bluuebunny/crossref_metadata_2025 huggingface dataset:
Substance Abuse Screening and Brief Intervention for Adolescents in Primary Care
Authors: Pitts Sarah , Shrier Lydia A.
Published: October 2014

Adolescent substance use is common and is associated with serious mental, physical, and social risks, warranting systematic screening in the primary care setting. It is important for clinicians to become familiar with Screening, Brief Intervention, and Referral to Treatment (SBIRT), including administration of validated screening tools to identify level of risk associated with substance use and application of appropriate brief interventions. Positive reinforcement and brief advice is indicated for those adolescents with no or minimal risk for a substance use disorder. Providing a brief intervention using motivational interviewing strategies with subsequent close clinical follow-up is warranted when an adolescent meets criteria for a mild to moderate substance use disorder. Referral to treatment is recommended in cases of severe substance use. Immediate action, including breaking confidentiality, may be necessary when an adolescent’s behavior raises acute safety concerns. Making time to interview adolescents alone is essential. It is also important to review the limitations of confidentiality with patients and parents/guardians and offer them strategies to discuss sensitive issues with their adolescents. Available resources for adolescents, parents/guardians, and clinicians regarding the risks of adolescent substance use and evidence-based treatment options can be used to support implementation of SBIRT in adolescent primary care.

[
Pediatr Ann
. 2014;43(10):e248–e252.]
A Rare Association of Intravitreal Bevacizumab Injection With Double Ridge Formation in Retinopathy of Prematurity
Authors: Yaz Yasemin , Erol Nazmiye , Gursoy Huseyin , Basmak Hikmet , Bilgec Mustafa D.
Published: October 2014

A second anterior ridge formed 8 weeks after therapy in a case of zone II, stage 3 retinopathy of prematurity, which was treated with intravitreal bevacizumab injection alone. The clinical appearance was defined as “double ridge.” Retinopathy of prematurity cases treated only with intravitreal bevacizumab injections may progress; therefore, close follow-up is recommended.

[
J Pediatr Ophthalmol Strabismus
2014;51:e66–e68.]
Suvorexant: A Novel Therapy for the Treatment of Insomnia
Authors: Howland Robert H.
Published: October 2014

Suvorexant is a pharmacologically novel dual antagonist of orexin receptors OX1R and OX2R, which has an effect that promotes sleep by reducing arousal and wakefulness. Its approval for the treatment of insomnia was based on three clinical trials that found it to be efficacious and relatively well tolerated. Somnolence, headache, and dry mouth are the most common side effects. Because suvorexant has unique effects on arousal systems and rapid eye movement (REM) sleep, it is contraindicated in patients with narcolepsy, and its use should be avoided or closely monitored in patients at risk for REM sleep behavior disorder, depression, or delirium. [
Journal of Psychosocial Nursing and Mental Health Services, 52
(10), 23–26.]
Topographic Analysis of the Centration of the Treatment Zone After SMILE for Myopia and Comparison to FS-LASIK: Subjective Versus Objective Alignment
Authors: Lazaridis Apostolos , Droutsas Konstantinos , Sekundo Walter
Published: October 2014

PURPOSE:

To evaluate the centration of the treatment zone after small incision lenticule extraction (SMILE) and compare it to femtosecond laser-assisted LASIK (FS-LASIK).

METHODS:

Sixty-nine myopic eyes of 36 patients who underwent SMILE were compared to 69 myopic eyes of 36 patients treated with FS-LASIK. All procedures were performed by a single surgeon using the VisuMax platform (Carl Zeiss Meditec, Jena, Germany). The Pentacam (Oculus Optikgeräte GmbH, Wetzlar, Germany) was used for preoperative and postoperative topography and pachymetry. The centration of the treatment zone was estimated pachymetrically by the distance of the thickest point on the corneal thickness differential map from the topographical center of the entrance pupil and the coaxial corneal light reflex.

RESULTS:

In SMILE cases, the mean decentration of the lenticule from the center of the entrance pupil was 0.326 ± 0.196 mm (range: 0.014 to 1.062 mm), whereas the distribution of the lenticule centers demonstrated a nasalization pattern. In FS-LASIK cases, this value was 0.452 ± 0.224 mm (range: 0.02 to 1.040 mm), whereas the ablation centers were distributed randomly. In relation to the coaxial corneal light reflex, the decentration in SMILE was 0.315 ± 0.211 mm (range: 0.0 to 1.131 mm), whereas FS-LASIK eyes demonstrated a mean decentration of 0.516 ± 0.254 mm (range: 0.103 to 1.265 mm). The decentration from the reference point of its technique (coaxial corneal light reflex in SMILE, the entrance pupil center in FS-LASIK) was significantly more extended in the FS-LASIK group (
P
< .001).

CONCLUSIONS:

The centration of the treatment zone as measured by the Pentacam was better for patient-controlled fixation during SMILE than active eye tracker-assisted FS-LASIK.

[
J Refract Surg.
2014;30(10):680–686.]
Impact of Personality Characteristics on Patient Satisfaction After Multifocal Intraocular Lens Implantation: Results From the “Happy Patient Study”
Authors: Mester Ulrich , Vaterrodt Thomas , Goes Frank , Huetz Werner , Neuhann Irmingard , Schmickler Stefanie , Szurman Peter , Gekeler Katrin
Published: October 2014

PURPOSE:

This prospective multicenter study assessed personality characteristics that may influence patient satisfaction after implantation of multifocal intraocular lenses (MIOLs).

