bluuebunny/crossref_metadata_2025 huggingface dataset:
Advanced numerical models for the propagation of floods with high-sediment concentrations in mountain rivers
Authors: Contreras María Teresa , Gironás Jorge , Westerink Joannes , Escauriaza Cristián
Published: September 2018

Rapid floods induced by extreme precipitation are common events in regions near the Andes mountain range. Growing urban development, combined with the changing climate and the influence of El Niño, have increased the exposure of the population in many regions of South America. Simulations of flash floods in these watersheds are very challenging, due to the complex morphology, the insufficient hydrometeorological data, and the uncertainty posed by the variability of sediment concentration. To address these issues, we develop a high-resolution numerical model of the non-linear shallow water equations, coupled with the mass conservation of sediment, and considering the density effects and changes of rheology in the momentum equation. Based on these simulations we develop a real-time early-warning system, by creating a surrogate model or meta-model from the simulations. Using a small set of parameters, we define storms for a wide range of meteorological conditions, and utilize the high-fidelity model results to create a database of flood propagation under different conditions. Through this second model we perform a sophisticated interpolation/regression, and approximate efficiently the flow depths and velocities. This is the first application of its kind in the Andes region, which can be used to improve the prediction of flood hazard in real conditions, employing low computational resources. We also create a framework to develop early warning systems, and to help decision makers and city planners in these mountain regions.
Neue WHO-Empfehlungen zur Geburtsbetreuung
Authors: Kerlen-Petri Katharina
Published: September 2018

Die Weltgesundheitsorganisation (WHO) hat im Februar 2018 evidenzbasierte Empfehlungen zur „Geburtsbetreuung für eine positive Geburtserfahrung“ herausgegeben (Originaltitel: Intrapartum care for a positive childbirth experience) 1. Sie sollen globale Gesundheitsstandards für gesunde schwangere Frauen definieren und helfen, unnötige Interventionen zu reduzieren.
Rund um das Thema Erben und Vererben
Authors: Polok Adrian
Published: September 2018

Was ist der der Unterschied zwischen einem Erbe und einem Vermächtnis? Wie sollte ein Testament formuliert sein? Was ist eine Zustiftung? Auf diese und weitere Fragen zum Thema Erben und Vererben geht eine Informationsbroschüre der Deutschen Diabetes Stiftung ein.
Diabetes im Alter
Authors: Zeyfang Andrej
Published: September 2018

Die Angabe von HbA1c-Korridoren, abhängig von Folge- und Begleiterkrankungen des Diabetes, der Multimorbidität und bestehenden funktionellen Einschränkungen hat sich für die Blutglukose-Zielplanung des geriatrischen Patienten inzwischen weltweit etabliert. Dabei darf das Erreichen eines gesetzten HbA1c-Zieles nicht die Gefahren von schweren Hypoglykämien oder längerfristigen Hyperglykämien aus den Augen geraten lassen. Bei langdauernder Diabeteserkrankung mit über Jahre hinweg schlechter HbA1c-Einstellung und bestehender kardiovaskulärer Begleitmorbidität ist eine zu straffe Blutglukoseeinstellung mit starker HbA1c-Senkung für den älteren Menschen eher schädlich als nützlich. Für die Planung der „individualisierten Therapie“ des Älteren müssen geriatrische Syndrome, besonders im Bereich der Kognition sowie das strikte Vermeiden von Hypoglykämien priorisiert werden. Generell ist für den Älteren mit Diabetes eine Abkehr von glukozentrischen, allein auf HbA1c-Werten basierenden Zielen, zu beobachten.
Geburtseinleitung bei Erstgebärenden ab errechnetem Termin in einem Niedrigrisiko-Kollektiv
Authors: Pretscher Jutta , Weiss Christel , Dammer Ulf , Stumpfe Florian , Faschingbauer Florian , Beckmann Matthias , Kehl Sven
Published: September 2018

Ziel Ziel dieser Arbeit war es zu untersuchen, ob die Rate an Entbindungen per Sectio caesarea nach Geburtseinleitung ab 40+0 SSW abhängig vom Gestationsalter ist.

Material und Methodik In dieser Kohortenstudie wurden Geburtseinleitungen in einem Niedrigrisikokollektiv zwischen 3 Gruppen (Gruppe 1: 40+0 – 40+6 SSW, Gruppe 2: 41+0 – 41+3 SSW, Gruppe 3:>41+3 SSW) verglichen. Der primäre Zielparameter war die Kaiserschnittrate.

Ergebnis Es zeigte sich kein signifkanter Unterschied hinsichtlich des primären Zielparameters Kaiserschnittrate zwischen den Gruppen 1–3 (p=0,4036). Auch in der multivariablen Analyse waren die Gruppenzuteilung und damit das Gestationsalter nicht relevant. Zu den Faktoren, die die Kaiserschnittrate beeinflussten, gehörten der maternale BMI (p<0,0001), das maternale Alter (p=0,0005) und das Geburtsgewicht (p=0,0151). Bei den sekundären Outcomeparametern wie dem pH- und dem Apgar-Wert sowie der Rate an postpartaler Verlegung in die Kinderklinik zeigten sich ebenfalls keine signifikanten Unterschiede zwischen den Gruppen.

