bluuebunny/crossref_metadata_2025 huggingface dataset:
CO2 Reduction Potential of Water Saving in Vietnam
Authors: Otani Takayuki , Toyosada Kanako , Shimizu Yasutoshi
Published: May 2015

In a previous study, we showed that widespread adoption of water-saving equipment had the potential to reduce CO2 emissions by 1% in Japan. The usage of already diffused equipment was used as an evaluation baseline. This was an evaluation model of developed countries. In order to evaluate the potential benefits of water-saving in developing countries, it is necessary to set the baseline, as cities in developing countries are expected to have the necessary infrastructure in place in the near future. In this paper, the potential for reducing CO2 emissions by water saving in Vietnam was evaluated. Based on the development of water infrastructure, and envisioning a society in which the latest high-efficiency flush toilet bowls and showers installed in Hanoi and Ho Chi Minh City are used in all Vietnamese houses as a near future baseline, we evaluated the potential reduction when a water-saving project is implemented. Under these conditions, an 8.8% reduction in CO2 emissions in Vietnam would be achieved by the widespread adoption of water-saving equipment. Following the recognition of the large environmental contribution potential of water saving, a water-saving project has been planned for implementation in Vietnam in the near future.
Introduction : la géographie des télécommunications aujourd'hui (Introduction : telecommunications geography to day)
Authors: Bakis Henry
Published: May 2015

Résumé. - Les télécommunications offrent aux acteurs territoriaux un pont immatériel entre les lieux. Les réseaux de la communication électronique permettent une articulation nouvelle entre le «local» et le «global». A ce titre au moins ils doivent intéresser les géographes.
COMBINING B&B-BASED HYBRID FEATURE SELECTION AND THE IMBALANCE-ORIENTED MULTIPLE-CLASSIFIER ENSEMBLE FOR IMBALANCED CREDIT RISK ASSESSMENT
Authors: SUN Jie , LEE Young-Chan , LI Hui , HUANG Qing-Hua
Published: May 2015

An ideal model for credit risk assessment is supposed to select important features and process imbalanced data sets in an effective manner. This paper proposes an integrated method that combines B&B (branch and bound)-based hybrid feature selection (BBHFS) with the imbalanceoriented multiple-classifier ensemble (IOMCE) for imbalanced credit risk assessment and uses the support vector machine (SVM) and the multiple discriminant analysis (MDA) as the base predictor. BBHFS is a hybrid feature selection method that integrates the t-test and B&B with the k-fold crossvalidation method to search for a satisfactory feature subset. The IOMCE divides majority samples into several subsets and then combines them with minority samples to construct several training sets for constructing a multiple-classifier ensemble model. We conduct main experiments using a 1:3 imbalanced corporate credit risk data set with continuous features and extended experiments using a 1:5 imbalanced data set with continuous features and a 1:3 imbalanced data set with discrete and nominal features. We combine no feature selection and five feature selection methods (the pure B&B, the factor analysis, the pure t-test, t-test & correlation analysis, and BBHFS) with single-classifier and the IOMCE to construct SVM and MDA models for an empirical comparison. When all features are continuous, the BBHFS-IOMCE method generally outperforms all the other methods. More specifically, BBHFS provides more stable and satisfactory results than the other feature selection methods, and compared with single-classifier models, IOMCE models can significantly enhance the recognition rate for minority samples while incurring a small reduction in the recognition rate for majority samples and maintaining an acceptable overall accuracy. When the features are almost discrete or nominal, the IOMCE method retains its ability to deal with an imbalanced data set, although the five feature selection methods have no significant advantages over no feature selection. This suggests that BBHFS is effective in retaining useful information when reducing the dimensionality of continuous features and that the BBHFS-IOMCE method is an important tool for imbalanced credit risk assessment.
A TWO PHASED FUZZY METHODOLOGY FOR SELECTION AMONG MUNICIPAL PROJECTS
Authors: BAYSAL Mehmet Emin , KAYA İhsan , KAHRAMAN Cengiz , SARUCAN Ahmet , ENGIN Orhan
Published: May 2015

A municipality improves the quality of community life through its projects and actions. However, project selection and prioritization by municipalities are highly complex processes. Therefore, multicriteria decision making (MCDM) methodologies are very suitable for determining the best alternative. Recently, some studies have concentrated on the selection of the best project alternatives. In this paper, a two phased fuzzy MCDM methodology is proposed for the selection among municipal projects. In the first phase, fuzzy TOPSIS method is used to select the main project group and then fuzzy AHP is used to select the best sub-municipal project. The application of the suggested methodology has been made at the central district municipality in Konya, Turkey.
A MULTI-OBJECTIVE INPUT-OUTPUT MODEL TO ASSESS E4 IMPACTS OF BUILDING RETROFITTING MEASURES TO IMPROVE ENERGY EFFICIENCY
Authors: OLIVEIRA HENRIQUES Carla , COELHO Dulce Helena , ANTUNES Carlos Henggeler
Published: May 2015

This paper develops a bottom-up approach in the scope of a multi-objective linear programming model (MOLP) based on Input-Output (I-O) analysis to account for investment options aimed at improving the thermal properties of building envelope (e.g., the insulation of external walls and roof, and the replacement of window frames and window glazing). This methodological framework aims at assessing the trade-offs between the overall employment, GDP and energy savings associated with the building sector (residential, private services and public services). Distinct impacts, namely on direct and indirect employment generation, environment (CO2 emissions), energy security supply (energy imports and renewable energy production) and other relevant economic indicators are also analysed. Different sets of input parameters for the economic context and the environmental impacts have been defined as interval coefficients to account for uncertainty. Robust solutions are then obtained by considering the minimisation of the worst possible deviation of the interval objective functions to the corresponding interval ideal solutions.
Therapeutic Doll Play in the Treatment of a Severely Impaired Psychiatric Inpatient: Dramatic Clinical Improvements With a Nontraditional Nursing Intervention
Authors: Birnbaum Shira , Hanchuk Hilary , Nelson Marjorie
Published: May 2015

