bluuebunny/crossref_metadata_2025 huggingface dataset:
Spine Surgery in the Ambulatory Surgery Center Setting: Value-Based Advancement or Safety Liability?
Authors: Sivaganesan Ahilan , Hirsch Brandon , Phillips Frank M , McGirt Matthew J
Published: February 2018

Here, we systematically review clinical studies that report morbidity and outcomes data for cervical and lumbar surgeries performed in ambulatory surgery centers (ASCs). We focus on anterior cervical discectomy and fusion (ACDF), posterior cervical foraminotomy, cervical arthroplasty, lumbar microdiscectomy, lumbar laminectomy, and minimally invasive transforaminal interbody fusion (TLIF) and lateral lumbar interbody fusion, as these are prevalent and surgical spine procedures that are becoming more commonly performed in ASC settings.

A systematic search of PubMed was conducted, using combinations of the following phrases: “outpatient,” “ambulatory,” or “ASC” with “anterior cervical discectomy fusion,” “ACDF,” “cervical arthroplasty,” “lumbar,” “microdiscectomy,” “laminectomy,” “transforaminal lumbar interbody fusion,” “spine surgery,” or “TLIF.”

In reviewing the available literature to date, there is ample level 3 (retrospective comparisons) and level 4 (case series) evidence to support both the safety and effectiveness of outpatient cervical and lumbar surgery. While no level 1 or 2 (randomized clinical trials) evidence currently exists, the plethora of real-world clinical data creates a formidable argument for serious investments in ASCs for multiple spine procedures.
Histopathological Findings After Reirradiation Compared to First Irradiation of Spinal Bone Metastases With Stereotactic Body Radiotherapy: A Cohort Study
Authors: Foerster Robert , Cho B C John , Fahim Daniel K , Gerszten Peter C , Flickinger John C , Grills Inga S , Jawad Maha S , Kersh C Ronald , Létourneau Daniel , Mantel Frederick , Sahgal Arjun , Shin John H , Winey Brian A , Guckenberger Matthias
Published: February 2018

BACKGROUND

Stereotactic body radiotherapy (SBRT) of the spine provides superior tumor control, but vertebral compression fractures are increased and the pathophysiological process underneath is not well understood. Data on histopathological changes, particularly after salvage SBRT (sSBRT) following conventional irradiation, are scarce.

OBJECTIVE

To investigate surgical specimens after sSBRT and primary SBRT (pSBRT) regarding histopathological changes.

METHODS

We assessed 704 patients treated with spine SBRT 2006 to 2012. Thirty patients underwent salvage surgery; 23 histopathological reports were available. Clinical and histopathological findings were analyzed for sSBRT (69.6%) and pSBRT (30.4%).

RESULTS

Mean time to surgery after sSBRT/pSBRT was 8.3/10.3 mo (P = .64). Reason for surgery included pain (sSBRT/pSBRT: 12.5%/71.4%, P = .25), fractures (sSBRT/pSBRT: 37.5%/28.6%, P = .68), and neurological symptoms (sSBRT/pSBRT: 68.8%/42.9%, P = .24). Radiological tumor progression after sSBRT/pSBRT was seen in 71.4%/42.9% (P = .2). Most specimens displayed viable/proliferative tumor (sSBRT/pSBRT: 62.5%/71.4%, P = .68 and 56.3%/57.1%, P = .97). Few specimens showed soft tissue necrosis (sSBRT/pSBRT: 20%/28.6%, P = .66), osteonecrosis (sSBRT/pSBRT: 14.3%/16.7%, P = .89), or bone marrow fibrosis (sSBRT/pSBRT: 42.9%/33.3%, P = .69). Tumor bed necrosis was more common after sSBRT (81.3%/42.9%, P = .066). Radiological tumor progression correlated with viable/proliferative tumor (P = .03/P = .006) and tumor bed necrosis (P = .03). Fractures were increased with bone marrow fibrosis (P = .07), but not with osteonecrosis (P = .53) or soft tissue necrosis (P = .19). Neurological symptoms were common with radiological tumor progression (P = .07), but not with fractures (P = .18).

CONCLUSION

For both, sSBRT and pSBRT, histopathological changes were similar. Neurological symptoms were attributable to tumor progression and pathological fractures were not associated with osteonecrosis or tumor progression.
Pathogenicity ofPhyllosticta citricarpaAscospores onCitrusspp.
Authors: Tran Nga T. , Miles Andrew K. , Smith Malcolm W. , Dietzgen Ralf G. , Drenth André
Published: February 2018

Citrus black spot, caused by Phyllosticta citricarpa, is one of the most important fungal diseases in many citrus-growing regions with hot and humid summers. Ascospores and conidia are known to contribute to epidemic development of the disease. However, pathogenicity testing has never been done for pure ascospores produced from fully characterized P. citricarpa isolates, due to the inability to induce the sexual state in vitro. Recently, an in vitro mating technique was developed to readily produce pure P. citricarpa ascospores for use in host inoculation studies. To test the pathogenicity of P. citricarpa ascospores, we inoculated Troyer citrange leaves and Murcott tangor fruit with ascospores produced in vitro from characterized P. citricarpa isolates. Typical symptoms of citrus black spot occurred. Recovery of P. citricarpa isolates from symptomatic lesions and their characterization using genetic markers enabled us to identify recombinant genotypes among the isolates recovered from ascospore inoculations and, as such, fulfill Koch’s postulates for ascospores. We have also identified Troyer citrange seedlings as a potential model system for citrus black spot inoculation studies, because it allows typical symptoms of citrus black spot to be expressed with a much shorter latent period than on fruit. This will facilitate future studies of epidemiological aspects of P. citricarpa ascospores relative to conidia and improve our understanding of the citrus black spot pathosystem. The susceptibility of Troyer citrange seedlings will also facilitate experimenting with disease management methods, aimed at reducing the impact of citrus black spot.
Outcomes and Costs of Patients Admitted to the ICU Due to Spontaneous Intracranial Hemorrhage
Authors: Fernando Shannon M. , Reardon Peter M. , Dowlatshahi Dar , English Shane W. , Thavorn Kednapa , Tanuseputro Peter , Perry Jeffrey J. , Rosenberg Erin , Wijdicks Eelco F. , Heyland Daren K. , Kyeremanteng Kwadwo
Published: February 2018

