bluuebunny/crossref_metadata_2025_split huggingface dataset:
On Probability Distributions of the Operational Law of Container Liner Ships
Authors: Song Yunting , Wang Nuo 
Published: March 2019

SummaryThe probability distribution of the operational law of container liner ships in port is the significant theoretical basis for the study of container liners and ports, but there has been a lack of corresponding statistical analysis and theoretical research on that distribution since maritime container transportation came into being. The main purpose of this paper is to identify probabilistic models of the operational law of container liners by statistically analysing the operation data collected from Dalian, Kaohsiung and Rotterdam ports. The results demonstrate that both the interarrival time and the handling time of container liner ships follow higher order Erlang distributions. Under the combined influence of schedule constraints and the interference of some uncertain factors, container liners run between randomness and certainty, presenting the same feature as higher order Erlang distributions. In addition, the world container trade in container ports is subject to similar operational rules and time limits, so it is reasonable to deduce that the above conclusion could be generalized to other container ports. Finally, this paper quantitatively evaluates the degree of port congestion under various probabilistic models, which shows that the study not only has theoretical significance but also values in application.
Stress coping styles among anaesthesiology and intensive care unit personnel – links to the work environment and personal characteristics: a multicentre survey study
Authors: Kwiatosz‐Muc Magdalena , Fijałkowska‐Nestorowicz Anna , Fijałkowska Magdalena , Aftyka Anna , Pietras Paulina , Kowalczyk Michał 
Published: March 2019

BackgroundHigh levels of stress among anaesthesiology and intensive care unit workers are commonly reported. Personnel in these units are prone to stress because of specific characteristics of their work. Their development of skills to cope with stress may affect their psychophysical condition and, consequently, patient safety.ObjectivesThe aim of this study was to define the coping styles of anaesthesiology and intensive care unit personnel and to evaluate the connections between the work environment as well as personal characteristics and the dominant coping styles.MethodsAnaesthesiology and intensive care unit personnel from 15 selected Polish hospitals were surveyed using the Coping Inventory for Stressful Situations, which examines task‐oriented coping, emotion‐oriented coping and avoidance‐oriented coping. The Perceived Stress Scale was used to assess stress levels.ResultsThe analysis included 425 successfully completed surveys. The examined population was divided into two groups: Group N comprised 311 nurses (73.18%) and group P comprised 114 physicians (26.82%). For 167 participants (39.29%), the dominant coping style was defined. The most common style was the task‐oriented coping style; it was dominant in 96 participants (22.58% of the entire examined population). This style was significantly predominant among men. The domination of some coping styles coexisted with marital status, number of children and financial situation. The occurrence of different coping styles did not significantly differ among workers at different‐sized hospitals, with different job seniority or with different living locations. Perceived stress was correlated with all coping styles.ConclusionsWork‐related stress among anaesthesiology and intensive care unit workers is an important problem. Further investigations of stress levels and the causes and effects of stress in this population are necessary.
The relationship of postpartum sleep quality and breastfeeding self‐efficacy of Turkish mothers
Authors: Aksu Aslıhan , Vefikulucay Yilmaz Duygu 
Published: March 2019

