bluuebunny/crossref_metadata_2025 huggingface dataset:
Hybrid POD-FFT analysis of nonlinear evolving coherent structures of DNS wavepacket in laminar-turbulent transition
Authors: Kang Kean Lee , Yeo K. S.
Published: August 2017

This paper concerns the study of direct numerical simulation data of a wavepacket in laminar turbulent transition in a Blasius boundary layer. The decomposition of this wavepacket into a set of “modes” (a basis that spans an approximate solution space) can be achieved in a wide variety of ways. Two well-known tools are the fast Fourier transform (FFT) and the proper orthogonal decomposition (POD). To synergize the strengths of both methods, a hybrid POD-FFT is pioneered, using the FFT as a tool for interpreting the POD modes. The POD-FFT automatically identifies well-known fundamental, subharmonic, and Klebanoff modes in the flow, even though it is blind to the underlying physics. Moreover, the POD-FFT further separates the subharmonic content of the wavepacket into three fairly distinct parts: a positively detuned mode resembling a Lambda-vortex, a Craik-type tuned mode, and a Herbert-type positive-negative detuned mode pair, in decreasing order of energy. This distinction is less widely recognized, but it provides a possible explanation for the slightly positively detuned subharmonic mode often observed in previous experiments and simulations.
Initiation structure of oblique detonation waves behind conical shocks
Authors: Yang Pengfei , Ng Hoi Dick , Teng Honghui , Jiang Zonglin
Published: August 2017

The understanding of oblique detonation dynamics has both inherent basic research value for high-speed compressible reacting flow and propulsion application in hypersonic aerospace systems. In this study, the oblique detonation structures formed by semi-infinite cones are investigated numerically by solving the unsteady, two-dimensional axisymmetric Euler equations with a one-step irreversible Arrhenius reaction model. The present simulation results show that a novel wave structure, featured by two distinct points where there is close-coupling between the shock and combustion front, is depicted when either the cone angle or incident Mach number is reduced. This structure is analyzed by examining the variation of the reaction length scale and comparing the flow field with that of planar, wedge-induced oblique detonations. Further simulations are performed to study the effects of chemical length scale and activation energy, which are both found to influence the formation of this novel structure. The initiation mechanism behind the conical shock is discussed to investigate the interplay between the effect of the Taylor-Maccoll flow, front curvature, and energy releases from the chemical reaction in conical oblique detonations. The observed flow fields are interpreted by means of the energetic limit as in the critical regime for initiation of detonation.
Positron generation via two sequent laser pulses irradiating a solid aluminum target
Authors: Liu Jian-Xun , Gan Long-Fei , Ma Yan-Yun , Zhao Jun , Yang Xiao-Hu , Yu Tong-Pu , Zhuo Hong-Bin , Shao Fu-Qiu
Published: August 2017

A scheme of two sequent laser pulses irradiating a thin solid aluminum target to generate electron-positron pairs via the multi-photon Breit-Wheeler (BW) process is proposed, in order to ease the usual requirement of the laser intensity. 2D and 3D particle-in-cell simulations show that the peak intensity of the laser pulses used in our scheme is only half of that in the case of one laser pulse with a peak intensity of 2 × 1023 W/cm2, but the positron yield is one order higher than that of the latter, which is around 3.7894 × 107 and has a maximal density of 3.134 × 1022 cm−3 when the time interval between the two pulses is set to Δt ≈ 2T0. Therefore, our scheme provides a helpful suggestion for the observation of the BW process in laboratories.
Developing the evidence base for gender- and age-relevant school sex education: questionnaire findings from an adolescent sample using an augmented theory of planned behaviour
Authors: Bayley Julie E. , Baines Darrin , Brown Katherine E.
Published: August 2017

Background: Positive adolescent sexual health is supported by effective school-based sex education. Methods to promote positive sexual health need to reflect determinants of contraception intention, which must include understanding gender and age (year group) differences. To date, there has been limited theory-based exploration of these determinants in school age participants, placing limitations on sexual health educators to tailor learning most effectively. Methods: Cross-sectional survey data were collected from UK school pupils (n = 1378) aged 12–16 years. Measures included theory of planned behaviour, prototype willingness, anticipated regret and knowledge items. Linear regression determined significant predictors of intention to use condoms, the oral contraceptive pill and emergency contraception (EC). The significance of differences by gender and school year was evaluated using t-tests and analysis of variance (ANOVA). Results: Three distinct predictive models emerged for condom, pill and EC use, predicting 36%, 18% and 23% of variance respectively. Attitude, gender and anticipated regret for unprotected sex significantly predicted intention for all types of contraception (P < 0.001). The effects of other explanatory variables differed by contraceptive. Girls scored higher on all variables except condom intention, and intention scores peaked in Year 10. Conclusion: Intention to use condoms, the pill and EC have different predictive profiles, with girls more strongly motivated and Year 10 a crucial stage for intention. Social comparisons and control beliefs exert different effects across contraceptive types, whereas attitudes and anticipated regret are consistently strong influences. The findings suggest clear scope for supporting sexual health and well being through modified school sex education.
Breaking magic: Foreign language suppresses superstition
Authors: Hadjichristidis Constantinos , Geipel Janet , Surian Luca
Published: August 2017