Schlussfolgerung Der Zeitpunkt der Geburtseinleitung ab 40+0 SSW hatte in dem Niedrigrisikokollektiv keinen Einfluss auf die Kaiserschnittrate.
Determinants of Visfatin/NAMPT Serum Concentration and its Leukocyte Expression in Hyperthyroidism
Authors: Sawicka-Gutaj Nadia , Zybek-Kocik Ariadna , Kloska Michał , Czarnywojtek Agata , Sowiński Jerzy , Budny Bartłomiej , Woliński Kosma , Ziemnicka Katarzyna , Mańkowska-Wierzbicka Dorota , Ruchała Marek
Published: September 2018

We aimed to analyze the potential influence of thyroid autoimmunity on visfatin/NAMPT serum concentration and its leukocyte expression in hyperthyroid patients. This is a single-center, cross-sectional study with consecutive enrollment. All patients with newly diagnosed overt hyperthyroidism in a course of Graves' disease or toxic nodular goiter were included in the study. They underwent physical examination, laboratory investigation, body composition analysis, and thyroid ultrasound. NAMPT mRNA leukocyte expressions were measured using RT-qPCR. Of the 173 patients, 95 were enrolled in further analysis [67 patients with Graves' disease (GD) and 28 with toxic nodular goiter (TNG)]. Control group consisted of 43 healthy volunteers adjusted for age, sex, and BMI. Higher NAMPT/visfatin serum concentration was found in patients with GD comparing with patients with TNG (p=0.03855). We found significant NAMPT leukocyte overexpression in GD patients (n=32) as compared to TNG patients (n=18) and euthyroid controls (n=24) (p=0.005965). Simple linear regression analysis revealed that NAMPT/visfatin serum concentration was significantly associated with NAMPT leukocyte expression, thyroid autoimmunity, age, HOMA-IR, and fat mass percentage (FM%). NAMPT leukocyte expression was related to thyroid autoimmunity, age, and TRAb levels. The stepwise multiple regression analysis revealed FM% and HOMA-IR as independent predictors of visfatin/NAMPT serum levels. In a separate stepwise multiple regression analysis, we confirmed the association between NAMPT leukocyte expression and TRAb levels. We found that fat mass percentage together with HOMA-IR are the most significant predictors of visfatin/NAMPT serum elevation in hyperthyroid patients.
Applying the RE-AIM Framework for the Evaluation of a Clinical Decision Support Tool for Pediatric Head Trauma: A Mixed-Methods Study
Authors: Masterson Creber Ruth , Dayan Peter , Kuppermann Nathan , Ballard Dustin , Tzimenatos Leah , Alessandrini Evaline , Mistry Rakesh , Hoffman Jeffrey , Vinson David , Bakken Suzanne ,   for the Pediatric Emergency Care Applied Research Network (PECARN) and the Clinical Research on Emergency Services and Treatments (CREST) Network
Published: September 2018

Background The overuse of cranial computed tomography (CT) to diagnose potential traumatic brain injuries (TBIs) exposes children with minor blunt head trauma to unnecessary ionizing radiation. The Pediatric Emergency Care Applied Research Network and the Clinical Research on Emergency Services and Treatments Network implemented TBI prediction rules via electronic health record (EHR) clinical decision support (CDS) to decrease use of CTs in children with minor blunt head trauma.

Objective This article aims to facilitate implementation and dissemination of a CDS alert into emergency departments around the country.

Methods We evaluated the EHR CT CDS tool through a mixed-methods analysis of 38 audio-recorded interviews with health care stakeholders and quantitative data sources, using the Reach, Efficacy, Adoption, Implementation, and Maintenance framework.

Results Reach
—The demographics of participants enrolled in the clinical trial were consistent with national estimates of TBI prevalence. Efficacy—There was a variable and modest reduction in CT rates for the 8,067 children with minor head trauma whose clinicians received CDS. Adoption
—The EHR CT CDS tool was well matched with the organizational mission, values, and priorities of the implementation sites. Implementation— The most important predisposing factors for successful implementation were the presence of an approachable clinical champion at each site and belief that the tool was a relevant, reusable knowledge asset. Enabling factors included an effective integration within the clinical workflow, organizational investment in user training, and ease of use. Maintenance
— Reinforcing factors for the EHR CT CDS tool included a close fit with the institutional culture, belief that it was useful for providers and families, and a good educational and informational tool. As such, the EHR CT CDS tool was maintained in clinical practice long after study completion.

Conclusion Data from this mixed-methods study complement findings from the efficacy trial and provide critical components for consideration prior to integration and subsequent dissemination of the EHR CT CDS tool.

Trial Registration NCT01453621, Registered September 27, 2011
Ignition and self-propagating reactions in Al/Pt multilayers of varied design
Authors: Adams D. P. , Reeves R. V. , Abere M. J. , Sobczak C. , Yarrington C. D. , Rodriguez M. A. , Kotula P. G.
Published: September 2018

The different rate-limiting processes underlying ignition and self-propagating reactions in Al/Pt multilayers are examined through experiments and analytical modeling. Freestanding, ∼1.6 μm-thick Al/Pt multilayers of varied stoichiometries and nanometer-scale layer thicknesses ignite at temperatures below the melting point of both reactants (and eutectics) demonstrating that initiation occurs via solid-state mixing. Equimolar multilayers exhibit the lowest ignition temperatures when comparing structures having a specific bilayer thickness. An activation energy of 76.6 kJ/mol at. associated with solid state mass transport is determined from the model analysis of ignition. High speed videography shows that equimolar Al/Pt multilayers undergo the most rapid self-sustained reactions with wavefront speeds as large as 73 m/s. Al- and Pt-rich multilayers react at reduced rates (as low as 0.3 m/s), consistent with reduced heat of reaction and lower adiabatic temperatures. An analytical model that accounts for key thermodynamic properties, preliminary mixing along interfaces, thermal transport, and mass diffusion is used to predict the wavefront speed dependencies on bilayer thickness. Good fits to experimental data provide estimates for activation energy (51 kJ/mol at.) associated with mass transport subject to high heating rates and thermal diffusion coefficient of premixed interfacial volumes (2.8 × 10−6 m2/s). Pt dissolution into molten Al is identified as a rate-limiting step underlying high temperature propagating reactions in Al/Pt multilayers.
Thermoelectric efficiency of graded SicGe1–c alloys
Authors: Rogolino P. , Cimmelli V. A.
Published: September 2018