IntroductionBreastfeeding self‐efficacy reflects the mother's confidence regarding breastfeeding, and it positively affects breastfeeding. Traditionally, people attach importance to breastfeeding in Turkey and the vast majority of mothers breastfeed their babies. It is a known fact that mothers feel sleepless and tired in the postpartum period reduces the amount of secreted milk. However, it is not known whether there is a relationship between the perception of breastfeeding self‐efficacy which positively affects breastfeeding and sleep quality of the mothers in this period.AimThis study was conducted in order to determine the relationship between sleep quality and breastfeeding self‐efficacy of the mothers in the postpartum period.Materials and methodsThis descriptive study included 128 primiparous women who had vaginal deliveries from 2 January to 27 May 2018 in a public obstetrics and children's hospital in Mersin. The data of the research were gathered with a questionnaire intended for collecting the sociodemographic characteristics of mothers who completed their second week in the postpartum period, Postpartum Sleep Quality Scale intended for determining their sleep quality and Breastfeeding Self‐efficacy Scale intended for determining their breastfeeding self‐efficacy. The data obtained were assessed with the Pearson correlation coefficient to determine the relationship between the descriptive statistics and two continuous variables.ResultsThe mean score gotten by the mothers from Postpartum Sleep Quality Scale and Breastfeeding Self‐efficacy Scale was determined to be ‘33.57 ± 11.26’ and ‘46.82 ± 14.89’, respectively. A strong relationship in the negative direction was detected between the scores gotten from Postpartum Sleep Quality Scale and Breastfeeding Self‐efficacy Scale (p < 0.01).ConclusionsAs a result of the research, it was determined that as the sleep quality of mothers in the postpartum period increases their breastfeeding self‐efficacy increases as well. In the light of the results obtained, it is suggested that nurses, being aware that there is a strong relationship between sleep quality and breastfeeding self‐efficacy in the postpartum period, should pay more attention to the role of education and counselling in these subjects. In addition, it is recommended that nurses make attempts intended for improving the sleep quality of primiparous individuals in order to increase their self‐efficacy of breastfeeding.
Evolution of an ancient (Lower Cretaceous) marginal‐marine system from tide‐dominated to wave‐dominated deposition, McMurray Formation
Authors: Weleschuk Zennon P. , Dashtgard Shahin E. 
Published: March 2019

AbstractRegionally extensive parasequences in the upper McMurray Formation, Grouse Paleovalley, north‐east Alberta, Canada, preserve a shift in depositional processes in a paralic environment from tide domination, with notable fluvial influence, through to wave domination. Three stacked parasequences form the upper McMurray Formation and are separated by allogenic flooding surfaces. Sediments within the three parasequences are grouped into three facies associations: wave‐dominated/storm‐dominated deltas, storm‐affected shorefaces to sheltered bay‐margin and fluvio‐tidal brackish‐water channels. The two oldest parasequences comprise dominantly tide‐dominated, wave‐influenced/fluvial‐influenced, shoreface to bay‐margin deposits bisected by penecontemporaneous brackish‐water channels. Brackish‐water channels trend approximately north‐west/south‐east, which is perpendicular to the interpreted shoreline trend; this implies that the basinward and progradational direction was towards the north‐west during deposition of the upper McMurray Formation in Grouse Paleovalley. The youngest parasequence is interpreted as amalgamated wave‐dominated/storm‐dominated delta lobes. The transition from tide‐dominated deposition in the oldest two parasequences to wave‐dominated deposition in the youngest is attributed mainly to drowning of carbonate highlands to the north and north‐west of the study area, and potentially to relative changes in accommodation space and deposition rate. The sedimentological, ichnological and regional distribution of the three facies associations within each parasequence are compared to modern and Holocene analogues that have experienced similar shifts in process dominance. Through this comparison it is possible to consider how shifts in depositional processes are expressed in the rock record. In particular, this study provides one of few ancient examples of preservation of depositional process shifts and showcases how topography impacts the character and architecture of marginal‐marine systems.
Why do lung transplant patients discontinue triazole prophylaxis?
Authors: Pennington Kelly M. , Razonable Raymund R. , Peters Steve , Scott John P. , Wylam Mark , Daly Richard C. , Kennedy Cassie C. 
Published: March 2019

AbstractBackgroundLung transplant recipients are prone to invasive fungal infections prompting many transplant centers to use prolonged triazole antifungal prophylaxis. From a practical standpoint, it is unclear if lung transplant recipients are able to continue prolonged or lifelong prophylaxis without premature discontinuation from side effects, drug interactions, development of fungal disease, or medication cost. We examined the number of patients that are able to reach a prophylactic endpoint and understand the reasons for early termination.MethodsWe conducted a retrospective chart review of all lung and heart‐lung transplant patients at Mayo Clinic Rochester from May 1, 2002 to December 31, 2017. Type, duration, and reason for discontinuation of triazole prophylaxis were examined.ResultsDuring the study period, 193 patients underwent lung or heart‐lung transplantation. Itraconazole, voriconazole, and posaconazole were given to 180, 73, and 60 post‐transplant patients, respectively. Providers switched itraconazole to another prophylactic antifungal medication for reasons other than prophylactic completion in 61.8% (126 out of 204) of exposure episodes; this was similar with voriconazole (68.8%, 53 out of 77, P = 0.41). Posaconazole was actively discontinued significantly less often (18.3%, 11 out of 60, P < 0.05). The most common reasons for discontinuing itraconazole were malabsorption (15.5% of exposure episodes) and concern for breakthrough fungal infection (10.2%). In comparison, the most common reason for voriconazole discontinuation was side effect or intolerance (54.5% of VR exposure episodes vs 9.8% of IT exposure episodes, P < 0.05).ConclusionsItraconazole and posaconazole appeared to have fewer side effects prompting discontinuation than voriconazole, but itraconazole was discontinued more often because of malabsorption and clinical suspicion of fungal infections.
MRI of osteosarcoma metastases in the brain of an old English Sheepdog
Authors: Toni Cristina , Ricco Cristoforo , Erles Kerstin , Griffin Sally , Carrera Inés 
Published: March 2019

