bluuebunny/crossref_metadata_2025 huggingface dataset:
Psychiatric nursing liaison in a combat zone: an autoethnography
Authors: Whybrow D.
Published: December 2012

Accessible summary

Military mental health nurses deploy to combat zones where they are expected to liaise with the management structure of the British forces in order to help service personnel to remain in their fighting roles.

During a recent deployment, I kept a journal of my experiences of liaising with the Chain of Command. Upon return to the UK, I then reviewed this journal line by line until I generated three key themes about my experience of psychiatric nursing liaison. These were ‘being me’, ‘being a nurse’ and ‘relating to the Chain of Command’.

When visiting combat units, I adopted a ‘least intrusive’ approach to psychiatric nursing liaison. I achieved this by targeting key players within the organization, specifically, the Officer in Command, the Sergeant Major, the Trauma Risk Management co‐ordinator (usually the Sergeant Major) and the medic. It worked for me because it suited my personality and my sense of being authentic or credible within my nursing role.

Other nurses may have different experiences of psychiatric nursing liaison in a combat zone. A grounded theory study aimed at bringing together these different experiences might offer greater insight. In the mean time, if elements of my experience resonate with other nurses it may serve to inform their practice.

Military mental health nurses are tasked with providing psychiatric liaison to British forces deployed to combat zones. This forms part of a wider effort to maintain the combat effectiveness of the fighting force. During a recent deployment, I maintained a reflexive journal of my experience of liaising with the British Chain of Command. I then used line by line coding via the NVIVO 9 software package to formulate the core themes that became a framework for this autoethnography. My personality and social anxieties shaped how I performed the psychiatric liaison role. I was able to develop a template for liaison that accounted for both ‘me’ and my need to feel authentic or credible as a nurse, yet still enabled me to communicate effectively with the Chain of Command. One template for psychiatric nursing liaison with British combat forces is to focus upon key stakeholders within the Chain of Command, specifically, the Officer Commanding, the Sergeant Major, the Trauma Risk Management co‐ordinator (usually the Sergeant Major) and the embedded medical asset. Further research is needed to establish how other nurses approach psychiatric nursing liaison.
Response of plasma fatty acid profiles to changes in dietary n‐3 fatty acids and its correlation with erythrocyte fatty acid profiles in dogs
Authors: Stoeckel K. , Bachmann L. , Dobeleit G. , Fuhrmann H.
Published: December 2012

An elevated level of long‐chain n‐3 fatty acids (FA) in tissue membranes has a positive influence on the progression and treatment of many diseases. Therefore, dietary supplementation of n‐3 FA is recommended in some diseases. Even though n‐3 FA are absorbed readily from the diet, their incorporation into tissues may be compromised in diseased animals. In a clinical setting, it is desirable to monitor the success of dietary intervention. Plasma FA as well as erythrocyte membrane (EM) FA can be used to monitor dietary FA intake. This study compares FA from EM and plasma with regard to their reaction time and reliability for monitoring dietary changes of tissue FA profiles in dogs. Thirty dogs were divided into three groups and fed for 12 weeks. The control group (CONT) was fed a commercial standard diet low in n‐3 FA. One group received the standard diet and 85 mg/kg body weight of a docosahexaenoic acid (DHA) concentrate (ADD). The third group was fed a commercial dog food containing fish oil (FO), which is rich in eicosapentaenoic acid (EPA). EM and plasma FA profiles were analysed by GC separately. Data on EM FA were published recently. n‐3 FA in plasma reached the new level after 2 weeks (8 weeks in EM). Dietary differences between DHA and EPA are obvious after 1 week already. The concomitant decrease in plasma n‐6 FA differed between ADD and FO. In general, the correlation of n‐6 FA between plasma and EM was low. We therefore conclude that analysis of plasma FA is sufficient for monitoring a diet‐induced increase in tissue n‐3 FA in dogs. However, EM FA should be analysed if the effect of dietary intervention on tissue n‐6 FA is important.
Quorum‐sensing regulation of a capsular polysaccharide receptor for the Rhodobacter capsulatus gene transfer agent (RcGTA)
Authors: Brimacombe Cedric A. , Stevens Aaron , Jun Daniel , Mercer Ryan , Lang Andrew S. , Beatty J. Thomas
Published: December 2012

The gene transfer agent produced by Rhodobacter capsulatus (RcGTA) resembles a small tailed bacteriophage that packages almost random genomic DNA segments that may be transferred to other R. capsulatus cells. Gene transfer agents are produced by a number of prokaryotes; however, no receptors have been identified. We investigated the RcGTA recipient capability of wild‐type R. capsulatus cells at different culture growth phases, and found that the frequency of RcGTA‐dependent acquisition of an allele increases as cultures enter the stationary phase. We also found that RcGTA adsorption to cells follows a similar trend. RcGTA recipient capability and adsorption were found to be dependent on the GtaR/I quorum‐sensing (QS) system. Production of an extracellular polysaccharide was found to be regulated by GtaR/I QS, as was production of the cell capsule. A number of QS‐regulated putative polysaccharide biosynthesis genes were identified, and mutagenesis of two of these genes, rcc01081 and rcc01932, yielded strains that lack a capsule. Furthermore, these mutants were impaired in RcGTA recipient capability and adsorption, as was a non‐encapsulated wild‐type isolate of R. capsulatus. Overall, our results indicate that capsular polysaccharide is a receptor for the gene transfer agent of R. capsulatus, RcGTA.
Systemic resistance induced by Bacillus lipopeptides in Beta vulgaris reduces infection by the rhizomania disease vector Polymyxa betae
Authors: Desoignies Nicolas , Schramme Florence , Ongena Marc , Legrève Anne
Published: December 2012

