bluuebunny/crossref_metadata_2025 huggingface dataset:
Opioid Use among Same‐Day Surgery Patients: Prevalence, Management and Outcomes
Authors: Wilson Jennifer LC , Poulin Patricia A , Sikorski Robert , Nathan Howard J , Taljaard Monica , Smyth Catherine
Published: March 2016

OBJECTIVES: To determine whether the prevalence of opioid use among patients requiring elective same‐day admission (SDA) surgery is greater than the 2.5% prevalence found in the general population. Secondary objectives were to assess compliance with expert recommendations on acute pain management in opioid‐tolerant patients and to examine clinical outcomes.

METHODS: A retrospective review of 812 systematically sampled adult SDA surgical cases between April 1, 2008 and March 31, 2009 was conducted.

RESULTS: Among 798 eligible patients, 148 (18.5% [95% CI 15.9% to 21.2%]) were prescribed opioids, with 4.4% prescribed long‐acting opioids (95% CI 3.0% to 5.8%). Use of opioids was most prevalent among orthopedic and neurosurgery patients. Among the 35 patients on long‐acting opioids who had a high likelihood of being tolerant, anesthesiologists correctly identified 33, but only 13 (37%) took their usual opioid preoperatively while 22 (63%) had opioids continued postoperatively. Acetaminophen, nonsteroidal anti‐inflammatory drugs and pregabalin were ordered preoperatively in 18 (51%), 15 (43%) and 18 (51%) cases, respectively, while ketamine was used in 15 (43%) patients intraoperatively. Acetaminophen, nonsteroidal anti‐inflammatory drugs and pregabalin were ordered postoperatively in 31 (89%), 15 (43%) and 17 (49%) of the cases, respectively. No differences in length of stay, readmissions and emergency room visits were found between opioid‐tolerant and opioid‐naïve patients.

CONCLUSION: Opioid use is more common in SDA surgical patients than in the general population and is most prevalent within orthopedic and neurosurgery patients. Uptake of expert opinion on the management of acute pain in the opioid tolerant patient population is lacking.
Randomized Controlled Trial Comparing Outcomes of Video Capsule Endoscopy with Push Enteroscopy in Obscure Gastrointestinal Bleeding
Authors: Segarajasingam Dev S , Hanley Stephen C , Barkun Alan N , Waschke Kevin A , Burtin Pascal , Parent Josée , Mayrand Serge , Fallone Carlo A , Jobin Gilles , Seidman Ernest G , Martel Myriam
Published: March 2016

BACKGROUND: Optimal management of obscure gastrointestinal bleeding (OGIB) remains unclear.

OBJECTIVE: To evaluate diagnostic yields and downstream clinical outcomes comparing video capsule endoscopy (VCE) with push enteroscopy (PE).

METHODS: Patients with OGIB and negative esophagogastroduodenoscopies and colonoscopies were randomly assigned to VCE or PE and followed for 12 months. End points included diagnostic yield, acute or chronic bleeding, health resource utilization and crossovers.

RESULTS: Data from 79 patients were analyzed (VCE n=40; PE n=39; 82.3% overt OGIB). VCE had greater diagnostic yield (72.5% versus 48.7%; P<0.05), especially in the distal small bowel (58% versus 13%; P<0.01). More VCE-identified lesions were rated possible or certain causes of bleeding (79.3% versus 35.0%; P<0.05). During follow-up, there were no differences in the rates of ongoing bleeding (acute [40.0% versus 38.5%; P not significant], chronic [32.5% versus 45.6%; P not significant]), nor in health resource utilization. Fewer VCE-first patients crossed over due to ongoing bleeding (22.5% versus 48.7%; P<0.05).

CONCLUSIONS: A VCE-first approach had a significant diagnostic advantage over PE-first in patients with OGIB, especially with regard to detecting small bowel lesions, affecting clinical certainty and subsequent further small bowel investigations, with no subsequent differences in bleeding or resource utilization outcomes in follow-up. These findings question the clinical relevance of many of the discovered endoscopic lesions or the ability to treat most of these effectively over time. Improved prognostication of both patient characteristics and endoscopic lesion appearance with regard to bleeding behaviour, coupled with the impact of therapeutic deep enteroscopy, is now required using adapted, high-quality study methodologies.
Supporting Chronic Pain Management across Provincial and Territorial Health Systems in Canada: Findings from Two Stakeholder Dialogues
Authors: Wilson Michael G , Lavis John N , Ellen Moriah E
Published: March 2016

BACKGROUND: Chronic pain is a serious health problem given its prevalence, associated disability, impact on quality of life and the costs associated with the extensive use of health care services by individuals living with it.

OBJECTIVE: To summarize the research evidence and elicit health system policymakers’, stakeholders’ and researchers’ tacit knowledge and views about improving chronic pain management in Canada and engaging provincial and territorial health system decision makers in supporting comprehensive chronic pain management in Canada.

METHODS: For these two topics, the global and local research evidence regarding each of the two problems were synthesized in evidence briefs. Three options were generated for addressing each problem, and implementation considerations were assessed. A stakeholder dialogue regarding each topic was convened (with 29 participants in total) and the deliberations were synthesized.

