bluuebunny/crossref_metadata_2025 huggingface dataset:
Multilevel Safety Intervention Implementation Strategies for Nigeria Construction Industry
Authors: Okoye Peter Uchenna , Okolie Kevin Chuks , Ngwu Chukwuemeka
Published: April 2017

This study was aimed at examining the relationships between the effectiveness of safety intervention programmes and implementation strategies in the Nigeria construction industry. Structured questionnaires were distributed to construction stakeholders across some selected states in Nigeria and the data generated were analysed using Pearson’s product moment correlation. The study found that the effectiveness of safety intervention programmes for construction site accidents prevention is significantly related to the communication implementation strategies. Based on the principles of social ecological theory and UNICEF’s communication for development strategies, this study developed a multilevel safety intervention implementation strategy for construction industries in Nigeria. Four communication strategies, namely, advocacy, social mobilisation, social change communication, and behaviour change communication, which are central to the effectiveness of safety intervention implementation programmes for construction site accidents prevention, were identified. It further revealed that these communication strategies could be individually and collectively applied at different intervention levels but that the greatest effect would be felt when all strategies are systematically combined with more efficient use of resources. The study recommended systematic actions by policy makers, construction organisations, and various community groups towards construction safety interventions, since maximum effect could only be felt when safety interventions are implemented across all levels.
An Improved Heuristic Algorithm for UCAV Path Planning
Authors: Zhang Kun , Liu Peipei , Kong Weiren , Zou Jie , Liu Min
Published: April 2017

The study of unmanned combat aerial vehicle (UCAV) path planning is increasingly important in military and civil field. This paper presents a new mathematical model and an improved heuristic algorithm based on Sparse A⁎ Search (SAS) for UCAV path planning problem. In this paper, flight constrained conditions will be considered to meet the flight restrictions and task demands. With three simulations, the impacts of the model on the algorithms will be investigated, and the effectiveness and the advantages of the model and algorithm will be validated.
Wearable Modular Telemetry System for the Integrated Rescue System Operational Use
Authors: Kliment Radim , Smrčka Pavel , Hána Karel , Schlenker Jakub , Socha Vladimír , Socha Luboš , Kutílek Patrik
Published: April 2017

The article summarizes the development of the FlexiGuard modular telemetry system designed for enhancing safety of the Integrated Rescue System team members in solving crisis situations and for improving training processes. Further framework solutions, which lead to the development of automatic modular telemetry system allowing for real time monitoring of physiological parameters, are provided as well. The system provides for the signalization of critical states such as exhaustion, mental stress, and overheating. It further provides differentiation between the nature and intensity of movement, including actual and overall energy output, monitoring environmental parameters, and analysis of an intervention or training. The system has been tested in laboratories as well as in the terrain under real circumstances, and the eventual end users participated in its optimization process. Following the theory of games, a model of a transmission system was also created which demonstrates higher transmission efficiency when using higher number of nodes.
Predictive Value of Second-Trimester Biomarkers and Maternal Features for Adverse Pregnancy Outcomes
Authors: Yefet Enav , Kuzmin Olga , Schwartz Naama , Basson Flora , Nachum Zohar
Published: April 2017

Objective: To establish the predictive probability for placenta-associated morbidities using second-trimester α-fetoprotein (AFP), human chorionic gonadotropin (HCG), and maternal features. Patients and Methods: A retrospective database of all singleton deliveries with available second-trimester HCG and AFP results from 2005 to 2012 was built and divided into 0, 1, or 2 elevated markers (defined as ≥2 multiples of the median [MoM]). For each group, we analyzed the risk for adverse obstetric outcome - comprising preeclampsia, placental abruption, and birth weight below the 10th percentile - and the time of delivery in those pregnancies. Additionally, prediction models for adverse obstetric outcome, using logistic regression incorporating AFP, HCG, and other maternal characteristics, were calculated. Results: Among 22,124 women who delivered, 16,197 (73%) had AFP and HCG results. Compared with the group with normal markers, the adverse obstetric outcome rate was mildly increased with elevated HCG or AFP, but it was markedly increased when both markers were elevated (13 vs. 31%, OR 2.9, 95% CI 2.0-4.3). Delivery of newborns with adverse obstetric outcome was earlier with each additional elevated marker. The accuracy of predicting adverse obstetric outcome was improved by using prediction models for women with HCG or AFP ≥1.2 MoM that incorporated maternal age, BMI, parity, and chronic hypertension (C-statistic 61-75%). Conclusion: HCG and AFP combined with other maternal characteristics are useful tools for predicting the risk for adverse obstetric outcome.
Serum Lymphocyte-Associated Cytokine Concentrations Change More Rapidly over Time in Multiple System Atrophy Compared to Parkinson Disease
Authors: Csencsits-Smith Keri , Suescun Jessika , Li Kan , Luo Sheng , Bick Diane L. , Schiess Mya
Published: April 2017

