bluuebunny/crossref_metadata_2025 huggingface dataset:
Of scales and stationarity in animal movements
Authors: Benhamou Simon
Published: December 2013

With recent technological advances in tracking devices, movements of numerous animal species can be recorded with a high resolution over large spatial and temporal ranges. This opens promising perspectives for understanding how an animal perceives and reacts to the multi‐scale structure of its environment. Yet, conceptual issues such as confusion between movement scales and searching modes prevent us from properly inferring the movement processes at different scales. Here, I propose to build on stationarity (i.e. stability of statistical parameters) to develop a consistent theoretical framework in which animal movements are modelled as a generic composite multi‐scale multi‐mode random walk model. This framework makes it possible to highlight scales that are relevant to the studied animal, the nature of the behavioural processes that operate at each of these different scales, and the way in which the processes involved at any given scale can interact with those operating at smaller or larger scales. This explicitly scale‐focused approach should help properly analyse actual movements by relating, for each scale and each mode, the values of the main model parameters (speed, short‐ and long‐term persistences, degree of stochasticity) to the animal's needs and skills and its response to its environment at multiple scales.
Disentangling the interaction among host resources, the immune system and pathogens
Authors: Cressler Clayton E. , Nelson William A. , Day Troy , McCauley Edward
Published: December 2013

The interaction between the immune system and pathogens is often characterised as a predator–prey interaction. This characterisation ignores the fact that both require host resources to reproduce. Here, we propose novel theory that considers how these resource requirements can modify the interaction between the immune system and pathogens. We derive a series of models to describe the energetic interaction between the immune system and pathogens, from fully independent resources to direct competition for the same resource. We show that increasing within‐host resource supply has qualitatively distinct effects under these different scenarios. In particular, we show the conditions for which pathogen load is expected to increase, decrease or even peak at intermediate resource supply. We survey the empirical literature and find evidence for all three patterns. These patterns are not explained by previous theory, suggesting that competition for host resources can have a strong influence on the outcome of disease.
Recognition of DNA bulges by dinuclear iron(II) metallosupramolecular helicates
Authors: Malina Jaroslav , Hannon Michael J. , Brabec Viktor
Published: December 2013

Bulged DNA structures are of general biological significance because of their important roles in a number of biochemical processes. Compounds capable of targeting bulged DNA sequences can be used as probes for studying their role in nucleic acid function, or could even have significant therapeutic potential. The interaction of [Fe2L3]4+ metallosupramolecular helicates (L = C25H20N4) with DNA duplexes containing bulges has been studied by measurement of the DNA melting temperature and gel electrophoresis. This study was aimed at exploring binding affinities of the helicates for DNA bulges of various sizes and nucleotide sequences. The studies reported herein reveal that both enantiomers of [Fe2L3]4+ bind to DNA bulges containing at least two unpaired nucleotides. In addition, these helicates show considerably enhanced affinity for duplexes containing unpaired pyrimidines in the bulge and/or pyrimidines flanking the bulge on both sides. We suggest that the bulge creates the structural motif, such as the triangular prismatic pocket formed by the unpaired bulge bases, to accommodate the [Fe2L3]4+ helicate molecule, and is probably responsible for the affinity for duplexes with a varying number of bulge bases. Our results reveal that DNA bulges represent another example of unusual DNA structures recognized by dinuclear iron(II) ([Fe2L3]4+) supramolecular helicates.
Demographic consequences of climate change and land cover help explain a history of extirpations and range contraction in a declining snake species
Authors: Pomara Lars Y. , LeDee Olivia E. , Martin Karl J. , Zuckerberg Benjamin
Published: December 2013

Developing conservation strategies for threatened species increasingly requires understanding vulnerabilities to climate change, in terms of both demographic sensitivities to climatic and other environmental factors, and exposure to variability in those factors over time and space. We conducted a range‐wide, spatially explicit climate change vulnerability assessment for Eastern Massasauga (Sistrurus catenatus), a declining endemic species in a region showing strong environmental change. Using active season and winter adult survival estimates derived from 17 data sets throughout the species' range, we identified demographic sensitivities to winter drought, maximum precipitation during the summer, and the proportion of the surrounding landscape dominated by agricultural and urban land cover. Each of these factors was negatively associated with active season adult survival rates in binomial generalized linear models. We then used these relationships to back‐cast adult survival with dynamic climate variables from 1950 to 2008 using spatially explicit demographic models. Demographic models for 189 population locations predicted known extant and extirpated populations well (AUC = 0.75), and models based on climate and land cover variables were superior to models incorporating either of those effects independently. These results suggest that increasing frequencies and severities of extreme events, including drought and flooding, have been important drivers of the long‐term spatiotemporal variation in a demographic rate. We provide evidence that this variation reflects nonadaptive sensitivity to climatic stressors, which are contributing to long‐term demographic decline and range contraction for a species of high‐conservation concern. Range‐wide demographic modeling facilitated an understanding of spatial shifts in climatic suitability and exposure, allowing the identification of important climate refugia for a dispersal‐limited species. Climate change vulnerability assessment provides a framework for linking demographic and distributional dynamics to environmental change, and can thereby provide unique information for conservation planning and management.
Late onset of clinically apparent central vein stenosis due to previous central venous catheter in a patient with inherited thrombophilia
Authors: Eleftheriadis Theodoros , Liakopoulos Vassilios , Antoniadi Georgia , Pissas Georgios , Leivaditis Konstantinos , Stefanidis Ioannis
Published: December 2013