AbstractA 9‐year‐old, male neutered old English Sheepdog was presented for further investigation of altered mentation, impaired vision, and hemineglect syndrome of 10 days duration. An MRI study of the brain revealed multifocal, contrast‐enhancing intra‐axial lesions that had a stippled hypointense appearance in all sequences but lacked evidence of a strong signal void on T2* images. Histological examination of the brain postmortem confirmed the lesions were metastases arising from an osteosarcoma, which was later identified in the right humerus. To the authors’ knowledge, these MRI characteristics of osteosarcoma metastases in the canine brain have not been previously reported.
Regulation of GLUT4 translocation in an in vitro cell model using postprandial human serum ex vivo
Authors: Cogan Karl E. , Carson Brian P. , Patel Bijal , Amigo‐Benavent Miryam , Jakeman Philip M. , Egan Brendan 
Published: March 2019

New Findings
What is the research question?
This study used a new experimental model, in which culture medium is conditioned with human serum ex vivo, to investigate nutrient‐mediated regulation of GLUT4 translocation in skeletal muscle cells in vitro.

What is the main finding and importance?
Human serum stimulated GLUT4 translocation, an effect differentially modulated by whether the culture medium was conditioned with serum from fasted subjects or with serum collected after feeding of intact or hydrolysed whey protein. Conditioning cell culture medium with human serum ex vivo represents a new approach to elucidate the effects of ingesting specific nutrients on skeletal muscle cell metabolism.

AbstractIndividual amino acids, amino acid mixtures and protein hydrolysates stimulate glucose uptake in many experimental models. To replicate better in vitro the dynamic postprandial response to feeding in vivo, in the present study we investigated the effects of culture media conditioned with fasted and postprandial human serum on GLUT4 translocation in L6‐GLUT4myc myotubes. Serum samples were collected from healthy male participants (n = 8) at baseline (T0), 60 (T60) and 120 min (T120) after the ingestion of 0.33 g (kg body mass)−1 of intact (WPC) or hydrolysed (WPH) whey protein and an isonitrogenous non‐essential amino acid (NEAA) control. L6‐GLUT4myc myotubes were starved of serum and amino acids for 1 h before incubation for 1 h in medium containing 1% postprandial human serum, after which GLUT4 translocation was determined via colorimetric assay. Medium conditioned with fasted human serum at concentrations of 5–20% increased cell surface GLUT4myc abundance. Incubation with serum collected after the ingestion of WPH increased cell surface GLUT4myc at T60 relative to T0 [mean (lower, upper 95% confidence interval)]; [1.13 (1.05, 1.22)], whereas WPC [0.98 (0.90, 1.07)] or NEAA [1.02 (0.94, 1.11)] did not. The differential increases in cell surface GLUT4myc abundance were not explained by differences in serum concentrations of total, essential and branched‐chain amino acids or insulin, glucagon‐like peptide 1 (GLP‐1) and gastric inhibitory polypeptide (GIP). Using a new ex vivo, in vitro approach, cell culture medium conditioned with postprandial serum after the ingestion of a whey protein hydrolysate increased GLUT4 translocation in skeletal muscle cells.
Chemosensitivity of Phox2b‐expressing retrotrapezoid neurons is mediated in part by input from 5‐HT neurons
Authors: Wu Yuanming , Proch Katherine L. , Teran Frida A. , Lechtenberg Ryan J. , Kothari Harsh , Richerson George B. 
Published: March 2019