RESULTS: To inform the first stakeholder dialogue, the authors found that systematic reviews supported the use of evidence‐based tools for strengthening chronic pain management, including patient education, self‐management supports, interventions to implement guidelines and multidisciplinary approaches to pain management. While research evidence about patient registries/treatment‐monitoring systems is limited, many dialogue participants argued that a registry/system is needed. Many saw a registry as a precondition for moving forward with other options, including creating a national network of chronic pain centres with a coordinating ‘hub’ to provide chronic pain‐related decision support and a cross‐payer, cross‐discipline model of patient‐centred primary health care‐based chronic pain management. For the second dialogue, systematic reviews indicated that traditional media can be used to positively influence individual health‐related behaviours, and that multistakeholder partnerships can contribute to increasing attention devoted to issues on policy agendas. Dialogue participants emphasized the need to mobilize behind an effort to build a national network that would bring together existing organizations and committed individuals.

CONCLUSIONS: Developing a national network and, thereafter, a national pain strategy are important initiatives that garnered broad‐based support during the dialogues. Efforts toward achieving this goal have been made since convening the dialogues.
Avian Influenza a (H5N1) Infection with Respiratory Failure and Meningoencephalitis in a Canadian Traveller
Authors: Rajabali Naheed , Lim Thomas , Sokolowski Colleen , Prevost Jason D , Lee Edward Z
Published: March 2016

In an urban centre in Alberta, an otherwise healthy 28‐year‐old woman presented to hospital with pleuritic chest and abdominal pain after returning from Beijing, China. After several days, this was followed by headache, confusion and, ultimately, respiratory failure, coma and death. Microbiology yielded influenza A subtype H5N1 from various body sites and neuroimaging was consistent with meningoencephalitis. While H5N1 infections in humans have been reported in Asia since 1997, this is the first documented case of H5N1 influenza in the Western Hemisphere. The present case demonstrated the typical manifestation of H5N1 influenza but, for the first time, also confirmed previous suggestions from human and animal studies that H5N1 is neurotropic and can manifest with neurological symptoms and meningoencephalitis.
The Role of Pediatricians as Key Stakeholders in Influencing Immunization Policy Decisions for the Introduction of Meningitis B Vaccine in Canada: The Ontario Perspective
Authors: Yamashiro Hirotaka , Cutcliffe Nora , Dobson Simon , Fisman David , Gold Ronald
Published: March 2016

As key stakeholders in immunization policy decisions, the Pediatricians of Ontario held an accredited conference on January 18, 2014, to discuss prevention of invasive meningococcal disease. Five key recommendations were put forth regarding immunization strategies to protect children from meningococcal serogroup B disease. The recently approved four‐component meningococcal B (4CMenB) vaccine should be recommended and funded as part of Ontario’s routine immunization schedule and should also be mandated for school attendance. Public funding for 4CMenB immunization is justified based on current MenB epidemiology, vaccine coverage, cost effectiveness and acceptability, as well as legal, political and ethical considerations related to 4CMenB immunization, particularly because routine recommendations and funding are currently in place for vaccination against meningococcal serogroups that cause significantly less disease in Canada than MenB. Broadly, the goals are to assist individual practitioners in advocating the benefits of 4CMenB vaccination to parents, and to counterbalance recommendations from the National Advisory Committee on Immunization and the Canadian Paediatric Society.
Past, Present and Future of Respiratory Research: A Survey of Canadian Health Care Professionals
Authors: Nonoyama Mika Laura , Mathur Sunita , Herbert Rosemary , Jenkins Heather , Lobchuk Michelle , McEvoy Michelle
Published: March 2016

BACKGROUND: The Canadian Respiratory Health Professionals (CRHP) is the multidisciplinary health care professional group of the Canadian Lung Association. Although the CRHP has a growing number of highly qualified researchers, the landscape of their research in Canada has not been described.

OBJECTIVES: To describe the level of respiratory research engagement; identify barriers and facilitators to research engagement; describe the experience and interest in developing research skills; and identify priority areas of future respiratory research among health care professionals.

METHODS: An online survey of CRHP members was used to collect demographic information; barriers and facilitators to conducting research; future directions in respiratory research; and research funding and mentorship. Experience with and interest in ‘upskilling’ research skills were also evaluated.

RESULTS: A total of 119 surveys were completed (22% response rate), of which 69 (58%) respondents were engaged in respiratory research. Reasons for not being involved in respiratory research were lack of mentorship, support and funding. The top research areas were chronic obstructive pulmonary disease (74%) and asthma (41%). The top facilitators for research engagement were amount of funding (29%) and mentorship (28%). Respondents in research positions rated their experience in research skills as high; those in nonresearch positions as low. However, both groups expressed interest in improving their research skills.

CONCLUSIONS: Areas of development, such as research skills, greater funding opportunities and mentorship to increase the research capacity of health care professionals in respiratory health were identified. Health professional researchers have an important role in the national respiratory research strategy to increase interdisciplinary engagement and build collaborative teams.
Multiple Interventions Improve Analgesic Treatment of Supracondylar Fractures in a Pediatric Emergency Department
Authors: Porter Robert N , Chafe Roger E , Newhook Leigh A , Murnaghan Kyle D
Published: March 2016

BACKGROUND: Provision of appropriate and timely treatment for pain in the pediatric population has been challenging. Children with painful conditions commonly present to emergency departments (EDs), a setting in which it may be particularly difficult to consistently provide timely analgesic interventions.

OBJECTIVES: To measure the effectiveness of a set of interventions in improving the rate and timeliness of analgesic medication administration, as well as appropriate backslab immobilization (application of a moldable plaster or fiberglass splint), in a pediatric ED.

