bluuebunny/crossref_metadata_2025 huggingface dataset:
Stability of Attitudes to the Ethical Issues Raised by the Return of Incidental Genomic Research Findings in Children: A Follow-Up Study
Authors: Fernandez Conrad V. , OʼConnell Colleen , Ferguson Meghan , Orr Andrew C. , Robitaille Johane M. , Knoppers Bartha M. , McMaster Christopher R.
Published: September 2015

Objective: We explore the stability of parental attitudes to the ethical issues raised by the return of genomic research results. Methods: A 19-item questionnaire was mailed to participants in a large genome research consortium 18 months following a baseline survey. We describe the stability of parental attitudes to (a) sharing of genomic research results, (b) endorsement of children in genomic research, (c) responsibilities of researchers, and (d) responsibilities to extended family. We also explore their experience in receiving results. Results: Of 170 original participants, 154 (91%) responded. Most participants expressed positive rights to receive incidental genomic research findings (85%), including when ameliorative therapy was unknown (85%). Only 3% found it acceptable to delegate the decision to return results to an independent committee. Researchers, either with a parent (42%) or physician (17%), were felt to be responsible to convey research results to children when they reach adulthood. Most participants (74%) indicated that results should be shared with potentially affected extended family. These results are very similar to those of the baseline survey. All participants who received genomic results would do so again and reported actions similar to their expressed attitudes. Conclusions: The opinions of parents regarding genomic research remain stable over time. Guidelines on the return of results should incorporate these findings.
The Responsibility to Protect Human Rights and the RtoP: Prospective and Retrospective Responsibility
Authors: Karp David Jason
Published: September 2015

This article argues that—contrary to the way that it is often framed—the first pillar of the Responsibility to Protect (RtoP) is not best understood as an instantiation of a broader international responsibility to protect human rights. Firstly, the RtoP reverts to a discourse of powerful savours and passive victims, which runs against advocates’ claim that the RtoP is a ‘rights-based norm’. Secondly, although it distinguishes between prevention and response, the RtoP is still fundamentally a discussion of retrospective responsibility. The responsibility to protect human rights, by contrast, is importantly prospective. The article’s separation of prospective/retrospective responsibility from the responsibility to prevent and to respond is an independent contribution, with broader significance beyond the RtoP context. Thirdly, the RtoP becomes activated when atrocity is building, imminent or underway; whereas the responsibility to protect human rights may be breached even without a clear causal link to harm.
Covert Actions and the Responsibility to Protect
Authors: Roff Heather M.
Published: September 2015

Fifteen years on, the Responsibility to Protect (R2P) doctrine is still facing questions over its content, scope and attendant obligations. Recent conflicts in Syria, Ukraine and Iraq show, how, when and if states intervene is a matter of political will and calculation. Yet the question of political will remains largely unaddressed, and many ignore the conceptual and practical distance between stating that the international community should encourage and assist states to fulfill R2P obligations and requiring third parties to use diplomatic, humanitarian or ‘other’ means to protect populations when states fail to do so. I propose we acknowledge this distance and minimize it through covert action. Embracing the reality that some states cannot intervene due to political constraints entails that we can theorize about other ways to uphold R2P. Moreover, covert action involves a range of means and types of targets and is a flexible option for R2P.
Taxonomic Results of the BRYOTROP Expedition to Zaire and Rwanda 9. Pallaviciniaceae, Haplomitriaceae

Authors: Grolle R.
Published: September 2015

Taxonomic Results of the BRYOTROP Expedition.
Taxonomic Results of the BRYOTROP Expedition to Zaire and Rwanda 10. Trichocoleaceae, Geocalycaceae, Acrobolbaceae, Balantiopsidaceae, Lepidoziaceae (Telaranea, Arachniopsis), Calypogeiaceae, Adelanthaceae, Porellaceae, Jubulaceae, Marchantiaceae (Dumortiera), Polytrichaceae

Authors: Fischer Eberhard
Published: September 2015

A survey of the families Trichocoleaceae, Geocalycaceae, Acrobolbaceae, Balantiopsidaceae, Lepidoziaceae (Telaranea, Arachniopsis), Calypogeiaceae, Adelanthaceae, Porellaceae, Jubulaceae, Marchantiaceae (Dumortiera) (Hepaticae) and Polytrichaceae (Musci) for Central Africa (Zaire and Rwanda) is presented. Leptoscyphus infuscatus, Tylimanthus ruwenzoriensis, Calypogeia fissa, Adelanthus lindenbergianus and Porella subdentata are recorded as new to Rwanda. Telaranea trifida and Calypogeia fusca are new to Zaire. Leptoscyphus hedbergii and Calypogeia afrocaerulea are new records for Zaire and Rwanda.
axonomic Results of the BRYOTROP Expedition to Zaire and Rwanda 18. Calymperaceae

Authors: Orbán Sándor
Published: September 2015

The first species list of the examined countries was published by Demaret (1940,1946) and the revision of the Syrrhopodon species of this area were made by Demaret and Leroy (1947). Further additional data were published on the basis of the collection of S. Lisowski (Orbán 1987). The tropical African species of the genera were revised by the Author (Orbán 1981) and later the key for the species was prepared by Orbán and Reese (1986). This key is suitable to identify practically all tropical African taxa, therefore I do not supply a key here for the 7 species collected in Central Africa. The world ranges of Syrrhopodon species was given by Reese (1987).
Taxonomic Results of the BRYOTROP Expedition to Zaire and Rwanda I. Introduction