The control of rhizomania, one of the most important diseases of sugar beet caused by the Beet necrotic yellow vein virus, remains limited to varietal resistance. In this study, we investigated the putative action of Bacillus amylolequifaciens lipopeptides in achieving rhizomania biocontrol through the control of the virus vector Polymyxa betae. Some lipopeptides that are produced by bacteria, especially by plant growth‐promoting rhizobacteria, have been found to induce systemic resistance in plants. We tested the impact of the elicitation of systemic resistance in sugar beet through lipopeptides on infection by P. betae. Lipopeptides were shown to effectively induce systemic resistance in both the roots and leaves of sugar beet, resulting in a significant reduction in P. betae infection. This article provides the first evidence that induced systemic resistance can reduce infection of sugar beet by P. betae.
Diagnosing Neuropathic Pain in Patients with Cancer: Comparative Analysis of Recommendations in National Guidelines from European Countries
Authors: Piano Virginie , Verhagen Stans , Schalkwijk Annelies , Burgers Jako , Kress Hans , Treede Rolf‐Detlef , Hekster Yechiel , Lanteri‐Minet Michel , Engels Yvonne , Vissers Kris
Published: December 2012

Background

Neuropathic pain is a prevalent symptom in patients with cancer, which needs a more specific algorithm than nociceptive pain or neuropathic pain from other origin. Clinical practice guidelines (CPGs) can be helpful in optimizing the diagnosis of neuropathic pain in patients with cancer.

Methods

In this study, 9 national CPGs in Europe on the diagnosis of neuropathic pain in patients with cancer were included. Recommendations with their grade (according SIGN 55 classification) and supporting literature (first author, patients' population, year, and type of publication) were compared between CPGs.

Results

Nine CPGs including recommendations on neuropathic pain could be selected and were assessed. In total, they used 149 references of which 72 (48%) were about cancer conditions, 39 (26%) about neuropathic pain, and only 3 about neuropathic pain in patients with cancer (2%). Only 28 (19%) references were shared between 2 or more guidelines. There was only one shared reference specifically related to cancer neuropathic pain. Recommendations and their evidence grading strongly differ between CPGs.

Conclusion

This work demonstrates an important heterogeneity between European recommendations on diagnosis and assessment of neuropathic pain in patients with cancer. The main weaknesses are the low level of evidence and the absence of specific data focusing on neuropathic pain in patients with cancer. We recommend that physicians dealing with neuropathic pain in patients with cancer should be specially trained, that a specific methodology to develop CPGs should followed, and that specific research should be developed on the diagnosis of neuropathic pain in patients with cancer.
Randomized Controlled Trial on the Efficacy of Bilateral Superficial Cervical Plexus Block in Thyroidectomy
Authors: Karthikeyan Vilvapathy Senguttuvan , Sistla Sarath Chandra , Badhe Ashok Shankar , Mahalakshmy Thulasingam , Rajkumar Nagarajan , Ali Sheik Manwar , Gopalakrishnan S.
Published: December 2012

Background and Objective

As thyroid surgery is being performed as an ambulatory procedure, recent studies concerning post thyroidectomy analgesia have focused on regional techniques such as bilateral superficial cervical plexus block (BSCPB) and bilateral combined superficial and deep cervical plexus block. But, data regarding the efficacy of BSCPB are controversial. Hence we compared the efficacy of BSCPB with 0.25% bupivacaine with and without clonidine in thyroidectomy, as preventative analgesia.

Methods

Patients (n = 60) undergoing thyroidectomy were randomized into 3 groups (n = 20 each) to receive BSCPB using 15 mL of 0.25% bupivacaine (group B) or 0.25% bupivacaine with 1 μg/kg clonidine (group BC) or 0.9% normal saline (group S) on each side after induction. Intraoperative (fentanyl) and postoperative (morphine) analgesic requirements were assessed. Postoperative pain scores, nausea, vomiting, and sedation were assessed for 24 hours.

Results

Intraoperative fentanyl requirement was significantly lesser in groups B and BC (P = 0.012). Postoperative pain scores were significantly lower in group BC (compared to S) at 2 (P = 0.002), 4 (P = 0.016), and 8 (P = 0.012) hours. First analgesic requirement time (min) was significantly higher in groups B and BC (P = 0.002), and postoperative morphine requirement was significantly lower in groups B and BC (P = 0.001). Incidence of postoperative vomiting was significantly reduced in group BC (P = 0.022).