In three studies, we found that reading information in a foreign language can suppress common superstitious beliefs. Participants read scenarios in either their native or a foreign language. In each scenario, participants were asked to imagine performing an action (e.g., submitting a job application) under a superstitious circumstance (e.g., broken mirror, four-leaf clover) and to rate how they would feel. Overall, foreign language prompted less negative feelings towards bad-luck scenarios and less positive feelings towards good-luck scenarios, while it exerted no influence on non-superstitious, control scenarios. We attribute these findings to language-dependent memory. Superstitious beliefs are typically acquired and used in contexts involving the native language. As a result, the native language evokes them more forcefully than a foreign language.
A microsatellite baseline for genetic stock identification of European Atlantic salmon (Salmo salar L.)
Authors: Gilbey John , Coughlan Jamie , Wennevik Vidar , Prodöhl Paulo , Stevens Jamie R , Garcia de Leaniz Carlos , Ensing Dennis , Cauwelier Eef , Cherbonnel Corrine , Consuegra Sofia , Coulson Mark W , Cross Tom F , Crozier Walter , Dillane Eileen , Ellis Jonathan S , García-Vázquez Eva , Griffiths Andrew M , Gudjonsson Sigurdur , Hindar Kjetil , Karlsson Sten , Knox David , Machado-Schiaffino Gonzalo , Meldrup Dorte , Eg Nielsen Einar , Ólafsson Kristinn , Primmer Craig R , Prusov Sergey , Stradmeyer Lee , Vähä Juha-Pekka , Veselov Alexey Je , Webster Lucy M I , McGinnity Philip , Verspoor Eric
Published: August 2017

Atlantic salmon (Salmo salar L.) populations from different river origins mix in the North Atlantic during the marine life stage. To facilitate marine stock identification, we developed a genetic baseline covering the European component of the species’ range excluding the Baltic Sea, from the Russian River Megra in the north-east, the Icelandic Ellidaar in the west, and the Spanish Ulla in the south, spanning 3737 km North to South and 2717 km East to West. The baseline encompasses data for 14 microsatellites for 26 822 individual fish from 13 countries, 282 rivers, and 467 sampling sites. A hierarchy of regional genetic assignment units was defined using a combination of distance-based and Bayesian clustering. At the top level, three assignment units were identified comprising northern, southern, and Icelandic regions. A second assignment level was also defined, comprising eighteen and twenty-nine regional units for accurate individual assignment and mixed stock estimates respectively. The baseline provides the most comprehensive geographical coverage for an Atlantic salmon genetic data-set, and a unique resource for the conservation and management of the species in Europe. It is freely available to researchers to facilitate identification of the natal origin of European salmon.
Star Bodies with Completely Symmetric Sections
Authors: Myroshnychenko Sergii , Ryabogin Dmitry , Saroglou Christos
Published: August 2017

We say that a star body $K$ is completely symmetric if it has centroid at the origin and its symmetry group $G$ forces any ellipsoid whose symmetry group contains $G$, to be a ball. In this short note, we prove that if all central sections of a star body $L$ are completely symmetric, then $L$ has to be a ball. A special case of our result states that if all sections of $L$ are origin symmetric and 1-symmetric, then $L$ has to be a Euclidean ball. This answers a question from [12]. Our result is a consequence of a general theorem that we establish, stating that if the restrictions to almost all equators of a real function $f$ defined on the sphere, are isotropic functions, then $f$ is constant a.e. In the last section of this note, applications, improvements, and related open problems are discussed, and two additional open questions from [11] and [12] are answered.
Malignant Hyperthermia
Authors: Heine Christopher L.
Published: August 2017

In this chapter we discuss the pathophysiology of malignant hyperthermia, identify those who are known to be susceptible to MH, delineate how best to prepare the operating for those patients, and provide step by step treatment recommendations for patients that develop MH. Malignant hyperthermia (MH) is a pharmacogenetic disease. When susceptible individuals are exposed to a triggering agent, a hypermetabolic response develops. Succinylcholine and halogenated, inhaled anesthetics are triggers of MH. The MH reaction is initiated by a rapid influx of calcium ions into the myoplasm that triggers uncontrolled muscle contraction. Prompt recognition and treatment of the reaction is critical to a successful outcome.
Valvular Disease
Authors: Chandrasekhar Shobana , Mason C. LaToya
Published: August 2017

Cardiovascular disease is a leading cause of maternal morbidity and mortality worldwide. Complex valvular heart disease accounts for approximately 30% to 50% of all cardiac diseases of pregnancy and presents significant challenges to the management of the parturient affected by it. Determination of disease severity and maternal risk assessment are especially important to development of appropriate plans of care for the labor, delivery, and immediate postpartum periods, when adverse events for both mother and fetus may occur. An understanding of the pathophysiology of the causative lesions and hemodynamic goals, thorough evaluation, and a multidisciplinary approach are key components to the successful management of these patients, allowing for appropriate selection of an anesthetic technique that balances the benefits and consequences to both mother and infant, thereby leading to optimal patient outcomes.
Voltage Disturbances During Pregnancy
Authors: Nixon Heather C.
Published: August 2017