Authors: Frahm Jan-Peter
Published: September 2015

The Bryotrop project was planned in 1981 by several bryologists from Germany. Aim of this project was a comparative study of the bryoflora and -vegetation of rain forest areas in different parts of the tropics. In contrast to other bryological research in the tropics, this project should not be limited to pure floristic studies at various collecting sites but consist of interdisciplinary work of researchers from different fields together in a small region, an attempt which was not made before in bryology. For the field studies, the transect method was chosen. By this way a survey should be given of
Taxonomic Results of the BRYOTROP Expedition to Zaire and Rwanda 20. Grimmiaceae, Funariaceae, Bartramiaceae (Philonotis), Amblystegiaceae, Plagiotheciaceae

Authors: Ochyra Ryszard
Published: September 2015

Taxonomic Results of the BRYOTROP Expedition
Taxonomic Results of the BRYOTROP Expedition to Zaire and Rwanda 22. Orthotrichum

Authors: Lewinsky J.
Published: September 2015

Taxonomic Results of the BRYOTROP Expedition
Taxonomic Results of the BRYOTROP Expedition to Zaire and Rwanda 24. Leskeaceae, Brachytheciaceae, Stereophyllaceae, Plagiotheciaceae, Entodontaceae, Sematophyllaceae p.pte, Hypnaceae (except Hypnum)

Authors: Buck William R.
Published: September 2015

Taxonomic Results of the BRYOTROP Expedition
Taxonomic Results of the BRYOTROP Expedition to Zaire and Rwanda 26. A new checklist of the mosses of Central Africa

Authors: Born S. , Frahm J. -P. , Pócs T.
Published: September 2015

Central Africa was one of the first regions in the tropics, if not the first, for which a checklist of mosses was compiled. In 1940, Demaret published the “Prodrome des Bryophytes du Congo Belge et du Ruanda-Urundi”, followed by a supplement in 1946. In the 50 years since that time, numerous new contributions to the bryophyte flora of Central Africa have been made. Demaret added seven more publications on Zaire (formerly Belgian Congo). Potier de la Varde studied the bryophyte collections made during the surveys of the flora of the Central African volcanoes by Hedberg. De Sloover published a series of 14 papers dealing with his collections in Rwanda, Burundi and Zaire, combined with revisionary work. Finally, numerous nomenclatural changes, revisions and monographs have been made during the past 20 years. Therefore an update of Demaret’s checklist seemed desirable. For that reason a new list has been compiled, based on the data of Demaret (1940, 1946), with all available additions. This includes publications as well as herbarium specimens distributed by J.L. De Sloover (marked with the herbarium abbreviation NAM) and the collections made during the Bryotrop expedition to Rwanda and Zaire in 1991 (see special contributions in this volume).
Lichens from Mount Kinabalu
Authors: Sipman J. J.M.
Published: September 2015

286 species of lichenized fungi on Mount Kinabalu are recorded by field survey and investigation of literature records and herbarium material. An annotated catalogue is presented, together with habitat notes, and a list of collectors. The summit area has a saxicolous lichen flora of boreal affinities, while the lower zones are more closely related to other SE Asian mountains. Eleven species appear to be restricted to the mountain, and four new species are described: Phaeographis kinabalensis, Stereocaulon granulans, Pertusaria epitheciifera and Thelotrema subweberi.
Taxonomic Results of the BRYOTROP-Expedition to Zaire and Rwanda 5. Anthocerotae

Authors: Hasegawa J.
Published: September 2015

Taxonomic Results of the BRYOTROP-Expedition
Taxonomic Results of the BRYOTROP Expedition to Zaire and Rwanda 8. Riccia vulcanicola E. Fischer (subgenus Ricciella, Sectio Cavernosae), a new species from the Virunga Volcanoes, Rwanda

Authors: Fischer Eberhard
Published: September 2015

A new Riccia species, R. vulcanicola is described and illustrated. It is closely related to R. crystallina, differing by the incomplete rosettes of the thallus and the larger and fewer areolae of the spores.
Two new Bdellidae (Trombidiformes: Bdelloidea) from Iran and the status of Neobiscirus Gomelauri, 1963
Authors: PAKTINAT-SAEEJ SAEED , BAGHERI MOHAMMAD , SABOORI ALIREZA , AHANIAZAD MANSOUREH
Published: September 2015

Two new Bdellidae, Biscirus iranensis Paktinat-Saeej & Bagheri sp. nov. and Bdella farabii Paktinat-Saeej & Bagheri sp. nov., are described from northern Iran. The monotypic genus Neobiscirus considered a junior synonym of Biscirus, and its only species therefore considered Biscirus kobachidzei (Gomelauri, 1963) comb. nov.
A new species of Alopecosa Simon, 1885 (Araneae, Lycosidae) from the Altai Mountains (South Siberia, Russia)
Authors: FOMICHEV ALEXANDER A. , LOGUNOV DMITRI V.
Published: September 2015