Objective: Chronic inflammatory processes contribute to the eventual death of motor neurons and the development of symptoms in both idiopathic Parkinson disease (PD) and multiple system atrophy (MSA). Given the faster rate of progression and more severe symptoms associated with MSA, we hypothesized that markers of inflammation would be more evident in the peripheral blood of MSA than PD patients, and that evidence of this inflammation might assist early diagnosis of MSA versus PD. Methods: We performed multiplex analysis to determine the concentrations of 37 immune-associated cytokines and chemokines isolated from the plasma of patients with PD (n = 25) and MSA (n = 14) and compared our results to those of age-matched controls (n = 15). We then applied a mixed-effect multiple regression model to determine if the concentration of cytokines in the plasma of patients with PD and MSA changed significantly over time. Results: Patients with MSA had a trend towards overall lower levels of immune-associated cytokines, while serum cytokine levels were increased in patients with PD. Statistically adjusted comparisons of overall changes in cytokine concentrations between the PD and MSA groups revealed higher concentrations of T-cell-associated cytokines TNFβ and IL-7 in PD. Comparison of samples taken over time revealed significantly faster rates of change in 4 different cytokine concentrations (IL-4, IL-15, IL-2, and IL-9) in patients with MSA versus patients with PD. Conclusions: Our results suggest that single measurements of plasma concentrations of inflammation-associated cytokines cannot be used to distinguish disease states. However, measurements made over time may correlate with pathogenesis. The significant changes in T-cell-associated cytokines may shed light on immune mechanisms that contribute to PD and MSA disease progression.
Lower Visual Avoidance in Dementia Patients Is Associated with Greater Psychological Distress in Caregivers
Authors: Otero Marcela C. , Levenson Robert W.
Published: April 2017

Caring for a spouse with dementia can lead to increased health problems in caregivers. The present study examined whether patient deficits in visual avoidance, a common form of emotion regulation, are related to greater psychological distress in caregivers. Participants were 43 Alzheimer disease (AD) patients, 43 behavioral variant frontotemporal dementia (bvFTD) patients, and their spousal caregivers. Patient visual avoidance (e.g., gaze aversion) was measured using behavioral coding of head, body, and eye position while viewing a disgusting film. Caregiver psychological distress was measured using a standard self-report symptom inventory. Lower use of visual avoidance by patients was associated with greater psychological distress in their caregivers. This relationship was partially mediated by patient overall emotional functioning (as reported by caregivers), such that patients with less visual avoidance were seen as having worse emotional functioning, which in turn related to greater caregiver psychological distress. Dementia diagnosis moderated this effect, with diminished patient visual avoidance particularly detrimental to psychological distress of bvFTD caregivers. Findings suggest that the use of visual avoidance may serve as a marker of overall emotional functioning in patients and that preservation of this emotion regulatory behavior may help reduce the negative effects of caregiving.
Immunoglobulin A Lambda Multiple Myeloma in a Patient with HIV: An Unusual Cause of Massive Ascites
Authors: Abdulsamad Molham , Abbas Naeem , Patel Harish , Balar Bhavna , Khaja Misbahuddin
Published: April 2017

Multiple myeloma (MM) is a neoplastic proliferation of plasma cells with overproduction of monoclonal immunoglobulins and infiltration into the bone and other organs. Ascites can develop in patients with lymphoproliferative and solid malignancies involving the peritoneum. However, ascites is unusual in MM and rarely the initial presenting sign or symptom. The development of ascites can be due to peritoneal infiltration or secondary to hepatic involvement, heart failure, or kidney failure. Ascites in MM reflects a more aggressive stage, and the reported prognosis is poor, with a median survival of 1–2 months. Here we present a rare case of immunoglobulin A lambda MM presenting with massive myelomatous ascites.
Spontaneous Unilateral Subperiosteal Hematoma in the Orbit due to Self-Induced Asphyxia: Unusual Cause of Unilateral Exophthalmos
Authors: Subiras Xavier , Koch Konrad R. , Schrittenlocher Silvia , Cursiefen Claus , Heindl Ludwig M.
Published: April 2017

Background: To report an unusual case of subperiosteal bleeding of nontraumatic etiology. Case Description: A 48-year-old female presented with an acute protrusion of the left eye after nonaccomplished suicide by means of asphyxia using a cable around the neck. At the time of presentation, the MRI showed an orbital subperiosteal hematoma causing an exophthalmos. After conservative treatment, there was a complete remission of the lesion. Conclusion: Nontraumatic subperiosteal bleedings without involvement of the intraocular structures and no vision-threatening intraorbital changes should be treated conservatively.
Optical Coherence Tomography Angiography of Retinal Microvascular Changes Overlying Choroidal Nodules in Neurofibromatosis Type 1
Authors: Cassiman Catherine , Casteels Ingele , Stalmans Peter , Legius Eric , Jacob Julie
Published: April 2017