We describe a case of a patient with a functional kidney transplant who was admitted to our department with clinically evident central vein stenosis (CVS) 7 years after the removal of a central venous catheter (CVC) from the right internal jugular vein. The catheter was used as a hemodialysis access for a 2‐month period. In the interval before his last admission, the patient suffered two episodes of deep vein thrombosis. Investigation revealed heterozygosity for factor V Leiden, the most common inherited thrombophilia encountered in 5% of Caucasians, and anticoagulation treatment was started. Magnetic resonance angiography showed stenosis just after the convergence of the right subclavian vein with the internal jugular vein to the innominate vein. Transluminal angioplasty restored venous patency and right upper arm edema resolved. Coexistence of CVS, accompanied by hemodynamic changes and endothelial dysfunction, with thrombophilia fulfill all the elements of the Virchow's triad. Therefore, the patient was at great risk for central vein thrombosis, from which he was possibly protected by the early administration of anticoagulant treatment. This case indicates that CVS can be asymptomatic for several years after CVC removal and also raises the question if thrombophilia workup and investigation for CVS may be beneficial in every patient with CVC placement in order to avoid any harmful outcomes.
Relationship between prosthodontic status and nutritional intake in the elderly in Korea: National Health and Nutrition Examination Survey (NHANES IV)
Authors: Choi YK , Park DY , Kim Y
Published: December 2013

Objectives

Many health issues have been reported to be associated with poor nutritional status. We sought to examine the association between nutritional intake and oral health status in elderly people.

Methods

The association between perceived disability in mastication and prosthodontic status was analysed using multiple logistic regression. Multiple linear regression was used to analyse the association between prosthodontic status and nutritional intake.

Results

The elderly subjects with partial or full dentures reported chewing difficulties 1.62‐fold more frequently (95% CI: 1.06–2.49) than those with natural teeth or a fixed prosthesis after adjusting for gender, TMD (temporomandibular disorder), household income and education level. Additionally, daily nutritional intakes of energy, protein, fat, ash, calcium, phosphorus and thiamine were decreased significantly in elderly with partial or full dentures compared with those with no prosthesis or with a fixed prosthesis (P < 0.05).

Conclusions

Our findings underline oral health status and perceived disability in mastication are associated with dietary imbalances in the elderly. We suggest that the evaluation of patients' nutritional status should be considered as a part of an overall plan for dental hygiene care.
Fatigue life enhancement of NiTi rotary endodontic instruments by progressive reciprocating operation
Authors: Shin C. S. , Huang Y. H. , Chi C. W. , Lin C. P.
Published: December 2013

Aim

To evaluate the effect of reciprocating amplitude and progressive angular increment on fatigue life enhancement of NiTi rotary endodontic instruments.

Methodology

ProTaper F2 instruments were operated in steel artificial canals with both stationary reciprocating (SR) and progressive reciprocating (PR) motions. The SR motions involved symmetric to and fro reciprocation of ±180o, ±135o, ±90o, ±60o and ±45o. The PR motions were ±45o stationary motion superimposed with angular increments of 7o, 11o, 22.5o or 31o whenever an instrument completed 1, 10 or 30 reciprocating cycles (rc). The fatigue lives were compared with those under continuous rotation (CR) and a reciprocating operation with a forward 144o and backward 72o motion proposed by Yared (2008). The statistical significance of these operating modes on fatigue life was examined using one way anova and post hoc Tukey's tests at P = 0.05. Fractographic analysis was also applied to probe the fracture mechanisms of different rotation motions.

Results

Fatigue life increased with decreasing reciprocating amplitude. Operating in the SR increased fatigue life by 355% over that in the CR. Except for the 22.5o increment, all PR motions yielded longer fatigue lives than the SR motion. A progressive reciprocating operation with a ± 45o reciprocating amplitude and a + 7o progressive angular increment every 10 reciprocating cycles (±45o/10rc/+7o) increased fatigue life by 990% over that in the CR motion. In terms of life enhancement over the CR motion, the larger the curvature the less are the differences between different movements. Single crack initiation sites were found in the CR and SR motions, while three crack initiation sites were typical in the ±45o/10rc/+7o motion.

Conclusions

Fatigue life increased with decreasing reciprocating amplitude in stationary reciprocation. A progressive reciprocating operation with ±45o/10rc/+7o motion led to significant fatigue life enhancement and multiple fatigue crack initiation in NiTi endodontic instruments.
INTERACT2: A Reason for Optimism with Spontaneous Intracerebral Hemorrhage?
Authors: Barber P. Alan , Kleinig Timothy J.
Published: December 2013

