bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pediatric Appendicitis Severity in KwaZulu‐Natal, South Africa: A Retrospective Cohort Analysis
Authors: Hernandez Matthew C. , Kong Victor Y. , Bruce John L. , Aho Johnathon M. , Laing Grant L. , Zielinski Martin D. , Clarke Damian L. 
Published: May 2018

AbstractBackgroundAcute appendicitis is a common pediatric surgical emergency; however, there are few grading systems to assign disease severity. The American Association for the Surgery of Trauma (AAST) recently developed a grading system for a variety of emergency surgical conditions, including appendicitis. The severity of acute appendicitis in younger patients in KwaZulu‐Natal (South Africa) is unknown. We aimed to describe the disease severity in this patient population using the AAST grading system hypothesizing that the AAST grade would correlate with morbidity, management type, and duration of stay.MaterialsSingle institutional review of patients <18 years old with a final diagnosis of acute appendicitis during 2010–2016 in KwaZulu‐Natal, South Africa, was performed. Demographics, physiologic and symptom data, procedural details, postoperative complications, and Clavien–Dindo classification were abstracted. AAST grades were generated based on intraoperative findings. Summary, univariate, and nominal logistic regression analyses were performed to compare AAST grade and outcomes.ResultsA total of 401 patients were identified with median [IQR] age of 11 [5–13], 65% male. Appendectomy was performed in all patients; 2.4% laparoscopic, 37.6% limited incision, and 60% midline laparotomy. Complications occurred in 41.6%, most commonly unplanned relaparotomy (22.4%), surgical site infection (8.9%), pneumonia (7.2%), and acute renal failure (2.9%). Complication rate and median length of stay increased with greater AAST grade (all p < 0.001). AAST grade was independently associated with increased risk of complications.ConclusionPediatric appendicitis is a morbid disease in a developing middle‐income country. The AAST grading system is generalizable and accurately corresponds with management strategies as well as key clinical outcomes.Level of evidenceRetrospective study, Level IV.Study typeRetrospective single institutional study.
Performance implications of the fit between suppliers' flexibility and their customers' expected flexibility: A dyadic examination⋆
Authors: Gligor David 
Published: May 2018

AbstractAlthough an increase in flexibility for firms usually entails further investments and higher operating overhead for their suppliers (Sheikhzadeh et al., 1998Koste and Malhotra, 1999), most studies have focused exclusively on the benefits derived from additional flexibility enjoyed by the buyer firms neglecting the impact on the financial performance of their suppliers (e.g., Malhotra and Mackelprang, 2012; Gligor, 2014; Mandal, 2015). To explore the complex supplier‐customer interplay, we introduce the concept ofbuyer‐supplier flexibility fit(i.e., the match between the level of flexibility the customer expects from its supplier and the supplier's level of flexibility) and explore its impact on the supplier's financial performance (i.e., ROA). We collected dyadic archival and survey data from 638 firms (319 supplier‐customer dyads) to test these relationships. Our results indicate that buyer‐supplier flexibility fit has a direct and positive impact on the supplier's ROA. Further, the strength of the relationship increases when firms operate in munificent and/or dynamic environments but does not change significantly in complex environments. The relationship also becomes stronger as the exchanged business volume increases between the customer and its supplier, and as the relationship progresses in age. In addition, our findings indicate that firms with perfect buyer‐supplier flexibility fit perform best, followed by firms with negative misfit (i.e., the supplier's level of flexibility is lower than its customer's expected level of flexibility), while firms with positive misfit (i.e., the supplier's level of flexibility is higher than its customer's expected level of flexibility) are the laggards. Interestingly, positive misfit has a stronger negative impact on suppliers' ROA compared to misfit in general and negative misfit. Key corresponding managerial implications are derived.
Investigations of the synergy of Composite Cycle and intercooled recuperation
Authors: Kaiser Sascha , Nickl Markus , Salpingidou Christina , Vlahostergios Zinon , Donnerhack Stefan , Klingels Hermann 
Published: May 2018