Purpose: To report 3 cases of neurofibromatosis type 1 (NF1) with choroidal nodules associated with retinal microvascular changes imaged with optical coherence tomography angiography (OCTA). Methods: Small case series in 3 NF1 patients. OCTA examinations were performed by a trained examiner (J.J.) after pupillary dilation. A standard scan, centered over the macula measuring 6 × 6 mm and 3 × 3 mm was obtained according to the findings on standard color photography. Additional scans were obtained in the zones with microvascular abnormalities. The segmentation provided by the machine software was used. Results: Corkscrew retinal vessels were observed in association with “placoid”-type choroidal nodules as shown by near-infrared reflectance imaging. In all cases, multiple lesions were found. They were second- or third-order tortuous vessels originating from the superior or inferior temporal veins. OCTA demonstrated that the tortuous venules were located in the superficial capillary plexus, and no abnormalities were found in the deep capillary plexus. Discussion: Corkscrew retinal vessels are part of a spectrum of retinal microvascular alterations seen in association, sometimes overlying choroidal nodules in patients with NF1 and are visualized in the superficial capillary plexus on OCTA. We demonstrated with OCTA that they are not associated with flow loss or ischemia in the superficial and deep capillary plexus. The link between the underlying nodule remains unclear. Since neovascularization was described in choroidal ganglioneuroma, we hypothesize that corresponding secretory substances from Schwann cells, ganglion cells, or melanocytes in choroidal nodules might alter the retinal vasculature. Conclusion: We report on 3 cases of NF1 with choroidal nodules in association with retinal microvascular changes imaged with OCTA. OCTA demonstrated preservation of the blood flow in the deep and superficial capillary plexus of the retina. We hypothesize that angiogenic factors secreted by the underlying choroidal nodules could have an effect on the retinal vasculature. Further immunohistological studies in NF1 patients with choroidal nodules to detect angiogenic factors (such as VEGF) are necessary to confirm this hypothesis.
Indole-3-Carbinol Induces Apoptosis of Hepatic Stellate Cells through K63 De-Ubiquitination of RIP1 in Rats
Authors: Li Bin , Cong Meng , Zhu Yanan , Xiong Ying , Jin Wenyi , Wan Yang , Zhou Yunjiao , Ao Ying , Wang Hui
Published: April 2017

Background/Aims: The apoptosis of activated hepatic stellate cells (HSCs) is the central event in the reversal of liver fibrosis. K63 de-ubiquitinated receptor-interacting protein (RIP)1 promotes apoptosis in tumor necrosis factor (TNF)-α signaling pathway. In the previous study, we have proved that indole-3-carbinol (I3C) could reverse different models of liver fibrosis in rats, but the mechanism is still unclear. Thus, the present research aimed to demonstrate the induction of I3C on apoptosis of HSCs and the underlying molecular mechanism. Methods: HSC-T6, an immortalized rat liver stellate cell line, was treated for 24 hours with 25, 50 and 100 µM of I3C. The apoptosis of HSC-T6 was analyzed by flow cytometric analysis, acridine orange staining and RT-PCR, respectively. K63 de-ubiquitination of RIP1 and the expression of ubiquitin ligases and deubiquitinases were analyzed by Co-IP assay and western blot. Knockdown of deubiquitinases was undertaken by small interfering RNA (siRNA). Results: The results of flow cytometric analysis indicated that the apoptotic rate of HSC-T6 was induced by I3C in a dose-dependent manner. Observation by acridine orange staining exhibited nuclear condensation and apoptotic bodies in I3C treated cells. Consistently, the expression ratio of Bax/bcl-2 was markedly increased by I3C. These results indicated that I3C could significantly induce apoptosis of HSC-T6 cells. Furthermore, Co-IP assay revealed K63 de-ubiquitination of RIP1 by I3C, associated with the induction of caspase 8. Although I3C had no effect on the expression of ubiquitin ligases cellular inhibitor of apoptosis 1/2 (cIAP1/2), the protein level of deubiquitinase cylindromatosis (CYLD) was significantly induced by I3C. Moreover, CYLD silencing reversed the pro-apoptosis induction effect of I3C and reduced the expression ratio of Bax/bcl-2 in HSC-T6 cells. Conclusion: These results demonstrated that I3C could induce apoptosis of HSC through RIP1 K63 de-ubiquitination by upregulating deubiquitinase CYLD.
Undiagnosed Obstructive Sleep Apnea and Postoperative Outcomes: A Prospective Observational Study
Authors: Devaraj Uma , Rajagopala Srinivas , Kumar Ajay , Ramachandran Priya , Devereaux Philip J. , D'Souza George A.
Published: April 2017

Background: The prevalence of undiagnosed obstructive sleep apnea (OSA) during preoperative evaluation and the best method to screen OSA and its association with postoperative complications remain unclear. Objectives: To determine the prevalence of undiagnosed OSA in preoperative Indian patients undergoing noncardiac surgery, to compare the diagnostic accuracy of the STOP-BANG questionnaire to a preoperative level III sleep study, and to assess the association of OSA with postoperative complications. Methods: A prospective cohort of 245 consecutive adults with ≥2 risk factors for OSA who underwent noncardiac surgery between July 2011 and February 2013 were studied. The STOP-BANG questionnaire was administered to all patients, and 182/245 (74.2%) patients underwent a preoperative level III sleep study. Patients were followed for postoperative complications in hospital and contacted at 30 days after surgery. Results: 70/182 (38.5%) obtained a new diagnosis of OSA, including 11/182 (6%) with moderate to severe OSA (apnea-hypopnea index ≥15/h). On logistic regression analyses, the presence of OSA was independently associated with postoperative oxygen desaturation (OR 5.96, 95% CI 2.35-15.1, p < 0.01), a postoperative complication within 7 days (OR 3.63, 95% CI 1.77-7.45, p < 0.01) and within 30 days (OR 3.5, 95% CI 1.74-7.1, p < 0.01). The STOP-BANG questionnaire did not identify 12/70 (17%) of the patients diagnosed with OSA and classified 28% of the cohort as OSA when the level III sleep study was negative. Conclusions: Unrecognized OSA is common in preoperative patients and is independently associated with postoperative complications. The STOP-BANG questionnaire had a lower performance in the diagnosis of OSA in a South Indian population than the level III sleep study.
Type 3 Neovascularization Associated with Retinitis Pigmentosa
Authors: Sayadi Jihene , Miere Alexandra , Souied Eric H. , Cohen Salomon Y.
Published: April 2017

