bluuebunny/crossref_metadata_2025 huggingface dataset:
Causes of elective surgery cancellation and theatre throughput efficiency in an Australian urology unit
Authors: Keller Andrew , Ashrafi Akbar , Ali Ahmad
Published: August 2014

Objective:

To evaluate our unit’s theatre throughput efficiency, to identify where inefficiencies existed and consequently where the greatest improvement might be made.

To identify the causes of day of surgery cancellations and how they might be avoided. 

Patients and Methods:

A prospective audit of theatre utilisation was undertaken over a 6 month period between 05/02//2013 and 02/08/2013 at Ipswich General Hospital, QLD, Australia.

Times collected were: time of patient arrival in anaesthetic bay, start time of operative procedure, end time of operative procedure, and time of patient leaving theatre.

The causative factors for any delays or day of surgery cancellations were identified and recorded where possible.

 Results:

In the six month period 26,850 sessional minutes were available for elective operating over 100 operating sessions.

304 elective cases were performed, split between 21 major and 283 minor procedures

The sessions ran overtime a cumulative 2114 minutes.

Total non-operative minutes totalled 13,209 (50.3% of all available time), split between late starts 499 minutes (1.8%), early list finishes 1894 minutes (7.05%),  changeover time 1869 minutes (6.9%) and anaesthetic time, 8974 minutes (33.4%)

Actual operating time only compromised 50.7% of all available elective operating session time (13,614 minutes)

Theatre utilisation was 91.8%.

51 procedures were cancelled on the day of surgery during the audit period, representing 14.3% of all scheduled procedures.

The most common reason for cancellation was lack of surgical fitness, followed by inadequate operative time.

 Conclusion:

 A significant proportion of all elective operative time was consumed by non-operative minutes.

Inefficiencies existed in turnover of patients as well as over as well as underbooking of patients on elective lists.

An excessive number of cases were cancelled on the day of surgery, wasting valuable operative time.

A multi-parametric approach must be taken to improve operation list utilisation.
The Carbon Impacts of Wood Products
Authors: Bergman Richard D. , Puettmann Maureen , Taylor Adam , Skog Kenneth E.
Published: August 2014

Wood products have many environmental advantages over nonwood alternatives. Documenting and publicizing these merits helps the future competitiveness of wood when climate change impacts are being considered. The manufacture of wood products requires less fossil fuel than nonwood alternative building materials such as concrete, metals, or plastics. By nature, wood is composed of carbon that is captured from the atmosphere during tree growth. These two effects—substitution and sequestration—are why the carbon impact of wood products is favorable. This article shows greenhouse gas emission savings for a range of wood products by comparing (1) net wood product carbon emissions from forest cradle–to–mill output gate minus carbon storage over product use life with (2) cradle-to-gate carbon emissions for substitute nonwood products. The study assumes sustainable forest management practices will be used for the duration of the time for the forest to regrow completely from when the wood was removed for product production during harvesting. The article describes how the carbon impact factors were developed for wood products such as framing lumber, flooring, moulding, and utility poles. Estimates of carbon emissions saved per unit of wood product used are based on the following: (1) gross carbon dioxide (CO2) emissions from wood product production, (2) CO2 from biofuels combusted and used for energy during manufacturing, (3) carbon stored in the final product, and (4) fossil CO2 emissions from the production of nonwood alternatives. The results show notable carbon emissions savings when wood products are used in constructing buildings in place of nonwood alternatives.
A protocol for the use of roadkill or stranded animals as material for research and teaching
Authors: Auricchio Paulo , Catenacci Lilian Silva , Santos Karina Rodrigues , Britto Fabio Barros
Published: August 2014

Many aspects of the Brazilian fauna dynamics remain unknown. Often, researches on zoology depend on invasive protocols that require the death of specimens of rare or endangered species. This is the first time a combined protocol is proposed for the use of roadkill or stranded animals in research and teaching by different professionals. It turns such undesired deaths into a source of taxonomic material, tissue for histology, DNA analysis and parasitological tests and as ecological evidence. This is a non-invasive protocol that requires no sacrifice of any specimens. Skins and skeletons can be processed as taxonomic material and stomach contents provide information about feeding habits and ecology. In addition, regional zoological collections can be improved and these specimens can be used for practical classes in different areas, including environmental conservation. This article thus describes thirteen steps which can be taken to take the best advantage of these victims of human progress.
Flora da Bahia: Zygophyllaceae
Authors: Silva Uiara Catharina Soares e , De Oliveira Reyjane Patricia , Harley Raymond Mervyn , Giulietti Ana Maria
Published: August 2014

This account of the Zygophyllaceae is a further contribution to the ongoing Flora of Bahia project. Kallstroemia tribuloides and Tribulus terrestris are recognized for the state of Bahia, Brazil. A key to species is provided together with descriptions, illustrations, and general notes for the taxa.
Flora da Bahia: Typhaceae
Authors: De Carvalho Maria Luiza Silveira , De Lima Carla Teixeira , De Oliveira Reyjane Patricia , Giulietti Ana Maria
Published: August 2014

We present a floristic survey of Typhaceae from Bahia State, Brazil, as a contribution to the knowledge of the Flora of the State. Two species are recognized in the genus Typha: T. domingensis and T. latifolia. We present a key to distinguish the species, descriptions and general comments for the taxa, illustrations and distribution map of species in Bahia.
Out of the shadows: disability movements
Authors: Slorach Roddy
Published: August 2014