The first Intensive Blood Pressure Reduction in Acute Intracerebral Hemorrhage Trial (INTERACT1) study found that early intensive BP lowering seemed to attenuate haematoma growth when compared with a more conservative guideline based policy. Clinicians were therefore waiting with anticipation for the results of INTERACT2, in which 2839 patients with spontaneous ICH and a systolic BP between 150 and 220 mmHg were randomly assigned to receive intensive antihypertensive therapy with a systolic target of <140 mmHg within one hour, or a standard guideline recommended treatment of <180 mmHg. INTERACT2 failed to show a significant reduction in the rate of the primary outcome of death or major disability [modified Rankin scale score (mRS) of 3–6], with early intensive BP lowering. However, in the key secondary endpoint of an ordinal analysis of the distribution of mRS scores, there was a significant favorable shift in those patients with aggressive therapy. There were also more patients who were normal or near normal (mRS of 0–1) at 90 days. Reassuringly, there were no differences in the rate of death or numbers of serious adverse events between the two groups. INTERACT2 has shown that a strategy of early and aggressive BP lowering is safe in a wide range of clinical settings, and is probably effective. The Antihypertensive Treatment of Acute Cerebral Haemorrhage (ATACH) II trial, which is using similar BP targets to INTERACT, should shed further light on the benefit of early aggressive BP lowering in patients with spontaneous ICH.
Successful penile reconstruction after multimodal therapy in patients with primitive neuroectodermal tumor originating from the penis
Authors: Akino Tomoshige , Shinohara Nobuo , Hatanaka Kanako , Kobayashi Nozomi , Yamamoto Yuhei , Nonomura Katsuya
Published: December 2013

We herein present an extremely rare case of primitive neuroectodermal tumor originating in the penis. A 16‐year‐old male adolescent presented with painful penile swelling. Pathological, immunohistochemical and cytogenetical examinations of the specimens obtained from total penectomy confirmed the diagnosis of primitive neuroectodermal tumor. After total penectomy, the patient received adjuvant chemotherapy with ifosfamide‐based regimen for 48 weeks. As a series of therapies, the patient underwent penile reconstruction surgery after completing adjuvant chemotherapy. The patient has not shown any evidence of recurrence for the 7 years after penile reconstruction surgery, and voiding function is completely normal. A favorable outcome was observed by multimodal therapy including aggressive resection for local control, intensive adjuvant chemotherapy, and penile reconstruction with cosmetic and functional success. Similar therapeutic approaches might be selected for children with primary malignant tumors of the penis.
Efficacy and safety of once‐daily oxybutynin patch versus placebo and propiverine in Japanese patients with overactive bladder: A randomized double‐blind trial
Authors: Yamaguchi Osamu , Uchida Eiji , Higo Naruhito , Minami Hidenao , Kobayashi Shigeo , Sato Hiroyuki ,   Oxybutynin Patch Study Group
Published: December 2013

Objectives

To evaluate the efficacy and safety of once‐daily oxybutynin patch therapy for overactive bladder.

Methods

A randomized double‐blind trial was carried out in patients with overactive bladder syndrome, who received an oxybutynin patch, propiverine (20 mg) or placebo once daily for 12 weeks. The primary efficacy end‐point was the change of the mean daily number of micturitions in week 12.

Results

A total of 1530 patients were randomized to receive the oxybutynin patch (573), propiverine (576) or placebo (381). The change of the mean daily frequency of micturition from baseline in the full analysis set was −1.89 ± 2.04 with the oxybutynin patch, which was significantly higher than with placebo (−1.44 ± 2.23) (P = 0.0015). The difference of the mean change in the mean daily number of micturitions between the oxybutynin patch and propiverine groups showed a 95% confidence interval of −0.28 to 0.21, and the upper limit of this interval was below the predefined non‐inferiority margin of 0.37, showing non‐inferiority of the oxybutynin patch to propiverine. The incidence of dry mouth and constipation was higher with propiverine than with the oxybutynin patch or placebo. Application site dermatitis was more frequent with the oxybutynin patch (31.8%) than with propiverine (5.9%) or placebo (5.2%), but the dermatitis was generally mild.

Conclusion

This trial shows the efficacy of the new once‐daily oxybutynin patch for overactive bladder. Despite a higher rate of dermatitis with the oxybutynin patch, dry mouth and constipation occurs less often than during treatment with propiverine.
Testing for temporal coherence across spatial extents: the roles of climate and local factors in regulating stream macroinvertebrate community dynamics
Authors: Huttunen Kaisa‐Leena , Mykrä Heikki , Huusko Ari , Mäki‐Petäys Aki , Vehanen Teppo , Muotka Timo
Published: December 2013

Temporal coherence or spatial synchrony refers to the tendency of population, community or ecosystem dynamics to behave similarly among locations through time as a result of spatially‐correlated environmental stochasticity (Moran effect), dispersal or trophic interactions. While terrestrial studies have treated synchrony mainly as a population‐level concept, the majority of freshwater studies have focused on community‐level patterns, particularly in lake planktonic communities. We used spatially and temporally hierarchical data on benthic stream invertebrates across six years, with three seasonal samples a year, in 11 boreal streams to assess temporal coherence at three spatial extents: 1) among regions (watersheds), 2) among streams within a region, and 3) among riffles within a stream, using the average of correlation coefficients for stream/riffle pairs across years. Our results revealed the primacy of strongly synchronized climatic factors (precipitation, air temperature) in inducing temporal coherence of macroinvertebrate assemblages across geographically distinct sites (i.e. Moran effect). Coherence tended to decrease with increasing spatial extent, but positive coherence was detected for most biological variables even at the largest extent (about 350 km). The generally high level of coherence reflected the strong seasonality of boreal freshwater communities. A hydrologically exceptional year enhanced the synchrony of biological variables, particularly total macroinvertebrate abundance. Regionally low precipitation in that year led to a substantial decrease in benthic densities across a broad spatial extent, followed by a rapid post‐drought recovery. Coherence at the among‐riffle (within‐stream) extent was lower than expected, implying that local‐scale habitat filters determine community dynamics at smaller spatial extents. Thus, temporal coherence of stream benthic communities appears to be controlled by partly different processes at different spatial scales.
Contrasting effects of habitat area and connectivity on evenness of pollinator communities
Authors: Marini Lorenzo , Öckinger Erik , Bergman Karl‐Olof , Jauker Birgit , Krauss Jochen , Kuussaari Mikko , Pöyry Juha , Smith Henrik G. , Steffan‐Dewenter Ingolf , Bommarco Riccardo
Published: December 2013

