bluuebunny/crossref_metadata_2025 huggingface dataset:
Undulation locomotion analysis of fish in cruising swimming
Authors: Jia Laibing , Chen Xiaopeng
Published: March 2018

The locomotion of fish swimming is an important topic in the bio- and bio-inspired mechanics. The study of this locomotion provides a fundamental knowledge about how a fish interacts with ambient fluid and utilizes the flow vortex. Cruising swimming is a most common way adopted by fish in moving. In this study, we measured the undulation locomotion of fish in cruising swimming. Proper Orthogonal Decomposition is adopted to analyze the measured data. We found that in the cruising swimming, the first two proper orthogonal modes capture the major features of the total motion. Two approaching methods are given to depict the undulation locomotion approximately with only six parameters. Comparing with the traditional methods depicting the swimming of a fish, they are less complicated than directly using measured swimming data and they are more physical than using an artificial assumed swimming locomotion. The undulation locomotion analysis using Proper Orthogonal Decomposition proposed here provides a quantitative way to depict the motion and its major locomotion modes.
Prescription Adaptation Services: A Regulatory and Practice Perspective
Authors: Adams Alex J.
Published: March 2018

“Prescription adaptation services” refers to the ability of a pharmacist to autonomously “adapt” an existing prescription when the action is intended to optimize the therapeutic outcome. Adaptation services typically fall into 2 categories: (1) renewals and (2) changes. Renewals ensure continuity of care for patients and may be emergency renewals (typically 72 hours) or continuation-of-therapy renewals (typically 90 or more days). Changes include therapeutic substitutions or changes to quantity, formulation, route of administration, dose/interval, and completing missing information. With an appropriate framework in place, adaptation services can safely optimize medication therapy outcomes while promoting efficiencies.
Queer narratives and minority stress: Stories from lesbian, gay and bisexual individuals in Norway
Authors: Synnes Oddgeir , Malterud Kirsti
Published: March 2018

Aims: This study aims to explore how minority stress related to sexual orientation is reflected in narratives from lesbian, gay and bisexual (LGB) individuals in Norway, with an impact for national public health policy. Methods: Arthur Frank’s dialogical narrative analysis was applied to personal stories from 65 persons self-referring to different categories of queer identities, submitted online anonymously to a Norwegian national archive for queer history. A purposive sample of three different stories were selected due to their capacity to illuminate how various aspects of minority stress are narrated in diverse interplays between individual voices and resources, and cultural scripts and societal influences. Results: Our analysis highlighted how stories may offer significant glimpses into the dynamic and complex fashioning of sexual identities, giving precious clues to the vulnerabilities and strengths of the narrator. Contemporary queer narratives from Norway reflect meaning-making related to sexual orientation that are influenced by, and expand upon, the classical scripts dominated by tragedy and tristesse, personal progress or simply no particular tension. LGB individuals of different ages and backgrounds had experienced aspects of minority stress related to their sexual orientation, with a substantial impact on identity, even when significant others were encouraging. Conclusions: The stories indicate that positive proximal processes, such as personal resilience and sympathetic environments, can support mental health and counteract negative effects of distal processes contributing to minority stress, such as heteronormativity and subtle microaggression. Public health strategies addressing attitudes to sexual orientation among the general population may contribute to diverse affirmative cultural scripts about queer lives, thereby enhancing queer mental health.
Car seats: Facing backward is the way forward
Authors: Gan Jo Han , Davison Caroline , Prince Nick , Gour Anami
Published: March 2018

Road traffic accidents are one of the commonest causes of death in children. Child safety car seats have played a pivotal role in reducing the mortality and morbidity associated with road traffic accidents. However, there have been some concerns about the about the design of front facing car seats versus their rear facing counterparts. Legislation governing the use of rear facing car seats is variable, with some Scandinavian countries recommending their use up to the age of four, while others mandate their use only until one year of age. We present three case narratives of patients aged under 3 years who sustained catastrophic injuries after being involved in a road traffic accident despite being placed in an appropriately sized forward facing car seat. We reviewed the literature for evidence comparing the safety and efficacy of front versus rear facing car seats. Accident registry and crash test results support the increased safety of rear facing child seats. Frontal sled test have demonstrated that forward facing car seats expose children to much higher neck loads and chest displacement resulting in higher injury scores. Epidemiological data from registries and observational studies support the experimental data and demonstrate a clear injury-reducing effect of rear facing child seats compared to their forward facing counterpart. We recommend keeping children in rear facing car seats until the age of four, which is common practice in Sweden.
Severe antithrombin deficiency in pregnancy: Achieving adequate anticoagulation
Authors: Pearson-Stuttard Ben , Bagot Catherine , Ciantar Etienne , Myers Bethan , Davies Rosalyn , Rayment Rachel , Clark Amanda , McKernan Angela , Pavord Sue
Published: March 2018

