bluuebunny/crossref_metadata_2025 huggingface dataset:
Surgical Performance in Minimally Invasive Surgery Plus Recombinant Tissue Plasminogen Activator for Intracerebral Hemorrhage Evacuation Phase III Clinical Trial
Authors: Fam Maged D , Hanley Daniel , Stadnik Agnieszka , Zeineddine Hussein A , Girard Romuald , Jesselson Michael , Cao Ying , Money Lynn , McBee Nichol , Bistran-Hall Amanda J , Mould W Andrew , Lane Karen , Camarata Paul J , Zuccarello Mario , Awad Issam A
Published: February 2017

BACKGROUND

Minimally invasive thrombolytic evacuation of intracerebral hematoma is being investigated in the ongoing phase III clinical trial of Minimally Invasive Surgery plus recombinant Tissue plasminogen activator for Intracerebral hemorrhage Evacuation (MISTIE III).

OBJECTIVE

To assess the accuracy of catheter placement and efficacy of hematoma evacuation in relation to surgical approach and surgeon experience.

METHODS

We performed a trial midpoint interim assessment of 123 cases that underwent the surgical procedure. Accuracy of catheter placement was prospectively assessed by the trial Surgical Center based on prearticulated criteria. Hematoma evacuation efficacy was evaluated based on absolute volume reduction, percentage hematoma evacuation, and reaching the target end-of-treatment volume of <15 mL. One of 3 surgical trajectories was used: anterior (A), posterior (B), and lobar (C). Surgeons were classified based on experience with the MISTIE procedure as prequalified, qualified with probation, and fully qualified.

RESULTS

The average hematoma volume was 49.7 mL (range 20.0-124), and the mean evacuation rate was 71% (range 18.4%-99.8%). First placed catheters were 58% in good position, 28% suboptimal (but suitable to dose), and 14% poor (requiring repositioning). Posterior trajectory (B) was associated with significantly higher rates of poor placement (35%, P = .01). There was no significant difference in catheter placement accuracy among surgeons of varying experience. Hematoma evacuation efficacy was not significantly different among the 3 surgical approaches or different surgeons’ experience.

CONCLUSION

Ongoing surgical education and quality monitoring in MISTIE III have resulted in consistent rates of hematoma evacuation despite technical challenges with the surgical approaches and among surgeons of varying experience.
1-(2,4-Dibromophenyl)-3,6,6-trimethyl-1,5,6,7-tetrahydro-4H-indazol-4-one
Authors: Chao Po-Kuan , Ueng Shau-Hua , Ou Li-Chin , Yeh Teng-Kuang , Chang Wan-Ting , Chang Hsiao-Fu , Chen Shu-Chun , Tao Pao-Luh , Law Ping-Yee , Loh Horace H. , Cheng Ming-Fu , Chuang Jian-Ying , Chen Chiung-Tong , Shih Chuan , Yeh Shiu-Hwa
Published: February 2017

Background

The authors investigated the pharmacology and signaling pathways of the opioid receptors modulated by compound 1, 1-(2,4-dibromophenyl)-3,6,6-trimethyl-1,5,6,7-tetrahydro-4H-indazol-4-one.

Methods

In vitro studies of compound 1 were assessed by using a radioligand-binding assay (n = 3), a cyclic adenosine monophosphate assay (n = 3), a β-arrestin assay (n = 3), an internalization assay (n = 3), and an immunohistochemistry (n = 8). In vivo studies of compound 1 were characterized using a tail-flick test (n = 5 to 6), tail-clip test (n = 7), von Frey hair test (n = 5), and charcoal meal test (n = 5).

Results

Compound 1 elicited robust effects in μ-opioid (mean ± SD; binding affinity: 15 ± 2 nM; cyclic adenosine monophosphate assay: 24 ± 6 nM), δ-opioid (82 ± 7 nM; 1.9 ± 0.1 μM), and κ-opioid (76 ± 9 nM; 1.4 ± 0.5 μM) receptor–expressing cells. Compound 1 acts as a full agonist of β-arrestin-2 recruitment in μ-opioid (1.1 ± 0.3 μM) and δ-opioid (9.7 ± 1.9 μM) receptor–expressing cells. Compound 1 caused less gastrointestinal dysfunction (charcoal meal test: morphine: 82 ± 5%; compound 1: 42 ± 5%) as well as better antinociception in mechanical pain hypersensitivity (tail-clip test: morphine: 10 ± 3 s; compound 1: 19 ± 1 s) and in cancer-induced pain (von Frey hair test: morphine: 0.1 ± 0.1 g; compound 1: 0.3 ± 0.1 g) than morphine at equi-antinociceptive doses.