Interest has grown in the use of doll therapy, particularly in geropsychiatric and dementia care settings. In a long-term state psychiatric hospital, a dollhouse-play activity was implemented in an effort to engage an acutely disturbed, middle-aged woman undergoing medication trials and whose symptoms had been refractory to conventional treatments. A schedule of nondirective dollhouse-play activities was implemented over an 8-week period. Measures of behavioral change were tracked. Dramatic clinical improvements were seen, including significant reductions in verbal and physical aggression, use of as-needed medications, and need for close one-to-one monitoring. Improvements were seen prior to achievement of therapeutic drug levels. The patient was successfully discharged from the hospital. Doll play has recently been associated with clinical benefits in the care of patients with dementia and has long been deployed in childhood mental health treatment. The current findings suggest doll play may have applications as a time-limited intervention in the treatment of major psychiatric disorders in adults and warrants consideration when achieving therapeutic alliance has proven particularly challenging. [
Journal of Psychosocial Nursing and Mental Health Services
,
53
(5), 22–27.]
Evaluation of Keratometry With a Novel Color-LED Corneal Topographer
Authors: Klijn Stijn , Reus Nicolaas J. , Sicam Victor Arni D. P.
Published: May 2015

PURPOSE:

To assess the performance of a novel keratometer based on reflections of colored light-emitting diodes (LEDs) and compare it with devices based on Placido rings, monochromatic LEDs, and Scheimpflug images.

METHODS:

Sixty-three eyes of 63 patients with virgin corneas underwent keratometry with color-LED corneal topography (Cassini; i-Optics, The Hague, The Netherlands) and with devices based on Placido ring reflections (Keratron; Optikon, Rome, Italy), monochromatic LED reflections (Lenstar; Haag-Streit, Koeniz, Switzerland), and Scheimpflug imaging (Pentacam; Oculus Optikgeräte, Wetzlar, Germany). Three repeated measurements were performed with each device. Comparability and repeatability of corneal power and cylinder measurements were assessed. The Bonferroni-corrected α-threshold for statistical significance was 0.016.

RESULTS:

Corneal power measurements with the Cassini topographer were not statistically significantly different from those with the Pentacam (
P
= .64). They were statistically significantly lower than those with the Keratron and Lenstar (
P
< .01), but the differences were of negligible clinical relevance. Cylinder measurements with the Cassini topographer were not statistically significantly different from those with any other device (
P
= .46). Repeatability of Cassini corneal power measurements was not statistically significantly different from that of the Keratron (
P
= .02), but was statistically significantly lower than that of the Lenstar and Pentacam (
P
< .001). Repeatability of Cassini cylinder measurements was statistically significantly higher than that of the Pentacam and Keratron (
P
< .001), but was not statistically significantly different from that of the Lenstar (
P
> .05).

CONCLUSIONS:

Corneal power and cylinder measurements with color-LED corneal topography yielded values that were comparable to those of other commonly used devices. Repeatability of corneal power measurements was lower compared to some devices, but repeatability of cylinder measurements was relatively high. This may be of particular interest when using toric intraocular lenses.

[
J Refract Surg.
2015;31(4):249–256.]
Intraocular Lens Power Selection and Positioning With and Without Intraoperative Aberrometry
Authors: Hatch Kathryn M. , Woodcock Emily C. , Talamo Jonathan H.
Published: May 2015

PURPOSE:

To determine the value of intraoperative aberrometry in cases of toric intraocular lens (IOL) implantation and positioning.

METHODS:

In this non-randomized retrospective comparative trial, two groups of eyes underwent cataract extraction with toric IOL implantation: the aberrometry group (n = 37 eyes), where toric IOL power and alignment were determined before surgery with automated keratometry, standard optical biometry, and an online calculator and then refined using intraoperative aberrometry, and the toric calculator group (n = 27 eyes), where IOL selection was performed in a similar manner but without intraoperative aberrometry. The primary outcome measure was mean postoperative residual refractive astigmatism (RRA).

RESULTS:

Mean RRA measured at follow-up after surgery was 0.46 ± 0.42 and 0.68 ± 0.34 diopters (D) in the aberrometry and toric calculator groups, respectively (
P
= .0153). A 75% and 57% reduction in cylinder was noted between preoperative keratometric astigmatism and postoperative RRA in the aberrometry and toric calculator groups, respectively (
P
= .0027). RRA of 0.25 D or less, 0.50 D or less, 0.75 D or less, and 1.00 D or less was seen 38%, 78%, 86%, and 95% of the time, respectively, in the aberrometry group and 22%, 33%, 74%, and 89% of the time, respectively, in the toric calculator group. These data show that the chance of a patient being in a lower postoperative RRA range increased when intraoperative aberrometry was used (
P
= .0130).

CONCLUSIONS:

Patients undergoing cataract extraction with toric IOL placement aided by intraoperative aberrometry were 2.4 times more likely to have less than 0.50 D of RRA compared to standard methods.