Antithrombin deficiency is identified as one of the most potent risk factors for venous thromboembolism during pregnancy. Therapeutic low molecular weight heparin is recommended, but it can be difficult to attain sufficient anticoagulation since low molecular weight heparin requires antithrombin to exert its anticoagulant effect. We carried out a multicentre case-series assessing the dose of low molecular weight heparin required to achieve therapeutic anti-activated factor X levels in pregnant women with antithrombin deficiency. We assessed 27 pregnancies in 18 women with severe antithrombin deficiency, which we defined as an antithrombin level of <0.55 IU/ml (with or without prior venous thromboembolism) or an antithrombin level < 0.8 IU/ml and a personal history of venous thromboembolism. Our data illustrate the need for high doses of low molecular weight heparin to achieve therapeutic anti-activated factor X levels (average 20,220 IU/day). All pregnancies ended in live birth (excluding one elective termination), although intrauterine growth restriction occurred in five (18%).
A reference equation for maximal aerobic power for treadmill and cycle ergometer exercise testing: Analysis from the FRIEND registry
Authors: de Souza e Silva Christina G , Kaminsky Leonard A , Arena Ross , Christle Jeffrey W , Araújo Claudio Gil S , Lima Ricardo M , Ashley Euan A , Myers Jonathan
Published: March 2018

Background

Maximal oxygen uptake (VO2max) is a powerful predictor of health outcomes. Valid and portable reference values are integral to interpreting measured VO2max; however, available reference standards lack validation and are specific to exercise mode. This study was undertaken to develop and validate a single equation for normal standards for VO2max for the treadmill or cycle ergometer in men and women.

Methods

Healthy individuals ( N = 10,881; 67.8% men, 20–85 years) who performed a maximal cardiopulmonary exercise test on either a treadmill or a cycle ergometer were studied. Of these, 7617 and 3264 individuals were randomly selected for development and validation of the equation, respectively. A Brazilian sample (1619 individuals) constituted a second validation cohort. The prediction equation was determined using multiple regression analysis, and comparisons were made with the widely-used Wasserman and European equations.

Results

Age, sex, weight, height and exercise mode were significant predictors of VO2max. The regression equation was: VO2max (ml kg–1 min–1) = 45.2 – 0.35*Age – 10.9*Sex (male = 1; female = 2) – 0.15*Weight (pounds) + 0.68*Height (inches) – 0.46*Exercise Mode (treadmill = 1; bike = 2) ( R = 0.79, R2 = 0.62, standard error of the estimate = 6.6 ml kg–1 min–1). Percentage predicted VO2max for the US and Brazilian validation cohorts were 102.8% and 95.8%, respectively. The new equation performed better than traditional equations, particularly among women and individuals ≥60 years old.

Conclusion

A combined equation was developed for normal standards for VO2max for different exercise modes derived from a US national registry. The equation provided a lower average error between measured and predicted VO2max than traditional equations even when applied to an independent cohort. Additional studies are needed to determine its portability.
Ethanol sclerotherapy or polidocanol sclerotherapy for symptomatic hepatic cysts
Authors: Wijnands Titus FM , Schoenemeier Bastian , Potthoff Andrej , Gevers Tom JG , Groenewoud Hans , Gebel Michael J , Rifai Kinan , Manns Michael P , Drenth Joost PH
Published: March 2018

Background

Over the past decades, multiple approaches to aspiration sclerotherapy of large symptomatic hepatic cysts have been investigated. However, comparative data are scarce.

Objective

The objective of this article is to compare cyst reduction, symptomatic relief, and adverse events between ethanol sclerotherapy and polidocanol sclerotherapy.

Methods

This retrospective study included adults having a symptomatic hepatic cyst treated at a European tertiary referral center with ethanol sclerotherapy (Center 1) or polidocanol‐sclerotherapy (Center 2). We compared cyst diameter reduction (%) and symptom improvement (yes/no) within 12 months’ post‐treatment between centers using multivariate regression analyses adjusted for confounding factors. Finally, we compared adverse events using Fisher's exact test.

Results

We included 71 patients from Center 1 and 66 patients from Center 2 (median age 57 years; 126/137 (92%) female). Cyst reduction was comparable between Centers 1 and 2: 37.5% (IQR 15.7–61.0%) versus 44.2% (IQR 24.6–60.5%), respectively (p = 0.35). Correspondingly, symptomatic relief was comparable: 30/53 (56.6%) versus 43/66 (65.2%), respectively (p = 0.88). Center 1 reported significantly more (11 versus 3; p = 0.047) adverse events than Center 2.

Conclusion

We found comparable cyst reduction and symptomatic relief rates between ethanol‐ and polidocanol sclerotherapy, while adverse events occurred more often in the ethanol group. Prospective studies focused on clinical response are needed to further explore differences between approaches.
Safety, diagnostic accuracy and therapeutic efficacy of digital single‐operator cholangioscopy
Authors: Lenze Frank , Bokemeyer Arne , Gross Dina , Nowacki Tobias , Bettenworth Dominik , Ullerich Hansjoerg
Published: March 2018

Background

Digital single‐operator cholangioscopes (digital SOCs), equipped with an improved image quality, have been recently introduced.

Objective

The aim of this study is to evaluate the safety and diagnostic and therapeutic efficacy of digital SOCs (Spyglass™ DS).

Methods

Sixty‐seven digital SOC procedures performed between 2015 and 2017 were retrospectively analyzed.