Purpose: To report a case of type 3 neovascular lesion in a patient with retinitis pigmentosa (RP) complicated by macular edema. Case Report: A 78-year-old man with a long follow-up for RP was referred for painless visual acuity decrease in the right eye. Best-corrected visual acuity was 20/125 in the right eye and 20/40 in the left. Fundus examination showed typical RP and macular edema in both eyes. In the right eye, spectral domain optical coherence tomography revealed a marked cystic macular edema associated with disruption of the Bruch membrane/retinal pigment epithelium complex overlying a pigmentary epithelium detachment, with a vascular structure which appeared to originate from the deep capillary plexus and to be connected with the subretinal pigment epithelium space. Optical coherence tomography angiography showed a high-flow vessel infiltrating the outer retinal layers in the deep capillary plexus segmentation, and a tuft-shaped, bright, high-flow network that seemed to be connected with the subretinal pigment epithelium space in the outer retinal layer segmentation. This presentation was consistent with an early type 3 neovascular lesion in the right eye. Conclusion: Type 3 neovascularization may be considered a possible complication of RP.
Urinary Angiotensinogen and Renin Excretion are Associated with Chronic Kidney Disease
Authors: Juretzko Annett , Steinbach Antje , Hannemann Anke , Endlich Karlhans , Endlich Nicole , Friedrich Nele , Lendeckel Uwe , Stracke Sylvia , Rettig Rainer
Published: April 2017

Background/Aims: Several studies sought to identify new biomarkers for chronic kidney disease (CKD). As the renal renin-angiotensin system is activated in CKD, urinary angiotensinogen or renin excretion may be suitable candidates. We tested whether urinary angiotensinogen or renin excretion is elevated in CKD and whether these parameters are associated with estimated glomerular filtration rate (eGFR). We further tested whether urinary angiotensinogen or renin excretion may convey additional information beyond that provided by albuminuria. Methods: We measured urinary and plasma angiotensinogen, renin, albumin and creatinine in 177 CKD patients from the Greifswald Approach to Individualized Medicine project and in 283 healthy controls from the Study of Health in Pomerania. The urinary excretion of specific proteins is given as protein-to-creatinine ratio. Receiver operating characteristic (ROC) curves, spearman correlation coefficients and linear regression models were calculated. Results: Urinary angiotensinogen [2,511 (196-31,909) vs. 18.6 (8.3-44.0) pmol/g, *P<0.01] and renin excretion [0.311 (0.135-1.155) vs. 0.069 (0.045-0.148) pmol/g, *P<0.01] were significantly higher in CKD patients than in healthy controls. The area under the ROC curve was significantly larger when urinary angiotensinogen, renin and albumin excretion were combined than with urinary albumin excretion alone. Urinary angiotensinogen (ß-coefficient -2.405, standard error 0.117, P<0.01) and renin excretion (ß-coefficient -0.793, standard error 0.061, P<0.01) were inversely associated with eGFR. Adjustment for albuminuria, age, sex, systolic blood pressure and body mass index did not significantly affect the results. Conclusion: Urinary angiotensinogen and renin excretion are elevated in CKD patients. Both parameters are negatively associated with eGFR and these associations are independent of urinary albumin excretion. In CKD patients urinary angiotensinogen and renin excretion may convey additional information beyond that provided by albuminuria.
Risk Factors for Intraoperative Hypertension during Surgery for Primary Hyperparathyroidism
Authors: Sabljak Vera D. , Zivaljevic Vladan R. , Milicic Biljana R. , Paunovic Ivan R. , Toskovic Anka R. , Stevanovic Ksenija S. , Tausanovic Katarina M. , Markovic Dejan Z. , Stojanovic Marina M. , Lakicevic Mirko V. , Jovanovic Milan D. , Diklic Aleksandar D. , Kalezic Nevena K.
Published: April 2017

Objective: To investigate the incidence and identify risk factors for the occurrence of intraoperative hypertension (IOH) during surgery for primary hyperparathyroidism (pHPT). Subjects and Methods: The study included 269 patients surgically treated between January 2008 and January 2012 for pHPT. IOH was defined as an increase in systolic blood pressure ≥20% compared to baseline values which lasted for 15 min. The investigated influence were demographic characteristics, surgical risk score related to physical status (based on the American Society of Anesthesiologists [ASA] classification), comorbidities, type and duration of surgery, and duration of anesthesia on IOH occurrence. The investigated factors were obtained from the patients' medical history, anesthesia charts, and the daily practice database. Logistic regression analysis was done to determine the predictors of IOH. Results: Of the 269 patients, 153 (56.9%) had IOH. Based on the univariate analysis, age, body mass index, ASA status, duration of anesthesia, and preoperative hypertension were risk factors for the occurrence of IOH. Multivariate analysis showed that independent predictors of IOH were a history of hypertension (OR = 2.080, 95% CI: 1.102-3.925, p = 0.024) and age (OR = 0.569, 95% CI: 0.360-0.901, p = 0.016). Conclusion: In this study, a high percentage (56%) of the patients developed IOH during surgery for pHPT, which indicates that special attention should be paid to these patients, especially to the high-risk groups: older patients and those with a history of hypertension. Further, this study showed that advanced age and hypertension as a coexisting disease prior to parathyroid surgery were independent risk factors for the occurrence of IOH.
The genus Thelepus Leuckart, 1849 (Annelida, Thelepodidae) in Brazil, with a redescription of the holotype of T. setosus (Quatrefages, 1866)
Authors: CARRERETTE ORLEMIR , NOGUEIRA JOÃO MIGUEL DE MATOS , HUTCHINGS PAT
Published: April 2017

