bluuebunny/crossref_metadata_2025 huggingface dataset:
A revision of the Hawaiian and Wake Island species of the genus Conchopus Takagi (Diptera, Dolichopodidae)
Authors: MASUNAGA KAZUHIRO , SAIGUSA TOYOHEI
Published: January 2019

Six shore-dwelling species of the rectus group of the genus Conchopus Takagi are recognized from the Hawaiian and Wake Islands, including five new species. Conchopus is restricted to this species group herein. Contrary to some earlier records, C. acrosticalis (Parent, 1937) occurs only on four of the Hawaiian Islands (Hawai‘i, Maui, Lāna‘i, and Moloka‘i). The new species are distributed as follows: C. ciliatus sp. nov. (Hawai‘i, Maui, O‘ahu and Lisianski Is.); C. crassinervis sp. nov. (Kaua‘i); C. minutus sp. nov. (Hawai‘i, Maui, Lāna‘i, O‘ahu, and French Frigate Shoals); C. menehune sp. nov. (Kaua‘i and Nihoa Is.); and C. pacificus sp. nov. (Hawai‘i, O‘ahu, Kaua‘i, and Wake Is). A key to the males of all known species of the rectus group is provided.
Odiomarinae nov. subfam., a new subfamily for two primitive genera of Hymenosomatidae MacLeay, 1838, with preliminary remarks on the family (Crustacea, Decapoda, Brachyura)
Authors: GUINOT DANIÈLE
Published: January 2019

A new subfamily Odiomarinae nov. subfam. is erected to receive two primitive genera of the eubrachyuran family Hymenosomatidae MacLeay, 1838: Odiomaris Ng & Richer de Forges, 1996, and Amarinus Lucas, 1980, mostly from fresh and estuarine waters of the Indo-West Pacific region. The new subfamily is characterised by the presence of “intercalated platelets” on the male abdomen, either articulated and moveable or relatively less well demarcated. The hymenosomatid platelets are actually vestigial uropods that are similar to those, also showing as dorsal plates, of the podotreme Dynomenidae Ortmann, 1892, and Dromiidae De Haan, 1833. The hymenosomatid uropod differs from the podotreme ones by the deep socket that is excavated at its ventral side and thus corresponds to the typical eubrachyuran press-button system. The odiomarine socket is particularly interesting because it provides morphological and phylogenetic criteria for identifying podotreme uropods and eubrachyuran sockets as homologues. In addition to several other plesiomorphic characters, the retention of dorsal uropods in the Hymenosomatidae, a unique known case in the Eubrachyura Saint Laurent, 1980, and evidence of an ancient lineage, allows re-defining and preliminarily interpreting the exclusive combination of characters of the family and to reconsider its status within the Eubrachyura.
Three new species of Indochinamon Yeo & Ng, 2007 (Crustacea: Brachyura: Potamoidea: Potamidae) from Vietnam, with a redescription of Ranguna (Ranguna) kimboiensis Dang, 1975
Authors: NARUSE TOHRU , QUYNH NGUYEN XUAN , YEO DARREN C. J.
Published: January 2019

Three new species of Indochinamon Yeo & Ng, 2007, are described from Vietnam. The poorly known Vietnamese species Indochinamon kimboiense (Dang, 1975) is redescribed. The holotype of I. kimboiense is lost, and a topotypic specimen is designated as the neotype. Indochinamon bavi n. sp. from Ba Vi National Park, Ha Tay Province, and I. phongnha n. sp. from Phong Nha, Quang Binh Province, are allied to I. kimboiense, but can be distinguished by the characters of the carapace, chela and male first pleopod. Indochinamon dangi n. sp. is allied to I. lipkei (Ng & Naiyanetr, 1993) [type locality northern Thailand], but can be distinguished by characters of the carapace, telson, and male first pleopod.
Heterotrissocladius Spärck from China (Diptera: Chironomidae)
Authors: KONG FANQING , WANG XINHUA
Published: January 2019

Heterotrissocladius Spärck from China, including 5 species is reviewed. Three new species, H. flectus sp. n., H. quartus sp. n. and H. reductus sp. n. are described and illustrated as adult males, and H. scutellatus Goetghebuer is recorded from China for the first time. A key to the males of the reviewed species is presented.
Erratum: PALADINI, ANDRESSA (2010) A new species of Ferorhinella with an unusual pattern of sexual size dimorphism (Hemiptera, Cercopidae, Tomaspidinae). Zootaxa, 2728, 57–60.
Authors: PALADINI ANDRESSA
Published: January 2019

(Erratum)
Caliothrips tongi sp.n. (Thysanoptera, Thripidae) from China, and a dubious record of North American Bean Thrips
Authors: MOUND LAURENCE A. , ZHANG HONGRUI , BEI YAWEI
Published: January 2019

A new species, Caliothrips tongi, is described from eastern China, and an old record of the North American bean thrips, Caliothrips fasciatus (Pergande), from the same area is considered unreliable. Oneilliella pallidizonata Kudo is transferred to Caliothrips as a new combination.
A new karst-dwelling species of Kalophrynus (Anura: Microhylidae) from Gunung Mulu National Park, Borneo, Malaysia
Authors: DEHLING J. MAXIMILIAN
Published: January 2019