Conclusion

BSCPB with 0.25% bupivacaine with or without clonidine is effective in reducing both intraoperative and postoperative pain and analgesic requirements in thyroidectomy, and adding clonidine to bupivacaine reduces postoperative vomiting.
Resistance breeding strategy for Stenocarpella maydis and Fusarium graminearum cob rots in tropical maize
Authors: Tembo Langa , Asea Godfrey , Gibson Paul T. , Okori Patrick
Published: December 2012

Maize cob rot caused by Fusarium graminearum and Stenocarpella maydis affects grain yield and quality. The objective of this study was to investigate the appropriateness of multiple infection as a selection and breeding strategy for multiple resistance to F. graminearum and S. maydis. Twelve tropical inbred lines with varying resistance to either or both pathogens were mated in a full diallel and the progeny and their parents evaluated for reaction to single or multiple infection. Under multiple inoculation, S. maydis suppressed colonization of cobs by F. graminearum. General combining ability (GCA) effects indicated that inbred WL 118–10 effectively transmitted resistance to both diseases. Hybrids' resistant to S. maydis was also resistant to F. graminearum, but the reverse was not true. Therefore, efficient screening should initially involve screening for S. maydis followed by F. graminearum. Overall, the suppression of F. graminearum by S. maydis shows that multiple infection cannot be used as an appropriate breeding strategy to obtain multiple resistance. The use of F. graminearum and S. maydis separately is, therefore, the best breeding strategy.
The role of the kinase OXI1 in cadmium‐ and copper‐induced molecular responses in Arabidopsis thaliana
Authors: SMEETS KAREN , OPDENAKKER KELLY , REMANS TONY , FORZANI CELINE , HIRT HERIBERT , VANGRONSVELD JACO , CUYPERS ANN
Published: December 2012

The hypothesis that mitogen‐activated protein kinase (MAPK) signalling is important in plant defences against metal stress has become accepted in recent years. To test the role of oxidative signal‐inducible kinase (OXI1) in metal‐induced oxidative signalling, the responses of oxi1 knockout lines to environmentally realistic cadmium (Cd) and copper (Cu) concentrations were compared with those of wild‐type plants. A relationship between OXI1 and the activation of lipoxygenases and other initiators of oxylipin production was observed under these stress conditions, suggesting that lipoxygenase‐1 may be a downstream component of OXI1 signalling. Metal‐specific differences in OXI1 action were observed. For example, OXI1 was required for the up‐regulation of antioxidative defences such as catalase in leaves and Fe‐superoxide dismutase in roots, following exposure to Cu, processes that may involve the MEKK1‐MKK2‐WRKY25 cascade. Moreover, the induction of Cu/Zn superoxide dismutases in Cu‐exposed leaves was regulated by OXI1 in a manner that involves fluctuations in the expression of miRNA398. These observations contrast markedly with the responses to Cd exposure, which also involves OXI1‐independent pathways but rather involves changes in components mediating intracellular communication.
Parent Characteristics and Early Coparenting Behavior at the Transition to Parenthood
Authors: Schoppe‐Sullivan Sarah J. , Mangelsdorf Sarah C.
Published: December 2012

This study examined parent characteristics as correlates of coparenting behavior in 57 primiparous couples. Parents' negative emotionality and perceptions of maternal acceptance in childhood, mothers' beliefs about fathers' roles, and observed marital behavior and family socioeconomic status were assessed during the third trimester of pregnancy, and coparenting behavior was observed at 3.5 months postpartum. Couples who exhibited high‐quality marital interaction showed higher supportive coparenting behavior, but couples who showed lower quality marital interaction demonstrated higher supportive coparenting behavior when mothers held more progressive beliefs about fathers' roles. Couples showed more undermining coparenting behavior when family socioeconomic status was lower and when fathers were higher on negative emotionality. Greater perceived maternal acceptance in childhood was only associated with lower levels of undermining behavior when prenatal marital interaction was high in quality. Thus, the characteristics of both parents, especially in combination with preexisting marital behavior, are important determinants of coparenting behavior.
Disseminated toxoplasmosis presenting as septic shock five weeks after renal transplantation
Authors: Vaughan L.B. , Wenzel R.P.
Published: December 2012

We discuss a case of acute disseminated toxoplasmosis in a renal transplant recipient presenting with septic shock. Our literature review of disseminated toxoplasmosis presenting as septic shock reveals a disease process that is rapid and almost uniformly fatal. This unusual presentation warrants a high index of suspicion in transplant recipients with immediate administration of appropriate empiric antimicrobials.
Village health workers in Bihar, India: an untapped resource in the struggle against kala‐azar
Authors: Malaviya P. , Hasker E. , Singh R. P. , Van Geertruyden J. P. , Boelaert M. , Sundar S.
Published: December 2012

Introduction

In 2005 a visceral leishmaniasis (VL) elimination initiative was launched on the Indian subcontinent; important components of early case finding and treatment are entrusted to the primary health care system (PHC). In an earlier study in Bihar, India, we discovered some major shortcomings in implementation, in particular related to monitoring of treatment and treatment outcomes. These shortcomings could be addressed through involvement of village health workers. In the current study we assessed knowledge, attitude and practice of these village health workers in relation to VL. Main objective was to assess the feasibility of their involvement in VL control.

Methods

We obtained a list of auxiliary nurses/midwives and accredited social health activists for the highly endemic district of Muzaffarpur. We randomly sampled 100 auxiliary nurses and 100 activists, who were visited in their homes for an interview. Questions were asked on knowledge, attitude and practice related to visceral leishmaniasis and to tuberculosis.

Results

Auxiliary nurses and activists know the presenting symptoms of visceral leishmaniasis, they know how it is diagnosed but they are not aware of the recommended first‐line treatment. Many are already involved in tuberculosis control and are very well aware of the treatment modalities of tuberculosis, but few are involved in control of visceral leishmaniasis control. They are well organised, have strong links to the primary healthcare system and are ready to get more involved in visceral leishmaniasis control.