The genus Thelepus Leuckart, 1849 is well known in Brazilian waters, from a species recorded by several authors as T. setosus (Quatrefages, 1866), which is considered to be a cosmopolitan species. However, the type locality of T. setosus is in France, which renders the presence of this species in Brazilian waters rather unlikely. The wide range of distribution of T. setosus is most likely due to misidentifications, especially because the original description of the species is very brief and does not include several characters now relevant at species level. We provide herein a redescription of the holotype of T. setosus and describe two new species from Brazilian material previously identified as belonging to that species. Thelepus megalabiatum n. sp. is characterised by having an expanded lower lip extending ventrally, many branchial filaments, originating from swollen cushions, with wide mid-dorsal gap between filaments within pairs, 26–33 segments with glandular areas, and 44–61+ pairs of notopodia. Thelepus brevitori n. sp. is characterised by having fewer branchial filaments, originating directly from the body wall, about 17 segments highly glandular ventrally, and up to 27 pairs of notopodia. Both new species are compared to the most similar congeners, including T. setosus.
Lee Mixing and Nocturnal Structure over Gentle Topography
Authors: Mahrt L.
Published: April 2017

This study analyzes measurements from a network of sonic anemometers over gentle topography to investigate the possibility of nocturnal lee-generated turbulence. Although the valley side slopes are less than 6° and extend only about 12 m above the floor of the valley, the turbulence can be enhanced in the lee of one of the slopes. Significant lee turbulence develops downwind from an abrupt slope transition between a miniplateau and the modest valley side slope. Lee-generated turbulence is not observed on the opposite slope, where the slope magnitude gradually decreases with height. With intermediate 1-m wind speeds of roughly 2–4 m s−1, the cold pool is advected up the downwind slope. This downwind displacement of the cold pool and warming by lee-generated turbulence, when it occurs, leads to significant horizontal asymmetry of the temperature across the valley. For stronger winds, the cold pool is eliminated by mixing. For weak winds, a more traditional cold pool forms centered on the valley floor with limited or no lee-generated turbulence. While the impact of the gentle topography is modest compared to more dramatic terrain, less organized gentle topography covers a large fraction of Earth’s surface. However, with gentle topography, various relationships show substantial scatter, and the generalization of results from an individual network is probably not possible.
Ice–Atmosphere Feedbacks Dominate the Response of the Climate System to Drake Passage Closure
Authors: England Matthew H. , Hutchinson David K. , Santoso Agus , Sijp Willem P.
Published: April 2017

The response of the global climate system to Drake Passage (DP) closure is examined using a fully coupled ocean–atmosphere–ice model. Unlike most previous studies, a full three-dimensional atmospheric general circulation model is included with a complete hydrological cycle and a freely evolving wind field, as well as a coupled dynamic–thermodynamic sea ice module. Upon DP closure the initial response is found to be consistent with previous ocean-only and intermediate-complexity climate model studies, with an expansion and invigoration of the Antarctic meridional overturning, along with a slowdown in North Atlantic Deep Water (NADW) production. This results in a dominance of Southern Ocean poleward geostrophic flow and Antarctic sinking when DP is closed. However, within just a decade of DP closure, the increased southward heat transport has melted back a substantial fraction of Antarctic sea ice. At the same time the polar oceans warm by 4°–6°C on the zonal mean, and the maximum strength of the Southern Hemisphere westerlies weakens by ≃10%. These effects, not captured in models without ice and atmosphere feedbacks, combine to force Antarctic Bottom Water (AABW) to warm and freshen, to the point that this water mass becomes less dense than NADW. This leads to a marked contraction of the Antarctic overturning, allowing NADW to ventilate the abyssal ocean once more. Poleward heat transport settles back to very similar values as seen in the unperturbed DP open case. Yet remarkably, the equilibrium climate in the closed DP configuration retains a strong Southern Hemisphere warming, similar to past studies with no dynamic atmosphere. However, here it is ocean–atmosphere–ice feedbacks, primarily the ice-albedo feedback and partly the weakened midlatitude jet, not a vigorous southern sinking, which maintain the warm polar oceans. This demonstrates that DP closure can drive a hemisphere-scale warming with polar amplification, without the presence of any vigorous Southern Hemisphere overturning circulation. Indeed, DP closure leads to warming that is sufficient over the West Antarctic Ice Sheet region to inhibit ice-sheet growth. This highlights the importance of the DP gap, Antarctic sea ice, and the associated ice-albedo feedback in maintaining the present-day glacial state over Antarctica.
Classification of Ciprofloxacin Tablets Using Near-Infrared Spectroscopy and Chemometric Modeling
Authors: Fuenffinger Nathan , Arzhantsev Sergey , Gryniewicz-Ruzicka Connie
Published: April 2017