Results

The most frequent indications for examination were indeterminate biliary strictures (61.2%) and biliary stone disease (23.9%). In 25 patients (37.3), visual findings predicted malignancy with a sensitivity of 88.9%, a specificity of 97.6%, a positive predictive value (PPV) of 96.0% and a negative predictive value (NPV) of 92.9%. For histological analysis, forceps biopsies were performed in 29 patients (43.2%). Compared with visual findings, forceps biopsies yield a lower diagnostic efficacy in diagnosing malignancy (sensitivity 62.5%, specificity 90.0%, PPV 90.9%, NPV 60.0%). Therapeutic interventions were performed in 19 patients with a technical success rate of 89.4%. Adverse events were observed in 17 patients (25.4%). Of these, 11 patients (16.4%) suffered from severe adverse events (pancreatitis, cholangitis or major bleeding), which led to a prolonged hospital stay.

Conclusion

Digital SOCs have excellent diagnostic and therapeutic efficacies, but are accompanied by high rates of adverse events; therefore, physicians should use digital SOCs in carefully selected cases.
Toxicological assessment of Euglena gracilis strain Eu029 shows no adverse effects in vivo and in vitro
Authors: Symonds Jennifer M , Beauchamp Nicole , Takeuchi Takuto , Yamada Koji , Atsuji Kohei , Asayama Yuta , Suzuki Kengo , Kruger Claire L
Published: March 2018

Euglena gracilis is a single-celled organism capable of photosynthesis and heterotrophy. Euglena sp. have long been studied in the laboratory for its metabolic pathways, cell motility, and ease of culture. The safety of E. gracilis strain eu029 (EG029) for use as a food ingredient was assessed in a bacterial reverse mutagenesis assay (Ames), rec assay, in vivo micronucleus assay, acute toxicity study in mice, 13-week toxicology in rats, and a teratology study in mice and rats. EG029 was not genotoxic. The No Observed Adverse Effect Level (NOAEL) in the 13-week study was greater than 1000 mg/kg/day, the highest dose tested. Teratogenicity studies did not find any defects in fetal development or effects to maternal health in rats at 1000 mg/kg/day, the highest dose tested.
Integrated shale-gas reservoir characterization: A case study incorporating multicomponent seismic data
Authors: Weston Bellman Laurie M.
Published: March 2018

The objective of this case study is to predict geologic properties of a shale reservoir interval to guide production and completion planning for successful development of the reservoir. The conditioning, analysis, and blending of the converted-wave (PS) seismic data into a quantitative interpretation (QI) workflow are described in detail, illustrating the successful integration of geologic information and multiple seismic attributes. A multicomponent 3D seismic survey, several wells with dipole sonic logs, and a multicomponent (3C) 3D vertical seismic profile are available for the study. For comparisons of the incremental value of PS data, the QI workflow is completed entirely using only PP data and then modified and redone to incorporate information from the PS data. Predictions of the geologic properties for both workflows are assessed for accuracy against the existing well log and core evidence. Determining reservoir properties of the shale units of interest is important to the successful placement of horizontal wells for efficient multistage hydraulic fracturing and maximum gas production. Although conventional interpretation of conventional seismic data can only provide reservoir geometry, the quantitative analysis of prestack multicomponent data in this study reveals detailed distinctions between reservoir units and relative measures of porosity and brittleness bulk properties within each unit. Using all of the elastic properties derived from the seismic data analysis allowed for the classification of lithological units, which were, in turn, subclassified based on unit-specific reservoir properties. The upper reservoir units (Muskwa and Otter Park) were shown to have more variability in brittleness than the lower reservoir unit (Evie). Validation at a reliable well control confirmed these distinctive units and properties to be very high resolution and accurate, particularly when the PS data were incorporated into the workflow. The results of this method of analysis provided significantly more useful information for appraisal and development decisions than conventional seismic data interpretation alone.
Morality, Policy, and the Brain
Authors: Rustichini Aldo
Published: March 2018

The book Moral Tribes: Emotion, Reason, and the Gap between Us and Them, by Joshua Greene, invites the reader to give a new look at the foundation of ethics and, by implication, to policy. Its specific strength is the systematic integration of new methods from neuroscience into a very old debate. Having something new and substantial to add in an investigation that has been at the center of the philosophical debate in Western civilization for twenty-five centuries is remarkable. While I invite everyone to read and enjoy this wonderful book, I take here the opportunity to invite economists to take the challenge. We are particularly interested in the question, “Is there a specific contribution that economics can give to this debate?” I believe there is and this insight is now in danger of being lost. This is my attempt to indicate where the research should look now. Maybe it is not too late. (JEL D12, D63, D87, Z13)
High monocyte to lymphocyte ratio is associated with impaired protection after subcutaneous administration of BCG in a mouse model of tuberculosis
Authors: Zelmer Andrea , Stockdale Lisa , Prabowo Satria A. , Cia Felipe , Spink Natasha , Gibb Matthew , Eddaoudi Ayad , Fletcher Helen A.
Published: March 2018

Background: The only available tuberculosis (TB) vaccine, Bacillus Calmette-Guérin (BCG), has variable efficacy. New vaccines are therefore urgently needed. Why BCG fails is incompletely understood, and the tools used for early assessment of new vaccine candidates do not account for BCG variability. Taking correlates of risk of TB disease observed in human studies and back-translating them into mice to create models of BCG variability should allow novel vaccine candidates to be tested early in animal models that are more representative of the human populations most at risk. Furthermore, this could help to elucidate the immunological mechanisms leading to BCG failure. We have chosen the monocyte to lymphocyte (ML) ratio as a correlate of risk of TB disease and have back-translated this into a mouse model.

