bluuebunny/crossref_metadata_2025 huggingface dataset:
Smoothing Parameter Selection in two Frameworks for Penalized Splines
Authors: Krivobokova Tatyana
Published: March 2013

There are two popular smoothing parameter selection methods for spline smoothing. First, smoothing parameters can be estimated by minimizing criteria that approximate the average mean-squared error of the regression function estimator. Second, the maximum likelihood paradigm can be employed, under the assumption that the regression function is a realization of some stochastic process. The asymptotic properties of both smoothing parameter estimators for penalized splines are studied and compared. A simulation study and a real data example illustrate the theoretical findings.
Point Process Modelling for Directed Interaction Networks
Authors: Perry Patrick O. , Wolfe Patrick J.
Published: March 2013

Network data often take the form of repeated interactions between senders and receivers tabulated over time. A primary question to ask of such data is which traits and behaviours are predictive of interaction. To answer this question, a model is introduced for treating directed interactions as a multivariate point process: a Cox multiplicative intensity model using covariates that depend on the history of the process. Consistency and asymptotic normality are proved for the resulting partial-likelihood-based estimators under suitable regularity conditions, and an efficient fitting procedure is described. Multicast interactions—those involving a single sender but multiple receivers—are treated explicitly. The resulting inferential framework is then employed to model message sending behaviour in a corporate e-mail network. The analysis gives a precise quantification of which static shared traits and dynamic network effects are predictive of message recipient selection.
Dissecting graft‐versus‐leukemia from graft‐versus‐host‐disease using novel strategies
Authors: Warren E. H. , Deeg H. J.
Published: March 2013

The intrinsic anti‐leukemic effect of allogeneic hematopoietic cell transplantation (HCT) is dependent on genetic disparity between donor and recipient, intimately associated with graft‐versus‐host disease (GVHD), and mediated by lymphocytes contained in or derived from the donor hematopoietic cell graft. Three decades of intense effort have not identified clinical strategies that can reliably separate the graft‐versus‐leukemia (GVL) effect from the alloimmune reaction that drives clinical GVHD. For patients who require HCT and for whom two or more human leukocyte antigen (HLA)‐A, ‐B, ‐C, and ‐DRB1‐matched donor candidates can be identified, consideration of donor and recipient genotype at additional genetic loci both within and outside the major histocompatibility complex may offer the possibility of selecting the donor [candidate(s)] that poses the lowest probability of GVHD and the highest probability of a potent GVL effect. Strategies for engineering conventional donor lymphocyte infusion also hold promise for prevention or improved treatment of post‐transplant relapse. The brightest prospects for selectively enhancing the anti‐leukemic efficacy of allogeneic HCT, however, are likely to be interventions that are designed to enhance specific antitumor immunity via vaccination or adoptive cell transfer, rather than those that attempt to exploit donor alloreactivity against the host. Adoptive transfer of donor‐derived T cells genetically modified for tumor‐specific reactivity, in particular, has the potential to transform the practice of allogeneic HCT by selectively enhancing antitumor immunity without causing GVHD.
Direct binding to antigen‐coated beads refines the specificity and cross‐reactivity of four monoclonal antibodies that recognize polymorphic epitopes of HLA class I molecules
Authors: Hilton H. G. , Parham P.
Published: March 2013

Monoclonal antibodies with specificity for human leukocyte antigen (HLA) class I determinants of HLA were originally characterized using serological assays in which the targets were cells expressing three to six HLA class I variants. Because of this complexity, the specificities of the antibodies were defined indirectly by correlation. Here we use a direct binding assay, in which the targets are synthetic beads coated with 1 of 111 HLA class I variants, representing the full range of HLA‐A, ‐B and ‐C variation. We studied one monoclonal antibody with monomorphic specificity (W6/32) and four with polymorphic specificity (MA2.1, PA2.1, BB7.2 and BB7.1) and compared the results with those obtained previously. W6/32 reacted with all HLA class I variants. MA2.1 not only exhibits high specificity for HLA‐A*02, ‐B*57 and ‐B*58, but also exhibited cross‐reactivity with HLA‐A*11 and ‐B*15:16. At low concentration (1 µg/ml), PA2.1 and BB7.2 were both specific for HLA‐A*02 and ‐A*69, and at high concentration (50 µg/ml) exhibited significant cross‐reactions with HLA‐A*68, ‐A*23 and ‐A*24. BB7.1 exhibits specificity for HLA‐B*07 and ‐B*42, as previously described, but reacts equally well with HLA‐B*81, a rare allotype defined some 16 years after the description of BB7.1. The results obtained with cell‐based and bead‐based assays are consistent and, in combination with amino acid sequence comparison, increase understanding of the polymorphic epitopes recognized by the MA2.1, PA2.1, BB7.2 and BB7.1 antibodies. Comparison of two overlapping but distinctive bead sets from two sources gave similar results, but the overall levels of binding were significantly different. Several weaker reactions were observed with only one of the bead sets.
Determinants of the Location of Foreign Firms inPolish Regions: Does Firm Size Matter?
Authors: CieŚlik Andrzej
Published: March 2013