Exposure to unknown, mislabeled, and counterfeit pharmaceutical products is a worldwide problem that presents a serious risk to public health. Near-infrared (NIR) spectroscopy can serve as a useful tool for screening pharmaceuticals in a rapid and cost-effective manner to ensure that drug products are safe and effective. By applying chemometric techniques to NIR spectra from finished products in tablet form, minor spectral differences are discoverable, even in instances where the tablets being evaluated contain the same active pharmaceutical ingredients (APIs). Differences in NIR spectra can occur as a result of various factors including the types and quantities of pharmaceutical excipients used to generate the product and associated manufacturing site process variables. In this study, variability in the NIR spectra of intact tablets with the same API was evaluated using an unsupervised chemometric technique in the form of hierarchical cluster analysis (HCA) on a data set consisting of NIR spectra from more than 800 ciprofloxacin tablets from six manufacturers. Results obtained from HCA and squared Euclidean distance measurements indicate the largest dissimilarities in NIR spectra occur between manufacturers. Based on these findings, a quadratic discriminant analysis (QDA) model was built following dimensionality reduction by principal component analysis for the purpose of predicting the origin of ciprofloxacin tablets. Using QDA, we were able to correctly classify a collection of 907 tablets with greater than 96% accuracy. Chemometric models such as the one developed here could ultimately be employed as part of a large, diversified drug surveillance program.
Suicidal behaviour in Indigenous compared to non-Indigenous males in urban and regional Australia: Prevalence data suggest disparities increase across age groups
Authors: Armstrong Gregory , Pirkis Jane , Arabena Kerry , Currier Dianne , Spittal Matthew J , Jorm Anthony F
Published: April 2017

Objectives:

We compare the prevalence of suicidal thoughts and attempts between Indigenous and non-Indigenous males in urban and regional Australia, and examine the extent to which any disparity between Indigenous and non-Indigenous males varies across age groups.

Methods:

We used data from the baseline wave of The Australian Longitudinal Study on Male Health (Ten to Men), a large-scale cohort study of Australian males aged 10–55 years residing in urban and regional areas. Indigenous identification was determined through participants self-reporting as Aboriginal, Torres Strait Islander or both. The survey collected data on suicidal thoughts in the preceding 2 weeks and lifetime suicide attempts.

Results:

A total of 432 participants (2.7%) identified as Indigenous and 15,425 as non-Indigenous (97.3%). Indigenous males were twice as likely as non-Indigenous males to report recent suicidal thoughts (17.6% vs 9.4%; odds ratio = 2.1, p < 0.001) and more than three times as likely to report a suicide attempt in their lifetime (17.0% vs 5.1%; odds ratio = 3.6; p < 0.001). The prevalence of recent suicidal thoughts did not differ between Indigenous and non-Indigenous males in younger age groups, but a significant gap emerged among men aged 30–39 years and was largest among men aged 40–55 years. Similarly, the prevalence of lifetime suicide attempts did not differ between Indigenous and non-Indigenous males in the 14- to 17-years age group, but a disparity emerged in the 18- to 24-years age group and was even larger among males aged 25 years and older.

Conclusion:

Our paper presents unique data on suicidal thoughts and attempts among a broad age range of Indigenous and non-Indigenous males. The disparity in the prevalence of suicidal thoughts increased across age groups, which is in contrast to the large disparity between the Indigenous and non-Indigenous suicide rates in younger age groups.
Explaining Variation in Broker Strategies: A Lab-in-the-Field Experiment in Senegal
Authors: Gottlieb Jessica
Published: April 2017

The implications of clientelism for democratic accountability are mixed: Brokers not only help coordinate votes for collective gain but also exploit their position to advance personal interest. I argue that brokers use distinct strategies—persuasion, reciprocation, and punishment—to motivate voters as a function of their local institutional context. Competitively selected brokers whose preferences are aligned with those of followers can rely more on persuasion than instrumental inducements. Economically autonomous brokers are more likely to rely on sanctions than reciprocity. Evidence to support both the proposed typology of broker strategies and their determinants is collected in Senegal, a clientelistic democracy where group-level heterogeneity generates natural variation in broker types. A coordination game played with real brokers illustrates that participants are less likely to sacrifice personal gain when brokers are competitively selected, more likely when they most fear retribution. Qualitative data suggest that results from the laboratory game plausibly generalize to behavior in elections.
Decision Making on the Labor and Delivery Unit: An Investigation of Influencing Factors
Authors: Gregory Megan E. , Sonesh Shirley C. , Feitosa Jennifer , Benishek Lauren E. , Hughes Ashley M. , Salas Eduardo
Published: April 2017

Objective

The aim of this study was to describe the relationship between negative affect (NA), decision-making style, time stress, and decision quality in health care.

Background

Health care providers must often make swift, high-stakes decisions. Influencing factors of the decision-making process in this context have been understudied.

Method

Within a sample of labor and delivery nurses, physicians, and allied personnel, we used self-report measures to examine the impact of trait factors, including NA, decision-making style, and perceived time stress, on decision quality in a situational judgment test (Study 1). In Study 2, we observed the influence of state NA, state decision-making style, state time stress, and their relationship with decision quality on real clinical decisions.

Results

In Study 1, we found that trait NA significantly predicted avoidant decision-making style. Furthermore, those who were higher on trait time stress and trait avoidant decision-making style exhibited poorer decisions. In Study 2, we observed associations between state NA with state avoidant and analytical decision-making styles. We also observed that these decision-making styles, when considered in tandem with time stress, were influential in predicting clinical decision quality.