A new species of Kalophrynus is described from Gunung Mulu National Park in East Malaysia. The species is endemic to the karst hills and mountains of the Melinau Limestone Formation where it occurs at elevations between 70 and at least 1200 m. It differs from all other species of the genus by the combination of the following morphological characters: medium size (SVL of adult males 29.7–30.1 mm, adult females 35.5–38.8 mm), snout obtusely pointed, tympanum diameter slightly larger than half the eye diameter, upper jaw with weak dentition, fore limbs slender, Finger IV shorter than Fingers I and II, subarticular tubercles prominent, numbering one on Fingers I, II, and IV, and two on Finger III, a smaller, supernumerary metacarpal tubercle present between each finger and palmar tubercle, nuptial pads or asperities absent, heel reaching to posterior margin of eye when legs are adpressed to body, foot shorter than tibiofibula, Toe III longer than Toe V, toes webbed, inner and outer metatarsal tubercle prominent, dorsum and flanks black in life, separated from each other by white dorsolateral line running on both sides of body, chin and chest black, abdomen and proximal third of thigh grey in life, iris red to reddish-orange in life, advertisement call a single note consisting of 7 pulses and lasting 161 ms on average, with dominant frequency at 2250–2650 Hz.
Two new genera and two new species of Oriental dictyopharid planthoppers (Hemiptera: Fulgoromorpha: Dictyopharidae) from Sri Lanka and southern India
Authors: SONG ZHI-SHUN , LIANG AI-PING
Published: January 2019

Two new Oriental dictyopharid genera are described from Sri Lanka and southern India, respectively. Truncatomeria gen. nov. is established based on a single known species from Sri Lanka. Its type species, Dictyophora [sic] viridistigma Kirby, 1891 was first described in Dictyophara and then assigned to Centromeria Stål by Distant (1906). However, it bears many different characters from other Centromeria species and should be transferred to a new genus. The second new genus, Paradictyopharina gen. nov. is established for two new species, P. parallela sp. nov. and P. spina sp. nov., both from southern India. The new genus is externally similar to Dictyopharina Melichar, but can be distinguished from the latter by the differences of its mesonotum, fore femora, hind tibiae and aedeagus. Photographs of the adults of all species are presented. Descriptions of the two genera and their included species are provided together with structural illustrations.
A new genus of hawker dragonfly (Odonata: Anisoptera: Aeshnidae) from the Early Eocene Fur Formation of Denmark
Authors: BECHLY GÜNTER , RASMUSSEN JAN AUDUN
Published: January 2019

A new genus and species of fossil hawker dragonfly, Parabaissaeshna ejerslevense gen. et sp. nov. (Aeshninae: Allopetaliini), is described from the Early Eocene Fur Formation (Mo-clay) of the island of Mors, northern Denmark. Its position among traditional “gomphaeschnine” dragonflies is discussed, and it is attributed to the tribe Allopetaliini as close relative to the Cretaceous genus Baissaeshna, documenting the survival of this lineage through the K-Pg mass extinction. The Recent genus Boyeria and the Eocene genus Anglogomphaeschna are also transferred to Allopetaliini.
Evaluation of the Ventilation Index in Complex Terrain: A Dispersion Modeling Study
Authors: Kiefer Michael T. , Charney Joseph J. , Zhong Shiyuan , Heilman Warren E. , Bian Xindi , Hom John L. , Patterson Matthew
Published: January 2019

In this study, the Flexible Particle (FLEXPART)-WRF, a Lagrangian particle dispersion model, is employed to simulate pollutant dispersion in and near the Lehigh Gap, a gap in a prominent ridgeline in eastern Pennsylvania. FLEXPART-WRF is used to evaluate the diagnostic value of the ventilation index (VI), an index that describes the potential for smoke or other pollutants to ventilate away from a source, for indicating dispersion potential in complex terrain. Little is known about the effectiveness of the ventilation index in diagnosing dispersion potential in complex terrain. The modeling approach used in this study is to release a dense cloud of particles across a portion of the model domain and evaluate particle behavior and VI diagnostic value in areas of the domain with differing terrain characteristics. Although both horizontal and vertical dispersion are examined, the study focuses primarily on horizontal dispersion, assessed quantitatively by calculating horizontal residence time (HRT) within a 1-km-radius circle surrounding the particle release point. Analysis of HRT across the domain reveals horizontal dispersion patterns that are influenced by the ridgeline and the Lehigh Gap. Comparison of VI and HRT in different areas of the domain reveals a robust relationship windward of the ridgeline and a weak relationship leeward of the ridgeline and in the vicinity of the Lehigh Gap. The results of this study suggest that VI users should consider whether they are windward or leeward of topographic features, and highlight the need for an alternative metric that better takes into account the influence of the terrain on dispersion.
Rapid Relationality: How Peripheral Experts Build a Foundation for Influence with Line Managers
Authors: DiBenigno Julia
Published: January 2019

This paper develops grounded theory to understand how and when experts in lower-power peripheral roles can develop influential relationships with higher-power line managers in core functions to regularly elicit their cooperation. I use data from an ethnographic study of experts in peripheral roles—mental health professionals hired by the U.S. Army to provide rehabilitative services to active-duty soldiers suffering from conditions such as post-traumatic stress disorder (PTSD)—and the line managers in core functions they depended on for their soldier-care recommendations to be followed—their soldiers’ direct commanders. I analyze relational histories of 56 commander–provider dyads and detail a three-phase process model I refer to as “rapid relationality.” Through the process of rapid relationality, mental health professionals capitalized on short windows of opportunity to quickly develop influential relationships with commanders, despite lacking formal authority over them, before a series of minor conflicts or a major conflict threatened their burgeoning influence. My analysis suggests it is not only what peripheral experts do that allows them to elicit cooperation from line managers but also when and how quickly they do it that matters. Speed and taking early action are important because experts cannot predict when conflict will occur and hence may have short initial windows of opportunity for establishing an influential relationship. I further find that some experts have fewer tactics available to them or must use more time-consuming and energy-intensive tactics than others to achieve the same relational influence based on their personal characteristics (e.g., gender). As a result, it may be harder for some experts to achieve relational influence before their window of opportunity closes.
Salivary IgA to MAA-LDL and Oral Pathogens Are Linked to Coronary Disease
Authors: Akhi R. , Wang C. , Nissinen A.E. , Kankaanpää J. , Bloigu R. , Paju S. , Mäntylä P. , Buhlin K. , Sinisalo J. , Pussinen P.J. , Hörkkö S.
Published: January 2019

