bluuebunny/crossref_metadata_2025 huggingface dataset:
Transient force augmentation due to counter-rotating vortex ring pairs
Authors: Fu Zhidong , Liu Hong
Published: November 2015

Of particular significance to biological locomotion is vortex ring interaction. In the wakes of animals, this unsteady process determines the changes in the impulse of counter-rotating vortex ring pairs (VRPs), which consist of two vortex rings with opposite sense of rotation. In this paper, these VRPs are proposed to be of particular importance to unsteady force generation. We carry out numerical computations, simulating the piston–cylinder apparatus, to study the transient changes in the impulse of counter-rotating VRPs composed of a positive and a negative vortex ring. We model the negative vortex ring (NeVR) of a VRP by making reasonable assumptions about their vorticity distributions and spatial locations, which are initially prescribed. The result of modelling is superimposed on the flow, which has a pre-existing positive vortex ring (PoVR), leading to a VRP. The simulation quantitatively demonstrates that the unsteady force resulting from a VRP is significantly larger compared with an isolated PoVR (without an NeVR). The force enhancement is also correlated to vortex configurations. A normalised force coefficient characterising force augmentation over the entire stroke is given. The force augmentation coefficient grows significantly and then reaches a plateau as the momentum input increases. The results are consistent with those in fully unsteady vortex interaction, which involves the generation of an NeVR. It is suggested that counter-rotating VRPs could offer a new perspective to explain unconventional force generation for biological swimming and flying.
The Effects of Malapportionment on Cabinet Inclusion: Subnational Evidence from India
Authors: Bhavnani Rikhil R.
Published: November 2015

Malapportionment doubly penalizes people from relatively large electoral districts or constituencies by under-representing them in the legislature and in the political executive or cabinet. The latter effect has not been studied. This article develops theoretical reasons for large constituency disadvantage in the cabinet formation process, and tests them using a new repeated cross-sectional dataset on elections and cabinet formation in India’s states, from 1977–2007. A one-standard-deviation increase in relative constituency size is associated with a 22 per cent fall in the probability of a constituency’s representative being in the cabinet. Malapportionment affects cabinet inclusion by causing large parties to focus on winning relatively small constituencies. These effects are likely to hold in parliamentary systems, and in other contexts where the legislature influences cabinet inclusion.
The Growth Bound for Strongly Continuous Semigroups on Fréchet Spaces
Authors: Wegner Sven-Ake
Published: November 2015

We introduce the concepts of growth and spectral bound for strongly continuous semigroups acting on Fréchet spaces and show that the Banach space inequality s(A) ⩽ ω0(T) extends to the new setting. Via a concrete example of an even uniformly continuous semigroup, we illustrate that for Fréchet spaces effects with respect to these bounds may happen that cannot occur on a Banach space.
Geochemistry and Nd isotope signature of the Collserola Range Palaeozoic succesion (NE Iberia): Gondwana heritage and pre-Mesozoic geodynamic evolution
Authors: VILÀ MIQUEL , PIN CHRISTIAN
Published: November 2015

The Collserola Range includes a representative stratigraphic succession of the Palaeozoic of the central part of the Catalan Coastal Ranges, ranging from Cambro-Ordovician to Carboniferous times. In this paper we present an up-to-date review of the stratigraphy and structure of the Palaeozoic of the Collserola Range, and provide geochemical and Sm–Nd isotope data to constrain the pre-Mesozoic crustal evolution of this sector of the Variscan Belt. Geochemical compositions indicate that the Palaeozoic siliciclastic rocks of the Collserola Range were fed by a relatively mature heterogeneous source of sediment, comprising quartz-rich sediments to intermediate igneous rocks. The siliciclastic rocks of the Collserola Range show great geochemical affinity with the turbidites of passive margins. The Sm–Nd signature of the siliciclastic rocks is compatible with those of the Palaeozoic and late Proterozoic fine-grained siliciclastic rocks of the neighbouring terrains of SW Europe. There is a small decrease of the εNdT with decreasing age of sedimentation from the Cambro-Ordovician to the Carboniferous, suggesting an increase of the amount of more ‘juvenile’ material. The presence of small volumes of alkaline basaltic rocks provides evidence for the input of juvenile material in the early Palaeozoic basin and suggests that an extensional tectonic regime prevailed during the Cambro-Ordovician sedimentation. From a geodynamic point of view, the overall analysis of the data implies that the Palaeozoic rocks of the Catalan Coastal Ranges were part of the Northern Gondwana passive margin before the closure of the Rheic Ocean and the subsequent Variscan Orogeny.
A study of mastoid pneumatisation and the presence of cholesteatoma in 393 patients
Authors: Iqbal I Z , Watson C
Published: November 2015

Objectives:

This study aimed to evaluate the relationship between cholesteatoma formation and the degree of mastoid pneumatisation, and to assess the relationship between the location of cholesteatoma and the degree of mastoid pneumatisation.

Methods:

Data on all patients undergoing mastoid exploration for cholesteatoma between 1993 and 2011 were collected prospectively. Basic demographics, the degree of mastoid pneumatisation and cholesteatoma site were recorded.