Objectives:

Spontaneous intracranial hemorrhage, including subarachnoid hemorrhage and intracerebral hemorrhage, is associated with significant morbidity and mortality. Although many of these patients will require ICU admission, little is known regarding their outcomes and the costs incurred. We evaluated this population in order to identify outcomes and cost patterns.

Design:

Retrospective cohort analysis of a health administrative database.

Setting:

Two ICUs within a single hospital system.

Patients:

Eight-thousand four-hundred forty-seven patients admitted to ICU from 2011 to 2014, of whom 332 had a diagnosis of spontaneous intracranial hemorrhage. Control patients were defined as randomly selected age, sex, and comorbidity index–matched nonintracranial hemorrhage ICU patients (1:4 matching ratio).

Interventions:

None.

Measurements and Main Results:

Mean age of ICU intracranial hemorrhage patients was 60.1 years, and 120 (36.1%) died prior to discharge. Intracranial hemorrhage was associated with a mean total cost of $75,869, compared with $52,471 in control patients (p < 0.01). Mean cost per survivor of intracranial hemorrhage patients was $118,813. Subarachnoid hemorrhage was associated with significantly higher mean total costs than intracerebral hemorrhage ($92,794 vs $53,491; p < 0.01) and higher mean cost per day ($4,377 vs $3,604; p < 0.01). Patients with intracranial hemorrhage who survived to hospital discharge were significantly costlier than decedents ($100,979 vs $30,872; p < 0.01). Intracranial hemorrhage associated with oral anticoagulant use had a mean total cost of $152,373, compared with $66,548 in nonoral anticoagulant intracranial hemorrhage (p < 0.01).

Conclusions:

Patients admitted to ICU with intracranial hemorrhage have high costs and high mortality, leading to elevated cost per survivor. Subarachnoid hemorrhage patients incur greater costs than intracerebral hemorrhage patients, and oral anticoagulant–associated intracerebral hemorrhage is particularly costly. Our findings provide novel information regarding financial impact of this common ICU population.
Swedish women’s awareness of human papillomavirus, and health-related quality of life, anxiety, and depression after a notification of an abnormal Pap smear result: a cross-sectional study
Authors: Rask Marie , Swahnberg Katarina , Oscarsson Marie
Published: February 2018

This study aims to assess (a) women’s awareness of the human papillomavirus (HPV), (b) women’s health-related quality of life (HRQoL) and levels of anxiety and depression symptoms, and (c) to compare the outcomes between women who are aware of the sexually transmitted nature of the HPV infection and women who are not. Swedish women who have been notified of an abnormal Pap smear result completed a questionnaire. This questionnaire consisted of sociodemographic characteristics, items on awareness of HPV, and how to cope with the Pap smear result and the instruments: the Functional Assessment of Chronic Illness Therapy – Cervical Dysplasia and the Hospital Anxiety and Depression Scale (HADS). Data were analyzed using descriptive statistics, Student’s t-test, χ
2-tests, Fisher’s exact test, the Mann–Whitney U-test, and Fisher–Freeman–Halton exact test. In total, 122 women participated. The women reported a median (quartile 1-quartile 3) score of 87.6 on the Functional Assessment of Chronic Illness Therapy – Cervical Dysplasia (81.8–107.0), compatible with a good HRQoL. The median (quartile 1-quartile 3) scores on HADS-anxiety and HADS-depression were 7.0 (4.0–10.0) and 3.0 (1.0–5.3), respectively; however, 48.4% of the women reported anxiety (compared with 20% in a normal population). There were no statistically significant differences in the median scores in any of the scales, including the prevalence of distress between the subgroups. Women with abnormal Pap smear results have a good HRQoL; they can become anxious, but not depressed. Awareness of HPV as a sexually transmitted infection is low, but being aware does not impact on women’s HRQoL or on anxiety and depression.
Differential Prognostic Impact of Strong PD-L1 Expression and 18F-FDG Uptake in Triple-negative Breast Cancer
Authors: Choi Seo Hee , Chang Jee Suk , Koo Ja Seung , Park Jong Won , Sohn Joo Hyuk , Keum Ki Chang , Suh Chang-Ok , Kim Yong Bae
Published: February 2018

Objectives:

Triple-negative breast cancers (TNBC) is an aggressive disease and often associated with early distant metastases, which negate the role of adjuvant radiotherapy. We studied the clinical utility of programmed death ligand-1 (PD-L1) and other available factors in predicting clinical outcome in TNBC.

Methods:

Of the 539 patients with newly diagnosed TNBC between 2004 and 2011, we analyzed 117 patients who had both tumor samples which PD-L1 protein expression could be evaluated using immunohistochemistry and initial staging 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) data to find available immunologic or metabolic factors. Median follow-up duration was 53 months.