A large body of literature has established the link between periodontal disease and cardiovascular disease. Oxidized low-density lipoproteins (OxLDLs) have a crucial role in atherosclerosis progression through initiation of immunological response. Monoclonal IgM antibodies to malondialdehyde-modified low-density lipoprotein (MDA-LDL) and to malondialdehyde acetaldehyde–modified low-density lipoprotein (MAA-LDL) have been shown to cross-react with the key virulence factors of periodontal pathogens Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans. We have previously shown that salivary IgA antibodies to MAA-LDL cross-react with P. gingivalis in healthy humans. In this study, we aim to assess whether oral mucosal immune response represented by salivary IgA to MAA-LDL and oral pathogens is associated with coronary artery disease (CAD). Also, the molecular mimicry through antibody cross-reaction between salivary IgA to MAA-LDL and oral pathogens was evaluated. The study subjects consisted of 451 patients who underwent a coronary angiography with no CAD ( n = 133), stable CAD ( n = 169), and acute coronary syndrome (ACS, n = 149). Elevated salivary IgA antibody levels to MAA-LDL, Rgp44 (gingipain A hemagglutinin domain of P. gingivalis), and Aa-HSP60 (heat shock protein 60 of A. actinomycetemcomitans) were discovered in stable-CAD and ACS patients when compared to no-CAD patients. In a multinomial regression model adjusted for known cardiovascular risk factors, stable CAD and ACS were associated with IgA to MAA-LDL ( P = 0.016, P = 0.043), Rgp44 ( P = 0.012, P = 0.004), Aa-HSP60 ( P = 0.032, P = 0.030), Tannerella forsythia ( P = 0.002, P = 0.004), Porphyromonas endodontalis ( P = 0.016, P = 0.020), Prevotella intermedia ( P = 0.038, P = 0.005), and with total IgA antibody concentration ( P = 0.002, P = 0.016). Salivary IgA to MAA-LDL showed cross-reactivity with the oral pathogens tested in the study patients. The study highlights an association between salivary IgA to MAA-LDL and atherosclerosis. However, whether salivary IgA to MAA-LDL and the related oral humoral responses play a causal role in the development in the CAD should be elucidated in the future.
Creating equitable outcomes in a segregated state
Authors: Hatch Thomas , Roegman Rachel , Allen David
Published: January 2019

Thomas Hatch, Rachel Roegman, and David Allen draw on examples from three districts in New Jersey — one of the most segregated states in the United States for Black and Latinx students — to present a multidimensional approach to creating equitable learning experiences. This approach begins with a focus on instruction but also takes into account the technical, political, and normative issues that determine which students gain access to the teachers, content, and other resources that support high-level learning. These stories show how local education leaders can combat the differences in access to educational opportunities and outcomes that come with segregation.
Why we need a diverse teacher workforce
Authors: Goldhaber Dan , Theobald Roddy , Tien Christopher
Published: January 2019

Despite the consistent policy focus on diversifying the teacher workforce, this workforce still fails to reflect the diversity of the student body in U.S. public schools. Dan Goldhaber, Roddy Theobald, and Christopher Tien examine the theoretical arguments and empirical evidence supporting the importance of teacher workforce diversity. They conclude that there are good theoretical reasons to believe that students of color would benefit from a more diverse teaching workforce, and these theoretical arguments are largely backed by empirical evidence suggesting that there are small but meaningful “role model effects” when students of color are taught by teachers of the same race.
Twenty Years in Prison: Reflections on Conducting Research in Correctional Environments
Authors: Field Courtney , Archer Vicki , Bowman Julia
Published: January 2019

Prisons are a difficult terrain in which to undertake research. Our experience in conducting a comprehensive prevalence study of health factors across New South Wales has provided us with a unique perspective on how to overcome common difficulties when undertaking prison-based research that may otherwise seem insurmountable. We outline six domains that constitute major challenges to the successful completion of projects as we understand them and offer practical solutions where possible. Our aim is to encourage researchers to undertake this important work in a manner that will provide positive outcomes for researchers, organizations working in the corrections space, and inmates.
Official Secrecy in England
Authors: Williams D. G. T.
Published: January 2019

The battles over official secrecy have to be fought on many different fronts. In the United Kingdom—whose ministers and public servants allegedly have a “passion for secrecy”—this was more than usually evident during 1967. Two pieces of legislation—namely, the Parliamentary Commissioner Act, 1967 (U.K.) and the Public Records Act, 1967 (Eng.)—represented a modest triumph for those who would wish to see more light shed upon the affairs of the nation. Elsewhere the picture was rather more familiar. The Security Commission recommended a further tightening of documentary security in the Cabinet Office; this followed upon the conviction under the Official Secrets Acts, 1911 to 1939 (U.K.) of a young typist in the Cabinet Office, “the first known occasion on which classified papers have been extracted from” this inner sanctum of government.
The Sea-Bed
Authors: Harders C. W.
Published: January 2019

Nearly half a century has gone by since Sir Cecil Hurst invited readers of the British Year Book of International Law to consider with him the question—“Whose is the Bed of the Sea? ”

Almost twenty-five years ago, President Truman initiated State action to assert authority over the natural resources of the sea-bed and sub-soil of the continental shelf beyond the limits of the territorial sea.