This chapter covers the incidence, etiology, and treatment of the most common electrocardiogram and rhythm disturbances encountered during pregnancy. Baseline electrocardiogram changes associated with pregnancy include left ventricular hypertrophy and ST segment depressions secondary to anatomic and metabolic changes of pregnancy. The most common arrhythmias include atrial and ventricular ectopy, which are usually benign in nature. Supraventricular and ventricular tachycardia are also discussed in detail, along with the impact of antiarrhythmic and electrical conversion therapy on fetal and maternal well-being. An understanding of the pathophysiology, assessment, and treatment of these rhythm disturbances is requisite knowledge for all anesthesiologists to provide optimal and timely care to parturients.
Introduction to Acute Neurologic Events in the Perioperative Period
Authors: Lee Lorri A.
Published: August 2017

Anesthesiologists may encounter patients with a wide variety of acute neurologic events in the perioperative period at various stages in their workup, diagnosis, and treatment. The urgency of diagnosis, workup, and definitive treatment falls on a spectrum from minutes to days to weeks depending on the clinical scenario. This section deals primarily with the emergent and urgent acute neurologic events where time to treatment is paramount to a good neurological outcome. A thorough understanding of the pathophysiology, assessment, and treatment of these neurologic conditions is essential for all anesthesia professionals in order to ensure optimal care delivery and outcomes for patients.
Delirium
Authors: Alvis Bret D. , Hughes Christopher G.
Published: August 2017

Delirium in the postoperative period, characterized by inattention, disorganized thinking, disorientation, and/or altered levels of consciousness within the first few days after surgery, has been associated with significant increases in hospital stay, functional decline, prolonged cognitive dysfunction, and mortality. It is underdiagnosed without routine assessments with validated tools such as the Confusion Assessment Method (CAM), the 4AT, the Confusion Assessment Method for Intensive Care Unit (CAM-ICU), or the Intensive Care Delirium Screening Checklist (ICDSC). Prevention strategies for postoperative delirium include multimodal pain control, judicious use of medications that affect the sensorium, including benzodiazepines and anticholinergics, maintenance of appropriate volume status, and optimization of the patient’s environment. In patients who develop delirium with severe agitation, antipsychotic and alpha-2 agonist medications may be useful. Because postoperative delirium occurs commonly and is associated with worse outcomes, an understanding of its disease process, risk factors, and management is essential for an anesthesiologist.
Nontraumatic Intracranial Hemorrhage
Authors: Sharma Deepak , Metzner Julia
Published: August 2017

Nontraumatic subarachnoid, intraventricular, or intraparenchymal hemorrhage can be caused by either rupture of an aneurysm or arteriovenous malformation or by coagulopathy, hypertension, or vasculitis. Pituitary apoplexy results from spontaneous hemorrhage or infarction into a pituitary tumor. Additionally, anesthesiologists must be prepared to manage intraoperative bleeding during craniotomies. Successful management of nontraumatic intracranial hemorrhage requires (1) careful preoperative evaluation and preparation considering extracranial manifestations of intracranial bleeding; (2) administration of balanced anesthesia to facilitate surgical exposure and neurophysiological monitoring; (3) maintenance of cerebral perfusion by preserving circulating volume, judicious use of blood product transfusion and vasopressors, and avoidance of excessive hyperventilation; and, when possible, (4) providing timely emergence from anesthesia to allow neurological assessment. Close communication between the surgical and anesthesia teams is critical for optimizing the potential for good patient outcomes.
Refractory Intracranial Hypertension
Authors: Mathews Letha , Barwise John
Published: August 2017

Intracranial pressure remains constant in adults at 10–15 mmHg under normal conditions with some fluctuations associated with respirations, coughing, sneezing, and so forth. Refractory intracranial hypertension (ICH) is defined by recurrent episodes of intracranial pressure elevation above 20 mmHg for sustained periods (10–15 min) despite medical therapy. The common causes of ICH are traumatic brain injury, brain tumors, subarachnoid hemorrhage, and brain infarction from arterial occlusion, cerebral venous thrombosis, and anoxic encephalopathy. Intracranial infections, abscesses, acute liver encephalopathy, and idiopathic ICH are also recognized causes of ICH. For the purposes of this chapter, the discussion is limited to ICH related to traumatic brain injury.
Drowning and Near Drowning
Authors: Jeziorski Alison M.
Published: August 2017

Drowning and near drowning are submersion injuries that are the fifth leading cause of unintentional death in the United States and the second leading cause of unintentional death in children under 14 years old. The lungs are the primary organ affected by a submersion event, however the resulting hypoxemia allows for a cascade of organ involvement. Several factors have been identified in determining survival and neurologic recovery, including submersion duration, temperature of water, initiation of bystander resuscitation, and initial neurologic exam. Treatment can be viewed as two-tiered: out-of-hospital and in-hospital resuscitation. Often, after a period of stabilization, patients may have a change in clinical status requiring escalation of care, therefore it is important to be mindful of even minor status changes. The importance of water safety and education of parents, children, and adolescents may decrease the likelihood of submersion injuries in the future.
Sickle Cell Disease
Authors: Franklin Andrew
Published: August 2017