Conclusions

Compound 1 produced antinociception with less gastrointestinal dysfunction than morphine.
Directional Microphone Contralateral Routing of Signals in Cochlear Implant Users: A Within-Subjects Comparison
Authors: Wimmer Wilhelm , Kompis Martin , Stieger Christof , Caversaccio Marco , Weder Stefan
Published: February 2017

Objectives:

For medical or financial reasons, bilateral cochlear implantation is not always possible in bilaterally deafened patients. In such cases, a contralateral routing of signals (CROS) device could complement the monaural implant. The goal of our study was to compare the benefit of three different conditions: (1) unilateral cochlear implant (CI) alone, (2) unilateral CI complemented with a directional CROS microphone, and (3) bilateral CIs.

Design:

Twelve bilateral experienced CI users were tested. Speech reception in noise and sound localization were measured in the three above-mentioned conditions. Patients evaluated which condition they presumed to be activated and the subjective benefit on a hearing scale.

Results:

Compared with the unilateral CI condition, the additional CROS device provided significantly better speech intelligibility in noise when speech signals came from the front or side of the CROS microphone. Only small subjective improvement was observed. Bilateral-activated CIs further improved the hearing performance. This was the only condition where sound localization was possible. Subjective evaluation showed a clear preference for the bilateral CI treatment.

Conclusions:

In bilateral deafened patients, bilateral implantation is the most preferable form of treatment. However, patients with one implant only could benefit from an additional directional microphone CROS device.
Health Policy, Ethical, Business, and Financial Issues Related to Blood Management in Orthopedics
Authors: Johnson Daniel J. , Yang William W. , Sikorski Robert A. , Khanuja Harpal S. , Frank Steven M.
Published: February 2017

For patients with hemorrhage or severe anemia, blood transfusion can be life-saving, and without a safe and available blood supply, many orthopedic procedures would not be possible. In fact, blood transfusion is the most commonly performed medical procedure in the United States hospitals. However, transfusion is also one of the top 5 overused procedures, according to the Joint Commission. This determination is based primarily on multiple recent studies showing that “less is more” in terms of transfusion, and that lower hemoglobin thresholds of 7 to 8 g/dL are ideal in patients who are not actively bleeding. With increasing efforts to optimize blood utilization, the field of patient blood management (PBM) has grown rapidly over the past decade. According to some, PBM means giving the right dose of the right product to the right patient for the right reason. One of the most enticing concepts behind blood management in orthopedic surgery is that we can reduce risk, improve outcomes, and save money, all at the same time. Given that blood is reimbursed either poorly or not at all in the United States, owing to the bundled payment system, and that the overhead costs of transfusion that are ∼4-fold the acquisition cost, a solid PBM program will easily support itself by reducing unnecessary transfusions and their associated costs. The purpose of this article was to review the health care policy, ethical considerations, and financial implications of PBM and to illustrate how blood management adds value to the care we deliver.
Development of a Large Animal Model of Non-Weight-Bearing
Authors: Aruwajoye Olumide O. , Phipps Matthew C. , Wassell Tracy , Kim Harry K.W.
Published: February 2017

Decreased weight-bearing (WB) is commonly recommended to treat lower limb bone and joint disorders. The availability of a large animal model of decreased or non–weight–bearing (NWB) would be invaluable to study its effects on bone and joint healing. We report here the development of a piglet model of NWB following the induction of ischemic osteonecrosis of the femoral head. The purpose of this study was to assess the feasibility, effectiveness, and complications of various methods to induce decreased or NWB on a hind limb of piglets. The methods used to decrease WB on a hind limb evolved from an Ehmer sling to patellar and/or Achilles tenotomies to below and above knee amputations (AKAs). The Ehmer sling (n=2) was not tolerated by the piglets and tenotomies (n=3) were ineffective in decreasing WB after 4 weeks. A below knee amputation-induced NWB in 4 out of 7 animals but the 3 remaining animals were found to weight bear on the residual limb which developed a pressure sore, and were later converted to an AKA. AKA induced NWB in all animals (n=8). At 8 weeks, a significantly decreased femoral head deformity was observed in the AKA amputation group (n=8) compared with the WB control group (n=8) indicating the protective effect of NWB (P<0.001). A bony overgrowth was observed at the end of the residual bone in all amputated animals. In conclusion, AKA method consistently induced NWB in immature pigs.
Developing a Community of Practice for HIV Care: Supporting Knowledge Translation in a Regional Training Initiative
Authors: Gallagher Donna M. , Hirschhorn Lisa R. , Lorenz Laura S. , Piya Priyatam
Published: February 2017

Introduction:

Ensuring knowledgeable, skilled HIV providers is challenged by rapid advances in the field, diversity of patients and providers, and the need to retain experienced providers while training new providers. These challenges highlight the need for education strategies, including training and clinical consultation to support translation of new knowledge to practice. New England AIDS Education and Training Center (NEAETC) provides a range of educational modalities including academic peer detailing and distance support to HIV providers in six states. We describe the interprofessional perspectives of HIV providers who participated in this regional program to understand success and areas for strengthening pedagogical modality, content, and impact on clinical practice.