Alopecosa Simon, 1885 is a large genus of wolf spiders containing more than 166 named species (World Spider Catalog 2015), of which 81 valid species have been recorded from the territory of ex-USSR (Mikhailov 2013). In the mountains of South Siberia, to which the Altai Mts belong, 35 species of Alopecosa have been recorded to date (Mikhailov 2013), but findings of some of them require confirmation upon reference to the pertinent material. Yet, some authors (e.g., Marusik & Kovblyuk 2011) argue that the genus Alopecosa is a paraphyletic taxon that needs to be split up into a number of separate genera.
Size Distributions of Hydrometeors: Analysis with the Maximum Entropy Principle
Authors: Yano Jun-Ichi , Heymsfield Andrew J. , Phillips Vaughan T. J.
Published: September 2015

This paper proposes that the maximum entropy principle can be used for determining the drop size distribution of hydrometeors. The maximum entropy principle can be applied to any physical systems with many degrees of freedom in order to determine a distribution of a variable when the following are known: 1) the restriction variable that leads to a homogeneous distribution without constraint and 2) a set of integrals weighted by the distribution, such as mean and variance, that constrain the system. The principle simply seeks a distribution that gives the maximum possible number of partitions among all the possible states. A continuous limit can be taken by assuming a constant bin size for the restriction variable.

This paper suggests that the drop mass is the most likely restriction variable, and the laws of conservation of total bulk mass and of total vertical drop mass flux are two of the most likely physical constraints to a hydrometeor drop size distribution. Under this consideration, the distribution is most likely constrained by the total bulk mass when an ensemble of drops under the coalescence–breakup process is confined inside a closed box. Alternatively, for an artificial rain produced from the top of a high ceiling under a constant mass flux of water fall, the total drop mass flux is the most likely constraint to the drop size distribution. Preliminary analysis of already-published data is not inconsistent with the above hypotheses, although the results are rather inconclusive. Data in the large drop size limit are required in order to reach a more definite conclusion.
Intraseasonal Sea Surface Temperature Variability across the Indonesian Seas*
Authors: Napitu Asmi M. , Gordon Arnold L. , Pujiana Kandaga
Published: September 2015

Sea surface temperature (SST) variability at intraseasonal time scales across the Indonesian Seas during January 1998–mid-2012 is examined. The intraseasonal variability is most energetic in the Banda and Timor Seas, with a standard deviation of 0.4°–0.5°C, representing 55%–60% of total nonseasonal SST variance. A slab ocean model demonstrates that intraseasonal air–sea heat flux variability, largely attributed to the Madden–Julian oscillation (MJO), accounts for 69%–78% intraseasonal SST variability in the Banda and Timor Seas. While the slab ocean model accurately reproduces the observed intraseasonal SST variations during the northern winter months, it underestimates the summer variability. The authors posit that this is a consequence of a more vigorous cooling effect induced by ocean processes during the summer. Two strong MJO cycles occurred in late 2007–early 2008, and their imprints were clearly evident in the SST of the Banda and Timor Seas. The passive phase of the MJO [enhanced outgoing longwave radiation (OLR) and weak zonal wind stress) projects on SST as a warming period, while the active phase (suppressed OLR and westerly wind bursts) projects on SST as a cooling phase. SST also displays significant intraseasonal variations in the Sulawesi Sea, but these differ in characteristics from those of the Banda and Timor Seas and are attributed to ocean eddies and atmospheric processes independent from the MJO.
What Controls Seasonal Variations of the Diurnal Cycle of Sea Surface Temperature in the Eastern Tropical Indian Ocean?*
Authors: Yang Yang , Li Tim , Li Kuiping , Yu Weidong
Published: September 2015

Recent in situ buoy observations revealed interesting seasonal features of the diurnal sea surface temperature cycle (DSST) in the eastern tropical Indian Ocean. Composite analysis shows that areas away from the equator exhibit stronger seasonal variations of DSST, while weaker seasonal variations appear near the equator. The most interesting characteristic is the distinctive contrast of the seasonal variations of DSST between the Bay of Bengal (BOB) and the region south of the equator (particularly around 12°S). While the range of DSST is weakest in the BOB during boreal summer, it has its largest range around 12°S in austral summer. Furthermore, BOB DSST exhibits two peaks that occur during the monsoon transitions (March–April and October), whereas DSST south of the equator shows only a single peak in its annual cycle.