Sickle cell disease, a hemoglobinopathy that affects multiple organ systems, is a complex disease entity that presents unique challenges during the perioperative period. The hallmark of sickle cell disease, vaso-occlusion, results from sickling of erythrocytes containing hemoglobin of abnormal conformation due to genetically mutated beta globin genes. The perioperative clinician must properly care for acute sickle cell crises including acute painful episodes and acute chest syndrome, and safely care for the sickle cell patient through the preoperative, intraoperative, and postoperative phases of surgical treatment. Both acute painful episodes and acute chest syndrome result from vaso-occlusive crises, and early stabilization of these emergencies is crucial to ensuring a positive patient outcome. The singular perioperative objective for the care of sickle cell disease patients is both simple and daunting: to achieve physiologic homeostasis in patients with preexisting multiorgan dysfunction undergoing a series of physiologic insults during and after surgery.
Coagulation System
Authors: Kilkelly Shannon
Published: August 2017

Despite the development of entirely new classes of anticoagulant medication, vitamin K antagonists like warfarin continue to be commonly prescribed for a wide range of cardiovascular diagnoses. Conversely, the advent of low molecular weight heparin has greatly simplified the use of the drug to the point that patients can dose themselves at home with no need for any type of monitoring. Given the widespread use of these medications, it is not surprising that an increasing number of patients requiring urgent or emergent surgery will present with a medically induced coagulopathy. Managing this coagulopathy requires assessment of the urgency of the operation, the patient’s volume status, and the need for reanticoagulation following surgical intervention.
Opioid and Benzodiazepine Overdose
Authors: Eastman Brad , Field Larry
Published: August 2017

This chapter, “Opioid and Benzodiazepine Overdose,” reviews the pathophysiology of disease state pertaining to overdose as well as the molecular mechanisms involved with drug receptor binding. It discusses common presenting signs and symptoms of opioid and benzodiazepine overdose in the context of a clinical scenario. It also discusses specific patient populations that are at increased risk of opioid and benzodiazepine overdose. Initial and subsequent treatment options are thoroughly examined while allowing the reader to engage in clinical discussions to open-ended questions provided throughout the chapter. The use of opioid and benzodiazepine antagonists as antidotes is reviewed in detail along with common doses and regimens.
Introduction to biological and molecular psychiatry
Authors: Hodgkiss Andrew
Published: August 2017

An introduction to biological and molecular psychiatry is offered, intended for oncology and palliative medicine clinicians. A recent historical perspective is used, beginning with a summary of monoaminergic and cholinergic neurotransmission as understood in the 1980s. One endocrine theory of depression, based on HPA axis dysfunction, is described. Recognition of the limits of these models has led to a deeper molecular psychiatry ‘beyond the synapse’ and to an appreciation of the importance of amino acid neurotransmission. Selective expression of proteins, and their covalent and allosteric modification, is now seen as central to neuroplasticity. The NMDA receptor and excitotoxicity are introduced. The chapter closes with an overview of the amygdala and of hippocampal neurogenesis.
Further clinical issues
Authors: Hodgkiss Andrew
Published: August 2017

The clinical challenges arising when a person with a severe mental illness, such as schizophrenia or bipolar disorder, develops a cancer are surveyed. Delayed diagnosis and access to oncological treatment, factors contributing to reduced adherence, and the interruption of specialist community psychiatric care are discussed. Long-term psychotropic medication may complicate end-of-life care, and access to palliative care is usually limited for those in secure mental health inpatient units. The striking inverse relationship between neurodegenerative disorders (Alzheimer-type dementia) and proliferative disorders (cancers) is considered.

Psychiatric aspects of haematopoietic stem cell transplantation (HSCT) are reviewed, including psychopathology arising from drugs used to prevent graft-versus-host disease and from infections complicating chronic immunosuppression. Cognitive impairment and suicide after HSCT are considered.
Therapeutic strategies
Authors: Hodgkiss Andrew
Published: August 2017

A wide range of therapeutic strategies to manage cancer-related psychopathology are described. Evidence-based interventions include: surgery (e.g. oophorectomy for anti-NMDAR limbic encephalitis), radiotherapy, immunotherapy, anti-glucocorticoids, correction of electrolyte abnormalities, correction of vitamin or endocrine deficiencies, and the use of carefully selected antidepressant or antipsychotic medication. Particular attention is paid to the management of cancer-related delirium and mania, and to the depressive phenomena provoked by systemic cancer treatments. The quality of the evidence-base for these treatments is critically reviewed.
Valve and outflow tract lesions
Authors: Thorne Sara , Bowater Sarah
Published: August 2017

This chapter discusses valve and outflow tract lesions. It considers left ventricular outflow tract obstruction (LVOTO), including subvalvar aortic stenosis (AS), bicuspid aortic valve, and supravalvar AS. Also discussed are left ventricular inflow lesions, including congenital mitral valve abnormalities, cor triatriatum, and Shone syndrome. It also covers right ventricular outflow tract obstruction (RVOTO), including pulmonary valvar stenosis, supravalvar pulmonary stenosis, pulmonary artery stenosis, pulmonary atresia with intact septum, and double-chambered right ventricle. Ebstein anomaly is also discussed, including incidence, associations, natural history, presenting features in the adult, investigations, and management.
Aortic lesions
Authors: Thorne Sara , Bowater Sarah
Published: August 2017

This chapter describes aortic lesions, including coarctation of the aorta (CoA), patent ductus arteriosus (PDA), aortopulmonary (AP) window, common arterial trunk/truncus arteriosus, Marfan syndrome, and Loeys Dietz syndrome.
Tetralogy of Fallot and pulmonary atresia with VSD
Authors: Thorne Sara , Bowater Sarah
Published: August 2017