ABSTRACTThe synergistic combination of two promising engine architectures for future aero engines is presented. The first is the Composite Cycle Engine, which introduces a piston system in the high pressure part of the core engine, to utilise closed volume combustion and high temperature capability due to instationary operation. The second is the Intercooled Recuperated engine that employs recuperators to utilise waste heat from the core engine exhaust and intercooler to improve temperature levels for recuperation and to reduce compression work. Combinations of both architectures are presented and investigated for improvement potential with respect to specific fuel consumption, engine weight and fuel burn against a turbofan. The Composite Cycle alone provides a 15.6% fuel burn reduction against a turbofan. Options for adding intercooler were screened, and a benefit of up to 1.9% fuel burn could be shown for installation in front of a piston system through a significant, efficiency-neutral weight decrease. Waste heat can be utilised by means of classic recuperation to the entire core mass flow before the combustor, or alternatively on the turbine cooling bleed or a piston engine bypass flow that is mixed again with the main flow before the combustor. As further permutation, waste heat can be recovered either after the low pressure turbine – with or without sequential combustion – or between the high pressure and low pressure turbine. Waste heat recovery after the low pressure turbine was found to be not easily feasible or tied to high fuel burn penalties due to unfavourable temperature levels, even when using sequential combustion or intercooling. Feasible temperature levels could be obtained with inter-turbine waste heat recovery but always resulted in at least 0.3% higher fuel burn compared to the non-recuperated baseline under the given assumptions. Consequently, only the application of an intercooler appears to provide a considerable benefit for the examined thermodynamic conditions in the low fidelity analyses of various engine architecture combinations with the specific heat exchanger design. Since the obtained drawbacks of some waste heat utilisation concepts are small, innovative waste heat management concepts coupled with the further extension of the design space and the inclusion of higher fidelity models may achieve a benefit and motivate future investigations.
Posttraumatic Stress, Depression, and Coping Following the 2015 Nepal Earthquake: A Study on Adolescents
Authors: Sharma Asmita , Kar Nilamadhab 
Published: May 2018

ABSTRACTObjectiveThe study aimed to gather data on posttraumatic stress and depression in adolescents following the 2015 Nepal earthquake and explore the adolescents’ coping strategies.MethodsIn a questionnaire-based, cross-sectional study about 1 year after the earthquake, adolescents in two districts with different degrees of impact were evaluated for disaster experience, coping strategies, and symptoms of posttraumatic stress and depression measured with the Child Posttraumatic Stress Scale and the Depression Self Rating Scale.ResultsIn the studied sample (N=409), the estimated prevalence of posttraumatic stress disorder (PTSD) (43.3%) and depression (38.1%) was considerable. Prevalence of PTSD was significantly higher in the more affected area (49.0% v 37.9%); however, the prevalence figures were comparable in adolescents who reported a stress. The prevalence of depression was comparable. Female gender, joint family, financial problems, displacement, injury or being trapped in the earthquake, damage to livelihood, and fear of death were significantly associated with a probable PTSD diagnosis. Various coping strategies were used: talking to others, praying, helping others, hoping for the best, and some activities were common. Drug abuse was rare. Most of the coping strategies were comparable among the clinical groups.ConclusionsA considerable proportion of adolescents had posttraumatic stress and depression 1 year after the earthquake. There is a need for clinical interventions and follow-up studies regarding the outcome. Disaster Med Public Health Preparedness. 2019;13:236–242)
Radiocarbon-dated peat development: anthropogenic and climatic signals in a Holocene raised bog and lake profile from the Eastern part of the Carpathian Basin
Authors: Tapody Réka Orsolya , Gulyás Sándor , Törőcsik Tünde , Sümegi Pál , Molnár Dávid , Sümegi Balázs P , Molnár Mihály 
Published: May 2018