Using a one-dimensional, oceanic, mixed layer model, the authors examined the cause of the distinctive annual cycles of DSST north and south of the equator. Two parallel experiments were conducted at buoy sites 12°N, 90°E and 12°S, 80.5°E driven by surface forcing from the Modern-Era Retrospective Analysis for Research and Applications (MERRA) product. The results demonstrated that, in the BOB, both surface shortwave radiation and wind stress contribute to the March maximum, whereas the wind stress alone drives the October maximum. In contrast, the seasonal variation of DSST south of the equator is primarily caused by the annual cycle of the wind stress, which is extremely weak in austral summer near the intertropical convergence zone (ITCZ). How the monsoon and ITCZ modulate the distinctive annual cycles of DSST is discussed.
The Interaction of an Eastward-Flowing Current and an Island: Sub- and Supercritical Flow
Authors: Pedlosky Joseph , Spall Michael A.
Published: September 2015

An eastward-flowing current of a homogeneous fluid with velocity U, contained in a channel of width L, impinges on an island of width of O(L), and the resulting interaction and dynamics are studied for values of the supercriticality parameter, b = βL2/U, both larger and smaller than π2. The former case is subcritical with respect to Rossby waves, and the latter is supercritical. The nature of the flow field depends strongly on b, and in particular, the nature of the flow around the island and the proportion of the flow passing to the north or south of the island are sensitive to b and to the position of the island in the channel. The problem is studied analytically in a relatively simple, nonlinear quasigeostrophic and adiabatic framework and numerically with a shallow-water model that allows a qualitative extension of the results to the equator. Although the issues involved are motivated by the interaction of the Equatorial Undercurrent and the Galapagos Islands, the analysis presented here focuses on the fundamental issue of the distinctive nature of the flow as a function of Rossby wave criticality.
Pharyngeal Tube Flap and Palatoglossal Rotation Flap in Subtotal Soft Palate Reconstruction
Authors: Mai Johnny P. , Sadeghi Nader
Published: September 2015

Reconstruction of the soft plate after oncologic resection is complex owing to the palate’s complex role in speech and swallow. This challenge becomes more complex as defects increase in size. Current management of soft plate reconstruction includes obturation as well as local or microvascular flaps. These methods, though, are limited by poor function and complexity. In regard to large subtotal central soft palate defects, we expand on previous descriptions of a tubed posterior pharyngeal constrictor flap to include a palatoglossal rotational flap that is facile and hardy and has a decreased recovery time. Furthermore, we present 2 representative cases, including 1 with previous radiation, in which our technique was utilized with successful closure of the defect and without subsequent breakdown.
“Beaned”
Authors: Carniol Eric T. , Shaigany Kevin , Svider Peter F. , Folbe Adam J. , Zuliani Giancarlo F. , Baredes Soly , Eloy Jean Anderson
Published: September 2015

Objectives

Baseball remains one of the most popular and safest games played by children and adults in America and worldwide. Rules and equipment changes have continued to make the game safer. For youth leagues, pitching restrictions, safety balls, helmets, and face mask equipment continue to make the game safer. With increased utilization of safety equipment, the objective was to analyze recent trends in baseball‐related facial injuries.

Study Design

Cross‐sectional analysis of a national database.

Methods

The National Electronic Injury Surveillance System was searched for baseball‐related facial injuries with analysis of incidence, age, and sex and specific injury diagnoses, mechanisms, and facial locations.

Results

From 2009 to 2013, there were 5270 cases entries, or 187,533 estimated emergency department (ED) visits, due to baseball‐related facial injuries. During this time, there was a significant decline in the incidence of ED visits (P =. 014). Inclusion criteria were met by 3208 visits. The majority of injuries occurred in patients ≤18 years old (81.5%). The most common injury was laceration (33.2%), followed by contusion (29.7%) and fracture (26.9%), while the most common injury site on the face was the nose (24.9%). The injuries were most commonly due to impact from a baseball (70%) or a bat (12.5%).

Conclusion

The overall incidence of ED visits due to baseball‐related facial injuries has decreased over the past 5 years, concurrent with increased societal use of protective equipment. Nonetheless, these injuries remain a common source for ED visits, and a continued effort to utilize safety measures should be made, particularly in youth leagues.
PRIS may be diagnosed before ICU period for patients undergoing cardiopulmonary bypass
Authors: Şahin Türker
Published: September 2015

There are many published articles on the clinical manifestations of propofol-related infusion syndrome (PRIS), but they are not the same in each case.1 Moreover, PRIS is only encountered infrequently and, therefore, it may create a diagnostic challenge. Nearly all of the published articles on PRIS are related to the use of long-term (>48 hour) propofol infusion with a dose range of at least 4-5 mg/kg/h.2-11 In this case, not only a short duration, but also a low-dose propofol administration seems to induce PRIS. A 73-year-old male patient under cardiopulmonary bypass (CPB) suffered from some clinical symptoms of PRIS, such as hyperlactatemia and persistent low metabolic acidosis which promptly resolved on the discontinuation of propofol. Therefore, we suggest that any propofol administration (bolus or infusion) may result in such clinical symptoms, which may be the earliest indicators of PRIS. When those symptoms are observed on propofol administration during cardiopulmonary bypass (CPB), the perfusionist must alert both the anaesthesiologist and the surgeon to stop the propofol in order to prevent the patient from further adverse effects of PRIS.
An anatomy of gentrification processes: variegating causes of neighbourhood change
Authors: Hochstenbach Cody , van Gent Wouter PC
Published: September 2015