Results:

Strong PD-L1 expression was significantly associated with increased risk of recurrence along with tumor hypermetabolism. The systemic recurrence rate was significantly higher in the strong PD-L1 group than the weak PD-L1 group (35% vs. 11%; P=0.002); whereas there was no difference in locoregional failures (8% vs. 8%). Meanwhile, tumor hypermetabolism seemed to relate with an increase in overall recurrences (26% vs. 8%; P=0.019), not with specific type (locoregional, 9% vs. 3% [P=0.289]; systemic, 22% vs. 8% [P=0.051]). The relationship between PD-L1 expression and survival outcomes retained significance even after adjusting potential risk factors.

Conclusions:

PD-L1 and tumor metabolism might have role of predicting an increase in treatment failures. Especially, strong PD-L1 expression status was related to distant metastasis-dominant recurrence pattern which needs for intensive systemic therapy.
BIMANUAL MICROINCISION VITREOUS SURGERY FOR SEVERE PROLIFERATIVE DIABETIC RETINOPATHY
Authors: Shroff Cyrus M. , Gupta Charu , Shroff Daraius , Atri Neelam , Gupta Priyanka , Dutta Ranjan
Published: February 2018

Purpose:

To evaluate the visual and anatomical outcomes and safety of bimanual microincision vitreous surgery for severe proliferative diabetic retinopathy.

Methods:

Retrospective review of 315 eyes of 282 patients who underwent 23-gauge or 25-gauge pars plana vitrectomy with bimanual membrane dissection for diabetic tractional detachment from January 2007 to September 2016. Minimum follow-up was 3 months, and the average duration of follow-up was 23 months (range 3–100 months; median 15 months). Outcome measures were best-corrected visual acuity, anatomical success, and postoperative complications.

Results:

Postoperatively, 84.3% of eyes improved (>2 lines), 10.5% were stable, and 5.4% worsened (>2 lines). Comparing gauges, two-line improvement was seen in 87.4% of 23-gauge eyes compared with 79.7% of 25-gauge eyes (P = 0.029). Mean peak best-corrected visual acuity improved from 20/930 (1.67 ± 0.63) preoperatively to 20/120 (0.78 ± 0.63) postoperatively (P < 0.001). Primary reattachment was achieved in 310 eyes (98.4%) and final reattachment in 312 eyes (99%). Recurrent vitreous hemorrhage was the commonest postoperative complication (18.4%). Lower incidence of recurrent vitreous hemorrhage was seen with 25 gauge (13.5%) compared with 23 gauge (22%, P = 0.038). Epiretinal membrane formation (7.9%), intractable glaucoma (2.5%), and endophthalmitis (0.6%) were some of the other postoperative complications.

Conclusion:

Sustained visual improvement, anatomical restoration, and low complication rates were obtained in complex situations with bimanual microincision vitreous surgery in a large series. Visual outcomes were poorer in older age group, tractional retinal detachments involving macula, and eyes with extensive membranes and with silicone oil as tamponade. Both 23-gauge and 25-gauge groups were comparable in relation to visual improvement, anatomical success, and intraoperative and postoperative complications.
Reduced Retinal Vessel Density in Primary Angle Closure Glaucoma: A Quantitative Study Using Optical Coherence Tomography Angiography
Authors: Zhu Li , Zong Yuan , Yu Jian , Jiang Chunhui , He Yi , Jia Yali , Huang David , Sun Xinghuai
Published: February 2018

Purpose:

The purpose of this article is to investigate the changes in the retinal vasculature in different parts of the fundus in eyes with primary angle closure glaucoma (PACG).

Methods:

Healthy subjects and those with PACG were enrolled. Optical coherence tomography and a split-spectrum amplitude decorrelation angiography algorithm were used to quantify the retinal vessel densities in the parafoveal and peripapillary areas.

Results:

Thirty-nine eyes from 24 PACG patients and 39 eyes from 20 age-matched and sex-matched healthy subjects were included. The retinal vessel densities in the parafoveal and peripapillary areas and every sector of the 2 areas were significantly lower in the PACG eyes than in the healthy eyes. The difference was greater in the peripapillary area (11.75%) than in the parafoveal area (7.55%, P<0.05). In the PACG eyes, the vessel density in the peripapillary area correlated closely with the intraocular pressure, but that in the parafoveal area did not. When the PACG eyes were divided into groups with well-controlled and not well-controlled intraocular pressure (≤21 mm Hg or not), the vessel density and retinal nerve fiber layer thickness in the peripapillary area were much lower in the not well-controlled eyes (P<0.05), whereas the vessel density in the parafovea and the ganglion cell complex thickness were similar in the 2 subgroups.

Conclusion:

Retinal vessel density was significantly reduced in PACG eyes. The magnitude of this difference varied between the fundus areas, and was greater in the peripapillary area.
Exfoliation Syndrome: A Historical Perspective
Authors: Tarkkanen Ahti
Published: February 2018

The discoverer of exfoliation was John Lindberg of Helsinki, Finland. He conducted his research as a young ophthalmology resident with the aim of elucidating 2 types of age-related degenerations of the iris and presenting it as an academic thesis. To this end, he had to construct a slit lamp, because they were not commercially available. During this investigation, he paid attention to greyish flakes and fringes on the anterior lens capsule and the pupillary border, which had not been previously described. His material consisted of 202 patients. The findings were recorded by time-consuming skillful drawings. His conclusions that the condition was age-related and often linked to chronic glaucoma and cataract are still valid today. The work was accepted as an academic thesis at the University of Helsinki in 1917.
Effect of Rotavirus Vaccination on Acute Diarrheal Hospitalizations Among Low and Very Low Birth Weight US Infants, 2001–2015
Authors: Dahl Rebecca M. , Curns Aaron T. , Tate Jacqueline E. , Parashar Umesh D.
Published: February 2018

Background:

The effectiveness of rotavirus vaccines in low and very low birth weight infants (LBW and VLBW) weighing <2500 and <1500 g at birth, respectively, a high-risk population for severe rotavirus gastroenteritis, has not been well examined.