This chapter describes tetralogy of Fallot and pulmonary atresia with ventricular septal defect (VSD), including natural (unoperated) or shunt-palliated history, operated history, follow-up after radical repair, and pulmonary atresia with VSD.
Ventricular septal defects
Authors: Katritsis Demosthenes G. , Gersh Bernard J. , Camm A. John
Published: August 2017

Ventricular septal defects are classified, and their diagnosis and management are discussed. Indications of closure and the recommendations of ACC/AHA and ESC are presented.
Arrhythmogenic right ventricular cardiomyopathy/dysplasia
Authors: Katritsis Demosthenes G. , Gersh Bernard J. , Camm A. John
Published: August 2017

Arrhythmogenic right ventricular cardiomyopathy (dysplasia) is discussed. Diagnosis and indications for ICD therapy are presented.
Epidemiology, presentation, and therapy of supraventricular tachycardias
Authors: Katritsis Demosthenes G. , Gersh Bernard J. , Camm A. John
Published: August 2017

Supraventricular tachycardias (SVT) are traditionally considered as sinus nodal tachycardias, atrial tachycardia and flutter, AVNRT and other junctional arrhythmias, and AVRT. In this chapter, classification, epidemiology, and presentation of SVT in various clinical settings are presented.
Definitions of inherited arrhythmias
Authors: Katritsis Demosthenes G. , Gersh Bernard J. , Camm A. John
Published: August 2017

Inherited arrhythmias are defined; genetic mechanisms of channelopathies are presented, and a glossary on the terms used in genetics is provided.
Long QT syndrome
Authors: Katritsis Demosthenes G. , Gersh Bernard J. , Camm A. John
Published: August 2017

Long QT syndromes are described, and risk stratification and management of patients are discussed. Indications for genetic testing and specific therapy are provided.
Genetic syndromes associated with thoracic aneurysm and dissection
Authors: Katritsis Demosthenes G. , Gersh Bernard J. , Camm A. John
Published: August 2017

Inherited conditions, such as Marfan’s and Loeys–Dietz syndrome, are discussed. Specific recommendations for diagnosis and management are provided.
Pulmonary arterial hypertension and hypertension associated with pulmonary venous abnormalities
Authors: Katritsis Demosthenes G. , Gersh Bernard J. , Camm A. John
Published: August 2017

Pulmonary arterial hypertension and pulmonary hypertension associated with pulmonary venous or capillary abnormalities, i.e. pulmonary veno-occlusive disease and pulmonary capillary haemangiomatosis, are discussed.
Cardiovascular disease in pregnancy
Authors: Katritsis Demosthenes G. , Gersh Bernard J. , Camm A. John
Published: August 2017

Adaptation of the cardiovascular system to intense athletic activity and differentiation from pathological conditions are discussed.
Cardiovascular drugs
Authors: Katritsis Demosthenes G. , Gersh Bernard J. , Camm A. John
Published: August 2017

Cardiovascular drugs are referred to particular chapters where they are discussed. Drugs for erectile dysfunction are presented.
Role of stem cell transplant in lymphoma in the era of new drugs
Authors: Benekou Katerina , Montoto Silvia
Published: August 2017

Purpose of review

Better understanding of the lymphoma pathogenesis and molecular biology has introduced a new era in the lymphoma therapy with the advent of targeted drugs. In this new era, the role of hematopoietic stem cell transplantation (HSCT) is evolving, and the purpose of this review is to demonstrate how the introduction of novel agents has affected the current treatment strategy of different subtypes of lymphoma.

Recent findings

Autologous stem cell transplantation (ASCT) remains the standard of care for patients with relapsed Hodgkin Lymphoma and high-grade non-Hodgkin lymphoma (NHL). In the group of the indolent lymphomas, ASCT maintains its role in the relapsed setting. Novel targeted agents like idelalisib and ibrutinib have shown to induce prolonged remissions with a very good safety profile. However, the follow-up is still relatively short and none of these drugs have demonstrated a curative potential, as opposed to HSCT.

For many authors, the advent of new targeted drugs is challenging the role of HSCT in different subsets of lymphoma. The actual challenge is how to make the best use of these drugs, in certain circumstances in combination with HSCT, to further improve the outcome of patients with lymphoma.
Let’s be civil: Elaborating the link between civility climate and hospital performance
Authors: Oppel Eva-Maria , Mohr David C. , Benzer Justin K.
Published: August 2017

Background:

The importance of interpersonal behavior at the workplace is increasingly recognized in the health care industry and related literature. An unresolved issue in the existing health care research is how a climate of courteous interpersonal behavior may form the foundation for strong hospital care performance.

Purpose:

The aim of this study was to test the link between a climate of courteous interpersonal behavior, termed “civility climate,” and hospital care performance. We conceptualize a multidimensional model of care performance by contrasting two dimensions: performance as perceived by employees and performance as perceived by patients. Furthermore, for both performance perspectives, we test an intermediate variable (error orientation climate) that may explain the relationship between civility climate and hospital care performance.

Methodology:

The 2011 study sample comprised responses from 6,094 nurses and 38,627 patients at 123 Veterans Health Administration acute care inpatient hospitals in the United States. We developed and empirically tested a theoretical model using regression modeling, and we used a bootstrap method to test for mediation.

