bluuebunny/crossref_metadata_2025 huggingface dataset:
Examining Age, Sex, and Race Characteristics of Velopharyngeal Structures in 4- to 9-Year-Old Children Using Magnetic Resonance Imaging
Authors: Perry Jamie L. , Kollara Lakshmi , Kuehn David P. , Sutton Bradley P. , Fang Xiangming
Published: January 2018

Objective:

The purpose of this study was to quantify the growth of the various craniofacial and velopharyngeal structures and examine sex and race effects.

Methods:

Eight-five healthy children (53 white and 32 black) with normal velopharyngeal anatomy between 4 and 9 years of age who met the inclusion criteria and successfully completed the magnetic resonance imaging (MRI) scans were included in the study.

Results:

Developmental normative mean values for selected craniofacial and velopharyngeal variables by race and sex are reported. Facial skeleton variables (face height, nasion to sella, sella to basion, palate height, palate width) and velopharyngeal variables (levator muscle length, angle of origin, sagittal angle, velar length, velar thickness, velar knee to posterior pharyngeal wall, and posterior nasal spine to levator muscle) demonstrated a trend toward a decrease in angle measures and increase in linear measures as age increased (with the exception of posterior nasal spine to levator muscle). Only hard palate width and levator muscle length showed a significant sex effect. However, 2 facial skeleton and 6 velopharyngeal variables showed a significant race effect. The interactions between sex, race, and age were not statistically significant across all variables, with the exception of posterior nasal spine to posterior pharyngeal wall.

Conclusion:

Findings established a large age- and race-specific normative reference for craniofacial and velopharyngeal variables. Data reveal minimal sexual dimorphism among variables used in the present study; however, significant racial effects were observed.
Academic Achievement Among Children With Nonsyndromic Orofacial Clefts
Authors: Watkins Stephanie E. , Meyer Robert E. , Aylsworth Arthur S. , Marcus Jeffrey R. , Allori Alexander C. , Pimenta Luiz , Lipinski Robert J. , Strauss Ronald P.
Published: January 2018

Objective:

Children with orofacial clefts (OFCs) may experience poor reading proficiency, learning disabilities, and academic underachievement. We examined the association between nonsyndromic (NS) OFCs and end-of-grade (EOG) performance in reading and math from third through eighth grade in a sample subgroup.

Participants:

We identified a cohort of 559 children with NS-OFCs and 6822 children without birth defects, classifying cleft type by cleft lip alone, with or without cleft alveolar ridge (CL); cleft lip with cleft palate (CL+P); and cleft palate only (CP).

Main Outcome Measures:

Using logistic regression, we estimated the odds of not meeting grade-level standards among children with NS-OFCs compared to unaffected peers. Using longitudinal analyses, we estimated the odds of not meeting grade-level standards and average change in test scores through eighth grade.

Results:

Children with NS-OFCs were 1.22 (95% CI: 0.96, 1.83) times as likely not to meet grade-level standards in reading compared to unaffected peers. The effect was similar for math (OR: 1.17; 95% CI: 0.92, 1.48). Children with CL+P were 1.33 (95% CI: 0.86, 1.83) and 1.74 (95% CI: 1.19, 2.56) times as likely not to meet grade-level standard in reading and in both subjects, respectively, compared to unaffected peers. The average rate of change in both scores was similar for children with and without OFCs.

Conclusions:

Poor academic performance appears greatest for children with CL+P, a finding compatible with previous observations and hypothesized mechanisms associating orofacial clefts with subtle abnormalities in brain development. Academic performance monitoring and referral for academic assistance is warranted.
Facial Growth at 5 and 10 Years After Veau-Wardill-Kilner Versus Minimal-Incision Technique Repair of Isolated Cleft Palate
Authors: Parikakis Konstantinos , Larson Ola , Larson Margareta , Karsten Agneta
Published: January 2018

Objective:

To compare the Veau-Wardill-Kilner technique with the Minimal-Incision technique repair of isolated clefts of the hard and soft palate regarding facial growth at 5 and 10 years of age.

Design:

Retrospective study of lateral cephalograms.

Setting:

Hospital and university based.

Patients:

A consecutive series of 145 Caucasian nonsyndromic children born with isolated cleft palate between 1980 and 1996 were studied. Children with Pierre Robin sequence (PRS) were included in the study. The patients were divided into 4 groups: 2 groups regarding surgical technique and 2 groups regarding cleft length.

Intervention:

Veau-Wardill-Kilner or Minimal-Incision palatoplasty.

Main Outcome Measures:

Eleven skeletal and 1 soft tissue measurement were evaluated from lateral cephalograms taken at 5 and 10 years of age.

Results:

Only minor differences in cephalometric morphology were found between the Veau-Wardill-Kilner technique group and the Minimal-Incision technique group. Similar results were found independent of cleft length or the inclusion of PRS in the sample.