Several theoretical debates in gentrification literature deal with the role and importance of migration, in situ social mobility, and demographic change in urban social change. These debates focus primarily on structural processes. However, we have comparatively little insight into how and to what degree different mechanisms actually underpin upgrading in urban neighbourhoods. This paper uses Dutch register data to show how residential mobility, social mobility, and demographic change each contribute to gentrification in Amsterdam and Rotterdam. First, our findings show that residential mobility remains key to understanding the growth of higher-income residents in gentrifiying neighbourhoods. At the same time, social mobility and demographic change— notably ageing—are most important in explaining dwindling numbers of lower-income residents. Second, large differences exist across neighbourhoods. By mapping three idealtypical drivers of gentrification, we show how the migration-based ‘displacement model’ occurs predominantly in upgrading neighbourhoods with a high status. Conversely, in low-status upgrading neighbourhoods social mobility is more important in explaining gentrification. These different forms of upgrading occur simultaneously in both cities and should be integrated to advance our understanding of gentrification as a process that is both widespread and occurs in different, ever-changing forms across neighbourhoods.
Assessing Resting Metabolic Rate in Overweight and Obese Adolescents With a Portable Indirect Calorimeter
Authors: Henes Sarah T. , Johnson Abby , Toner Marti , Mamaril Kamille , Kelkar Maya , Xiao Yuanhui , Warren Gordon L.
Published: September 2015

Background: Indirect calorimetry measured via the traditional indirect calorimeter is considered the “gold standard” for determining resting metabolic rate (RMR). Portable devices for assessing RMR are a less expensive option for measuring RMR in the clinical setting. This pilot study tested the reliability and validity of a portable device for measuring RMR, specifically in overweight and obese adolescents. Materials and Methods: Participants aged 17–19 years (n = 19) and ≥85th percentile on the Centers for Disease Control and Prevention body mass index growth curves for age and sex were recruited from a university campus. Participants completed testing on a traditional indirect calorimeter and a portable indirect calorimeter in a randomized order on 2 separate testing days. Results: A paired samples t test comparing the means of the portable device and the traditional indirect calorimeter found no significant difference (P = .22). The test‐retest intraclass correlation coefficient for assessing RMR was 0.91, indicating reliability of the portable indirect calorimeter. Compared with measured RMR, the Mifflin–St Jeor equation demonstrated 37% accuracy, and the Molnar equation demonstrated 57% accuracy. Conclusion: This pilot study found portable indirect calorimetry to be reliable and valid for assessing RMR in an overweight and obese adolescent population. In addition, this study indicates that portable indirect calorimetry may be an acceptable option for assessing RMR in this population compared with the traditional indirect calorimeter or predictive equations.
Delinquent Subculture and Juvenile Offenders’ Attitudes Toward the Police in China
Authors: Ren Ling , Zhang Hongwei , Zhao Jihong Solomon , Zhao Ruohui
Published: September 2015

This study made use of delinquent subculture theories developed in the United States to examine juvenile attitudes toward the police in China. The data were collected from face-to-face interviews conducted with 358 adjudicated youth offenders incarcerated in a province-run juvenile prison in an ethnic minority autonomous region of China. The analysis includes variables derived from delinquent subcultures theories as well as traditional models commonly employed in the U.S. literature. The findings suggest that juvenile offenders in the sample tend to rate the police positively and delinquent subculture theories have their utility in explaining juvenile offenders’ sentiments toward the police. Explanations were provided for findings that are distinctive for this Chinese sample. Study limitations and relevant policy implications were discussed.
Improvement of flame retardancy of poly(lactic acid) nonwoven fabric with a phosphorus- containing flame retardant
Authors: Cheng Xian-Wei , Guan Jin-Ping , Tang Ren-Cheng , Liu Kai-Qiang
Published: September 2015

A cyclic phosphonate ester flame retardant was applied to improve the flame retardancy of poly(lactic acid) (PLA) nonwoven fabric by a pad-dry-cure technique. The effects of curing temperature and flame retardant dosage on the flammability of PLA fabric were analyzed. The burning behavior, thermal stability and flame-retardant mechanism of the flame-retardant PLA fabric were investigated by limiting oxygen index (LOI), vertical burning test, microscale combustion calorimetry (MCC), thermogravimetric (TG) analysis and scanning electron microscopy (SEM) with energy dispersive spectrum (EDS). The treated PLA fabric exhibited good flame retardancy, and its LOI was about 35%, whereas this value was 26.3% for the untreated fabric. No obvious difference of the MCC test results between the untreated and treated fabrics was found. The results from TG analyses indicated the formation of a very small amount of char during the thermal degradation process of the treated PLA fabric. The SEM-EDS analysis showed an obvious decrease in the phosphorus content of the flame retardant fabric after burning. These indicate that the gas-phase flame-retardant mechanism during combustion is dominant, and results in the good flame retardancy of the treated fabric in the presence of a very small amount of char residue.
Lower Extremity Wounds in Patients With Idiopathic Thrombocytopenic Purpura and Systemic Lupus Erythematosus
Authors: Akita Sadanori
Published: September 2015