We consider SicGe1–c graded systems of length L = 3 mm and L = 100 nm, under the action of an electric field E, and crossed by an electrical current i, the two sides of which are kept at two different temperatures Th and Tc. The dependence on composition and temperature of the thermal conductivity is analyzed. We evaluate the thermal conductivity in correspondence of the constant temperatures T = 300 K, T = 400 K, and T = 500 K and investigate the thermoelectric efficiency of the system as a function of the stoichiometric variable c and of the effective temperature gradient Th−TcL. For each temperature, we calculate the values of c in the interval [0, 1] which realize the optimal efficiency of the thermoelectric energy conversion. The corresponding values of the thermal conductivity are determined as well. For L = 3 mm, we find that the best efficiency of thermoelectric energy conversion is achieved at T = 500 K, c = 0.325568, and λ = 7.3444 Wm−1 K−1. For L = 100 nm, we obtain the best efficiency at T = 500 K, c = 0.613937, and λ = 0.1510 Wm−1 K−1.
Correspondence between host crystal conditions and emission spectrum shape of Eu3+ ions doped in ZnO and ZnGa2O4 films
Authors: Akazawa Housei , Shinojima Hiroyuki
Published: September 2018

We investigated the photoluminescence of Eu-doped ZnO and ZnGaxO1 + 1.5x (x = 1.8–2.8) films upon bandgap excitation to identify the occupation sites of Eu3+ ions through varying the host crystal material, substrate material, and reactant gas. Eu3+ emissions from ZnGaxO1 + 1.5x:Eu films deposited on Si and SiO2 substrates had similar spectral shapes, but their intensities were different, correlated with different defect emission levels. When depositions were carried out in H2O gas, the Eu3+ emissions from the c-axis oriented ZnO:Eu films consisted of a very sharp main peak (P1) at 612 nm and a sub-peak (P2) at 619 nm for 5D0 → 7F2 transition, whereas those from randomly oriented polycrystalline ZnGaxO1 + 1.5x:Eu films were broader and could be divided into four components (P1, P2, P3, and P4), of which the wavelengths of P1 and P2 matched those of the ZnO:Eu films. The availability of both Ga3+ and Zn2+ sites in the ZnGa2O4 lattice expands the variance of chemically distinct sites that can be occupied with Eu3+ compared with only divalent Zn2+ sites in the ZnO crystal. Films deposited with O2 exhibited lower emission intensities with a narrower spectrum width than those deposited with H2O. This behavior was correlated with the X-ray diffraction peak width of ZnGa2O4(311). High-quality crystal lattices formed with O2 allowed only a few sites to accommodate Eu3+ ions. In contrast, OH− and H+ derived from H2O will modify crystallinity to generate various emission-active sites, resulting in intense and broad emissions. Possible sites for the four components are discussed.
Tension-compression asymmetry in plasticity of nanotwinned 3C-SiC nanocrystals
Authors: Chavoshi Saeed Zare , Xu Shuozhi
Published: September 2018

Encompassing nanoscale thin twins in metals induces diverse influences, either strengthening triggered by the lattice dislocation blockage effects or softening prompted by dislocation emission from coherent twin boundary (CTB)/grain boundary (GB) intersections as well as CTB migration; yet the deformation mechanism remains poorly understood in ceramic nanostructures possessing covalent bonds. Here, we report the results of uniaxial compressive and tensile stress loading of twin-free and nanotwinned nanocrystalline cubic silicon carbide (3C-SiC) ceramic attained by large-scale molecular dynamics simulations. We find a strong and unique tension-compression asymmetry in strength of nanocrystalline ceramics, much higher than that of metals. We demystify that strength and ductility behaviour do not correlate simply with the amount of dislocation density, voids, intergranular disordered phase, and total strain energy; instead, it arises from a complex interplay of the aforementioned features and structural characteristics, e.g., GB and triple junction area distribution along/normal to the direction of straining as well as the capability of strain accommodation by the GBs and CTBs, with the dominant role of the structural characteristics in nanotwinned samples. Our results also reveal that primarily intergranular crack propagation and fracture along the GBs transpires, and not along the CTBs, resulting from the high energy of the GBs. However, a high density of nanoscale twins in the 3C-SiC nanocrystals could give rise to the alternation of the crack path from intergranular to intragranular type induced by shear, which brings about the glide of Shockley partials along the CTBs and subsequent formation of CTB steps and twin plane migration.
ASCT1 (Slc1a4) transporter is a physiologic regulator of brain
d
-serine and neurodevelopment
Authors: Kaplan Eitan , Zubedat Salman , Radzishevsky Inna , Valenta Alec C. , Rechnitz Ohad , Sason Hagit , Sajrawi Clara , Bodner Oded , Konno Kohtarou , Esaki Kayoko , Derdikman Dori , Yoshikawa Takeo , Watanabe Masahiko , Kennedy Robert T. , Billard Jean-Marie , Avital Avi , Wolosker Herman
Published: September 2018