Conclusion:

The craniofacial cephalometric morphology at 5 and 10 years of age in patients with isolated cleft palate is similar between the Veau-Wardill-Kilner and the Minimal-Incision technique group.
Maternal Representations and Parenting Style in Children Born With and Without an Orofacial Cleft
Authors: Habersaat Stephanie , Turpin Helene , Möller Cecile , Borghini Ayala , Ansermet François , Müller-Nix Carole , Urben Sébastien , Hohlfeld Judith
Published: January 2018

Objective:

To investigate the evolution of maternal representations (ie, the way parents perceive their child in term of temperament, character, behaviors, etc) of children with a cleft at 3 major milestones: before/after reconstructive surgeries and at school age. Parenting style was also analyzed and compared with parents of children born without a cleft.

Design and participants:

The sample was composed of 30 mothers of children with an orofacial cleft and 14 mothers of children without a cleft. Maternal representations were assessed when the child was 2 months (before surgery), 12 months (after surgery), and 5 years of age (when starting school) using semistructured interviews that were transcribed and coded according to the subscales of the Working Model of the Child Interview and the Parental Development Interview. At the 5-year appointment, mothers also completed a questionnaire about parenting style.

Results:

Results showed no difference across groups (cleft/noncleft) in maternal representations at the 2-month, 12-month, and 5-year assessments. In the cleft group, significant differences were shown between 2 and 12 months in caregiving sensitivity, perceived infant difficulty, fear for the infant’s safety, and parental pride, all factors being higher at 12 months. Those differences in parental representations over time were not found in the noncleft group. Additionally, mothers of the cleft group were significantly more authoritarian than mothers of children without a cleft.

Conclusion:

The absence of differences across cleft and noncleft groups suggests that having a child with a cleft does not affect maternal representations and emotions between 2 months and 5 years of the child’s age. However, parenting style seems to be influenced by the presence of a cleft in the present sample.
Surgical Closure of the Cleft Palate Has a Transient Obstructive Effect on the Upper Airway in Children
Authors: Prado Priscila Capelato , de Bragança Lopes Fernandes Marilyse , dos Santos Trettene Armando , Graziela Noronha Silva Salgueiro Alícia , Kiemle Trindade-Suedam Ivy , Trindade Inge Elly Kiemle
Published: January 2018

Objective:

To prospectively investigate the occurrence of respiratory symptoms related to obstructive sleep apnea (OSA) following primary palatoplasty in children with cleft palate (CP).

Method:

Fifty-six nonsyndromic children presenting CP with a previously repaired cleft lip (CL) or without CL were assessed before and after palate repair. Twenty nonsyndromic children with isolated CL were analyzed as controls before and after lip repair. Respiratory symptoms were investigated preoperatively, and at early and late postoperative periods. Based on the parent reports of “difficulty of breathing (D), apnea events (A) and/or snoring (S) during sleep, a validated OSA index (1.42D + 1.41A + 0.71S – 3.83) was used to predict absence of OSA, possible OSA, and presence of OSA, at the 3 periods analyzed.

Results:

Screening for OSA showed that the CP group exhibited an increased mean index at the early postoperative assessment, suggesting “possible OSA,” and a higher frequency of snoring at the early and late postoperative assessments, as compared to the CL group ( P < .05). Sleep apnea events were not reported.

Conclusions:

Surgical closure of the palate has an obstructive effect on the upper airway in the short term, causing OSA-related respiratory symptoms, mostly transient. However, the high prevalence of snoring still observed in the long term indicate that children with a palatal cleft who undergo surgical repair are at risk for OSA. The results support the conclusion that OSA is underappreciated in this population.
What Drives Opposition to Economic Reforms? The Role of Ex Ante Uncertainty
Authors: Potter Alan
Published: January 2018

The theoretical literature on support for pro-market economic reforms identifies uncertainty about the future consequences of reform as an important determinant of opposition to pro-market policies. However, this literature does not rigorously test the role of uncertainty on support for pro-market reforms. This paper addresses this gap by testing the role of uncertainty using a new geocoded dataset of state-owned enterprises in India and a difference-in-differences strategy. I find that voters who are threatened with privatization but do not experience the policy vote against the privatizing party whereas voters that actually experience privatization vote in favor of the privatizing party. These results provide strong empirical support for the role of uncertainty to explain opposition to economic reform programs.
Gendered Opportunities and Constraints: How Executive Sex and Approval Influence Executive Decree Issuance
Authors: Shair-Rosenfield Sarah , Stoyan Alissandra T.
Published: January 2018

Do female executives exercise the authority of their office distinctly from their male counterparts? Anecdotal evidence suggests women legislators are likely to govern in a more consensual manner than men. Yet there has been little systematic research extending such claims to women in executive office. Using an original data set, we evaluate one aspect of policy agenda setting—rates of executive decree issuance—among four male–female pairs of Latin American presidents between 2000 and 2014. Female presidents are generally less prone to rule by decree, but this relationship is conditioned by presidential popularity. Female executives with high presidential approval ratings are less likely to rule via unilateral action than similarly popular male executives, but the gendered differences in decree issuance disappear when executives possess low approval ratings. Our findings have implications for understanding the potential benefits of feminine leadership styles for executive–legislative relations and good governance.
The Changing Urban Political Order and Politics of Space: A Study of Hong Kong’s POSPD Policy
Authors: Yu Yang
Published: January 2018