[
J Refract Surg.
2015:31(4):237–242.]
BACTERIAL EPIDEMIOLOGY AND ANTIMICROBIAL RESISTANCE IN THE SURGERY WARDS OF A LARGE TEACHING HOSPITAL IN SOUTHERN ITALY
Authors: Esposito Silvano , Gioia Renato , De Simone Giuseppe , Noviello Silvana , Leone Sebastiano
Published: May 2015

Objectives: Surgical infections represent an increasingly important problem for the National Health System. In this study we retrospectively evaluated the bacterial epidemiology and antimicrobial susceptibility of the microorganisms concerned as well as the utilization of antibiotics in the General and Emergency Surgery wards of a large teaching hospital in southern Italy in the period 2011-2013.Methods: Data concerning bacterial isolates and antimicrobial susceptibility were retrieved from the Vitek II database. The pharmacy provided data about the consumption of antibiotics in the above reported wards. Chi-square or Fisher’s exact test were used to analyze categorical variables.Results: In all, 94 Gram-negative were isolated in 2011, 77 in 2012, and 125 in 2013, Escherichia coli, Acinetobacter baumannii and Pseudomonas aeruginosa always being the most frequently isolated microorganisms. In the same years, there were respectively 105, 93, and 165 Gram-positive isolated, Enterococcus faecalis, Staphylococcus epidermidis and Staphylococcus aureus being the most commonly found. No significant variation in the antibiotic susceptibility pattern was observed, either among Gram-negative or among Gram-positive pathogens; carbapenems (especially meropenem) consumption remained stable over time.Conclusions: Our results show no significant increase in antimicrobial resistance over the period in question, and a higher rate of both MRSA isolates and resistance to carbapenems in A. baumannii compared with other European data.
Hemoglobin and Ferritin Concentrations in Subjects with Metabolic Syndrome
Authors: Adediran Adewumi , Uche Ebele , Akinbami Akinsegun , Dada Akin , Wakama Tamunomieibi , Damulak Dapus , Ajibola Sarah , Okwegbuna Oluwakemi
Published: May 2015

Background

Metabolic syndrome (MetS), a clinical condition characterized by insulin resistance, glucose intolerance, dyslipidemia, hypertension, and obesity, has been linked with raised levels of serum ferritin (Sfr) concentrations.

Objectives

This study was carried out to compare hemoglobin (Hb) and Sfr concentrations in patients with MetS, regular donors and first-time donors.

Materials and Methods

A total of 102 subjects who were between 18 and 60 years were enrolled for the study. They were divided into three groups. The first group ( n = 20) was made up of 5 males and 15 females, all who met the criteria that define MetS. The second group ( n = 52; M = 34, F = 18) were regular donors, while the last group ( n = 30; M = 16, F = 14) were first-time donors or those who had not donated before. Following an overnight fast, 20 mL of venous blood was drawn from each subject. About 5 mL of this was put into sodium ethylenediaminetetraacetate (EDTA) specimen bottles for the full blood count parameters with Sysmex KX-21N hematology analyzer (made in Japan). The remaining 15 mL had serum separated for Sfr assay using enzyme-linked immunosorbent assay (ELISA) with a commercial assay kit manufactured by Teco Diagnostics.

Results

Significant difference was found in the mean Sfr concentration of subjects with MetS (163 ± 136.92 ng/mL) and regular donors (41.46 ± 40.33 ng/mL), P = 0.001. The mean Sfr concentrations of subjects with MetS (163 ± 136.92 ng/mL) were also higher than that of first-time donors (102.46 ± 80.26 ng/mL), but it was not statistically significant, P = 0.053. The Hb concentrations of the three groups were not significantly different.

Conclusion

Sfr concentrations of regular donors were lower than that of subjects with MetS and first-time donors. The difference between regular donors and subjects with MetS was statistically significant. However, there is no significant difference in the Hb concentrations in the three groups. MetS is not associated with anemia or hyperferritinemia.
On regularity properties of solutions to the hysteresis-type problem
Authors: Apushkinskaya Darya E. , Uraltseva Nina N.
Published: May 2015

We consider equations with the simplest hysteresis operator at the right-hand side. Such equations describe the so-called processes “with memory” in which various substances interact according to the hysteresis law.

We restrict our consideration on the so-called “strong solutions” belonging to the Sobolev class

W^{2,1}_q

with sufficiently large

q

and prove that in fact

q = \infty

. In other words, we establish the optimal regularity of solutions. Our arguments are based on quadratic growth estimates for solutions near the free boundary.
Oceanic bromine emissions weighted by their ozone depletion potential
Authors: Tegtmeier S. , Ziska F. , Pisso I. , Quack B. , Velders G. J. M. , Yang X. , Krüger K.
Published: May 2015