Methods:

We analyzed inpatient commercial claims data for US children <5 years of age from July 2001 to June 2015. Claims for acute gastroenteritis (AGE) and rotavirus-coded hospitalizations and LBW, VLBW and normal birth weight (NBW) infants were identified. Receipt of rotavirus vaccine was defined using Current Procedural Terminology. Rate reductions were calculated using prevaccine (2001–2006) and postvaccine (2007–2015) annual AGE and rotavirus hospitalization rates.

Results:

As of December 2014, rotavirus vaccine coverage was 87%, 82% and 64%, for NBW, LBW and VLBW infants, respectively. For 2014–2015, among NBW, LBW and VLBW children <5 years of age, AGE hospitalization rate reductions relative to the prevaccine introduction period were 60% [95% confidence interval (CI): 58%–61%], 64% (95% CI: 57%–70%) and 55% (95% CI: 39%–67%), respectively. Rotavirus hospitalization rate reductions were 91% (95% CI: 90%–92%), 98% (95% CI: 93%–100%) and 93% (95% CI: 70%–98%). Rotavirus vaccines resulted in a 62% (95% CI: 51%–71%), 72% (95% CI: 44%–86%) and 71% (95% CI: 7%–91%) reduction in AGE hospitalization rates comparing vaccinated versus unvaccinated NBW, LBW and VLBW children 3–23 months of age, respectively.

Conclusions:

Rotavirus vaccines have substantially reduced AGE hospitalizations and are highly effective in LBW and VLBW infants, similar to NBW infants. Efforts to improve vaccination coverage, particularly in LBW and VLBW infants, should continue.
Impact of Cerebrospinal Fluid Multiplex Assay on Diagnosis and Outcomes of Central Nervous System Infections in Children
Authors: O’Brien Matthew P. , Francis Joshua R. , Marr Ian M. , Baird Robert W.
Published: February 2018

Background:

This study evaluated the performance of cerebrospinal fluid multiplex assay in the diagnosis of pediatric central nervous system (CNS) infection, and assessed for the effect on clinical management.

Methods:

A 15-month prospective cohort of pediatric patients with confirmed CNS infection was compared with a 15-month retrospective cohort from the Top End region of the Northern Territory, Australia. The study characterized all the CNS infections over the 30-month period and compared the time to organism identification and antibiotic management before and after the introduction of the multiplex assay.

Results:

Thirty-six cases of pediatric CNS infection were diagnosed before the introduction of the multiplex assay, and 29 afterwards. Multiplex assay was performed on 26/29 (90%) of the cerebrospinal fluid isolates from children with confirmed CNS infections in the prospective cohort. Enterovirus was the most common causative organism identified in 14 children, followed by human parechovirus in 4 children. The multiplex assay performed with 93.8% sensitivity and 90.0% specificity when compared with microbiologic culture or reference laboratory results. The median time to organism identification reduced from 6.0 to 2.0 days (P value <0.001), the median duration of antibiotic therapy from 3.0 to 2.0 days (P value <0.001) and median hospitalization reduced from 5.0 to 3.0 days (P value 0.016) after introduction of the multiplex assay.

Conclusions:

The multiplex assay is a useful adjunct diagnostic tool enabling prompt organism identification and reducing antibiotic treatment and hospitalization duration. The assay would be of most value to hospitals that do not have access to an onsite molecular laboratory.
Effect of Treating Vitamin D Deficiency in Uncontrolled Type 2 Diabetes: A Randomized, Placebo-Controlled Study
Authors: Lo Margaret C. , Abushamat Layla , Mramba Lazarus K.
Published: February 2018

Background:

Literature increasingly supports the inverse relationship of vitamin D (VitD) level and type 2 diabetes (T2DM). Proposed protective mechanisms of VitD include its anti-inflammatory effects, increased insulin secretion via pancreatic β-cell stimulation, and downregulation of parathyroid hormone levels. Interventional studies show mixed results of VitD therapy in prediabetic patients with VitD deficiency or diabetic patients with normal VitD levels.

Study Question:

Does high-dose VitD replacement improve glycemic control and microalbuminuria (MAU) in uncontrolled T2DM and concurrent VitD deficiency?

Study Design:

This placebo-controlled, double-blinded study randomized 30 subjects aged 30–65 years with an elevated HbA1c level of 7.5%–10% and a low total 25-hydroxyvitamin-D value of <20 ng/mL to either placebo (n = 16) or ergocalciferol 50,000 IU (n = 14) once weekly for 8 weeks then once monthly for 4 months.

Measures and Outcomes:

Primary outcome was difference in HbA1c from baseline to month 6 between the VitD-intervention group and the placebo-controlled group. Secondary end points were differences in total 25-hydroxyvitamin-D and MAU. Paired t tests and linear mixed-effects models were used for statistical analysis.