There is an increasing tension between the land development regime and grassroots antigrowth coalitions in Hong Kong, where public spaces have played a critical role. This article aims to examine (1) whether the transitional process of urban political orders is punctuated or gradual; (2) whether transitional change is driven by exogenous factors, endogenous factors, or both; (3) the extent to which the social production model of power is still applicable in the postindustrial era; and (4) how political sociospatial dialectic works in the changing urban political order. This study first reviews the development of Public Open Spaces in Private Development (POSPD) with the changing urban political order, and then explains why POSPD policy has become the concern of both the regime and the emerging antigrowth coalition. Two representative spatial protests are explored to illustrate how awakening civil power challenges the regime and how the regime resists and defends its realm.
Genetic basis for relapse rate in multiple sclerosis: Association with LRP2 genetic variation
Authors: Hilven Kelly , Vandebergh Marijne , Smets Ide , Mallants Klara , Goris An , Dubois Bénédicte
Published: January 2018

Background:

In contrast to successes for multiple sclerosis (MS) susceptibility, the genetic basis for clinical heterogeneity remains largely unresolved.

Objectives:

We investigate the first reported genetic association with relapse rate.

Methods:

We genotyped variant rs12988804 in LRP2 in a homogeneous study population of 527 Belgian MS patients with 970 documented relapses.

Results:

The rs12988804*T allele is associated with a 1.16-fold increased hazard rate for a relapse occurring ( P = 0.0078) and a higher baseline relapse rate prior to immunomodulatory treatment ( P = 0.044).

Conclusion:

Variant rs12988804 in LRP2, the first example of a genome-wide significant association with relapse rate in MS, is replicated in an independent study.
Numerical modeling and seismic evaluation of masonry-infilled reinforced concrete frames retrofitted with carbon fiber–reinforced polymer wraps
Authors: Pan Xiaolan , Yan Jiachuan , Wang Zhenyu , Zou Chaoying
Published: January 2018

This article investigates the efficiency of various retrofitting schemes using carbon fiber–reinforced polymers in improving the seismic performance of a substandard masonry-infilled reinforced concrete frame. One virtual five-story reinforced concrete frame was designed according to out-of-date Chinese codes. In total, 15 carbon fiber–reinforced polymers retrofitting schemes were adopted before earthquakes, and three sets of earthquakes representing low, medium, and high frequency contents were selected to conduct the incremental dynamic analysis. The influence of infills’ collapse due to out-of-plane effect was discussed detailedly, and then, the effectiveness of different retrofitting schemes was evaluated. It was found that the collapse of infills obviously reduced the seismic capacity and finally resulted in a soft-story failure mechanism for the reinforced concrete frame. For earthquakes with low frequency content, the enhancement efficiency of retrofitting infills or both columns and infills was increased with the increase in the number of retrofitted stories; however, for medium and high earthquake frequency contents, retrofitting infills or both columns and infills were inefficient when less than half of the structure height was retrofitted. Among the adopted 15 schemes, carbon fiber–reinforced polymers retrofit of both columns and infills along the full building height was found to be the most efficient. Improper selection of a retrofitting scheme could lead to the change of soft-story location. The inter-story drift ratio capacity of effectively retrofitted frames can meet the requirements of current seismic code.
Public awareness of palliative care in Sweden
Authors: Westerlund Caroline , Tishelman Carol , Benkel Inger , Fürst Carl Johan , Molander Ulla , Rasmussen Birgit H. , Sauter Sylvia , Lindqvist Olav
Published: January 2018

Objective: The aim of this study was to investigate the awareness of palliative care (PC) in a general Swedish population. Design: We developed an e-survey based on a similar study conducted in Northern Ireland, consisting of 10 questions. Closed questions were primarily analyzed using descriptive statistics. Open questions were subject to inductive qualitative analysis. Subjects: The study utilized a population sample of 7684 persons aged 18–66, of which 2020 responded, stratified by gender, age and region. Results: Most participants reported ‘no’ ( n = 827, 41%) or ‘some’ ( n = 863, 43%) awareness of PC. Being female or older were associated with higher levels of awareness, as was a university-level education, working in a healthcare setting and having a friend or family member receiving PC. Most common sources of knowledge were the media, close friends and relatives receiving PC, as well as working in a healthcare setting. Aims of PC were most frequently identified as ‘care before death’, ‘pain relief’, ‘dignity’ and a ‘peaceful death’. The preferred place of care and death was one’s own home. The main barriers to raising awareness about PC were fear, shame and taboo, along with perceived lack of information and/or personal relevance. The term ‘palliative care’ was said to be unfamiliar by many. A number of strategies to enhance awareness and access to PC were suggested, largely reflecting the previously identified barriers. Conclusions: This survey found limited awareness of palliative care in an adult sample of the Swedish general public ≤ 66 years, and points to a more widespread disempowerment surrounding end-of-life issues.
Effects of a Story Grammar Intervention With Repeated Retells for English Learners With Language Impairments
Authors: Miller Rhonda D. , Correa Vivian I. , Katsiyannis Antonis
Published: January 2018