Britain’s disability movement can be divided into two distinct phases. The first, reaching a peak in the late 1980s to mid-1990s, was seen by its leading activists as a civil rights movement, whereas the second has been a response to the recent and ongoing government spending cuts. The outlook and strategies of the current movement have much in common with its predecessor but also differ in important ways. In resisting cuts to disability benefits and services, today’s disability activists have consciously established themselves as an important part of a wider resistance to austerity.
Empowering the people: ‘empowerment’ and the British Journal of Social Work, 1971–99
Authors: McLaughlin Kenneth
Published: August 2014

This paper offers a historical and contextual discussion of the concept of empowerment, a term that proliferates in contemporary social work and social policy discourse. First, I discuss the rise of ‘empowerment’ within social policy and social work highlighting some of the factors that have led to it becoming embedded within such circles, discussing the justifications and criticisms of both the term and the interventions that can result from it. Second, I take a more specific look at the way empowerment was discussed and debated within the British Journal of Social Work from the journal’s inception in 1971 through to the end of 1999.

The discussion alerts us of the need to view empowerment not as a fixed a priori good, but as embedded within social and political relationships, and therefore as a concept that can be used for either progressive or regressive social policies and related social work practices.
The neoliberal agenda and social work values: using critical discourse analysis to explore the role of language in processes of cultural hegemony
Authors: Mearns George
Published: August 2014

The well-documented impact of neoliberal policies on all aspects of the social work process has been accompanied more broadly by the legitimation of neoliberal values within the profession. However, there is a noted lack of research into the methods whereby this infiltration has occurred. This article explores these methods by using critical discourse analysis to focus on the role of language in effecting this legitimation. The coalition government’s policy Caring for our future is examined and the terms ‘choice’ and ‘independence’ are critically discussed as ideological articulations of neoliberal values, before being contrasted with a social justice agenda, which is argued to be fundamental to social work values. It is contended that the neoliberal values expressed in the policy are incongruent with a social justice agenda. Finally, some thoughts are offered as to how this analysis might be utilised to stimulate resistance to the proposed cultural hegemony of neoliberalism.
Multiple solutions for Dirichlet impulsive equations
Authors: Ferrara Massimiliano , Heidarkhani Shapour , Pizzimenti Pasquale F.
Published: August 2014

In this paper we are interested to ensure the existence of
multiple nontrivial solutions for some classes of problems under
Dirichlet boundary conditions with impulsive effects. More
precisely, by using a suitable analytical setting, the existence
of at least three solutions is proved exploiting a recent
three-critical points result for smooth functionals defined in a
reflexive Banach space. Our approach generalizes some well-known
results in the classical framework.
A new species of marine Dactylospora and its phylogenetic affinities within the Eurotiomycetes, Ascomycota
Authors: Pang Ka-Lai , Guo Sheng-Yu , Alias Siti Aisyah , Hafellner Josef , Jones E.B. Gareth
Published: August 2014

An apparently undescribed lignicolous Dactylospora species was collected on a rocky shore in northern Taiwan. The ascomatal morphology of this fungus is similar to other marine Dactylospora species, whereas the unique feature of the new fungus is a distinct perispore forming an ascospore appendage, which comprises a thick and hyaline sheath connected at the septum that opens at both ends. Dactylospora vrijmoediae is described and illustrated as new to science. On the basis of a phylogenetic analysis of the partial 18S and 28S rRNA and RPB2 genes, D. vrijmoediae occurs with other marine species, D. haliotrepha, D. mangrovei, and the terrestrial Sclerococcum sphaerale in an unnamed clade within the Eurotiomycetes, Ascomycota. The marine Dactylospora species are distantly placed and are separated from the terrestrial Dactylospora species included in the analysis (D. lobariella, D. imperfecta).
Classification of irreducible representations of Lie algebra of vector fields on a torus
Authors: Billig Yuly , Futorny Vyacheslav
Published: August 2014

We solve a long standing problem of the classification of all simple
modules with finite-dimensional weight spaces over Lie algebra of
vector fields on n-dimensional torus for any n. This generalizes
the classical result of O.Mathieu on simple weight modules for the
Virasoro algebra (

n
=
1

${n=1}$

).
Every such module is either of a highest weight type
or is a quotient of a module of tensor fields on a torus, which was
conjectured by Eswara Rao.
Ambitoric geometry I: Einstein metrics and extremal ambikähler structures
Authors: Apostolov Vestislav , Calderbank David M. J. , Gauduchon Paul
Published: August 2014

We present a local classification of conformally equivalent
but oppositely oriented 4-dimensional Kähler metrics which are toric with
respect to a common 2-torus action. In the generic case, these
“ambitoric” structures have an intriguing local geometry depending on a
quadratic polynomial q and arbitrary functions A and B of one variable.

We use this description to classify 4-dimensional Einstein metrics which are
hermitian with respect to both orientations, as well as a class of solutions
to the Einstein–Maxwell equations including riemannian analogues of the
Plebański–Demiański metrics. Our classification can be viewed as a
riemannian analogue of a result in relativity due to R. Debever, N. Kamran, and R. McLenaghan, and is a natural extension of the classification of
selfdual Einstein hermitian 4-manifolds, obtained independently by R. Bryant
and the first and third authors.