METHODS:

One hundred eighty-three patients who underwent bilateral implantation of different MIOLs were enrolled. Uncorrected and corrected distance visual acuity for distance and near (ie, UDVA, UNVA, CDVA, and CNVA) were assessed preoperatively and 3 and 6 months after implantation. Before surgery, personality characteristics were evaluated using a questionnaire based on the NEO Personality Inventory Test and the Compulsiveness Inventory Test. At the 3- and 6-month postoperative visits, patients answered a questionnaire concerning overall satisfaction, need for spectacles at different distances, visual function at different distances and lighting conditions, photic phenomena, and ease of performing daily activities.

RESULTS:

Three months after surgery (n = 163), mean CDVA was 0.03 ± 0.09 logMAR, UDVA was 0.05 ± 0.09 logMAR, and UNVA was 0.04 ± 0.11 logMAR. At the 6-month visit (n = 131), mean CDVA was 0.02 ± 0.07 logMAR, UDVA was 0.06 ± 0.09 logMAR, and UNVA was 0.05 ± 0.01 logMAR. Most patients (82.2%) would opt for an MIOL again, 3.7% would not, and 14.1% were uncertain. Overall satisfaction with the procedure was correlated to low astigmatism, good visual function, low spectacle dependence, and less halos or glare. The personality characteristics of compulsive checking, orderliness, competence, and dutifulness were statistically significantly correlated to subjective disturbance by glare and halos.

CONCLUSIONS:

Postoperative patient satisfaction after MIOL implantation is correlated to visual performance, spectacle independence, and less photic phenomena. Personality characteristics have an impact on subjective disturbance by photic phenomena and thus are important for patient satisfaction.

[
J Refract Surg
2014;30(10):674–678.]
Differences in the Corneal Biomechanical Changes After SMILE and LASIK
Authors: Wang Danyang , Liu Manli , Chen Yile , Zhang Xiaoying , Xu Yangtao , Wang Jianchao , To Chi-ho , Liu Quan
Published: October 2014

PURPOSE:

To compare the corneal biomechanical properties before and after small incision lenticule extraction (SMILE) and femtosecond laser-assisted LASIK in different levels of myopia with the Ocular Response Analyzer (Reichert Ophthalmic Instruments, Depew, NY).

METHODS:

A total of 187 and 79 eyes that received SMILE or LASIK, respectively, between January and June 2013 at Zhongshan Ophthalmic Center were enrolled in this study. Patients were grouped according to surgery type (SMILE or LASIK) and −6.00 diopters (D) or less (⩽ −6.00 D) or myopia greater than −6.00 D (>−6.00 D). Corneal hysteresis, corneal resistance factor, and 37 waveform parameters were recorded and compared preoperatively and at 1 week and 1 and 3 months postoperatively.

RESULTS:

There was a significant decrease of corneal hysteresis, corneal resistance factor, p1area, and p2area, and an increase of path1 and path2 in both SMILE and LASIK. In myopia −6.00 D or less, the differences between SMILE and LASIK were not significant (
P
> .05), but in myopia greater than −6.00 D, the corneal hysteresis, corneal resistance factor, p1area, and p2area decreased significantly more in LASIK than in SMILE (
P
< .05).

CONCLUSIONS:

When comparing SMILE with LASIK, myopia was greater than −6.00 D, and the corneal hysteresis, corneal resistance factor, p1area, and p2area decrease was less after SMILE.

[
J Refract Surg
. 2014;30(10):702–707.]
Nueva especie del género Lestes Leach, 1815 (Insecta, Odonata) del Mioceno de Bellver de Cerdanya (Lérida)
Authors: Compte-Sart Arturo
Published: October 2014

Se describe la nueva especie fósil de insecto Lestes dianacompteae n. sp. del orden Odonata, perteneciente al género Lestes Leach, 1815, sobre un ala procedente del yacimiento de Coll de Saig, en Bellver de Cerdanya (Lérida, España), del piso Vallesiense (Mioceno). La especie es comparada con todas las fósiles del género Lestes y las actuales más parecidas de las regiones Paleártica y Etiópica.
Fitness difference between cryptic salinity-related phenotypes of sea bass (Dicentrarchus labrax)
Authors: Guinand Bruno , Quéré Nolwenn , Cerqueira Frédérique , Desmarais Erick , Bonhomme François
Published: October 2014