This study investigated the effects of a narrative intervention that employed repeated story retells and a Story Grammar Marker on the oral narrative skills of Spanish-speaking English learners with language impairments. Four third- and fourth-grade students participated in the study. Using a single-case multiple probe across participants design, the authors measured three dependent variables: narrative organization skills, narrative productivity, and syntactic complexity. As a result of the intervention, stories became more cohesive and scores for narrative organization increased by approximately 7 points from baseline to intervention across participants. Smaller effects for narrative complexity and syntactic complexity measures were noted. Implications for future research and for practice are provided.
Factors Influencing the Potency of Alzheimer Inhibitors: Computational and Docking Studies
Authors: Atlam Faten , Awad Mohamed , Salama Rehab
Published: January 2018

Density functional theory (B3LYP/6-31G [d]) is performed to study the effect of molecular and electronic structures of the investigated β-secretase 1 (BACE1) Alzheimer’s inhibitors on their biological activities and discuss the correlation between their inhibition efficiencies and quantum chemical descriptors. IC50 values of the investigated compounds are mostly affected by the substituted R2 phenyl moiety. The calculations show that the presence of electron withdrawing group increases the half maximal inhibitory concentration (IC50). Structure–activity relationship studies show that the electronic descriptors, energy of high occupied molecular orbital, ΔE, lipophilicity, hardness, and ionization potential index, are the most significant descriptors for the correlation with IC50. Molecular docking simulation is performed to explain the mode of interaction between the most potent drug and the binding sites of the BACE1 target. A good correlation between the experimental and the theoretical data confirms that the quantum chemical methods are successful tools for the discovery of novel BACE1 drugs.
Soft Robotic Manipulator for Improving Dexterity in Minimally Invasive Surgery
Authors: Diodato Alessandro , Brancadoro Margherita , De Rossi Giacomo , Abidi Haider , Dall’Alba Diego , Muradore Riccardo , Ciuti Gastone , Fiorini Paolo , Menciassi Arianna , Cianchetti Matteo
Published: January 2018

Background. Combining the strengths of surgical robotics and minimally invasive surgery (MIS) holds the potential to revolutionize surgical interventions. The MIS advantages for the patients are obvious, but the use of instrumentation suitable for MIS often translates in limiting the surgeon capabilities (eg, reduction of dexterity and maneuverability and demanding navigation around organs). To overcome these shortcomings, the application of soft robotics technologies and approaches can be beneficial. The use of devices based on soft materials is already demonstrating several advantages in all the exploitation areas where dexterity and safe interaction are needed. In this article, the authors demonstrate that soft robotics can be synergistically used with traditional rigid tools to improve the robotic system capabilities and without affecting the usability of the robotic platform. Materials and Methods. A bioinspired soft manipulator equipped with a miniaturized camera has been integrated with the Endoscopic Camera Manipulator arm of the da Vinci Research Kit both from hardware and software viewpoints. Usability of the integrated system has been evaluated with nonexpert users through a standard protocol to highlight difficulties in controlling the soft manipulator. Results and Conclusion. This is the first time that an endoscopic tool based on soft materials has been integrated into a surgical robot. The soft endoscopic camera can be easily operated through the da Vinci Research Kit master console, thus increasing the workspace and the dexterity, and without limiting intuitive and friendly use.
Patient Preferences and Utilization of Online Resources for Patients Treated in Hand Surgery Practices
Authors: Rao Allison J. , Dy Christopher J. , Goldfarb Charles A. , Cohen Mark S. , Wysocki Robert W.
Published: January 2018

Background: The Internet is a widely used resource by patients however, objective data on details such as frequency of usage and specific sites visited is lacking. We surveyed patients from hand surgery practices to describe patient preferences and utilization patterns for online resources. Methods: From October 2015 to June 2016, we enrolled patients presenting to 4 orthopedic hand surgeons at 2 academic institutions. Patients completed a survey, with questions related to their preference for learning about their diagnosis and Internet utilization both before and after the visit. Results: A total of 226 patients were enrolled in the study. Forty-five percent of the patients had done online research prior to the office visit, and 81% preferred to learn about their diagnosis through verbal communication, as opposed to only 8% who listed Web site information. Fifty percent indicated that there was a greater than 50% chance or they would definitely seek additional information on the Internet after the office visit. When asked to choose from a list of Web sites to visit, the most popular Web site was WebMD. Specialty society Web sites (American Society for Surgery of the Hand and American Academy of Orthopaedic Surgeons) were less popular. Conclusions: This survey-based study found that a majority of patients utilize the Internet both before and after the office visit; however, they often utilize unregulated sites for information. This information can help physicians guide patients to high-quality Web sites for information on their clinical diagnosis and treatment.
A case of intra-arterial thrombolysis with alteplase in a patient with hypothenar hammer syndrome but without underlying aneurysm
Authors: Shukla Harshal , Yaghdjian Vicken , Koleilat Issam
Published: January 2018