Results:

A total of 393 patients (222 males and 171 females) underwent surgery for cholesteatoma. Patients' mean age was 37 years (range, 6–79 years). Pneumatisation of the mastoid was sclerotic in 23 per cent (n = 90), diploic in 16.7 per cent (n = 66) and cellular in 60.3 per cent of cases (n = 237) (p < 0.001). Atticoantral disease was present in 88.9 per cent of sclerotic, 95.4 per cent of diploic and 91.1 per cent of cellular mastoids. Middle-ear cholesteatoma was present in 54.4 per cent of sclerotic, 56 per cent of diploic and 51.9 per cent of cellular mastoids.

Conclusion:

The findings demonstrate the presence of cholesteatoma in well-pneumatised mastoids. It is hypothesised that a well-pneumatised mastoid may lead to cholesteatoma formation.
Critical densities for Korteweg–de Vries-like acoustic solitons in multi-ion plasmas
Authors: Verheest Frank
Published: November 2015

A generic proof has been given that, for the acoustic mode with the highest velocity in a plasma comprising a number of fluid species and one kind of inertialess electrons, even though there can be critical densities (making the coefficient of the quadratic nonlinearity in a Korteweg–de Vries equation vanish), no supercritical densities exist (requiring the simultaneous annulment of both the quadratic and cubic nonlinearities in a reductive perturbation treatment). Similar conclusions hold upon expansion of the corresponding Sagdeev pseudopotential treatment. When there is only one (hot) electron species, the highest-velocity mode is an ion-acoustic one, but if there is an additional cool electron species, with its inertia taken into account, the highest-velocity mode is an electron-acoustic mode in a two-temperature plasma. The cool fluid species can have various polytropic pressure–density relations, including adiabatic and/or isothermal variations, whereas the hot inertialess electrons are modelled by extensions of the usual Boltzmann description that include non-thermal effects through Cairns, kappa or Tsallis distributions. Together, in this way quite a number of plasma models are covered. Unfortunately, there seems to be no equivalent generic statement for the slow modes, so that these have to be studied on a case-by-case basis, which for models with more than three species is far from straightforward, given the parameter ranges to be discussed.
Diagnostic uncertainty of herpangina and hand-foot-and-mouth disease and its impact on national enterovirus syndromic monitoring
Authors: YANG T. O. , HUANG W.-T. , CHEN M.-H. , CHEN P.-C.
Published: November 2015

The community burden of enterovirus is often monitored through syndromic monitoring systems based on reported cases of enterovirus-related infection (EVI) diagnoses. The extent to which this is affected by under- and over-diagnosis has not been reported. In Taiwan, children often make more than one healthcare visit during an episode of infection. We used change of diagnosis within an episode of infection as a guide of diagnostic uncertainty in a nationally representative cohort of Taiwanese children (n = 13 284) followed from birth to the 9th birthday through electronic health records. We conducted a nested case-control analysis and estimated cross-diagnosis ratios (CDRs) as the observed proportion of acute respiratory infection (ARI) diagnoses following an EVI diagnosis in excess of background ARI burdens. With 19 357 EVI diagnoses in this cohort, the CDR within 7 days was 1·51 (95% confidence interval 1·45–1·57), confirming a significant excess of ARI diagnoses within the week following an EVI diagnosis. We used age-specific CDRs to calibrate the weekly EVI burden in children aged 3–5 years in 2008, and the difference between observed and calibrated weekly EVI burdens was small. Therefore, there was evidence suggesting a small uncertainty in EVI diagnosis, but the observed EVI burdens through syndromic monitoring were not substantially affected by the small uncertainty.
The Valeo stent: a pre-mounted, open-cell, large stent for use in small children with CHD
Authors: Travelli Frances C. , Sullivan Patrick M. , Takao Cheryl , Ing Frank F.
Published: November 2015

Objectives

The aim of the present study was to determine the outcomes of using the Valeo stent (Bard Peripheral Vascular, Tempe, Arizona, United States of America) in small children with CHD.

Background

Stenting vascular stenoses is safe and effective in adults and older children with CHD but is limited in smaller children. The design of the Valeo stent addresses these limitations but has not been extensively described.

Methods

Bench testing was conducted to determine the maximum diameter of the stent, foreshortening, and side-cell diameter. A retrospective analysis of Valeo stents implanted between October, 2012 and October, 2014 was performed. Patient profile, pre-implant/post-implant catheterization data, and stent geometry were reviewed.

Results

Bench testing: medium and large Valeo stents can be dilated up to 13 mm and 20 mm diameters, respectively. Side-cells are dilatable up to 12 mm. Valeo stents are of low profile – delivered through 6- or 7-Fr sheaths – and show minimal foreshortening. Retrospective analysis: a total of 81 stents were implanted in 61 patients with CHD. The median weight was 15.3 kg, and the median age was 58.9 months. Stents were implanted in the pulmonary artery, systemic vein, aorta, and pulmonary vein. Overall, mean vessel diameters increased from 4.1 to 7.7 mm (121.7%). There was effective mean gradient reduction: 3.7–0.5 mmHg (63%) in the venous systems, 28.2–12.5 mmHg (63.7%) in the pulmonary arteries, and 17.4–4 mmHg (77.1%) in the aorta. The mean stent foreshortening was 2.5%, and the mean recoil was 5.9%. Side-cells that crossed other vessels were dilated in four cases, and stents were re-mounted onto different-sized balloons in seven cases.