These Einstein metrics are precisely the ambitoric structures with vanishing
Bach tensor, and thus have the property that the associated toric Kähler
metrics are extremal (in the sense of E. Calabi). Our main results also
classify the latter, providing new examples of explicit extremal Kähler
metrics. For both the Einstein–Maxwell and the extremal ambitoric structures,
A and B are quartic polynomials, but with different conditions on the
coefficients. In the sequel to this paper we consider global examples, and use
them to resolve the existence problem for extremal Kähler metrics on toric
4-orbifolds with second Betti number

b
2

=
2

${b_{2}=2}$

.
Degrees of strongly special subvarieties and the André–Oort conjecture
Authors: Daw Christopher
Published: August 2014

In this paper we give a new proof of the André–Oort conjecture under the generalised Riemann hypothesis. In fact, we generalise the strategy pioneered by Edixhoven, and implemented by Klingler and Yafaev, to all special subvarieties. Thus, we remove ergodic theory from the proof of Klingler, Ullmo and Yafaev and replace it with tools from algebraic geometry. Our key ingredient is a lower bound for the degrees of strongly special subvarieties coming from Prasad’s volume formula for S-arithmetic quotients of semisimple groups.
Breakdowns in communication of radiological findings: an ethical and medico-legal conundrum
Authors: Berlin Leonard , Murphy Daniel R. , Singh Hardeep
Published: August 2014

Communication problems in diagnostic testing have increased in both number and importance in recent years. The medical and legal impact of failure of communication is dramatic. Over the past decades, the courts have expanded and strengthened the duty imposed on radiologists to timely communicate radiologic abnormalities to referring physicians and perhaps the patients themselves in certain situations. The need to communicate these findings goes beyond strict legal requirements: there is a moral imperative as well. The Code of Medical Ethics of the American Medical Association points out that “Ethical values and legal principles are usually closely related, but ethical obligations typically exceed legal duties.” Thus, from the perspective of the law, radiologists are required to communicate important unexpected findings to referring physicians in a timely fashion, or alternatively to the patients themselves. From a moral perspective, radiologists should want to effect such communications. Practice standards, moral values, and ethical statements from professional medical societies call for full disclosure of medical errors to patients affected by them. Surveys of radiologists and non-radiologic physicians reveal that only few would divulge all aspects of the error to the patient. In order to encourage physicians to disclose errors to patients and assist in protecting them in some manner if malpractice litigation follows, more than 35 states have passed laws that do not allow a physician’s admission of an error and apologetic statements to be revealed in the courtroom. Whether such disclosure increases or decreases the likelihood of a medical malpractice lawsuit is unclear, but ethical and moral considerations enjoin physicians to disclose errors and offer apologies.
Multi-parameter Triebel–Lizorkin spaces associated with the composition of two singular integrals and their atomic decomposition
Authors: Ding Wei , Lu Guozhen , Zhu Yueping
Published: August 2014

Atomic decomposition plays an important role in establishing the boundedness of operators on function spaces.
Let

0
<
p
,
q
<
∞

${0<p, q<\infty }$

and

α
=

(

α
1

,

α
2

)

∈

ℝ
2

${\alpha =(\alpha _1,\alpha _2)\in \mathbb {R}^2}$

. In this paper, we introduce multi-parameter Triebel–Lizorkin spaces

F
˙

p

α
,

q

(

ℝ
m

)

${\dot{F}^{\hspace*{0.85358pt}\alpha ,\,q}_{p}(\mathbb {R}^{m})}$

associated with different
homogeneities arising from the composition of two singular integral operators whose weak (1,1) boundedness was first studied by Phong and Stein [Amer. J. Math. 104 (1982), 141–172]. We then establish its atomic decomposition which is substantially different from that for the classical one-parameter Triebel–Lizorkin spaces. As an application of our atomic decomposition, we obtain the necessary and sufficient conditions for the
boundedness of an operator T on the multi-parameter Triebel–Lizorkin type
spaces. In the special case of

α
1

=

α
2

=
0

${\alpha _1=\alpha _2=0}$

, q = 2 and

0
<
p
≤
1

${0<p\le 1}$

, our spaces

F
˙

p

α
,

q

(

ℝ
m

)

${\dot{F}^{\hspace*{0.85358pt}\alpha ,\,q}_{p}(\mathbb {R}^{m})}$

coincide with the Hardy spaces

H
com
p

${H^p_{\mathrm {com}}}$

associated with the composition of two different singular integrals (see []). Therefore, our results also
give an atomic decomposition of

H
com
p

${H^p_{\mathrm {com}}}$

. Our work appears to be the first result of atomic decomposition in
the Triebel–Lizorkin spaces in the multi-parameter setting.
Evaluation of Cathode Heater Assembly for 42 GHz, 200 kW Gyrotron
Authors: Sharma S. K. , Singh Narendra Kumar , Singh Udaybir , Khatun Hasina , Kumar Nitin , Alaria M. K. , Raju R. S. , Jain P. K. , Sinha A. K.
Published: August 2014

In this paper, the evaluation of cathode-heater assembly of magnetron injection gun (MIG) for 42 GHz, 200 kW gyrotron is presented. The cathode-heater assembly is purchased from M/S SEMICON.The cathode-heater assembly is experimentally studied in three different conditions; in a belljar system, during vacuum processing of MIG and during MIG testing to ensure the required rise of cathode surface temperature for pre-set heater power.
Three-Pole Tunable Bandpass Filters With Constant Fractional Bandwidth Using Mixed Comb-line Resonators
Authors: Zhao Zhiyuan , Chen Jiang , Yang Lin , Chen Kunhe
Published: August 2014