Abstract. At present, anthropogenic halogens and oceanic emissions of Very Short-Lived Substances (VSLS) are responsible for stratospheric ozone destruction. Emissions of the, mostly long-lived, anthropogenic halogens have been reduced, and as a consequence, their atmospheric abundance has started to decline since the beginning of the 21st century. Emissions of VSLS are, on the other hand, expected to increase in the future. VSLS are known to have large natural sources; however increasing evidence arises that their oceanic production and emission is enhanced by anthropogenic activities. Here, we introduce a new approach of assessing the overall impact of all oceanic halogen emissions on stratospheric ozone by calculating Ozone Depletion Potential (ODP)-weighted emissions of VSLS. Seasonally and spatially dependent, global distributions are derived exemplary for CHBr3 for the period 1999–2006. At present, ODP-weighted emissions of CHBr3 amount up to 50% of ODP-weighted anthropogenic emissions of CFC-11 and to 9% of all long-lived ozone depleting substances. The ODP-weighted emissions are large where strong oceanic emissions coincide with high-reaching convective activity and show pronounced peaks at the equator and the coasts with largest contributions from the Maritime Continent and West Pacific. Variations of tropical convective activity lead to seasonal shifts in the spatial distribution of the ODP with the updraught mass flux explaining 71% of the variance of the ODP distribution. Future climate projections based on RCP8.5 scenario suggest a 31% increase of the ODP-weighted CHBr3 emissions until 2100 compared to present values. This increase is related to larger convective activity and increasing emissions in a future climate; however, is reduced at the same time by less effective bromine-related ozone depletion. The comparison of the ODP-weighted emissions of short and long-lived halocarbons provides a new concept for assessing the overall impact of oceanic bromine emissions on stratospheric ozone depletion for current conditions and future projections.
Investigation of balancing effects in long term renewable energy feed-in with respect to the transmission grid
Authors: Kies A. , Nag K. , von Bremen L. , Lorenz E. , Heinemann D.
Published: May 2015

Abstract. A European power system mainly based on renewable sources will have dominant contributions from wind and solar power. However, wind and solar generation facilities have, due to the weather dependent nature of their resources, highly fluctuating feed-in profiles. To overcome the mismatch between power consumption and generation it is important to study and understand the generation patterns and balancing potentials. High temporally and spatially resolved long term weather data was used to simulate the feed-in from wind and photovoltaics for European countries for the years 2003 to 2012. We investigate storage energy and capacity needs in Europe in dependency of the generation mix from wind onshore, wind offshore and photovoltaics and the share of renewables. Furthermore we compute the storage energy and capacity needs for different transmission scenarios. We show that for unlimited transmission storage needs are reduced mostly by high wind offshore shares. We also show that higher shares above 100% of renewables can decrease the required storage capacity to a higher extent than the required storage energy.
Effects of soil settlement and deformed geometry on a historical structure
Authors: Yardım Y. , Mustafaraj E.
Published: May 2015

Abstract. Protecting the historical character of a valued structure during the assessment and damage repair process is a very challenging task for many engineers. Heritage protection is complicated by a lack of design details and restrictions on sample extraction needed to obtain accurate material properties and limited studies on the restoration of certain types of historical structures. This study aims to assess the effects of soil settlement on a structure's stress concentrations and the value of laser scanning techniques on structure analysis in obtaining correct data of settlement vs. deformation. Terrestrial laser scanner (TLS) data are used to analyse the 500-year-old historical structure of Naziresha's Mosque. The obtained TLS data allow an accurate definition of the imperfect geometry patterns lying on every side of the structure. The soil profile and general crack formation together with TLS measurement proves that the structure deformed toward the south façade, where a railway and motorway are also located. Stress concentration and mode period results have a considerable difference, which highlights earthquake vulnerability and failure mechanisms and changes the strategy of possible retrofitting.
ULK3 regulates cytokinetic abscission by phosphorylating ESCRT-III proteins
Authors: Caballe Anna , Wenzel Dawn M , Agromayor Monica , Alam Steven L , Skalicky Jack J , Kloc Magdalena , Carlton Jeremy G , Labrador Leticia , Sundquist Wesley I , Martin-Serrano Juan
Published: May 2015

The endosomal sorting complexes required for transport (ESCRT) machinery mediates the physical separation between daughter cells during cytokinetic abscission. This process is regulated by the abscission checkpoint, a genome protection mechanism that relies on Aurora B and the ESCRT-III subunit CHMP4C to delay abscission in response to chromosome missegregation. In this study, we show that Unc-51-like kinase 3 (ULK3) phosphorylates and binds ESCRT-III subunits via tandem MIT domains, and thereby, delays abscission in response to lagging chromosomes, nuclear pore defects, and tension forces at the midbody. Our structural and biochemical studies reveal an unusually tight interaction between ULK3 and IST1, an ESCRT-III subunit required for abscission. We also demonstrate that IST1 phosphorylation by ULK3 is an essential signal required to sustain the abscission checkpoint and that ULK3 and CHMP4C are functionally linked components of the timer that controls abscission in multiple physiological situations.
Sonographic Features of Medullary Thyroid Carcinomas According to Tumor Size
Authors: Zhou Liguang , Chen Bo , Zhao Miaoqing , Zhang Huawei , Liang Bo
Published: May 2015

Objectives

The aim of this study was to evaluate the differences in sonographic features of medullary thyroid carcinomas according to nodule size and compared with findings for papillary thyroid carcinomas.

Methods

This study included 38 medullary thyroid carcinoma nodules and 91 papillary thyroid carcinoma nodules, which were confirmed by pathologic examination between May 2008 and September 2013. Nodules were divided into those that were greater than 10 mm (large nodules) and 10 mm or less (small nodules). The differences in sonographic features (composition, echogenicity, margin, calcifications, and shape) between groups were analyzed with a χ2 test.

Results

Large medullary thyroid carcinomas more frequently showed an ovoid‐to‐round shape and a smooth margin; small medullary thyroid carcinomas more frequently showed a taller‐than‐wide shape and a spiculated margin; the differences were statistically significant between the groups (P < .05). Compared with papillary thyroid carcinomas, large medullary thyroid carcinomas tended to have an ovoid‐to‐round shape, a smooth margin, and macrocalcifications and were more frequently diagnosed as indeterminate nodules (P < .05); however, there were no significant differences in the internal composition, calcifications, echogenicity, margin, and shape between small medullary thyroid carcinomas and small papillary thyroid carcinomas (P > .05).