d
-serine is a physiologic coagonist of NMDA receptors, but little is known about the regulation of its synthesis and synaptic turnover. The amino acid exchangers ASCT1 (Slc1a4) and ASCT2 (Slc1a5) are candidates for regulating
d
-serine levels. Using ASCT1 and ASCT2 KO mice, we report that ASCT1, rather than ASCT2, is a physiologic regulator of
d
-serine metabolism. ASCT1 is a major
d
-serine uptake system in astrocytes and can also export
l
-serine via heteroexchange, supplying neurons with the substrate for
d
-serine synthesis. ASCT1-KO mice display lower levels of brain
d
-serine along with higher levels of
l
-alanine,
l
-threonine, and glycine. Deletion of ASCT1 was associated with neurodevelopmental alterations including lower hippocampal and striatal volumes and changes in the expression of neurodevelopmental-relevant genes. Furthermore, ASCT1-KO mice exhibited deficits in motor function, spatial learning, and affective behavior, along with changes in the relative contributions of
d
-serine vs. glycine in mediating NMDA receptor activity. In vivo microdialysis demonstrated lower levels of extracellular
d
-serine in ASCT1-KO mice, confirming altered
d
-serine metabolism. These alterations are reminiscent of some of the neurodevelopmental phenotypes exhibited by patients with ASCT1 mutations. ASCT1-KO mice provide a useful model for potential therapeutic interventions aimed at correcting the metabolic impairments in patients with ASCT1 mutations.
Preclinical characterization of Sintilimab, a fully human anti-PD-1 therapeutic monoclonal antibody for cancer
Authors: Zhang Shuang , Zhang Min , Wu Weiwei , Yuan Zhijun , Tsun Andy , Wu Min , Chen Bingliang , Li Jia , Miao Xiaoniu , Miao Xiaoliang , Liu Xiaolin , Yu Dechao , Liu Junjian
Published: September 2018

Background

Programmed cell death 1 (PD-1) is an inhibitory immune checkpoint expressed on activatedT cells. Upon the formation of T cell receptor (TCR)-pMHC complexes, concomitant PD-1 ligation to its ligands programmed death-ligand 1 (PD-L1) or programmed death-ligand 2 (PD-L2) downregulates TCR signaling and effector function. Here we describe the preclinical characterization of Sintilimab, a fully human IgG4 antibody that potently blocks PD-1 interactions with PD-L1 and PD-L2.

Methods

The binding affinity and blockade function were detected by using surface plasmon resonance (SPR), Enzyme-linked immunosorbent assay (ELISA) and flow cytometry. The biology function properties were measured with luciferase assay and mixed lymphocyte reaction assay. In vivo anti-tumor function and preclinical pharmacokinetic (PK) were identified with human PD-1 transgenic mice and non-human primates separately.

Results

Sintilimab can specifically and strongly bind to human PD-1 (hPD-1) and cynomolgus PD-1 and the affinity of Sintilimab to human PD-1 was measured at 0.3 nm via surface SPR, and displayed slow dissociation kinetics. Sintilimab can block the interaction of PD-1 to PD-L1 and PD-L2 and induce high secretion levels of interferon (IFN)-γ and interleukin (IL)-2 in primary T cell assays. In humanized hPD-1 knock-in mouse models, Sintilimab showed potent anti-tumor activity and increased tumor-infiltrating CD8/CD4 T cell and CD8/ Treg ratios. Preclinical experimentation in non-human primates following a single intravenous infusion of Sintilimab at 1, 6 and 30 mg/kg presented with no signs of drug-related toxicity, and showed typical PK characteristics of an IgG antibody.

Conclusions

Sintilimab has desirable preclinical attributes that supports its clinical development for cancer treatment.
Spray Drift from a Conventional Axial Fan Airblast Sprayer in a Modern Orchard Work Environment
Authors: Kasner Edward J , Fenske Richard A , Hoheisel Gwen A , Galvin Kit , Blanco Magali N , Seto Edmund Y W , Yost Michael G
Published: September 2018

Pesticide spray drift represents an important cause of crop damage and farmworker illness, especially among orchard workers. We drew upon exposure characteristics from known human illness cases to design a series of six spray trials that measured drift from a conventional axial fan airblast sprayer operating in a modern orchard work environment. Polyester line drift samples (n = 270; 45 per trial) were suspended on 15 vertical masts downwind of foliar applications of zinc, molybdenum, and copper micronutrient tracers. Samples were analyzed using inductively coupled plasma mass spectrometry and resulting masses were normalized by sprayer tank mix concentration to create tracer-based drift volume levels. Mixed-effects modeling described these levels in the context of spatial variability and buffers designed to protect workers from drift exposure. Field-based measurements showed evidence of drift up to 52 m downwind, which is approximately 1.7 times greater than the 30 m (100 ft) ‘Application Exclusion Zone’ defined for airblast sprayers by the United States Environmental Protection Agency Worker Protection Standard. When stratified by near (5 m), mid (26 m), and far (52 m) distances, geometric means and standard deviations for drift levels were 257 (1.8), 52 (2.0), and 20 (2.3) µl, respectively. Fixed effect model coefficients showed that higher wind speed [0.53; 95% confidence interval (CI): 0.35, 0.70] and sampling height (0.16; 95% CI: 0.11, 0.20) were positively associated with drift; increasing downwind distance (−0.05; 95% CI: −0.06, −0.04) was negatively associated with drift. Random effects showed large within-location variability, but relatively few systematic changes for individual locations across spray trials after accounting for wind speed, height, and distance. Our study findings demonstrate that buffers may offer drift exposure protection to orchard workers from airblast spraying. Variables such as orchard architecture, sampling height, and wind speed should be included in the evaluation and mitigation of risks from drift exposure. Data from our study may prove useful for estimating potential exposure and validating orchard-based bystander exposure models.
Optimal modality selection in external beam radiotherapy
Authors: Nourollahi Sevnaz , Ghate Archis , Kim Minsun
Published: September 2018