The goal of this paper is to study empirically the determinants of foreign firms' location inPolish regions with a special focus on the role of firm size. To derive testable hypotheses on the firm location choice an analytical framework that combines the firm heterogeneity and the new economic geography literatures is used. In this framework, agglomeration economies, technical infrastructure, and labour market characteristics may affect location decisions of foreign investors. The hypotheses derived from the theory are validated empirically using the regional dataset atNUTS2 level of spatial aggregation for the period 1999–2010. The empirical evidence confirms the existence of firm heterogeneity with respect to the determinants of firm location choice.
Evidence for long‐lasting subcortical facilitation by transcranial direct current stimulation in the cat
Authors: Bolzoni Francesco , Pettersson Lars‐Gunnar , Jankowska Elzbieta
Published: March 2013

Key points

Transcranial constant current polarization of the human brain is on the increase in neurological practice because it improves several motor and cognitive functions of the human nervous system and because it is non‐invasive and technically simple.

Here we show that transcranial brain polarization in anaesthetized animals not only affects cortical neurons, as is often assumed, but also facilitates activation of neurons in all investigated subcortical motor systems.

In addition, the subcortical facilitation greatly outlasts (by at least hours) the period of transcranial polarization. These findings provide new evidence of plasticity at subcortical levels, the mechanisms for which remain to be investigated.

In clinical practice, the subcortical effects of transcranial polarization may thus make an essential contribution to the beneficial effects of the treatment of motor impairments.

Abstract  The main aim of the study was to examine the effects of transcranial polarization on neurons in two descending motor systems, rubro‐ and reticulospinal. Anodal DC current was applied through an electrode in contact with the skull over the contralateral sensori‐motor cortex, against an electrode placed between the skull and the ipsilateral temporal muscles in deeply anaesthetized cats. Its effects were estimated from changes in descending volleys evoked by electrical stimuli applied in the red nucleus (RN), medial longitudinal fascicle (MLF; to reticulospinal fibres) and the pyramidal tract (PT; to corticospinal or corticoreticular fibres). The descending volleys were recorded from the surface of the spinal cord at a cervical level. Rubrospinal neurones were activated either directly or indirectly, via interpositorubral fibres. Reticulospinal neurons were likewise activated directly and indirectly, via other reticulospinal or corticospinal fibres. Transcranial polarization facilitated transsynaptic activation of both rubrospinal and reticulospinal neurons, shortening the latency of the indirect descending volleys and/or increasing them, Direct activation of descending axons was much less affected. The facilitation of all subcortical neurons examined was potentiated by repeated applications of transcranial direct current stimulation (tDCS) and outlasted the polarization by at least 1–2 h, replicating tDCS effects on indirect activation of cortical neurons. The results indicate that the beneficial effects of tDCS on motor performance in humans may be due to more efficient activation of not only cortical but also subcortical neuronal systems. Combined actions of tDCS on cortical and subcortical neurones might thus further improve recovery of motor functions during rehabilitation after central injuries. 249/250
ZnuD, a Potential Candidate for a Simple and Universal Neisseria meningitidis Vaccine
Authors: Hubert Kerstin , Devos Nathalie , Mordhorst Ines , Tans Christine , Baudoux Guy , Feron Christiane , Goraj Karine , Tommassen Jan , Vogel Ulrich , Poolman Jan T. , Weynants Vincent
Published: March 2013

Neisseria meningitidis
serogroup B (MenB) is a major cause of bacterial sepsis and meningitis, with the highest disease burden in young children. Available vaccines are based on outer membrane vesicles (OMVs) obtained from wild-type strains. However, particularly in toddlers and infants, they confer protection mostly against strains expressing the homologous protein PorA, a major and variable outer membrane protein. In the quest for alternative vaccine antigens able to provide broad MenB strain coverage in younger populations, but potentially also across all age groups, ZnuD, a protein expressed under zinc-limiting conditions, may be considered a promising candidate. Here, we have investigated the potential value of ZnuD and show that it is a conserved antigen expressed by all MenB strains tested except for some strains of clonal complex ST-8. In mice and guinea pigs immunized with ZnuD-expressing OMVs, antibodies were elicited that were able to trigger complement-mediated killing of all the MenB strains and serogroup A, C, and Y strains tested when grown under conditions of zinc limitation. ZnuD is also expressed during infection, since anti-ZnuD antibodies were detected in sera from patients. In conclusion, we confirm the potential of ZnuD-bearing OMVs as a component of an effective MenB vaccine.
Non-lethal? Penetrating chest injury due to beanbag bullet
Authors: Thakur Sanjay , Teloken Patrick Ely , Gilfillan Ian , Sharma Sanjay
Published: March 2013

We report a case of serious lung injury from beanbag bullet. A 46-year-old gentleman, shot with beanbag bullets was brought to the emergency department. Upon arrival he was in obvious respiratory distress and complained of severe pain in the right chest. A 3.0×3.5 cm entry wound on the right parasternal area was identified. Chest x-ray revealed a right haemopneumothorax, parenchymal changes at the right lung base and a radiopaque foreign body. A right-sided intercostal chest tube was inserted, draining air and 750 ml of blood. After stabilisation patient underwent a right thoracotomy. A beanbag bullet was found in the oblique fissure of the right lung, with extensive haematoma of the middle lobe. The bullet and skin fragments overlying the lung and along the bullet track were extracted. The pleural cavity was washed with normal saline and haemostasis was confirmed. The patient had an uneventful postoperative recovery.
‘Mechanical thrombectomy alone’ as a definite therapy for rescue angioplasty
Authors: Jamil Gohar , Ouda Husam , Jamil Mujgan , Qureshi Anwer
Published: March 2013