The existence of cryptic salinity-related phenotypes has been hypothesized in the “euryhaline” sea bass (Dicentrarchus labrax). How differential osmoregulation costs between freshwater and saltwater environments affect fitness and phenotypic variation is misunderstood in this species. During an experiment lasting around five months, we investigated changes in the whole body mass and in the expression of growth-related genes (insulin-like growth factor 1 [IGF-1]; growth hormone receptor [GHR]) in the intestine and the liver of sea bass thriving in sea water (SSW), successfully acclimated to freshwater (SFW), and unsuccessfully acclimated to freshwater (UFW). Albeit non-significant, a trend toward change in body mass was demonstrated among SSW, UFW and SFW fish, suggesting that SSW fish were a mixture of the other phenotypes. Several mortality peaks were observed during the experiment, with batches of UFW fish showing higher expression in the osmoregulatory intestine due to down-regulation of genes in the liver and significant up-regulation of GHR in the intestine compared with SFW fish. Energy investment toward growth or ion homeostasis hence partly mediates the fitness difference between cryptic SFW and UFW phenotypes. The use of a genetic marker located within the IGF-1 gene showed no genotype-phenotype relationship with levels of gene expression.
The nematode assemblage of a coastal lagoon (Lake Varano, southern Italy): ecology and biodiversity patterns
Authors: Semprucci Federica , Balsamo Maria , Frontalini Fabrizio
Published: October 2014

This study was conducted in Lake Varano (southern Italy) in order to determine the environmental parameters that influence nematode taxonomic and functional diversity and how they influence them, and to classify for the first time the ecological quality status of a transitional environment. The general composition and level of taxonomic diversity were comparable with those reported for transitional environments worldwide. Principal component analysis revealed that the main environmental factors controlling the assemblages in terms of both composition and biological traits were grain size, organic matter, pollution load index and, only secondarily, salinity. Molgolaimus allgeni, Terschellingia longicaudata and Leptolaimus luridus showed higher values in relation to silt, organic matter and pollution load index, while Axonolaimus caudostriatus, Odontophora wieseri, Paramonhystera pellucida and Paracanthonchus longicaudatus showed higher values in relation to the redox potential and sand percentage. Salinity was detected as an influencing parameter only secondarily and particularly for Calomicrolaimus honestus, Daptonema normandicum, Thalassomonhystera parva and Sabatieria pulchra. With respect to functional traits, the trophic groups seemed to be mainly related to sediment type, which is in turn reflected by the nature of the available food. The maturity index, as well as c-p classes, did not always permit a clear interpretation of the interaction between anthropogenic and natural factors. However, the greater influence of the San Antonino and San Francesco Canals was perfectly revealed by the nematode assemblage. In accordance with the current ecological quality classes, Lake Varano can mainly be classified as having good to poor ecological quality status.
Market Reactions to XBRL-Formatted Financial Information: Empirical Evidence from China
Authors: Peng Emma Y. , Shon John , Tan Christine
Published: October 2014

XBRL (eXtensible Business Reporting Language) facilitates the efficient processing/interpreting of corporate financial information by investors. This paper examines market reactions to financial statement filings in China in the period before and after the XBRL mandate in China to assess the extent to which XBRL may impact the processing of financial information. It finds that absolute price reactions of financial statement filings are larger (smaller) in the post-XBRL (pre-XBRL) period. This result holds for the cumulative 3-day window surrounding filings, as well as for each individual day during the event window. This paper also finds similar results for the average volume of trading around these event windows. Consistent with its expectations, its findings suggest XBRL financial statements play a significant role in investors' decision making process.
Understanding the Weak Performance of Technology in Urban Management
Authors: Simonneau Claire
Published: October 2014

The article questions the appropriation of existing urban planning and management tools in Sub-Saharan Africa, through a multiple case study: the implementation of a land information system (or simplified cadastre) in three cities in Benin. An ethnographic exploration of the use of the tool is conducted. The first section presents the historical context of the design of land information systems, framed by the urban management paradigm, and unwarranted confidence in new technologies. The second section presents the theoretical framework and the methodology of the research, inspired by public policy analysis and development anthropology. The third section describes findings of the multiple case studies. A vicious circle is highlighted, made up of: lack of political support, obsolescence, and decline of cost-effectiveness. The fourth section discusses the results of the ethnographic inquiry. These are, essentially, the interpretation of the paradoxes, blockages, and conflicts in the implementation of the tool in light of social, political and economic dynamics that take place at the local level, although unexpected by the creators of the tool.
Disability Issues and Planning Education
Authors: Moon Nathan W. , Baker Paul M.A. , Roy Robert G.B. , Bozzorg Ariyana
Published: October 2014

In the United States, planning education is frequently concerned with problems and solutions associated with the physical environment rather than socioeconomic barriers and solutions, including issues of workforce/workplace, community inclusion and participation, and e-democracy. Legislation such as the 1973 Rehabilitation Act and the 1990 Americans with Disabilities Act, generally place more emphasis on accessibility in the physical landscape than on social and economic barriers faced by people with disabilities. Through a longitudinal survey of selected university planning programs in the United States (in 2005 and again in 2013), this article discusses how the lack of attention to disability issues in planning literature may be linked to the education of planners and planning curricula. It also suggests possible areas of progress as an emerging group of planners have become concerned with the role of technologies such as telecommuting in facilitating the inclusion of people with disabilities into the social environment.
On the Updating of Domain OWL Models at Runtime in Factory Automation Systems
Authors: Puttonen Juha , Lobov Andrei , Lastra José L. Martinez
Published: October 2014

