespective of the parasite abundance. This may increase susceptibility ofE. octoculatato predation by the final avian host. We conclude that differences in patterns of infection and in behavioural alterations among alternative sympatric host species may arise in narrow spatial scales, which emphasises the importance of local infection and transmission dynamics for parasite life cycles.
Buffer zones: Anachronism, power vacuum, or confidence builder?
Authors: Menon Rajan , Snyder Jack L.
Published: May 2017

Amidst calls for containing an assertive Russia, politicians and pundits have been debating whether Ukraine should serve as a ‘buffer zone’ between the Russian and Western spheres of influence. These debates provide an opportunity to revisit the long and varied history of major powers’ efforts to manage buffer zones. We draw on this history to learn the conditions under which buffer zones succeed or fail to stabilise regions, how buffers are most successfully managed, and when alternative arrangements for borderlands work better.
The Effects of Specific Learning Difficulties on Processes of Multilingual Language Development
Authors: Kormos Judit
Published: May 2017

This article reviews current research findings on how specific learning difficulties (SLDs) impact on the processes of multilingual language development. The review includes studies of young language learners in instructed classroom settings, as well as of multilingual children in second language (L2) contexts. Starting with a definition of the concepts of disability and SLDs, it next discusses the interaction of cognitive factors with first language (L1) and L2 literacy development and L2 learning. Also outlined are possible ways in which SLDs can be identified in different L2 learning contexts. A detailed analysis of how cognitive factors influence the development of L2 skills of young learners with learning difficulties is given in the last part of the article.
A Tale of Two Cities: Aleppo and Istanbul
Authors: Kaya Ayhan
Published: May 2017

There are 7.6 million internally displaced persons (IDPs) in Syria, and an additional 5 million people have taken refuge in Syria’s immediate neighbourhood: Turkey, Lebanon, Jordan and Iraq. Among these countries, due to its open border policy, Turkey has received the largest number of Syrian refugees. As of 31 August 2016, there are more than 3 million Syrian refugees in Turkey. This article will concentrate on the findings of a recent qualitative and quantitative study conducted among Syrian refugees in Istanbul, with a particular focus on their strong attachment to this city. I shall claim that historical, cultural and religious forms of affinity are likely to particularly attach the Sunni-Muslim-Arab-Syrians originating from Aleppo province to Istanbul. This article is expected to contribute to the discipline of Refugee Studies by shedding light on the historical and human elements, which are often the missing elements in such analysis.
ASYMPTOTIC BEHAVIOUR OF A CLASS OF RESOURCE COMPETITION BIOLOGY SPECIES SYSTEM BY THE FRACTIONAL BROWNIAN MOTION
Authors: ZHANG Q. , YE M. , LEI H. , JIN Q.
Published: May 2017

We analyse the asymptotic behaviour of a biological system described by a stochastic competition model with $n$ species and $k$ resources (chemostat model), in which the species mortality rates are influenced by the fractional Brownian motion of the extrinsic noise environment. By constructing a Lyapunov functional, the persistence and extinction criteria are derived in the mean square sense. Some examples are given to illustrate the effectiveness of the theoretical result.
Refining the Frommelt Attitude Toward the Care of the Dying Scale (FATCOD–B) for medical students: A confirmatory factor analysis and Rasch validation study
Authors: Loera Barbara , Molinengo Giorgia , Miniotti Marco , Leombruni Paolo
Published: May 2017

Objective:

Given the increasing number of patients requiring palliative care and the need for more professionals who are able to provide care for the dying comfortably, assessment of medical attitudes toward end-of-life care is becoming a key aspect of medical education. The present study aimed to establish whether the Frommelt Attitude Toward the Care Of the Dying, Form B (FATCOD–B) meets current psychometric standards of validity for an assessment tool in medical education.

Method:

The participants were 200 undergraduate medical students. Since in a previous study the FATCOD–B was found to have a weak structure due to poor item validity, a refined version was proposed and tested in the present study. Confirmatory factor analysis and the Rasch model were employed to assess its dimensionality and psychometric properties.

Results:

The construct measured by the FATCOD–B continues to be misspecified. The tool has a two-dimensional structure. The first is well-structured and demonstrates appreciable measurement and discriminant capabilities. The second has low validity because its measurement capabilities are based on weakly correlated items.