A novel three-pole tunable bandpass filter using mixed combline resonators with a center frequency band of 0.9–1.8 GHz is proposed in this paper. The varactor-tuned filter is designed on a Rogers substrate with
On the First and the Second Order Statistics of the Capacity of κ-μ Fading Channels
Authors: Panić Stefan , Stefanović Mihajlo , Vasić Selena , Milić Dejan , Cvetković Aleksandar
Published: August 2014

Consideration of the channel capacity temporal behavior, in order to design a system that could adapt the transmission rate according to the capacity evolving process, and could transmit close to the ergodic capacity, is provided in this paper. Channel conditions have been modeled by the recently introduced general
On the Performance of the Golden Code in the Presence of Channel Estimation Error in Correlated MIMO Rayleigh Fading Channels
Authors: Ammari Mohamed Lassaad , Abid Wahiba
Published: August 2014

The Golden Code (GC) is a full-rate and full-diversity, space-time code for 2 × 2 multiple-input multiple-output (MIMO) systems with non-vanishing minimum determinant. Thanks to its algebraic construction, the GC achieves diversity-multiplexing gain trade-off and preserves the mutual information. The zero-forcing (ZF) detection is one of the simplest detection techniques that has a low computational complexity and provides a suboptimal performance. The purpose of this work is to investigate the effect of channel estimation error on the performance of the MIMO-ZF receiver for golden coded systems in spatio-temporally correlated Rayleigh fading channels. An upper and a lower bounds of the error probability are delivered and compared to the Monte Carlo simulation results. We quantify the capacity reduction due to the channel estimation error and to the spatio-temporally correlation. A tight lower bound of the ergodic capacity is provided. Numerical results show an excellent agreement between analytic bounds and Monte Carlo simulation curves. Moreover, the performances of the GC, in terms of bit error rate (BER) and channel capacity, are compared with those of the Alamouti coding.
Evaluations of SSC Diversity Receiver over EGK Fading Channels
Authors: Anastasov Jelena A. , Djordjevic Goran T. , Panic Stefan R. , Stefanovic Mihajlo C.
Published: August 2014

In this paper, a detailed performance analysis of switch-and-stay combining receivers over non identical distributed extended generalized K fading channels is presented. The analysis has been performed in both noise and interference-limited environments (the level of interference or noise is ignored, respectively). The expressions for the output signal-to-noise (SNR) and signal-to-interference (SIR) probability density function and cumulative distribution function, in a form of Fox's H functions, are presented. Based on this, analytical expressions for evaluating the moments, outage probability, average bit error rate and average channel capacity are derived. The influence of fading and shadowing phenomena, as well as the influence of unbalanced input SNR/SIR on the most important performance metrics is obtained. Presented numerical results are confirmed by Monte Carlo simulations.
A prospective drug use evaluation of antihypertensive drugs in in-patients of a tertiary referral care hospital
Authors: Mankadavath Ajmal , Chandrasekhar Dilip , Thomas Tina , Zuhra Fathimath , Kaipanthodi Shanoob , Parambil Jafer Chalil
Published: August 2014

Background: Hypertension is a chronic illness associated with high morbidity and mortality. Once hypertension is diagnosed, starting antihypertensive therapy on a long-term basis along with regular follow up is important. Standardizing treatment guidelines and conducting drug utilization studies at regular intervals help physicians to prescribe drugs rationally. The present study was conducted to analyze the prescription patterns of antihypertensive drugs in a tertiary care referral hospital in Malabar region, Kerala, India.

Methods: The study was conducted at the General Medicine and Cardiology Department involving the in-patients. Patients suffering from essential hypertension with or without other co-morbidities were included in the study. The frequency and proportion of prescribing different groups of antihypertensive drugs as monotherapy or combination therapy, and prescription of fixed drug combinations (FDCs) were analyzed. A total of 200 hypertensive patients were included in the study. Patient data were collected from in-patient’s case sheets and direct interviews with the patients and their observers.

Results: The majority of the patients were females with 56%, whereas the males comprised 44%, with most of the patients suffering from stage-II hypertension. The study revealed that a high proportion of the hypertensive patients had co-morbid diabetes mellitus. The most commonly prescribed class of antihypertensive drugs was angiotensin receptor blockers, followed by calcium channel blockers and β-blockers. With regard to patient therapy, 32.0% received monotherapy, whereas 68.0% received combination therapy, 16% of which received FDCs.

Conclusions: The study shows that clinical pharmacists can play a key role in promoting rational prescription and improving adherence to medication.
Acute mononeuropathy in a child with newly diagnosed type 1 diabetes mellitus
Authors: Rangel Maria Adriana , Baptista Carolina , Santos Fátima , Real Marta Vila , Campos Rosa Arménia , Leite Ana Luísa
Published: August 2014

: Neuropathy is a frequent complication of diabetes mellitus (DM), increasing with the duration of the disease, poor glycemic control and advanced age. Acute presentation of a neuropathy in the setting of a newly diagnosed type 1 DM is rare and holds a diagnostic challenge.