Software agents controlling production devices must maintain an up-to-date view of the physical world state in order to efficiently reason and plan their actions. Especially in a factory automation system, the world state undergoes rapid evolution. To enable accurate decision-making, the world view must constantly be synchronized with the changes. This paper discusses two approaches to updating the world view based on event notifications sent by web services representing production devices in a manufacturing system. One approach requires that a set of update rules is separately specified, whereas the other involves automatically deriving the update rules from the semantic web service descriptions. While this paper specifically focuses on the factory automation domain, both of the approaches presented are applicable to other domains as well. The main assumptions are that the domain is composed of world-altering web services, which provide adequate service interfaces to detect changes in their state, and that all relevant changes in the overall domain state can be directly derived from the service state changes.
A Novel Physics Inspired Approach for Web Service Composition
Authors: Ahmed Tanveer , Srivastava Abhishek
Published: October 2014

Service oriented architecture has revolutionized the way a traditional business process is executed. The success of this architecture is Indue to the composition of multiple heterogeneous services at runtime. Web service composition is a mechanism where several web services are combined at runtime to build a complex application for a user. It is one of the most sought after processes in the context of semantic web. But, composition of web services at runtime is a difficult task owing to the availability of multiple service providers offering the same functionality. The process if exasperated by due conflicting preferences of a service consumer. In this paper, the authors address the issue of selecting a service based on Quality of Service (QoS) attributes. They utilize concepts customized from physics to create an environment that facilitates the selection of a best service from the set of similar services. The technique not only facilitates the selection of the service with the best QoS attributes, but distributes the load among expeditiously. Here in this paper, the authors concentrate on minimizing and equitably balancing the waiting time for a user. They conduct in silico experiments on multiple workflows to demonstrate the efficacy of the proposed technique to balance load efficiently among similar service offerings.
Improving Context Aware Recommendation Performance by Using Social Networks
Authors: Boroujeni Golshan Assadat Afzali , Golpayegani Seyed Alireza Hashemi
Published: October 2014

Ecommerce systems employ recommender systems to enhance the customer loyalty and hence increasing the cross-selling of products. In collaborative filtering—as the most popular method in recommender systems—an implicit network is formed among all the people. In any network, there are some individuals who have some inspirational power over the others leading them to influence their decisions and behaviours. But it seems that these methods do not support context awareness in mobile commerce environments. Furthermore, they lack high accuracy and also require high volume of computations due to not distinguish between neighbours as a friend or a stranger. This paper proposes a new model for recommender systems which are based on mobile data. This model uses these data to extract current users' context and also to identify individuals with the highest influence. Then, the system uses the information of these identified impressive users in the current context existed in the social networks for making recommendations. Beside of achieving higher accuracy, the proposed model has resolved cold start problem in collaborative filtering systems.
Multi-Disciplinary Research Issues in Cloud Computing
Authors: Singh Jitendra , Kumar Vikas
Published: October 2014

Cloud computing, characterized by on demand availability of resources is gaining a lot of popularity in the present day business scenario. This new computing paradigm is predicted to revolutionize the Information Technology industry with its dynamic and scalable capabilities. Cloud computing is catering to the needs of a wide variety of users, across the different parts of the world with its huge number of offerings. Information technology resources are offered as services over the Internet, which leads to a number of technical and management concerns. Data is stored away from the users' premises, leading to various challenges in maintaining security, privacy and regulatory compliances. Therefore, cloud computing does not involve single discipline rather multi-discipline. Considering this multi-disciplinary involvement, current work focuses on identification of research issues in the cloud computing environment, and categorizing these issues in the technical, legal and management domains. Work further discusses the multi-disciplinary research areas where cloud computing is currently focused and suggests the potential areas for further research.
Information Attacks on Online Social Networks
Authors: Franchi Enrico , Poggi Agostino , Tomaiuolo Michele
Published: October 2014

Online social networks have changed the way people interact, allowing them to stay in touch with their acquaintances, reconnect with old friends, and establish new relationships with other people based on hobbies, interests, and friendship circles. Unfortunately, the regrettable concurrence of the users' carefree attitude in sharing information, the often sub-par security measures from the part of the system operators and, eventually, the high value of the published information make online social networks an interesting target for crackers and scammers alike. The information contained can be used to trigger attacks to even more sensible targets and the ultimate goal of sociability shared by the users allows sophisticated forms of social engineering inside the system. This work reviews some typical social attacks that are conducted on social networking systems, carrying real-world examples of such violations and analysing in particular the weakness of password mechanisms. It then presents some solutions that could improve the overall security of the systems.
Dendritic Cell Maturation and Survival Are Differentially Regulated by TNFR1 and TNFR2
Authors: Maney Nicola J. , Reynolds Gary , Krippner-Heidenreich Anja , Hilkens Catharien M. U.
Published: October 2014