METHODS: Data regarding pain management were collected on a consecutive sample of cases of supracondylar fracture over a 13‐month period. This followed the implementation of a formal triage pain assessment and treatment medical directive, supplemented with relevant education of nursing and house staff, and posters in the ED. These data were compared with data previously collected from a similar cohort of cases, which presented before the interventions.

RESULTS: Postintervention, the proportion of patients treated with an analgesic within 60 min of triage increased from 15% to 54% (P<0.001), and the median time to administration of an analgesic decreased from 72.5 min to 11 min (P<0.001). Rates for backslab application before radiography were similar before and after the intervention (29% and 33%, respectively; P=0.646).

CONCLUSIONS: A multifaceted approach to improving early analgesic interventions was associated with considerably improved rates of early analgesic treatments for supracondylar fracture; however, no improvement in early immobilization was observed.
The Use of the Bispectral Index in the Detection of Pain in Mechanically Ventilated Adults in the Intensive Care Unit: A Review of the Literature
Authors: Coleman Robin Marie , Tousignant-Laflamme Yannick , Ouellet Paul , Parenteau-Goudreault Élizabeth , Cogan Jennifer , Bourgault Patricia
Published: March 2016

BACKGROUND: Pain assessment is an immense challenge for clinicians, especially in the context of the intensive care unit, where the patient is often unable to communicate verbally. Several methods of pain assessment have been proposed to assess pain in this environment. These include both behavioural observation scales and evaluation of physiological measurements such as heart rate and blood pressure. Although numerous validation studies pertaining to behavioural observation scales have been published, several limitations associated with using these measures for pain assessment remain. Over the past few years, researchers have been interested in the use of the bispectral index monitoring system as a proxy for the evaluation of encephalography readings to assess the level of anesthesia and, potentially, analgesia.

OBJECTIVES: To synthesize the main studies exploring the use of the bispectral index monitoring system for pain assessment, to guide future research in adults under sedation in the intensive care unit.

METHOD: The EMBASE, Medline, CINAHL and PsycINFO databases were searched for studies published between 1996 and 2013 that evaluated the use of the bispectral index in assessing pain.

RESULTS: Most studies conclude that nociceptive stimulation causes a significant increase in the bispectral index and revealed the importance of controlling certain confounding variables such as the level of sedation.

DISCUSSION: Further studies are needed to clearly demonstrate the relationship between nociceptive stimuli and the bispectral index, as well as the specificity of the bispectral index in detecting pain.
Canadian Public Health Laboratory Network laboratory Guidelines for the Use of Serological Tests (excluding point‐of‐care tests) for the Diagnosis of Syphilis in Canada
Authors: Levett Paul N , Fonseca Kevin , Tsang Raymond SW , Kadkhoda Kamran , Serhir Bouchra , Radons Sandra M , Morshed Muhammad
Published: March 2016

Syphilis, caused by the bacterium Treponema pallidum subsp. pallidum, is an infection recognized since antiquity. It was first reported at the end of the 15th century in Europe. Infections may be sexually transmitted as well as spread from an infected mother to her fetus or through blood transfusions. The laboratory diagnosis of syphilis infection is complex. Because this organism cannot be cultured, serology is used as the principal diagnostic method. Some of the issues related to serological diagnoses are that antibodies take time to appear after infection, and serology screening tests require several secondary confirmatory tests that can produce complex results needing interpretation by experts in the field. Traditionally, syphilis screening was performed using either rapid plasma reagin or Venereal Disease Research Laboratory tests, and confirmed by treponemal tests such as MHA‐TP, TPPA or FTA‐Abs. Currently, that trend is reversed, ie, most of the laboratories in Canada now screen for syphilis using treponemal enzyme immunoassays and confirm the status of infection using rapid plasma reagin or Venereal Disease Research Laboratory tests; this approach is often referred to as the reverse algorithm. This chapter reviews guidelines for specimen types and sample collection, treponemal and non‐treponemal tests utilized in Canada, the current status of serological tests for syphilis in Canada, the complexity of serological diagnosis of syphilis infection and serological testing algorithms. Both traditional and reverse sequence algorithms are recommended and the algorithm used should be based on a combination of local disease epidemiology, test volumes, performance of the proposed assays and available resources.
Qualitative Assessment of Challenges in Tuberculosis Control in West Gojjam Zone, Northwest Ethiopia: Health Workers’ and Tuberculosis Control Program Coordinators’ Perspectives
Authors: Gebreegziabher Senedu B. , Yimer Solomon A. , Bjune Gunnar A.
Published: March 2016

Background.Weak health systems pose many barriers to effective tuberculosis (TB) control. This study aimed at exploring health worker’s and TB control program coordinator’s perspectives on health systems challenges facing TB control in West Gojjam Zone, Amhara Region, Ethiopia.Methods.This was a qualitative descriptive study. Eight in-depth interviews with TB control program coordinators and two focus group discussions among 16 health workers were conducted. Purposive sampling was used to recruit study participants. Thematic analysis was used to identify and analyse main themes.Results.We found that intermittent interruptions of laboratory reagents and anti-TB drugs supplies, absence of trained and motivated health workers, poor TB data documentation, lack of adherence to TB treatment guideline, and lack of access to TB diagnostic tools at peripheral health institutions were challenges facing the TB control program performance in the study zone.Conclusions.Ensuring uninterrupted supply of anti-TB drugs and laboratory reagents to all health institutions is essential. Continuous refresher training of health workers on standard TB care and data handling and developing and implementing a sound retention strategy to attract and motivate health professionals to work in rural areas are necessary interventions to improve the TB control program performance in the study zone.
Hiatus Hernia: A Rare Cause of Acute Pancreatitis
Authors: Patel Shruti , Shahzad Ghulamullah , Jawairia Mahreema , Subramani Krishnaiyer , Viswanathan Prakash , Mustacchia Paul
Published: March 2016