The goal in external beam radiotherapy (EBRT) for cancer is to maximize damage to the tumour while limiting toxic effects on the organs-at-risk. EBRT can be delivered via different modalities such as photons, protons and neutrons. The choice of an optimal modality depends on the anatomy of the irradiated area and the relative physical and biological properties of the modalities under consideration. There is no single universally dominant modality. We present the first-ever mathematical formulation of the optimal modality selection problem. We show that this problem can be tackled by solving the Karush–Kuhn–Tucker conditions of optimality, which reduce to an analytically tractable quartic equation. We perform numerical experiments to gain insights into the effect of biological and physical properties on the choice of an optimal modality or combination of modalities.
Prevalence of Chronic Kidney Disease and Poor Diagnostic Accuracy of Dipstick Proteinuria in Human Immunodeficiency Virus-Infected Individuals: A Multicenter Study in Japan
Authors: Yanagisawa Naoki , Muramatsu Takashi , Koibuchi Tomohiko , Inui Akihiro , Ainoda Yusuke , Naito Toshio , Nitta Kosaku , Ajisawa Atsushi , Fukutake Katsuyuki , Iwamoto Aikichi , Ando Minoru
Published: September 2018

Background

Chronic kidney disease (CKD) has become one of the common comorbid conditions affecting the human immunodeficiency virus (HIV) population. Human immunodeficiency virus-infected individuals are at increased risk of developing CKD, and they are likely to experience faster progression of renal dysfunction compared with HIV-uninfected individuals. Albuminuria represents not only kidney damage but also manifests metabolic syndrome and vascular dysfunction.

Methods

We conducted a multicenter, cross-sectional study involving 2135 HIV-infected individuals in Japan to test the prevalence of CKD and proteinuria/albuminuria. Urine sample was analyzed by both dipstick test and albumin-to-creatinine ratio (ACR) assay. Chronic kidney disease was classified according to the Kidney Disease Outcomes Quality Initiative (K/DOQI) and Kidney Disease: Improving Global Outcomes (KDIGO) guidelines. The diagnostic performance of dipstick test to detect albuminuria (ACR ≥30 mg/g) was evaluated.

Results

The prevalence of CKD, evaluated by K/DOQI and KDIGO guidelines, was 15.8% and 20.4%, respectively. Age, total cholesterol level, prevalence of hypertension, diabetes mellitus, and hepatitis C infection tended to increase, whereas levels of hemoglobin, serum albumin, and CD4 cell count tended to decrease as CKD risk grades progressed. Proteinuria and albuminuria were present in 8.9% and 14.5% of individuals, respectively. Dipstick test ≥1+ to detect albuminuria had an overall sensitivity of 44.9% and specificity of 97.2%.

Conclusions

The KDIGO guideline may enable physicians to capture HIV-infected patients at increased risk more effectively. The sensitivity of dipstick proteinuria to detect albuminuria is so poor that it may not serve as an alternative in HIV-infected individuals.
WALL THICKNESS OPTIMISATION OF AN IONISATION CHAMBER FOR DIRECTIONAL DOSE EQUIVALENT RATE MEASUREMENT AT LOW AND MEDIUM PHOTON ENERGIES
Authors: Singh Sunil K , Kulkarni M S
Published: September 2018

A thin and plane wall ionisation chamber having 900 cc volume was designed and fabricated to study the calibration coefficient dependency on ionisation chamber wall thickness for directional dose equivalent rate (Ḣ′(d)) at various low and medium energy X-ray beam qualities. Optimised wall thickness was established through measurements to achieve a near flat energy response using the developed ionisation chamber. The measurement shows that in the energy range 12–213 keV, the average calibration coefficient for directional dose equivalent rate lies within ±10% for wall thickness 1.2 mg/cm2 and 480 mg/cm2 (4 mm poly methyl methacrylate) for skin and eye lens dose monitoring, respectively. The study could be useful for the estimation of skin and eye lens doses for the paramedical staff and patient during the interventional radiology and interventional cardiology procedures by monitoring the directional dose equivalent rate.
Prevalence of subclinical ketosis and production diseases in dairy cows in Central and South America, Africa, Asia, Australia, New Zealand, and Eastern Europe1
Authors: Brunner Nikolaus , Groeger Stephan , Canelas Raposo Joao , Bruckmaier Rupert M , Gross Josef J
Published: September 2018