Coronary reperfusion strategies for acute ST segment elevation myocardial infarction (STEMI) include primary percutaneous coronary intervention (PCI), intravenous thrombolytic agents and recently mechanical thrombectomy alone during PCI, the latter reserved for those without significant residual disease post-thrombectomy. We describe the success of ‘mechanical thrombectomy alone’ in two young patients undergoing rescue angioplasty at our institution. Both patients were thrombolysed for inferior STEMI. During rescue PCI, post-thrombus aspiration, mild underlying atherosclerotic burden was detected in both patients, thus possibly obviating the need for further balloon angioplasty or stenting. Cost and compliance with long-term dual antiplatelet therapy (DAPT) was an additional factor to avoid stenting. Both patients received aspirin, clopidogrel, heparin and additional standard therapy for myocardial infarction (MI). Medication compliance was ensured by providing 1 month DAPT at no extra cost. Short-term follow-up at 1 and 3 months, for both patients was uneventful. Two-year, long-term follow-up, available for one patient has been uneventful.
EMG evaluation of hip adduction exercises for soccer players: implications for exercise selection in prevention and treatment of groin injuries
Authors: Serner Andreas , Jakobsen Markus Due , Andersen Lars Louis , Hölmich Per , Sundstrup Emil , Thorborg Kristian
Published: March 2013

Introduction

Exercise programmes are used in the prevention and treatment of adductor-related groin injuries in soccer; however, there is a lack of knowledge concerning the intensity of frequently used exercises.

Objective

Primarily to investigate muscle activity of adductor longus during six traditional and two new hip adduction exercises. Additionally, to analyse muscle activation of gluteals and abdominals.

Materials and methods

40 healthy male elite soccer players, training >5 h a week, participated in the study. Muscle activity using surface electromyography (sEMG) was measured bilaterally for the adductor longus during eight hip adduction strengthening exercises and peak EMG was normalised (nEMG) using an isometric maximal voluntary contraction (MVC) as reference. Furthermore, muscle activation of the gluteus medius, rectus abdominis and the external abdominal obliques was analysed during the exercises.

Results

There were large differences in peak nEMG of the adductor longus between the exercises, with values ranging from 14% to 108% nEMG (p<0.0001). There was a significant difference between legs in three of the eight exercises (35–48%, p<0.0001). The peak nEMG results for the gluteals and the abdominals showed relatively low values (5–48% nEMG, p<0.001).

Conclusions

Specific hip adduction exercises can be graded by exercise intensity providing athletes and therapists with the knowledge to select appropriate exercises during different phases of prevention and treatment of groin injuries. The Copenhagen Adduction and the hip adduction with an elastic band are dynamic high-intensity exercises, which can easily be performed at any training facility and could therefore be relevant to include in future prevention and treatment programmes.
LT COL G O HOPKINS, RAMC
Authors: Hopkins G O.
Published: March 2013

The historical aspects of osteoarticular tuberculosis are briefly recounted. Difficulties of diagnosis and management are discussed in relation, to the disease occurrence in both the West and the Indian Subcontinent.
New Blast Weapons
Authors: Dearden P
Published: March 2013

Over the last decade a large number of weapon systems have appeared that use blast as their primary damage mechanism. This is a notable trend; until recently very few warheads relied on blast as their primary output. Most warheads in service use explosives to drive metal such as fragments and shaped charge jets to engage targets. New technologies are now being integrated into warheads that claim to have enhanced blast performance. Blast weapons could have been designed to fill a gap in capability; they are generally used for the attack of ‘soft’ targets including personnel, both in the open and within protective structures.

With the increased number and range of these weapons, it is likely that UK forces will have to face them in future conflicts. This paper briefly describes fuel-air explosive blast weapons and reviews a range of enhanced blast weapons that have been developed recently. The paper concludes with a brief discussion on the reasons why enhanced blast technologies may be proliferating and how this could affect the Defence Medical Services.
Surgical Workload From An Integrated UK Field Hospital During The 2003 Gulf Conflict
Authors: Rew David A , Clasper Jon , Kerr Gregor
Published: March 2013

Aims

This paper reports the surgical experience of a UK reserve field surgical hospital during military operations in Iraq during March and April 2003. Particular reference is given to the integration of the surgical specialities, consultant led and multidisciplinary teamworking in the treatment of military and civilian casualties from all sources and of all causes.

Methods

All surgical workload data was collected prospectively for the warfighting (Phase One) and specialist referral (Phase Two) phases of the operation. Standard military and Red Cross protocols were used for all injuries and microbiology studies were undertaken for penetrating ballistic injuries. Operations were classified by anatomical region; upper or lower limb; head and neck; thoracic; abdominal, including genitourinary; ophthalmic; and burns, and by whether they were primary; secondary planned or secondary unplanned.