Hiatal hernia (HH) is the herniation of elements of the abdominal cavity through the esophageal hiatus of the diaphragm. A giant HH with pancreatic prolapse is very rare and its causing pancreatitis is an even more extraordinary condition. We describe a case of a 65-year-old man diagnosed with acute pancreatitis secondary to pancreatic herniation. In these cases, acute pancreatitis may be caused by the diaphragmatic crura impinging upon the pancreas and leading to repetitive trauma as it crosses the hernia; intermittent folding of the main pancreatic duct; ischemia associated with stretching at its vascular pedicle; or total pancreatic incarceration. Asymptomatic hernia may not require any treatment, while multiple studies have supported the recommendation of early elective repair as a safer route in symptomatic patients. In summary, though rare, pancreatic herniation should be considered as a cause of acute pancreatitis. A high index of suspicion for complications is warranted in cases like these.
Unsaturated Seepage Analysis of Cracked Soil including Development Process of Cracks
Authors: Cao Ling , Wang Zhijian , Chen Yong
Published: March 2016

Cracks in soil provide preferential pathways for water flow and their morphological parameters significantly affect the hydraulic conductivity of the soil. To study the hydraulic properties of cracks, the dynamic development of cracks in the expansive soil during drying and wetting has been measured in the laboratory. The test results enable the development of the relationships between the cracks morphological parameters and the water content. In this study, the fractal model has been used to predict the soil-water characteristic curve (SWCC) of the cracked soil, including the developmental process of the cracks. The cracked expansive soil has been considered as a crack-pore medium. A dual media flow model has been developed to simulate the seepage characteristics of the cracked expansive soil. The variations in pore water pressure at different part of the model are quite different due to the impact of the cracks. This study proves that seepage characteristics can be better predicted if the impact of cracks is taken into account.
Properties of Self-Compacting Concrete with Recycled Coarse Aggregate
Authors: Tang W. C. , Ryan P. C. , Cui H. Z. , Liao W.
Published: March 2016

The utilisation of recycled concrete aggregate (RCA) in Self-Compacting Concrete (SCC) has the potential to reduce both the environmental impact and financial cost associated with this increasingly popular concrete type. However, to date limited research exists exploring the use of coarse RCA in SCC. The work presented in this paper seeks to build on the existing knowledge in this area by examining the workability, strength, and fracture properties of SCCs containing 0%, 25%, 50%, 75%, and 100% coarse RCA. The experimental programme indicated that at RCA utilisation levels of 25% to 50% little or no negative impact was observed for strength, workability, or fracture properties, with the exception of a slight reduction in Young’s modulus.
FCM Clustering Algorithms for Segmentation of Brain MR Images
Authors: Dubey Yogita K. , Mushrif Milind M.
Published: March 2016

The study of brain disorders requires accurate tissue segmentation of magnetic resonance (MR) brain images which is very important for detecting tumors, edema, and necrotic tissues. Segmentation of brain images, especially into three main tissue types: Cerebrospinal Fluid (CSF), Gray Matter (GM), and White Matter (WM), has important role in computer aided neurosurgery and diagnosis. Brain images mostly contain noise, intensity inhomogeneity, and weak boundaries. Therefore, accurate segmentation of brain images is still a challenging area of research. This paper presents a review of fuzzyc-means (FCM) clustering algorithms for the segmentation of brain MR images. The review covers the detailed analysis of FCM based algorithms with intensity inhomogeneity correction and noise robustness. Different methods for the modification of standard fuzzy objective function with updating of membership and cluster centroid are also discussed.
Effect of Magnetic Field on Mixed Convection Heat Transfer in a Lid-Driven Square Cavity
Authors: Bakar N. A. , Karimipour A. , Roslan R.
Published: March 2016

The effect of magnetic field on fluid flow and heat transfer in two-dimensional square cavity is analyzed numerically. The vertical walls are insulated; the top wall is maintained at cold temperature, Tc while the bottom wall is maintained at hot temperature, Th where Th>Tc. The dimensionless governing equations are solved using finite volume method and SIMPLE algorithm. The streamlines and isotherm plots and the variation of Nusselt numbers on hot and cold walls are presented.
Mast Cell-Derived Exosomes Promote Th2 Cell Differentiation via OX40L-OX40 Ligation
Authors: Li Fei , Wang Yuping , Lin Lihui , Wang Juan , Xiao Hui , Li Jia , Peng Xia , Dai Huirong , Li Li
Published: March 2016