Methods: Four commercially available, inbred mouse strains were chosen. We investigated their baseline ML ratio by flow cytometry; extent of BCG-mediated protection from Mtb infection by experimental challenge; vaccine-induced interferon gamma (IFNγ) response by ELISPOT assay; and tissue distribution of BCG by plating tissue homogenates.

Results: The ML ratio varied significantly between A/J, DBA/2, C57Bl/6 and 129S2 mice. A/J mice showed the highest BCG-mediated protection and lowest ML ratio, while 129S2 mice showed the lowest protection and higher ML ratio. We also found that A/J mice had a lower antigen specific IFNγ response than 129S2 mice. BCG tissue distribution appeared higher in A/J mice, although this was not statistically significant.

Conclusions: These results suggest that the ML ratio has an impact on BCG-mediated protection in mice, in alignment with observations from clinical studies. A/J and 129S2 mice may therefore be useful models of BCG vaccine variability for early TB vaccine testing. We speculate that failure of BCG to protect from TB disease is linked to poor tissue distribution in a ML high immune environment.
Sexual transmission of Hepatitis C Virus infection in a heterosexual population: A systematic review
Authors: Wuytack Francesca , Lutje Vittoria , Jakobsen Janus Christian , Weiss Karl Heinz , Flanagan Paula , Gethin Georgina , Murphy Louise , Smyth Siobhan , Devane Declan , Smith Valerie
Published: March 2018

Background: Hepatitis C virus (HCV) infection is an important cause of liver disease worldwide. Identification of risk factors can guide screening and prevention. Sexual transmission in monogamous heterosexual relationships is rare but it is uncertain which sexual behaviours are linked to HCV transmission. This review aimed to determine risk factors for sexual HCV transmission in heterosexuals in low HCV prevalence countries (PROSPERO registration CRD42016051099).

Methods: We searched Medline, Embase, Science Citation Index-Expanded, Social Sciences Citation index, Conference proceedings (Web of Science), CINAHL, Scopus, LILACS, PubMed, and grey literature (04/11/2016).

We included studies published in/after the year 2000 that examined sexual risk factors for HCV infection, other than interspousal transmission, in heterosexual adults (≥18 years). We excluded prisoners, people who inject drugs (PWIDs), people co-infected with HIV or from high prevalence countries. Two reviewers completed study selection, data extraction, risk of bias and quality of evidence assessment (GRADE) independently. Meta-analysis could not be conducted.

Results: Eight studies were included, examining seven factors (multiple sex partners, receiving/providing sex commercially, PWID partner, and unprotected vaginal, oral, anal sex). None were significant, except the evidence for the factor having a PWID partner was conflicting.

Conclusions: We are uncertain about the results due to the very low quality of evidence (GRADE). A more liberal approach to review inclusion criteria might be useful in further identifying factors associated with an increased risk of sexual transmission of HCV infection in a heterosexual population. However, caution should be applied to avoid the impact of confounders on the findings.
Detection and quantification of Anopheles gambiae sensu lato mosquito larvae in experimental aquatic habitats using environmental DNA (eDNA).
Authors: Odero Joel , Gomes Bruno , Fillinger Ulrike , Weetman David
Published: March 2018

Background: Growing insecticide resistance and changes in biting and resting behavior of malaria vectors threaten efficacy of insecticide treated nets and indoor residual spraying. Larval source management (LSM) is a promising approach that can target mosquitoes irrespective of their behavior as adults. However, the use of traditional monitoring methods for immature stages of Anopheles mosquitoes is a major challenge to LSM due to the variability in their breeding habitats.  We evaluate the use of an environmental DNA (eDNA) analysis technique in monitoring Anopheles gambiae sensu lato larvae in experimental aquatic habitats.

Methods: eDNA was simultaneously sampled and extracted from different volumes of water, number of larvae, and occupation time. Larval presence was detected using PCR and eDNA concentration in samples from 1 L habitats quantified using an IGS and cyt b TaqMan assays. The limit of detection of the two assays was tested and larval density correlated with eDNA positivity.

Results: 74% of replicates in the 50 mL habitats were PCR positive with at least 6h required to get a signal from a single larva (0.02 larvae/mL). All 12 replicates where 1 L of water was used were positive with stronger PCR bands than replicates with the same larval density in 50 mL for 24 h. There was a correlation between larval densities and eDNA detection in both assays: IGS, r = 0.503, p = 0.047; and cyt b, r = 0.558, p = 0.025. There was stochasticity in eDNA detection rates, using both PCR and qPCR across all the dilutions.