The capacity of dendritic cells (DC) to regulate adaptive immunity is controlled by their maturation state and lifespan. Although TNF is a well-known maturation and survival factor for DC, the role of the two TNFR, TNFR1 and TNFR2, in mediating these effects is poorly understood. By using unique TNF variants that selectively signal through TNFR1 and/or TNFR2, we demonstrate differential functions of TNFR in human monocyte-derived and blood CD1c+ DC. Activation of TNFR1, but not TNFR2, efficiently induced DC maturation, as defined by enhanced expression of cell surface maturation markers (CD83, CD86, and HLA-DR) as well as enhanced T cell stimulatory capacity. In contrast, both TNFR1 and TNFR2 significantly protected DC against cell death, indicating that innate signals can promote DC survival in the absence of DC maturation. We further show differential activation of NF-κB signaling pathways by the TNFR: TNFR1 activated both the p65 and p52 pathways, whereas TNFR2 triggered p52, but not p65, activation. Accordingly, the p65 NF-κB pathway only played a role in the prosurvival effect of TNFR1. However, cell death protection through both TNFR was mediated through the Bcl-2/Bcl-xL pathway. Taken together, our data show that TNFR1, but not TNFR2, signaling induces DC maturation, whereas DC survival can be mediated independently through both TNFR. These data indicate differential but partly overlapping responses through TNFR1 and TNFR2 in both inflammatory and conventional DC, and they demonstrate that DC maturation and DC survival can be regulated through independent signaling pathways.
Antigen-Specific Immunotherapeutic Vaccine for Experimental Autoimmune Myasthenia Gravis
Authors: Luo Jie , Lindstrom Jon
Published: October 2014

Myasthenia gravis (MG) and experimental autoimmune myasthenia gravis (EAMG) are caused by Ab-mediated autoimmune responses to muscle nicotinic acetylcholine receptors (AChRs) that impair neuromuscular transmission, thereby causing muscle weakness. Previously, we discovered that i.p. injection of a therapeutic vaccine consisting of bacterially expressed cytoplasmic domains of human AChR subunits reduced the development of chronic EAMG in rats. In this article, we show that immunization with the therapeutic vaccine in adjuvants does not induce EAMG and, thus, is safe. The potency and efficacy of the therapeutic vaccine were greatly increased by s.c. administration of repeated low doses in IFA. Onset of chronic EAMG could be prevented. Established chronic EAMG could be rapidly reversed, modeling therapy of chronic MG. Therapy reduced pathological Abs assayed by immune precipitation of a main immunogenic region chimera. Successfully treated rats exhibited long-term resistance to reinduction of EAMG, suggesting a lasting cure of MG. A long-term effect of therapy was to change the isotype of the pathogenic Ab response from IgG2b, which fixes complement, to IgG1, which does not. Prevention and reversal of chronic EAMG was not caused by the isotype switch, but the isotype switch may contribute to resistance to reinduction of EAMG. Immunization with AChR cytoplasmic domains in adjuvant is promising as a safe, Ag-specific, potent, effective, rapidly acting, and long-lasting therapeutic approach to MG.
Using Wind Tunnel Tests for Slung-Load Clearance, Part 2: Other Loads
Authors: Raz Reuben , Rosen Aviv , Cicolani Luigi S. , Lusardi Jeffery , Gassaway Bryan , Thompson Tom
Published: October 2014

The first new load is the TRIO container that can be flown in three configurations with different heights. The second new load is a ribbon bridge interior bay section. Wind tunnel results with models of the new loads exhibit in general good agreement with flight-test results. The results
of the new loads strengthen further the approach of using wind tunnel tests to accelerate slung-load clearance, as well as reduce risk and cost.
Combination of glucose transporter inhibitors and oestrone analogues on breast cancer cells
Authors: Van Tonder A. , Joubert A.J. , Cromarty A.D.
Published: October 2014

Combinations of chemotherapeutic agents are commonly used in the clinical setting as this allows for a reduction in the dose of each agent, and thus reduced toxicity, with increased therapeutic efficacy. This study proved the feasibility of synergy between two novel oestrone analogues and GLUT inhibitors. The synergistic combinations which have been identified indicate that the different molecular subtypes of breast cancer, as represented by the cell lines used, respond differently to the combination therapy. These differences will be further investigated.
Engineered microRNA therapeutics
Authors: Gibson NW
Published: October 2014

Targeting of microRNAs that are overexpressed or replacement of microRNAs whose expression is lost are two distinct and novel approaches to treat disease(s) driven by microRNA dysregulation. This can be achieved by chemical modification of either a single stranded oligonucleotide called an antimiR or a double stranded nucleic acid molecule termed a microRNA mimic. With hundreds of microRNAs identified and knowledge of their role in disease becoming clearer there is the prospect, over the coming years, to harness engineered microRNA therapeutics to revolutionise the way diseases are treated. Both types of engineered microRNA therapeutics have advanced into clinical development with human proof of concept achieved with an anti-miR targeting miR-122 (one of the most abundant microRNAs in human hepatocytes that is utilised by the hepatitis C virus to enable its function and replication). Rather than targeting individual proteins or enzymes involved in human disease, an opportunity now exists to modulate multiple different proteins/enzymes which act in concert in the progression of disease.
Feeding decisions in advanced dementia
Authors: Harwood RH
Published: October 2014

When close to death, people stop eating. In neurodegenerative conditions swallowing may become unsafe, and artificial nutrition and hydration (ANH) may be proposed or requested. But nutrition is surrounded by other considerations: opportunity, help, environment, enjoyment, mood, social being and symbolic importance. Poor care or deliberate attempts to end life might also result in poor nutrition and dehydration.

Decisions about ANH are open to conventional ethical analysis and subject to mental capacity law. Most people with appetite or swallowing failure have advanced dementia and lack capacity. Determining someone’s best interests means considering values and preferences, previous and current wishes, and requires consultation with families and other carers.