Conclusion

NA predicts some decision-making styles, and decision-making style can affect decision quality under time stress. This is particularly true for state factors.

Application

Individual differences, such as affect and decision-making style, should be considered during selection. Training to reduce time stress perceptions should be provided.
Preparation and properties of novel sulfonic graphene oxide–epoxy resin nanocomposites by resin transfer molding process
Authors: Li Wei , Li Hongyu , Yang Xinguo , Feng Wei , Huang Hongyun
Published: April 2017

This paper reported a facile one-pot strategy for fabrication of sulfonic graphene oxide–epoxy resin nanocomposites. The rheological and thermal properties were employed to characterize the viscosity and the curing temperature of epoxy resin. Fourier transform infrared spectra for sulfonic graphene oxide and nanocomposites indicated that the sulfonic graphene oxide contains chemical cross-linking responsible for better interactions with the epoxy resin. The state of dispersion was evaluated at different scales by still picture camera and scanning electron microscopy (SEM). Tensile property tests indicated that the tensile strength and elasticity modulus of sulfonic graphene oxide–epoxy resin nanocomposites decreased slowly with increasing of sulfonic graphene oxide content. The critical flexural property and impact strength of epoxy resin filled with sulfonic graphene oxide nanocomposites were measured. The content, size, and dispersion state of sulfonic graphene oxide were examined. It was found that the content of sulfonic graphene oxide has greater impact on both flexural property and impact strength of nanocomposites compared with other conditions. For instance, the impact strength increased by 113.0% and the flexural strength and modulus increased by 39.3% and 55.7% using 1 wt.% sulfonic graphene oxide as compared to neat epoxy resin.
Deconstructing Unlawful Act Manslaughter
Authors: Leigh Gavin
Published: April 2017

The aim of this article is to separate out and justify two means of proving manslaughter by an unlawful (and dangerous) act. One is manslaughter by an act of intended bodily harm. The other is manslaughter by an unlawful and dangerous act. Some historical authority for these two kinds of unlawful act manslaughter is established, but the line of argument centres on the separate justifications for each kind. The justification for manslaughter by an act of intended bodily harm centres on the relationship between intention and luck. The justification for manslaughter by an unlawful and dangerous act concentrates on the distinction between negligence and heedlessness. This article concludes that manslaughter by an act of intended bodily harm may be justifiable, but that this may be possible where death is caused through any advertent crime. This is with a view to potential development or reform through the courts or Law Commission.
Full and Short Versions of the Coping Inventory for Stressful Situations and Social Problem-Solving Inventory-Revised
Authors: van Horn J. E. , Wilpert J.
Published: April 2017

Inadequate problem solving is associated with recidivism in sex offenders. However, the psychometric properties of two of the most widely used coping self-report questionnaires, the Social Problem-Solving Inventory-Revised and Coping Inventory for Stressful Situations, have not been established for outpatient sex offenders. Using structural equation modeling, the present study aims to contribute to an empirically based decision as to which version of the Coping Inventory for Stressful Situations or Social Problem-Solving Inventory-Revised is best suited to use with forensic outpatient sex offenders. The sample consisted of 530 Dutch sex offenders treated in an outpatient forensic facility. Results support the use of the Coping Inventory for Stressful Situations-Short Form 20 for identifying problem-solving deficits among outpatient sex offenders, consequently facilitating the assessment of treatment needs.
Self-Reported Use of Supplemental Nutrition Assistance Program Benefits to Purchase Soda in a Public Health Center Population: Los Angeles County, California, 2012
Authors: Barragan Noel , Gase Lauren , Butler Rebecca , Smith Lisa , Simon Paul , Kuo Tony
Published: April 2017

To better inform local program planning for the Supplemental Nutrition Assistance Program (SNAP), the Los Angeles County Department of Public Health used self-reported data from a public health center population to examine the prevalence of benefits used to purchase soda. We performed statistical analyses, including multivariable regression modeling, using data from a local health and nutrition examination survey. The survey response rate was 69% ( n=1,503). More than one-third of survey participants reported receiving, or living in a household where someone receives, nutrition assistance benefits. When asked, 33% ( n=170) reported using these benefits to purchase soda “sometimes” and 18% ( n=91) reported “often” or “always,” suggesting that the use of program benefits to purchase soda was not uncommon in this subpopulation. These findings have meaningful policy and planning implications, as they contribute to ongoing dialogue about strategies for optimizing nutrition among SNAP recipients.
Infant Mortality: Development of a Proposed Update to the Dollfus Classification of Infant Deaths
Authors: Nakamura Ann M. , Dove Melanie S. , Minnal Archana , Damesyn Mark , Curtis Michael P.
Published: April 2017

Objective.

Identifying infant deaths with common underlying causes and potential intervention points is critical to infant mortality surveillance and the development of prevention strategies. We constructed an International Classification of Diseases 10th Revision (ICD-10) parallel to the Dollfus cause-of-death classification scheme first published in 1990, which organized infant deaths by etiology and their amenability to prevention efforts.

Methods.

Infant death records for 1996, dual-coded to the ICD Ninth Revision (ICD-9) and ICD-10, were obtained from the CDC public-use multiple-cause-of-death file on comparability between ICD-9 and ICD-10. We used the underlying cause of death to group 27,821 infant deaths into the nine categories of the ICD-9-based update to Dollfus' original coding scheme, published by Sowards in 1999. Comparability ratios were computed to measure concordance between ICD versions.