Conclusion

To ensure adequate monitoring of visceral leishmaniasis treatment and treatment outcomes, the control programme urgently needs to consider involving auxiliary nurses and activists.
Modeling and Analysis of the Meshing Losses of Involute Spur Gears in High-Speed and High-Load Conditions
Authors: Chang L. , Jeng Yeau-Ren , Huang Pay-Yau
Published: December 2012

A first-principle based mathematical model is developed in this paper to analyze the meshing losses in involute spur gears operating in high-load and high-speed conditions. The model is fundamentally simple with a few clearly defined physical parameters. It is computationally robust and produces meaningful trends and relative magnitudes of the meshing losses with respect to the variations of key gear and lubricant parameters. The model is evaluated with precision experimental data. It is then used to study the effects of various gear and lubricant parameters on the meshing losses including gear module, pressure angle, tooth addendum height, thermal conductivity, and lubricant pressure-viscosity and temperature-viscosity coefficients. The results and analysis suggest that gear module, pressure angle, and lubricant pressure-viscosity and temperature-viscosity coefficients can significantly affect the meshing losses. They should be the design parameters of interest to further improve the energy efficiency in high-performance, multistage transmission systems. Although the model is developed and results obtained for spur gears, the authors believe that the trends and relative magnitudes of the meshing losses with respect to the variations of the gear and lubricant parameters are still meaningful for helical gears.
Development of a Hybrid Dynamic Model and Experimental Identification of Robotic Bulldozing
Authors: Olsen Scott G. , Bone Gary M.
Published: December 2012

The low-level modeling and control of mobile robots that interact forcibly with their environment, such as robotic excavation machinery, is a challenging problem that has not been adequately addressed in prior research. This paper investigates the low-level modeling of robotic bulldozing. The proposed model characterizes the three primary degrees-of-freedom (DOF) of the bulldozer, the blade position, the material accumulation on the blade, and the material distribution in the environment. It includes discrete operation modes contained within a hybrid dynamic model framework. The dynamics of the individual modes are represented by a set of linear and nonlinear differential equations. An instrumented scaled-down bulldozer and environment are developed to emulate the full scale operation. Model parameter estimation and validation are completed using experimental data from this system. The model is refined based on a global sensitivity analysis. The refined model is suitable for simulation and design of robotic bulldozing control strategies.
Reconstitution of the Vital Functions of Munc18 and Munc13 in Neurotransmitter Release
Authors: Ma Cong , Su Lijing , Seven Alpay B. , Xu Yibin , Rizo Josep
Published: December 2012

Reconstituting Synaptic Vesicle Fusion

Membrane fusion reactions have been reconstituted in vitro, but often the reconstituted reactions have not directly mirrored the requirements for synaptic vesicle fusion in vivo. Previous work generally used only
N
-ethylmaleimide–sensitive factor (NSF) attachment protein SNAP receptors (SNAREs) and one or two additional components and could not explain why deletion of Munc18-1 or Munc13 abolishes neurotransmitter release completely, yielding the severe disruptions of synaptic vesicle release in knockout mouse.

Ma
et al.

(p.
421
, published online 20 December; see the Perspective by

Hughson

) now present a faithful reconstitution of synaptic vesicle fusion. Membrane fusion required Munc18-1 and Munc13 when the reconstitution experiments included all eight key components (three SNAREs, Munc18-1, Munc13, synaptotagmin-1, NSF, and α-SNAP).
Comparative Analysis of Bat Genomes Provides Insight into the Evolution of Flight and Immunity
Authors: Zhang Guojie , Cowled Christopher , Shi Zhengli , Huang Zhiyong , Bishop-Lilly Kimberly A. , Fang Xiaodong , Wynne James W. , Xiong Zhiqiang , Baker Michelle L. , Zhao Wei , Tachedjian Mary , Zhu Yabing , Zhou Peng , Jiang Xuanting , Ng Justin , Yang Lan , Wu Lijun , Xiao Jin , Feng Yue , Chen Yuanxin , Sun Xiaoqing , Zhang Yong , Marsh Glenn A. , Crameri Gary , Broder Christopher C. , Frey Kenneth G. , Wang Lin-Fa , Wang Jun
Published: December 2012

Bat Genomes

Bats are of great interest because of their ability to fly and as hosts for infectious disease.

Zhang
et al.

(p.
456
, published online 20 December) sequenced the genomes of two distantly related bat species, David's Myotis and Black flying fox. Analysis of the two genomes revealed likely changes that accompanied the evolution of bats, including selection for increased expression of genes involved in the oxidative phosphorylation pathway needed to generate the energy required for flight. Furthermore, while some immune genes have been lost, others are under positive selection, which may potentially explain bats' status as viral reservoirs.
Olefin Cyclopropanation via Carbene Transfer Catalyzed by Engineered Cytochrome P450 Enzymes
Authors: Coelho Pedro S. , Brustad Eric M. , Kannan Arvind , Arnold Frances H.
Published: December 2012

Putting a C in Cytochrome

Cytochrome P450 enzymes oxidize hydrocarbons using a highly reactive iron oxo intermediate. Much research has focused on tuning the protein structure to broaden the range of hydrocarbons that can be functionalized.

Coelho
et al.