Conclusions

Our data indicate that the sonographic features of medullary thyroid carcinomas are associated with tumor size; furthermore, the sonographic features of medullary thyroid carcinomas are similar to those of small papillary thyroid carcinomas but greatly different from those of large papillary thyroid carcinomas. Large medullary thyroid carcinomas are more commonly diagnosed as indeterminate nodules by sonography than large papillary thyroid carcinomas, and fine‐needle aspiration biopsy or serum calcitonin measurement may be helpful.
Shooting With Sound
Authors: Tanious Shariff F. , Cline Jamie , Cavin Jennifer , Davidson Nathan , Coleman J. Keegan , Goodmurphy Craig W.
Published: May 2015

Objectives

The goal of this study was to investigate the durability and longevity of gelatin formulas for the production of staged ultrasound phantoms for education.

Methods

Gelatin phantoms were prepared from Knox gelatin (Kraft Foods, Northfield, IL) and a standard 10%‐by‐mass ordinance gelatin solution. Phantoms were durability tested by compressing to a 2‐cm depth until cracking was visible. Additionally, 16 containers with varying combinations of phenol, container type, and storage location were tested for longevity against desiccation and molding. Once formulation was determined, 4 stages of phantoms from novice to clinically relevant were poured, and clinicians with ultrasound training ranked them on a 7‐point Likert scale based on task difficulty, phantom suitability, and fidelity.

Results

On durability testing, the ballistic gelatin outperformed the Knox gelatin by more than 200 compressions. On longevity testing, gelatin with a 0.5% phenol concentration stored with a lid and refrigeration lasted longest, whereas containers without a lid had desiccation within 1 month, and those without phenol became moldy within 6 weeks. Ballistic gelatin was more expensive when buying in small quantities but was 7.4% less expensive when buying in bulk. The staged phantoms were deemed suitable for training, but clinicians did not consistently rank the phantoms in the intended order of 1 to 4 (44%).

Conclusions

Refrigerated and sealed ballistic gelatin with phenol was a cost‐effective method for creating in‐house staged ultrasound phantoms suitable for large‐scale ultrasound educational training needs. Clinician ranking of phantoms may be influenced by current training methods that favor biological tissue scanning as easier.
A Randomized Controlled Trial Evaluating the See, Tilt, Align, and Rotate (STAR) Maneuver on Skill Acquisition for Simulated Ultrasound‐Guided Interventional Procedures
Authors: Lam Nicholas C. K. , Fishburn Steven J. , Hammer Angie R. , Petersen Timothy R. , Gerstein Neal S. , Mariano Edward R.
Published: May 2015

Objectives

Achieving the best view of the needle and target anatomy when performing ultrasound‐guided interventional procedures requires technical skill, which novices may find difficult to learn. We hypothesized that teaching novice performers to use 4 sequential steps (see, tilt, align, and rotate [STAR] method) to identify the needle under ultrasound guidance is more efficient than training with the commonly described probe movements of align, rotate, and tilt (ART).

Methods

This study compared 2 instructional methods for transducer manipulation including alignment of a probe and needle by novices during a simulated ultrasound‐guided nerve block. Right‐handed volunteers between the ages of 18 and 55 years who had no previous ultrasound experience were recruited and randomized to 1 of 2 groups; one group was trained to troubleshoot misalignment with the ART method, and the other was trained with the new STAR maneuver. Participants performed the task, consisting of directing a needle in plane to 3 targets in a standardized gelatin phantom 3 times. The performance assessor and data analyst were blinded to group assignment.

Results

Thirty‐five participants were recruited. The STAR group was able to complete the task more quickly (P < .001) and visualized the needle in a greater proportion of the procedure time (P = .004) compared to the ART group. All STAR participants were able to complete the task, whereas 41% of ART participants abandoned the task (P = .003).

Conclusions

Novices are able to complete a simulated ultrasound‐guided nerve block more quickly and efficiently when trained with the 4‐step STAR maneuver compared to the ART method.
Improved Method for Calculating Hepatic Steatosis Using the Hepatorenal Index
Authors: Shiralkar Kaustubh , Johnson Stephen , Bluth Edward I. , Marshall Richard H. , Dornelles Adriana , Gulotta Paul M.
Published: May 2015

Objectives

Marshall et al (AJR Am J Roentgenol 2012; 199:997–1002) initially demonstrated that the hepatorenal index is an effective and noninvasive tool to screen patients for hepatic steatosis. The aim of this study was to determine whether the hepatorenal index can be accurately calculated directly from a picture archiving and communication system (PACS) quickly and efficiently without the need for the multiple steps and specialized software used to calculate hepatorenal index in the study by Marshall et al.

Methods

We evaluated 99 of the 101 patients included in the study by Marshall et al: patients being followed by hepatologists with plans for liver biopsy. The hepatorenal index was calculated by using Digital Imaging and Communications in Medicine (DICOM) images from a PACS and a markup region‐of‐interest tool. We compared this value to the value that Marshall et al derived by using specialized software and to standard histologic estimates. We created similar subgroups: patients with steatosis based on histologically estimated intracellular fat exceeding 5% and patients without steatosis.

Results

The mean hepatorenal index ± SD for those with steatosis according to histologic findings was 1.87 ± 0.6, and for those without, it was 1.14 ± 0.2. A hepatorenal index of 1.34 or higher had 92% sensitivity for identifying fat exceeding 5%, 85% specificity, a 94% negative predictive value, and a 79% positive predictive value. Substantial agreement was found between the hepatorenal index calculated from DICOM images and macrovesicular fat categorized at the cut point of 1.34 or higher (κ = 0.76; 95% confidence interval, 0.62–0.88; P < .001).