: A 10-year-old girl, presented at the emergency service with complaints of polydipsia, polyuria, asthenia and weight lost over the last 15 days, accompanied by difficulties in flexing the right foot, during the previous week. The patient denied any pain, paresthesias, or altered sensibility. There was no fever documented, or recent infectious intercurrence or trauma. On physical examination, she was conscious, collaborative and space and time-orientated, had a diminished strength in the right foot, namely in the dorsiflexion, conditioning a steppage gait ipsilateral. Hyperalgesia was felt in the dorsum of the right feet to the ankle. DM type 1 was diagnosed based on serum glucose of 629 mg/dL and mild ketoacidosis. Investigation for infectious, immune and nutritional aetiologies for the mononeuropathy was negative. Electrophysiological study was suggestive of a lesion of the peroneal nerve on the popliteal cesspit, but was not conclusive. The patient started physiotherapy during her hospital stay and exhibited a slight improvement in the dorsiflexion of the foot. Four months later she was asymptomatic and with good glycaemic control.

: Diabetic neuropathy is a heterogeneous group that still lacks adequate comprehension. Its approach is empirical and demands exclusion of other etiologies. A definitive diagnosis is not always possible and sometimes is retrospective.
Functional characterization of the novel sequence variant p.S304R in the hinge region of TSHR in a congenital hypothyroidism patients and analogy with other formerly known mutations of this gene portion
Authors: Cerqueira Taise Lima Oliveira , Carré Aurore , Chevrier Lucie , Szinnai Gabor , Tron Elodie , Léger Juliane , Cabrol Sylvie , Queinnec Chrystelle , De Roux Nicolas , Castanet Mireille , Polak Michel , Ramos Helton Estrela
Published: August 2014

Thyroid dysgenesis may be associated with loss-of-function mutations in the thyrotropin receptor (

The aim of this study was to characterize a novel

This cross-sectional cohort study involved 118 patients with CH and their family members, including 45 with familial and 73 with sporadic diseases. The thyroid gland was normal in 23 patients, 25 patients had hypoplasia, 25 hemithyroid agenesis, 21 had athyreosis, and 21 had ectopy. Genomic DNA was extracted, and 10 exons of the

We identified one previously unknown missense variation in the hinge region (HinR) of the

We report the ocurrence of a novel nonsynonymous substitution in the HinR of the large N-terminal extracellular domain of the
The T/QRS ratio values in pregnancies complicated by threatened preterm labour treated with intravenous infusions of fenoterol
Authors: Fuchs Tomasz , Pomorski Michał , Grobelak Krzysztof , Zimmer Mariusz
Published: August 2014

Aims: To evaluate values of foetal T/QRS ratios in pregnancies complicated by threatened preterm labour treated with intravenous infusions of fenoterol using non-invasive methods with transabdominal electrodes.

Materials and Methods: The study group consisted of 451 Caucasian women (63 preterm pregnancies and 327 healthy controls) whose pregnancies ranged from 28 to 37 gestational weeks. Foetal electrocardiograms were recorded and T/QRS ratios were calculated by KOMPOREL software (ITAM, Zabrze, Poland). The first recording was performed 30 min after the start of fenoterol infusion and the second 2 days after finishing tocolysis. T/QRS ratio variables were calculated. One-way analysis of variance was carried out.

Results: Significantly higher mean values of the T/QRS ratio were observed in pregnancies during tocolytic treatment in comparison to controls and pregnancies after tocolysis (P=0.0158 and P=0.0071, respectively). The T/QRS ratio values fall again shortly after finishing intravenous tocolysis.

Conclusions: The T/QRS ratio is one of the methods used for non-invasive foetal distress assessment that can be used in antepartum foetal monitoring in complicated pregnancies. Raised values of the T/QRS ratio in the foetus during tocolysis with fenoterol and next its fall to values observed in physiological pregnancies may indicate transient worsening of fetal well-being, however, additional research is required.
A spectral method for isotropic diffusion equation with random concentration fluctuations of incoming flux of particles through circular-shaped boundaries
Authors: Sabelfeld Karl K. , Levykin Alexander I.
Published: August 2014

We present in this paper a further development of the stochastic spectral method for solving boundary value problems
in domains which are composed by a set of overlapped discs first suggested by the first author in Appl. Math. Comput. 219 (2013), no. 10, 5123–5139].
We study statistical characteristics of the solution to isotropic diffusion problem in response to fluctuating
incoming flux of particles through the circular-shaped boundaries.
Performance of the method is illustrated by a series of numerical experiments.
The method can be considered as a direct inversion of the integral Poisson formula
representing the solution in the disc, so it is highly accurate and fast for the class of domains considered.
This makes possible to solve an ensemble of equations with random samples of boundary conditions
and calculate the desired statistical characteristics.
Learning about Vertebrate Limb Development
Authors: Liang Jennifer O. , Noll Matthew , Olsen Shayna
Published: August 2014

We have developed an upper-level undergraduate laboratory exercise that enables students to replicate a key experiment in developmental biology. In this exercise, students have the opportunity to observe live chick embryos and stain the apical ectodermal ridge, a key tissue required for development of the vertebrate limb. Impressively, every student who has tried this protocol has been successful, making it a good introduction to the use of the chick model system in studying development. The array of materials about limb development, using chick embryos in teaching laboratories, and the history of this experiment provide a rich background for teachers and students.
The Cell Cycle
Authors: Scherer Yvette D.
Published: August 2014

In this activity, students are given the opportunity to combine skills in math and geometry for a biology lesson in the cell cycle. Students utilize the data they collect and analyze from an online onion-root-tip activity to create a paper-plate time clock representing a 24-hour cell cycle. By dividing the paper plate into appropriate phases of the cell’s cycle on the basis of the data they collected, they can visualize the data, hypothesize, and predict how the time spent in each of the phases in the cycle might change in abnormal situations, such as in cancer or other diseases that affect control of the cell cycle.
Modeling Evolution in the Classroom
Authors: Lark Amy , Richmond Gail , Pennock Robert T.
Published: August 2014