Results:

No significant differences were seen in HbA1c or MAU between baseline versus postintervention visits within the placebo group (HbA1c: 8.4% ± 0.2 vs. 8.1% ± 0.3, P = 0.088; MAU: 94.1 mg/g ± 43.9 vs. 45.9 mg/g ± 20.2, P = 0.152) and the intervention group (HbA1c: 8.8% ± 0.3 vs. 8.7% ± 0.4, P = 0.692; MAU: 167.8 mg/g ± 70.1 vs. 108.5 mg/g ± 39.9, P = 0.356). The difference between placebo-slope and intervention-slope was nonsignificant for MAU (β = −0.1 mg/g ± 0.4, P = 0.835) but was significant for total 25-hydroxyvitamin-D (β = 11.7 ng/mL ± 2.5, P ≤ 0.001). Greater HbA1c reduction occurred unexpectedly in the placebo group (

JOURNAL/ajthe/04.03/00045391-201908000-00002/inline-formula1/v/2023-09-17T022658Z/r/image-tiff

= −0.4% ± 0.2) than in the intervention group (

JOURNAL/ajthe/04.03/00045391-201908000-00002/inline-formula2/v/2023-09-17T022658Z/r/image-tiff

= −0.2% ± 0.4), although the difference in slopes was not significant (β = 0.2% ± 0.4, P = 0.640).

Conclusions:

Our proof-of-concept study found no benefit of high-dose VitD therapy in glycemic control and MAU in uncontrolled T2DM and VitD deficiency. Post hoc analyses raise concerns for high-dose VitD therapy to delay glycemic improvement. Large-scale interventional trials are much needed in this patient population to substantiate our findings and elucidate VitD's mechanisms on glucose metabolism.
Review of Routes to Administer Medication During Prolonged Neonatal Resuscitation
Authors: Wagner Michael , Olischar Monika , O’Reilly Megan , Goeral Katharina , Berger Angelika , Cheung Po-Yin , Schmölzer Georg M.
Published: February 2018

Objective:

During neonatal cardiopulmonary resuscitation, early establishment of vascular access is crucial. We aimed to review current evidence regarding different routes for the administration of medications during neonatal resuscitation.

Data Sources:

We reviewed PubMed, EMBASE, and Google Scholar using MeSH terms “catheterization,” “umbilical cord,” “delivery room,” “catecholamine,” “resuscitation,” “simulation,” “newborn,” “infant,” “intraosseous,” “umbilical vein catheter,” “access,” “intubation,” and “endotracheal.”

Study Selection:

Articles in all languages were included. Initially, we aimed to identify only neonatal studies and limited the search to randomized controlled trials.

Data Extraction:

Due to a lack of available studies, studies in children and adults, as well as animal studies and also nonrandomized studies were included.

Data Synthesis:

No randomized controlled trials comparing intraosseous access versus peripheral intravascular access versus umbilical venous catheter versus endotracheal tube versus laryngeal mask airway or any combination of these during neonatal resuscitation in the delivery room were identified. Endotracheal tube: endotracheal tube epinephrine administration should be limited to situations were no vascular access can be established. Laryngeal mask airway: animal studies suggest that a higher dose of epinephrine for endotracheal tube and laryngeal mask airway is required compared with IV administration, potentially increasing side effects. Umbilical venous catheter: European resuscitation guidelines propose the placement of a centrally positioned umbilical venous catheter during neonatal cardiopulmonary resuscitation; intraosseous access: case series reported successful and quick intraosseous access placement in newborn infants. Peripheral intravascular access: median time for peripheral intravascular access insertion was 4–5 minutes in previous studies.

Conclusions:

Based on animal studies, endotracheal tube administration of medications requires a higher dose than that by peripheral intravascular access or umbilical venous catheter. Epinephrine via laryngeal mask airway is feasible as a noninvasive alternative approach for drug delivery. Intraosseous access should be considered in situations with difficulty in establishing other access. Randomized controlled clinical trials in neonates are required to compare all access possibilities described above.
Childhood Drowning
Authors: Cohen Neta , Scolnik Dennis , Rimon Ayelet , Balla Uri , Glatstein Miguel
Published: February 2018

Objective

Drowning is a leading cause of death among infants and toddlers. Unique physiological and behavioral factors contribute to high mortality rates. Drowning incidents predominantly occur during warmer months and holidays. The aim of this study was to describe the characteristics of pediatric drowning victims who attended 2 different emergency departments (EDs), 1 near and 1 distant from the sea coast, to recognize risk factors, complications, causes of death, and the educational needs of families and caregivers.

Methods

Retrospective cohort analysis of incident history, clinical presentation, treatments, and outcomes of drowning victims was performed. Data were analyzed both by age group and proximity of institution to the sea coast.

Results

From 2005 to 2015, 70 drowning patients presented to the 2 institutions; there was no difference in incident history or outcomes based on proximity to the sea coast. Fifty-six percent of patients were younger than 6 years, the majority drowning in pools. More of the older children drowned in the sea (48% vs 23%). Half of all patients were treated and followed in the ED or ward, and the other half were treated in the pediatric intensive care unit; 12 suffered severe complications, including 5 diagnosed with brain death. Cardiopulmonary resuscitation was performed in 80% of the fatal group and 23% of the nonfatal group (P = 0.006). Seven children who experienced a cardiac arrest with hypothermia were treated before arrival in the ED, and 5 had ongoing cardiac arrest upon arrival in the ED (these were the 5 suffering brain death).