Conclusion: This study has demonstrated the potential use of eDNA analysis for detection and quantification of An. gambiae s.s. mosquito larvae in aquatic habitats. The stochasticity observed in eDNA detection suggest that this technique is best for monitoring aquatic habitats with many larvae at low densities.
Increasing participation of people with learning disabilities in bowel screening
Authors: Gray Jonathan
Published: March 2018

Learning disability nurses have a key role in addressing the health inequalities experienced by people with learning disabilities. People with learning disabilities are less likely to participate in bowel screening than other sectors of the population, despite there being evidence of this population being at an increased risk of developing bowel cancer. There are a range of barriers at individual and systemic levels that impact on participation in bowel screening by people with learning disabilities. Actions to address these barriers have been identified in the literature and learning disability nurses are a key agent of change in enabling people with learning disabilities to participate in the national screening programmes.
Black, Asian and minority ethnic female nurses: colonialism, power and racism
Authors: Brathwaite Beverley
Published: March 2018

The history of black, Asian and minority ethnic (BAME) women who came to the UK to work as nurses is interwoven with the history of the NHS. The colonial construct of the BAME female nurse is embedded in British society. From the post-second-world-war years to the 1960s, to today, BAME women chose to become nurses and work in the ‘motherland’, a term regularly used by those immigrating to England from the former colonies. The experiences of the BAME female nurse in the 1970s and early 1980s were of overt racism and lack of advancement. Although racism was less overt in the late 1980s and 1990s, these experiences continued and BAME female nurse advancement levels remained lower than among their white female counterparts. In the 21st century there continues to be significant differences in treatment of BAME female nurses compared with white nursing colleagues, with the enduring effects of the coloniser holding the power to impact on the BAME female nurse who is the colonised, racially stereotyped and less powerful. There are multifaceted reasons for the unequal treatment of BAME female nurses. However, the persistent construct of colonialism and power needs to be recognised if the NHS is to acknowledge ongoing racialised inequalities experienced by BAME female nurses. A recognition of racist and sexist discriminatory actions must occur to permit the development of equal opportunity strategies to address these unacceptable inequalities and generate a real cultural shift.
Organisational culture: why is it important?
Authors: Scammell Janet
Published: March 2018

Janet Scammell, Associate Professor (Nursing), Bournemouth University, considers what organisational culture is, and how it can affect the student experience and, ultimately, the quality of care provision
Updating the National Early Warning Score algorithm: saving more lives
Authors: Glasper Alan
Published: March 2018

Emeritus Professor Alan Glasper, University of Southampton, discusses the contribution of the Royal College of Physicians to effective monitoring of sick patients in hospital
Sharing the results of a patient satisfaction audit
Authors: Walker Kim , Watkins Rebecca , Newman Sue , Pullen Judy , Osborne Debbie , Milton Samantha , Davies Tara
Published: March 2018

Regular service audits since 2008 gave a stoma care department confidence in the service it provides. In 2016 the department undertook a new audit to benchmark its services, using the Association of Stoma Care Nurses (ASCN) UK Revised Stoma Care Nursing Standards and Audit Tool (2015) . Of the 60 questionnaires given out, 43 were returned (71%). The results highlighted areas of good practice with positive patient feedback. However, it also identified that the team needed to improve documentation when offering patients the opportunity to meet a former patient with a stoma preoperatively and when discussing lifestyle issues. The results demonstrated poor preoperative compliance; this was lower than expected and did not concur with department statistics. The audit highlights the importance of clarity when developing a questionnaire to ensure all respondents not only interpret its meaning in the same way, but also only answer the questions specific to them.
Small Animal Review
Authors: Tennant Bryn
Published: March 2018

Introduction:

Canine parvovirus is an under-recognised cause of myocarditis and myocardial fibrosis. Canine parvovirus 2 DNA was detected in 12/40 cases and its presence was significantly associated with myocarditis and myocardial fibrosis.
Fracture management in growing animals
Authors: Perry Karen L , Woods Samantha
Published: March 2018

There are important differences to consider when fractures are encountered in growing animals, particularly those under six months of age, rather than in mature animals. Physeal fractures are common and must be diagnosed promptly if satisfactory results following reduction and stabilisation are to be achieved. When physeal fractures are encountered, closed reduction and stabilisation using Kirschner wires applied in various configurations is generally recommended. Careful adherence to the principles of physeal fracture repair will reduce the risks of postoperative complications, including the development of growth deformity. Treatment of diaphyseal fractures in juvenile patients also differs to that in the mature animal. External coaptation may lead to serious complications if inappropriately applied or managed, and must be monitored closely if used. While intramedullary pins are often appropriate in skeletally immature patients, caution is recommended when considering use in the femur. Elastic plate osteosynthesis was developed specifically for use in growing animals and may offer an advantage, particularly for management of femoral fractures. For both physeal and diaphyseal fractures, minimally invasive techniques may be beneficial in skeletally immature patients where case presentation allows.
Disease outbreak investigation in waterfowl collections in the UK
Authors: O'Brien Michelle F , Costa Taiana , Beckmann Katie M , Cromie Ruth L , Brown Martin J
Published: March 2018

Disease outbreaks in waterfowl collections can occur at any time of the year, and in all cases immediate investigation into the causative factors of morbidity and mortality is imperative. Clinical examination of affected birds and post-mortem examination of carcasses, together with appropriate sample analysis, are essential for diagnosis, and to inform treatment and disease mitigation. Methods of investigation, significant UK waterfowl diseases and treatment options are presented here as a framework for practitioners managing similar scenarios.
Funding the fight against cancer in pets
Authors: Adams Vicki J
Published: March 2018

The Animal Cancer Trust is a registered charity committed to educating veterinary personnel and owners, providing information, facilitating decision-making and best practice treatment, and funding ethical research.
The use of a non-invasive extendable prosthesis at the time of revision arthroplasty
Authors: Gilg M. M. , Gaston C. L. , Jeys L. , Abudu A. , Tillman R. M. , Stevenson J. D. , Grimer R. J. , Parry M. C.
Published: March 2018

Aims

The use of a noninvasive growing endoprosthesis in the management of primary bone tumours in children is well established. However, the efficacy of such a prosthesis in those requiring a revision procedure has yet to be established. The aim of this series was to present our results using extendable prostheses for the revision of previous endoprostheses.