Conclusions

The features of the Valeo stent, such as low profile, large maximum diameter, open-cell design, minimal foreshortening, and recoil, make it suitable for treating vascular stenoses in small children with CHD.
Parent education discharge instruction program for care of children at home after cardiac surgery in Southern India
Authors: Staveski Sandra L. , Parveen V. P. , Madathil Sai B. , Kools Susan , Franck Linda S.
Published: November 2015

Introduction

In many developing countries, children with CHD are now receiving surgical repair or palliation for their complex medical condition. Consequently, parents require more in-depth discharge education programmes to enable them to recognise complications and manage their children’s care after hospital discharge. This investigation evaluated the effectiveness of a structured nurse-led parent discharge teaching programme on nurse, parent, and child outcomes in India.

Materials and methods

A quasi-experimental investigation compared nurse and parent home care knowledge before and at two time points after the parent education discharge instruction program’s implementation. Child surgical-site infections and hospital costs were compared for 6 months before and after the discharge programme’s implementation.

Results

Both nurses (n=63) and parents (n=68) participated in this study. Records of 195 children who had undergone cardiac surgery were reviewed. Nurses had a high-level baseline home care knowledge that increased immediately after the discharge programme’s implementation (T1=24.4±2.89; T2=27.4±1.55; p<0.005; 30 point scale), but decreased to near baseline (T3=23.8±3.4; ns) 4 months after the programme’s implementation. Nurse teaching documentation increased by 56% after the programme’s implementation. Parent knowledge scores increased from 1.76±1.4 for Cohort 1 to 3.68±0.852 for Cohort 2 (p<0.005; 0–4 scale) after the discharge programme’s implementation. Surgical-site infections decreased from 27% in Cohort 1 to 2% in Cohort 2 (p>0.05) after the programme’s implementation.

Conclusion

Nurse, parent, and child outcomes were improved after implementation of the structured nurse-led parent discharge programme for parents in India. Structured nurse-led parent discharge programmes may help prepare parents to provide better home care for their children after cardiac surgery. Further investigation of causality and influencing factors is warranted.
Financial Burden of Emergency Preparedness on an Urban, Academic Hospital
Authors: Petinaux Bruno
Published: November 2015

This study assessed the direct human resource costs of a hospital's emergency preparedness planning (in 2005) by surveying participants retrospectively. Forty participants (74% of the identified population) were surveyed. Using the self-reported hourly salary of the participant, a direct salary cost was calculated for each participant. The population was 40% male and 60% female; 65% had a graduate degree or higher; 65% were administrators; 35% were clinicians; and 50% reported that their job description included a reference to emergency planning activities. All participants spent a combined total of 3,654.25 hours on emergency preparedness activities, including 20.1% on personal education/train-ing; 11.6% on educating other people; 39.3% on paperwork or equipment maintenance; 22.2% on attendance at meetings; 5.6% on drill participation; and <1% on other activities. Considering the participants' hourly salary, direct personal costs spent on emergency preparedness activities at the institution totaled US$232,417. Ten percent, all of whom were physicians, reported no compen-sation for their emergency preparedness efforts at the hospital level.

As much as these results illustrate the strong commitment of the institu-tion to its community, they represent a heavy burden in light of the oftenunfunded mandate of emergency preparedness planning that a hospital may incur. Such responsibility is carried to some extent by all hospitals.
Fluid Therapy in Pediatric Victims of the 2003 Bam, Iran Earthquake
Authors: Sanadgol H. , Najafi I. , Vahid M. Rajabi , Hosseini M. , Ghafari A.
Published: November 2015

Introduction:

On 26 December 2003, at 05:26 hours, an earthquake of magnitude 6.6 (Richter scale) caused a disaster in the Bam region of Southeastern Iran, which had a population of approximately 102,000. In this study, the clinical and laboratory features and therapeutic interventions in pediatric (three months to 14 years) crush victims were analyzed. Determination of the type and amount of fluid therapy for prevention of acute renal failure (ARF) was the main aim of this study.

Methods:

The clinical and laboratory data and therapeutic interventions provided to 31 pediatric crush victims were collected. Early and vigorous fluid resuscitation was immediately performed. Resuscitation of the children from hypovolemic shock was initiated by interavenous (IV) administration of normal saline until the signs and symptoms of shock disappeared. For victims with crush injuries, an alkaline intravenous solution, up to 3 to 5 times more than maintenance doses was provided. In this study, there were two groups with decreasing severity of injury: (1) crush injury (CI), with or without ARF; and (2) non-crush injury (Non-CI). According to the above mentioned classification, there were 15 and 16 patients in group I and II, respectively.

Results:

The mean time spent under the rubble was 2.2 ±2.5 hours and 0.5 ±0.5 hours in Groups I and II, respectively. Seventy-five percent of ARF patients (n = 8), were admitted to the hospital the day of the earthquake (Day 0) and the day after earthquake (Day 1). In non-ARF patients (n = 7), 85.7% of the victims were admitted on Day 0 and Day 1. In Group II (ARF and non-ARF), all patients were admitted within three days after the earthquake. Although ARF did not develop in any of the children without CI, it was observed in eight of 15 patients with CI. There was no significant difference between CI with ARF (n = 8) and CI without ARF (n = 7) patients, in terms of the admission date, time of admission, hospitalization duration, and time under the rubble (TUR). Admission SGOTs were significantly different between these two groups. The ratio of the amount of delivered IV fluid (DL) to expected (EX) was based on weight of children was the only fluid therapy parameter in which there was a statistically significant difference between ARF and non-ARF groups. It was 3.6 ±0.99 in ARF and 4.8 ±0.74 in Nnon-ARF group (p = 0.01).

