bluuebunny/crossref_metadata_2025_split huggingface dataset:
Robust multi‐rate modulation for cognitive radio communications over land mobile satellite channel at Ku‐band
Authors: Murroni Maurizio , Popescu Vlad , Fadda Mauro , Giusto Daniele 
Published: October 2016

SummaryThe usable satellite spectrum is becoming scarce because of continuously increasing demand for broadcast, multimedia and interactive services. Because of the extensive use of predictive coding, multimedia data exhibit different sensitivities to transmission errors, which makes them suitable for unequal error protection (UEP) techniques. UEP mainly relies on differentiated error control coding which raises the robustness of data, but also increases the transmission bandwidth, which can be unwanted in case of limited resources often occurring in satellite communications. In this context, cognitive radio (CR) satellite communications has received important attention lately in the research community. In multi‐rate modulations (MRM), the properties of dy‐homogeneous signals are exploited to transmit over multiple band frequencies and time scales. MRM have been proved to be effective on unknown channels either in bandwidth or time. These conditions occur in CR networks where opportunistic communications are set up while preserving primaries licensed users. In CR, the uncertainty of transmission opportunity makes the use of error correcting codes not trivial. Therefore, to achieve robustness, this work proposes unequal power allocation (UPA) over the symbols of MRM according to both data sensitivity to channel errors and spectrum availability. As optimization criterion, the mean square error between the original and the decoded message, which has shown strong correlation with subjective perception, is used. To assess the effectiveness of the proposed scheme in realistic condition for CR satellite networks, the Land Mobile Satellite (LMS) model at Ku‐band is used to reproduce the memory associated with real channels. The non‐linearity of the satellite channel because of high power amplifier (HPA) prior to transmission has been accounted using the Saleh model. Copyright © 2016 John Wiley & Sons, Ltd.
Stillbirth and intrauterine fetal death: factors affecting determination of cause of death at autopsy
Authors: Man J. , Hutchinson J. C. , Heazell A. E. , Ashworth M. , Levine S. , Sebire N. J. 
Published: October 2016

ABSTRACTObjectivesThere have been several attempts to classify cause of death (CoD) in stillbirth; however, all such systems are subjective, allowing for observer bias and making comparisons between systems challenging. This study aimed to examine factors relating to determination of CoD using a large dataset from two specialist centers in which observer bias had been reduced by classifying findings objectively and assigning CoD based on predetermined criteria.MethodsDetailed autopsy reports from intrauterine deaths in the second and third trimesters during 2005–2013 were reviewed and findings entered into a specially designed database, in which CoD was assigned using predefined objective criteria. Data regarding CoD categories and factors affecting determination of CoD were examined.ResultsThere were 1064 intrauterine deaths, including 246 early intrauterine fetal deaths (IUFD) (< 20 weeks), 179 late IUFDs (20–23 weeks) and 639 stillbirths (≥ 24 weeks' gestation). Overall, around 40% (n = 412) had a clear CoD identified, whilst around 60% (n = 652) were classified as ‘unexplained’, including around half with identified risk factors or lesions of uncertain significance, with the remaining half (n = 292 (45%)) being entirely unexplained. A stepwise increase in the proportion of unexplained deaths was observed with increasing maceration. Black and Asian women had significantly greater proportions of deaths due to ascending infection, whilst women aged over 40 years had significantly increased placenta‐related CoDs. There was no significant difference in CoD distribution according to maternal body mass index or with increasing postmortem interval. Around half of those with an identifiable CoD could be identified from clinical review and external fetal examination or imaging, with most of the remainder being determined following placental examination.ConclusionsBased on objective criteria, many intrauterine deaths throughout gestation remain unexplained despite autopsy examination. The rate of unexplained death varies from around 30% to 60% depending on interpretation of the significance of features. CoD determination is dependent on both the classification system used and subjective interpretation, such that variation in the proportion of ‘unexplained’ cases is based largely on speculation regarding mechanisms of death. Novel methods to determine objectively the mechanism of death at postmortem examination are required. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.
Organ weights and ratios for postmortem identification of fetal growth restriction: utility and confounding factors
Authors: Man J. , Hutchinson J. C. , Ashworth M. , Jeffrey I. , Heazell A. E. , Sebire N. J. 
Published: October 2016