Key points
Neurons of the retrotrapezoid nucleus (RTN) and medullary serotonin (5‐HT) neurons are both candidates for central CO2/pH chemoreceptors, but it is not known how interactions between them influence their responses to pH.
We found that RTN neurons in brain slices were stimulated by exogenous 5‐HT and by heteroexchange release of endogenous 5‐HT, and these responses were blocked by antagonists of 5‐HT7 receptors.
The pH response of RTN neurons in brain slices was markedly reduced by the same antagonists of 5‐HT7 receptors.
Similar results were obtained in dissociated, primary cell cultures prepared from the ventral medulla, where it was also found that the pH response of RTN neurons was blocked by preventing 5‐HT synthesis and enhanced by blocking 5‐HT reuptake. Exogenous 5‐HT did not enable latent intrinsic RTN chemosensitivity.
RTN neurons may play more of a role as relays from other central and peripheral chemoreceptors than as CO2 sensors.
AbstractPhox2b‐expressing neurons in the retrotrapezoid nucleus (RTN) and serotonin (5‐HT) neurons in the medullary raphe have both been proposed to be central respiratory chemoreceptors. How interactions between these two sets of neurons influence their responses to acidosis is not known. Here we recorded from mouse Phox2b+ RTN neurons in brain slices, and found that their response to moderate hypercapnic acidosis (pH 7.4 to ∼7.2) was markedly reduced by antagonists of 5‐HT7 receptors. RTN neurons were stimulated in response to heteroexchange release of 5‐HT, indicating that RTN neurons are sensitive to endogenous 5‐HT. This electrophysiological behaviour was replicated in primary, dissociated cell cultures containing 5‐HT and RTN neurons grown together. In addition, pharmacological inhibition of 5‐HT synthesis in culture reduced RTN neuron chemosensitivity, and blocking 5‐HT reuptake enhanced chemosensitivity. The effect of 5‐HT on RTN neuron chemosensitivity was not explained by a mechanism whereby activation of 5‐HT7 receptors enables or potentiates intrinsic chemosensitivity of RTN neurons, as exogenous 5‐HT did not enhance the pH response. The ventilatory response to inhaled CO2 of mice was markedly decreased in vivo after systemic treatment with ketanserin, an antagonist of 5‐HT2 and 5‐HT7 receptors. These data indicate that 5‐HT and RTN neurons may interact synergistically in a way that enhances the respiratory chemoreceptor response. The primary role of RTN neurons may be as relays and amplifiers of the pH response from 5‐HT neurons and other chemoreceptors rather than as pH sensors themselves.
Position Prediction of Marine Seismic Streamer Cables Using Various Kalman Filter Methods
Authors: Grindheim Jan Vidar , Revhaug Inge , Pedersen Egil , Solheim Peder 
Published: March 2019

Abstract
Towed seismic streamer cables are extensively employed for offshore marine petroleum exploration. With the increasing need for accurate streamer steering due to rising number and length of streamers and decreasing intrastreamer separation, as well as new types of survey configurations, accurate modeling, positioning, and path prediction of the streamers are imperative. In the present study, a variety of models and methods have been implemented and utilized for data assimilation of full-scale seismic streamer position data for a marine seismic streamer, followed by path prediction ahead of time. The methods implemented are described, including various models used with the Kalman filter, extended Kalman filter, and ensemble Kalman filter, with comparison and evaluation of prediction results. One particular method, the Path-In-the-Water ensemble Kalman filter (PIW-EnKF), appears to be the most robust method with good prediction results compared to the other methods, as well as having low computational cost. As a case study with full-scale data, the PIW-EnKF is further employed for estimation and prediction of a complete streamer spread.
Extensive circumferential partial-thickness sclerectomy in eyes with extreme nanophthalmos and spontaneous uveal effusion
Authors: Mansour Ahmad , Stewart Michael W , Shields Carol L , Hamam Rola , Abdul Fattah Maamoun , Sheheitli Huda , Mehanna Carl-Joe , Yassine Salma , Chahine Hasan , Keaik Mona , Maalouf Fadi , Jaroudi Mahmoud 
Published: March 2019