Hypothenar hammer syndrome is a cause of symptomatic ischemia of the hand secondary to the formation of aneurysm or thrombosis of the ulnar artery in the setting of a complete or incomplete palmar arch. Acute occlusive thrombus or embolus of the hand represents a complex problem that often may require immediate surgical intervention. We report a case of acute unilateral arterial hand ischemia requiring catheter-directed thrombolysis with Alteplase therapy in a patient with acute occlusive arterial thrombosis of the left ulnar artery. A catheter-directed thrombolytic regimen consisted of Alteplase 1 mg/h for 24 h, and heparin was infused through the sheath side arm at a rate of 500 units per hour for resolution of the thrombus and improvement in symptoms. A former truck driver presented with worsening pain and subsequent development of significant cyanosis with early gangrenous changes of the left second and third fingertips. He had significant callous of the hypothenar eminence and reported that his left hand was not only his “driving” hand but also a cane has been used in his left hand to ambulate. Initial angiogram revealed only ulnar artery occlusion at the wrist with reconstitution just distal to the hypothenar eminence. After 24 h of the initiation of thrombolysis, repeat angiography revealed resolution with a widely patent ulnar artery. His symptoms and the color of his digits immediately improved, and within a few months, his hand had normalized. The patient had no clinical sequelae of thrombolytic therapy. Catheter-directed thrombolytic therapy in situations of acute occlusive thrombus of the hand may provide a therapeutic option for patients with suspected hypothenar hammer syndrome. However, thrombolytic therapy carries risk of significant hemorrhagic complications. Before initiating therapy, careful judgment about the possibility for bleeding risk is required. This provides for a minimally invasive alternative to open surgical revascularization especially in the absence of underlying correctable anatomic defect such as aneurysm.
Acute myeloid leukemia with KMT2A-SEPT5 translocation: A case report and review of the literature
Authors: Elzamly Shaimaa , Chavali Santosh , Tonk Vijay , Tonk Sahil , Gaur Sumit , Tarango Darlene , Torabi Alireza
Published: January 2018

Chromosomal rearrangement involving the KMT2A gene is one of the most common genetic alteration in acute myeloid leukemia. A total of 135 different KMT2A rearrangements have been identified, where 94 translocation partner genes are now characterized at the molecular level. Of these 94 translocation partner genes, 35 translocation partner genes occur recurrently, but only 9 specific gene fusions account for more than 90% of cases. Translocation of KMT2A with SEPT5 gene at 22q11.2 is rare, with few reported cases in the literature. In this report, we are presenting a case of KMT2A-SEPT5 fusion in de novo acute myeloid leukemia with t(11;22)(q23;q11.2) with a review of the literature.
Lichen planus following tetanus–diphtheria–acellular pertussis vaccination: A case report and review of the literature
Authors: Rosengard Heather C , Wheat Chikoti M , Tilson Matthew P , Cuda Jonathan D
Published: January 2018

Lichen planus is an inflammatory dermatosis with a prevalence of approximately 1%. Recent meta-analyses show that patients with hepatitis C virus have a 2.5- to 4.5-fold increased risk of developing lichen planus. Lichen planus has also followed vaccinations and has specifically been attributed to the hepatitis B vaccine, the influenza vaccine, and the tetanus–diphtheria–acellular pertussis vaccine. We describe a case of lichen planus in a hepatitis C virus–infected African American male occurring in temporal association with the administration of the tetanus–diphtheria–acellular pertussis vaccine. The patient’s presentation was clinically consistent with lichen planus and confirmed by biopsy. It is likely that many cases of vaccine-induced lichen planus have gone unpublished or unrecognized. In areas with high prevalence of hepatitis C virus infection, we may expect to see more cases of vaccine-induced lichen planus especially in light of the updated Centers for Disease Control and Prevention tetanus–diphtheria–acellular pertussis vaccination recommendations. This case serves to educate healthcare providers about vaccine-induced lichen planus and, in particular, the need to counsel hepatitis C virus–infected patients about a potential risk of developing lichen planus following vaccination. We also reflect on current theories suggesting the T-cell–mediated pathogenesis of lichen planus and the role that hepatitis C virus and toxoid or protein vaccines may play in initiating the disease.
Secondary multifocal intraocular lens implantation: A novel management strategy for white cataracts
Authors: Ling Jiawen , Qian Yiyong , Lu Peirong
Published: January 2018

Objectives:

This study was designed to analyse the outcomes of secondary multifocal intraocular lens implantation in eyes with white cataracts.

Methods:

White cataract patients undergoing secondary multifocal intraocular lens implantation between June 2014 and January 2015 were evaluated prospectively. As opposed to a conventional primary intraocular lens implantation for an optimal patient, the white cataract was first extracted, followed by optical biometry measurements. Whether or not the patient had adequate visual acuity was identified, and the multifocal intraocular lens was implanted secondarily. A total of five appropriate white cataract patients were enrolled in this secondary multifocal intraocular lens implantation study and were retrospectively reviewed.

Results:

All five secondary implantations of the multifocal intraocular lenses were successful, without obvious adverse events. The uncorrected near visual acuity LogMAR was 0.4–0.5, and the distance visual acuity was −0.1 to 0.1 after 12 months of the multifocal intraocular lens implantation. All patients achieved satisfactory near and distance visual acuities and spectacle freedom.