Losses of both habitat area and connectivity have been identified as important drivers of species richness declines, but little theoretical and empirical work exists that addresses the effect of fragmentation on relative commonness of highly mobile species such as pollinating insects. With a large dataset of wild bee and butterfly abundances collected across Europe, we first tested the effect of habitat area and connectivity on evenness in pollinator communities using a large array of indexes that give different weight to dominance and rarity. Second, we tested if traits related to mobility and diet breadth could explain the observed evenness patterns. We found a clear negative effect of area and a weaker, but positive effect of connectivity on evenness. Communities in small habitat fragments were mainly composed of mobile and generalist species. The higher evenness in small fragments could thereby be generated by highly mobile species that maintain local populations with frequent inter‐fragment movements. Trait analysis suggested an increasing importance of dispersal over local recruitment, as we move from large to small fragments and from less to more connected fragments. Species richness and evenness were negatively correlated indicating that the two variables responded differently to habitat area and connectivity, although the mechanisms underlying the observed patterns are difficult to isolate. Even though habitat area and connectivity often decrease simultaneously due to habitat fragmentation, an interesting practical implication of the contrasting effect of the two variables is that the resulting community composition will depend on the relative strength of these two processes.
Preparation of Phase‐Pure K0.5Na0.5NbO3 Fine Powders by a Solid‐State Reaction at 625°C from a Precursor Comprising Nb2O5 and K,Na Acetates
Authors: Senna Mamoru , Pavlic Jernej , Rojac Tadej , Malic Barbara , Kosec Maria
Published: December 2013

Phase‐pure K0.5Na0.5NbO3 (KNN) fine powders were synthesized via a solid‐state route from a homogeneous solid mixture. A colloidal dispersion comprising a mixed ethanol solution of potassium and sodium acetates and Nb2O5 fine particles was attrition milled and dried carefully to avoid water absorption. Two‐step calcination in air at 450°C and 625°C, each for 3 h, resulted in the phase‐pure KNN powders. The volume‐based median diameter of the final product was ca. 0.8 μm. Starting from the same precursors without dissolving the acetates, the phase‐pure KNN was never achieved even when the two calcination temperatures were increased to 550°C and 700°C, in spite of the same milling conditions. Key issues of eliminating second phases were (i) starting from a wet‐milled mixture with a single solution containing both of the A‐site species, and (ii) repeated wet milling of the reaction mixture to disintegrate reaction‐induced agglomerates. These enabled rapid nuclei growth from chemically interacted precursor prior to calcination, and short diffusion path due to repeated deagglomeration, excluding formation of off‐stoichiometric second phases. All these items were confirmed by different analytical tools, among others, thermo‐gravimetry and differential thermal analysis (TG‐DTA), particle size analyses, and XPS at various reaction stages. On the heating stage microscope, a shrinkage onset was observed at 850°C, that is, 150 K lower than that of conventionally prepared KNN, that is, via a solid‐state synthesis from carbonates by a two‐step calcination at 800°C and 750°C, for 4 h each. No second phase was observed after sintering up to 1100°C.
The Competitive and Combining Effects of Grain Boundary and Fe/Mo Antisite Defects on the Low‐Field Magnetoresistance in Sr2FeMoO6
Authors: Wang Jin‐Feng , Li Zheng , Xu Xi‐Jun , Gu Zheng‐Bin , Yuan Guo‐Liang , Zhang Shan‐Tao
Published: December 2013

Sr2FeMoO6 ceramics with different Fe/Mo antisite defect (ASD) concentrations and grain‐boundary (GB) properties were prepared. The competitive and combining effects of GB and Fe/Mo ASD on the transport and magnetoresistance were discussed. The GB properties, that is, intergrain coupling strength, positively related with resistivity value, is extremely sensitive to the total flux of reducing gas, in general, lower total gas flux leads to larger resistivity, thus stronger intergrain coupling strength, and then the contributions of GB effect to low‐field magnetoresistance (LFMR) increase appreciably regardless of the amount of ASD. In detail, when ASD concentration is less than 26%, LFMR is dominantly controlled by the GB effect. However, the suppressed ASD effect on LFMR behavior comes to play when the ASD content is larger than or equal to 26%, where the GB and ASD effects contribute together to the LFMR.
Simulation of Impedance Spectra for a Full Three‐Dimensional Ceramic Microstructure Using a Finite Element Model
Authors: Dean Julian S. , Harding John H. , Sinclair Derek C.
Published: December 2013