In 1953, Australia contributed significantly to the body of State practice. On 11 September 1953, the Governor-General issued a proclamation declaring the existence under international law of Australia's sovereign rights over the sea-bed and subsoil of the continental shelf contiguous to the coasts of Australia and its Territories for the purpose of exploring and exploiting the natural resources of that sea-bed and subsoil. At about the same time, the Commonwealth Parliament enacted the Pearl Fisheries Act (No.2) 1953 (Cth) amending the Pearl Fisheries Act 1952-1953 (Cth), which made subject to Australian control foreign nationals and foreign vessels engaging in pearling on the continental shelf. In section 5 of the Principal Act, “pearling” was defined to include—

the work of searching for or obtaining pearl shell, trochus, bêchede-mer or green snails
Commonwealth Digest
Authors: Burmester H. C. , Pascoe J. H.
Published: January 2019

This Digest is intended to provide lawyers with a key to those questions and Ministerial Statements in the Commonwealth Parliament in which they are most likely to be interested, and it is, of course, selective. It covers the period 12 March to 28 November 1968, and is compiled from the published debates of the Parliament of the Commonwealth of Australia.

The page references to Parliamentary Debates (“S.Deb.” and “H.R. Deb.”) are to the published debates of the Senate and the House of Representatives, for the second Session of the Twenty-sixth Parliament, first and second periods.
Two composite guidance laws based on the backstepping control and disturbance observers with autopilot lag
Authors: Man Chaoyuan , Zhang Zhenxing , Li Shihua
Published: January 2019

A composite three-dimensional (3D) missile guidance law is proposed for manoeuvering targets with the consideration of the first-order autopilot dynamics without any linearization. This guidance law consists of a backstepping controller and a feedforward compensation based on disturbance observers. In this control scheme, the unknown target acceleration is regarded as part of the lumped disturbance, estimated by a disturbance observer, and then feedforward compensated. The backstepping controller is introduced to deal with unmatched disturbances. Moreover, both the nonlinear disturbance observer (NDOB) and the generalized proportional integral observer (GPIO) are employed in the derivation. Simulation studies demonstrate the effectiveness of the proposed guidance law, and compare the guidance performance of the two composite guidance laws with different disturbance observers.
Degree of Frontal Bone Exposure via Upper Blepharoplasty Incision: Considerations for Frontal Sinus Fracture
Authors: Kinzinger Michael , Steele Toby O. , Chin Oliver , Strong Edward B.
Published: January 2019

Objective

The upper eyelid blepharoplasty incision affords direct access to the frontal bone for skull base surgery and trauma reconstruction with a well‐hidden scar. The goal of this study is to quantify frontal bone exposure that can be achieved with an upper eyelid blepharoplasty incision.

Design

Anatomic study with human cadaver heads.

Setting

UC Davis Medical Center.

Subjects/Methods

Fourteen human cadaver heads were used to perform 26 upper blepharoplasty approaches. Exposure was measured with virtual planning software to create virtual reference points at the midline of the superior orbital rim. Surgical navigation was used with a 3‐dimensionally printed drill model to measure the maximum exposure achievable relative to the virtual reference point at 5 standardized angles.

Results

Mean ± SD exposures at medial 60°, medial 30°, 0°, lateral 30°, and lateral 60° were 16.1 ± 1.3 mm, 17.8 ± 1.3, 18.3 ± 1.4, 19.3 ± 1.9, and 20.9 ± 1.9, respectively. Significant differences were detected between exposures at 60° laterally and 60° medially and between exposures 60° laterally and 30° medially (P <. 05).

Conclusions

The upper eyelid blepharoplasty incision provides direct surgical access to the inferior frontal bone. Access was greatest with far lateral extension (mean, 20.9 mm) and most limited with far medial extension (mean, 16.1 mm). Treatment of injuries above this level could be achieved with additional percutaneous incisions for screw placement.
Relationship of Vitamin D Deficiency and Intraoperative Parathyroid Hormone Elevation in Completion and Total Thyroidectomy
Authors: Lawson Bradley R. , Hinson Andrew M. , Lucas Jacob C. , Bodenner Donald L. , Stack Brendan C.
Published: January 2019

Objective

To quantify how frequently intraoperative parathyroid hormone levels increase during thyroid surgery and to explore a possible relationship between secondary hyperparathyroidism due to vitamin D deficiency and elevation in intraoperative parathyroid hormone.

Study Design

Case series with chart review.

Setting

Tertiary academic center.

Subjects and Methods

A total of 428 consecutive patients undergoing completion and total thyroidectomy by the senior author over a 7‐year period were included for analysis. All patients had baseline and postexcision intraoperative parathyroid hormone levels as well as vitamin D levels from the same laboratory. Institute of Medicine criteria were employed for vitamin D stratification (>30, normal; 20‐29.9, insufficient; <20, deficient). Other data analyzed include sex, age, neck dissection status, and parathyroid autotransplantation.

Results

A total of 118 patients (27.6%) had an intraoperative parathyroid hormone elevation above baseline. Patients with vitamin D deficiency were significantly more likely to experience hormone elevation (P =. 04). When parathyroid hormone rose, it did so by a mean 32.1 pg/mL. Patients with vitamin D deficiency demonstrated significantly larger hormone increases (P =. 03).