Short-term prognosis is difficult to judge in non-malignant conditions. We often do not know the views of the individual. Moreover, we are unsure if ANH can achieve the goals intended of it – there is little evidence that tube feeding prolongs life, prevents aspiration or improves wellbeing.

Palliative care and best practice dementia care have much in common. Open communication, good relationships with families and carers, skilled approaches to problems and respect for individuals and their diversity. Modified oral feeding will be appropriate for most; ANH is rarely appropriate, but some individuals and their families feel differently. Careful assessment for potentially treatable causes of swallowing and appetite problems, honest communication about uncertainties over prognosis and the impact of interventions and ascertainment of individuals’ values and beliefs make for better care for people with dementia and better decisions about feeding.
Tratamento biológico de formaldeído: toxicidade residual monitorada por bioensaios com Daphnia similis
Authors: Nour Edson Aparecido Abdul , Candello Fernando Pena , Dos Santos Eloisa Maria dos Reis , Barretto Angela dos Santos , Domingues Ligia Maria
Published: October 2014

Formaldeído é encontrado naturalmente no ambiente e pode atingir concentrações de até 4000 mg L-1 em efluentes industriais. Embora germicida, pesquisas indicam sua possível degradação biológica em sistemas de tratamento, destacando-se os reatores com biomassa aderida e metabolismo aeróbio ou anaeróbio. Esse estudo verifica a eficiência físico-química e capacidade de redução da concentração de formaldeído adicionado a esgoto sanitário no tratamento biológico combinado (anaeróbio e aeróbio), e avalia a toxicidade aguda residual ao microcrustáceo Daphnia similis, em amostras de sistema composto por filtro anaeróbio (FA), biofiltro aerado submerso (BAS), ambos de leito fixo e fluxo ascendente, seguido de decantador secundário, nas fases: formaldeído afluente: 200 mg L-1 (F1: 7 bioensaios) e 400 mg L-1 (F2: 8 bioensaios). A eficiência de remoção de DQO e DBO foi de 93±4% e 97±2% (F1) e 93±7% e 99±1% (F2), respectivamente; a redução de formaldeído foi de 100% (F1) e 99,8±0,3% (F2). A toxicidade aguda (CE50-48h) foi de 7,22% e 3,40% (afluente), >67% e >60% (efluente FA), para F1 e F2, respectivamente. O efluente final não apresentou toxicidade aguda, comprovando a robustez do sistema combinado e a importância de tecnologias que visam à destinação adequada de resíduos e à proteção da vida aquática.
Construction of merged satellite total O3 and NO2 time series in the tropics for trend studies and evaluation by comparison to NDACC SAOZ measurements
Authors: Pastel M. , Pommereau J.-P. , Goutail F. , Richter A. , Pazmiño A. , Ionov D. , Portafaix T.
Published: October 2014

Abstract. Long time series of ozone and NO2 total column measurements in the southern tropics are available from two ground-based SAOZ (Système d'Analyse par Observation Zénithale) UV-visible spectrometers operated within the Network for the Detection of Atmospheric Composition Change (NDACC) in Bauru (22° S, 49° W) in S-E Brazil since 1995 and Reunion Island (21° S, 55° E) in the S-W Indian Ocean since 1993. Although the stations are located at the same latitude, significant differences are observed in the columns of both species, attributed to differences in tropospheric content and equivalent latitude in the lower stratosphere. These data are used to identify which satellites operating during the same period, are capturing the same features and are thus best suited for building reliable merged time series for trend studies. For ozone, the satellites series best matching SAOZ observations are EP-TOMS (1995–2004) and OMI-TOMS (2005–2011), whereas for NO2, best results are obtained by combining GOME version GDP5 (1996–2003) and SCIAMACHY – IUP (2003–2011), displaying lower noise and seasonality in reference to SAOZ. Both merged data sets are fully consistent with the larger columns of the two species above South America and the seasonality of the differences between the two stations, reported by SAOZ, providing reliable time series for further trend analyses and identification of sources of interannual variability in the future analysis.
A case study of gravity wave dissipation in the polar MLT region using sodium LIDAR and radar data
Authors: Takahashi T. , Nozawa S. , Tsutsumi M. , Hall C. , Suzuki S. , Tsuda T. T. , Kawahara T. D. , Saito N. , Oyama S. , Wada S. , Kawabata T. , Fujiwara H. , Brekke A. , Manson A. , Meek C. , Fujii R.
Published: October 2014