Conclusion:

Two-stage multifocal intraocular lens implantation is a safe and novel technique for the management of white cataract patients to optimise near and distance visual acuities.
Staphylococcal scalded skin syndrome: A pediatric dermatology case report
Authors: Meshram Girish Gulab , Kaur Neeraj , Hura Kanwaljeet Singh
Published: January 2018

Staphylococcal scalded skin syndrome is a condition which predominantly affects children and causes a spectrum of skin lesions. We present a case of a 2-month-old infant with complaints of fever and fragile blisters over the body. The mucosal areas were spared. The diagnosis of staphylococcal scalded skin syndrome was reached on clinical grounds and culture report. The patient responded well to the treatment, which included an antibiotic (cloxacillin), an analgesic (paracetamol), and hydration with intravenous fluids. He was discharged after 8 days, with almost complete resolution of his skin lesions. Having a high clinical suspicion for staphylococcal scalded skin syndrome, early diagnosis/treatment, and following robust hygiene measures are imperative for the effective management of staphylococcal scalded skin syndrome. More efforts are needed to develop novel therapies for staphylococcal scalded skin syndrome.
Associations Between Substance Use Disorders and Suicidal Ideation: An Investigation of Latino Emerging Adults
Authors: Limas Emily A. , Vaughan Ellen L.
Published: January 2018

Suicide is ranked as the second leading cause of death among emerging adults (aged 18–25 years). The purpose of this study was to test the associations between substance use disorders and suicidal ideation while controlling for religiosity and depression, among Latino emerging adults. Participants were 3,372 Latino, noninstitutionalized, U.S. residents aged 18- to 25-year-old who participated in the 2011 National Survey on Drug Use and Health. Binomial logistic regression analyses tested the relationships between major depressive episodes (MDEs), substance abuse/dependence, and past-year suicidal ideation. Results showed that substance use disorders and MDEs were both associated with increased odds of suicidal ideation in emerging adult Latinos within the past year. Clinical and research implications as well as study limitations are discussed.
Clinical Legal Education and Its Asian Characteristics
Authors: Lasky Bruce Avery , Sarker Shuvro Prosun
Published: January 2018

This article began with a consideration of the history and an evaluation of CLE in the United States, and it now moves on to evaluate the characteristics of CLE in Asia. However, using the term ‘Asian characteristic’ is somewhat amorphous. It can be quite vexing to try to define what is meant by Asia, as it is a broad continent with many nationalities, religions, ethnicities, languages and cultures. The same can be said for Asian legal systems, which possess a mixture of common law, civil law, Sharia law and customary law structures, often with a number of these structures existing within a single nation state. These legal systems have a multitude of roots and origins, with some dating back centuries and others having a more recent strong colonialist influence.
Foregrounding Accessibility Through (Inclusive) Universal Design in Professional Communication Curricula
Authors: Hitt Allison
Published: January 2018

Incorporating universal design (UD) both as a topic of discussion and as a pedagogical approach allows business and professional communication instructors to foreground accessibility in ways that acknowledge the rhetorical situatedness of accessibility. This article offers UD strategies that reimagine accessibility not just as a requirement that accommodates users but as an opportunity to create a rich rhetorical user experience for diverse populations. To illustrate how accessibility can be foregrounded in professional communication curricula, this article details the development of an information design course focused on usability and accessibility.
A Kitchen Table Pedagogy for Interrogating Whiteness through a Research Experience Course
Authors: Friedman Jennifer , Graham Laurel
Published: January 2018

After sociology undergraduates have learned about inequalities in their substantive courses, a research experience course in which they critically apply these concepts can be invaluable for fostering deep learning. Coteaching a sociological research experience for undergraduates course three times, the authors witnessed the emergence of an emotional connection to critical perspectives on race and ethnicity that enabled students to analyze and creatively apply these concepts to their research projects. The inquiry-based course was built around the authors’ current research project on how families with tween and/or teen children manage food provisioning. Although the course was not explicitly about race or whiteness, many students could relate to the marginalization felt by study participants because of their own ethnicity or race, leading the whole class to become a cohesive team that was attuned to the power of white supremacy in food discourse. Here the authors describe two key assignments they believe were essential components of the course: (1) writing and sharing your food autobiography and (2) analyzing “what’s interesting here?” to find themes in the interview data. The authors found that the intercultural sensitivity cultivated in the first weeks of the course through personal storytelling carried forward into the interviewing process, into the grounded theory discussions that took place in the classroom, and into the students’ final research projects. The result was that each semester, students interrogated the whiteness of American food discourse by studying the forms of difference embedded in the food stories of themselves and of the study participants.
Measures of Success: Exploring Student Approaches to Learning Public Health
Authors: Runnerstrom Miryha Gould , Koralek Thrissia
Published: January 2018