Exosomes are nanovesicles released by different cell types, such as dendritic cells (DCs), mast cells (MCs), and tumor cells. Exosomes of different origin play a role in antigen presentation and modulation of immune response to infectious disease. In this study, we demonstrate that mast cells and CD4+T cells colocated in peritoneal lymph nodes from BALB/c mouse. Further, bone marrow-derived mast cells (BMMCs) constitutively release exosomes, which express CD63 and OX40L. BMMC-exosomes partially promoted the proliferation of CD4+T cells. BMMC-exosomes significantly enhanced the differentiation of naive CD4+T cells to Th2 cells in a surface contact method, and this ability was partly inhibited by the addition of anti-OX40L Ab. In conclusion, BMMC-exosomes promoted the proliferation and differentiation of Th2 cells via ligation of OX40L and OX40 between exosomes and T cells. This method represents a novel mechanism, in addition to direct cell surface contacts, soluble mediators, and synapses, to regulate T cell actions by BMMC-exosomes.
Physical Training Status Determines Oxidative Stress and Redox Changes in Response to an Acute Aerobic Exercise
Authors: Seifi-skishahr Farnaz , Damirchi Arsalan , Farjaminezhad Manoochehr , Babaei Parvin
Published: March 2016

Objective. To assess the influence of different physical training status on exercise-induced oxidative stress and changes in cellular redox state.Methods. Thirty male subjects participated in this study and were assigned as well-trained (WT), moderately trained (MT), and untrained (UT) groups. The levels of cortisol, creatine kinase, plasma reduced glutathione to oxidized glutathione (GSH/GSSG), cysteine/cystine (Cys/CySS), and GSH/GSSG ratio in red blood cells (RBCs) were measured immediately and 10 and 30 min after exercise.Results. Following the exercise, plasma GSH/GSSG (p=0.001) and Cys/CySS (p=0.005) were significantly reduced in all groups. Reduction in plasma GSH/GSSG ratio in all groups induced a transient shift in redox balance towards a more oxidizing environment without difference between groups (p=0.860), while RBCs GSH/GSSG showed significant reduction (p=0.003) and elevation (p=0.007) in UT and MT groups, respectively. The highest level of RBCs GSH/GSSG ratio was recorded in MT group, and the lowest one was recorded in the WT group.Conclusion. Long term regular exercise training with moderate intensity shifts redox balance towards more reducing environment, versus intensive exercise training leads to more oxidizing environment and consequently development of related diseases.
Specifics and Challenges to Flexible Organic Light-Emitting Devices
Authors: Aleksandrova Mariya
Published: March 2016

Several recent developments in material science and deposition methods for flexible organic light-emitting devices (OLEDs) are surveyed. The commonly used plastic substrates are compared, according to their mechanical, optical, thermal, and chemical properties. Multilayer electrode structures, used as transparent electrodes, replacing conventional indium tin oxide (ITO) are presented and data about their conductivity, transparency, and bending ability are provided. Attention is paid to some of the most popular industrial processes for flexible OLEDs manufacturing, such as roll-to-roll printing, inkjet printing, and screen printing. Main specifics and challenges, related to the foils reliability, mechanical stability of the transparent electrodes, and deposition and patterning of organic emissive films, are discussed.
Preparation of Ag/HBP/PAN Nanofiber Web and Its Antimicrobial and Filtration Property
Authors: Yao Li-Rong , Song Xiao-Mo , Zhang Guang-Yu , Xu Shan-Qing , Jiang Ye-Qun , Cheng De-Hong , Lu Yan-Hua
Published: March 2016

To widen the application of nanofibers web in the field of medical health materials, a new Ag/amino-terminated hyperbranched polymer (HBP)/polyacrylonitrile (PAN) nanofiber web with excellent antimicrobial activity and filtration property was produced with Ag/HBP dispersion solution and PAN nanofiber. Ag/HBP dispersion solution was prepared with HBP as reducer and stabilizer, and Ag/HBP/PAN nanofiber was prepared by modifying electrospun PAN nanofiber with Ag/HBP aqueous solution. The characterization results showed that spherical Ag nanoparticles were prepared and they had a narrow distribution in HBP aqueous solution. The results of Ag/HBP/PAN nanofiber characterized with SEM and EDS showed that the content of silver nanoparticles on the surface of PAN nanofiber was on the increase when the treating temperature rose. The bacterial reduction rates of HBP-treated PAN nanofiber againstS. aureusandE. coliwere about 89%, while those of the Ag/HBP/PAN nanofiber againstS. aureusandE. coliwere 99.9% and 99.96%, respectively, due to the cooperative effects from the amino groups in HBP and Ag nanoparticles. Moreover, the small pores and high porosity in Ag/HBP/PAN nanofiber web resulted in high filtration efficiency (99.9%) for removing smaller particles (0.1 μm~0.7 μm), which was much higher than that of the gauze mask.
Children and Adolescent Obesity Associates with Pressure-Dependent and Age-Related Increase in Carotid and Femoral Arteries’ Stiffness and Not in Brachial Artery, Indicative of Nonintrinsic Arterial Wall Alteration
Authors: García-Espinosa Victoria , Curcio Santiago , Castro Juan Manuel , Arana Maite , Giachetto Gustavo , Chiesa Pedro , Zócalo Yanina , Bia Daniel
Published: March 2016