Infections in lower extremities are sometimes concerned with systemic immunological disorders such as idiopathic thrombocytopenic purpura and systemic lupus erythematosus, which are treated with systemic steroids. Steroid therapy impairs the epithelial wound healing and with systemic condition, especially with systemic lupus erythematosus, the wound is susceptible for infection. Even a pyoderma gangrenosum sometimes occurs in a patient with idiopathic thrombocytopenic purpura with an incisional wound of hernia. The severe signs and symptoms are the deep skin and soft tissue infections, mainly caused by group A streptococcus, composed of necrotizing fasciitis and muscle necrosis. Medically suspected necrotizing fasciitis patients should be empirically and immediately administered with broad-spectrum antibiotics, which may cover the common suspected pathogens. In type I (polymicrobial) infection, the selection of antimicrobial should be based on medical history and Gram staining and culture. The coverage against anaerobes is important in type I infection. Metronidazole, clindamycin, or beta-lactams with beta-lactamase inhibitor or carbapenems are the treatment of choice against anaerobes, while early surgical debridement—wide enough and deep enough—is the core treatment of necrotizing fasciitis and results in significantly better mortality compared with those who underwent surgery after a few hours of delay. When necrotizing fasciitis is considered and the patient is brought to the operation room, aggressive and extensive surgical debridement is explored. Tissue involved should be completely removed until no further evidence of infection is seen. When further debridement is required, the patient must return to the operating room immediately. In this context, the temporal coverage using the artificial dermis after debridement is useful because there is no loss of the patient’s own tissue and yet it is easier for “second-look” surgery or secondary reconstruction, and extensive enough debridement is always the mainstay of the therapy.
The Reverberations of a Graduate Study Abroad Course in India
Authors: Anderson Sathe Laurie , Geisler Carol C.
Published: September 2015

Faculty in a transdisciplinary graduate program in holistic health studies, which is grounded in transformational learning led a study abroad course in India. The focus of the course is on perspectives of health and healing in India, including an understanding of Yoga, meditation, Ayurvedic medicine, and Tibetan medicine. The purpose of this phenomenological research is to describe the experiences of 13 holistic health studies graduate students who participated in this graduate study abroad course. Qualitative data were collected from students at the time of application to the course, 1 month after returning from India, and 1 year later. In addition, student applications, posttrip reflection papers, photographs, notes taken by faculty at a 1-year reunion, and results of an electronic survey were used as data. Results suggest that students experienced “mind, body and spirit” transformations with reverberations on personal, community, and global levels.
Neck pain
Authors: Lowe Adam
Published: September 2015

Neck pain is a common musculoskeletal presentation in primary care; it can be due to a number of aetiologies. It may present as a prolonged history or secondary to a recent acute event. Neck pain that persists for less than 6 weeks is termed as acute and, in general, is thought to carry a favourable prognosis. Sub-acute is used to describe cases where neck pain persists from 6 weeks to 6 months. For durations greater than 6 months, neck pain tends to be classified as chronic. Careful history and clinical examination in primary care can differentiate the small number of patients with potential red flag symptoms from non-specific aetiologies. This may be a difficult task, and requires skill in ascertaining an accurate history and examination. In the majority of cases non-specific neck pain is the likely diagnosis, however, alternative significant causes should be considered in each presenting case. This article is aimed mainly at initial assessment in primary care and when to consider onward referral. The assessment and overall management is a similar approach to that used with regards to low back pain. Neck pain is overall less prevalent in comparison; however, serious pathology must be excluded in each case. It tends to be more prevalent in women. A significant percentage of patients who recover from neck pain will relapse. As a result early input management and education in patients presenting with neck pain can be a vital intervention.
Disclosing the potential impact of placebo controls in antidepressant trials
Authors: Chen Stephanie C. , McCullumsmith Cheryl , Kim Scott Y. H.
Published: September 2015

Background

Although placebo-control clinical trials that withhold effective treatments can be permissible, how best to inform participants of the placebo design has received little attention.

Aims

To determine the effect of disclosing quantitative outcome estimates of individual treatment v. entering placebo-control randomised control trial (RCT) on willingness to enrol in such an RCT.

Method

We randomised 278 adult patients at a depression clinic to receive standard disclosure (n = 129) or enhanced (n = 149) quantitative outcome estimates (based on decision analysis) of individual treatment v. RCT, and assessed their willingness to enrol in the RCT.

Results

A greater proportion of those in the standard arm preferred enrolling in RCT (41.3% v. 23.8%, P = 0.002). Those in the standard arm preferred RCT more for direct benefit than altruism reasons, whereas the opposite was true in the enhanced arm.

Conclusions

Disclosing the quantitative outcome implications of placebos may select for fewer but more altruistic participants.
Prevalence and correlates of explosive anger among pregnant and post-partum women in post-conflict Timor-Leste
Authors: Silove Derrick , Rees Susan , Tam Natalino , Mohsin Mohammed , Tay Alvin Kuowei , Tol Wietse
Published: September 2015

Background

Little is known about explosive anger as a response pattern among pregnant and post-partum women in conflict-affected societies.

Aims

To investigate the prevalence and correlates of explosive anger among this population in Timor-Leste.

Method

We assessed traumatic events, intimate partner violence, an index of adversity, explosive anger, psychological distress and post-traumatic stress disorder among 427 women (257 in the second trimester of pregnancy, 170 who were 3–6 months postpartum) residing in two districts of Timor-Leste (response >99%).

Results

Two-fifths (43.6%) had explosive anger. Levels of functional impairment were related to frequency of explosive anger episodes. Explosive anger was associated with age (>35 years), being married, low levels of education, being employed, traumatic event count, ongoing adversity and intimate partner violence.