Conclusion

Elevation in intraoperative parathyroid hormone levels above baseline after completion and total thyroidectomy occurs in over one‐fourth of cases and is significantly associated with vitamin D deficiency. This study is the first to report this observation. We hypothesize that vitamin D deficiency in these patients may create a subclinical secondary hyperparathyroidism that leads to intraoperative parathyroid hormone elevation when the glands are manipulated. Additional studies will be needed to explore this physiologic mechanism and its clinical significance.
Fracture shortly before stroke in mice leads to hippocampus inflammation and long-lasting memory dysfunction
Authors: Li Zhengxi , Wei Meng , Lyu Haiyan , Huo Kang , Wang Liang , Zhang Meng , Su Hua
Published: January 2019

Cognitive impairment occurs in stroke and hip fracture patients. In mice, bone fracture (BF) exacerbates stroke-related neuronal damage and sensorimotor dysfunction. We hypothesize that BF exacerbates post-stroke cognitive impairment. Adult mice were randomly assigned into BF, stroke, BF+stroke (BF 6 h before stroke), and control (sham operated) groups. Memory function was evaluated weekly for eight weeks by Y maze test and at eight weeks post-surgeries by novel object recognition (NOR) test. The neuronal damage and inflammation in hippocampus were analyzed three days and eight weeks after the surgeries. In Y maze test, BF+stroke mice started making fewer alternations than controls two weeks after the surgeries. Significant difference between BF+stroke and stroke groups started at five weeks post-injury and continued to the end of the experiment. In NOR test, BF+stroke group spent less time on novel objective than that of other groups. Cx3cr1+ cells and CD68+ cells accumulated in the stratum lacunosum moleculare (SLM) on the ipsilateral side of stroke injury in stroke and BF+stroke mice. BF+stroke mice had a higher ratio of ipsilateral/contralateral Cx3cr1+ cell-density than that of stroke mice. Therefore, BF shortly before stroke exacerbates hippocampal inflammation and causes long-lasting memory dysfunction.
The Development of a Performance Indicator to Objectively Monitor the Quality of Care Provided by an Acute Pain Team
Authors: Hammond E. J. , Veltman M. G. , Turner G. A. , Oh T. E.
Published: January 2019

Quality assurance procedures are essential in the maintenance of clinical standards in medicine. Conventional analysis techniques have difficulty in detecting gradual changes over time. Cumulative sum techniques monitor the frequency with which an event occurs and can detect changes in its frequency as soon as they become statistically significant. This study explores the use of cumulative sum techniques to monitor the performance of an acute pain team in a teaching hospital. It shows that periods of suboptimal performance can be readily identified. The prospective use of these techniques in clinical audit may allow the earlier identification and correction of technical or organisational problems. These should lead to improvements in patient care and satisfaction.
Vasopressin Effective in Reversing Catecholamine-Resistant Vasodilatory Shock
Authors: Lim T. W. , Lee S. , Ng K. S.
Published: January 2019

A patient with perforated appendicitis developed progressive vasodilatory shock which was complicated by perioperative acute myocardial infarction. Cardiovascular support included dopamine infusion, and later, intra-aortic balloon counterpulsation balloon pump and noradrenaline and dobutamine infusion. Vasopressin was introduced as a final attempt to reverse the refractory shock and was associated with recovery. The experience with this case suggests that vasopressin may be a valuable adjunct to the treatment of catecholamine-resistant vasodilatory shock.
Agreement between Two Plasma Bicarbonate Assays in Critically Ill Patients
Authors: Story D. A. , Poustie S.
Published: January 2019

Previous studies have suggested that measurement of plasma bicarbonate concentration using the Henderson-Hasselbalch equation may be unreliable, particularly in critically ill patients. We examined the agreement between two plasma bicarbonate concentration assays in critically ill patients. Data were collected from records of routine daily blood samples. Paired samples were taken at the same time from arterial lines. A Bland-Altman analysis was used to compare two bicarbonate assays in clinical use. The first used the Henderson-Hasselbalch equation for blood-gas machine calculations. The second used a spectrophotometric enzymatic technique. Comparing the enzymatic method to the calculated method (enzymatic minus calculated) the bias was -1.6 mmol/l (95% CI: -1.2 to -2.0 mmol/l). The limits of agreement were -5.85 mmol/l to 2.65 mmol/l. This study found poor agreement between the two bicarbonate assays. This poor agreement is clinically important but the causes are unclear. We suggest further investigation of the reliability of bicarbonate assays.
Unwashed Shed Blood Infusion Causes Deterioration in Right Ventricular Function after Coronary Artery Surgery
Authors: Kitano T. , Hattori S. , Miyakawa H. , Yoshitake S. , Iwasaka H. , Noguchi T.
Published: January 2019

We investigated right ventricular function after infusion of unwashed shed blood collected from mediastinal and chest tube drainage. Changes in thromboxane B 2 (TXB 2 ) and 6-keto-PGF 1α, which are stable metabolites of thromboxane A 2 (TXA 2 ) and prostacyclin respectively, were also investigated. The amount of infused shed blood was 484±76 ml (mean±SD). Right ventricular ejection fraction decreased rapidly after the infusion and did not return to its original level until 120 minutes later (P<0.05). Mean pulmonary artery pressure rose after infusion of the shed blood (P<0.05). The TXB 2 level in the unwashed shed blood was about 20,000 times higher than the preoperative plasma level. The plasma TXB 2 level at 30 minutes after the infusion was significantly elevated (P<0.05), and at 120 minutes it had returned to the original level. Unwashed shed blood may contain vasoactive substances that induce the release of TXA 2 and increase right ventricular afterload.
Do Antisiphon Valves Reduce Flow Irregularities during Vertical Displacement of Infusion Pump Systems?
Authors: Weiss M. , Fischer J. , Neff T. , Schulz G. , Bänziger O.
Published: January 2019

Vertical displacement of syringe pumps may cause irregular drug delivery due to hydrostatic pressure changes in the infusion line. The extent of flow fluctuations depends on the internal compliance of infusion lines, syringes and syringe pumps. We evaluated whether pressure regulation by antisiphon valves (ASV) reduces the flow variation during vertical displacement of 50 ml standard syringes and infusion pumps.