Aim. To analyze if childhood obesity associates with changes in elastic, transitional, and/or muscular arteries’ stiffness.Methods. 221 subjects (4–15 years, 92 females) were assigned to normal weight (NW,n=137) or obesity (OB,n=84) groups, considering their body mass indexz-score. Age groups were defined: 4–8; 8–12; 12–15 years old. Carotid, femoral, and brachial artery local stiffness was determined through systodiastolic pressure-diameter and stress-strain relationships. To this end, arterial diameter and peripheral and aortic blood pressure (BP) levels and waveforms were recorded. Carotid-femoral, femoropedal, and carotid-radial pulse wave velocities were determined to evaluate aortic, lower-limb, and upper-limb regional arterial stiffness, respectively. Correlation analysis between stiffness parameters and BP was done.Results. Compared to NW, OB subjects showed higher peripheral and central BP and carotid and femoral stiffness, reaching statistical significance in subjects aged 12 and older. Arterial stiffness differences disappeared when levels were normalized for BP. There were no differences in intrinsic arterial wall stiffness (elastic modulus), BP stiffness relationships, and regional stiffness parameters.Conclusion. OB associates with BP-dependent and age-related increase in carotid and femoral (but not brachial) stiffness. Stiffness changes would not be explained by intrinsic arterial wall alterations but could be associated with the higher BP levels observed in obese children.
An Evolutionary Algorithm of the Regional Collaborative Innovation Based on Complex Network
Authors: Wang Kun , Sun Duoyong
Published: March 2016

This paper proposed a new perspective to study the evolution of regional collaborative innovation based on complex network theory. The two main conceptions of evolution, “graph with dynamic features” and “network evolution,” have been provided in advance. Afterwards, we illustrate the overall architecture and capability model of the regional collaborative innovation system, which contains several elements and participants. Therefore, we can definitely assume that the regional collaborative innovation system could be regarded as a complex network model. In the proposed evolutionary algorithm, we consider that each node in the network could only connect to less than a certain amount of neighbors, and the extreme value is determined by its importance. Through the derivation, we have created a probability density function as the most important constraint and supporting condition of our simulation experiments. Then, a case study was performed to explore the network topology and validate the effectiveness of our algorithm. All the raw datasets were obtained from the official website of the National Bureau of Statistic of China and some other open sources. Finally, some meaningful recommendations were presented to policy makers, especially based on the experimental results and some common conclusions of complex networks.
Treatment of a Femur Nonunion with Microsurgical Corticoperiosteal Pedicled Flap from the Medial Femoral Condyle
Authors: Guzzini Matteo , Calderaro Cosma , Guidi Marco , Civitenga Carolina , Ferri Germano , Ferretti Andrea
Published: March 2016

Introduction. The vascularized corticoperiosteal flap is harvested from the medial femoral condyle and it is nourished by the articular branch of the descending genicular artery and the superomedial genicular artery. This flap is usually harvested as a free flap for the reconstruction of bone defects at forearm, distal radius, carpus, hand, and recently at lower limb too.Case Report. A 50-year-old Caucasian man referred to our department for hypertrophic nonunion of the distal femur, refractory to the conservative treatments. The first surgical choice was the revision of the nail and the bone reconstruction with a corticoperiosteal pedicled flap from the medial femoral condyle. We considered union to have occurred 3.5 months after surgery when radiographs showed bridging of at least three of the four bony cortices and clinically the patient was able to walk with full weight bearing without any pain. At the last follow-up (25 months), the patient was completely satisfied with the procedure.Discussion. The corticoperiosteal flap allows a faster healing of fractures with a minimal morbidity at the donor site. We suggest that the corticoperiosteal pedicled flap graft is a reliable and effective treatment for distal femur nonunion.
Evaluation of Antiviral Therapy Performed after Curative Therapy in Patients with HBV-Related Hepatocellular Carcinoma: An Updated Meta-Analysis
Authors: Yuan Peng , Chen Peng , Qian Yeben
Published: March 2016

Background.The long-term prognosis after curative therapy for hepatitis B virus- (HBV-) related hepatocellular carcinoma (HCC) remains unsatisfactory due to the high incidence of recurrence. The effect of treatment with nucleotide analogues (NAs) in patients with HBV-related HCC after curative therapy remains unclear.Objective.To assess the impact of using NAs after curative therapy.Method.A computerized literature search was performed; eligible studies were identified from databases. The pooled risk ratios (RRs) and 95% CIs were calculated using Review Manager 5.3.Result.The meta-analysis included a total of 15 studies with 8060 patients. The one-year and three-year recurrence (one-year recurrence: RR 0.41 [95% CI 0.28 to 0.61];P<0.00001; three-year recurrence: RR 0.63 [95% CI 0.43 to 0.94];P=0.001) and the one-, three-, and five-year overall survival (OS) and disease-free survival (DFS) were significantly better in the treatment group.Conclusion.NAs can reduce the recurrence and improve the prognosis of HBV-related HCC after curative therapy.
Fast Analytic Sampling Approximation from Cauchy Kernel
Authors: Li Youfa , Shang Jing , Yang Honglei , Zhang Gengrong , Yang Shouzhi
Published: March 2016

The paper aims at establishing a fast numerical algorithm forBk(f), wherefis any function in the Hardy spaceH2(Td)andkis the scale level. Here,Bk(f)is an approximation tofwe recently constructed by applying the multiscale transform to the Cauchy kernel. We establish the matrix expression ofBk(f)and find that it has the structure of a multilevel Hankel matrix. Based on the structure, a fast numerical algorithm is established to computeBk(f). The computational complexity is given. A numerical experiment is carried out to check the efficiency of our algorithm.
Risk for Gestational Diabetes Mellitus and Adverse Birth Outcomes in Chinese Women with Polycystic Ovary Syndrome
Authors: Xiao Qing , Cui Yong-Yi , Lu Jine , Zhang Guo-Zheng , Zeng Fang-Ling
Published: March 2016