Conclusions

A combination of social programmes and novel psychological therapies may assist in reducing severe anger among pregnant and post-partum women in conflict-affected countries such as Timor-Leste.
Psychological distress among tsunami refugees from the Great East Japan earthquake
Authors: Goodwin Robin , Takahashi Masahito , Sun Shaojing , Ben-Ezra Menachem
Published: September 2015

Background

The 2011 Great Japan tsunami and nuclear leaks displaced 300 000 people, but there are no large studies of psychological distress suffered by these refugees.

Aims

To provide a first assessment of major factors associated with distress and dysfunctional behaviour following the disasters.

Method

All refugee families living in Miyagi were sent a questionnaire 10–12 months after the disasters. 21 981 participants (73%) returned questionnaires. Questions assessed psychological distress (Kessler Psychological Distress Scale, K6), dysfunctional behaviours, demographics, event exposure, change in physical activity, household visitors and emotional support.

Results

Nine percent scored 13+ on the K6 indicating risk of severe mental illness. Psychological distress was greater among Fukushima refugees. Demographic variables, family loss, illness history and change in physical activity were associated with psychological distress and dysfunctional behaviours. Associations between psychological distress and dysfunction and visitors/supporters depended on relation to supporter.

Conclusions

Practitioners need to recognise existing disease burden, community histories and family roles when intervening following disasters.
Childhood IQ and risk of bipolar disorder in adulthood: prospective birth cohort study
Authors: Smith Daniel J. , Anderson Jana , Zammit Stanley , Meyer Thomas D. , Pell Jill P. , Mackay Daniel
Published: September 2015

Background

Intellectual ability may be an endophenotypic marker for bipolar disorder.

Aims

Within a large birth cohort, we aimed to assess whether childhood IQ (including both verbal IQ (VIQ) and performance IQ (PIQ) subscales) was predictive of lifetime features of bipolar disorder assessed in young adulthood.

Method

We used data from the Avon Longitudinal Study of Parents and Children (ALSPAC), a large UK birth cohort, to test for an association between measures of childhood IQ at age 8 years and lifetime manic features assessed at age 22–23 years using the Hypomania Checklist-32 (HCL-32; n=1881 individuals). An ordinary least squares linear regression model was used, with normal childhood IQ (range 90–109) as the referent group. We adjusted analyses for confounding factors, including gender, ethnicity, handedness, maternal social class at recruitment, maternal age, maternal history of depression and maternal education.

Results

There was a positive association between IQ at age 8 years and lifetime manic features at age 22–23 years (Pearson's correlation coefficient 0.159 (95% CI 0.120–0.198), P>0.001). Individuals in the lowest decile of manic features had a mean full-scale IQ (FSIQ) which was almost 10 points lower than those in the highest decile of manic features: mean FSIQ 100.71 (95% CI 98.74–102.6) v. 110.14 (95% CI 107.79–112.50), P>0.001. The association between IQ and manic features was present for FSIQ, VIQ and for PIQ but was strongest for VIQ.

Conclusions

A higher childhood IQ score, and high VIQ in particular, may represent a marker of risk for the later development of bipolar disorder. This finding has implications for understanding of how liability to bipolar disorder may have been selected through generations. It will also inform future genetic studies at the interface of intelligence, creativity and bipolar disorder and is relevant to the developmental trajectory of bipolar disorder. It may also improve approaches to earlier detection and treatment of bipolar disorder in adolescents and young adults.
Antipsychotics for the management of psychosis in Parkinson's disease: systematic review and meta-analysis
Authors: Jethwa Ketan Dipak , Onalaja Oluwademilade A.
Published: September 2015

Background

Antipsychotics can exacerbate motor symptoms in Parkinson's disease psychosis.

Aims

To systematically review the literature on the efficacy and acceptability of antipsychotics for Parkinson's disease psychosis.

Method

Randomised controlled trials comparing an antipsychotic with placebo were systematically reviewed.

Results

The final selection list included nine studies using quetiapine (3), clozapine (2), olanzapine (3) and pimavanserin (1). A narrative synthesis and meta-analyses (where appropriate) were presented for each antipsychotic. Clozapine demonstrated superiority over placebo in reducing psychotic symptoms. Quetiapine and olanzapine did not significantly improve psychotic symptoms. All three antipsychotics may exacerbate motor symptoms. Quetiapine studies were associated with high drop-out rates due to adverse events. Pimavanserin is a novel treatment that warrants further investigation.