Discussion

Most of patients younger than 6 years drowned in swimming pools, suggesting that parents are perhaps less vigilant in these circumstances, even though they may remain in close proximity. Active adult supervision entails attention, proximity, and continuity. Educational efforts should be aimed at reminding parents of this, especially in the summer months.
Application of the Rochester Criteria to Identify Febrile Infants With Bacteremia and Meningitis
Authors: Aronson Paul L. , McCulloh Russell J. , Tieder Joel S. , Nigrovic Lise E. , Leazer Rianna C. , Alpern Elizabeth R. , Feldman Elana A. , Balamuth Fran , Browning Whitney L. , Neuman Mark I.
Published: February 2018

Objectives

The Rochester criteria were developed to identify febrile infants aged 60 days or younger at low-risk of bacterial infection and do not include cerebrospinal fluid (CSF) testing. Prior studies have not specifically assessed criteria performance for bacteremia and bacterial meningitis (invasive bacterial infection). Our objective was to determine the sensitivity of the Rochester criteria for detection of invasive bacterial infection.

Methods

Retrospective cohort study of febrile infants aged 60 days or younger with invasive bacterial infections evaluated at 8 pediatric emergency departments from July 1, 2012, to June 30, 2014. Potential cases were identified from the Pediatric Health Information System using International Classification of Diseases, Ninth Revision diagnosis codes for bacteremia, meningitis, urinary tract infection, and fever. Medical record review was then performed to confirm presence of an invasive bacterial infection and to evaluate the Rochester criteria: medical history, symptoms or ill appearance, results of urinalysis, complete blood count, CSF testing (if obtained), and blood, urine, and CSF culture. An invasive bacterial infection was defined as growth of pathogenic bacteria from blood or CSF culture.

Results

Among 82 febrile infants aged 60 days or younger with invasive bacterial infection, the sensitivity of the Rochester criteria were 92.7% (95% confidence interval [CI], 84.9%–96.6%) overall, 91.7% (95% CI, 80.5%–96.7%) for neonates 28 days or younger, and 94.1% (95% CI, 80.9%–98.4%) for infants aged 29 to 60 days old. Six infants with bacteremia, including 1 neonate with bacterial meningitis, met low-risk criteria.

Conclusions

The Rochester criteria identified 92% of infants aged 60 days or younger with invasive bacterial infection. However, 1 neonate 28 days or younger with meningitis was classified as low-risk.
Origin of the superstructure elucidated by atomic resolution HAADF-STEM and HREM in the Ce10W22O81lanthanide tungstate phase
Authors: Patout Loïc , Hallaoui Abdelali , Neisius Thomas , Campos Andrea P. C. , Dominici Christian , Alfonso Claude , Charaï Ahmed
Published: February 2018

The present paper provides new information on the attribution of the cationic sites of the orthorhombic Ce10W22O81crystal phase prepared in the CeO2–Ce2O3–WO3ternary system. Atomic resolution HAADF-STEM (high-angle annular dark-field scanning transmission electron microscopy) and HREM (high-resolution electron microscopy) investigations have highlighted the presence of two mixed columns of Ce and W cations along theaaxis that were previously assigned to pure W cations in the asymmetric unit. This discovery explains the presence of a commensurate superstructure doubling the orthorhombic unit-cell lengthao.
Neutron diffraction from aligned stacks of lipid bilayers using the WAND instrument
Authors: Marquardt Drew , Frontzek Matthias D. , Zhao Yu , Chakoumakos Bryan C. , Katsaras John
Published: February 2018

Neutron diffraction from aligned stacks of lipid bilayers is examined using the Wide-Angle Neutron Diffractometer (WAND), located at the High Flux Isotope Reactor, Oak Ridge, Tennessee, USA. Data were collected at different levels of hydration and neutron contrast by varying the relative humidity (RH) and H2O/D2O ratio from multi-bilayers of dioleoylphosphatidylcholine and sunflower phosphatidylcholine extract aligned on single-crystal silicon substrates. This work highlights the capabilites of a newly fabricated sample hydration cell, which allows the lipid bilayers to be hydrated with varying H/D ratios from the RH generated by saturated salt solutions, and also demonstrates WAND's capability as an instrument suitable for the study of aligned lipid multi-bilayers.
Polarization-independent absorption enhancement in a graphene square array with a cascaded grating structure
Authors: Wu Jun
Published: February 2018

The polarization-independent enhanced absorption effect of graphene in the near-infrared range is investigated. This is achieved by placing a graphene square array on top of a dielectric square array backed by a two-dimensional multilayer grating. Total optical absorption in graphene can be attributed to critical coupling, which is achieved through the combined effect of guided-mode resonance with the dielectric square array and the photonic band gap with the two-dimensional multilayer grating. To reveal the physical origin of such a phenomenon, the electromagnetic field distributions for both polarizations are illustrated. The designed graphene absorber exhibits near-unity polarization-independent absorption at resonance with an ultra-narrow spectrum. Moreover, the polarization-independent absorption can be tuned simply by changing the geometric parameters. The results may have promising potential for the design of graphene-based optoelectronic devices.
First-row transition metal–pyridine (py)–sulfate [(py)xM](SO4) complexes (M= Ni, Cu and Zn): crystal field theory in action
Authors: Roy Mrittika , Pham Duyen N. K. , Kreider-Mueller Ava , Golen James A. , Manke David R.
Published: February 2018