Conclusions:

Early intravenous volume replacement may prevent both ARF and dialysis need that may develop on the basis of rhabdomyolysis. In adults, six liters or 12–14 liters of fluids for prophylaxis of ARF in crush syndrome, were suggest-ed. In children, it seems that DL/EX ratio (delivered to expected ratio) is the best marker for evolution of IV fluid therapy in pediatric patients. In children with crush injuries, DL/EX ratio of >4.8 was sufficient for the prevention of ARF.
Is There an Association Between Risk Perception and Disaster Preparedness in Rural US Hospitals?
Authors: Cliff Barbara J. , Morlock Laura , Curtis Amy B.
Published: November 2015

Introduction:

This study examined disaster preparedness, risk perception, and their association in rural hospitals in the United States. The focus of disaster preparedness largely has been centered on urban areas, in part because of the perception that more concentrated areas have an increased risk of a disastrous event. Therefore, it was hypothesized that risk perception may be a contributing factor for adequate preparedness in rural areas. This research was a component of a larger study of rural hospital preparedness. The objective of this study was to describe the perceived risk of disaster events and the status of disaster preparedness in rural hospitals. It was hypothesized that there is a positive association between risk perception and preparedness.

Methods:

Secondary data analysis was conducted using the National Study of Rural Hospitals (2006–2007) from Johns Hopkins University. The study, based on a regionally stratified, random sample of rural hospitals, consisted of a mailed questionnaire and a follow-up telephone interview with each hospital's Chief Executive Officer (n = 134). A model of disaster preparedness was utilized to examine seven elements of preparedness. Risk perception was examined through seven perceived risk threats.

Results:

The results indicated that rural hospitals were moderately prepared, overall,(78% prepared on average), with higher preparedness in education/training (89%) and isolation/decontamination (91%); moderate preparedness in administration/planning (80%), communication/notification (83%), staffing/support (66%), and supplies/pharmaceuticals/laboratory support (70%); and lower preparedness in surge capacity (64%).

The respondents reported greater perceived risk from disasters due to natural hazards (79% reported moderate to high risk) and vehicular accidents (77%) than from humanmade disasters (23%). Results obtained from logistic regression models indicated that there was no statistically significant difference in the odds of a hospital being prepared overall when comparing high versus low risk perception (OR = 0.61; 95% CI = 0.26–1.44). Positive associations were identified only between higher perceived risk overall and the subcategory of education/training preparedness (OR = 1.24; 95% CI = 1.05–1.27).

Conclusions:

Rural hospitals reported being moderately prepared in the event of a disaster with a low perception of risk for human-made disasters. Further research should be conducted to identify predictors of preparedness in rural hospitals in order to optimize readiness for potential disaster events.
Paramedic Knowledge, Attitudes, and Training in End-of-Life Care
Authors: Stone Susan C. , Abbott Jean , McClung Christian D. , Colwell Chris B. , Eckstein Marc , Lowenstein Steven R.
Published: November 2015

Introduction:

Paramedics often are asked to care for patients at the end of life. To do this, they must communicate effectively with family and caregivers, understand their legal obligations, and know when to withhold unwanted interventions. The objectives of this study were to ascertain paramedics' attitudes toward end-of-life (EOL) situations and the frequency with which they encounter them; and to compare paramedics' preparation during training for a variety of EOL care skills.

Methods:

A written survey was administered to a convenience sample of paramedics in two cities: Denver, Colorado and Los Angeles, California. Questions addressed: (1) attitudes toward EOL decision-making in prehospital settings; (2) experience (number of EOL situations experienced in the past two years); (3) importance of various EOL tasks in clinical practice (pronouncing and communicating death, ending resuscitation, honoring advance directives (ADs)); and (4) self-assessed preparation for these EOL tasks. For each task, importance and preparation were measured using a four-point Likert scale. Proportions were compared using McNemar chi-square statistics to identify areas of under or over-preparation.

Results:

Two hundred thirty-six paramedics completed the survey. The mean age was 39 years (range 22–59 years), and 222 (94%) were male. Twenty percent had >20 years of experience. Almost all participants (95%; 95% CI = 91–97%) agreed that prehospital providers should honor field ADs, and more than half (59%; 95% CI = 52–65%) felt that providers should honor verbal wishes to limit resuscitation at the scene. Ninety-eight percent of the participants (95% CI = 96–100%) had questioned whether specific life support interventions were appropriate for patients who appeared to have a terminal disease. Twenty-six percent (95% CI = 20–32%) reported to have used their own judgment during the past two years to withhold or end resuscitation in a patient who appeared to have a terminal disease. Significant discrepancies between the importance in practice and the level of preparation during training for the four EOL situations included: (1) understanding ADs (75% very important vs. 40% well prepared; difference 35%: 95% CI = 26–43%); (2) knowing when to honor written ADs (90% very important vs. 59% well-prepared; difference 31%: 95% CI = 23–38%); and (3) verbal ADs (75% very important vs. 54% well-prepared, difference 21%: 95% CI = 12–29%); and (4) communicating death to family or friends (79% very important vs. 48% well prepared, difference 31%: 95% CI = 23–39%). Paramedics' preparation in EOL skills was significantly lower than that for clinical skills such as endotracheal intubation or defibrillation.