Conclusions

Further research is needed. Clozapine and pimavanserin appear to be a promising treatment for Parkinson's disease psychosis.
Influence of age, irradiation and humanization on NSG mouse phenotypes
Authors: Knibbe-Hollinger Jaclyn S. , Fields Natasha R. , Chaudoin Tammy R , Epstein Adrian A. , Makarov Edward , Akhter Sidra P. , Gorantla Santhi , Bonasera Stephen J. , Gendelman Howard E. , Poluektova Larisa Y.
Published: September 2015

Humanized mice are frequently utilized in bench to bedside therapeutic tests to combat human infectious, cancerous and degenerative diseases. For the fields of hematology-oncology, regenerative medicine, and infectious diseases, the immune deficient mice have been used commonly in basic research efforts. Obstacles in true translational efforts abound, as the relationship between mouse and human cells in disease pathogenesis and therapeutic studies requires lengthy investigations. The interplay between human immunity and mouse biology proves ever more complicated when aging, irradiation, and human immune reconstitution are considered. All can affect a range of biochemical and behavioral functions. To such ends, we show age- and irradiation-dependent influences for the development of macrocytic hyper chromic anemia, myelodysplasia, blood protein reductions and body composition changes. Humanization contributes to hematologic abnormalities. Home cage behavior revealed day and dark cycle locomotion also influenced by human cell reconstitutions. Significant age-related day-to-day variability in movement, feeding and drinking behaviors were observed. We posit that this data serves to enable researchers to better design translational studies in this rapidly emerging field of mouse humanization.
Canine MPV17 truncation without clinical manifestations
Authors: Hänninen Reetta L. , Ahonen Saija , Màrquez Merce , Myöhänen Maarit J. , Hytönen Marjo K. , Lohi Hannes
Published: September 2015

Mitochondrial DNA depletion syndromes (MDS) are often serious autosomal recessively inherited disorders characterized by tissue-specific mtDNA copy number reduction. Many genes, including MPV17, are associated with the hepatocerebral form of MDS. MPV17 encodes for a mitochondrial inner membrane protein with a poorly characterized function. Several MPV17 mutations have been reported in association with a heterogeneous group of early-onset manifestations, including liver disease and neurological problems. Mpv17-deficient mice present renal and hearing defects. We describe here a MPV17 truncation mutation in dogs. We found a 1-bp insertion in exon 4 of the MPV17 gene, resulting in a frameshift and early truncation of the encoded protein. The mutation halves MPV17 expression in the lymphocytes of the homozygous dogs and the truncated protein is not translated in transfected cells. The insertion mutation is recurrent and exists in many unrelated breeds, although is highly enriched in the Boxer breed. Unexpectedly, despite the truncation of MPV17, we could not find any common phenotypes in the genetically affected dogs. The lack of observable phenotype could be due to a late onset, mild symptoms or potential tissue-specific compensatory mechanisms. This study suggests species-specific differences in the manifestation of the MPV17 defects and establishes a novel large animal model to further study MPV17 function and role in mitochondrial biology.
Photochemical Cleavage of Axial Group Attached to the Central Carbon Atom of Triangulene Leuco Derivatives at the Ethanol/Au(111) Substrate
Authors: Yokoyama Soichi , Hirose Takashi , Matsuda Kenji
Published: September 2015

Triangulene leuco derivatives bearing phenylethynyl group at the central carbon atom show a photocleavage reaction affording their cationic form with the quantum yield (Φr) of 0.33–0.67 in ethanol. The photoreaction can be detected not only by the change of absorption and fluorescence due to the generation of the cation, but also by scanning tunneling microscopy (STM) at the single-molecule resolution at the air/Au(111) interface.
A Railway Timetable Rescheduling Approach for Handling Large-Scale Disruptions
Authors: Veelenturf Lucas P. , Kidd Martin P. , Cacchiani Valentina , Kroon Leo G. , Toth Paolo
Published: September 2015

On a daily basis, large-scale disruptions require infrastructure managers and railway operators to reschedule their railway timetables together with their rolling stock and crew schedules. This research focuses on timetable rescheduling for passenger train services on a macroscopic level in a railway network. An integer linear programming model is formulated for solving the timetable rescheduling problem, which minimizes the number of cancelled and delayed train services while adhering to infrastructure and rolling stock capacity constraints. The possibility of rerouting train services to reduce the number of cancelled and delayed train services is also considered. In addition, all stages of the disruption management process (from the start of the disruption to the time the normal situation is restored) are taken into account. Computational tests of the described model on a heavily used part of the Dutch railway network show that the model is able to find optimal solutions in short computation times. This makes the approach applicable for use in practice.
Delivering compassionate care: the enablers and barriers
Authors: Christiansen Angela , O'Brien Mary R , Kirton Jennifer A , Zubairu Kate , Bray Lucy
Published: September 2015

The importance of providing compassionate care to patients is well established. While compassionate care can be understood as an individual response to others' vulnerability, it is acknowledged that healthcare environments can impact significantly on this aspect of practice. This study sought to explore how health professionals and pre-qualifying healthcare students (HCS) understand compassionate care and factors that hinder or enable them to practice compassionately. The perceptions of health professionals (n=146) and HCS (n=166) registered at a university in Northwest England were explored using mixed methods. This article reports on the data gained from the qualitative interviews and responses to open-text questions from the mainly quantitative questionnaire. The findings are discussed under the following themes: individual and relationship factors that impact on compassionate care practice; organisational factors that impact on the clinical environment and team; and leadership factors that hinder or enable a compassionate care culture. This article argues that there are a number of enabling factors that enhance a culture conducive to providing compassionate care. These include leaders who act as positive role models, good relationships between team members and a focus on staff wellbeing.
Practical advice for baby skin care
Authors: Lawton Sandra
Published: September 2015

There is a lack of high-quality evidence to support best practice for infant skin cleansing, says Sandra Lawton