The crystal structures of three first-row transition metal–pyridine–sulfate complexes, namelycatena-poly[[tetrakis(pyridine-κN)nickel(II)]-μ-sulfato-κ2O:O′], [Ni(SO4)(C5H5N)4]n, (1), di-μ-sulfato-κ4O:O-bis[tris(pyridine-κN)copper(II)], [Cu2(SO4)2(C5H5N)6], (2), andcatena-poly[[tetrakis(pyridine-κN)zinc(II)]-μ-sulfato-κ2O:O′-[bis(pyridine-κN)zinc(II)]-μ-sulfato-κ2O:O′], [Zn2(SO4)2(C5H5N)6]n, (3), are reported. Ni compound (1) displays a polymeric crystal structure, with infinite chains of NiIIatoms adopting an octahedral N4O2coordination environment that involves four pyridine ligands and two bridging sulfate ligands. Cu compound (2) features a dimeric molecular structure, with the CuIIatoms possessing square-pyramidal N3O2coordination environments that contain three pyridine ligands and two bridging sulfate ligands. Zn compound (3) exhibits a polymeric crystal structure of infinite chains, with two alternating zinc coordination environments,i.e.octahedral N4O2coordination involving four pyridine ligands and two bridging sulfate ligands, and tetrahedral N2O2coordination containing two pyridine ligands and two bridging sulfate ligands. The observed coordination environments are consistent with those predicted by crystal field theory.
On the effect of Ga and In substitutions in the Ca11Bi10and Yb11Bi10bismuthides crystallizing in the tetragonal Ho11Ge10structure type
Authors: Ovchinnikov Alexander , Bobev Svilen
Published: February 2018

The Ga- and In-substituted bismuthides Ca11GaxBi10–x, Ca11InxBi10–x, Yb11GaxBi10–x, and Yb11InxBi10–x(x< 2) can be readily synthesized employing molten Ga or In metals as fluxes. They crystallize in the tetragonal space groupI4/mmmand adopt the Ho11Ge10structure type (Pearson codetI84; Wyckoff sequencen2m j h2e2d). The structural response to the substitution of Bi with smaller and electron-poorer In or Ga has been studied by single-crystal X-ray diffraction methods for the case of Ca11InxBi10–x[x= 1.73 (2); octabismuth undecacalcium diindium]. The refinements show that the In atoms substitute Bi only at the 8hsite. The refined interatomic distances show an unconventional – for this structure type – bond-length distribution within the anionic sublattice. The latter can be viewed as consisting of isolated Bi3−anions and [In4Bi820−] clusters for the idealized Ca11In2Bi8model. Formal electron counting and first-principle calculations show that the peculiar bonding in this compound drives the system toward an electron-precise state, thereby stabilizing the observed bond-length pattern.
New solvates of the drug naltrexone: protonation, conformation and interplay of synthons
Authors: Gonçalves Karolina de Oliveira , Ribeiro Leandro , Oliveira Cecilia Maria Alves de , Carvalho Jesiel Freitas , Martins Felipe T.
Published: February 2018

Naltrexone [systematic name: (4R,4aS,7aR,12bS)-3-cyclopropylmethyl-4a,9-dihydroxy-2,4,5,6,7a,13-hexahydro-1H-4,12-methanobenzofuro[3,2-e]isoquinolin-7-one] is an important morphine-related drug used for combating alcoholism and opioid dependence. Of the eight crystal forms of naltrexone known thus far, only one exists in the neutral form and it crystallizes as a monohydrate. We have isolated the naltrexone free base as two new solvate forms,i.e.the ethyl acetate 0.33-solvate, C20H23NO4·0.33C4H8O2, (I), and the diethyl ether hemisolvate, C20H23NO4·0.5C4H10O, (II). While just one solvent molecule is present in the asymmetric unit of each solvate, there are three drug molecules (Z′ = 3) in ethyl acetate solvate (I) and two (Z′ = 2) in diethyl ether solvate (II). In (I), one of the three crystallographically independent drug molecules is present with its cyclopropyl group disordered over two sets of positions, as is the whole diethyl ether solvent molecule in (II). In all known forms, including the title forms, the naltrexone molecule exhibits the same conformation of the fused rings. The only conformational variability of naltrexone is in the cyclopropylmethyl group. Two conformations can be found around the bond connecting this group to the N-heterocycle, which is directly related to drug protonation. We have calculated, at the B3LYP/6-31G** level of theory, the minimum energy conformations of protonated and neutral naltrexone molecules for a chosen torsion angle about this bond. The lowest energy conformers depend on the protonation state and are in agreement with those found in the solid state. Within the cyclopropylmethyl group, the bond joining the methylene C atom to the cyclopropyl fragment also evidences conformational variability. In the literature, there are two well defined conformations around this bond. A third cyclopropyl conformation around this second bond is observed in the title solvates. Concerning the supramolecular features of the previously reported crystal structures, only one classical hydrogen bond between naltrexone molecules and oneC(8) homosynthon is known, pointing to the robustness of this synthon and the difficulty in disrupting it. NewR22(7) andC22(10) homosynthons are found in both (I) and (II), suggesting that their occurrence derives from crystallization of the neutral drug from nonpolar solvents.
Structuring social and environmental management control and accountability
Authors: Parker Lee D. , Chung Lai Hong
Published: February 2018

Purpose

The purpose of this paper is to investigate the construction of social and environmental strategies and the related implementation of management control by a key organisation located in a pivotal Asian location in the global hospitality industry. In doing so, it sets out to elucidate the forms and processes of strategic social and environmental control as well their relationship to the traditional financial control system.

Design/methodology/approach

The study employs field-based case study of a single case operating in both regional and global context. Drawing upon documentary, survey and interview sources, the study employs structuration theory to inform its design and analysis.

Findings

The findings reveal the interaction of top-down global corporate framing and bottom-up local-level staff initiatives that combine to develop a locally focussed and differentiated social and environmental programme and expedite an associated management control and accountability system. The study also reveals the dominance of the traditional financial control system over the social and environmental management control system and the simultaneously enabling and constraining nature of that relationship.