Conclusions:

There is a need to include more training in EOL care into prehospital training curricula, including how to verify and apply ADs, when to withhold treatments, and how to discuss death with victims' family or friends.
Cognitive biases in binge eating disorder: the hijacking of decision making
Authors: Voon Valerie
Published: November 2015

Binge eating disorder (BED) is the most common of eating disorders and is characterized by excessive, out-of-control, rapid food intake. This review focuses on cognitive impairments in BED, which represent an endophenotype that mediates brain function and behavior. Here we focus on reviewing impulsivity, compulsivity, attentional biases to food cues, and executive function. Behavioral regulation in BED appears to be influenced by the context of motivationally salient food cues and the degree of obesity. Deficits in delay discounting and risk taking under ambiguity are impaired in obesity irrespective of BED status. However, in BED subjects with milder obesity, greater risk seeking under explicit probabilistic risk is observed to monetary rewards, whereas this shifts to risk aversion and enhanced delay discounting in more severe obesity. Relative to non-BED obese subjects, BED is characterized by enhanced behavioral inflexibility or compulsivity across multiple domains, with subjects selecting the same choices despite change in relevance (set shifting), being no longer rewarding (habit formation), or irrespective of outcome (perseveration). The context of food cues was associated with multiple attentional and early and late inhibitory impairments and enhanced memory bias, although BED patients also have generalized cognitive interference in working memory. These findings may help explain the phenotype of binge eating. Motivationally salient food cues provoke attentional and memory biases along with impairing response inhibitory processes. Those with BED are also more susceptible to cognitive interference and have impaired decisional impulsivity, with the tendency to inflexibly stick with the same choices irrespective of changes in context. These findings suggest critical cognitive domains that may guide therapeutic interventions.
Rapid infant weight gain and early childhood obesity in low-income Latinos and non-Latinos
Authors: Polk Sarah , Thornton Rachel Johnson , Caulfield Laura , Muñoz Alvaro
Published: November 2015

Objective

To examine the growth of infants and toddlers in a population that is both under-represented in the literature and at high risk for childhood obesity.

Design

Weight and height measurements were extracted from all visits for a sample of 0–4-year-old, low-income, Latino and non-Latino patients of an urban, academic general paediatric practice. Early growth was characterized as change in weight-for-length Z-score (WLZ) from birth to 3 years. The outcome of interest was BMI Z-score (BMIZ) at age 3 years. Mixed-effects models and multivariate linear regression were used to analyse the association between infant growth and early childhood obesity.

Setting

Baltimore, MD, USA.

Subjects

Latino (n 210) and non-Latino (n 253) children, born in 2003–2004.

Results

An increase in WLZ from birth to 2 years was observed for this cohort as well as a high incidence of overweight and obesity. WLZ at birth and change in WLZ from birth to 2 years were both significantly and positively associated with increases in BMIZ at 3 years of age. The effect of the change in WLZ was twofold higher than the effect of WLZ at birth.

Conclusions

An increase in WLZ during the first 2 years of life increased the risk of early childhood obesity. Latino children had a higher incidence of early childhood obesity than non-Latino children in this low-income sample.
Attitudes to statistics in primary health care physicians, Qassim province
Authors: Jahan Saulat , Al-Saigul Abdullah Mohammed , Suliman Amel Abdalrhim
Published: November 2015

Aim

To investigate primary health care (PHC) physicians’ attitudes to statistics, their self-reported knowledge level, and their perceived training needs in statistics.

Background

In spite of realization of the importance of statistics, inadequacies in physicians’ knowledge and skills have been found, underscoring the need for in-service training. Understanding physicians’ attitudes to statistics is vital in planning statistics training.

Methods

The study was based on theory of planned behavior. A cross-sectional survey of all PHC physicians was conducted in Qassim province, from August to October 2014. Attitudes to statistics were determined by a self-administered questionnaire. The attitudes were assessed on four subscales including general perceptions; perceptions of knowledge and training; perceptions of statistics and evidence-based medicine; and perceptions of future learning.

Findings

Of 416 eligible participants, 338 (81.25%) responded to the survey. On a scale of 1–10, the majority (73.6%) of the participants self-assessed their level of statistics knowledge as five or below. The attitude scores could have a minimum of 20 and a maximum of 100, with higher scores showing a positive attitude. The participants showed a positive attitude with the mean score of 71.14 (±7.73). Out of the four subscales, ‘perceptions of statistics and evidence-based medicine’ subscale scored the highest, followed by ‘perceptions of future learning’.

Conclusion

PHC physicians have a positive attitude to statistics. However, they realize their gaps in knowledge in statistics, and are keen to fill these gaps. Statistics training, resulting in improved statistics knowledge is expected to lead to clinical care utilizing evidence-based medicine, and thus improvement to health care services.
Young clinicians dealing with death: Problems and opportunities
Authors: Nissen Kathrine G.
Published: November 2015

Objective:

The formation of a strong bond between patients and therapists can lead to successful treatment outcomes. Yet, little is known about the mechanisms that function to control this relationship. The objective of this case report was to examine the ruptures and repairs in the working alliance between a young therapist and an elderly caregiver, and to suggest ways in which to deal with age-related challenges to such an alliance.