Patients and Methods

All patients who had a noninvasive growing endoprosthesis inserted at the time of a revision procedure were identified from our database. A total of 21 patients (seven female patients, 14 male) with a mean age of 20.4 years (10 to 41) at the time of revision were included. The indications for revision were mechanical failure, trauma or infection with a residual leg-length discrepancy. The mean follow-up was 70 months (17 to 128). The mean shortening prior to revision was 44 mm (10 to 100). Lengthening was performed in all but one patient with a mean lengthening of 51 mm (5 to 140).

Results

The mean residual leg length discrepancy at final follow-up of 15 mm (1 to 35). Two patients developed a deep periprosthetic infection, of whom one required amputation to eradicate the infection; the other required two-stage revision. Implant survival according to Henderson criteria was 86% at two years and 72% at five years. When considering revision for any cause (including revision of the growing prosthesis to a non-growing prosthesis), revision-free implant survival was 75% at two years, but reduced to 55% at five years.

Conclusion

Our experience indicates that revision surgery using a noninvasive growing endoprosthesis is a successful option for improving leg length discrepancy and should be considered in patients with significant leg-length discrepancy requiring a revision procedure. Cite this article: Bone Joint J 2018;100-B:370–7.
Comparison between a multicentre, collaborative, closed-loop audit assessing management of supracondylar fractures and the British Orthopaedic Association Standard for Trauma 11 (BOAST 11) guidelines
Authors: Goodall R. , Claireaux H. , Hill J. , Wilson E. , Monsell F. , BOAST 11 Collaborative  , Tarassoli P.
Published: March 2018

Aims

Supracondylar fractures are the most frequently occurring paediatric fractures about the elbow and may be associated with a neurovascular injury. The British Orthopaedic Association Standards for Trauma 11 (BOAST 11) guidelines describe best practice for supracondylar fracture management. This study aimed to assess whether emergency departments in the United Kingdom adhere to BOAST 11 standard 1: a documented assessment, performed on presentation, must include the status of the radial pulse, digital capillary refill time, and the individual function of the radial, median (including the anterior interosseous), and ulnar nerves.

Materials and Methods

Stage 1: We conducted a multicentre, retrospective audit of adherence to BOAST 11 standard 1. Data were collected from eight hospitals in the United Kingdom. A total of 433 children with Gartland type 2 or 3 supracondylar fractures were eligible for inclusion. A centrally created data collection sheet was used to guide objective analysis of whether BOAST 11 standard 1 was adhered to. Stage 2: We created a quality improvement proforma for use in emergency departments. This was piloted in one of the hospitals used in the primary audit and was re-audited using equivalent methodology. In all, 102 patients presenting between January 2016 and July 2017 were eligible for inclusion in the re-audit.

Results

Stage 1: Of 433 patient notes audited, adherence to BOAST 11 standard 1 was between 201 (46%) and 232 (54%) for the motor and sensory function of the individual nerves specified, 318 (73%) for radial pulse, and 247 (57%) for digital capillary refill time. Stage 2: Of 102 patient notes audited, adherence to BOAST 11 standard 1 improved to between 72 (71%) and 80 (78%) for motor and sensory function of the nerves, to 84 (82%) for radial pulse, and to 82 (80%) for digital capillary refill time. Of the 102 case notes reviewed in stage 2, only 44 (43%) used the quality improvement proforma; when the proforma was used, adherence improved to between 40 (91%) and 43 (98%) throughout.

Conclusion

Adherence to BOAST 11 standard 1 is poor in hospitals across the country. This is concerning as neurovascular deficit may be an indication for emergent surgery, and missed neurovascular injury can cause long-term, or even permanent, functional impairment. We present a simple proforma that improves adherence to this standard, can easily be implemented into emergency departments, and may improve patient safety. Cite this article: Bone Joint J 2018;100-B:346–51.
Glenoid osteotomy for atraumatic posteroinferior shoulder instability associated with glenoid dysplasia
Authors: Inui H. , Nobuhara K.
Published: March 2018

Aims

We report the clinical results of glenoid osteotomy in patients with atraumatic posteroinferior instability associated with glenoid dysplasia.

Patients and Methods

The study reports results in 211 patients (249 shoulders) with atraumatic posteroinferior instability. The patients comprised 63 men and 148 women with a mean age of 20 years. The posteroinferior glenoid surface was elevated by osteotomy at the scapular neck. A body spica was applied to maintain the arm perpendicular to the glenoid for two weeks postoperatively. Clinical results were evaluated using the Rowe score and Japan Shoulder Society Shoulder Instability Score (JSS-SIS); bone union, osteoarthrosis, and articular congruity were examined on plain radiographs.