Objective.To examine the association of polycystic ovary syndrome (PCOS) in early pregnancy with gestational diabetes mellitus (GDM) and adverse birth outcomes.Methods.In this retrospective cohort study including 2389 pregnant women, the medical records of 352 women diagnosed with PCOS were evaluated. Outcomes included GDM, preterm birth, low birth weight, macrosomia, and being small and large for gestational age. Multivariable logistic regression models were used to examine the association of the risk for GDM and adverse birth outcomes with PCOS after adjusting for confounders.Results.Women previously diagnosed with PCOS had a higher risk of GDM (adjusted odds ratio [OR] 1.55, 95% confidence interval [CI]: 1.14–2.09). A strong association was seen between PCOS and preterm birth (adjusted OR 1.69, 95% CI: 1.08–2.67). On stratified analysis, the adjusted OR for GDM among women with PCOS undergoing assisted reproductive technology was 1.44 (95% CI: 1.03–1.92) and among women with PCOS who conceived spontaneously was 1.60 (1.18–2.15). No increased risk for other adverse birth outcomes was observed.Conclusions.Women with PCOS were more likely to experience GDM and preterm birth.
Gas Chromatography/Atmospheric Pressure Chemical Ionization-Fourier Transform Ion Cyclotron Resonance Mass Spectrometry of Pyrolysis Oil from German Brown Coal
Authors: Zuber Jan , Kroll Marius M. , Rathsack Philipp , Otto Matthias
Published: March 2016

Pyrolysis oil from the slow pyrolysis of German brown coal from Schöningen, obtained at a temperature of 500°C, was separated and analyzed using hyphenation of gas chromatography with an atmospheric pressure chemical ionization source operated in negative ion mode and Fourier transform ion cyclotron resonance mass spectrometry (GC-APCI-FT-ICR-MS). Development of this ultrahigh-resolving analysis method is described, that is, optimization of specific GC and APCI parameters and performed data processing. The advantages of GC-APCI-FT-ICR-MS hyphenation, for example, soft ionization, ultrahigh-resolving detection, and most important isomer separation, were demonstrated for the sample liquid. For instance, it was possible to separate and identify nine different propylphenol, ethylmethylphenol, and trimethylphenol isomers. Furthermore, homologous series of different acids, for example, alkyl and alkylene carboxylic acids, were verified, as well as homologous series of alkyl phenols, alkyl dihydroxy benzenes, and alkoxy alkyl phenols.
Infections Caused byActinomyces neuii: A Case Series and Review of an Unusual Bacterium
Authors: Zelyas Nathan , Gee Susan , Nilsson Barb , Bennett Tracy , Rennie Robert
Published: March 2016

Background. Actinomyces neuiiis a Gram-positive bacillus rarely implicated in human infections. However, its occurrence is being increasingly recognized with the use of improved identification systems.Objective. To analyseA. neuiiinfections in Alberta, Canada, and review the literature regarding this unusual pathogen.Methods. Cases ofA. neuiiwere identified in 2013-2014 in Alberta. Samples were cultured aerobically and anaerobically. A predominant catalase positive Gram-positive coryneform bacillus with no branching was isolated in each case. Testing was initially done with API-CORYNE® (bioMérieux) and isolates were sent to the Provincial Laboratory for Public Health for further testing. Isolates’ identities were confirmed by matrix-assisted laser desorption ionization time-of-flight mass spectrometry microbial identification system (MALDI-TOF MS MIS; bioMérieux) and/or DNA sequencing.Results. Six cases ofA. neuiiinfection were identified. All patients had soft tissue infections; typically, incision and drainage were done followed by a course of antibiotics. Agents used included cephalexin, ertapenem, ciprofloxacin, and clindamycin. All had favourable outcomes.Conclusions. WhileA. neuiiis infrequently recognized, it can cause a diverse array of infections. Increased use of MALDI-TOF MS MIS is leading to increased detection; thus, understanding the pathogenicity of this bacterium and its typical susceptibility profile will aid clinical decision-making.
Development of a Doxycycline Hydrochloride-Loaded Electrospun Nanofibrous Membrane for GTR/GBR Applications
Authors: Jia Lie-ni , Zhang Xin , Xu Hong-yu , Hua Fei , Hu Xiang-gang , Xie Qiao , Wang Wei , Jia Jun
Published: March 2016

A drug-loaded membrane was prepared by electrospinning Polyε-caprolactone (PCL) with doxycycline hydrochloride (DOX) (15–25% w/w). Scanning electron microscopy (SEM) images revealed that fibrous average diameter decreased from247.16±57.61 nm to194.43±43.33 nm with the drug proportion increasing from 15% to 20% w/w, while there was no significant difference between 20% and 25% groups. The polymer matrix showed good encapsulation value (58–75%) for DOX, and the drug showed an amorphous manner in the polymer matrix. The agar diffusion test revealed that DOX-loaded membranes had an obvious inhibited effect onAggregatibacter actinomycetemcomitans(Aa) andPorphyromonas gingivalis(Pg), respectively. In vitro release test showed that DOX could persistently be released for a prolonged time more than 28 days, and the DOX level in the eluent steadied at 3–5 μg/mL which was all above the minimum inhibitory concentration (MIC) of DOX against Aa (0.125 μg/mL) and Pg (0.0625 μg/mL). Cytocompatibility, assessed in human periodontal ligament cells (hPLCs) by MTT-test and the morphology of cells on the surface of DOX-loaded membranes by SEM, indicated that all of the investigated nanofibrous membranes can be used to treat periodontal disease by integrating the GTR/GBR operation and antibiotic therapy. Above all, DOX-loaded nanofibrous membranes could have a persistent inhibited effect on periodontal pathogens to provide a relatively sterile environment for tissue repair and regeneration.
Hydrothermal Synthesis and Responsive Characteristics of Hierarchical Zinc Oxide Nanoflowers to Sulfur Dioxide
Authors: Zhou Qu , Xie Bo , Jin Lingfeng , Chen Weigen , Li Jian
Published: March 2016