(p.
307
, published online 20 December; see the Perspective by

Narayan and Sherman

) substituted a carbene source for the oxygen to make a P450 mutant a cyclopropanation catalyst whereby a carbon fragment is transferred in place of oxygen. Though carbene activation by iron is chemically analogous to the native oxygen activation pathway, the overall reaction is completely different from any known enzymatic transformation.
Iliopsoas abscess masquerading as ‘sciatica’
Authors: Shields D W , Robinson Patrick G
Published: December 2012

A 35-year-old woman of Indian origin presented with a 5-month history of lower back pain, radiating down the back of her right leg in distribution of the sciatic nerve. Referral was made to the spinal clinic querying sciatica, but a deterioration in her symptoms developed, and the patient presented to the Accident and Emergency department. She was significantly tender at right sacroiliac joint and had positive psoas sign. The MRI scan showed a large iliopsoas abscess causing bony destruction, and extended culture was positive for mycobacterium tuberculosis. The patient was initially diagnosed with sciatica yet had a positive psoas sign and a painful sacrum. It is important that primary physicians are aware of the relations the iliopsoas muscle and the potential effect an abscess can have here. A sinister underlying cause of a patient's sciatic distribution of pain should be excluded before accepting a diagnosis of mechanical back pain.
‘The verses of madness’: schizophrenia and poetry
Authors: Hankir Ahmed Khaldoon , Holloway David , Agius Mark , Zaman Rashid
Published: December 2012

In the early 19th century, Lombroso introduced the concept ofhereditary taintto describe the coexistence of ‘madness’ and creativity. In a recent investigation, Rustet alreported a study designed to test the traditionally assumed relationship between creativity and schizophrenia. They uncovered an association between creative originality and the positive cognitive aspects of schizotypal thinking. Poetry is not only the ‘product’ of psychopathology but it can also be utilised as a form of therapy: “My name is David Holloway, I am a 33 year old poet/blogger with paranoid schizophrenia. A poet called Charles Bukowski has described poetry as the ‘ultimate psychiatrist’, and I am a firm believer in this. The strongest part of my personality is my belief in the power of love. My recovery has relied heavily on medication, diet and exercise. However it is the power of poetry that has been my true inspiration.”
Cyclofenil as a possible cause of non-arteritic anterior ischaemic optic neuropathy
Authors: Clarke Benjamin , Sykakis Evripidis , Parmar Dipak N
Published: December 2012

A 27-year-old woman receiving the steroid drug cyclofenil as a fertility adjunct, experienced blurred vision 24 h after missing a dose and taking a double dose to ‘catch up’ with her therapeutic protocol. She was found to have a non-arteritic anterior ischaemic optic neuropathy with a visual hemifield defect and impaired optic nerve function, which has not since shown any recovery. This case highlights the prothrombotic potential for the drug when used above normal dosing range, and is therefore of great guidance for those initiating it as a fertility treatment, or in unlicensed use.
Spectral domain OCT to diagnose clinically inapparent hypotony maculopathy using 3D image rendering software
Authors: Raja Muhammad , Boukavala Stavoroula , Goldsmith Craig , Mukherji Subhanjan
Published: December 2012

Three-dimensional (3D) image rendering capability of a commercially available 3D-optical coherence tomogram (OCT) system was used to diagnose a subclinical but symptomatic case of hypotony maculopathy in an eye with significant cataract and an only-eyed patient. Bleb revision improved intraocular pressure and symptoms, confirmed by repeat OCT imaging. Hypotony maculopathy may be subclinical and difficult to diagnose particularly in eyes with non-clear ocular media. Use of spectral domain OCT can be complementary to improve patient outcomes.
National survey of US primary care physicians’ perspectives about causes of obesity and solutions to improve care
Authors: Bleich Sara N , Bennett Wendy L , Gudzune Kimberly A , Cooper Lisa A
Published: December 2012

Objective

To describe physician perspectives on the causes of and solutions to obesity care and identify differences in these perspectives by number of years since completion of medical school.

Design

National cross-sectional online survey from 9 February to 1 March 2011.

Setting

USA.

Participants

500 primary care physicians.

Main Measures

We evaluated physician perspectives on: (1) causes of obesity, (2) competence in treating obese patients, (3) perspectives on the health professional most qualified to help obese patients lose or maintain weight and (4) solutions for improving obesity care.

Results

Primary care physicians overwhelmingly supported additional training (such as nutrition counselling) and practice-based changes (such as having scales report body mass index) to help them improve their obesity care. They also identified nutritionists/dietitians as the most qualified providers to care for obese patients. Physicians with fewer than 20 years since completion of medical school were more likely to identify lack of information about good eating habits and lack of access to healthy food as important causes of obesity. They also reported feeling relatively more successful helping obese patients lose weight. The response rate for the survey was 25.6%.

Conclusions

Our results indicate a perceived need for improved medical education related to obesity care.
In situ simulation: detection of safety threats and teamwork training in a high risk emergency department
Authors: Patterson Mary D , Geis Gary Lee , Falcone Richard A , LeMaster Thomas , Wears Robert L
Published: December 2012

Objective

Implement and demonstrate feasibility of in situ simulations to identify latent safety threats (LSTs) at a higher rate than lab-based training, and reinforce teamwork training in a paediatric emergency department (ED).

Methods

Multidisciplinary healthcare providers responded to critical simulated patients in an urban ED during all shifts. Unannounced in situ simulations were limited to 10 min of simulation and 10 min of debriefing, and were video recorded. A standardised debriefing template was used to assess LSTs. The primary outcome measure was the number and type of LSTs identified during the simulations. Secondary measures included: participants’ assessment of impact on patient care and value to participants. Blinded video review using a modified Anaesthetists Non-Technical Skills scale was used to assess team behaviours.