Conclusions

The hepatorenal index can be quickly and accurately calculated from DICOM images directly on a PACS without supplementary software.
Differential Diagnosis of Polypoid Lesions of the Gallbladder Using Contrast‐Enhanced Sonography
Authors: Liu Xue-Song , Gu Li-Hong , Du Jing , Li Feng-Hua , Wang Jian , Chen Tao , Zhang Yun-He
Published: May 2015

Objectives

The purpose of this study was to evaluate the usefulness of real‐time contrast‐enhanced sonography and microvascular imaging for differential diagnosis of neoplastic and non‐neoplastic polypoid lesions of the gallbladder.

Methods

Real‐time contrast‐enhanced sonography and microvascular imaging were performed in 128 patients with polypoid lesions of the gallbladder larger than 6 mm in diameter. The enhancement patterns, microvascular imaging types, and kinetic parameters were analyzed on contrast‐enhanced sonography. The maximum diameters of the lesions measured by conventional and contrast‐enhanced sonography were also recorded and subjected to a comparative analysis.

Results

Among the 128 patients, histologic diagnoses were obtained in 83 (27 neoplastic lesions and 56 non‐neoplastic lesions), which constituted the study group. On contrast‐enhanced sonography, mild enhancement and absence of contrast were more easily found in non‐neoplastic lesions (12 [21.4%]), whereas all neoplastic lesions showed marked enhancement (27 [100%]; P = .006). Of the 27 neoplastic lesions, 6 malignant tumors showed a perfusion defect on contrast‐enhanced sonography, whereas none of the non‐neoplastic lesions showed a perfusion defect (P = .003). The microvascular architecture of the lesions was categorized into 4 types: spotty, linear, branched, and spinous, and there were significant differences between the groups (P< .001). In a kinetic evaluation, none of the parameters reached statistical significance (all P> .05). There was a discrepancy in maximum diameters between conventional and contrast‐enhanced sonography in both groups but the discrepancy was significantly greater in the non‐neoplastic group (P = .026).

Conclusions

Contrast‐enhanced sonography is a useful imaging technique and an adjunct to conventional sonography for differential diagnosis of neoplastic and non‐neoplastic polypoid lesions of the gallbladder.
Grayscale and Color Doppler Features of Testicular Lymphoma
Authors: Bertolotto Michele , Derchi Lorenzo E. , Secil Mustafa , Dogra Vikram , Sidhu Paul S. , Clements Richard , Freeman Simon , Grenier Nicolas , Mannelli Lorenzo , Ramchandani Parvati , Cicero Calogero , Abete Luca , Bussani Rossana , Rocher Laurence , Spencer John , Tsili Athina , Valentino Massimo , Pavlica Pietro
Published: May 2015

Pooled data from 16 radiology centers were retrospectively analyzed to seek patients with pathologically proven testicular lymphoma and grayscale and color Doppler images available for review. Forty‐three cases were found: 36 (84%) primary and 7 (16%) secondary testicular lymphoma. With unilateral primary lymphoma, involvement was unifocal (n = 10), multifocal (n = 11), or diffuse (n = 11). Synchronous bilateral involvement occurred in 6 patients. Color Doppler sonography showed normal testicular vessels within the tumor in 31 of 43 lymphomas (72%). Testicular lymphoma infiltrates through the tubules, preserving the normal vascular architecture of the testis. Depiction of normal testicular vessels crossing the lesion is a useful adjunctive diagnostic criterion.
Desmoplastic Small Round Cell Tumor in Transverse Colon: Report of a Rare Case
Authors: Huang JianPing , Sha Li , Zhang Hao , Tang XueFeng , Zhang XiWei
Published: May 2015

Desmoplastic small round cell tumor (DSRCT) is an extremely rare, highly aggressive, malignant tumor of undetermined histogenesis. Adolescent males are primarily affected with a typically abdominal or pelvic mass. Diagnosis is based on histologic analysis of biopsy and cytogenetic studies. Owing to the rarity of the tumor and the unusually aggressive presentation, treatment is challenging and has not been standardized. DSRCT has a very poor prognosis, with a median survival range of 17 to 25 months. In this work, we report a case of DSRCT in the transverse colon, which has never before been reported in the literature. Our case study is of a 30-year-old Chinese female who presented with a history of 6 months abdominal discomfort and fatigue. A palpable, hardly mobile mass was detected in the right lower quadrant abdomen by physical examination. Abdominal and pelvic magnetic resonance imaging revealed an 8.0 × 10.5 × 11.1-cm mass with no pulmonary and hepatic metastasis. The patient underwent exploratory laparotomy and transverse colectomy, which revealed a mass in the transverse colon and no metastasis in the peritoneum, greater omentum, or mesentery. Immunohistochemistry findings revealed positive staining for epithelial, mesenchymal, and neural markers, which confirmed the presentation of DSRCT. A 6-month postoperative follow-up failed to find any recurrence. DSRCT is a highly aggressive, malignant, mesenchymal tumor with a very poor prognosis. No consensus has been reached for the treatment protocol of DSRCT. However, debulking surgery with postoperative chemotherapy or radiotherapy might promise more optimistic results on survival.
Is the Male Gender an Independent Risk Factor for Complication in Patients Undergoing Laparoscopic Cholecystectomy for Acute Cholecystitis?
Authors: Ambe Peter C. , Köhler Lothar
Published: May 2015