Abstract. This paper is primarily concerned with an event observed from 16:30 to 24:30 UT on 29 October 2010 during a very geomagnetically quiet interval (Kp ≤ 1). The sodium LIDAR observations conducted at Tromsø, Norway (69.6° N, 19.2° E) captured a clearly discernible gravity wave (GW) signature. Derived vertical and horizontal wavelengths, maximum amplitude, apparent and intrinsic period, and horizontal phase velocity were about ~ 11.9 km, ~ 1.38 × 103 km, ~ 15 K, 4 h, ~ 7.7 h, and ~ 96 m s−1, respectively, between a height of 80 and 95 km. Of particular interest is a temporal development of the uppermost altitude that the GW reached. The GW disappeared around 95 km height between 16:30 and 21:00 UT, while after 21:00 UT the GW appeared to propagate to higher altitudes (above 100 km). We have evaluated three mechanisms (critical-level filtering, convective and dynamic instabilities) for dissipations using data obtained by the sodium LIDAR and a meteor radar. It is found that critical-level filtering did not occur, and the convective and dynamic instabilities occurred on some occasions. MF radar echo power showed significant enhancements between 18:30 and 21:00 UT, and an overturning feature of the sodium mixing ratio was observed between 18:30 and 21:20 UT above about 95 km. From these results, we have concluded that the GW was dissipated by wave breaking and instabilities before 21:00 UT. We have also investigated the difference of the background atmosphere for the two intervals and would suggest that a probable cause of the change in the GW propagation was due to the difference in the temperature gradient of the background atmosphere above 94 km.
Drought in forest understory ecosystems – a novel rainfall reduction experiment
Authors: Gimbel K. F. , Felsmann K. , Baudis M. , Puhlmann H. , Gessler A. , Bruelheide H. , Kayler Z. , Ellerbrock R. H. , Ulrich A. , Welk E. , Weiler M.
Published: October 2014

Abstract. Climate change is predicted to severely affect precipitation patterns across central Europe. This may reduce water availability during the plant-growing season and hence affect the performance and vitality of forest ecosystems. We established a novel rainfall reduction experiment on nine sites in Germany to investigate drought effects on soil-forest-understory-ecosystems. A realistic, but extreme annual drought with a return period of 40 years, which corresponds to the 2.5% percentile of the annual precipitation, was imposed. At all sites, we were able to reach the target values of rainfall reduction, while other important ecosystem variables like air temperature, humidity and soil temperature remained unaffected due to the novel design of a flexible roof. The first year of drought showed considerable changes in the soil moisture dynamics relative to the control sites, which affected leaf stomatal conductance of understory species as well as evapotranspiration rates of the forest understory.
Chemical and U–Sr isotopic variations in stream and source waters of the Strengbach watershed (Vosges mountains, France)
Authors: Pierret M. C. , Stille P. , Prunier J. , Viville D. , Chabaux F.
Published: October 2014

Abstract. This is the first comprehensive study dealing with major and trace element data as well as 87Sr/86Sr isotope and (234U/238U) activity ratios (AR) determined on the totality of springs and brooks of the Strengbach catchment. It shows that the small and more or less monolithic catchment drains different sources and streamlets with very different isotopic and geochemical signatures. Different parameters control the diversity of the source characteristics. Of importance is especially the hydrothermal overprint of the granitic bedrock, which was stronger for the granite from the northern slope; also significant are the different meteoric alteration processes of the bedrock causing the formation of 0.5 to 9 m thick saprolite and above the formation of an up to 1m thick soil system. These processes mainly account for springs and brooks from the northern slope having higher Ca / Na, Mg / Na, and Sr / Na ratios, but lower 87Sr/86Sr isotopic ratios than those from the southern slope. The chemical compositions of the source waters in the Strengbach catchment are only to a small extent the result of alteration of primary bedrock minerals, and rather reflect dissolution/precipitation processes of secondary mineral phases like clay minerals. The (234U/238U) AR, however, are decoupled from the 87Sr/86Sr isotope system, and reflect to some extent the level of altitude of the source and, thus, the degree of alteration of the bedrock. The sources emerging at high altitudes have circulated through already weathered materials (saprolite and fractured bedrock depleted in 234U), implying (234U/238U) AR below 1, which is uncommon for surface waters. Preferential flow paths along constant fractures in the bedrocks might explain the – over time – homogeneous U AR of the different spring waters. However, the geochemical and isotopic variations of stream waters at the outlet of the catchment are controlled by variable contributions of different springs, depending on the hydrological conditions. It appears that the (234U/238U) AR are a very appropriate, important tracer for studying and deciphering the contribution of the different source fluxes at the catchment scale, because this unique geochemical parameter is different for each individual spring and at the same time remains unchanged for each of the springs with changing discharge and fluctuating hydrological conditions. This study further highlights the important impact of different and independent water pathways on fractured granite controlling the different geochemical and isotopic signatures of the waters. Despite the fact that soils and vegetation cover have a great influence on the water cycle balance (evapotranspiration, drainage, runoff), the chemical compositions of waters are strongly modified by processes occurring in deep saprolite and bedrock rather than in soils along the specific water pathways.
In vitro Air Removal Characteristics of Two Neonatal Cardiopulmonary Bypass Systems: Filtration May Lead to Fractionation of Bubbles
Authors: Stehouwer Marco C. , Kelder Johannes C. , van Oeveren Willem , de Vroege Roel
Published: October 2014

Introduction of gaseous microemboli (GME) into the arterial line of a pediatric cardiopulmonary bypass (CPB) circuit may lead to cognitive decline and adverse outcomes of the pediatric patient. Arterial filters are incorporated into CPB circuits as a safeguard for gross air and to reduce GME. Recently, arterial filters were integrated in two neonatal oxygenators to reduce volume and foreign surface area.

In this study a clinical CPB scenario was simulated. The oxygenators, the corresponding venous reservoirs and the complete CPB circuits were compared regarding air removal and bubble size distribution after the introduction of an air bolus or GME.