Significance of results:

Our results suggest that the FATCOD–B measures a two-dimensional construct and that only its first dimension is a robust measurement tool for use in medical education to evaluate undergraduates' attitudes about caring for the dying.
Do Women Vote for Women Candidates? Attitudes toward Descriptive Representation and Voting Behavior in the 2010 British Election
Authors: Campbell Rosie , Heath Oliver
Published: May 2017

A growing body of work on candidate traits shows that people with a given social characteristic tend to prefer candidates or leaders who share that characteristic (Campbell and Cowley 2014; Cutler 2002). However, the existing evidence for whether women vote for women is mixed. For example, Kathleen Dolan found that candidate sex was a driver of voting behavior for the U.S. House of Representatives in 1992, but not in 1994 or 1996 (Dolan 1998, 2001, 2004). Eric Smith and Richard Fox used pooled U.S. data from 1988 to 1992 and found that well-educated women were more inclined to support women candidates in House but not Senate races (Smith and Fox 2001), and others have found that women are more likely to vote for women candidates only when they are perceived as being pro-feminist (Plutzer and Zipp 1996). By contrast Fulton (2014) found that women are not more likely to vote for women candidates in the United States, but that male Independents are somewhat less likely to vote for them. Others have found little evidence whatsoever of an association between candidate gender and vote choice (McElroy and Marsh 2010).
MicroRNA-122 ameliorates corneal allograft rejection through the downregulation of its target CPEB1
Authors: Wang Ting , Li Fengjie , Geng Wenwen , Ruan Qingguo , Shi Weiyun
Published: May 2017

Transplant rejection is a major cause of corneal transplantation failure. MicroRNAs (miRNAs) are a family of small RNAs that regulates gene expression in a sequence-specific manner. miRNAs have recently been shown to have important roles in human organ transplantation, but reports of miRNAs directly associated with corneal transplantation rejection remain limited. To investigate the role of miRNAs during corneal allograft rejection, we established a mouse penetrating keratoplasty model and used microarrays to screen for differentially expressed miRNAs. Our results revealed that the expression of miR-122 was significantly decreased in the allogeneic group. Consistent with this result, the expression of cytoplasmic polyadenylation element-binding protein-1 (CPEB1), a direct target of miR-122, was significantly increased. Further analysis demonstrated that miR-122 inhibited inflammatory cytokine-induced apoptosis in corneal keratocytes through the downregulation of its target CPEB1. We also found that increased miR-122 expression significantly reduced the risk of corneal transplantation rejection. Thus, our results indicate that miR-122 is an important miRNA associated with corneal graft rejection and can be used as a therapeutic target for the prevention of immune rejection after keratoplasty.
Energy efficiency to reduce residential electricity and natural gas use under climate change
Authors: Reyna Janet L. , Chester Mikhail V.
Published: May 2017

Climate change could significantly affect consumer demand for energy in buildings, as changing temperatures may alter heating and cooling loads. Warming climates could also lead to the increased adoption and use of cooling technologies in buildings. We assess residential electricity and natural gas demand in Los Angeles, California under multiple climate change projections and investigate the potential for energy efficiency to offset increased demand. We calibrate residential energy use against metered data, accounting for differences in building materials and appliances. Under temperature increases, we find that without policy intervention, residential electricity demand could increase by as much as 41–87% between 2020 and 2060. However, aggressive policies aimed at upgrading heating/cooling systems and appliances could result in electricity use increases as low as 28%, potentially avoiding the installation of new generation capacity. We therefore recommend aggressive energy efficiency, in combination with low-carbon generation sources, to offset projected increases in residential energy demand.
New Blatter-type radicals from a bench-stable carbene
Authors: Grant Jacob A. , Lu Zhou , Tucker David E. , Hockin Bryony M. , Yufit Dmitry S. , Fox Mark A. , Kataky Ritu , Chechik Victor , O’Donoghue AnnMarie C.
Published: May 2017