Results:

The results indicate a direct effect of civility climate on employee perceptions of care performance and an indirect effect mediated by error orientation climate. With regard to patient perceptions of care performance, the analyses reveal a direct effect of civility climate. The indirect effect mediated by error orientation climate was not supported.

Practice Implications:

Our findings point to the importance of strengthening interpersonal interactions for ensuring and improving both employees’ and patients’ perceptions of care, which constitute key success factors in the increasingly competitive hospital market. The insights may further stimulate discussion regarding interventions to foster a strong civility climate in hospitals.
Detection of prevalent mechanism of extended spectrum β-lactamases, metallo β-lactamases, and AmpC β lactamases-producing Klebsiella pneumoniae in the tertiary care hospital
Authors: Alyousef Abdullah A. , Khazaal Saba Saadoon , Ali Alaa N. Mohammed , Hussein Nadheema Hammood , Hussein Sawsan Mustafa Aloahd
Published: August 2017

Increasing trends of resistance to antibiotics because of production of β-lactamases, such as carbapenamase-mediated resistance and extended spectrum β-lactamases (ESBL), are the most widespread mechanisms documented in Klebsiella pneumoniae. The objective of this study was to understand the prevalent mechanisms of resistance among the clinical isolates of multidrug-resistant (MDR) K. pneumonia from inpatients of a tertiary care hospital at Baghdad, Iraq. Among the 97 MDR K. pneumoniae isolates, 47.4% (n = 46) isolates showed ESBL production, 38.7% (n = 38) showed metallo β-lactamase (MBL) production, and 22.7% (n = 22) showed both ESBL and MBLs production. Out of 97 MDR K. pneumoniae, 94.3% were found to be biofilm producers. ESBL production was the predominant mechanism of resistance followed by MBL production. Since very limited therapeutic options are available, increasing resistance mechanisms among these organisms is an ‘alarming sign’.
Compliance of Nurses and Hospitals With Ventilator-Associated Pneumonia Prevention Guidelines
Authors: Aloush Sami M. , Abdelkader Fadia A. , Al-Sayaghi Khaled , Tawalbeh Loai I. , Suliman Mohammad , Al Bashtawy Mohammed , Shaban Insaf
Published: August 2017

This study was a self-reported cross-sectional survey that investigated nurses' and hospitals' compliance with ventilator-associated pneumonia prevention guidelines and the barriers and factors that affect their level of compliance. A questionnaire was completed by 471 intensive care unit nurses from 16 medical centers in 3 Middle Eastern countries: Jordan, Egypt, and Saudi Arabia. The results show that both nurses and hospitals have insufficient compliance. Previous education, experience, and academic degree were all found to affect nurses' compliance.
Developing a Mobile App for Neuroscience Nurses
Authors: DeLemos Christi D.
Published: August 2017

In this month’s Magnet® Perspectives column, the recipient of the 2016 Magnet Nurse of the Year® Award for New Knowledge, Innovations, and Improvements shares her journey to develop and disseminate a mobile application for nurses who care for neurological patients. “Neuroscience nurse” puts the latest, evidence-based information at the fingertips of nurses at the bedside in an effort to increase confidence when caring for patients with stroke, traumatic brain injury, and other neurological impairments.

Nurse practitioner Christi DeLemos explains where she got the idea and how she went about implementing it. She also discusses the ways in which the Magnet® environment at University of California (UC) Davis Medical Center encouraged and supported her. Since neurological nurse was released in 2015, more than 3000 users in 19 countries have downloaded it. The app’s success led to the production of a teaching video to help nurses perform a neurological examination. In addition to her role at UC Davis Medical Center, DeLemos is president of the World Federation of Neuroscience Nurses.
Embedding a Professional Practice Model Across a System
Authors: Mensik Jennifer S. , Martin Deborah Maust , Johnson Karen L. , Clark Carla M. , Trifanoff Christina M.
Published: August 2017

Professional practice models (PPMs) are an integral part of any organization on the Magnet® journey, whether initial designation or redesignation. Through the journey, the PPM should become embedded within the nursing culture. Leadership at multiple levels is crucial to ensure successful adoption and implementation.
Comparison of algorithms for the detection of enteroviruses in stool specimens from children diagnosed with Acute Flaccid Paralysis
Authors: Adeniji J.A. , Ayeni F. A. , Ibrahim A. , Tijani K.A. , Faleye T.O.C. , Adewumi M.O.
Published: August 2017

With poliovirus eradication within reach, the WHO has included in its recommendations a cell-culture independent algorithm for enterovirus surveillance. This study was designed to compare both the cell culture dependent and independent algorithms and assess how either might impact our perception of the diversity of enterovirus types present in a sample.

Sixteen paired samples (16 isolates from RD cell culture and their corresponding stool suspension. i.e. 32 samples) from AFP cases in Nigeria were analyzed in this study. One of these 16 sample pairs (the control) was previously identified and confirmed as poliovirus 2 (PV-2). All the samples were subjected to RNA extraction, cDNA synthesis, RT-snPCR (the WHO recommended cell-culture independent algorithm) and its modifications for co-infection detection and resolution. Amplicons were sequenced and strains identified using the enterovirus genotyping tool and phylogenetic analysis.