New science standards and reform recommendations spanning grades K–16 focus on a limited set of key scientific concepts from each discipline that all students should know. They also emphasize the integration of these concepts with science practices so that students learn not only the “what” of science but also the “how” and “why.” In line with this approach, we present an exercise that models the integration of fundamental evolutionary concepts with science practices. Students use Avida-ED digital evolution software to test claims from a study on mutated butterflies in the vicinity of the compromised Fukushima Daiichi Nuclear Power Plant complex subsequent to the Great East Japan Earthquake of 2011. This exercise is appropriate for use in both high school and undergraduate biology classrooms.
Specificity, propagation, and memory of pericentric heterochromatin
Authors: Müller‐Ott Katharina , Erdel Fabian , Matveeva Anna , Mallm Jan‐Philipp , Rademacher Anne , Hahn Matthias , Bauer Caroline , Zhang Qin , Kaltofen Sabine , Schotta Gunnar , Höfer Thomas , Rippe Karsten
Published: August 2014

The cell establishes heritable patterns of active and silenced chromatin via interacting factors that set, remove, and read epigenetic marks. To understand how the underlying networks operate, we have dissected transcriptional silencing in pericentric heterochromatin (PCH) of mouse fibroblasts. We assembled a quantitative map for the abundance and interactions of 16 factors related toPCHin living cells and found that stably bound complexes of the histone methyltransferaseSUV39H1/2 demarcate thePCHstate. From the experimental data, we developed a predictive mathematical model that explains how chromatin‐boundSUV39H1/2 complexes act as nucleation sites and propagate a spatially confinedPCHdomain with elevated histoneH3 lysine 9 trimethylation levels via chromatin dynamics. This “nucleation and looping” mechanism is particularly robust toward transient perturbations and stably maintains thePCHstate. These features make it an attractive model for establishing functional epigenetic domains throughout the genome based on the localized immobilization of chromatin‐modifying enzymes.
Long-term Study of a Quadrivalent Human Papillomavirus Vaccine
Authors: Ferris Daron , Samakoses Rudiwilai , Block Stan L. , Lazcano-Ponce Eduardo , Restrepo Jaime Alberto , Reisinger Keith S. , Mehlsen Jesper , Chatterjee Archana , Iversen Ole-Erik , Sings Heather L. , Shou Qiong , Sausser Timothy A. , Saah Alfred
Published: August 2014

BACKGROUND:

We present a long-term safety, immunogenicity, and effectiveness study of a quadrivalent human papillomavirus (HPV4) vaccine.

METHODS:

Sexually naive boys and girls aged 9 to 15 years (N = 1781) were assigned (2:1) to receive HPV4 vaccine or saline placebo at day 1 and months 2 and 6. At month 30, the placebo group (n = 482) received HPV4 vaccine following the same regimen and both cohorts were followed through month 96. Subjects ≥16 years were eligible for effectiveness evaluations. The primary objective was to evaluate the long-term anti-HPV6/11/16/18 serological levels. The secondary objective was to estimate vaccine effectiveness against HPV6/11/16/18-related persistent infection or disease.

RESULTS:

For each of the HPV4 vaccine types, vaccination-induced anti-HPV response persisted through month 96. Among 429 subjects who received HPV4 vaccine at a mean age of 12, none developed HPV6/11/16/18-related disease or persistent infection of ≥12 months’ duration. Acquisition of new sexual partners (among those ≥16 years) was ∼1 per year. Subjects receiving HPV4 vaccine at month 30 (mean age 15 years) had a similar baseline rate of seropositivity to ≥1 of the 4 HPV types to those vaccinated at day 1 (mean age 12 years; 1.9% [9 of 474] vs 1.7% [20 of 1157]); however, 4 of the 9 subjects vaccinated at the later age were seropositive to 3 vaccine types, indicating previous HPV exposure. No new significant serious adverse events were observed for 8 years postvaccination in both genders.

CONCLUSIONS:

When administered to adolescents, the HPV4 vaccine demonstrated durability in clinically effective protection and sustained antibody titers over 8 years.
Automated Urinalysis and Urine Dipstick in the Emergency Evaluation of Young Febrile Children
Authors: Kanegaye John T. , Jacob Jennifer M. , Malicki Denise
Published: August 2014

OBJECTIVE:

The performance of automated flow cytometric urinalysis is not well described in pediatric urinary tract infection. We sought to determine the diagnostic performance of automated cell counts and emergency department point-of-care (POC) dipstick urinalyses in the evaluation of young febrile children.

METHODS:

We prospectively identified a convenience sample of febrile pediatric emergency department patients <48 months of age who underwent urethral catheterization to obtain POC and automated urinalyses and urine culture. Receiver operating characteristic analyses were performed and diagnostic indices were calculated for POC dipstick and automated cell counts at different cutpoints.

RESULTS:

Of 342 eligible children, 42 (12%) had urinary bacterial growth ≥50 000/mL. The areas under the receiver operating characteristic curves were: automated white blood cell count, 0.97; automated bacterial count, 0.998; POC leukocyte esterase, 0.94; and POC nitrite, 0.76. Sensitivities and specificities were 86% and 98% for automated leukocyte counts ≥100/μL and 98% and 98% for bacterial counts ≥250/μL. POC urine dipstick with ≥1+ leukocyte esterase or positive nitrite had a sensitivity of 95% and a specificity of 98%. Combinations of white blood cell and bacterial counts did not outperform bacterial counts alone.