The goal of public health education consists of equipping competent future public health professionals with the skills necessary to effectively convert knowledge to meet current and future public health challenges. Although great focus has been placed on topics and skills that are relevant to undergraduate degree curricula in public health, little effort has been directed at identifying student perceptions about metacognitive strategies that best help them learn and recall public health skills or ideas. There is also little investigation of factors that contribute to students’ success in the field of public health. The purpose of this article is threefold: first, to describe common themes and gaps pertaining to public health undergraduates’ awareness of potent learning strategies; second, to characterize students’ definition of success in the field of public health; and third, to provide instructors with valuable information that may be used to enhance the design of classroom learning environments, course content, content delivery methods, and course assessments.
Economic burden of nosocomial infections caused by vancomycin-resistant enterococci
Authors: Puchter Laura , Chaberny Iris Freya , Schwab Frank , Vonberg Ralf-Peter , Bange Franz-Christoph , Ebadi Ella
Published: January 2018

Background

Nosocomial infections due to vancomycin-resistantenterococci(VRE) have become a major problem during the last years. The purpose of this study was to investigate the economic burden of nosocomial VRE infections in a European university hospital.

Methods

A retrospective matched case-control study was performed including patients who acquired nosocomial infection with either VRE or vancomycin-susceptible enterococci (VSE) within a time period of 3 years. 42 cases with VRE infections and 42 controls with VSE infections were matched for age, gender, admission and discharge within the same year, time at risk for infection, Charlson comorbidity index (±1), stay on intensive care units and non-intensive care units as well as for the type of infection, using criteria of the Centers for Disease Control and Prevention.

Results

The median overall costs per case were significantly higher than for controls (EUR 57,675 vs. EUR 38,344;p = 0.030). Costs were similar between cases and controls before onset of infection (EUR 17,893 vs. EUR 16,600;p = 0.386), but higher after onset of infection (EUR 37,971 vs. EUR 23,025;p = 0.049). The median attributable costs per case for vancomycin-resistance were EUR 13,157 (p = 0.036). The most significant differences in costs between cases and controls turned out to be for pharmaceuticals (EUR 6030 vs. EUR 2801;p = 0.008) followed by nursing staff (EUR 8956 vs. EUR 4621;p = 0.032), medical products (EUR 3312 vs. EUR 1838;p = 0.020), and for assistant medical technicians (EUR 3766 vs. EUR 2474;p = 0.023). Furthermore, multivariate analysis revealed that costs were driven independently by vancomycin-resistance (1.4 fold;p = 0.034).

Conclusions

This analysis suggested that nosocomial VRE infections significantly increases hospital costs compared with VSE infections. Therefore, hospital personal should implement control measures to prevent VRE transmission.
Healthcare associated infection and its risk factors among patients admitted to a tertiary hospital in Ethiopia: longitudinal study
Authors: Ali Solomon , Birhane Melkamu , Bekele Sisay , Kibru Gebre , Teshager Lule , Yilma Yonas , Ahmed Yesuf , Fentahun Netsanet , Assefa Henok , Gashaw Mulatu , Gudina Esayas Kebede
Published: January 2018

Background

Healthcare associated infection (HAI) is alarmingly increasing in low income settings. In Ethiopia, the burden of HAI is still not well described.

Methods

Longitudinal study was conducted from May to September, 2016. All wards of Jimma University Medical Centre were included. The incidence, prevalence and risk factors of healthcare associated infection were determined. A total of 1015 admitted patients were followed throughout their hospital stay. Biological specimens were collected from all patients suspected to have hospital aquired infection. The specimens were processed by standard microbiological methods to isolate and identify bacteria etiology. Clinical and laboratory data were collected using structured case report formats.

Results

The incidence rate of hospital acquired infection was 28.15 [95% C.I:24.40,32.30] per 1000 patient days while the overall prevalence was 19.41% (95% C.I: (16.97–21.85). The highest incidence of HAI was seen in intensive care unit [207.55 (95% C.I:133.40,309.1) per 1000 patient days] and the lowest incidence was reported from ophthalmology ward [0.98 (95% C.I: 0.05,4.90) per 1000patient days]. Among patients who underwent surgical procedure, the risk of HAI was found to be high in those with history of previous hospitalization (ARR = 1.65, 95% C.I:1.07, 2.54). On the other hand, young adults (18 to 30-year-old) had lower risk of developing HAI (ARR = 0.54 95% C.I: 0.32,0.93) Likewise, among non-surgical care groups, the risk of HAI was found to be high in patients with chest tube (ARR = 4.14, 95% C.I: 2.30,7.46), on mechanical ventilation (ARR = 1.99, 95% C.I: 1.06,3.74) and with underlying disease (ARR = 2.01, 95% C.I: 1.33,3.04). Furthermore, hospital aquired infection at the hosoital was associated with prolonged hospital stay [6.3 more days, 95% C.I: (5.16,7.48), t = 0.000] and increased in hospital mortality (AOR, 2.23, 95% CI:1.15,4.29).