Subclinical ketosis (SCK) and periparturient diseases considerably account for economic and welfare losses in dairy cows. The majority of scientific reports investigating the prevalence of SCK and production diseases are based on empirical studies conducted in Western Europe and North America. The present study surveyed the prevalence of SCK and production-related clinical diseases in early lactating cows in various countries across the world other than those in North America and Western Europe. Twelve countries of South and Central America (Argentina, Brazil, Chile, Colombia, Mexico), Africa (South Africa), Asia (Thailand, China), Eastern Europe (Russia, Ukraine), Australia, and New Zealand were assessed, and data from a total of 8,902 cows kept at 541 commercial dairy farms were obtained. A minimum of five cows per farm were blood sampled and examined once after parturition up to day 21 of lactation. Blood concentration of β-hydroxybutyrate was measured (threshold for SCK: 1.2 mmol/L), and the presence of production-related diseases such as milk fever, retained placenta, mastitis, metritis, displaced abomasum, lameness, and clinical ketosis was recorded. More than 95% of all cows were examined in their second week of lactation. Across all investigated countries, the SCK prevalence was 24.1%, ranging from 8.3% up to 40.1%. The prevalence of production-related diseases detected during the first 21 d of lactation was relatively low (<5%). Calculated odds ratios did not indicate an elevated risk for production diseases in cows with SCK. Despite differences in production systems across countries and variation between individual farms within a region, the present study data on SCK prevalence align with observations in Western European and North American dairy herds. At the very early stage of sampling and clinical examination for detection of SCK, it cannot be excluded that certain production diseases such as displaced abomasum, lameness, and mastitis have developed later.
Self-perceived Impact of Glaucomatous Visual Field Loss and Visual Disabilities on Driving Difficulty and Cessation
Authors: Tam Alex L.C. , Trope Graham E. , Buys Yvonne M. , Yang Yelin , Shen Carl , Jin Ya-Ping
Published: September 2018

Purpose:

To investigate if glaucoma severity and the presence of self-reported glare and difficulty with dark adaptation are associated with driving difficulty or cessation.

Patients and Methods:

Individuals with glaucoma, age 50+ and visual acuity in the better eye ≥20/50 were included. Glaucoma severity was defined by the visual field mean deviation (MD) in the better eye and was classified into 2 groups: mild (MD>−6 dB) and moderate/severe (MD≤−6 dB). Patient responses to the glare and dark adaptation subscales in Glaucoma Quality of Life-15 questionnaire were used to measure relevant visual disability. Associations were assessed utilizing prevalence ratios (PR).

Results:

A total of 99 participants (57% female) were included with 19% (19/99) reporting driving cessation. Patients with moderate/severe glaucoma when compared with mild glaucoma reported a significantly higher percentage of driving cessation (33% vs. 8%; P=0.002), presence of glare (27% vs. 6%; P=0.012), and difficulty with dark adaptation (31% vs. 10%; P=0.011).

Individuals with self-perceived difficulty with dark adaptation were about 4 times more likely than those without to have difficulty driving at night (adjusted PR=3.94; P<0.0001) or in poor driving conditions (adjusted PR=4.09; P=0.0002). Self-reported glare was associated with an increased risk of driving difficulty in poor driving conditions (PR=4.17; P=0.05).

Conclusions:

Patients with moderate/severe glaucomatous visual field loss reported significantly higher percentage of driving cessation, presence of glare and difficulty with dark adaptation. Difficulty with dark adaptation was significantly associated with difficulty driving at night or in poor driving conditions. Further studies are needed to confirm these findings.
Posttraumatic headache in pediatrics: an update and review
Authors: Blume Heidi K.
Published: September 2018

Purpose of review

Headache following concussion and mild traumatic brain injury is very common in pediatrics. There is significant concern about appropriate management of acute and persistent headache following mild head injuries in children among affected youth, their families and care providers.

Recent findings

The current article will review definitions and diagnoses of posttraumatic headache (PTHA), recent research regarding risk factors for persistence of postconcussion symptoms and headaches, current recommendations for the evaluation of youth with PTHA, recent data regarding efficacy of treatment options for PTHA, and current recommendations for the treatment of acute and persistent PTHA.

PTHA is common following concussion in pediatrics. Some of the most consistent risk factors for persistent symptoms following concussion include female sex, adolescent age, prior concussion with prolonged recovery, prior headache history and high number of acute symptoms, particularly migrainous symptoms, following concussion. There are few prospective studies of the treatment of PTHA in pediatrics; however, a recent study found that short-term use of ibuprofen for those with acute PTHA following concussion may be associated with lower risk of symptoms and better function 1 week after injury. Currently complete rest or cocooning following concussion is not recommended as it may actually be associated with longer recovery time; a gradual return to cognitive and physical activity appears to be most effective strategy but more study is needed.
Analysis of Mesenchymal Stromal Cell Engraftment After Allogeneic HSCT in Pediatric Patients: A Large Multicenter Study
Authors: Castello Laura M. , Leone Marco , Adamini Aloe , Castiglia Sara , Mareschi Katia , Ferrero Ivana , Marco De Gobbi , Carnevale-Schianca Fabrizio , Fagioli Franca , Berger Massimo
Published: September 2018

The mesenchymal stem cell (MSC) role after allogeneic hematopoietic stem cell transplantation (HSCT) is still a matter of debate; in particular, MSC engraftment in recipient bone marrow (BM) is unclear. A total of 46 patients were analyzed for MSC and hemopoietic stem cell engraftment after HSCT. The majority of patients had the BM as the stem cell source, and acute leukemia was the main indication for HSCT. Mesenchymal and hematopoietic stem cell chimerism analysis was carried out through specific polymorphic tandemly repeated regions. All patients reached complete donor engraftment; no evidence of donor-derived MSC engraftment was noted. Our data indicate that MSCs after HSCT remain of recipient origin despite the following: (i) myeloablative conditioning; (ii) the stem cell source; (iii) the interval from HSCT to BM analysis; (iv) the underlying disease before HSCT; and (v) the patients’ or the donors’ age at HSCT.
Best Practices in the Management of Central Vascular Access Devices
Authors: Di Fine Giovanni , Centini Giuliana , Gavetti Dario , Lemma Patrizia , Cavallo Franco , Pici Andrea , Garrino Lorenza , Dimonte Valerio
Published: September 2018