Stable benzotriazinyl radicals (Blatter’s radicals) recently attracted considerable interest as building blocks for functional materials. The existing strategies to derivatize Blatter’s radicals are limited, however, and synthetic routes are complex. Here, we report that an inexpensive, commercially available, analytical reagent Nitron undergoes a previously unrecognized transformation in wet acetonitrile in the presence of air to yield a new Blatter-type radical with an amide group replacing a phenyl at the C(3)-position. This one-pot reaction of Nitron provides access to a range of previously inaccessible triazinyl radicals with excellent benchtop stabilities. Mechanistic investigation suggests that the reaction starts with a hydrolytic cleavage of the triazole ring followed by oxidative cyclization. Several derivatives of Nitron were prepared and converted into Blatter-type radicals to test the synthetic value of the new reaction. These results significantly expand the scope of using functionalized benzotriazinyls as stable radical building blocks.
Mid-infrared coincidence measurements on twin photons at room temperature
Authors: Mancinelli M. , Trenti A. , Piccione S. , Fontana G. , Dam J. S. , Tidemand-Lichtenberg P. , Pedersen C. , Pavesi L.
Published: May 2017

Quantum measurements using single-photon detectors are opening interesting new perspectives in diverse fields such as remote sensing, quantum cryptography and quantum computing. A particularly demanding class of applications relies on the simultaneous detection of correlated single photons. In the visible and near infrared wavelength ranges suitable single-photon detectors do exist. However, low detector quantum efficiency or excessive noise has hampered their mid-infrared (MIR) counterpart. Fast and highly efficient single-photon detectors are thus highly sought after for MIR applications. Here we pave the way to quantum measurements in the MIR by the demonstration of a room temperature coincidence measurement with non-degenerate twin photons at about 3.1 μm. The experiment is based on the spectral translation of MIR radiation into the visible region, by means of efficient up-converter modules. The up-converted pairs are then detected with low-noise silicon avalanche photodiodes without the need for cryogenic cooling.
Explosive eruption, flank collapse and megatsunami at Tenerife ca. 170 ka
Authors: Paris Raphaël , Bravo Juan J. Coello , González María E. Martín , Kelfoun Karim , Nauret François
Published: May 2017

Giant mass failures of oceanic shield volcanoes that generate tsunamis potentially represent a high-magnitude but low-frequency hazard, and it is actually difficult to infer the mechanisms and dynamics controlling them. Here we document tsunami deposits at high elevation (up to 132 m) on the north-western slopes of Tenerife, Canary Islands, as a new evidence of megatsunami generated by volcano flank failure. Analyses of the tsunami deposits demonstrate that two main tsunamis impacted the coasts of Tenerife 170 kyr ago. The first tsunami was generated during the submarine stage of a retrogressive failure of the northern flank of the island, whereas the second one followed the debris avalanche of the subaerial edifice and incorporated pumices from an on-going ignimbrite-forming eruption. Coupling between a massive retrogressive flank failure and a large explosive eruption represents a new type of volcano-tectonic event on oceanic shield volcanoes and a new hazard scenario.
YAP regulates cell mechanics by controlling focal adhesion assembly
Authors: Nardone Giorgia , Oliver-De La Cruz Jorge , Vrbsky Jan , Martini Cecilia , Pribyl Jan , Skládal Petr , Pešl Martin , Caluori Guido , Pagliari Stefania , Martino Fabiana , Maceckova Zuzana , Hajduch Marian , Sanz-Garcia Andres , Pugno Nicola Maria , Stokin Gorazd Bernard , Forte Giancarlo
Published: May 2017

Hippo effectors YAP/TAZ act as on–off mechanosensing switches by sensing modifications in extracellular matrix (ECM) composition and mechanics. The regulation of their activity has been described by a hierarchical model in which elements of Hippo pathway are under the control of focal adhesions (FAs). Here we unveil the molecular mechanism by which cell spreading and RhoA GTPase activity control FA formation through YAP to stabilize the anchorage of the actin cytoskeleton to the cell membrane. This mechanism requires YAP co-transcriptional function and involves the activation of genes encoding for integrins and FA docking proteins. Tuning YAP transcriptional activity leads to the modification of cell mechanics, force development and adhesion strength, and determines cell shape, migration and differentiation. These results provide new insights into the mechanism of YAP mechanosensing activity and qualify this Hippo effector as the key determinant of cell mechanics in response to ECM cues.
Food security is related to adult type 2 diabetes control over time in a United States safety net primary care clinic population
Authors: Shalowitz M U , Eng J S , McKinney C O , Krohn J , Lapin B , Wang C-H , Nodine E
Published: May 2017

Background/Objectives:

Successful Type 2 diabetes management requires adopting a high nutrient-density diet made up of food items that both meet dietary needs and preferences and can be feasibly obtained on a regular basis. However, access to affordable, nutrient-dense foods often is lacking in poorer neighbourhoods. Therefore, low food security should directly impair glucose control, even when patients have full access to and utilize comprehensive medical management. The present study sought to determine whether food security is related longitudinally to glucose control, over-and-above ongoing medication management, among Type 2 diabetes patients receiving comprehensive care at a Midwestern multi-site federally qualified health centre (FQHC).