Method:

In order to examine the ruptures and repairs in a working alliance, this case report reflects on the interdependent relationship among therapist variables, patient variables, and the therapeutic alliance. The clinical experience presented describes a newly educated psychologist's struggles to overcome the challenges in forming a strong working alliance with an elderly dying cancer patient's spouse. The spouse was enrolled in the DOMUS study (Clinicaltrials.gov: NTC01885637), an ongoing randomized controlled trial of a patient-and-caregiver intervention for facilitating the transition from an oncology ward to palliative at-home care, and then bereavement. As part of the DOMUS study, the patient and spouse received a psychological intervention based on existential-phenomenological therapy.

Results:

A therapist's therapeutic approach to breaking down age-related barriers to communication matters greatly. The existential-phenomenological method of epoché offers a way to effectively address ruptures and repairs in a working alliance, as it enhances the therapist's openness to learning. In addition, the insights of senior supervisors can promote a therapist's openness to learning.

Significance of results:

In conclusion, the method of epoché benefits the working alliance in several ways, as it enhances personal insight and provides methods for repairing an alliance. The reflections in this paper may be applied to clinical settings in oncology, gerontology, and palliative care, which are likely to be of great interest to young clinicians experiencing age-related challenges in their daily work.
Threshold voltage-level change in ASK demodulator related to RF input signal amplitude for the ultra-high frequency RFID passive tag
Authors: Dastanian Rezvan , Abiri Ebrahim , Taherinia Khadije
Published: November 2015

In this paper, an amplitude shift keying (ASK) demodulator with 100% modulation depth is proposed. In order to achieve the higher power and wider reading range the designed ASK demodulator works in the ultra-high frequency. In this design, the average detector and voltage divider are used in order to define the appropriate threshold voltage level for the radio frequency input signal which leads to the accurate data detecting even at long distances between the tag and reader. In addition, for diminishing the power dissipation of the proposed demodulator, an enable input is used in the buffer and comparator. This circuit is simulated in 0.18 μm complementary metal–oxide–semiconductor (CMOS) technology with Cadence software. Its power dissipation and chip area are 3.9 nW and 0.0025 mm2, respectively.
The Slave Trade and the Right of Visit Under the Law of the Sea Convention: Exploitation in the Fishing Industry in New Zealand and Thailand
Authors: MACFARLANE Douglas
Published: November 2015

Severe exploitation of vulnerable persons is occurring in fishing industries globally. An overview of exploitation in New Zealand and Thailand highlights the incentive for states to downplay exploitation and underpins the appeal of a right of visit, which is provided for under the Law of the Sea Convention in regards to the slave trade. Although reported as forced labour, debt bondage, or human trafficking, an examination of international jurisprudence reveals that current practices likely amount to slavery; primarily due to the inherent vulnerability of persons at sea. Two persuasive cases, Kunarac and Tang, provide guidance on interpreting the definition of slavery, particularly “the powers attaching to the rights of ownership”. The operation of a right of visit is considered against the law of the sea regime, as are the implications in the light of international attempts to control IUU fishing.
Single living cell manipulation and identification using microsystems technologies
Authors: Stiharu Ion , Alazzam Anas , Nerguizian Vahé , Roman Dacian
Published: November 2015

The paper presents the principles and the results of the implementation of dielectrophoresis for separation and identification of rare cells such as circulation tumor cells (CTCs) from diluted blood specimens in media and further label-free identification of the origins of separated cells using radio-frequency (RF) imaging. The separation and the identification units use same fabrication methods which enable system integration on the same platform. The designs use the advantage of higher surface volume ratio which represents the particular feature for micro- and nanotechnologies. Diluted blood in solution of sucrose–dextrose 1–10 is used for cell separation that yields more than 95.3% efficiency. For enhanced sensitivity in identification, RF imaging is performed in 3.5–1 solution of glycerol and trypsin. Resonance cavity performance method is used to determine the constant permittivity of the cell lines. The results illustrated by the signature of specific cells subjected to RF imaging suggest a reliable label-free single cell detection method for identification of the type of CTC.
AF4 uses the SL1 components of RNAP1 machinery to initiate MLL fusion- and AEP-dependent transcription
Authors: Okuda Hiroshi , Kanai Akinori , Ito Shinji , Matsui Hirotaka , Yokoyama Akihiko
Published: November 2015

Gene rearrangements generate MLL fusion genes, which can lead to aggressive leukemia. In most cases, MLL fuses with a gene encoding a component of the AEP (AF4 family/ENL family/P-TEFb) coactivator complex. MLL–AEP fusion proteins constitutively activate their target genes to immortalize haematopoietic progenitors. Here we show that AEP and MLL–AEP fusion proteins activate transcription through selectivity factor 1 (SL1), a core component of the pre-initiation complex (PIC) of RNA polymerase I (RNAP1). The pSER domain of AF4 family proteins associates with SL1 on chromatin and loads TATA-binding protein (TBP) onto the promoter to initiate RNA polymerase II (RNAP2)-dependent transcription. These results reveal a previously unknown transcription initiation mechanism involving AEP and a role for SL1 as a TBP-loading factor in RNAP2-dependent gene activation.
Migration and horizontal gene transfer divide microbial genomes into multiple niches
Authors: Niehus Rene , Mitri Sara , Fletcher Alexander G. , Foster Kevin R.
Published: November 2015