Results

218 healthcare providers responded to 90 in situ simulations conducted over 1 year. A total of 73 LSTs were identified; a rate of one every 1.2 simulations performed. In situ simulations were cancelled at a rate of 28% initially, but the cancellation rate decreased as training matured. Examples of threats identified include malfunctioning equipment and knowledge gaps concerning role responsibilities. 78% of participants rated the simulations as extremely valuable or valuable, while only 5% rated the simulation as having little or no value. Of those responding to a postsimulation survey, 77% reported little or no clinical impact. Video recordings did not indicate changes in non-technical skills during this time.

Conclusions

In situ simulation is a practical method for the detection of LSTs and to reinforce team training behaviours. Embedding in situ simulation as a routine expectation positively affected operations and the safety climate in a high risk clinical setting.
More fatal all-terrain vehicle crashes occur on the roadway than off: increased risk-taking characterises roadway fatalities
Authors: Denning Gerene M , Harland Karisa K , Ellis David G , Jennissen Charles A
Published: December 2012

Background

All-terrain vehicles (ATVs) have steadily increased in popularity, size and speed, characteristics that likely contribute to the alarming rise in ATV-related fatalities. One potentially high-risk activity is riding on the road.

Objectives

To compare fatal ATV crashes that occur on the roadway and off, to more fully understand factors that contribute to fatalities at each location.

Methods

Fatality data from the US Consumer Product Safety Commission (CPSC) were used for descriptive and comparative analyses. Multivariate logistic regression analysis was performed to determine relative risk.

Results

Over 60% of all fatalities (1985–2009) resulted from roadway crashes. After 1998, roadway fatalities increased at over twice the rate of off-road fatalities. Roadway crashes were more likely than off-road crashes to involve multiple fatalities, carrying passengers, alcohol use, collisions and head injuries. Roadway victims were less likely to be helmeted than off-road victims. Passengers and operators with passengers were also less likely to be helmeted than operators riding alone. Helmeted victims were half as likely to suffer a head injury.

Conclusions

Fatal roadway crashes were more likely than off-road crashes to involve risk-taking behaviours (eg, carrying passengers) that could exacerbate the inherent difficulty of operating ATVs on roadway surfaces. Higher crash forces from greater speed, and lower use of protective equipment, may also have contributed to higher roadway mortality rates. Eliminating non-essential ATV road use may be an effective way to reduce ATV-related fatalities. This will likely require a substantial investment in rider education and better enforcement of ATV road use restriction laws.
Emergency endovascular management of penetrating gunshot injuries to the arteries in the face and neck: a case series and review of the literature
Authors: Yevich Steven M , Lee Stephen Robert , Scott Bradford G , Shaltoni Hashem M , Mawad Michel E , Benndorf Goetz
Published: December 2012

Introduction

Penetrating gunshot injuries (GSI) to supra-aortic arteries that cause life-threatening blood loss or major neurologic deficits are increasingly managed using modern endovascular treatment (EVT). We report our experience with EVT of acute GSIs and review the existing literature.

Methods

Emergency EVT was performed in nine of 10 patients (7 men, age 17–50 years) with acute GSIs to supra-aortic arteries requiring acute management. One patient presented with acute and delayed injuries and underwent EVT 4 weeks after initial admission. Patient selection was based on clinical presentation and radiographic findings from a cohort of 55 patients with GSIs to the face, neck or head between February 2009 and March 2012.

Results

EVT was successfully performed in all patients. Two transections of the vertebral arteries were embolized with coils and/or liquid embolic agent (acrylic glue). Eight penetrated external carotid artery branches were occluded with liquid embolic agents (acrylic glue or Onyx) or particles. One severe dissection of the internal carotid artery with a subsequent thromboembolic event was treated with stenting. All except one patient survived with minor or no residual deficits.

Conclusions

Emergency management of GSI injuries to the head and neck may involve all aspects of current EVT. Understanding endovascular techniques and being able to make rapid and appropriate treatment decisions in the setting of acute GSI to the face and neck can be a life-saving measure and greatly benefits the patient's outcome.
Creation of sidewall aneurysm in rabbits: aneurysm patency and growth follow-up
Authors: Ding Yong Hong , Tieu Tai , Kallmes David F
Published: December 2012

Introduction

To explore the patency and growth of surgical sidewall aneurysms in rabbits.

Materials and methods

Forty sidewall aneurysms were created in the right common carotid artery (RCCA). Intravenous digital subtraction angiography (DSA) through the ear vein was performed immediately after creation. Three weeks later, intra-arterial DSA through the femoral artery was performed. Aneurysm sizes (neck, width, height and volume) were measured and calculated immediately after creation and 3 weeks later. Aneurysm patency after creation was evaluated. Differences in aneurysm sizes immediately after creation and 3 weeks later were compared using the Student's t test.

Results

Aneurysms and the parent artery remained patent in 38 (95%) of the 40 rabbits 3 weeks after creation. Two other rabbits (5%) showed aneurysm occlusion. There was a significant difference in aneurysm neck size 3 weeks after creation (3.6±0.9 mm vs 2.4±0.4 mm, p<0.0001). The aneurysm became wider 3 weeks later (5.8±1.5 mm vs 4.3±1.2 mm, p<0.0001). Aneurysm length was also larger than immediately after creation (6.1±1.3 mm vs 4.3±1.4 mm, p<0.0001). The aneurysm volume was larger than that created immediately (127.5±89.4 mm3vs 51.0±34.9 mm3, p<0.0001).