AbstractThe peat bog at Homoródszentpál Kerek-tó (Round Lake), situated in Homoród Hills of the Eastern Carpathians in Romania, provides a continuous record of paleoclimatic and paleoenvironmental changes from the Early Holocene. In this study, we present a 7500-year-long high-resolution record of past climatic changes and signs of human impact recorded in a peat bog via integrating sedimentological, paleoecological and geochemical proxies. The basin of Round Lake formed around the Pleistocene–Holocene border when the permafrost thawed. Ponded water accumulated in the catchment basin from the beginning of the Holocene but ca. 7500 cal BP years ago lacustrine sedimentation was exchanged for peat accumulation. The 570-cm-long core was subsampled at 2–4 cm intervals and subjected to grain-size, loss-on-ignition (LOI), pollen, and radiocarbon (14C) analyses. Our findings were correlated with and interpreted in the light of paleobotanical records deriving from archaeological sites and the newest bioclimatological models of the nearby areas. Sedimentological analysis document erosion and accumulation events which were influenced by more complex processes like climate change. Based on environmental historical and climatic data we aimed to reconstruct the environmental changes of forested areas in the Homoródi Hills.
Dietaryl-threonine supplementation attenuates lipopolysaccharide-induced inflammatory responses and intestinal barrier damage of broiler chickens at an early age
Authors: Chen Yueping , Zhang Hao , Cheng Yefei , Li Yue , Wen Chao , Zhou Yanmin 
Published: May 2018

AbstractThis study was conducted to investigate the protective effects ofl-threonine (l-Thr) supplementation on growth performance, inflammatory responses and intestinal barrier function of young broilers challenged with lipopolysaccharide (LPS). A total of 144 1-d-old male chicks were allocated to one of three treatments: non-challenged broilers fed a basal diet (control group), LPS-challenged broilers fed a basal diet withoutl-Thr supplementation and LPS-challenged broilers fed a basal diet supplemented with 3·0 g/kgl-Thr. LPS challenge was performed intraperitoneally at 17, 19 and 21 d of age, whereas the control group received physiological saline injection. Compared with the control group, LPS challenge impaired growth performance of broilers, andl-Thr administration reversed LPS-induced increase in feed/gain ratio. LPS challenge elevated blood cell counts related to inflammation, and pro-inflammatory cytokine concentrations in serum (IL-1βand TNF-α), spleen (IL-1βand TNF-α) and intestinal mucosa (jejunal interferon-γ(IFN-γ) and ileal IL-1β). The concentrations of intestinal cytokines in LPS-challenged broilers were reduced byl-Thr supplementation. LPS administration increased circulatingd-lactic acid concentration, whereas it reduced villus height, the ratio between villus height and crypt depth and goblet density in both jejunum and ileum. LPS-induced decreases in jejunal villus height, intestinal villus height:crypt depth ratio and ileal goblet cell density were reversed withl-Thr supplementation. Similarly, LPS-induced alterations in the intestinal mRNA abundances of genes related to intestinal inflammation and barrier function (jejunal toll-like receptor 4,IFN-γand claudin-3, and ilealIL-1βand zonula occludens-1) were normalised withl-Thr administration. It can be concluded thatl-Thr supplementation could attenuate LPS-induced inflammatory responses and intestinal barrier damage of young broilers.
The difference between the scope of a norm and its apparent source
Authors: Birch Jonathan 
Published: May 2018

AbstractWe should distinguish between the apparent source of a norm and the scope of the norm's satisfaction conditions. Wide-scope social norms need not be externalised, and externalised social norms need not be wide in scope. Attending to this distinction leads to a problem for Stanford: The adaptive advantages he attributes to externalised norms are actually advantages of wide-scope norms.
Externalization is common to all value judgments, and norms are motivating because of their intersubjective grounding
Authors: Isern-Mas Carme , Gomila Antoni 
Published: May 2018

AbstractWe show that externalization is a feature not only of moral judgment, but also of value judgment in general. It follows that the evolution of externalization was not specific to moral judgment. Second, we argue that value judgments cannot be decoupled from the level of motivations and preferences, which, in the moral case, rely on intersubjective bonds and claims.
The Excitation of Secondary Gravity Waves From Local Body Forces: Theory and Observation
Authors: Vadas Sharon L. , Zhao Jian , Chu Xinzhao , Becker Erich 
Published: May 2018