An infusion assembly comprising a standard 50 ml BD Plastipak® or a 50 ml Fresenius syringe, with syringe pump and 2 m low compliance infusion line was used for in vitro measurement of fluid delivery. The assembly was tested without ASV, and with two ASVs of differing operating pressure (ASV:75: valve opening pressure=75 mmHg; ASV:155, 155 mmHg). Retrograde aspiration volume, zero-drug delivery time and valve opening bolus were determined after lowering the syringe pump by 50 cm. After elevating the syringe pump to its initial position the ensuing infusion bolus was recorded.

Without an antisiphon valve the observed zero-drug delivery times after lowering the syringe pump were (mean±SD) 2.4±0.2 min using the BD Plastipak® syringe and 4.09±0.55 min using the Fresenius® syringe. Introduction of the antisiphon valve prolonged the zero drug delivery time 58% (ASV:75) and 88% (ASV:155) in the BD Plastipak® syringe assembly and 43% (ASV:75) and 81% (ASV:155) in the Fresenius® syringe assembly (P<0.001).

Antisiphon valves worsen flow irregularities caused by vertical displacement of syringe pumps and when used with delivery of concentrated inotropic drugs at low infusion rates, they may aggravate haemodynamic consequences of inconstant drug delivery.
Ventricular Arrhythmias Associated with Hypoglycaemia
Authors: Chelliah Y. R.
Published: January 2019

Hypoglycaemia commonly manifests as increased sympathetic discharge or as neuroglycopaenia in the awake patient. This case may represent an example of the effect of hypoglycaemia on the heart giving rise to ventricular tachycardia, which promptly resolved at the time of correction of hypoglycaemia.
The Prevalence of Latex Allergy in Operating Theatre Staff
Authors: Hack M. E.
Published: January 2019

Latex allergy has become increasingly common amongst health care workers. The prevalence of latex allergy in 102 theatre personnel at Princess Alexandra Hospital was determined by the results of a standardized questionnaire and a latex specific IgE radioallergosorbent test (RAST). Volunteers had their forced expiratory volume in 1 second/forced vital capacity (FEV1/FVC) measured at the beginning and end of their working shifts.

Only one of 102 volunteers had a positive latex specific IgE RAST and he also experienced both local and systemic symptoms with latex exposure and a deterioration in daily FEV1/FVC. The 14 volunteers using asthma medications had significantly higher incidence of operating theatre symptoms (10/14), local reactions (8/14), and atopy (14/14). There was no clinically significant daily change in FEV1 in the total population or any specific group.

The 1% (1/102) prevalence of latex allergy and sensitization in theatre staff demonstrates a much lower incidence than previously reported (12.5%1, 15.8%2 ).
Intrathecal Anaesthesia for the Elderly Patient: The Influence of the Induction Position on Perioperative Haemodynamic Stability and Patient Comfort
Authors: Fredman B. , Zohar E. , Rislick U. , Sheffer O. , Jedeikin R.
Published: January 2019

Ninety elderly (>65 y) patients were studied to assess the influence of patient position during induction of spinal anaesthesia on the incidence of perioperative hypotension and haemodynamic stability. Prior to induction of anaesthesia, Lactated Ringer's solution (8–10 ml/kg) was administered. In the Sitting Group, intrathecal anaesthesia was performed with the patient in the sitting position. In the Lateral Group, patients assumed the lateral decubitus position. In all cases hyperbaric bupivacaine (10 mg) was administered using a 25 gauge Quincke spinal needle. Patients were placed in the supine (and thereafter lithotomy) position immediately after withdrawing the spinal needle. Incremental doses of ephedrine (5 mg, IV) were administered in response to hypotension (>20 % of baseline), nausea, vomiting, sweating, skin pallor or impaired consciousness. The mean arterial blood pressure, heart rate and the number of hypotensive episodes requiring ephedrine administration were unaffected by group affiliation. In the Sitting Group, nine patients received 24 doses of ephedrine 5 mg IV. In the Lateral Group, 21 incremental doses of ephedrine were administered to nine patients. The incidence of nausea, vomiting, sweating and pallor were similar between the groups. Patient comfort was similar.

In summary, the incidence of hypotension and hypotension-related adverse effects was similar when intrathecal anaesthesia was induced in the sitting or lateral position. Furthermore, subjective perception of the induction process or anaesthetic experience was not affected by patient position.
Severe Falciparum Malaria in Five Soldiers from East Timor: A Case Series and Literature Review
Authors: Blum P. G. , Stephens D.
Published: January 2019

Despite chemoprophylaxis, malaria remains a serious threat for large numbers of non-immune soldiers deployed in endemic areas. Five adult cases of severe falciparum malaria are reported. Three cases were complicated by multi-organ failure and one of these patients died from cerebral malaria. These cases serve to highlight issues, in an Australian intensive care unit, associated with the management of severe malaria, an uncommon disease in our country. The need for rapid diagnosis and commencement of appropriate treatment is paramount in preventing further morbidity and mortality. Understanding and management of malaria continues to evolve rapidly. The pathophysiology of acute lung injury, shock and brain injury associated with malaria are examined in light of recent research. This article discusses the current controversies of exchange blood transfusion and the use of the new artemisinin derivatives.
The Frequency and Nature of Drug Administration Error during Anaesthesia
Authors: Webster C. S. , Merry A. F. , Larsson L. , McGrath K. A. , Weller J.
Published: January 2019

We aimed to establish the frequency and nature of drug administration error in anaesthesia (a significant subset of error in medicine) at two hospitals.