Results

A wide range of patterns of wounding arising from combat and non-combat related military and civilian trauma and burns were seen and treated. 323 operations were performed. There were 116 operations in phase one and 207 operations in phase two. There were 160 primary procedures (new patients), 146 secondary planned and 17 unplanned procedures (range one to eight procedures per patient).

Close integration of general, orthopaedic, plastic, maxillofacial, ophthalmic and neurological surgeons and general and ITU anaesthetists allowed the delivery of a range of specialist treatment to a heterogenous patient population, including children as young as 6 months and a lady in the advanced stages of pregnancy.

Conclusions

Patterns of wounding in casualties surviving to reach specialist field hospital care were similar to those reported in other high intensity conflicts. A consultant led, multidisciplinary approach with field intensive care facilities allowed combined, staged and safe surgery for complex, multi-organ and multi-limb trauma in an austere environment.
Pertussis - A Case Finding Study Amongst Returnees from OP Herrick
Authors: Cooper N K , Bricknell MCM , Holden GR , McWilliam C
Published: March 2013

We present a case finding study of serologically confirmed Pertussis amongst BFG-based returnees from Op HERRICK. The role of Pertussis in the aetiology of the commonplace “Kabul Cough” is discussed. It is recommended that enhanced health surveillance for Pertussis takes place both during and after future deployments to Afghanistan, to prevent the potential onward transmission of a potentially fatal illness to unimmunised children.
Determining the Composition and Benefit of the Pre-Hospital Medical Response Team in the Conflict Setting
Authors: Davis Peter , Rickards AC , Ollerton JE
Published: March 2013

Aim

To determine the optimal composition of the pre-hospital medical response team (MERT) and the value of prehospital critical care interventions in a military setting, and specifically to determine both the benefit of including a doctor in the pre-hospital response team and the relevance of the time and distance to definitive care.

Method

A comprehensive review of the literature incorporating a range of electronic search engines and hand searches of key journals.

Results

There was no level 1 evidence on which to base conclusions. The 15 most relevant articles were analysed in detail. There was one randomized controlled trial (level 2 evidence) that supports the inclusion of a doctor on MERT. Several cohort studies were identified that analysed the benefits of specific critical care interventions in the pre-hospital setting.

Conclusions

A doctor with critical care skills deployed on the MERT is associated with improved survival in victims of major trauma. Specific critical care interventions including emergency endotracheal intubation and ventilation, and intercostal drainage are associated with improved survival and functional recovery in certain patients. These benefits appear to be more easily demonstrated for the rural and remote setting than for the urban setting.
Penetrating Cardiac Injury
Authors: O’Connor J , Ditillo M , Scalea T
Published: March 2013

It is understood that penetrating cardiac trauma is a highly lethal injury and those surviving to hospital have an overall mortality approaching 80%. Reported mortality figures vary widely and are extremely dependent on mechanism of wounding, cardiac chambers involved and possibly the presence of cardiac tamponade. Despite significant advances in prehospital care, operative techniques, and intensive care management, the mortality has not changed over several decades. This article will review the anatomic regions of concern for a cardiac injury, clinical presentation, and physical findings. The need for an expeditious evaluation and modalities available including, plain radiographs, sub-xiphoid window, and echocardiography will be considered. Options for surgical exposure, technical details of repairing cardiac injuries, and special circumstances such as injury adjacent to a coronary artery and intra-cardiac shunts are discussed in detail. Outcome data and future directions in managing this challenging injury are also examined.
PVL Staphylococcus Aureus Osteomyelitis Complicating Septic Arthritis in a Uk Soldier Serving in Iraq
Authors: Penn-Barwell Jowan G , Finnikin S , Sargeant I , Porter K
Published: March 2013

Musculoskeletal infections caused by Panton-Valentine Leukocidin (PVL) secreting Stapylocccus aureus in children and adolescents have previously been reported. We report the first adult case in a 26 year-old British Army soldier who presented with a S. aureus septic arthritis. He was treated by surgical washout and antibiotics and discharged but was readmitted five months later with an ipsilateral femoral osteomyelitis requiring debridement. The causative S. aureus grown from tissue biopsy taken at time of surgery was found to encode the PVL gene. Whilst there is evidence that soldiers in Iraq have a greater rate of S. aureus colonisation on their skin, the proportion that encode the PVL gene is similar to that observed in the UK. Soldiers are however, subject to the known risk factors that increase vulnerability to PVL secreting S. aureus infection. Military clinicians need to be aware of PVL secreting S. aureus and have a low threshold for requesting specific testing in aggressive musculoskeletal S. aureus infections.
Investigating Factors Associated with Reporting Concerns towards malaria prophylaxis, and the Content of Concerns Amongst Uk Service Personnel Deployed to the Iraq Conflict Between 2003-2006: A Mixed Methods Study
Authors: Murphy Dominic , Strong A
Published: March 2013

Background

There was a significant risk of malaria in the area to which military personnel were deployed during the Iraq War. In this paper we investigated attitudes towards anti malarial tablets, health and the reporting of military hazards during deployment.

Methods

A cross sectional study of military personnel deployed to Iraq between 2003 and 2006 was performed. A mixed methods model of analysis, with quantitative analysis of reported concerns regarding anti-malarial tablets, health and environmental exposures was undertaken with a qualitative analysis of responses to a free text question inviting comments on concerns regarding the prophylaxis.