Horizontal gene transfer is central to microbial evolution, because it enables genetic regions to spread horizontally through diverse communities. However, how gene transfer exerts such a strong effect is not understood. Here we develop an eco-evolutionary model and show how genetic transfer, even when rare, can transform the evolution and ecology of microbes. We recapitulate existing models, which suggest that asexual reproduction will overpower horizontal transfer and greatly limit its effects. We then show that allowing immigration completely changes these predictions. With migration, the rates and impacts of horizontal transfer are greatly increased, and transfer is most frequent for loci under positive natural selection. Our analysis explains how ecologically important loci can sweep through competing strains and species. In this way, microbial genomes can evolve to become ecologically diverse where different genomic regions encode for partially overlapping, but distinct, ecologies. Under these conditions ecological species do not exist, because genes, not species, inhabit niches.
Cavity quantum electrodynamics with ferromagnetic magnons in a small yttrium-iron-garnet sphere
Authors: Zhang Dengke , Wang Xin-Ming , Li Tie-Fu , Luo Xiao-Qing , Wu Weidong , Nori Franco , You JQ
Published: November 2015

Hybridizing collective spin excitations and a cavity with high cooperativity provides a new research subject in the field of cavity quantum electrodynamics and can also have potential applications to quantum information. Here we report an experimental study of cavity quantum electrodynamics with ferromagnetic magnons in a small yttrium-iron-garnet (YIG) sphere at both cryogenic and room temperatures. We observe for the first time a strong coupling of the same cavity mode to both a ferromagnetic-resonance (FMR) mode and a magnetostatic (MS) mode near FMR in the quantum limit. This is achieved at a temperature ~22 mK, where the average microwave photon number in the cavity is less than one. At room temperature, we also observe strong coupling of the cavity mode to the FMR mode in the same YIG sphere and find a slight increase of the damping rate of the FMR mode. These observations reveal the extraordinary robustness of the FMR mode against temperature. However, the MS mode becomes unobservable at room temperature in the measured transmission spectrum of the microwave cavity containing the YIG sphere. Our numerical simulations show that this is due to a drastic increase of the damping rate of the MS mode.
Silicon nanowire and carbon nanotube hybrid for room temperature multiwavelength light source
Authors: Lo Faro Maria Josè , D’Andrea Cristiano , Messina Elena , Fazio Barbara , Musumeci Paolo , Reitano Riccardo , Franzò Giorgia , Gucciardi Pietro Giuseppe , Vasi Cirino , Priolo Francesco , Iacona Fabio , Irrera Alessia
Published: November 2015

The realization of an innovative hybrid light source operating at room temperature, obtained by embedding a carbon nanotube (CNT) dispersion inside a Si nanowire (NW) array is reported. The NW/CNT system exhibits a peculiar photoluminescence spectrum, consisting of a wide peak, mainly observed in the visible range, due to quantum confined Si NWs and of several narrower IR peaks, due to the different CNT chiralities present in the dispersion. The detailed study of the optical properties of the hybrid system evidences that the ratio between the intensity of the visible and the IR emissions can be varied within a wide range by changing the excitation wavelength or the CNT concentration; the conditions leading to the prevalence of one signal with respect to the other are identified. The multiplicity of emission spectra obtainable from this composite material opens new perspectives for Si nanostructures as active medium in light sources for Si photonics applications.
Mesoporous Silica Gel–Based Mixed Matrix Membranes for Improving Mass Transfer in Forward Osmosis: Effect of Pore Size of Filler
Authors: Lee Jian-Yuan , Wang Yining , Tang Chuyang Y. , Huo Fengwei
Published: November 2015

The efficiency of forward osmosis (FO) process is generally limited by the internal concentration polarization (ICP) of solutes inside its porous substrate. In this study, mesoporous silica gel (SG) with nominal pore size ranging from 4–30 nm was used as fillers to prepare SG-based mixed matrix substrates. The resulting mixed matrix membranes had significantly reduced structural parameter and enhanced membrane water permeability as a result of the improved surface porosity of the substrates. An optimal filler pore size of ~9 nm was observed. This is in direct contrast to the case of thin film nanocomposite membranes, where microporous nanoparticle fillers are loaded to the membrane rejection layer and are designed in such a way that these fillers are able to retain solutes while allowing water to permeate through them. In the current study, the mesoporous fillers are designed as channels to both water and solute molecules. FO performance was enhanced at increasing filler pore size up to 9 nm due to the lower hydraulic resistance of the fillers. Nevertheless, further increasing filler pore size to 30 nm was accompanied with reduced FO efficiency, which can be attributed to the intrusion of polymer dope into the filler pores.
Diet composition, not calorie intake, rapidly alters intrinsic excitability of hypothalamic AgRP/NPY neurons in mice
Authors: Wei Wei , Pham Kevin , Gammons Jesse W. , Sutherland Daniel , Liu Yanyun , Smith Alana , Kaczorowski Catherine C. , O’Connell Kristen M.S.
Published: November 2015