Subjects/Methods:

In this longitudinal observational study, we completed a baseline assessment of patients’ food security (using the US Household Food Security Module), demographics (via Census items), and diabetes history/management (using a structured clinical encounter form) when patients began receiving diabetes care at the health centre. We then recorded those patients’ A1C levels several times during a 24-month follow-up period. Three hundred and ninety-nine patients (56% with low food security) had a baseline A1c measurement; a subsample of 336 (median age=52 years; 56% female; 60% Hispanic, 27% African American, and 9% White) also had at least one follow-up A1c measurement.

Results:

Patients with lower (vs higher) food security were more likely to be on insulin and have higher A1c levels at baseline. Moreover, the disparity in glucose control by food security status persisted throughout the next 2 years.

Conclusions:

Although results were based on one multi-site FQHC, potentially limiting their generalizability, they seem to suggest that among Type 2 diabetes patients, low food security directly impairs glucose control—even when patients receive full access to comprehensive medical management—thereby increasing their long-term risks of high morbidity, early mortality, and high health-care utilization and cost.
Flavonoid intake is inversely associated with obesity and C-reactive protein, a marker for inflammation, in US adults
Authors: Vernarelli J A , Lambert J D
Published: May 2017

Recent studies have demonstrated the importance of flavonoid intake and disease risk, however the association between flavonoid intake and obesity has not been evaluated in a nationally representative sample of US adults. The objective of the study was to evaluate the association between flavonoid consumption and established risk factors for obesity and obesity-related inflammation. Data from a nationally representative sample of 9551 adults who participated in the 2005–2008 National Health and Nutrition Examination Survey (NHANES) were analyzed. Flavonoid consumption was inversely associated with obesity in both men and women in multivariate models. Adults in the highest quartile of flavonoid intake had significantly lower body mass index and waist circumference than those in the lowest quartile of flavonoid intake (P<0.03 andP<0.04, respectively), and flavonoid intake was inversely related to C-reactive protein levels in women (p-trend, 0.01). These findings support a growing body of laboratory evidence that flavonoid consumption may be beneficial for disease prevention.
Mint3-mediated L1CAM expression in fibroblasts promotes cancer cell proliferation via integrin α5β1 and tumour growth
Authors: Nakaoka H J , Tanei Z , Hara T , Weng J S , Kanamori A , Hayashi T , Sato H , Orimo A , Otsuji K , Tada K , Morikawa T , Sasaki T , Fukayama M , Seiki M , Murakami Y , Sakamoto T
Published: May 2017

Fibroblasts are some of the major cells in tumour tissues that influence tumour progression and drug resistance. However, our understanding on fibroblast-mediated tumour malignancy remains incomplete. Munc18-1-interacting protein 3 (Mint3) is known as an activator of hypoxia-inducible factor-1 (HIF-1) even during normoxia in cancer cells, macrophages and fibroblasts. Although Mint3 promotes ATP production via glycolysis by activating HIF-1 in cancer cells and macrophages, the biological role of Mint3-mediated HIF-1 activation in fibroblasts remains unclear. To address this, we examined whether Mint3 in fibroblasts contributes to tumour growth. Mint3 depletion in mouse embryonic fibroblasts (MEFs) decreased tumour growth of co-injected human breast cancer cells, MDA-MB-231 and epidermoid carcinoma A431 cells in mice. In MEFs, Mint3 also promoted cancer cell proliferation in vitro in a cell–cell contact-dependent manner. Mint3-mediated cancer cell proliferation depended on HIF-1, and further gene expression analysis revealed that the cell adhesion molecule, L1 cell adhesion molecule (L1CAM), was induced by Mint3 and HIF-1 in fibroblasts. Mint3-mediated L1CAM expression in fibroblasts stimulated the ERK signalling pathway via integrin α5β1 in cancer cells, and promoted cancer cell proliferation in vitro and tumour growth. In cancer-associated fibroblasts (CAFs), knockdown of MT1-MMP, which promotes Mint3-mediated HIF-1 activation, or Mint3 decreased L1CAM expression. As MEFs, CAFs also promoted cancer cell proliferation in vitro, and tumour growth via Mint3 and L1CAM. In human breast cancer specimens, the number of fibroblasts expressing L1CAM, Mint3 and MT1-MMP was higher in cancer regions than in adjacent benign regions. In addition, more phospho-ERK1/2-positive cancer cells existed in the peripheral region surrounded by the stroma than in the central region of solid breast cancer nest. Thus, Mint3 in fibroblasts might be a good target for cancer therapy by regulating cancer cell-stromal cell communication.
Potential of PEDOT:PSS as a hole selective front contact for silicon heterojunction solar cells
Authors: Jäckle Sara , Liebhaber Martin , Gersmann Clemens , Mews Mathias , Jäger Klaus , Christiansen Silke , Lips Klaus
Published: May 2017