Anaesthetists were asked to return a study form anonymously for every anaesthetic, indicating whether or not a drug administration error or pre-error (defined as any incident with potential to become an error) had occurred. Further details were sought if the response was affirmative.

From 10806 anaesthetics, 7794 study forms were returned, representing response rates of 80% from Hospital A and 57% from Hospital B (72% overall). The frequency (95% confidence intervals) of drug administration error, of any type, per anaesthetic was 0.0075 (0.006 to 0.009), of IV bolus errors was 0.005 (0.0035 to 0.006) and of pre-errors was 0.004 (0.003 to 0.005), with no significant difference between hospitals. Overall, one drug administration error was reported for every 133 anaesthetics. The two largest individual categories of error involved incorrect doses (20%) and substitutions (20%) with IV boluses of drug. Of the IV bolus substitutions, 69% occurred between different pharmacological classes. One patient was aware while under muscle relaxation, and two required prolonged ventilation. In addition, 47 transient physiological effects were reported, of which five required intervention.

We conclude that drug administration error during anaesthesia is considerably more frequent than previously reported.
Cardiovascular Collapse Caused by Carbon Dioxide Insufflation during One-Lung Anaesthesia for Thoracoscopic Dorsal Sympathectomy
Authors: Harris R. J. D. , Benveniste G. , Pfitzner J.
Published: January 2019

Carbon dioxide insufflation into the pleural space during one-lung anaesthesia for thoracoscopic surgery is used in some centres to improve surgical access, even though this practice has been associated with well-described cardiovascular compromise. The present report is of a 35-year-old woman undergoing thoracoscopic left dorsal sympathectomy for hyperhidrosis. During one-lung anaesthesia the insufflation of carbon dioxide into the non-ventilated hemithorax for approximately 60 seconds, using a pressure-limited gas inflow, was accompanied by profound bradycardia and hypotension that resolved promptly with the release of the gas. Possible mechanisms for the cardiovascular collapse are discussed, and the role of carbon dioxide insufflation as a means of expediting lung collapse for procedures performed using single-lung ventilation is questioned.
Simulation of Potassium Extraction by Continuous Haemodiafiltration
Authors: Amaya F. , Fukui M. , Tsuruta H. , Kooguchi K. , Shimosato G.
Published: January 2019

Prediction of potassium extraction rates by continuous haemodiafiltration (CHDF) is useful for safe management of potassium levels in patients with hyperkalaemia. For this purpose, we developed a formula to predict the quantity of potassium extracted by CHDF.

We hypothesized that potassium concentration in efflux dialysate was completely saturated by the influx blood, and potassium concentration in efflux blood was calculated based on this hypothesis. To check the accuracy of the calculation, potassium concentration was measured in efflux blood, and values were compared to predicted concentrations.

Predicted potassium concentrations demonstrated good correlation to the measured values (95% confidence range, -0.32 to 0.58 mmol/l). These results confirmed that our hypothesis is applicable to clinical use of CHDF. Based on our observations, we created a formula to accurately predict the amount of potassium (dK) extracted by CHDF: dK=(Cb-Cd)xQd+CbxQf-CsxQs (Cb: plasma potassium concentration; Cd: potassium concentration in a dialysate; Cs: potassium concentration in the replacement fluid; Qd: dialysis rate; Qf: filtration rate and Qs: infusion rate of replacement fluid).
The Effects of Three Manual Hyperinflation Techniques on Pattern of Ventilation in a Test Lung Model
Authors: Maxwell L. , Ellis E. R.
Published: January 2019

Manual hyperinflation (MHI) is used by physiotherapists as a treatment technique in intubated patients. This study investigated the effect of three different MHI techniques using a Mapleson-C circuit configuration with a CIG Medishield valve on volume delivered (Vt), peak inspiratory (PIFR) and expiratory flow rates (PEFR), and peak airway pressure (PAP) in a test lung model. The protocols differed in the degree of valve closure and inclusion of an inspiratory pause. For protocols 1, 2 and 3 the measures were Vt—1.33 (0.21), 2.74 (0.13), 3.55 (0.12) litres; PAP— 14.30 (0.82), 24.00 (0.47), 30.20 (0.92) cmH 2 O and PIFR—1.13 (0.05), 1.51 (0.15), 1.32 (0.09) l/s respectively. All pair comparisons were statistically significant except for PEFR (l/s), which was significantly lower for protocol 1 [1.62 (0.06)], compared to protocols 2 [2.01 (0.25)] and 3 [2.10 (0.19)] but not between protocols 2 and 3. Circuit and technique choice should be considered in relation to the specific therapeutic aim of treatment.
Closed-loop Control of Blood Glucose Levels in Critically Ill Patients
Authors: Chee F. , Fernando T. , Van Heerden P. V.
Published: January 2019

A closed-loop control system was constructed for automatic intravenous infusion of insulin to control blood sugar levels (BSL) in critically ill patients. We describe the development of the system. A total of nine subjects were recruited to clinically test the control system. In the patients who underwent closed-loop control of BSL, the controller managed to control only one patient's glycaemia without any manual intervention. The average BSL attained during closed-loop control approached the target range of 6-10 mmol/l, and had less deviation than when BSL had been maintained manually.