Results.

The Dollfus classification system updated with ICD-10 codes had limited agreement with the 1999 modified classification system. Although prematurity, congenital malformations, Sudden Infant Death Syndrome, and obstetric conditions were the first through fourth most common causes of infant death under both systems, most comparability ratios were significantly different from one system to the other.

Conclusion.

The Dollfus classification system can be adapted for use with ICD-10 codes to create a comprehensive, etiology-based profile of infant deaths. The potential benefits of using Dollfus logic to guide perinatal mortality reduction strategies, particularly to maternal and child health programs and other initiatives focused on improving infant health, warrant further examination of this method's use in perinatal mortality surveillance.
Preventive Aspirin and other Antiplatelet Medication Use among U.S. Adults Aged ≥40 Years: Data from the National Health and Nutrition Examination Survey, 2011–2012
Authors: Gu Qiuping , Dillon Charles F. , Eberhardt Mark S. , Wright Jacqueline D. , Burt Vicki L.
Published: April 2017

Objective.

We estimated the prevalence of preventive aspirin and/or other antiplatelet medication use and the dosage of aspirin use in the U.S. adult population.

Methods.

We conducted cross-sectional analyses of a representative sample ( n=3,599) of U.S. adults aged ≥40 years from the National Health and Nutrition Examination Survey, 2011–2012.

Results.

In 2011–2012, one-third of U.S. adults aged ≥40 years reported taking preventive aspirin and/or other antiplatelet medications, 97% of whom indicated preventive aspirin use. Preventive aspirin use increased with age (from 11% of those aged 40–49 years to 54% of those ≥80 years of age, p<0.001). Non-Hispanic white (35%) and black (30%) adults were more likely to take preventive aspirin than non-Hispanic Asian (20%, p<0.001) and Hispanic (22%, p=0.013) adults. Adults with, compared with those without health insurance, and adults with ≥2 doctor visits in the past year, diagnosed diabetes, hypertension, or high cholesterol were twice as likely to take preventive aspirin. Among those with cardiovascular disease, 76% reported taking preventive aspirin and/or other antiplatelet medications, of whom 91% were taking preventive aspirin. Among adults without cardiovascular disease, 28% reported taking preventive aspirin. Adherence rates to medically recommended aspirin use were 82% overall, 91% for secondary prevention, and 79% for primary prevention. Among current preventive aspirin users, 70% were taking 81 milligrams (mg) of aspirin daily and 13% were taking 325 mg of aspirin daily.

Conclusion.

The vast majority of antiplatelet therapy is preventive aspirin use. A health-care provider's recommendation to take preventive aspirin is an important determinant of current preventive aspirin use.
Association between Neighborhood-Level Smoking and Individual Smoking Risk: Maternal Smoking among Latina Women in Pennsylvania
Authors: Chesnokova Arina , French Benjamin , Weibe Douglas , Camenga Deepa R. , Yun Katherine
Published: April 2017

Objective.

We examined whether or not high maternal smoking rates at the neighborhood level increase the likelihood of individual smoking by Latina women in the three months prior to and during pregnancy, independent of other individual and neighborhood factors.

Methods.

This study was observational in nature, using linked vital statistics records for 24,443 Latina women in Pennsylvania (2009–2010) and U.S. Census data for 2,398 census tracts. We used multilevel logistic regression models to determine the individual odds of self-reported maternal smoking given different census tract-level rates of maternal smoking in the previous three years (2006–2008), adjusting for maternal and census-tract characteristics, including ethnic density, population density, and poverty.

Results.

Higher levels of maternal smoking at the census-tract level were associated with increased individual odds of smoking among Latina mothers. In the fully adjusted model, a 10% increase in the neighborhood smoking rate was associated with a 1.28 (95% confidence interval 1.22, 1.34) increase in the individual odds of smoking.

Conclusion.

Latina women living in census tracts where more women have smoked during or immediately prior to pregnancy are themselves at higher risk of smoking during this period.
Screening for Homelessness in the Veterans Health Administration: Monitoring Housing Stability through Repeat Screening
Authors: Byrne Thomas , Fargo Jamison D. , Montgomery Ann Elizabeth , Roberts Christopher B. , Culhane Dennis P. , Kane Vincent
Published: April 2017

Objective.

This study examined veterans' responses to the Veterans Health Administration's (VHA's) universal screen for homelessness and risk of homelessness during the first 12 months of implementation.

Methods.

We calculated the baseline annual frequency of homelessness and risk of homelessness among all veterans who completed an initial screen during the study period. We measured changes in housing status among veterans who initially screened positive and then completed a follow-up screen, assessed factors associated with such changes, and identified distinct risk profiles of veterans who completed a follow-up screen.

Results.

More than 4 million veterans completed an initial screen; 1.8% ( n=77,621) screened positive for homelessness or risk of homelessness. Of those who initially screened positive for either homelessness or risk of homelessness and who completed a second screen during the study period, 85.0% ( n = 15,060) resolved their housing instability prior to their second screen. Age, sex, race, VHA eligibility, and screening location were all associated with changes in housing stability. We identified four distinct risk profiles for veterans with ongoing housing instability.

Conclusion.

To address homelessness among veterans, efforts should include increased and targeted engagement of veterans experiencing persistent housing instability.