Results

The Rowe score improved from 36 to 88 points, and the JSS-SIS improved from 47 to 81 points. All shoulders exhibited union without progression of osteoarthritis except one shoulder, which showed osteoarthritic change due to a previous surgery before the glenoid osteotomy. All but three shoulders showed improvement in joint congruency. Eight patients developed disordered scapulohumeral rhythm during arm elevation, and 12 patients required additional open stabilization for anterior instability.

Conclusion

Good results can be expected from glenoid osteotomy in patients with atraumatic posteroinferior instability associated with glenoid dysplasia. Cite this article: Bone Joint J 2018;100-B:331–7.
Is tranexamic acid toxic to articular cartilage when administered topically?
Authors: Parker J. D. , Lim K. S. , Kieser D. C. , Woodfield T. B. F. , Hooper G. J.
Published: March 2018

Aims

The intra-articular administration of tranexamic acid (TXA) has been shown to be effective in reducing blood loss in unicompartmental knee arthroplasty and anterior cruciate reconstruction. The effects on human articular cartilage, however, remains unknown. Our aim, in this study, was to investigate any detrimental effect of TXA on chondrocytes, and to establish if there was a safe dose for its use in clinical practice. The hypothesis was that TXA would cause a dose-dependent damage to human articular cartilage.

Materials and Methods

The cellular morphology, adhesion, metabolic activity, and viability of human chondrocytes when increasing the concentration (0 mg/ml to 40 mg/ml) and length of exposure to TXA (0 to 12 hours) were analyzed in a 2D model. This was then repeated, excluding cellular adhesion, in a 3D model and confirmed in viable samples of articular cartilage.

Results

Increasing concentrations above 20 mg/ml resulted in atypical morphology, reduced cellular adhesion and metabolic activity associated with increased chondrocyte death. However, the cell matrix was not affected by the concentration of TXA or the length of exposure, and offered cellular protection for concentrations below 20 mg/ml.

Conclusion

These results show that when in vitro chondrocytes are exposed to higher concentrations of TXA, such as that expected following recommended intra-articular administration, cytotoxicity is observed. This effect is dose-dependent, such that a tissue concentration of 10 mg/ml to 20 mg/ml could be expected to be safe. Cite this article: Bone Joint J 2018;100-B:404–12.
INOVAÇÃO, APRENDIZAGEM E COOPERAÇÃO NA CADEIA DE SUPRIMENTO TÊXTIL DA REGIÃO DE AMERICANA/SP
Authors: Dias Marcos de Carvalho
Published: March 2018

As abordagens que tratam da cooperação entre empresas numa cadeia de suprimentos geralmente consideram os aspectos benéficos desta cooperação, como ganhos de competitividade e produtividade, porém não consideram o fato de que as relações de cooperação ocorrem de forma assimétrica na cadeia, devido à heterogeneidade dos participantes. Com objetivo de analisar cooperação, aprendizagem e processos de inovação em uma cadeia cujo relacionamento é reconhecidamente assimétrico e que o grau de competitividade tem se acirrado nos últimos anos, como no caso da indústria têxtil brasileira, este trabalho foi realizado a partir de entrevistas, baseadas em questionários, com 14 empresas têxteis da região de Americana/SP. Essas entrevistas mostraram a existência de relações superficiais de cooperação entre os membros da cadeia entrevistados, e que essa forma de cooperação implica a inexistência de um processo sistemático e coordenado de aquisição de conhecimento e, por consequência, de inovações tecnológicas e organizacionais entre as empresas. Palavras-chave: Inovação; aprendizagem; cooperação; indústria têxtil.
ASSÉDIO MORAL NO TRABALHO: ESTADO DA ARTE E LACUNAS DE ESTUDOS
Authors: Mendonça Juliana Moro Bueno , Santos Marcelo Augusto Finazzi , Paula Kesley Morais de
Published: March 2018

Em virtude dos malefícios oriundos do assédio moral no trabalho e suas consequências deletérias na integridade física e psíquica dos trabalhadores, a temática merece atenção no âmbito dos estudos sociais e organizacionais. Realizou-se, assim, estudo bibliométrico de artigos em periódicos brasileiros relevantes nas áreas de Administração e Psicologia Social e do Trabalho datados de 2001 a outubro de 2016, além daqueles apresentados no congresso EnAnpad. Este estudo propicia um panorama da construção teórico-empírica sobre a temática de relevância social, indicando direções para futuras pesquisas. É preciso ampliar debates e estudos para o enfrentamento da violência moral a partir de olhares multidisciplinares, atuando de forma colaborativa. Desse modo, constatou-se a necessidade de fortalecimento do campo, para melhor compreensão do fenômeno, visto que o palco de sua ocorrência são justamente as organizações. Palavras-chave: Assédio moral; ambiente de trabalho; estado da arte; bibliometria; agenda de pesquisa.
Women in revolt: 1968 and today
Authors: Orr Judith
Published: March 2018

The discrimination that women still face in every area of life is in the international spotlight to an extent not seen since the turbulent years of the 1960s. What progress have women made since the rise of the second-wave Women’s Liberation Movement, what were the features of that movement and what is its legacy today?
An evaluation of the current status of EIA system in Pakistan focusing Khyber Pakhtunkhwa
Authors: Ahmed Deedar , Khan Abdullah , Ali Zulfiqar , Khan Daulat , Ullah Afridi Ihsan
Published: March 2018