A method of characterizing electrically heterogeneous electroceramics for a full three‐dimensional collection of randomly shaped grains is presented. Finite element modeling, solving Maxwell's equations in space and time is used to simulate impedance spectroscopy (IS) data. This technique overcomes several deficiencies associated with previous methods used to simulate IS data and allows comprehensive treatment of a full three‐dimensional granular representation of ceramic microstructure without the requirement for equivalent circuits based on the Brickwork layer model (BLM) or the introduction of constant phase elements to describe any nonideality of the IS response. This is applied to a full three‐dimensional ceramic microstructure with varying grain size and electrical properties to generate IS plots that highlight limitations of the BLM in data analysis.
European Commission Officials' Policy Attitudes
Authors: Schafer Jerome
Published: December 2013

European Commission officials are usually thought to prefer more to less supranational authority. A large body of work assumes that they maximize the power of their organization. This study suspends a priori preference attribution and empirically investigates variation in support for supranational authority over five policy areas. The analysis uses Kassim et al.'s survey data from 2008 (N = 1,901). The first finding in this article is that Commission officials do not systematically prefer more supranational decision‐making. Following the logic of fiscal federalism, they support changes in EU policy scope to the extent that this would improve public good provision. The second finding, taking a political psychology perspective, is that individual calculations of efficiency are mediated by ideological beliefs. Because issues are complex and information is costly, Commission officials rely on heuristics to assess what the European Union should do. They are biased information‐processors.
Metronidazole alone or with amoxicillin as adjuncts to non‐surgical treatment of chronic periodontitis: a secondary analysis of microbiological results from a randomized clinical trial
Authors: Soares Geisla M. S. , Mendes Juliana A. V. , Silva Maike P. , Faveri Marcelo , Teles Ricardo , Socransky Sigmund S. , Wang Xiaoshan , Figueiredo Luciene C. , Feres Magda
Published: December 2013

Aim

To evaluate the changes occurring in the subgingival microbial profile of subjects with generalized chronic periodontitis (ChP) treated by scaling and root planing (SRP) alone or with metronidazole (MTZ) or MTZ + amoxicillin (AMX). A secondary aim was to examine a possible added effect of chlorhexidine (CHX) to these therapies.

Methods

One hundred and eighteen subjects were randomly assigned to receive SRP‐only or with MTZ [400 mg/thrice a day (TID)] or MTZ + AMX (500 mg/TID) for 14 days. Half of the subjects in each group rinsed with 0.12% CHX twice a day (BID) for 2 months. Nine subgingival plaque samples/subject were analysed by checkerboard DNA–DNA hybridization for 40 bacterial species at baseline, 3, 6 and 12 months post‐therapy.

Results

At 12 months, the antibiotic‐treated groups harboured lower mean counts and proportions of key periodontal pathogens than the SRP group (p < 0.05). These benefits were observed at initially deep and shallow sites. Initial reductions in periodontal pathogens obtained with SRP partially rebound after 12 months. CHX rinsing enhanced the microbiological effects of the MTZ + AMX treatment in shallow sites.

Conclusion

The adjunctive use of MTZ and MTZ + AMX results in a greater reduction in the levels of periodontal pathogens in generalized ChP subjects compared to SRP alone.
First observation of African tigerfish Hydrocynus vittatus predating on barn swallows Hirundo rustica in flight
Authors: O'Brien G. C. , Jacobs F. , Evans S. W. , Smit N. J.
Published: December 2013

A population of African tigerfish Hydrocynus vittatus from the Schroda Dam, actively prey on barn swallows Hirundo rustica in flight. This behaviour was discovered during a radio telemetry study and documented using a motion picture video camera. These results show that an avivorous diet is a part of the feeding biology of H. vittatus, and may occur in other populations.
Competent authorities for the flood risk management plan – reflections on flood and spatial planning in England
Authors: Green Colin
Published: December 2013

National implementation of the Floods Directive required the member states to each designate a ‘competent authority’. This raises the question of what are the necessary competencies of the designated authority and what are the necessary powers required to deliver the directive. A fundamental problem in water governance is the ‘vertical‐horizontal problem’ of integration but rules necessarily fragment and water management is highly coupled with many other policy areas. This paper reviews how the emphasis on vertical and horizontal integration in flood risk management has evolved over time and argues that vertical integration has been promoted at increasing cost to horizontal integration.
Exploring the Frequency of Blood Pressure Documentation in Emergency Departments
Authors: Miltner Rebecca S. , Johnson Kimberly D. , Deierhoi Rhiannon
Published: December 2013

Purpose

One of the most commonly performed task in the emergency department (ED) is reported as the monitoring of vital signs, yet there are no published standards of care that provide guidelines for the frequency of obtaining vital signs in the ED. The purpose of this exploratory study was to determine the frequency of documentation of vital signs recorded during ED visits across Veterans Health Administration (VHA) facilities.

Methods

Deidentified patient level data from the VHA electronic health record (EHR) were abstracted for emergency department visits for 12 randomly selected days in calendar year 2011. The dataset included vital signs data, associated time stamps, facility, length of stay, triage category based on the Emergency Severity Index (ESI), and patient disposition for all patients. Descriptive statistics were used to describe the frequency of the specific vital sign measures, and parametric and nonparametric tests were used to examine study variables by ESI.