ABSTRACTObjectivesThe postmortem fetal brain:liver weight ratio is commonly used as a marker of nutrition for diagnosis of fetal growth restriction (FGR). However, there are limited data regarding the effects of intrauterine retention, fetal maceration and postmortem interval on organ weights and their ratios at autopsy. Our aims were to examine the relationships between gestational‐age‐adjusted and sex‐adjusted fetal organ weights at autopsy, cause of intrauterine death and effects of intrauterine retention, and to determine whether the brain:liver weight ratio is a reliable marker of FGR in intrauterine death.MethodsAs part of a larger study examining autopsy findings in intrauterine death, data from two specialist centers in London were collated in a specially designed database. Autopsy and clinical information for > 1000 intrauterine deaths between 2005 and 2013 were extracted. Adjusted (delta) organ weights were calculated by plotting against gestational age female and male brain, liver, thymus, heart, combined kidney, combined lung, spleen and combined adrenal gland weights. Polynomial regression was used to determine best fit and to calculate expected (50th centile) organ weights and deviations from expected. We compared adjusted organ weights and body:organ weight ratios in fetuses which were small‐for‐gestational age (SGA) at autopsy (birth weight < 10th centile for normal live births) vs those in fetuses which were not, and in macerated vs non‐macerated fetuses.ResultsThe majority of fetal organs (brain, liver, heart, thymus, lungs, kidneys and thyroid) in SGA fetuses were significantly lighter than those in non‐SGA fetuses. Body:organ weight ratios for thymus, liver and spleen were significantly greater in SGA fetuses, indicating these organs to be disproportionately small. The majority of organs were significantly lighter in macerated compared with non‐macerated fetuses and body:organ weight ratios for most organs (liver, thymus, lung, pancreas, adrenal gland, kidney, heart) were significantly greater in macerated compared with non‐macerated fetuses. When SGA cases with demonstrable placental histological abnormalities were compared with other SGA cases, there was a significant difference in the brain:liver weight ratio (median, 6 vs 3.5).ConclusionChanges after intrauterine death lead to loss of fetal weight, with preferential weight loss of visceral organs such as the liver. Maceration therefore affects the brain:liver weight ratio and adjustment should be made for such changes during interpretation of ratios. Fetal organ weights may be affected significantly by mechanism of death and postmortem changes. The fetal brain:liver weight ratio may provide useful information regarding intrauterine growth status at time of death, provided that adjustment is made for effects of intrauterine retention and that appropriate cut‐off values are used. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.
Stillbirth and intrauterine fetal death: contemporary demographic features of >1000 cases from an urban population
Authors: Man J. , Hutchinson J. C. , Ashworth M. , Heazell A. E. , Jeffrey I. , Sebire N. J. 
Published: October 2016