We show that the highly conductive polymer poly(3,4-ethylenedioxythiophene)-poly(styrenesulfonate) (PEDOT:PSS) can successfully be applied as a hole selective front contact in silicon heterojunction (SHJ) solar cells. In combination with a superior electron selective heterojunction back contact based on amorphous silicon (a-Si), mono-crystalline n-type silicon (c-Si) solar cells reach power conversion efficiencies up to 14.8% and high open-circuit voltages exceeding 660 mV. Since in the PEDOT:PSS/c-Si/a-Si solar cell the inferior hybrid junction is determining the electrical device performance we are capable of assessing the recombination velocity (v
I
) at the PEDOT:PSS/c-Si interface. An estimated v
I
of ~400 cm/s demonstrates, that while PEDOT:PSS shows an excellent selectivity on n-type c-Si, the passivation quality provided by the formation of a native oxide at the c-Si surface restricts the performance of the hybrid junction. Furthermore, by comparing the measured external quantum efficiency with optical simulations, we quantify the losses due to parasitic absorption of PEDOT:PSS and reflection of the device layer stack. By pointing out ways to better passivate the hybrid interface and to increase the photocurrent we discuss the full potential of PEDOT:PSS as a front contact in SHJ solar cells.
Multi-label Learning for Predicting the Activities of Antimicrobial Peptides
Authors: Wang Pu , Ge Ruiquan , Liu Liming , Xiao Xuan , Li Ye , Cai Yunpeng
Published: May 2017

Antimicrobial peptides (AMPs) are peptide antibiotics with a broad spectrum of antimicrobial activities. Activity prediction of AMPs from their amino acid sequences is of great therapeutic importance but imposes challenges on prediction methods due to label interactions. In this paper we propose a novel multi-label learning model to address this problem. A weighted K-nearest neighbor classifier is adopted for efficient representation learning of the sequence data. A multiple linear regression model is then employed to learn a mapping from the classifier score vectors to the target labels, with label correlations considered. Several popular multi-label learning algorithms and feature extraction methods were tested on a comprehensive, up-to-date AMP dataset with twelve biological activities covered and its filtered version with five activities covered. The experimental results showed that our proposed method has competitive performance with previous works and could be used as a powerful engine for activity prediction of AMPs.
Increased stem cells delivered using a silk gel/scaffold complex for enhanced bone regeneration
Authors: Ding Xun , Yang Guangzheng , Zhang Wenjie , Li Guanglong , Lin Shuxian , Kaplan David L. , Jiang Xinquan
Published: May 2017

The low in vivo survival rate of scaffold-seeded cells is still a challenge in stem cell-based bone regeneration. This study seeks to use a silk hydrogel to deliver more stem cells into a bone defect area and prolong the viability of these cells after implantation. Rat bone marrow stem cells were mingled with silk hydrogels at the concentrations of 1.0 × 105/mL, 1.0 × 106/mL and 1.0 × 107/mL before gelation, added dropwise to a silk scaffold and applied to a rat calvarial defect. A cell tracing experiment was included to observe the preservation of cell viability and function. The results show that the hydrogel with 1.0 × 107/mL stem cells exhibited the best osteogenic effect both in vitro and in vivo. The cell-tracing experiment shows that cells in the 1.0 × 107 group still survive and actively participate in new bone formation 8 weeks after implantation. The strategy of pre-mingling stem cells with the hydrogel had the effect of delivering more stem cells for bone engineering while preserving the viability and functions of these cells in vivo.