Sulfur dioxide, SO2, is one of the most important decomposition byproducts of sulfur hexafluoride, SF6, under partial discharge in GIS apparatus. The sensing performances of semiconductor gas sensors can be improved by morphology tailoring. This paper reported the synthesis method, structural characterization, and SO2responsive characteristics of hierarchical flower-shaped ZnO nanostructures. Hierarchical ZnO nanoflowers were successfully prepared via a facile and simple hydrothermal method and characterized by X-ray powder diffraction, scanning electron microscopy, energy dispersive X-ray spectroscopy, and X-ray photoelectron spectroscopy, respectively. Planar chemical gas sensor was fabricated and its responsive characteristics towards SO2were systematically performed. The optimum operating temperature of the fabricated sensor was measured to be about 260°C, and the corresponding maximum responses were 16.72 and 26.14 to 30 and 60 ppm of SO2. Its saturated gas concentration was 2000 ppm with a response value of 67.41. Moreover, a quick response and recovery feature (7 s and 8 s versus 80 ppm of SO2) and good stability were also observed. All results indicate that the proposed sensor is a promising candidate for detecting SF6decomposition byproduct SO2.
The Temporal and Spatial Distribution of Hazy Days in Cities of Jiangsu Province China and an Analysis of Its Causes
Authors: Wei Jiansu , Zhu Weijun , Liu Duanyang , Han Xiao
Published: March 2016

Based on the surface meteorological data of Jiangsu Province during 1980–2012, the climatic characteristics and the trends of haze were analyzed. The results indicated that during 1980–2012 haze days increased; in particular, severe and moderate haze days significantly increased. In the northern and coastal cities of Jiangsu Province China, haze days showed a significant increase. Haze often appeared in fall and winter and rarely in summer in the study area. It also occurred more often inland, and less along the coast. Haze occurred more often in June due to straw burning in the harvest time. The haze day increased during the 1990s over southern and southwestern Jiangsu Province; in central and northern Jiangsu, haze day increased after 2000. The continuous, regional, and regional continuous haze days all showed increasing trends. As the urban area expanded each year, industrial emissions, coal consumption, and car ownership increased accordingly, resulting in regional temperature increase and relative humidity decrease, which formed the urban heat island and dry island effects. Hence, haze formation and maintenance conditions became more favorable for more haze days, which led to the increase of haze days, and the significant increases of continuous, regional, and regional continuous haze days.
Assessing the Role of Climate Change in Malaria Transmission in Africa
Authors: Ngarakana-Gwasira E. T. , Bhunu C. P. , Masocha M. , Mashonjowa E.
Published: March 2016

The sensitivity of vector borne diseases like malaria to climate continues to raise considerable concern over the implications of climate change on future disease dynamics. The problem of malaria vectors shifting from their traditional locations to invade new zones is of important concern. A mathematical model incorporating rainfall and temperature is constructed to study the transmission dynamics of malaria. The reproduction number obtained is applied to gridded temperature and rainfall datasets for baseline climate and future climate with aid of GIS. As a result of climate change, malaria burden is likely to increase in the tropics, the highland regions, and East Africa and along the northern limit of falciparum malaria. Falciparum malaria will spread into the African highlands; however it is likely to die out at the southern limit of the disease.
Risk Factors for Peritonitis in a Pediatric Dialysis Program in Guatemala, 2011–2014
Authors: Chinchilla Jeda , Sebastián Karla , Meléndez Renato , Ramay Brooke , Lou-Meda Randall
Published: March 2016

Background. Peritonitis is the most common complication of peritoneal dialysis but there is limited data regarding peritonitis related risk factors in developing countries. Objective. Describe the PD program at Foundation for Children with Kidney Disease (FUNDANIER), in Guatemala, and identify peritonitis related risk factors in these patients. Methods. This retrospective open cohort study included medical records from FUNDANIER during 2011 to 2014. Baseline demographics, treatment modalities, caregivers’ characteristics, and socioeconomic status were recorded. Results. Eighty-nine medical records were included with a treatment time of 1855 months. Median age of patients was 11.3 years (range 6–17). Median duration of PD therapy was 20.8 months (range 1–28). Sixty-eight peritonitis episodes were registered; forty-eight patients (54%) remained peritonitis-free. Median time to first peritonitis episode was 5 months (range 2–16). Peritonitis rate was one episode every 27 months or 0.44 episodes per patient-year. Peritonitis rate in patients with fair housing was 2.5 times higher than in those with good housing (CI = 1.0–5.2, p=0.01). Conclusion. Housing conditions are a relevant risk factor related to peritonitis. Strategies toward preventing peritonitis must consider housing status, establishing adequate follow-up in high-risk patients. Close monitoring of technique serves to overcome understaffing issues in this setting.