Since 2009, the Department of Continuing Education at the Orthopedic and Trauma Center Hospital in Turin, Italy, has provided a training course for nurses in the management of central vascular access devices (CVADs). The course focuses on dressing and flushing procedures, as well as compliance with other CVAD guidelines. An observational study was conducted among nurses to determine the level of best practices in areas with a high prevalence of nurses trained in the management of CVADs. A correlation was observed between best practices and having attended the course, but other variables also influenced best practices.
Educating Nurses About End-of-Life Care for Patients With Implanted Cardioverter Defibrillators
Authors: Conelius Jaclyn , Mager Diana
Published: September 2018

Many people with implanted cardioverter defibrillators (ICDs) are living at home and receiving nursing services through home health care agencies. Near the end of life, it is not unusual for patients to request comfort measures and care that promotes quality rather than quantity of life. The purpose of this pilot study was twofold: (1) to educate home health care nurses on care of patients with ICDs nearing the end of life and (2) to measure changes in nurse knowledge pre to post educational session. None of the registered nurses in this study reported ever caring for a patient who had died with an ICD in place. Subsequently, their knowledge in end-of-life care surrounding this patient population significantly improved after the educational session (P < .006). Knowing how to care for such patients as they are dying is imperative for nurses, especially because many ICD recipients have insufficient knowledge themselves and can benefit from education provided by nurses.
Enhancing Cancer Pain Assessment and Management in Hospice
Authors: Miner Melissa B. , Stephens Kimberly , Swanson-Biearman Brenda , Leone Vickie , Whiteman Kimberly
Published: September 2018

Pain is one of the most common symptoms in individuals with cancer and is directly associated with significantly reduced quality of life. The purpose of this project was to enhance assessment and management of cancer-related pain for patients in the hospice setting. Nurse attitudes and knowledge about pain were evaluated using the Nurses' Knowledge and Attitudes Survey Regarding Pain before and 6 weeks after an educational program. Nurses completed a pain assessment at each home visit and followed an algorithm based on the National Comprehensive Cancer Network Clinical Practice Guidelines to manage pain. Baseline data were collected on the last 30 patients admitted into hospice with cancer as the primary diagnosis before project implementation. Following the practice change, chart audits of the patients' reported pain and adherence to recommended management were manually extracted from 26 patient records. Results revealed statistically significant differences in acquired knowledge (t = 3.95, P < .05) and attainment of patient-identified pain goals (t = 23.904, P < .05). Patient-reported pain levels decreased by 21%, and comprehensive pain assessment completion rates increased by 10% during the project. Current knowledge of evidence-based pain interventions and a management algorithm improved pain control in patients with cancer.
Nursing Professional Development Anti-Bullying Project
Authors: Balevre Sonia Maria , Balevre Park S. , Chesire David J.
Published: September 2018

This article describes a nursing professional development, evidence-based intervention project addressing the significant problem of bullying in the nursing workplace. The project entailed a 9-week, multitiered approach to teach behaviors to combat bullying and create the self-efficacy to do so. Results demonstrated statistically significant t-test comparisons of pre- and postsurvey measures, supporting the clinical question that empowerment and perceptual change drove individual and group behavior to confront bullying and create a positive culture shift.
Simulation Use in Acute Care Hospitals in the United States
Authors: Harper Mary G. , Gilbert Gregory E. , Gilbert Marie , Markey Linda , Anderson Krista
Published: September 2018

Three national nursing associations formed a collaborative partnership to research simulation use in acute care hospitals in the United States and military hospitals abroad. An electronic survey was used to determine simulation modalities used, participants engaged, space allocation, purposes of use, commonly taught skills, logistics, and barriers to use. Data from 521 respondents revealed widespread use of a variety of simulation modalities. However, use of this educational strategy could be expanded to patients and families.
Guideline Assessment Project: Filling the GAP in Surgical Guidelines
Authors: Antoniou Stavros A. , Tsokani Sofia , Mavridis Dimitrios , López-Cano Manuel , Antoniou George A. , Stefanidis Dimitrios , Francis Nader K. , Smart Neil , Muysoms Filip E. , Morales-Conde Salvador , Bonjer Hendrik Jaap , Brouwers Melissa C.
Published: September 2018

Objective:

The aim of the study was to identify clinical practice guidelines published by surgical scientific organizations, assess their quality, and investigate the association between defined factors and quality. The ultimate objective was to develop a framework to improve the quality of surgical guidelines.

Summary Background Data:

Evidence on the quality of surgical guidelines is lacking.

Methods:

We searched MEDLINE for clinical practice guidelines published by surgical scientific organizations with an international scope between 2008 and 2017. We investigated the association between the following factors and guideline quality, as assessed using the AGREE II instrument: number of guidelines published within the study period by a scientific organization, the presence of a guidelines committee, applying the GRADE methodology, consensus project design, and the presence of intersociety collaboration.

Results:

Ten surgical scientific organizations developed 67 guidelines over the study period. The median overall score using AGREE II tool was 4 out of a maximum of 7, whereas 27 (40%) guidelines were not considered suitable for use. Guidelines produced by a scientific organization with an output of ≥9 guidelines over the study period [odds ratio (OR) 3.79, 95% confidence interval (CI), 1.01–12.66, P = 0.048], the presence of a guidelines committee (OR 4.15, 95% CI, 1.47–11.77, P = 0.007), and applying the GRADE methodology (OR 8.17, 95% CI, 2.54–26.29, P < 0.0001) were associated with higher odds of being recommended for use.