Results

Individuals who reported concerns were more likely to report multiple physical symptoms, common mental health problems, side effects to NAPS tablets and anthrax vaccination and exposures during deployment to military hazards (odds ratios: 1.17-3.10). The majority did not voice concerns regarding malarial prophylaxis, in those that did however, strong themes of unease regarding safety and trust emerged.

Discussion

We found evidence of a link between reporting concerns about anti malarial tablets and reporting worse health and increased exposure to military hazards. We hypothesise that this relationship is mediated by negative affect.
The Development of Bacteriology, Sanitation Science and Allied Research in the British Army 1850-1918: Equipping the RAMC for War
Authors: Atenstaedt Rob
Published: March 2013

The recent 90 year anniversary of the end of the First World War is an opportune time to reconsider the important role of the Royal Army Medical Corps in this conflict. One area which has been neglected is the role of the Royal Army Medical Corps in responding to infectious diseases and to understand this properly it is important to consider the development of bacteriology, sanitation science and allied research in the British Army up to the Great War. The context of the home front is also central, with the British population from 1880-1914 increasingly benefiting from improved public sanitation and the new science of bacteriology. Historians acknowledge that the British campaign in the Crimea in the 1850s was pursued with inadequate medical provision and as a result, the Army suffered severely from infectious diseases. Limited changes were introduced after the Crimean War, such as the establishment of the Army Medical School, with its high quality instruction in military hygiene and later bacteriology. Army medics also led the way in various branches of scientific research, through research in the colonies. As compared with the continental powers, however, the application of bacteriology and sanitation to field craft in the British Army was delayed. It took the experiences of the South African and Russo-Japanese Wars for the importance of these sciences to be recognised by the Army as a whole. These subjects began to form part of the education of army Medical Officers, but training was basic and few trainees had specialised in bacteriology by 1914. In spite of these limitations, the Royal Army Medical Corps responded well to the demands placed upon it by World War One, recruiting civilian bacteriologists to its ranks, developing technological innovations such as mobile bacteriological laboratories for them to work in, forming a sanitation service and fostering medical research.
Nonfreezing Cold-Induced Injuries
Authors: Imray Chris , Richards P , Greeves J , Castellani JW
Published: March 2013

Non-freezing cold injury (NFCI) is the Cinderella of thermal injuries and is a clinical syndrome that occurs when tissues are exposed to cold temperatures close to freezing point for sustained periods. NFCI is insidious in onset, often difficult to recognize and problematic to treat, and yet the condition accounts for significant morbidity in both military and civilians who work in cold conditions. Consequently recognition of those at risk, limiting their exposure and the appropriate and timely use of suitable protective equipment are essential steps in trying to reduce the impact of the condition. This review addresses the issues surrounding NFCI.
Optimising Communication in the Damage Control Resuscitation- Damage Control Surgery Sequence in Major Trauma Management
Authors: Arul GS , Pugh HEJ , Mercer SJ , Midwinter MJ
Published: March 2013

Damage Control Resuscitation and Damage Control Surgery (DCR-DCS) is an approach to managing severely injured patients according to their physiological needs, in order to optimise outcome. Key to delivering DCR-DCS is effective communication between members of the clinical team and in particular between the surgeon and anaesthetist, in order to sequence and prioritise interventions. Although the requirement for effective communication is self-evident, the principles to achieving this can be forgotten and sub-optimal when unexpected problems arise at critical points during management of challenging cases. A system is described which builds on the ‘World Health Organisation (WHO) safer surgery checklist’ and formalises certain stages of communication in order to assure the effective passage of key points. We have identified 3 distinct phases: (i) The Command Huddle, once the patient has been assessed in the Emergency room; (ii) The Snap Brief, once the patient has arrived in the Operating Room but before the start of surgery; and (iii) The Sit-Reps, every 10 minutes for the entire theatre team to maintain situational awareness and allow effective anticipation and planning.
Op HERRICK Primary Care Casualties: The Forgotten Many
Authors: Nelson Toby , Wall C , Driver J , Simpson R
Published: March 2013

Objective:

The number of battle casualties generated during war is far outnumbered by non-battle casualties. Each year the current conflict in Afghanistan sees hundreds of service personnel medically evacuated direct from the front line to the care of their home units’ primary care facility. To date these casualties remain undiscovered by medical research. This is the first study to look at the care pathway of primary care casualties from Operation HERRICK using information from the Defence Patient Tracking System (DPTS).

Methods:

Information relating to all casualties from Afghanistan discharged at the airhead between 1 January 2009 and 31 December 2010 was collected from the DPTS. Common conditions were identified and information relating to the follow up care extracted to provide an overview of the care pathway.

Results:

387 aeromedical evacuations were identified as primary care casualties. The three commonest conditions were musculoskeletal (183 cases), mental health (29) and noise-induced hearing loss (26). 205 (53%) were not seen outside of primary care for the tracked condition. 166 (81%) of those that remained under primary care had two or less consultations during the time period of the study. The mean time frame between the 1st and 2nd consultation was 5.4 weeks.