AbstractWe examine the characteristics of secondary gravity waves (GWs) excited by a localized (in space) and intermittent (in time) body force in the atmosphere. This force is a horizontal acceleration of the background flow created when primary GWs dissipate and deposit their momentum on spatial and temporal scales of the wave packet. A broad spectrum of secondary GWs is excited with horizontal scales much larger than that of the primary GW. The polarization relations cause the temperature spectrum of the secondary GWs generally to peak at larger intrinsic periods τIr and horizontal wavelengths λH than the vertical velocity spectrum. We find that the one‐dimensional spectra (with regard to frequency or wave number) follow lognormal distributions. We show that secondary GWs can be identified by a horizontally displaced observer as “fishbone” or “>” structures in z − t plots whereby the positive and negative GW phase lines meet at the “knee,” zknee, which is the altitude of the force center. We present two wintertime cases of lidar temperature measurements at McMurdo, Antarctica (166.69°E, 77.84°S) whereby fishbone structures are seen with zknee=43 and 52 km. We determine the GW parameters and density‐weighted amplitudes for each. We show that these parameters are similar below and above zknee. We verify that the GWs with upward (downward) phase progression are downward (upward) propagating via use of model background winds. We conclude that these GWs are likely secondary GWs having ground‐based periods τr=6–10 hr and vertical wavelengths λz=6–14 km, and that they likely propagate primarily southward.
Six Decades of Glacial Mass Loss in the Canadian Arctic Archipelago
Authors: Noël Brice , van de Berg Willem Jan , Lhermitte Stef , Wouters Bert , Schaffer Nicole , van den Broeke Michiel R. 
Published: May 2018

The Canadian Arctic Archipelago comprises multiple small glaciers and ice caps, mostly concentrated on Ellesmere and Baffin Islands in the northern (NCAA, Northern Canadian Arctic Archipelago) and southern parts (SCAA, Southern Canadian Arctic Archipelago) of the archipelago, respectively. Because these glaciers are small and show complex geometries, current regional climate models, using 5‐ to 20‐km horizontal resolution, do not properly resolve surface mass balance patterns. Here we present a 58‐year (1958–2015) reconstruction of daily surface mass balance of the Canadian Arctic Archipelago, statistically downscaled to 1 km from the output of the regional climate model RACMO2.3 at 11 km. By correcting for biases in elevation and ice albedo, the downscaling method significantly improves runoff estimates over narrow outlet glaciers and isolated ice fields. Since the last two decades, NCAA and SCAA glaciers have experienced warmer conditions (+1.1°C) resulting in continued mass loss of 28.2 ± 11.5 and 22.0 ± 4.5 Gt/year, respectively, more than doubling (11.9 Gt/year) and doubling (11.9 Gt/year) the pre‐1996 average. While the interior of NCAA ice caps can still buffer most of the additional melt, the lack of a perennial firn area over low‐lying SCAA glaciers has caused uninterrupted mass loss since the 1980s. In the absence of significant refreezing capacity, this indicates inevitable disappearance of these highly sensitive glaciers.
Acoustic and Microseismic Characterization in Steep Bedrock Permafrost on Matterhorn (CH)
Authors: Weber Samuel , Faillettaz Jérome , Meyer Matthias , Beutel Jan , Vieli Andreas 
Published: May 2018