This paper was designed to investigate the gender dependent risk of complication in patients undergoing laparoscopic cholecystectomy for acute cholecystitis. Laparoscopic cholecystectomy is the standard procedure for benign gallbladder disorders. The role of gender as an independent risk factor for complicated laparoscopic cholecystectomy remains unclear. A retrospective single-center analysis of laparoscopic cholecystectomies performed for acute cholecystitis over a 5-year period in a community hospital was performed. Within the period of examination, 1884 laparoscopic cholecystectomies were performed. The diagnosis was acute cholecystitis in 779 cases (462 female, 317 male). The male group was significantly older (P = 0.001). Surgery lasted significantly longer in the male group (P = 0.008). Conversion was done in 35 cases (4.5%). There was no significant difference in the rate of conversion between both groups. However the rate of conversion was significantly higher in male patients > 65 years (P = 0.006). The length of postoperative hospital stay was significantly longer in the male group (P = 0.007), in the group > 65 years (P = 0.001) and following conversion to open surgery (P = 0.001). The male gender was identified as an independent risk factor for prolonged laparoscopic cholecystectomy on multivariate analysis. The male gender could be an independent risk factor for complicated or challenging surgery in patients undergoing laparoscopic cholecystectomy for acute cholecystitis.
Hepatic Adenomatosis: A Rare but Important Liver Disease With Severe Clinical Implications
Authors: Donato Maren , Jahromi Alireza Hamidian , Andrade Ana Ines , Kim Roger , Chaudhery Shabnum Ilyas , Sangster Guillermo
Published: May 2015

A 56-year-old white female presented to the emergency room (ER) with acute onset of right upper quadrant abdominal pain, nausea, and vomiting, and she was found to have a sudden drop in hemoglobin. Abdominal computed tomography (CT) with and without intravenous contrast revealed multiple bilobar focal hepatic hypervascular lesions, one of them demonstrating spontaneous rupture with active intraperitoneal bleeding. A moderate hemoperitoneum was present. The patient underwent exploratory laparotomy for right hepatic posterior segmentectomy (right posterior sectionectomy) and peritoneal lavage. The histopathology evaluation revealed multiple liver adenomas. Hepatic adenomatosis is a clinical entity characterized by 10 or more hepatic adenomas. It must be distinguished from isolated hepatic adenoma as it bears a much higher risk of complications, such as spontaneous rupture, hemorrhage and malignant transformation. Here we discuss the radiologic and histopathologic findings of the current case along with a review of the English language medical literature.
Antioxidant Activity of Syringic Acid Prevents Oxidative Stress in l-arginine–Induced Acute Pancreatitis: An Experimental Study on Rats
Authors: Cikman Oztekin , Soylemez Omer , Ozkan Omer Faruk , Kiraz Hasan Ali , Sayar Ilyas , Ademoglu Serkan , Taysi Seyithan , Karaayvaz Muammer
Published: May 2015

The aim of this study was to investigate the possible protective role of antioxidant treatment with syringic acid (SA) on l-arginine–induced acute pancreatitis (AP) using biochemical and histopathologic approaches. A total of 30 rats were divided into 3 groups. The control group received normal saline intraperitoneally. The AP group was induced by 3.2 g/kg body weight l-arginine intraperitoneally, administered twice with an interval of 1 hour between administrations. The AP plus SA group, after having AP induced by 3.2 g/kg body weight l-arginine, was given SA (50 mg kg−1) in 2 parts within 24 hours. The rats were killed, and pancreatic tissue was removed and used in biochemical and histopathologic examinations. Compared with the control group, the mean pancreatic tissue total oxidant status level, oxidative stress index, and lipid hydroperoxide levels were significantly increased in the AP group, being 30.97 ± 7.13 (P < 0.05), 1.76 ± 0.34 (P < 0.0001), and 19.18 ± 4.91 (P < 0.01), respectively. However, mean total antioxidant status and sulfhydryl group levels were significantly decreased in the AP group compared with the control group, being 1.765 ± 0.21 (P < 0.0001) and 0.21 ± 0.04 (P < 0.0001), respectively. SA reduces oxidative stress markers and has antioxidant effects. It also augments antioxidant capacity in l-arginine–induced acute toxicity of pancreas in rats.
Offset timing of climate oscillations during the last two glacial‐interglacial transitions connected with large‐scale freshwater perturbation
Authors: Jiménez‐Amat Patricia , Zahn Rainer
Published: May 2015

Multidecadal to centennial planktic δ18O and Mg/Ca records were generated at Ocean Drilling Program Site 976 (ODP976) in the Alboran Sea. The site is in the flow path of Atlantic inflow waters entering the Mediterranean and captured North Atlantic signals through the surface inflow and the atmosphere. The records reveal similar climatic oscillations during the last two glacial‐to‐interglacial transitions, albeit with a different temporal pacing. Glacial termination 1 (T1) was marked by Heinrich event 1 (H1), post‐H1 Bølling/Allerød warming, and Younger Dryas (YD) cooling. During T2 the H11 δ18O anomaly was twice as high and lasted 30% longer than during H1. The post‐H11 warming marked the start of MIS5e while the subsequent YD‐style cooling occurred during early MIS5e. The post‐H11 temperature increase at ODP976 matched the sudden Asian Monsoon Termination II at 129 ka B.P. Extending the 230Th‐dated speleothem timescale to ODP976 suggests glacial conditions in the Northeast Atlantic region were terminated abruptly and interglacial warmth was reached in less than a millennium. The early‐MIS5e cooling and freshening at ODP976 coincided with similar changes at North Atlantic sites suggesting this was a basin‐wide event. By analogy with T1, we argue that this was a YD‐type event that was shifted into the early stages of the last interglacial period. This scenario is consistent with evidence from northern North Atlantic and Nordic Sea sites that the continuing disintegration of the large Saalian Stage (MIS6) ice sheet in Eurasia delayed the advection of warm North Atlantic waters and full‐strength convective overturn until later stages of MIS5e.
Influence of West Antarctic Ice Sheet collapse on Antarctic surface climate
Authors: Steig Eric J. , Huybers Kathleen , Singh Hansi A. , Steiger Nathan J. , Ding Qinghua , Frierson Dargan M. W. , Popp Trevor , White James W. C.
Published: May 2015