Conclusions

The patency rate of sidewall aneurysms in rabbits is high. The aneurysm keeps growing for at least 3 weeks after creation.
SOFT QCD AND DIFFRACTIVE PHYSICS AT LHC
Authors: SCAPPARONE EUGENIO
Published: December 2012

After a short introduction on the importance of the soft and of the diffractive studies in the understanding of minimum bias events, the main results obtained at LHC are discussed. This overview includes identified particle and inclusive measurements, minimum bias and underlying events, all of them shedding light on the soft process production mechanisms. The results of the inelastic cross-section measurements obtained by the LHC experiments and their compatibility are discussed together with the models used to extrapolate the data at low diffractive masses. A review of the most recent diffraction results is presented, showing the different approaches used by the LHC experiments, relying on different experimental techniques. The combination of the results obtained by ALICE, ATLAS, CMS, LHCb and TOTEM provides a wide sample of informations, covering an unprecedented pseudorapidity range. A detailed comparison between the obtained results is shown, followed by a critical discussion on the still existing discrepancies between the experimental data and the Monte Carlo used at LHC to simulate soft and diffractive physics.
NEURO-GENETIC OBSERVER SPEED FOR DIRECT TORQUE NEURO-FUZZY CONTROL OF INDUCTION MOTOR DRIVE
Authors: DOUIRI MOULAY RACHID , CHERKAOUI MOHAMED , ESSADKI AHMED
Published: December 2012

In this work, we applied artificial intelligence techniques to improve the dynamic performance of sensorless direct torque control (DTC). First, we replace the conventional comparator and selection table applied to the DTC induction motor with a neural-fuzzy controller to learn the advantages of both methods; learning capacity of the first and readability and flexibility of the second. This evaluation is obtained using the electromagnetic torque error, the error module and angle of the stator flux vector. Then we propose a new estimation method rotor speed using an adaptive neural observer. The error between the desired state variable and the actual state variable of a neural model is back propagated to adjust the weights of neural model, so that the actual state variable tracks the desired value. Finally, the proportional and integral controller gains are optimized by a genetic algorithm to ensure the optimum performance of rotor speed. The simulation results show the effectiveness of control methods available.
USE OF ROBUST PREDICTIVE METHOD FOR NANO-CMOS PROCESS: APPLICATION TO BASIC BLOCK ANALOG CIRCUIT DESIGN
Authors: DAOUD HOUDA , BENSELEM SAMIR , ZOUARI SONIA , LOULOU MOURAD
Published: December 2012

This paper deals with the prediction of primary parameters of CMOS transistor for upcoming process using the robust Bisquare Weights method which is able to provide solutions to the challenges of some parameters of Nanoscale CMOS. Predicted parameters for 45 nm to 22 nm process nodes are obtained in order to solve design challenges generated by Nanoscale process. These predicted primary parameters are helpful to estimate the performance of a basic element circuit having a key role in the design of upcoming analog systems. Comparisons between predictive technology model data and predicted parameters are used to check the validity of the used method. As a study case, we will detail the behavior of optimized telescopic operational transconductance amplifier performance with process scaling.
HIGH LINEARITY 8-BIT VCO-BASED CASCADED ΣΔADC FOR DIGITAL DC-DC CONVERTERS
Authors: FOONG HUEY CHIAN , TAN MENG TONG , ZHENG YUANJIN
Published: December 2012

This paper presents the design and implementation of a high resolution voltage-controlled oscillator (VCO)-based ΣΔADC for digital DC-DC converters. The proposed ADC adopts a robust VCO and a sixth-order delta-sigma modulation to attenuate the phase noise and output ripples. The delta-sigma modulation is realized using a cascade of a second-order high-pass filter and a fourth-order band-stop noise shaping filter. Chopper modulation is further employed to reduce the effect of 1/f noise. These have significantly increased the signal-to-noise+distortion ratio (SNDR) and lead to high linearity. The proposed ADC was designed and fabricated using CMOS 0.18 μm process. From measurement, the differential and integral nonlinearities of the ADC are determined to be ±0.5 LSB and ±0.65 LSB, respectively. The SNDR of the ADC is 49 dB up to 500 kHz, which gives an ENOB of 8 bits and quantization step of 2 mV. The ADC also features a low power consumption of 120 μA and a small IC area of 0.18 mm2.
EFFECT OF THE TWO-PARAMETER ELASTIC FOUNDATION ON THE CRITICAL PARAMETERS OF NONHOMOGENEOUS ORTHOTROPIC SHELLS
Authors: SOFIYEV A. H. , SCHNACK E. , HACIYEV V. C. , KURUOGLU N.
Published: December 2012