The enterovirus diversity was shown to be the same between RD cell culture isolates and fecal suspension for the control and five (7, 10, 11, 12 & 14) of the samples analyzed. It was however, different for the remaining 10 (62.5%) samples analyzed. Fourteen different enterovirus types were identified in this study. To be precise, 9 (CV-B4, E6, E7, E13, E14, E19, E29, EV-B75 and EV-B77) and 5 (CV-A1, CV-A11, CV-A13, EV-C99 and PV2) EV-B and EV-C types, respectively where detected in this study. It is crucial to mention that E19 and EV-B75were only recovered from RD cell culture isolates while E14, EV-B77, CV-A11 and CV-A13 were only recovered from fecal suspension.

The results of this study show that both the cell culture dependent and independent protocols recommended by the WHO for enterovirus detection unavoidably bias our perception of the diversity of enterovirus types present in a sample. Hence, rather than jettison one for the other, effort should be directed at harmonizing both for increased sensitivity.
Odor source localization in complex visual environments by fruit flies
Authors: Saxena Nitesh , Natesan Dinesh , Sane Sanjay P.
Published: August 2017

Flying insects routinely forage in complex and cluttered sensory environments. Their search for a food or a pheromone source typically begins with a whiff of odor, which triggers a flight response, eventually bringing the insect in the vicinity of the odor source. The precise localization of an odor source, however, requires the use of both visual and olfactory modalities, aided by air currents that trap odor molecules into turbulent plumes, which the insects track. Here, we investigated odor tracking behavior in fruit flies (Drosophila melanogaster)presented with low- or high-contrast visual landmarks, which were either paired with or separate from an attractive odor cue. These experiments were conducted either in a gentle air stream which generated odor plumes, or in still air in which odor dissipates uniformly in all directions. The trajectories of the flies revealed several novel features of their odor-tracking behavior in addition to those that have been previously documented (e.g. cast- and-surge maneuvers). First, in both moving and still air, odor-seeking flies rely on the co-occurrence of visual landmarks with olfactory cues to guide them to putative odorant objects in the decisive phase before landing. Second, flies abruptly decelerate when they encounter an odor plume, and thereafter steer towards nearby visual objects that had no inherent salience in the absence of odor. This indicates that the interception of an attractive odor increases their salience to nearby high-contrast visual landmarks. Third, flies adopt distinct odor tracking strategies during flight in movingvs.still air. Whereas they weave in and out of plumes towards an odor source when airflow is present, their approach is more gradual and incremental in still air. Both strategies are robust and flexible, and can ensure that the flies reliably find the odor source under diverse visual and airflow environments. Our experiments also indicate the possibility of an olfactory “ working memory” that enables flies to continue their search even when the olfactory feedback is reduced or absent. Together, these results provide insights into how flies determine the precise location of an odor source.
Skip-mers: increasing entropy and sensitivity to detect conserved genic regions with simple cyclic q-grams
Authors: Clavijo Bernardo J. , Accinelli Gonzalo Garcia , Yanes Luis , Barr Katie , Wright Jonathan
Published: August 2017

Bioinformatic analyses and tools make extensive use of k-mers (fixed contiguous strings ofknucleotides) as an informational unit. K-mer analyses are both useful and fast, but are strongly affected by single nucleotide polymorphisms or sequencing errors, effectively hindering direct-analyses of whole regions and decreasing their usability between evolutionary distant samples. Q-grams or spaced seeds, subsequences generated with a pattern of used-and-skipped nucleotides, overcome many of these limitations but introduce larger complexity which hinders their wider adoption.

We introduce a concept of skip-mers, a cyclic pattern of used-and-skipped positions ofknucleotides spanning a region of sizeS ≥ k, and show how analyses are improved by using this simple subset of q-grams as a replacement for k-mers. The entropy of skip-mers increases with the larger span, capturing information from more distant positions and increasing the specificity, and uniqueness, of larger span skip-mers within a genome. In addition, skip-mers constructed in cycles of 1 or 2 nucleotides in every 3 (or a multiple of 3) lead to increased sensitivity in the coding regions of genes, by grouping together the more conserved nucleotides of the protein-coding regions.

We implemented a set of tools to count and intersect skip-mers between different datasets, a simple task given that the properties of skip-mers make them a direct substitute for k-mers. We used these tools to show how skip-mers have advantages over k-mers in terms of entropy and increased sensitivity to detect conserved coding sequence, allowing better identification of genic matches between evolutionarily distant species. We then show benefits for multi-genome analyses provided by increased and better correlated coverage of conserved skip-mers across multiple samples.

Software availability

the skm-tools implementing the methods described in this manuscript are available under MIT license athttp://github.com/bioinfologics/skm-tools/
Developmental changes within the genetic architecture of social communication behaviour: A multivariate study of genetic variance in unrelated individuals
Authors: Pourcain Beate St , Eaves Lindon J , Ring Susan M , Fisher Simon E , Medland Sarah , Evans David M , Smith George Davey
Published: August 2017

Background

Recent analyses of trait-disorder overlap suggest that psychiatric dimensions may relate to distinct sets of genes that exert their maximum influence during different periods of development. This includes analyses of social-communciation difficulties that share, depending on their developmental stage, stronger genetic links with either Autism Spectrum Disorder or schizophrenia. Here we developed a multivariate analysis framework in unrelated individuals to model directly the developmental profile of genetic influences contributing to complex traits, such as social-communication difficulties, during a ∼10-year period spanning childhood and adolescence.