AimTo describe an extensive scleral excision technique to treat uveal effusion in nanophthalmic eyes.MethodsThis prospective, interventional series of eight eyes of five consecutive patients with nanophthalmos underwent scleral window surgeries. Ninety per cent of the scleral thickness, extending from immediately behind the extraocular muscle insertions to the vortex veins for 3 and 1/4 quadrants, was removed. The main outcome measure was resolution of the uveal effusions.ResultsEight eyes of five patients (one female and four male) with a mean age of 46 years were studied. The mean (range) axial length was 16.1 mm (14.6–17.6 mm), and the mean refractive error was +13.6 dioptres (+10.75 to +16.00 dioptres). Following scleral excision surgery, all uveal effusions resolved within an average (±SD) of 13.9 (±8.7) days. The uveal effusion recurred in only one eye that had a vasoproliferative retinal tumour. The mean best corrected visual acuity improved from 0.69 logarithm of the minimum angle of resolution (logMAR) (Snellen equivalent: 20/97) at baseline to 0.51 logMAR (Snellen equivalent: 20/64; Wilcoxon paired t-test: p=0.016) after a mean follow-up of 35.6 months.ConclusionThe circumferential scleral window technique produces rapid resolution of uveal effusion in nanophthalmic eyes. No adverse effects were noted after surgery and the clinical effect was durable through 1 year.Trial registration numberNCT03748732.
Negative pressure dressings are no better than standard dressings for open fractures
Authors: Cook Rob , Thomas Vaughan , Martin Rosie 
Published: March 2019

The study
Effect of negative pressure wound therapy vs standard wound management on 12-month disability among adults with severe open fracture of the lower limb: the WOLLF randomised clinical trial.
Costa ML, Achten J, Bruce J, et al; UK WOLLF Collaboration

Published on 9 October 2018
JAMA
2018;319:2280-8.

This project was funded by the National Institute for Health Research Health Technology Assessment Programme (project number 10/57/20).

To read the full NIHR Signal, go to:
https://discover.dc.nihr.ac.uk/content/signal-000655/negative-pressure-dressings-are-no-better-than-standard-dressings-for-open-fractures
Bending the cost curve: time series analysis of a value transformation programme at an academic medical centre
Authors: Chatfield Steven C , Volpicelli Frank M , Adler Nicole M , Kim Kunhee Lucy , Jones Simon A , Francois Fritz , Shah Paresh C , Press Robert A , Horwitz Leora I 
Published: March 2019

BackgroundReducing costs while increasing or maintaining quality is crucial to delivering high value care.ObjectiveTo assess the impact of a hospital value-based management programme on cost and quality.DesignTime series analysis of non-psychiatric, non-rehabilitation, non-newborn patients discharged between 1 September 2011 and 31 December 2017 from a US urban, academic medical centre.InterventionNYU Langone Health instituted an institution-wide programme in April 2014 to increase value of healthcare, defined as health outcomes achieved per dollar spent. Key features included joint clinical and operational leadership; granular and transparent cost accounting; dedicated project support staff; information technology support; and a departmental shared savings programme.MeasurementsChange in variable direct costs; secondary outcomes included changes in length of stay, readmission and in-hospital mortality.ResultsThe programme chartered 74 projects targeting opportunities in supply chain management (eg, surgical trays), operational efficiency (eg, discharge optimisation), care of outlier patients (eg, those at end of life) and resource utilisation (eg, blood management). The study cohort included 160 434 hospitalisations. Adjusted variable costs decreased 7.7% over the study period. Admissions with medical diagnosis related groups (DRG) declined an average 0.20% per month relative to baseline. Admissions with surgical DRGs had an early increase in costs of 2.7% followed by 0.37% decrease in costs per month. Mean expense per hospitalisation improved from 13% above median for teaching hospitals to 2% above median. Length of stay decreased by 0.25% per month relative to prior trends (95% CI −0.34 to 0.17): approximately half a day by the end of the study period. There were no significant changes in 30-day same-hospital readmission or in-hospital mortality. Estimated institutional savings after intervention costs were approximately $53.9 million.LimitationsObservational analysis.ConclusionA systematic programme to increase healthcare value by lowering the cost of care without compromising quality is achievable and sustainable over several years.