Conclusions:

A significant number of aeromedical evacuations from Afghanistan are for primary care casualties. The DPTS can be used to provide a basic overview of the care pathway of repatriated personnel. Little contact with the medical services would appear to occur for these types of casualties. There is a significant gap in military medical research looking at primary care casualties repatriated from operations.
The safety and efficacy, and recommendations for the use of biologic drugs in the UK military rheumatology population
Authors: Bennett Alexander N , Green A D , Rees J , Jones T , Harris D , Etherington J
Published: March 2013

Inflammatory arthritis is a significant cause of morbidity in the military. In particular the sero-negative spondyloarthritides, which include ankylosing spondylitis, psoriatic arthritis, reactive arthritis, inflammatory bowel disease related arthritis and undifferentiated spondyloarthritis, are especially prevalent in the young male phenotype, which is common in the Armed Forces. It is estimated that there are more than 1500 patients in the Armed Forces with spondyloarthritis alone, based on the prevalence in the general population of approximately 1%. Inflammatory arthritides are eminently treatable, especially with the development and widespread use of biologic drugs such as anti-Tumour Necrosis Factor (TNF) therapy. The use of these drugs can deliver patients an exceptionally good outcome leading to symptom control and normal function in many cases. Initial concerns regarding safety and side effects of anti-TNF drugs have been allayed by the evidence provided from comprehensive national databases developed over the last 10 years. With early diagnosis and prompt treatment military patients can complete a full career including deployment with only minor limitations. This paper reviews the burden of inflammatory arthritis in the armed services, its management and outcome in this population, the evidence for the safety of anti-TNF treatments and the recommendations for employability and deployability for service personnel.
Angioplasty and stenting of intracranial atherosclerosis with the Wingspan system: 1-year clinical and radiological outcome in a single Asian center
Authors: Yu Simon Chun Ho , Leung Thomas Wai Hong , Lee Kwok Tung , Wong Lawrence Ka Sing
Published: March 2013

Background

This study aimed to evaluate the 1-year clinical and angiographic outcome of angioplasty and stenting of intracranial atherosclerosis using Wingspan and Gateway system.

Methods

In this prospective study, patients with symptomatic lesions were treated and followed clinically and angiographically by digital subtraction angiography (DSA) for 1 year. The two primary endpoints were recurrent ipsilateral ischemic stroke and in-stent restenosis (ISR) at 1 year. Secondary endpoints included periprocedural death or stroke and all strokes at 1 year. Potential factors correlated with ISR were studied using univariate and multivariate analysis.

Results

Treatment was attempted in 65 patients and successfully completed in 61 (93.8%). Fifty-nine patients (44 men, 15 women) aged 62.86±11.38 years with 66 stenoses (average degree of stenosis 71.78±11.23%) underwent clinical and DSA follow-up at 1 year. There were 66 stenotic lesions. ISR occurred in 11 of the 66 lesions (16.7%). Luminal gain occurred in 32 of the lesions (48.5%), an unchanged lumen in 4 (6%) and luminal loss in 30 (45.4%). The periprocedural stroke or death rate was 6.1% (4/65), including three hemorrhagic and one ischemic stroke, all of which occurred at the corresponding site and resulted in death. There were no interval strokes between the periprocedural time and the 1-year follow-up. The occurrence of ISR was correlated with the degree of stenosis before treatment and was not correlated with patient age or sex, vessel diameter, location of stenosis or failure to control risk factors for atherosclerosis.

Conclusions

One-year clinical and angiographic outcomes of angioplasty and stenting are promising for symptomatic intracranial atherosclerosis.
A phosphenium cation supported by a seven-membered thiophene based ring system
Authors: Price Jacquelyn T. , Jones Nathan D. , Ragogna Paul J.
Published: March 2013

A novel diamine ligand containing a simple thiophene ring in the backbone has been synthesized. Substitution at the nitrogen atoms with either 2,4,6-trimethylphenyl (Mes) or 2,6-diisopropylphenyl (Dipp) was varied via a condensation reaction between the corresponding aniline and 3,4-diformylthiophene, giving two different ligand derivatives. In onwards chemistry that targeted the cyclic diaminochlorophosphines, the substitution at phosphorus was dependent on the ligand used. For example, when a stoichiometric reaction between PCl3 and thiophene-3,4 diyldimethaneamine (R = Mes) was carried out, the synthesis of a bis-substituted diphosphino- product was isolated. If the R = Dipp ligand derivative was employed, both a 2:1 and 1:1 stoichiometric reaction between PCl3 and the diamine was observed. Nevertheless, the cyclic diaminochlorophosphine (i.e., 1:1 stoichiometry) for R = Dipp was isolated in high yields and the synthesis of the corresponding phosphenium cation was achieved and structurally characterized.
Species composition of the Late Cretaceous eutherian mammalParanyctoidesFox
Authors: Montellano-Ballesteros Marisol , Fox Richard C. , Scott Craig S.
Published: March 2013