A theoretical analysis is presented for determining the free vibrational and buckling characteristics of the nonhomogeneous, orthotropic, thin-walled, circular cylindrical and conical shells under a hydrostatic pressure and resting on a two-parameter elastic foundation. The basic relations have been obtained for the orthotropic truncated conical shell, the Young's moduli and density of which vary continuously in the thickness direction. By applying the Galerkin method, the buckling hydrostatic pressure and dimensionless frequency parameter of the homogeneous and nonhomogeneous orthotropic truncated conical shells with or without elastic foundations are obtained. Finally, the effects of the Winkler and Pasternak-type elastic foundations, the variations of shell characteristics, the effects of the nonhomogeneity and orthotropy on the critical parameters have been studied. The results are presented in tables, figures and compared with other works.
AEROSPACE STIFFENED PANEL INITIAL SIZING WITH NOVEL SKIN SUB-STIFFENING FEATURES
Authors: QUINN D. , MURPHY A. , GLAZEBROOK C.
Published: December 2012

The introduction of skin sub-stiffening features has the potential to modify the local stability and fatigue crack growth performance of stiffened panels. Proposed herein is a method to enable initial static strength sizing of panels with such skin sub-stiffening features. The method uses bespoke skin buckling coefficients, automatically generated by Finite Element analysis and thus limits the modification to the conventional aerospace panel initial sizing process. The approach is demonstrated herein and validated for prismatic sub-stiffening features. Moreover, examination of the generated buckling coefficient data illustrates the influence of skin sub-stiffening on buckling behavior, with static strength increases typically corresponding to a reduction in the number of initial skin longitudinal buckle half-waves.
NUMERICAL SOLUTIONS OF INTEGRO-DIFFERENTIAL EQUATIONS USING SOBOLEV GRADIENT METHODS
Authors: RAZA NAUMAN , SIAL SULTAN , NEUBERGER JOHN W. , AHMAD MUHAMMAD OZAIR
Published: December 2012

A numerical procedure for solving a class of integro-differential equations of Volterra type using the Sobolev gradient method is presented. Results are compared with those from the variational iteration method (VIM) and Adomian decomposition method (ADM) (Batiha, B., Noorani, M. S. M. and Hashmi, I. [2008] "Numerical solutions of the nonlinear integro-differential equations," Int. J. Open Probl. Compt. Math.1, 34–42). The capabilities of our codes are briefly described and test results from some examples are presented.
ON THE CONVERGENCE ANALYSIS OF THE SPLINE COLLOCATION METHOD FOR SYSTEM OF INTEGRAL ALGEBRAIC EQUATIONS OF INDEX-2
Authors: GHOREISHI F. , HADIZADEH M. , PISHBIN S.
Published: December 2012

This article presents some theoretical results for polynomial spline collocation solution to a new class of semi-explicit Integral Algebraic Equations (IAEs) of index-2, which has been introduced in a recent paper of the authors (Hadizadeh, M., Ghoreishi, F. and Pishbin, S. [2011] "Jacobi spectral solution for integral-algebraic equations of index-2, " Appl. Numer. Math.61, 131–148). Critical issues for numerical analysis of the spline collocation method for this type of Volterra systems are discussed and the necessary and sufficient conditions are presented which guarantee the convergence of the method. We analyze the rate of convergence for two disjoint cases of collocation parameter cm. Numerical results confirm the rate of decay of the error predicted by this theory.
AN EFFICIENT RECURSIVE ALGORITHM IN THE COMPUTATIONAL SIMULATION OF THE BOUNDED GROWTH OF BIOLOGICAL FILMS
Authors: MORALES-HERNÁNDEZ M. D. , MEDINA-RAMÍREZ I. E. , AVELAR-GONZÁLEZ F. J. , MACÍAS-DÍAZ J. E.
Published: December 2012

In this work, we present a simple, finite-difference method to approximate positive and bounded solutions of a parabolic partial differential equation with nonlinear diffusion, which describes the growth dynamics of colonies of bacteria. A theorem on the existence and uniqueness of positive and bounded solutions of the model considered is available in the standard literature; however, analytical solutions for this model are difficult to calculate in exact form. The linear approach used in this manuscript provides a convenient way to represent the method in vector form through the multiplication of the new approximations by a square matrix that, under suitable conditions, turns out to be an M-matrix. The facts that every M-matrix is invertible and that all the entries of their inverses are positive numbers, are employed to elucidate conditions, which guarantee that positive and bounded initial profiles evolve into positive and bounded new approximations. The method is relatively simple, the temporal step-size is variable in general, and its efficient computational implementation makes use of the stabilized bi-conjugate gradient method. We provide numerical simulations in order to evince that the method preserves the practice comprising the positive and the bounded characters of the approximations.
A NEW GENETIC ALGORITHM FOR MULTIPLE SEQUENCE ALIGNMENT
Authors: NARIMANI ZAHRA , BEIGY HAMID , ABOLHASSANI HASSAN
Published: December 2012

Multiple sequence alignment (MSA) is one of the basic and important problems in molecular biology. MSA can be used for different purposes including finding the conserved motifs and structurally important regions in protein sequences and determine evolutionary distance between sequences. Aligning several sequences cannot be done in polynomial time and therefore heuristic methods such as genetic algorithms can be used to find approximate solutions of MSA problems. Several algorithms based on genetic algorithms have been developed for this problem in recent years. Most of these algorithms use very complicated, problem specific and time consuming mutation operators. In this paper, we propose a new algorithm that uses a new way of population initialization and simple mutation and recombination operators. The strength of the proposed GA is using simple mutation operators and also a special recombination operator that does not have problems of similar recombination operators in other GAs. The experimental results show that the proposed algorithm is capable of finding good MSAs in contrast to existing methods, while it uses simple operators with low computational complexity.