Conclusion

This study revealed high burden and poor discharge outcomes of healthcare associated infection at Jimma University Medical Centre. There is a difference in risk factors between patients with and without surgery. Hence, any effort to control the observed high burden of HAI at the hospital should consider these differences for better positive out put.
(Re)considering sovereignty in the European integration process
Authors: Kaplan Yılmaz
Published: January 2018

The World War II (WWII) as a great shock significantly weakened the European nation-state paradigm and gave the European elites a chance to achieve a ‘paradigm shift’ from ‘the nation-state paradigm’ to a ‘federalist paradigm’. However, the nation-state’s strong institutionalization did not allow a paradigm shift and the WWII actually created a ‘paradigm duplication’ in the European integration process. In this two-layered atmosphere, ‘democracy’ was conceptualized under the influence of ‘federalist intellectual paradigm’ but its implementation had to be achieved in the nation-state paradigm. Therefore, this anomaly has played a significant role in the recent stalemate the European integration process has faced. For example, the literature clearly shows the relationship between the sensitivity of European nations towards their national sovereignty and the rise of Euroscepticism in the European integration process. Moreover, the institutional and legitimate strength of the nation-state gives the nation-state paradigm a gravitational power, which gradually weakens the feasibility of the ideas originating from the federalist paradigm. As a result, this article argues that a more symbiotic institutionalization of democracy and sovereignty is necessary to make the European integration more attractive again.
Improving the effectiveness of psychotherapy in two public hospitals in Nairobi
Authors: Falkenström Fredrik , Gee Matthew David , Kuria Mary Wangari , Othieno Caleb Joseph , Kumar Manasi
Published: January 2018

This paper is the first in a planned series of papers studying the effectiveness of psychotherapy and counselling in Nairobi. It describes a method for checking the effectiveness of psychotherapy and improving service quality in a Kenyan context. Rather than prematurely imposing psychotherapy protocols developed in Western countries in another cultural context, we believe that first studying psychological interventions as they are practised may generate understanding of which psychological problems are common, what interventions therapists use, and what seems to be effective in reducing psychiatric problems. The initial step is to assess outcome of psychological treatments as they are conducted. This is followed by statistical analyses aimed at identifying patient groups who are not improving at acceptable rates. Therapists will then be trained in a ‘best practice’ approach, and controlled trials are used in a final step, testing new interventions specifically targeted at patient groups with sub-optimal outcomes.
Edawu: a journey from in-patient rehabilitation to community-based treatment and rehabilitation in Nigeria
Authors: Chakraborty N. , Erinfolami A. , Lucas A.
Published: January 2018

Community-based rehabilitation is the strategy endorsed by the World Health Organization and other international bodies to promote the inclusion of people with disabilities, particularly in low- and middle-income countries. In this article we trace the journey of Edawu, a mental health rehabilitation unit in a rural area of Benue State, Nigeria, from an in-patient rehabilitation unit to a community-focused service. The partnership of organisations from the UK with Edawu along the journey is also described. The authors set out learning points from the project and the principles behind sustainable overseas organisational partnerships.
Prolines in the α-helix confer the structural flexibility and functional integrity of importin-β
Authors: Kumeta Masahiro , Konishi Hide A. , Zhang Wanzhen , Sakagami Sayuri , Yoshimura Shige H.
Published: January 2018

The karyopherin family of nuclear transport receptors is composed of a long array of amphiphilic α-helices and undergoes flexible conformational changes to pass through the hydrophobic crowding barrier of the nuclear pore. Here, we focused on the characteristic enrichment of prolines in the middle of the outer α-helices of importin-β. When these prolines were substituted with alanine, nuclear transport activity was reduced drastically in vivo and in vitro, and caused a severe defect in mitotic progression. These mutations did not alter the overall folding of the helical repeat or affect its interaction with cargo or the regulatory factor Ran. However, in vitro and in silico analyses revealed that the mutant lost structural flexibility and could not undergo rapid conformational changes when transferring from a hydrophilic to hydrophobic environment or vice versa. These findings reveal the essential roles of prolines in ensuring the structural flexibility and functional integrity of karyopherins.
A self-inhibitory interaction within Nup155 and membrane binding are required for nuclear pore complex formation
Authors: De Magistris Paola , Tatarek-Nossol Marianna , Dewor Manfred , Antonin Wolfram
Published: January 2018

Nuclear pore complexes (NPCs) are gateways through the nuclear envelope. How they form into a structure containing three rings and integrate into the nuclear envelope remains a challenging paradigm for coordinated assembly of macro-complexes. In vertebrates, the cytoplasmic and nucleoplasmic rings of NPCs are mostly formed by multiple copies of the Nup107–Nup160 complex, whereas the central, or inner ring is composed of Nup53, Nup93, Nup155 and the two paralogues Nup188 and Nup205. Inner ring assembly is only partially understood. Using in vitro nuclear assembly reactions, we show that direct pore membrane binding of Nup155 is crucial for NPC formation. Replacing full-length Nup155 with its N-terminal β-propeller allows assembly of the outer ring components to the NPC backbone that also contains Nup53. However, further assembly, especially recruitment of the Nup93 and Nup62 complexes, is blocked. Self-interaction between the N- and C-terminal domains of Nup155 has an auto-inhibitory function that prevents interaction between the N-terminus of Nup155 and the C-terminal region of Nup53. Nup93 can overcome this block by binding to Nup53, thereby promoting formation of the inner ring and the NPC.