Although the known record of Mesozoic eutherian mammals has been significantly enriched in recent years, early eutherian evolution is still not well understood. Among the more controversial of Mesozoic eutherians is Paranyctoides Fox, which was described in 1979 from the Judithian Dinosaur Park Formation, Alberta, Canada. It is a rare taxon and therefore has been identified in only a few other North American Late Cretaceous local faunas since. Within the past decade, dental and gnathic remains discovered in Central Asia have also been referred to Paranyctoides, thereby expanding the geographic range of the genus substantially and making it the only Late Cretaceous eutherian ostensibly occurring in both continents. As a result of our detailed study of Paranyctoides, however, we find that the Central Asian species lack the diagnostic characters of Paranyctoides and must be referred to other taxa. We conclude that this genus was limited to North America, ranging from Aquilan to Lancian time, and accordingly we recognize as valid only the following species: Paranyctoides sternbergi (Judithian, Alberta), P. maleficus (Aquilan, Alberta), Paranyctoides Wahweap sp. A and sp. B (Judithian, Utah), Paranyctoides Kaiparowits sp. A and sp. B (Judithian, Utah). Another purported species of Paranyctoides, P. megakeros, from the Lancian of Wyoming, is a junior synonym of Alostera saskatchewanensis.
ON THE GLOBAL DYNAMICS OF THE OWEN–SHERRATT MODEL DESCRIBING THE TUMOR–MACROPHAGE INTERACTIONS
Authors: STARKOV KONSTANTIN E. , POGROMSKY ALEXANDER YU.
Published: March 2013

In this paper, we examine the global dynamics of the complete Owen–Sherratt model describing the tumor–macrophage interactions. We show for this dynamics that there is a positively invariant polytope. We give upper and lower ultimate bounds for densities of cell populations involved in this model. Besides, we derive sufficient conditions under which each trajectory in [Formula: see text] tends to the mutant cells-free equilibrium point or to the equilibrium point of macrophages in isolation or to the coordinate plane corresponding to the absence of normal tissue cells depending on initial conditions. The biological sense of our results is discussed as well.
Delays Induce an Exponential Memory Gap for Rendezvous in Trees
Authors: Fraigniaud Pierre , Pelc Andrzej
Published: March 2013

The aim of rendezvous in a graph is meeting of two mobile agents at some node of an unknown anonymous connected graph. In this article, we focus on rendezvous in trees, and, analogously to the efforts that have been made for solving the exploration problem with compact automata, we study the size of memory of mobile agents that permits to solve the rendezvous problem deterministically. We assume that the agents are identical, and move in synchronous rounds.

We first show that if the delay between the starting times of the agents is
arbitrary
, then the lower bound on memory required for rendezvous is
Ω
(log
n
) bits, even for the line of length
n
. This lower bound meets a previously known upper bound of
O
(log
n
) bits for rendezvous in arbitrary graphs of size at most
n
. Our main result is a proof that the amount of memory needed for rendezvous
with simultaneous start
depends essentially on the number ℓ of leaves of the tree, and is exponentially less impacted by the number
n
of nodes. Indeed, we present two identical agents with
O
(log ℓ + log log
n
) bits of memory that solve the rendezvous problem in all trees with at most
n
nodes and at most ℓ leaves. Hence, for the class of trees with polylogarithmically many leaves, there is an exponential gap in minimum memory size needed for rendezvous between the scenario with arbitrary delay and the scenario with delay zero. Moreover, we show that our upper bound is optimal by proving that
Ω
(log ℓ + log log
n
) bits of memory are required for rendezvous, even in the class of trees with degrees bounded by 3.
Defect Electronics in SiC and Fabrication of Ultrahigh-Voltage Bipolar Devices
Authors: Kimoto Tsunenobu , Suda Jun , Feng G. , Miyake H. , Kawahara K. , Niwa H.-Y. , Okuda T. , Ichikawa S. , Nishi Y.
Published: March 2013

Fast epitaxial growth, defect reduction, device designing, and process development in SiC toward ultrahigh-voltage (> 10 kV) bipolar devices are investigated. 100~200 um-thick 4H-SiC epilayers with a low background doping concentration in the low 10^{13} cm^{-3} can be grown at a growth rate greater than 50 um/h. Impacts of extended defects on carrier recombination are clarified in photoluminescence mapping measurements. Generation and reduction of Z_{1/2} center, the dominant lifetime killer, are summarized. After Z_{1/2} elimination by thermal oxidation at 1400^{o}C, the carrier lifetime can be enhanced to 25 us or even longer. By utilizing space-modulated junction termination extension, a 21.7 kV PiN diode is demonstrated. Through unique process development, the current gain in bipolar junction transistors is increased to 250~330.
Aspects on SIC Switches for Soft-Switching Converters in an Industrial Application
Authors: Ranstad Per , Linner Jörgen
Published: March 2013

The paper presents an anlysis of the impact of power module parasitic inductances on the operation of a specific high frequency power converter for an industrial application which uses SIC Power switches. It is shown that in the analysed circuit the parasitic inductances limit the operational frequency.
Silicon Carbide Bulk Crystal Growth Modeling from Atomic Scale to Reactor Scale
Authors: Nishizawa Shin-ichi
Published: March 2013

The state of the art of silicon carbide crystal growth modeling is explained from the two aspects. One is the technical problems of SiC bulk single crystal growth process by sublimation method. Numerical modeling can contribute on the reactor design and process condition optimization. Then the shape of SiC grown crystal (diameter and length) can be controlled by modifying the growth crucible design. Second one is the theoretical problem of SiC polytype control. By calculating the bulk crystal energy of each polytype, and surface energy of each possible surface during growth, it is pointed out that growin surface energy has effects on the polytype stability of SiC crystals
Hydrophobic Growth of GaN Material: Current Status and Future Potential
Authors: Mann James Matthew , Wang Buguo , Bliss David
Published: March 2013