Practical implications

Signification and legitimation structures can be employed in building social and environmental values and programmes which then lay the foundations for related discourse and action at multiple levels of the organisation. This also has the potential to facilitate modes of staff commitment expressed through bottom-up initiatives and control, subject to but also facilitated by the dominating influence of the organisation’s financial control system.

Social implications

This study reveals the importance of national and regional governmental, cultural and social context as both potential enablers and beneficiaries of organisational, social and environmental strategy and control innovation and implementation.

Originality/value

The paper offers an intra-organisational perspective on social and environmental strategising and control processes and motivations that elucidates forms of action, control and accountability and the relationship between social/environmental control and financial control agendas. It further reveals the interaction between globally developed strategic and control frameworks and locally initiated bottom-up strategic initiatives and control.
Supply chain innovation-driven business models
Authors: Abdelkafi Nizar , Pero Margherita
Published: February 2018

Purpose

The purpose of this paper is to explore case studies of business models (BMs) driven by supply chain innovations (SCIs) in order to investigate how SCIs can lead companies to discover new BMs.

Design/methodology/approach

This research is based on an in-depth literature analysis. Literature supports that SCIs drive new BMs. An exploratory interview-based study with practitioners from German and Italian companies shed more light on the ways SCIs can contribute to the discovery of new BMs.

Findings

So-called operators can establish close links between SCIs and BM innovation. Because in general, supply chains are designed to improve operational performance, most BM improvements are incremental. Large companies, however, can leverage SCIs to generate new BMs that are complementary to their current BMs.

Research limitations/implications

This research is exploratory in nature. Further (quantitative) research studies can link SCIs types to specific BM patterns and examine contingency factors such as size and industry sector that influence the relationship between SCIs and BMs.

Practical implications

This research draws the attention of practitioners to SCIs as a valuable opportunity to discover new BMs. The operators enable companies to estimate the effects of specific SCIs on their BMs and to identify the SCIs required for achieving a targeted BM.

Originality/value

This paper elaborates propositions about the relationships between SCIs and BMs. It identifies supply chain and process management as important streams of literature that can support the advancement of BM research.
Do age, work experience and gender affect individuals’ propensity to trust others? An exploratory study in the United Arab Emirates
Authors: Zeffane Rachid
Published: February 2018

Purpose

The purpose of this paper is to examine the impact of age, work experience and gender on individuals’ propensity (inclination or readiness) to trust others.

Design/methodology/approach

The authors gathered literature arguments and developed a basic theoretical model explored through an empirical study. The study uses a sample of 324 retail business owners/operators in the United Arab Emirates. The authors developed and tested three main hypotheses.

Findings

Age has a significant positive impact on the propensity to trust. Work experience has a similar effect, but to a lesser degree. Females are generally less predisposed to trust. However, the impact of age on trust was significant for both males and females.

Research limitations/implications

This study focuses on a small sample of individuals in a single country. A larger multi-context study would be beneficial in verifying the above findings. Also, the concept of trust used in this study is general and focuses mainly on general likelihood/aspirations to trust others. Future research could examine the relationship of age to different aspects of trust and in different circumstances.

Practical implications

The findings of this study have several practical benefits. They draw the attention of human resource management practitioners and policy makers to the importance of age, work experience and gender in shaping trust relationships in both societal and business contexts.

Originality/value

The impact of age (and aging) work and society in general is a growing concern. Despite the number of studies examining trust and the process of trust formation, the relationships between age, gender and trust have been largely overlooked in previous research. This study attempts to address this gap and provides useful evidence likely to inspire further/future research on this issue.
The persisting link between physical recreation spending and education – the case of Finland
Authors: Keipi Teo , Räsänen Pekka , Kajava Olli , Saarinen Arttu
Published: February 2018

Purpose

The purpose of this paper is to examine the development of household spending on physical recreation and the structural distribution of spending over the years 1985-2012 in Finland linked to various contextual factors including education level, income and area of residence.

Design/methodology/approach

The study uses Statistics Finland’s consumption research data in a quantitative analysis toward adding a new dimension to research on Finns’ physical recreation spending.

Findings

Findings show that the amount of money spent on physical recreation equipment and services has grown steadily. Finns’ spending on physical recreation continues to be relatively conservative relative to income, though there are notable differences between population groups. The link between education level and physical recreation remains strong. The largest difference between education levels is between those having completed basic level education and those with higher education degrees. Household type also explains a great deal of the difference in amount spent on physical recreation. According to the results, physical recreation spending is central to the leisure activities of highly educated family units.

Originality/value

Research on the stratification of consumption habits in Finnish society has not yet addressed physical recreation spending. Furthermore, research on income spent on such activity by various population groups at different times has not been carried out. This paper provides research on both of these themes.
Effect of lubricant ageing on lubricants’ physical and chemical properties and tribological performance; Part I: effect of lubricant chemistry
Authors: Cen Hui , Morina Ardian , Neville Anne
Published: February 2018

Purpose

Ageing has been known to affect the performance of lubricants. However, there is a lot of debate as to whether ageing is beneficial or detrimental to the wear performance of lubricants.

Design/methodology/approach

The purpose of this research is to evaluate the effect of ageing on the viscosity, total acid number and Fourier-transform infrared spectroscopy information of a series of lubricants. The tribological performance (friction and wear) of the aged lubricants is also studied, followed by X-ray photoelectron spectroscopy analysis on the selected post-test samples to study the tribochemical features of the tribofilm.

Findings

The results show that ageing has a different impact on lubricants and tribological performances based on the physical and chemical properties.

Originality/value

These findings will be compared with the research on the role of water in lubricant ageing (Part II of this study).