Pakistan, like many other developing countries has adopted the integration of environmental concerns in its social and economic planning. Pakistan has developed some environmental legislation and policies at the national level for the protection and conservation of environment. This paper evaluates the current status of the environmental assessment system in Pakistan and especially in the Khyber Pakhtunkhwa (KP) province by using the Christopher Wood Evaluation Model. The EIA system in Pakistan has many strong features like the legal basis for assessment process, strong apprehension and willingness for screening and scoping, stakeholderâ€™s involvement and participation, mitigation of impacts, and cost & benefits of EIA system. The limitations found in the assessment process of Pakistan includes Preparation of EIA report and its review, monitoring and auditing, strategic environmental assessment, while consideration of alternatives and decision making mechanisms are completely ignored. Besides these, the study revealed the practice of ineffective remedial measures, non-professional, inexperience and unregistered consultants involved in the environmental assessment and sporadically the politically oriented decision making process. This evaluation led to a series of suggestions regarding the improvement of EIA system in Pakistan and especially KP Province with a view to develop its quality and effectiveness.
New Approaches in Cancer Biology Can Inform the Biology Curriculum
Authors: Jones Lynda , Gordon Diana , Zelinski Mary
Published: March 2018

Students tend to be very interested in medical issues that affect them and their friends and family. Using cancer as a hook, the ART of Reproductive Medicine: Oncofertility curriculum (free, online, and NIH sponsored) has been developed to supplement the teaching of basic biological concepts and to connect biology and biomedical research. This approach allows integration of up-to-date information on cancer and cancer treatment, cell division, male and female reproductive anatomy and physiology, cryopreservation, fertility preservation, stem cells, ethics, and epigenetics into an existing biology curriculum. Many of the topics covered in the curriculum relate to other scientific disciplines, such as the latest developments in stem cell research including tissue bioengineering and gene therapy for inherited mitochondrial disease, how epigenetics occurs chemically to affect gene expression or suppression and how it can be passed down through the generations, and the variety of biomedical careers students could pursue. The labs are designed to be open-ended and inquiry-based, and extensions to the experiments are provided so that students can explore questions further. Case studies and ethical dilemmas are provided to encourage thoughtful discussion. In addition, each chapter of the curriculum includes links to scientific papers, additional resources on each topic, and NGSS alignment.
The Use of Puppetry and Drama in the Biology Classroom
Authors: de Beer Josef , Petersen Neal , Brits Sanette
Published: March 2018

Teachers often wonder how best to teach the myriad of social and ethical issues that are encompassed in the biology curriculum. One can just think of issues such as genetic engineering, evolution (and the continuous evolution-creationism debate), research ethics (the haunting book The immortal life of Henrietta Lacks comes to mind), human population studies, health care and nutrition, sexuality and gender, drugs, environmental pollution, to name but a few. In this article we highlight the advantages of puppetry in the biology classroom, as an engaging pedagogy that could assist conceptual change in students. We explore the dual epistemological border-crossing that takes place in the classroom when puppetry is used: (a) the integration of societal and ethical issues within the biology curriculum, and (b) the infusion of art and drama within the natural sciences. We reflect on our own classroom action research on puppetry, and share our main findings. We also provide practical guidelines for using puppetry as pedagogy within a problem-based and cooperative learning setting.
An Inexpensive and Convenient Method to Culture Facultative Anaerobic Microorganisms from Yogurt
Authors: Weaver Mandy , Delaney Megan , Zitzner Jennifer R. , Castignetti Domenic
Published: March 2018

It is often difficult for students grasp the concept that some organisms can grow in the absence of oxygen and that oxygen can be toxic to organisms. However, as educators usually describe in the classroom, the importance of the anaerobic growth of microorganisms can be seen in many areas of industry, health, and the creation of several categories of food ranging from fermented alcohols to breads and cheeses. To demonstrate that microorganisms can grow and thrive in the absence of oxygen, we have developed an inexpensive and easy technique to culture facultative anaerobic bacteria from yogurt in high school or undergraduate biology laboratories. Using the method discussed, which uses readily available and low-cost equipment, students can culture and visually identify facultative anaerobic bacteria that they may consume on a regular basis, demonstrating the utility of organisms that thrive in an anaerobic environment.
Use of Crime Scene Investigations in Anatomy and Physiology: Potential for Going Beyond Knowing in NGSS Dimensions
Authors: Quinlan Catherine L.
Published: March 2018

To create and implement meaningful tasks that go beyond the cognitive processes of understanding and that integrate all three dimensions of the Next Generation Science Standards (NGSS) is challenging for both educators and curriculum makers. This issue is compounded when considering a content-rich biology course such as anatomy and physiology that requires first familiarity and understanding before engagement in higher-order thinking. The use of crime scene investigations that encourages students to examine evidence even as they learn specific biology concepts can encourage meaning making about scientific practices and science content. This paper deconstructs the implementation of a crime scene investigation titled the “Jewel Heist,” created by the New York Hall of Science and implemented in twelfth-grade anatomy and physiology classes in a diverse urban high school in the northeastern United States. The NGSS, the Framework for K-12 Science Education, along with Bloom's taxonomy and Krathwohl's revisions, are implicated in this process.