During a GME challenge, the Capiox FX05 oxygenator removed a significantly higher volume of GME than the QUADROX-i Neonatal oxygenator (97% vs. 86%). Detailed air removal characteristics showed that more GME in the range of 20-50 μm were leaving the devices than were entering. This phenomenon seems to be more present in the Capiox FX05. The circuits were also challenged with an air bolus. Each individual component tested removed 99.9%, which resulted in an air volume reduction of 99.99% by either complete CBP circuit.

Overall, we conclude that both CPB systems were very adequate in removing GME and gross air. The air removal properties of both systems are considered safe and reliable.

Detailed GME distribution data show that the Capiox FX05 showed more small GME (<50 μm) due to fractionation of larger GME when compared to the QUADROX-i Neonatal. We may conclude that filtration may lead to fractionation.
Hydraulic and Hemodynamic Performance of a Minimally Invasive Intra-arterial Right Ventricular Assist Device
Authors: Hsu Po-Lin , Graefe Roland , Boehning Fiete , Wu Chen , Parker Jack , Autschbach Rüdiger , Schmitz-Rode Thomas , Steinseifer Ulrich
Published: October 2014

Right ventricular assistance is still in the early phase of development compared to left ventricular assist device (LVAD) technology. In order to provide flexible pulmonary support and potentially reduce the known complications, we propose a minimally invasive right ventricular assist device (MIRVAD), located in the pulmonary artery (PA) and operating in series with the right ventricle (RV).

The MIRVAD is an intra-arterial rotary blood pump containing a single axial impeller, which is not enclosed by a rigid housing but stent-fixed within the vessel. The impeller geometry has been designed with the assistance of analytical methods and computational fluid dynamics (CFD). The hydraulic performance of the impeller was evaluated experimentally with a customized test setup using blood synthetic medium (HES). The blade-tip clearance (BTC) was varied between 0.25-4.25 mm to evaluate the effect of different PA sizes on impeller performance. Furthermore, the Langrangian particle-tracking method was used to estimate the level of hemolysis and generate numerical blood damage indexes.

The impeller design generated 25.6 mmHg for flow rates of 5 lpm at a speed of 6,000 rpm at the baseline condition, capable of providing sufficient support for the RV. The BTC presented a significant effect on the static pressure generation and the efficiency, but the operational range is suitable for most vessel sizes. The numerical results demonstrated a low risk of blood damage at the design point (mean Lagrangian damage index 2.6 * 10-7). The preliminary results have encouraged further impeller optimization and development of the MIRVAD.
Pore Size – a Key Property for Selective Toxin Removal in Blood Purification
Authors: Harm Stephan , Falkenhagen Dieter , Hartmann Jens
Published: October 2014

Purpose

Extracorporeal blood purification systems based on combined membrane/adsorption technologies are used in acute liver failure to replace detoxification as well as to remove inflammatory mediators in sepsis patients. In addition to coating and chemical modification of the surface, pore size significantly controls the selectivity of adsorption materials.

Methods

This study addresses the adsorption of albumin bound liver toxins, cytokines, and representative plasma compounds on three adsorbents which differ only in pore size distribution. All three adsorbents are based on hydrophobic poly(styrene-divinylbenzene) copolymer matrices and have mean pore sizes of 15, 30, and 100 nm.

Results

The pores of adsorbents act as molecular sieves and prevent the entry of molecules that are larger than their molecular cut-off. The results of this study reveal that adsorbents based on styrene-divinylbenzene polymers with 15 nm pores are suitable for cytokine removal, and the same adsorbents with 30-40 nm pores are the best choice for the removal of albumin-bound toxins in the case of liver failure. Adsorbents with very large pores lack selectivity which leads to uncontrolled adsorption of all plasma proteins. Therefore, hydrophobic adsorbents with large pores offer inadequate plasma compatibility and do not fulfill the requirements for blood purification.

Conclusions

Biocompatibility and efficiency of adsorbents used for blood purification can improved by fine tuning of adsorbent surface pore distributions.
Factors Affecting Kenya Alpine Dairy Goat Milk Production in Nyeri Region
Authors: Monica Mburu , Beatrice Mugendi , Anselimo Makhoka , Simon Muhoho
Published: October 2014

In Kenya use of exotic dairy goats in breeding programmes for smallholder production systems has become popular, but information on the milk production is scarce. A study was carried out to assess the milk yield of dairy goats reared in high potential and semi arid areas of Nyeri County. This involved 190 smallholder farmers rearing Alphine dairy goats in Nyeri County and registered with Dairy Goat association of Kenya (DGAK). Which formed 100% sampling of the population under study. The grade, feeding practices and age of the dairy goats were evaluated. The dairy goat average milk production was 1.90 litres per day, with the appendix grade in Kieni East giving the highest production of 2.69 liters per day while foundation grade in Mukurweini gave the lowest, 0.98 litres per day. The higher milk production in Kieni East, which is a semi arid area, was noted to be due to good feeding practices where 43% of the farmers used concentrates during milking and also 48% supplemented the feed with minerals. In the high potential area of Mukurweini none of the farmers used mineral supplements with only 5% using concentrates during milking. The age of the dam significantly affected the average milk production, with the onset of production being the age of 2.0 years, reaching the peak at the age of 6.5 years. Kieni East, gave the highest production of 4.2 litres at the age of 6 years. The results demonstrated that the low-input farming conditions affected the Alphine goats milk production.