ABSTRACTObjectivesOf 780 000 births annually in the UK, around 3300 are stillborn, a rate of approximately 4 per 1000 births. Traditional epidemiological associations are based on historic data. The aim of this study was to document contemporary demographic findings in a large series of > 1000 deaths in utero in London and compare these with national datasets.MethodsFrom a dedicated database, including > 400 data fields per case, of fetal, infant and pediatric autopsies performed at Great Ormond Street Hospital and St George's Hospital, London, we extracted information on all intrauterine deaths, excluding terminations of pregnancy, from 2005 to 2013, inclusive. Demographic data were analyzed according to the gestational age at which fetal death occurred (second‐trimester intrauterine fetal death (IUFD), subdivided into early (< 20 weeks) and late (20–23 weeks) IUFD, and third‐trimester stillbirth (≥ 24 weeks)) and compared with national datasets when available, using Mann–Whitney U‐test and comparison of proportions testing as appropriate.ResultsData were available from 1064 individual postmortem reports examining intrauterine deaths delivered between 12 and 43 weeks' gestation, including 425 IUFDs (246 early and 179 late) and 639 stillbirths. Compared with the overall UK pregnant population, women in whom an intrauterine death occurred were significantly older and more obese. White mothers had a higher proportion of stillbirths (as opposed to IUFDs) than did non‐white mothers, whereas black mothers had a higher proportion of IUFDs relative to stillbirths. Increased body mass index was associated with increased risk across all groups. Women who had uterine fibroids, those who had a history of vaginal bleeding in early pregnancy and those who had undergone assisted conception had a relatively higher proportion of IUFDs than stillbirths.ConclusionsBased on a large series of >1000 autopsies in cases of intrauterine death, these data highlight the increased risk for fetal loss associated with maternal demographic factors in contemporary clinical practice, particularly associations with increased maternal age and body mass index. Among women in whom an intrauterine death occurs, maternal ethnicity, mode of conception and gynecological history are associated with differing timing of fetal loss. Further research is required to understand the mechanisms involved in such maternal factors in order to develop preventative strategies. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.
Opportunities to encourage mobilization of sustainable bioenergy supply chains
Authors: Smith C. Tattersall , Lattimore Brenna , Berndes Göran , Bentsen Niclas Scott , Dimitriou Ioannis , (Hans) Langeveld J.W.A. , Thiffault Evelyne 
Published: October 2016

Significant opportunities exist to reduce greenhouse gas emissions, increase domestic energy security, boost rural economies, and improve local environmental conditions through the deployment of sustainable bioenergy and bio‐based product supply chains. There is currently a wide selection of possible feedstocks, a variety of conversion routes, and a number of different end products that can be produced at a range of scales. However, economic slowdown, low oil prices, lack of global political will, and lingering questions regarding land use change and the sustainability of bioenergy production systems provide a challenging global context to speed the pace of investment. The opinions expressed in this paper are derived from our collaboration within IEA Bioenergy to determine opportunities as well as barriers that need to be overcome to realize opportunities on a wider scale. This comprehensive and novel collaborative effort confirmed that feedstocks produced using logistically efficient production systems can be mobilized to make significant contributions to achieving global targets for bioenergy. At the same time, significant barriers to large‐scale implementation exist in many regions. The mobilization potential identified in the study will depend on both increases in supply chain efficiencies and profits and strong policy support to increase stakeholder and investor confidence. WIREs Energy Environ 2017, 6:e237. doi: 10.1002/wene.237This article is categorized under:

Bioenergy > Economics and Policy
Energy Policy and Planning > Climate and Environment
Graphene oxide as a scaffold for bone regeneration
Authors: Holt Brian D. , Wright Zoe M. , Arnold Anne M. , Sydlik Stefanie A. 
Published: October 2016

Graphene oxide (GO), the oxidized form of graphene, holds great potential as a component of biomedical devices, deriving utility from its ability to support a broad range of chemical functionalities and its exceptional mechanical, electronic, and thermal properties. GO composites can be tuned chemically to be biomimetic, and mechanically to be stiff yet strong. These unique properties make GO‐based materials promising candidates as a scaffold for bone regeneration. However, questions still exist as to the compatibility and long‐term toxicity of nanocarbon materials. Unlike other nanocarbons, GO is meta‐stable, water dispersible, and autodegrades in water on the timescale of months to humic acid‐like materials, the degradation products of all organic matter. Thus, GO offers better prospects for biological compatibility over other nanocarbons. Recently, many publications have demonstrated enhanced osteogenic performance of GO‐containing composites. Ongoing work toward surface modification or coating strategies could be useful to minimize the inflammatory response and improve compatibility of GO as a component of medical devices. Furthermore, biomimetic modifications could offer mechanical and chemical environments that encourage osteogenesis. So long as care is given to assure their safety, GO‐based materials may be poised to become the next generation scaffold for bone regeneration. WIREs Nanomed Nanobiotechnol 2017, 9:e1437. doi: 10.1002/wnan.1437This article is categorized under:

Implantable Materials and Surgical Technologies > Nanomaterials and Implants
Implantable Materials and Surgical Technologies > Nanotechnology in Tissue Repair and Replacement
Factors influencing spatial heterogeneity of female white‐tailed deer harvest dynamics
Authors: Karns Gabriel R. , Gates Robert J. , Matthews Stephen N. , Bruskotter Jeremy T. , McCoy J. Clint , Tonkovich Michael J. 
Published: October 2016

ABSTRACTSuccessful management of exploited wildlife populations is contingent upon understanding what variables most affect mortality rates (e.g., legal harvest mortality) and adopting regulations that directly address those factors in a manner that accomplishes desired outcomes. We tested biological, ecological, and sociocultural variables related to female white‐tailed deer (Odocoileus virginianus) harvest densities in Ohio, USA, during 2007–2012. At the county level, the proportion of farmland (standardized‐β = −0.37, P < 0.001), the proportion of noncrop cover types within farmland (standardized‐β = 0.46, P < 0.001), and per capita deer permit sales (hunting pressure; standardized‐β = 0.32, P < 0.001) explained 76% of the variance in female white‐tailed deer harvest density. Available habitat likely influences harvest density through the direct relationship of deer abundance and forage availability and indirectly through the effect of cover on deer vulnerability and hunter access. The proxy for hunting pressure also was positively related to female deer harvest density, thereby underscoring the important role of hunters in Ohio's white‐tailed deer management. Understanding how county‐level factors are related to female deer harvest densities is a first step toward basing deer management units and management actions on a solid understanding of landscape–harvest dynamics. © 2016 The Wildlife Society.
Efficacy of surgical sterilization for managing overabundant suburban white‐tailed deer
Authors: Boulanger Jason R. , Curtis Paul D. 
Published: October 2016

ABSTRACTBased on decades of increasing deer effects on local biodiversity, agricultural damage, and deer–vehicle collisions, we implemented a suburban white‐tailed deer (Odocoileus virginianus) research and management program in 2007 on Cornell University lands in Tompkins County, New York, USA. We attempted to reduce deer numbers by surgically sterilizing female deer in the 445‐ha suburban core campus via tubal ligation and ovariectomy. From 2007 to 2013, we sterilized 93 deer and radiocollared 67 adult females to monitor fawning. Tubal ligation and ovariectomy surgeries appeared to prevent birth in 96% and 100% of treated female deer, respectively. We implemented a camera survey, used a mark–resight model in Program NOREMARK to estimate annual deer abundance, and observed no reduction in female abundance by winter 2013. Conversely, we noted a 38% and 79% decrease of total adult females and fawns visible in sampled photographs, respectively, and an 873% increase in adult male visitation to camera traps on core campus. Surgical sterilization appeared to be ineffective for reducing the abundance of a geographically open population of white‐tailed deer in the absence of lethal management. We do not recommend surgical sterilization as a stand‐alone method for communities wishing to pursue mitigation of deer impacts with nonlethal approaches. © 2016 The Wildlife Society.
A Cost-Effectiveness Analysis of Gemcitabine plus Cisplatin Versus Gemcitabine Alone for Treatment of Advanced Biliary Tract Cancer in Japan
Authors: Tsukiyama Ikuto , Ejiri Masayuki , Yamamoto Yoshihiro , Nakao Haruhisa , Yoneda Masashi , Matsuura Katsuhiko , Arakawa Ichiro , Saito Hiroko , Inoue Tadao 
Published: October 2016

Abstract
Objectives
This study assessed the cost-effectiveness of combination treatment with gemcitabine and cisplatin compared to treatment with gemcitabine alone for advanced biliary tract cancer (BTC) in Japan.