We conclude that closed-loop BSL control using a sliding scale algorithm is feasible. The main deficiency in the current system is unreliability of the subcutaneous glucose sensor when used in this setting. This deficiency mandates high vigilance during use of the system as it is being developed.
Effectiveness of Intravenous Ephedrine Infusion during Spinal Anaesthesia for Caesarean Section Based on Maternal Hypotension, Neonatal Acid-base Status and Lactate Levels
Authors: Turkoz A. , Togal T. , Gokdeniz R. , Toprak H. I. , Ersoy O.
Published: January 2019

Maternal cardiovascular changes and neonatal acid-base status, including lactate levels, were assessed in 30 healthy women undergoing elective caesarean section under spinal anaesthesia. Patients were allocated randomly to receive IV ephedrine infusion (n=15) (5 mg.min -1 ) immediately after the spinal injection or bolus administration of IV ephedrine (n=15) (10 mg) in case of development of hypotension. Maternal and neonatal blood pressure, heart rate and acid-base status including lactate levels were compared between the groups. Systolic blood pressure in the bolus group was significantly lower when compared to the infusion group. Nausea was observed in one patient (6%) in the infusion group and nausea and vomiting were observed in 10 patients (66%) in the bolus group. Although umbilical arterial pH values were significantly lower in the bolus group, lactate levels were similar. In conclusion, ephedrine infusion prevented maternal hypotension, reduced the incidence of nausea and vomiting and led to improved umbilical blood pH during spinal anaesthesia for caesarean section.
Variability in Infusion Pressure and Continuous Flow Rate Delivered from Pressurized Bag Pump Flush Systems
Authors: Hug M. I. , Buettiker V. , Cornelius A. , Weiss M.
Published: January 2019

Using 10 different infusion bag pressure pumps, indicated manometer pressures were compared with measured infusion pressures proximal to the flow-regulating device in an in vitro experiment. Flow rates delivered through the flow-regulating device were gravimetrically measured at different monitored pressure levels.

Significant differences were found between manometer and measured infusion pressures among the tested pressure bag pumps (e.g. 500 ml bag volume pressurized to 300mmHg manometer pressure: 219.6±7.8 to 407.2±2.7 mmHg). The infusion pressures were additionally affected by the vertical level of the infusion bag pump and by the volume of the infusion bag. Flow rates delivered through the flow-regulating device were directly correlated to the measured infusion pressure (r 2 =0.9926).

Differences in flow rates can have a considerable impact on maintaining catheter patency and avoidance of fluid overload and retrograde flushing into the central arterial circulation in neonates and small children.

A simple manoeuvre using the invasive pressure transducer allows monitoring and adjustment of the infusion pressure in the clinical setting.
Bilateral Vocal Cord Palsy following Interscalene Brachial Plexus Nerve Block
Authors: Plit M. L. , Chhajed P. N. , Macdonald P. , Cole I. E. , Harrison G. A.
Published: January 2019

Acute respiratory complications of an interscalene brachial plexus block include ipsilateral phrenic nerve and recurrent laryngeal nerve palsies. A 71-year-old woman who had undergone a total thyroidectomy for papillary carcinoma 35 years ago was administered a right interscalene brachial plexus block for a shoulder hemi-arthroplasty. Subsequently she developed acute respiratory distress associated with marked stridor secondary to an acute right vocal cord palsy, which was superimposed on what was assumed to be a preexisting left-sided vocal cord palsy. On extubation the patient was noted to develop stridor again necessitating reintubation and tracheostomy was performed two weeks later. The vocal cord palsies failed to resolve over the subsequent 18-month follow-up. We describe this case to highlight the significant risk of this procedure in patients with preexisting or suspected contralateral vocal cord palsy.
Spontaneous Respiration via an Open Trachea for Resection of a High Tracheal Stenosis in a Child
Authors: Grace R. F.
Published: January 2019

The successful management of tracheal stenosis requires compromise between the competing interests of the surgical and anaesthetic teams and the resources available. A seven-year-old girl with marked tracheal stenosis was successfully managed spontaneously breathing via an open trachea and a laryngeal mask. Anaesthesia was maintained by propofol infusion. When the trachea was opened, supplemental oxygen was administered via a modified cholangiocatheter placed into the distal segment. At no point was the trachea intubated.
Effects of Diltiazem on in Vitro Cardiovascular Actions of Crude Venom Obtained from Okinawan Box-Jellyfish (Habu-kurage), Chiropsalmus quadrigatus
Authors: Sakanashi M. , Matsuzaki T. , Nakasone J. , Koyama T. , Sakanashi M. , Kukita I. , Sakanashi M.
Published: January 2019

The venom obtained from Okinawan box-jellyfish (Habu-kurage), Chiropsalmus quadrigatus, produced increases in contractions of isolated rat right atrial preparations in a concentration-dependent manner without changes in a spontaneous beating rate. These increases in contractions were significantly inhibited by diltiazem and did not show tachyphylaxis. The venom also produced increases in contractions of isolated rat aortic ring preparations (endothelium-intact) in a concentration-dependent fashion, which were reproducible with repeated application and were significantly inhibited by diltiazem or heating. These increases in vascular contractions were weakened in endothelium-denuded preparations, and almost abolished in a calcium-free medium. On the other hand, the venom at higher concentrations diminished contractions of both myocardial and vascular preparations and did not show reproducibility. These results suggest that the Habu-kurage venom is heat-labile and may increase contractions of cardiac muscle and aortic smooth muscle by increasing calcium influx into muscle cells, and that the venom at higher concentrations may produce dysfunction of muscle contractile systems due to calcium overload.