Obesity is a chronic condition resulting from a long-term pattern of poor diet and lifestyle. Long-term consumption of high-fat diet (HFD) leads to persistent activation and leptin resistance in AgRP neurons in the arcuate nucleus of the hypothalamus (ARH). Here, for the first time, we demonstrate acute effects of HFD on AgRP neuronal excitability and highlight a critical role for diet composition. In parallel with our earlier finding in obese, long-term HFD mice, we found that even brief HFD feeding results in persistent activation of ARH AgRP neurons. However, unlike long-term HFD-fed mice, AgRP neurons from short-term HFD-fed mice were still leptin-sensitive, indicating that the development of leptin-insensitivity is not a prerequisite for the increased firing rate of AgRP neurons. To distinguish between diet composition, caloric intake and body weight, we compared acute and long-term effects of HFD and CD in pair-fed mice on AgRP neuronal spiking. HFD consumption in pair-fed mice resulted in a significant increase in AgRP neuronal spiking despite controls for weight gain and caloric intake. Taken together, our results suggest that diet composition may be more important than either calorie intake or body weight for electrically remodeling arcuate AgRP/NPY neurons.
Space resource utilisation: a novel indicator to quantify species competitive ability for light
Authors: Zhang Pengfei , Zhou Xiaolong , Li Junyong , Guo Zhi , Du Guozhen
Published: November 2015

Species richness and productivity are two fundamental aspects of ecosystems. As a result, the relationship between species richness and productivity has been widely studied. A series of fertilisation experiments in an alpine meadow on the Tibetan Plateau were performed to study the relationship between species richness and productivity. In this paper, we present a novel indicator, i.e., space resource utilisation (SRU), which is calculated by a volume formula (Vi =  hi· Si; hi = plant height of species i, Si = quadrat area × percent cover of species i). SRU more fully reflected species competitive ability for light in both horizontal and vertical dimensions compared with plant height and cover. We used this novel indicator to investigate the effects of SRU on the changes in species richness and productivity following fertilisation. We found that the SRU of the community was correlated with increasing productivity and decreasing species richness following fertilisation and was a better predictor of species richness than productivity. The changes in SRU following fertilisation vary among species. These results demonstrate that SRU can be a more useful tool in explaining plant biodiversity loss and predicting the fate of different species than each of height, cover and productivity.
Characterizing Types of Human Mobility to Inform Differential and Targeted Malaria Elimination Strategies in Northeast Cambodia
Authors: Peeters Grietens Koen , Gryseels Charlotte , Dierickx Susan , Bannister-Tyrrell Melanie , Trienekens Suzan , Uk Sambunny , Phoeuk Pisen , Suon Sokha , Set Srun , Gerrets René , Hoibak Sarah , Muela Ribera Joan , Hausmann-Muela Susanna , Tho Sochantha , Durnez Lies , Sluydts Vincent , d’Alessandro Umberto , Coosemans Marc , Erhart Annette
Published: November 2015

Human population movements currently challenge malaria elimination in low transmission foci in the Greater Mekong Subregion. Using a mixed-methods design, combining ethnography (n = 410 interviews), malariometric data (n = 4996) and population surveys (n = 824 indigenous populations; n = 704 Khmer migrants) malaria vulnerability among different types of mobile populations was researched in the remote province of Ratanakiri, Cambodia. Different structural types of human mobility were identified, showing differential risk and vulnerability. Among local indigenous populations, access to malaria testing and treatment through the VMW-system and LLIN coverage was high but control strategies failed to account for forest farmers’ prolonged stays at forest farms/fields (61% during rainy season), increasing their exposure (p = 0.002). The Khmer migrants, with low acquired immunity, active on plantations and mines, represented a fundamentally different group not reached by LLIN-distribution campaigns since they were largely unregistered (79%) and unaware of the local VMW-system (95%) due to poor social integration. Khmer migrants therefore require control strategies including active detection, registration and immediate access to malaria prevention and control tools from which they are currently excluded. In conclusion, different types of mobility require different malaria elimination strategies. Targeting mobility without an in-depth understanding of malaria risk in each group challenges further progress towards elimination.
Extreme lithium isotopic fractionation in three zircon standards (Plešovice, Qinghu and Temora)
Authors: Gao Yu-Ya , Li Xian-Hua , Griffin William L. , Tang Yan-Jie , Pearson Norman J. , Liu Yu , Chu Mei-Fei , Li Qiu-Li , Tang Guo-Qiang , O’Reilly Suzanne Y.
Published: November 2015

To understand the behavior of Li in zircon, we have analyzed the abundance and isotopic composition of Li in three zircon standards (Plešovice, Qinghu and Temora) widely used for microbeam analysis of U-Pb ages and O-Hf isotopes. We have mapped Li concentration ([Li]) on large grains, using a Cameca 1280HR Secondary Ion Mass Spectrometer (SIMS). All zircons have a rim 5–20 μm wide in which [Li] is 5 to 20 times higher than in the core. Up to ~20‰ isotopic fractionation is observed on a small scale in the rims of a single zircon grain. The measured δ7Li values range from –14.3 to 3.7‰ for Plešovice, –22.8 to 1.4‰ for Qinghu and –4.7 to 16.1‰ for Temora zircon. The [Li] and δ7Li are highly variable at the rims, but relatively homogenous in the cores of the grains. From zircon rim to core, [Li] decreases rapidly, while δ7Li increases, suggesting that the large isotopic variation of Li in zircons could be caused by diffusion. Our data demonstrate that homogeneous δ7Li in the cores of zircon can retain the original isotopic signatures of the magmas, while the bulk analysis of Li isotopes in mineral separates and in bulk-rock samples may produce misleading data.