Findings

The sample consisted of over 43,232 unique patient visits to 94 VHA EDs with a median length of stay of 173.3 min (interquartile range [IQR], 96.1–286.9). The mean number of times that blood pressure (BP) was recorded per visit was 1.23 (SD 1.175). For the entire sample, median time between blood pressure measurements was 139.7 min (IQR, 81.6–230.1). There was a significant difference in median length of stay and median time between blood pressure by ESI category.

Conclusions

In this dataset, median time between documentation of BP in the ED was every 2.3 hr for all patients. While the median time was statistically significant between ESI categories, these times may not be clinically relevant. More important was the inconsistent documentation of vital signs of ED patients in the designated fields in the EHR. Most facilities (84.1%) documented BP for >75% of patient visits. However, eight facilities (9.1%) had BP documented in <50% of patient visits.

Clinical Relevance

It seems unlikely that vital signs are not monitored in the ED; nurses anecdotally report that vital signs are recorded on a paper chart and later scanned as an image into the EHR. However, lack of consistent process in documentation of vital signs may decrease the care team's ability to note early warning signs of physiological instability or deterioration.
Effect of linaclotide in irritable bowel syndrome with constipation (IBS‐C): a systematic review and meta‐analysis
Authors: Atluri D. K. , Chandar A. K. , Bharucha A. E. , Falck‐Ytter Y.
Published: December 2013

Background

Treatment options for constipation‐predominant irritable bowel syndrome (IBS‐C) are limited. While linaclotide improved IBS‐C symptoms in randomized controlled trials (RCTs), results vary among studies and the magnitude of benefit is unclear.

Methods

Two investigators independently extracted data on study participants, methods and outcomes (i.e., symptoms, quality of life, and adverse events) from eligible articles i.e., RCTs comparing linaclotide with placebo in adult patients with IBS‐C with a follow‐up of 12 weeks or longer. The grading of recommendations assessment, development and evaluation (GRADE) methodology was used to rate the quality of evidence.

Key Results

Of 182 identified citations, three RCTs enrolling 1773 patients met the inclusion criteria. Compared with placebo, fewer patients on linaclotide failed to achieve responses i.e., FDA endpoint (1604 patients, risk ratio [RR] = 0.80; 95%CI 0.76–0.85), adequate IBS symptom relief (1773 patients, RR = 0.73; 95%CI 0.65–0.82), and clinically meaningful improvement in IBS‐QOL (1659 patients, RR = 0.78; 95%CI 0.72–0.86). The incidence of diarrhea leading to discontinuation of treatment was higher for linaclotide (1773 patients, RR = 14.75; 95%CI 4.04–53.81). The quality of evidence was rated as moderate for FDA endpoint and adequate relief response, high for diarrhea, and low for IBS‐QOL. Generalizability may be limited by the study population (i.e., predominantly white female patients), lack of data regarding prior therapy, and availability of few RCTs. The number of patients is insufficient to identify rare adverse events.

Conclusions & Inferences

Linaclotide is moderately effective in improving symptoms of IBS‐C with diarrhea being the major side effect. Further studies are needed to evaluate the long‐term efficacy and safety of linaclotide for IBS‐C.
PLPKI: A novel serine protease inhibitor as a potential biochemical marker involved in horizontal resistance to Phytophthora infestans
Authors: Feldman Mariana Laura , Andreu Adriana Balbina , Korgan Samanta , Lobato María Candela , Huarte Marcelo , Walling Linda Lee , Daleo Gustavo Raúl
Published: December 2013

Potato leaves infected with Phytophthora infestans produced a serine protease inhibitor (PLPKI) with specificity for microbial proteases. Sequencing of the first twenty residues at the NH2‐terminus of the mature PLPKI polypeptide demonstrated that PLPKI is a novel member of the potato protease inhibitor I family. PLPKI inhibited the activity of extracellular proteases produced by two pathogens of potato, P. infestans and Rhizoctonia solani, but was inactive against proteases secreted into the culture media by the binucleate Rhizoctonia N2, a non‐pathogenic fungus for potato. Western blot analysis showed a positive correlation between the levels of PLPKI and the degree of horizontal resistance, showing its highest accumulation in clone OKA 5632.11, which has been described as highly resistant. This correlation, together with the ability of PLPKI to completely abolish the secreted serine protease activity of P. infestans, suggests that PLPKI may have an active role in protecting potato plants from this pathogenic oomycete and that it could be used as a suitable biochemical marker to help breeders in the selection of cultivars with high degree of horizontal resistance.
The effects of social exclusion on the ERN and the cognitive control of action monitoring
Authors: Themanson Jason R. , Ball Aaron B. , Khatcherian Stephanie M. , Rosen Peter J.
Published: December 2013

The current study investigated the influence of social exclusion, created through the Cyberball paradigm, on cognitive control using neural and behavioral measures of action monitoring. Healthy young adults performed a modified flanker task while their post‐error behavior (accuracy, RT) and error‐related negativity (ERN) were assessed. Results indicated that excluded participants showed decreased ERN and post‐error response accuracy compared to included participants following their social interactions. These findings suggest that a common neural framework may exist for cognitive control processes and that cognitive control allocated toward exclusion‐related processing following exclusionary social interactions may disrupt the capability to support self‐regulatory action monitoring.
Littleseed canarygrass (Phalaris minor) resistance to clodinafop‐propargyl in wheat fields in north‐western India: Appraisal and management
Authors: Das Tapas K. , Ahlawat Indra P.S. , Yaduraju Nanjapur T.
Published: December 2013