CONCLUSIONS:

Automated leukocyte and bacterial counts performed well in the diagnosis of urinary tract infection in these febrile pediatric patients, but POC dipstick may be an acceptable alternative in clinical settings that require rapid decision-making.
Pre- and Postnatal Exposure to Parental Smoking and Allergic Disease Through Adolescence
Authors: Thacher Jesse D. , Gruzieva Olena , Pershagen Göran , Neuman Åsa , Wickman Magnus , Kull Inger , Melén Erik , Bergström Anna
Published: August 2014

OBJECTIVES:

To examine the role of prenatal and postnatal second-hand tobacco smoke (SHS) exposure on asthma, rhinitis, and eczema development up to 16 years of age.

METHODS:

A birth cohort of 4089 children was followed for 16 years. Information on parental smoking habits, lifestyle factors, and symptoms of allergic disease was gathered using repeated parental questionnaires. Generalized estimating equations assessed the overall and age-specific associations between SHS exposure and allergic disease at ages 1 to 16 years.

RESULTS:

Exposure to SHS in utero was associated with an overall elevated risk of developing asthma up to 16 years (odds ratio [OR] = 1.45; 95% confidence interval [CI], 1.15–1.83) but not for rhinitis or eczema. After additional adjustment for parental smoking throughout childhood, excess overall risks for asthma remained statistically significant. Moreover, a dose-dependent pattern with SHS was observed. Exposure to SHS during infancy was associated with an overall elevated risk of asthma (OR = 1.23; 95% CI, 1.01–1.51), rhinitis (OR = 1.18; 95% CI, 1.01–1.39), and eczema (OR = 1.26; 95% CI, 1.09–1.45) up to 16 years. When age-specific associations were examined, the elevated risks related to SHS exposure in utero or during infancy were mostly confined to early childhood for asthma and rhinitis, whereas the excess risk of eczema appeared greatest at later ages.

CONCLUSIONS:

Our findings indicate that early SHS exposure, in utero or during infancy, influences the development of allergic disease up to adolescence. Excess risks for asthma and rhinitis were seen primarily in early childhood, whereas those for eczema occurred at later ages.
Missed Opportunities for HPV Vaccination in Adolescent Girls: A Qualitative Study
Authors: Perkins Rebecca B. , Clark Jack A. , Apte Gauri , Vercruysse Jessica L. , Sumner Justen J. , Wall-Haas Constance L. , Rosenquist Anna W. , Pierre-Joseph Natalie
Published: August 2014

OBJECTIVE:

The goal of this study was to identify the rationale by parents/guardians and providers for delaying or administering human papillomavirus (HPV) vaccination to girls.

METHODS:

Qualitative interviews were conducted with parents/guardians accompanying their vaccine-eligible 11- to 17-year-old daughters to medical visits. Interviews were conducted in 1 public clinic and 3 private practice settings to ascertain why girls did or did not receive HPV vaccination. Questions probed vaccine decision-making from the point of view of parents/guardians and providers.

RESULTS:

A total of 124 parents/guardians and 37 providers participated. The most common reasons parents reported for not vaccinating their daughters was the lack of a physician recommendation (44%). Both parents and providers believed that HPV vaccination provided important health benefits, but the timing of vaccination with relation to sexual activity was an important theme related to vaccine delay. Providers with lower self-reported vaccination rates delayed vaccine recommendations in girls perceived to be at low risk for sexual activity, and several parents reported that their providers suggested or supported delaying vaccination until their daughters were older. However, parents/guardians and providers agreed that predicting the timing of sexual debut was extremely difficult. In contrast, providers with high vaccination rates presented HPV vaccination as a routine vaccine with proven safety to prevent cancer, and parents responded positively to these messages.

CONCLUSIONS:

Although most parents and providers believe that HPV vaccination is important, missed opportunities result from assumptions about the timing of vaccination relative to sexual activity. Routinely recommending HPV vaccination as cancer prevention to be coadministered with other vaccines at age 11 years can improve vaccination rates.
Establishing Benchmarks for the Hospitalized Care of Children With Asthma, Bronchiolitis, and Pneumonia
Authors: Parikh Kavita , Hall Matt , Mittal Vineeta , Montalbano Amanda , Mussman Grant M. , Morse Rustin B. , Hain Paul , Wilson Karen M. , Shah Samir S.
Published: August 2014

BACKGROUND AND OBJECTIVES:

Asthma, pneumonia, and bronchiolitis are the leading causes of admission for pediatric patients; however, the lack of accepted benchmarks is a barrier to quality improvement efforts. Using data from children hospitalized with asthma, bronchiolitis, or pneumonia, the goals of this study were to: (1) measure the 2012 performance of freestanding children’s hospitals using clinical quality indicators; and (2) construct achievable benchmarks of care (ABCs) for the clinical quality indicators.

METHODS:

This study was a cross-sectional trial using the Pediatric Health Information System database. Patient inclusions varied according to diagnosis: asthma (International Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9-CM] codes 493.0–493.92) from 2 to 18 years of age; bronchiolitis (ICD-9-CM codes 466.11 and 466.19) from 2 months to 2 years of age; and pneumonia (ICD-9-CM codes 480–486, 487.0) from 2 months to 18 years of age. ABC methods use the best-performing hospitals that comprise at least 10% of the total population to compute the benchmark.