Climate model simulations are used to examine the impact of a collapse of the West Antarctic Ice Sheet (WAIS) on the surface climate of Antarctica. The lowered topography following WAIS collapse produces anomalous cyclonic circulation with increased flow of warm, maritime air toward the South Pole and cold‐air advection from the East Antarctic plateau toward the Ross Sea and Marie Byrd Land, West Antarctica. Relative to the background climate, areas in East Antarctica that are adjacent to the WAIS warm, while substantial cooling (several ∘C) occurs over parts of West Antarctica. Anomalously low isotope‐paleotemperature values at Mount Moulton, West Antarctica, compared with ice core records in East Antarctica, are consistent with collapse of the WAIS during the last interglacial period, Marine Isotope Stage 5e. More definitive evidence might be recoverable from an ice core record at Hercules Dome, East Antarctica, which would experience significant warming and positive oxygen isotope anomalies if the WAIS collapsed.
CSF neurofilament light chain reflects corticospinal tract degeneration in ALS
Authors: Menke Ricarda A. L. , Gray Elizabeth , Lu Ching‐Hua , Kuhle Jens , Talbot Kevin , Malaspina Andrea , Turner Martin R.
Published: May 2015

Objective

Diffusion tensor imaging (DTI) is sensitive to white matter tract pathology. A core signature involving the corticospinal tracts (CSTs) has been identified in amyotrophic lateral sclerosis (ALS). Raised neurofilament light chain protein (NfL) in cerebrospinal fluid (CSF) is thought to reflect axonal damage in a range of neurological disorders. The relationship between these two measures was explored.

Methods

CSF and serum NfL concentrations and DTI acquired at 3 Tesla on the same day were obtained from ALS patients (n = 25 CSF, 40 serum) and healthy, age‐similar controls (n = 17 CSF, 25 serum). Within‐group correlations between NfL and DTI measures of microstructural integrity in major white matter tracts (CSTs, superior longitudinal fasciculi [SLF], and corpus callosum) were performed using tract‐based spatial statistics.

Results

NfL levels were higher in patients compared to controls. CSF levels correlated with clinical upper motor neuron burden and rate of disease progression. Higher NfL levels were significantly associated with lower DTI fractional anisotropy and increased radial diffusivity in the CSTs of ALS patients, but not in controls.

Interpretation

Elevated CSF and serum NfL is, in part, a result of CST degeneration in ALS. This highlights the wider potential for combining neurochemical and neuroimaging‐based biomarkers in neurological disease.
Elastomeric Actuators on Airfoils for Aerodynamic Control of Lift and Drag
Authors: Xie Jingjin , McGovern James B. , Patel Rutvij , Kim Woobiehn , Dutt Saugata , Mazzeo Aaron D.
Published: May 2015

This paper investigates and characterizes the aerodynamic performance of a unique platform of airfoils with inflatable, elastomeric actuators. By controlling the actuators integrated in 3D‐printed airfoils, it is possible to manipulate aerodynamic lift and drag. The pseudo flap can increase lift by a factor of 20–300%. The top‐front inflated design increases lift and stalling angle at high angles of attack (>12°). Comparisons between numerical simulations and experiments verify the efficacy of the outlined approach. This work is the first to describe the dynamic fluid–soft material interactions for both lift and drag of inflatable actuators embedded in stiff structures.
Extracellular Microreactor for the Depletion of Phenylalanine Toward Phenylketonuria Treatment
Authors: Hosta‐Rigau Leticia , York‐Duran Maria J. , Kang Tse Siang , Städler Brigitte
Published: May 2015

Phenylketonuria (PKU) is a genetic enzyme defect affecting 1:10 000–20 000 newborn children every year. The amino acid phenylalanine (Phe) is not depleted but accumulates in tissues of several organs, which leads to severe medical conditions. A promising concept to restore the metabolism of the affected patients will be to orally administer the defective enzyme which will remove Phe in the intestine. Herein, capsosomes, a multicompartment carrier consisting of thousands of liposomes embedded within a polymeric carrier, are employed as encapsulation platform for this purpose. It is shown that the enzyme phenylalanine ammonia lyase can be entrapped within the liposomal compartments with preserved activity, demonstrated by the conversion of Phe into trans‐cinnamic acid (t‐ca). With the aim to mimic the dynamic environment in the intestine, the Phe conversion is performed in a microfluidic set up in the presence of human intestinal epithelial cells with applied intestinal flow and peristaltic motions. It is also shown that the microreactors are neither internalized by the cells nor exhibit inherent cytotoxicity while concurrently converting Phe into t‐ca. Taken together, the first active extracellular multicompartment microreactor is reported using the relevant enzymes and settings toward the treatment of the medical condition PKU.