Littleseed canarygrass (∼canarygrass) evolved populations that are resistant to isoproturon during the early 1990s in north‐western India. Clodinafop‐propargyl (∼clodinafop) was recommended for controlling these populations. It has been used extensively in wheat for the last several years. Recently, poor or no control of canarygrass by clodinafop has been observed in large areas, which could be related to cross‐resistance or multiple resistance. This study was designed to test whether resistance has evolved in canarygrass populations against clodinafop and to explore control of the resistant populations with sulfosulfuron and pinoxaden. Among the 311 canarygrass populations that were tested, 86, 55 and 34 showed variable phytotoxicity (0–99%) due to 0.030, 0.060 and 0.120 kg ha−1 clodinafop, respectively. Based on the resistance index, 11 populations were “highly resistant”, 60 were “resistant” and the rest (240) were “susceptible” to clodinafop. Five and six clodinafop‐resistant populations showed slight resistance to 0.0125 kg ha−1 sulfosulfuron and 0.025 kg ha−1 pinoxaden, respectively. But, sulfosulfuron at 0.025 and 0.050 kg ha−1 and pinoxaden at 0.050 and 0.100 kg ha−1 controlled all the canarygrass populations. Clodinafop used for 4 years increased the chance of resistance evolving, whereas its rotation with sulfosulfuron reduced the chance of resistance evolving. This study showed that considerable canarygrass populations have evolved a low‐to‐high degree of resistance against clodinafop. The further use of clodinafop would lead to the spread of resistance in larger areas through the dispersal of resistant seeds. Clodinafop should be replaced with 0.025 kg ha−1 sulfosulfuron or 0.050 kg ha−1 pinoxaden. Besides, where canarygrass has not evolved resistance, the yearly rotation of sulfosulfuron with clodanafop or pinoxaden might delay the evolution of resistance.
Air Suspension System Model Coupled With Leveling and Differential Pressure Valves for Railroad Vehicle Dynamics Simulation
Authors: Nakajima Toshihisa , Shimokawa Yoshiyuki , Mizuno Masaaki , Sugiyama Hiroyuki
Published: December 2013

In this investigation, a nonlinear air suspension system model that accounts for the coupling between air springs, leveling valves, and differential pressure valves is developed and integrated into general-purpose multibody dynamics computer algorithms. It is demonstrated that the proposed model can capture highly nonlinear air suspension characteristics resulting from the coupling with leveling and differential pressure valves, and good agreements are obtained between the numerical and on-track test results. Furthermore, the effect of flow characteristics of leveling valves on the wheel load unbalance on spiral curve sections is discussed. The numerical results obtained by the proposed model clearly indicate the importance of modeling the nonlinear flow characteristics of the leveling and differential pressure valves for assessing the vehicle safety in low speed operations on a small radius curved track.
On the Role of Nonlinearities in Vibratory Energy Harvesting: A Critical Review and Discussion
Authors: Daqaq Mohammed F. , Masana Ravindra , Erturk Alper , Dane Quinn D.
Published: December 2013

The last two decades have witnessed several advances in microfabrication technologies and electronics, leading to the development of small, low-power devices for wireless sensing, data transmission, actuation, and medical implants. Unfortunately, the actual implementation of such devices in their respective environment has been hindered by the lack of scalable energy sources that are necessary to power and maintain them. Batteries, which remain the most commonly used power sources, have not kept pace with the demands of these devices, especially in terms of energy density. In light of this challenge, the concept of vibratory energy harvesting has flourished in recent years as a possible alternative to provide a continuous power supply. While linear vibratory energy harvesters have received the majority of the literature's attention, a significant body of the current research activity is focused on the concept of purposeful inclusion of nonlinearities for broadband transduction. When compared to their linear resonant counterparts, nonlinear energy harvesters have a wider steady-state frequency bandwidth, leading to a common belief that they can be utilized to improve performance in ambient environments. Through a review of the open literature, this paper highlights the role of nonlinearities in the transduction of energy harvesters under different types of excitations and investigates the conditions, in terms of excitation nature and potential shape, under which such nonlinearities can be beneficial for energy harvesting.
Constant Flux States in Anisotropic Turbulence
Authors: Rubinstein Robert , Zhou Ye
Published: December 2013

An elementary closure theory is used to compute the scaling of anisotropic contributions to the correlation function in homogeneous turbulence. These contributions prove to decay with wavenumber more rapidly than the energy spectrum; this property is sometimes called the “recovery of isotropy” at small scales and is a key hypothesis of the Kolmogorov theory. Although comparisons with a more comprehensive theory suggest that the present theory is too crude, its elementary character makes the scaling analysis straightforward. The analysis reveals some characteristic features of anisotropic turbulence, including “angular” energy transfer in wavevector space.
Investigation of Squeaking in Pyrolytic Carbon Proximal Interphalangeal Joint Implants
Authors: Davis Caleb , Thoreson Andrew R. , Berglund Lawrence , Moran Steven L. , An Kai-Nan , Amadio Peter C.
Published: December 2013