Methods
A monthly transmitted Markov model of three states was constructed based on the Japan BT-22 trial. Transition probabilities among the health states were derived from a trial conducted in Japan and converted to appropriate parameters for our model. The associated cost components, obtained from a receipt-based survey undertaken at the Aichi Medical University Hospital, were those related to inpatient care, outpatient care, and treatment for BTC. Costs for palliative care and treatment of adverse events were obtained from the National Health Insurance price list. We estimated cost-effectiveness per quality-adjusted life year (QALY) at a time horizon of 36 months. An annual discount of 3 % for both cost and outcome was considered.

Results
The base case outcomes indicated that combination therapy was less cost-effective than monotherapy when the incremental cost-effectiveness ratio (ICER) was approximately 14 million yen per QALY gained. The deterministic sensitivity analysis of the ICER revealed that the ICER of the base case was robust. A probabilistic analysis conducted with 10,000-time Monte Carlo simulations demonstrated efficacy at the willingness to pay threshold of 6 million yen per QALY gained for approximately 33 % of the population.

Conclusion
In Japan, combination therapy is less cost-effective than monotherapy for treating advanced BTC, regardless of the statistical significance of the two therapies. Useful information on the cost-effectiveness of chemotherapy is much needed for the treatment of advanced BTC in Japan.
Back to Basics: Patient Care Transitions
Authors: Spruce Lisa 
Published: October 2016

AbstractOne of the most critical aspects of high‐quality patient care is communication. If a breakdown in communication occurs, vital patient information may be overlooked and not communicated at the patient hand over. Breakdowns in communication contribute to a majority of errors in health care. Implementing a standardized hand‐over protocol serves to improve the safety and reliability of this process and help decrease the risk of patient harm. This Back to Basics article highlights the steps to a successful hand over and provides strategies for developing an effective standardized communication process to reduce health care errors.
Conscious Leadership
Authors: Ward Suzanne F. , Haase Beth 
Published: October 2016

AbstractHealth care leaders need to use leadership methodologies that support safe patient care, satisfy employees, and improve the bottom line. Conscious leaders help create desirable personal and professional life experiences for themselves using specific tools that include mindfulness, context, and the observer‐self, and they strive to help their employees learn to use these tools as well. In perioperative nursing, conscious leaders create an environment in which nurses are supported in their aim to provide the highest level of patient care and in which transformations are encouraged to take place; this environment ultimately promotes safety, contributes to fulfilling and meaningful work, and enhances a facility's financial viability. This article discusses some of the key concepts behind conscious leadership, how perioperative leaders can reach and maintain expanded consciousness, and how they can best assist their staff members in their own evolution to a more mindful state.
Creating Healing Environments Through the Theory of Caring
Authors: Norman Vivian , Rossillo Kim , Skelton Katie 
Published: October 2016

AbstractWe describe the journey of personnel at one hospital to create a healing environment for patients and staff members at all levels through the implementation of Watson's Theory of Human Caring and her Caritas Processes (ie, loving kindness, authentic presence, spirituality, being the environment, believing in miracles). We used experiential teaching and learning to explore the nursing theory with staff members. Positive outcomes include using Caritas Processes care plans in our electronic medical record, greater ease in the understanding and application of Watson's theory, integrating a blessing for nurses during National Nurses Week, inclusion of ministry formation courses to extend the mission of the hospital's founding religious order to current and future employees, and positive patient feedback. As a result of theory application, our nurses are more open to discussing caring, authentic presence and, when appropriate, prayer in their clinical narratives and how it is affecting patients and themselves.
Clinical Issues‐November 2016
Authors: Kovac Melissa 
Published: October 2016

This MonthAORN guidelines in the National Guideline ClearinghouseKey words: National Guideline Clearinghouse, AORN guidelines.Role of medical librarians in developing AORN guidelinesKey words: medical librarians, systematic reviews, Institute of Medicine, National Guideline Clearinghouse.Articles cited in AORN guidelinesKey words: AORN guidelines, National Library of Medicine, PubMed, interlibrary loan.