RESULTS:

Encounters from 42 hospitals included: asthma, 22 186; bronchiolitis, 14 882; and pneumonia, 12 983. Asthma ABCs include: chest radiograph utilization, 24.5%; antibiotic administration, 6.6%; and ipratropium bromide use >2 days, 0%. Bronchiolitis ABCs include: chest radiograph utilization, 32.4%; viral testing, 0.6%; antibiotic administration, 18.5%; bronchodilator use >2 days, 11.4%; and steroid use, 6.4%. Pneumonia ABCs include: complete blood cell count utilization, 28.8%; viral testing, 1.5%; initial narrow-spectrum antibiotic use, 60.7%; erythrocyte sedimentation rate, 3.5%; and C-reactive protein, 0.1%.

CONCLUSIONS:

We report achievable benchmarks for inpatient care for asthma, bronchiolitis, and pneumonia. The establishment of national benchmarks will drive improvement at individual hospitals.
El Programa de Pensión Alimentaria (no contributivo) para adultos mayores en México, Distrito Federal ante el envejecimiento demográfico
Authors: Díaz Sandra , Silva Eliud
Published: August 2014

Se realizan diversas estimaciones que evidencian los alcances y limitaciones del programa de pensión alimentaria para adultos mayores en México, Distrito Federal (DF), ante su inminente envejecimiento poblacional. Según los últimos datos censales, se tiene y se presentará un proceso más acelerado de lo previsto del fenómeno, lo cual traería como consecuencia directa, serias implicaciones económicas para mantener en operación al programa. Se emplean proyecciones demográficas, se plantean supuestos y se cuantifican a valor futuro los recursos económicos requeridos. Se concluye que resulta altamente comprometida su viabilidad, sin un estrategia profunda capaz de financiarle.
Ecuaciones de predicción de la talla a partir de la altura de la rodilla de los adultos mayores de Costa Rica
Authors: Jiménez-Fontana Pamela , Chaves-Corea Abner
Published: August 2014

La talla es un parámetro antropométrico que permite evaluar el estado de salud de los adultos mayores, ya que nos permite determinar el índice de masa corporal y, con este, los niveles de obesidad, el grado de desnutrición proteico calórica, y otros factores de riesgo. Sin embargo, en adultos mayores con dificultad de movimiento, enfermedades avanzadas, o cambios en la curvatura normal de la columna vertebral, es complicado realizar una correcta medición de la talla. Cuando no se puede realizar una correcta medición de la talla, se pueden utilizar modelos de regresión lineal utilizando otras variables antropométricas para estimar la talla. Por ende, el objetivo de este estudio es definir ecuaciones de predicción de la talla a partir de la altura de la rodilla y la edad para los adultos mayores de Costa Rica por sexo. El estudio utilizó los datos de la encuesta longitudinal CRELES, muestra representativa de los adultos mayores de Costa Rica. Los coeficientes de predicción estimados a partir de CRELES se compararon con los coeficientes de predicción estimados por los modelos (externos) de Chumlea, Roche, y Steinbaugh (1985) y Palloni y Guend (2005). Los coeficientes de predicción estimados con base a CRELES son, en su mayoría, significativamente diferentes a los coeficientes de los modelos externos; además, los coeficientes de predicción estimados con la muestra CRELES producen residuos y errores puros menores que los modelos externos. Se recomienda utilizar las nuevas ecuaciones de predicción planteadas en este estudio para estimar la talla de adultos mayores costarricenses con problemas fisiológicos y de movilidad.
Control de Diabetes mellitus e hipertensión arterial en personas afiliadas al Seguro Popular. El caso de habitantes de las localidades rurales en Tabasco, México
Authors: Montero Mendoza Elda
Published: August 2014

En este artículo se presentan los resultados de un estudio cuyo objetivo fue conocer la atención que se brinda en las clínicas del primer nivel a personas que tienen un diagnóstico de diabetes mellitus o de hipertensión arterial y que cuentan con Seguro Popular. Participaron habitantes de tres localidades del municipio de Nacajuca, Tabasco con menos de 1,200 habitantes y 98,4% en  hogares indígenas. Se realizó una encuesta de hogares; entrevistas abiertas y pláticas informales con autoridades municipales y médicos alópatas. A través de la encuesta se obtuvo información completa de 328 hogares donde se identificó a 107 personas con una enfermedad crónica, 79,4% de ellas afiliadas al Seguro Popular. Las principales enfermedades reportadas son diabetes mellitus trastornos de la visión e hipertensión arterial. La mayoría de las personas entrevistadas (73,2%) acude al control de estas enfermedades a la clínica institucional que se ubica en o cerca de su localidad de residencia. Sin embargo, mencionan que esta cita de controles tiene un requisito a cumplir. En las clínicas de salud no se siguen los procedimientos normados y existe desabasto de medicamentos específicos, por lo que las personas entrevistadas siguen diversas estrategias para adquirir los medicamentos. Se concluye que el tratamiento y control de la hipertensión arterial y de la diabetes mellitus se contemplan en los servicios que otorga el Seguro Popular; sin embargo, existen deficiencias en el cumplimiento de lo normado oficialmente. Se sugiere que los tomadores de decisiones públicas en salud otorguen la importancia que merece el primer nivel de atención médica en la atención de las enfermedades crónicas.