One commonly reported complication of pyrolytic carbon arthroplasty at the proximal interphalangeal (PIP) joint is an annoying, painless, squeaking postoperatively. This squeak has been anecdotally associated with implant loosening or impending dislocation. The purpose of this study was to investigate the etiology of this squeaking. Proximal and distal components of the pyrolytic carbon PIP implant were inserted into foam bones and mounted onto an oscillating test device. We evaluated the effect of 96 combinations of load, velocity, contact angle, implant size, lubrication, and displacement amplitude over a total of 300 cycles for each condition. Sound analysis was performed on squeaking conditions. Fourteen conditions resulted in squeaking, all with a sound pattern similar to that noted clinically. Unlubricated, “dry” joints did not squeak. Squeaking most commonly occurred with fetal bovine serum lubrication, at higher loads, and at 0 deg hyperextension. Hyaluronic acid viscosupplementation stopped the squeaking in all cases.
Cancer Immunotherapy
Authors: McNutt Marcia
Published: December 2013

The war on cancer began a little more than 40 years ago as a national research program to radically improve the survival of patients with cancer, a leading cause of death in the United States and worldwide. The main weapons deployed have been surgery, radiation, and chemotherapy, treatments that often carry risks and/or cause adverse side effects. Although some forms of cancer yield to these therapies, not all do, and thus mortality remains high.
Cytotoxic T Cell Adoptive Immunotherapy as a Treatment for Nasopharyngeal Carcinoma
Authors: Lutzky Viviana P. , Crooks Pauline , Morrison Leanne , Stevens Natasha , Davis Joanne E. , Corban Monika , Hall David , Panizza Benedict , Coman William B. , Coman Scott , Moss Denis J.
Published: December 2013

Epstein-Barr virus (EBV) is associated with nasopharyngeal carcinoma (NPC). We assess the safety and tolerability of adoptive transfer of autologous cytotoxic T lymphocytes (CTLs) specific for the EBV latent membrane protein (LMP) in a patient with recurrent NPC. After infusion, the majority of pulmonary lesions were no longer evident, although the primary tumor did not regress.
Antibodies to Both Terminal and Internal B-Cell Epitopes of Francisella tularensisO-Polysaccharide Produced by Patients with Tularemia
Authors: Lu Zhaohua , Perkins Hillary M. , Sharon Jacqueline
Published: December 2013

Francisella tularensis, the Gram-negative bacterium that causes tularemia, is considered a potential bioterrorism threat due to its low infectivity dose and the high morbidity and mortality from respiratory disease. We previously characterized two mouse monoclonal antibodies (MAbs) specific for theO-polysaccharide (O antigen [OAg]) ofF. tularensislipopolysaccharide (LPS): Ab63, which targets a terminal epitope at the nonreducing end of OAg, and Ab52, which targets a repeating internal OAg epitope. These two MAbs were protective in a mouse model of respiratory tularemia. To determine whether these epitope types are also targeted by humans, we tested the ability of each of 18 blood serum samples from 11 tularemia patients to inhibit the binding of Ab63 or Ab52 toF. tularensisLPS in a competition enzyme-linked immunosorbent assay (ELISA). Although all serum samples had Ab63- and Ab52-inhibitory activities, the ratios of Ab63 to Ab52 inhibitory potencies varied 75-fold. However, the variation was only 2.3-fold for sequential serum samples from the same patient, indicating different distributions of terminal- versus internal-binding antibodies in different individuals. Western blot analysis using class-specific anti-human Ig secondary antibodies showed that both terminal- and internal-binding OAg antibodies were of the IgG, IgM, and IgA isotypes. These results support the use of a mouse model to discover protective B-cell epitopes for tularemia vaccines or prophylactic/therapeutic antibodies, and they present a general strategy for interrogating the antibody responses of patients and vaccinees to microbial carbohydrate epitopes that have been characterized in experimental animals.
Spectrum of Pneumococcal Serotype 11A Variants Results from Incomplete Loss of Capsule
O
-Acetylation
Authors: Calix Juan J. , Brady Allison M. , Du Victor Y. , Saad Jamil S. , Nahm Moon H.
Published: December 2013

Streptococcus pneumoniae
is a significant bacterial pathogen that expresses >90 capsule serotypes. Conventional serotyping methods assume that each serotype is a genetically and antigenically distinct entity; however, recent investigations have revealed pneumococcal isolates that cannot be unambiguously serotyped because they share the properties of more than one serotype. Here, we employed a novel serotyping method and NMR spectroscopy to examine clinical isolates sharing properties of serotypes 11A and 11E. These ambiguous clinical isolates were provisionally named 11A variant (11Av) isolates. Serotype 11A pneumococci characteristically express capsule β-galactose-6-
O
-acetylation (βGal6OAc) mediated by the capsule synthesis gene
wcjE
, while 11E strains contain loss-of-function mutations in
wcjE
and completely lack the expression of βGal6OAc. Although 11Av isolates also contained mutated
wcjE
alleles, 11Av clinical isolates were composed of antigenically homogeneous bacteria expressing reduced amounts of 11A-specific capsule antigen. NMR data confirmed reduced but detectable amounts of βGal6OAc on 11Av capsule polysaccharide. Furthermore, the transformation of strains with
wcjE
alleles from 11Av strains was sufficient to restore partial βGal6OAc in an 11E background. We conclude that, instead of being distinct entities, serotypes 11A and 11E represent two extremes of an antigenic spectrum resulting from variable capsule
O
-acetylation secondary to heterologous
wcjE
mutations. These findings challenge whether all clinically relevant pneumococci can be definitively categorized into distinct serotypes.