Due in part to the high breakdown voltage, gallium nitride is among a select few semiconductors investigated for next generation high power electronic devices. However, GaN based devices are currently performing far below their theoretical potential. Manufacturers of GaN HEMTs and FETs must de-rate the voltage of the device to maintain a high reliability. Conventional epitaxial growth of GaN thin films by HVPE, MOCVD, and MBE have been performed on nonnative substrates of Si, SiC, or sapphire, which results in defect formation and ultimately lowers operating voltages. To reduce the defects, several growth techniques have been utilized by researchers to produce bulk GaN single crystals. However, the fabrication of bulk GaN crystals of substantial size and suitable quality has proved quite difficult. This paper will review the current state of the art for the Ammonothermal, Flux growth, and HVPE techniques currently being pursued to produce bulk GaN.
Comparison of Si, Sapphire, SiC, and GaN Substrates for HEMT Epitaxy
Authors: Leszczynski Mike , Prystawko Pawel , Plesiewicz Jerzy , Dmowski Leslaw , Litwin-Staszewska Elzbieta , Grzanka Szymon , Grzanka Ewa , Roccaforte Fabrizio
Published: March 2013

The first part of the paper shows the advantages and disadvantages of using GaN and SiC substrates with an off-cut up to 2 degrees. The following experimental observations were made: i) higher efficiency in p-doping with magnesium, ii) higher critical conditions for AlGaN cracking, iii) trigonal deformation of AlGaN and InGaN unit cells. A successful growth of AlGaN/GaN HEMT epi structure on 2 degree-off SiC substrates will be shown, what paves the way to a monolithic integration of GaN-based and SiC based devices on a common SiC substrate. In the second part of the paper, we show the experimental results on AlGaN/GaN degradation upon prolonged annealing at 600oC. In the case of epi structures on Si and sapphire, the parasitic parallel conductivity appeared, whereas in the case of SiC substrates, annealing introduced no distinct changes.
Recent Advances in Wide Bandgap Power Switching Devices
Authors: Sheng Kuang , Guo Qing
Published: March 2013

The development of high voltage, high current density and high temperature power devices are playing a critical role in the advance of power conversion technology for energy saving and emission reduction applications. As hopeful replacements for current silicon-based devices, wide bandgap power semiconductor devices have been under intense research and development. This paper reviews the recent advances in SiC and GaN-based power switching devices for power electronics applications.
Advanced Driver and Control IC Requirements for GaN and SiC Power Devices
Authors: Pendharkar Sameer P , Chey Chris
Published: March 2013

This paper talks about the differences in wide band gap semiconductor power devices (III-N and SiC) as compared to more conventional Si switching devices and how these differences drive the need for different gate control and driver features. III-Nitride materials like GaN have the potential to switch large amounts of power at much higher speeds than what Si is capable of. To take advantage of this, gate drive circuits with high noise immunity, low propagation delay and high dV/dt capability are required. On the other hand, higher band gap and higher thermal conductivity of SiC allows for higher amounts of power conversion at much higher temperatures (up to 250C and beyond) as well as at higher speeds. This requires gate drive IC technology that is capable of operating at much higher temperatures and withstand higher level of noise than what is needed for Silicon power devices.
Device Breakdown and Dynamic effects in GaN Power Switching Devices: Dependencies on Material Properties and Device Design
Authors: Würfl Joachim , Bahat-Treidel Eldad , Brunner Frank , Cho Melani , Hilt Oliver , Knauer Arne , Kotara Przemyslaw , Krueger Olaf , Weyers Markus , Zhytnytska Rimma
Published: March 2013

High voltage GaN based transistors already showed promising de-vice properties which makes them very attractive for future highly efficient power switching application. To further optimize device switching performance at high bias voltages the dependency of de-vice breakdown and dynamic effects on device layer epitaxy and processing has to be analyzed. This paper discusses the dependen-cies of breakdown events, predominantly vertical breakdown be-tween the device on the chip front side and the conductive n-type SiC or Si substrate on various technological parameters. They comprise high voltage buffer design and material quality, SiC sub-strate conductivity as well as metal contact technology of GaN HEMT devices. Furthermore a correlation between many of those parameters and dynamic switching properties has been determined. Physical mechanisms are then proposed to explain the basic inter-dependencies.
Band Diagrams and Trap Distributions in Metal-SiO2-SiC(3C) Structures with Different Metal Gates
Authors: Przewlocki Henryk Maria , Gutt Tomasz , Piskorski Krzysztof , Bakowski Mietek
Published: March 2013

Cubic silicon carbide (3C-SiC) is a particularly promising material for high and medium power MOS transistors, because it offers higher inversion channel mobility than other SiC polytypes. Optimizing the field effect devices made of 3C-SiC and choosing the appropriate materials to be incorporated in the device requires knowledge of the investigated structure band diagram. Hence, the first part of this work is devoted to determination of band diagrams of various MOS structures on 3C-SiC substrates. Since trap densities and distributions are still important for field effect devices on 3C-SiC substrates, the second part of this work is devoted to this problem.