Methods

Longitudinally assessed quantitative social-communication problems (N≤ 5,551) were studied in participants from a UK birth cohort (ALSPAC, 8 to 17 years). Using standardised measures, genetic architectures were investigated with novel multivariate genetic-relationship-matrix structural equation models (GSEM) incorporating whole-genome genotyping information. Analogous to twin research, GSEM included Cholesky decomposition, common pathway and independent pathway models.

Results

A 2-factor Cholesky decomposition model described the data best. One genetic factor was common to SCDC measures across development, the other accounted for independent variation at 11 years and later, consistent with distinct developmental profiles in trait-disorder overlap. Importantly, genetic factors operating at 8 years explained only ∼50% of the genetic variation at 17 years.

Conclusion

Using latent factor models, we identified developmental changes in the genetic architecture of social-communication difficulties that enhance the understanding of ASD and schizophrenia-related dimensions. More generally, GSEM present a framework for modelling shared genetic aetiologies between phenotypes and can provide prior information with respect to patterns and continuity of trait-disorder overlap.
Preventing photomorbidity in long-term multi-color fluorescence imaging ofS. cerevisiaeandS. pombe
Authors: Schmidt Gregor W. , Cuny Andreas P. , Rudolf Fabian
Published: August 2017

Time-lapse imaging using multiple fluorescent reporters is an essential tool to study molecular processes in single cells. However, exposure to even moderate doses of visible excitation light can disturb cellular physiology and alter the quantitative behavior of the cells under study. Here, we set out to develop guidelines to avoid the confounding effects of excitation light in multi-color long-term imaging. We use widefield fluorescence microscopy to measure the effect of the administered excitation light on growth (here called photomorbidity) in yeast. We find that photomorbidity is determined by the cumulative light dose at each wavelength, but independent of the way excitation light is applied. Importantly, photomorbidity possesses a threshold light dose below which no effect is detectable (NOEL, no-observed-effect level). We found, that the suitability of fluorescent proteins for live-cell imaging at the respective excitation light NOEL is equally determined by the cellular autofluorescence and the fluorescent protein brightness. Last, we show that photomorbidity of multiple wavelengths is additive and imaging conditions absent of photomorbidity can be predicted. Our findings enable researchers to find imaging conditions with minimal impact on physiology and can provide a framework for how to approach photomorbidity in other organisms.
CardioClassifier – demonstrating the power of disease- and gene-specific computational decision support for clinical genome interpretation
Authors: Whiffin Nicola , Walsh Roddy , Govind Risha , Edwards Matthew , Ahmad Mian , Zhang Xiaolei , Tayal Upasana , Buchan Rachel , Midwinter William , Wilk Alicja E , Najgebauer Hanna , Francis Catherine , Wilkinson Sam , Monk Thomas , Brett Laura , O'Regan Declan P , Prasad Sanjay K , Morris-Rosendahl Deborah J , Barton Paul JR , Edwards Elizabeth , Ware James S , Cook Stuart A
Published: August 2017

Purpose

Internationally-adopted variant interpretation guidelines from the American College of Medical Genetics and Genomics (ACMG) are generic and require disease-specific refinement. Here we developed CardioClassifier (www.cardioclassifier.org), a semi-automated decision-support tool for inherited cardiac conditions (ICCs).

Methods

CardioClassifier integrates data retrieved from multiple sources with user-input case-specific information, through an interactive interface, to support varian interpretation. Combining disease- and gene-specific knowledge with variant observations in large cohorts of cases and controls, we refined 14 computational ACMG criteria and created three ICC-specific rules.

Results

We benchmarked CardioClassifier on 57 expertly-curated variants and show full retrieval of all computational data, concordantly activating 87.3% of rules. A generic annotation tool identified fewer than half as many clinically-actionable variants (64/219 vs 156/219, Fisher’s P=1.1x10-18), with important false positives; illustrating the critical importance of disease and gene-specific annotations. CardioClassifier identified putatively disease-causing variants in 33.7% of 327 cardiomyopathy cases, comparable with leading ICC laboratories. Through addition of manually-curated data, variants found in over 40% of cardiomyopathy cases are fully annotated, without requiring additional user-input data.

Conclusion

CardioClassifier is an ICC-specific decision-support tool that integrates expertly curated computational annotations with case-specific data to generate fast, reproducible and interactive variant pathogenicity reports, according to best practice guidelines.
Activating the regenerative potential of Müller glia cells in a regeneration-deficient retina
Authors: Lust Katharina , Wittbrodt Joachim
Published: August 2017

Regeneration responses in animals are widespread across phyla. To identify molecular players that confer regenerative capacities to non-regenerative species is of key relevance for basic research and translational approaches. Here we report a differential response in retinal regeneration between medaka (Oryzias latipes) and zebrafish (Danio rerio). In contrast to zebrafish, medaka Müller glia (olMG) cells behave like progenitors and exhibit a restricted capacity to regenerate the retina. After injury, olMG cells proliferate but fail to self-renew and ultimately only restore photoreceptors.

In our injury paradigm, we observed that in contrast to zebrafish, proliferating olMG cells do not maintainsox2expression. Sustainedsox2expression in olMG cells confers regenerative responses similar to those of zebrafish MG (drMG) cells. We show that a single, cell-autonomous factor reprograms olMG cells and establishes a regeneration-like mode. Our results position medaka as an attractive model to delineate key regeneration factors with translational potential.