Understanding of processes and factors influencing slope stability is essential for assessing the stability of potentially hazardous slopes. Passive monitoring of acoustic emissions and microseismology provides subsurface information on fracturing (timing and identification of the mechanism) and therefore complement surface displacement data. This study investigates for the first time acoustic and microseismic signals generated in steep, fractured bedrock permafrost, covering the broad frequency range of 1 − 105 Hz. The analysis of artificial forcing experiments using a rebound hammer in a controlled setting led to two major findings: First, statistically insignificant cross correlation between signals indicates that waveforms change strongly with propagation distance. Second, a significant amplification is found in the frequency band 33–67 Hz. This finding is strongly supported by evidence from artificial rockfall events and more importantly by naturally occurring fracture events identified in fracture displacement data. Thus, filtering this frequency band enables enhanced detection of microseismic events relevant for slope stability assessment. The analysis of 2‐year time series in this frequency band further suggests that the detected energy rate baseline of all automatically triggered events using the STA/LTA algorithm is not sensitive to temperature forcing, an observation of primary importance for long‐term data collection, analysis, and interpretation. The event detection in the established frequency band is not only improved but also not affected by the short‐ and long‐term temperature changes in such a rapidly changing environment.
Spatial‐Temporal Patterns of Evapotranspiration Along an Elevation Gradient on Mount Gongga, Southwest China
Authors: Hu Zhaoyong , Wang Genxu , Sun Xiangyang , Zhu Meizhuang , Song Chunlin , Huang Kewei , Chen Xiaopeng 
Published: May 2018

AbstractEvapotranspiration (ET) is a crucial component of the hydrological cycle in terrestrial ecosystems, but estimating ET in mountainous regions is challenging. In this study, the performance of a generalized nonlinear formulation of the complementary principle while estimating daily ET was evaluated, and the spatial‐temporal variation of ET was analyzed across four vegetation types along an elevation gradient on Mount Gongga, Southwest China. The values of the calibrated Priestley and Taylor coefficients for each of the four sites ranged from 0.98 to 1.13. The correlation coefficients between the estimated and observed daily actual evapotranspiration for each of the four sites ranged from 0.71 to 0.92. A markedly asymmetrical complementary relationship existed among the four studied sites, and the values showed less scattered during the wet season. The annual ET rates were 779.12, 781.63, 701.77, and 625.17 mm/yr in the broadleaf forest (BLF), broadleaf and coniferous mixed forest (BCF), coniferous forest (CF), and shrub land (SL), respectively, and showed a decreasing trend of 9.72 mm per 100 m along the elevation gradient. After recalibration of the seasonal αe values, the estimated annual ET rates increased and were closer to the observed values in BLF and BCF. The results indicate that daily ET in mountainous areas can be estimated using the generalized nonlinear formulation of the complementary relationship together with routine meteorological data alone, but seasonal changes in αe values should be taken into consideration in forests with deciduous trees.
The Sleep Checkup: Sleep Screening, Guidance, and Management in Pediatric Primary Care
Authors: Honaker Sarah Morsbach , Saunders Taylor 
Published: May 2018

Few studies have examined strategies to address sleep difficulties and promote sleep health in pediatric primary care. The aims of the current study are to (a) describe the content, acceptability, and preliminary feasibility of the Sleep Checkup delivered by behavioral health providers in two urban primary care clinics and (b) report child sleep outcomes from the implementation of the Sleep Checkup. Participants were 83 children ages birth to 18 years, presenting to their primary care provider (PCP) for a sick- or well-child visit. Thirteen faculty PCPs responded to an anonymous survey about their perception of the service. The percentage of parents with concerns about their child’s sleep ranged from 0% for newborns to 41.6% for preschoolers. Of those reporting no concern, more than half subsequently reported sleep symptoms or practices suggesting a sleep problem or disorder. Providers reported overall high satisfaction. They rated the service as beneficial to providers ( M = 4.85; 5 = strongly agree), to patients ( M = 4.77), and to trainee learning ( M = 4.77). Providers did not find the Sleep Checkup disruptive to patient flow ( M = 1.08; 1 = strongly disagree). High rates of problematic sleep habits and symptoms of sleep disorders were found in an urban primary care sample, including in children whose parents denied any sleep concerns. Implications for Impact Statement This study introduces the Sleep Checkup, a novel clinical tool designed to prevent, identify, and manage pediatric sleep disturbances in primary care settings. Data from its implementation support preliminary acceptability and feasibility of the Sleep Checkup. Further, sleep outcomes suggest high rates of sleep disturbance and highlight the need for systematic sleep screening and guidance.