Conclusions:

Development by a guidelines committee, routine guideline output, and adhering to the GRADE methodology were found to be associated with higher guideline quality in the field of surgery.
Origin of biomolecular games: deception and molecular evolution
Authors: Massey Steven E. , Mishra Bud
Published: September 2018

Biological macromolecules encode information: some of it to endow the molecule with structural flexibility, some of it to enable molecular actions as a catalyst or a substrate, but a residual part can be used to communicate with other macromolecules. Thus, macromolecules do not need to possess information only to survive in an environment, but also to strategically interact with others by sending signals to a receiving macromolecule that can properly interpret the signal and act suitably. These sender–receiver signalling games are sustained by the information asymmetry that exists among the macromolecules. In both biochemistry and molecular evolution, the important role of information asymmetry remains largely unaddressed. Here, we provide a new unifying perspective on the impact of information symmetry between macromolecules on molecular evolutionary processes, while focusing on molecular deception. Biomolecular games arise from the ability of biological macromolecules to exert precise recognition, and their role as units of selection, meaning that they are subject to competition and cooperation with other macromolecules. Thus, signalling game theory can be used to better understand fundamental features of living systems such as molecular recognition, molecular mimicry, selfish elements and ‘junk’ DNA. We show how deceptive behaviour at the molecular level indicates a conflict of interest, and so provides evidence of genetic conflict. This model proposes that molecular deception is diagnostic of selfish behaviour, helping to explain the evasive behaviour of transposable elements in ‘junk’ DNA, for example. Additionally, in this broad review, a range of major evolutionary transitions are shown to be associated with the establishment of signalling conventions, many of which are susceptible to molecular deception. These perspectives allow us to assign rudimentary behaviour to macromolecules, and show how participation in signalling games differentiates biochemistry from abiotic chemistry.
Risk factors for human cutaneous anthrax outbreaks in the hotspot districts of Northern Tanzania: an unmatched case–control study
Authors: Mwakapeje Elibariki R. , Høgset Sol , Softic Adis , Mghamba Janneth , Nonga Hezron E. , Mdegela Robinson H. , Skjerve Eystein
Published: September 2018

Bacillus anthracis
is an aerobic, Gram-positive and spore-forming bacterium, which causes anthrax in herbivores. Humans get infected after coming into contact with infected animals' products. An unmatched case–control study was conducted to identify the importance of demographic, biological and/or behavioural factors associated with human cutaneous anthrax outbreaks in the hotspot areas of Northern Tanzania. A semi-structured questionnaire was administered to both cases and controls. The age range of participants was 1–80 years with a median age of 32 years. In the younger group (1–20 years), the odds of being infected were 25 times higher in the exposed group compared to the unexposed group (OR= 25, 95% CI = 1.5–410). By contrast, the odds of exposure in the old group (≥20 years) were three times lower in the exposed group compared to the unexposed group (OR = 3.2, 95% CI = 1.28–8.00). Demographic characteristics, sleeping on animal's skins, contacting with infected carcasses through skinning and butchering, and not having formal education were linked to exposure for anthrax infection. Hence, a One Health approach is inevitable for the prevention and control of anthrax outbreaks in the hotspot areas of Northern Tanzania.
Nonlinear Bloch waves and balance between hardening and softening dispersion
Authors: Hussein M. I. , Khajehtourian R.
Published: September 2018

The introduction of nonlinearity alters the dispersion of elastic waves in solid media. In this paper, we present an analytical formulation for the treatment of finite-strain Bloch waves in one-dimensional phononic crystals consisting of layers with alternating material properties. Considering longitudinal waves and ignoring lateral effects, the exact nonlinear dispersion relation in each homogeneous layer is first obtained and subsequently used within the transfer matrix method to derive an approximate nonlinear dispersion relation for the overall periodic medium. The result is an amplitude-dependent elastic band structure that upon verification by numerical simulations is accurate for up to an amplitude-to-unit-cell length ratio of one-eighth. The derived dispersion relation allows us to interpret the formation of spatial invariance in the wave profile as a balance between hardening and softening effects in the dispersion that emerge due to the nonlinearity and the periodicity, respectively. For example, for a wave amplitude of the order of one-eighth of the unit-cell size in a demonstrative structure, the two effects are practically in balance for wavelengths as small as roughly three times the unit-cell size.
Social interactions shape individual and collective personality in social spiders
Authors: Hunt Edmund R. , Mi Brian , Fernandez Camila , Wong Brandyn M. , Pruitt Jonathan N. , Pinter-Wollman Noa
Published: September 2018

The behavioural composition of a group and the dynamics of social interactions can both influence how social animals work collectively. For example, individuals exhibiting certain behavioural tendencies may have a disproportionately large impact on the group, and so are referred to as keystone individuals, while interactions between individuals can facilitate information transmission about resources. Despite the potential impact of both behavioural composition and interactions on collective behaviour, the relationship between consistent behaviours (also known as personalities) and social interactions remains poorly understood. Here, we use stochastic actor-oriented models to uncover the interdependencies between boldness and social interactions in the social spider
Stegodyphus dumicola
. We find that boldness has no effect on the likelihood of forming social interactions, but interactions do affect boldness, and lead to an increase in the boldness of the shyer individual. Furthermore, spiders tend to interact with the same individuals as their neighbours. In general, boldness decreases over time, but once an individual's boldness begins to increase, this increase accelerates, suggesting a positive feedback mechanism. These dynamics of interactions and boldness result in skewed boldness distributions of a few bold individuals and many shy individuals, as observed in nature. This group behavioural composition facilitates efficient collective behaviours, such as rapid collective prey attack. Thus, by examining the relationship between behaviour and interactions, we reveal the mechanisms that underlie the emergence of adaptive group composition and collective behaviour.