Methods:

This 2013 to 2014 mixed-methods study analyzed quantitative programmatic data to understand changes in training participants and modalities and used semistructured interviews with 30 HIV providers and coded for preidentified and emerging themes.

Results:

Since 2010, NEAETC evolved modalities to a greater focus on active learning (case discussion, clinical consultation), decreasing didactic training by half (18–9%). This shift was designed to move from knowledge transfer to translation, and qualitative findings supported the value of active learning approaches. Providers valued interactive trainings and presentation of cases supporting knowledge translation. On-site training encouraged peer networking and sharing of lessons learned. Diversity in learning priorities across providers and sites validated NEAETC's approach of tailoring topics to local needs and encouraging regional networking.

Discussion:

Tailored approaches resulted in improved provider-reported capacity, peer learning, and support. Future evaluations should explore the impact of this multipronged approach on supporting a community of practice and empowerment of provider teams.
Generalized Indeterminate Cell Histiocytosis Presenting as Eroded Papules and Crusts
Authors: Li Yaping , Bai Harrison Xiao , Su Chang , Zhang Guiying
Published: February 2017

Indeterminate cell histiocytosis (ICH) is a very rare histiocytic disease. We reported a case of generalized ICH presenting as eroded papules and crusts, accompanied with intermittent fever, pulmonary disorder, lymphadenectasis in the mediastinum, and the retroperitoneum. The histopathology indicated a neoplasm that was composed of small nests of large cells with ample pale cytoplasm. Immunohistochemistry results and the absence of Birbeck granules led us to the diagnosis of ICH. Four months later, the patient died of anemia, ascites, and swelling of the limbs.
Targeting Transforming Growth Factor-β Signaling in Primary Open-Angle Glaucoma
Authors: Wang Jenny , Harris Alon , Prendes Mark A. , Alshawa Loor , Gross Josh C. , Wentz Scott M. , Rao Ambika B. , Kim Nathaniel J. , Synder Alexander , Siesky Brent
Published: February 2017

Transforming growth factor-β (TGF-β) may play a role in the pathogenesis of primary open-angle glaucoma (POAG). Elevated levels of TGF-β are found in the aqueous humor and in reactive optic nerve astrocytes in patients with glaucoma. In POAG, aqueous humor outflow resistance at the trabecular meshwork (TM) leads to increased intraocular pressure and retinal ganglion cell death. It is hypothesized that TGF-β increases outflow resistance by altering extracellular matrix homeostasis and cell contractility in the TM through interactions with other proteins and signaling molecules. TGF-β may also be involved in damage to the optic nerve head. Current available therapies for POAG focus exclusively on lowering intraocular pressure without addressing extracellular matrix homeostasis processes in the TM. The purpose of this review is to discuss possible therapeutic strategies targeting TGF-β in the treatment of POAG. Herein, we describe the current understanding of the role of TGF-β in POAG pathophysiology, and examine ways TGF-β may be targeted at the levels of production, activation, downstream signaling, and homeostatic regulation.
Choroidal Vessel Diameters in Pseudoexfoliation and Pseudoexfoliation Glaucoma Analyzed Using Spectral-Domain Optical Coherence Tomography
Authors: Sarrafpour Soshian , Adhi Mehreen , Zhang Jason Y. , Duker Jay S. , Krishnan Chandrasekharan
Published: February 2017

Purpose of the Study:

The purpose of the study was to analyze choroidal vessel diameters in pseudoexfoliation (PXF) and pseudoexfoliation glaucoma (PXFG) using spectral-domain optical coherence tomography (SD-OCT).

Materials and Methods:

Fifty patients (100 eyes) with PXF and PXFG who underwent high-definition 1-line raster SD-OCT imaging at New England Eye Center, Boston, were retrospectively identified and divided into unilateral PXFG (26 patients, 52 eyes), unilateral PXF (4 patients, 8 eyes), bilateral PXFG (4 patients, 8 eyes), and bilateral PXF (16 patients, 32 eyes). Eyes with concomitant chorioretinal pathology, history of shunting/filtering for glaucoma, and significant anisometropia were excluded. SD-OCT scans were divided into subfoveal, central, and peripheral zones and choroidal vessel diameters were measured.

Results:

In patients with unilateral PXFG, mean choroidal vessel diameter was 12.9 μm smaller in the affected eyes when compared with their contralateral eyes (45.7 vs. 58.6 μm; P<0.0001) with the greatest reduction (16.6 μm) in the subfoveal zone (49.0 vs. 65.6 μm; P<0.0001). In patients with unilateral PXF, the mean choroidal vascular diameter was 13.3 μm smaller in the affected eyes when compared with their contralateral eyes (42.8 vs. 56.1 μm; P=0.02). As expected, no significant difference was observed between the 2 eyes of patients with bilateral PXFG (45.5 vs. 45.7 μm; P=0.95) and bilateral PXF (51.4 vs. 50.2 μm; P=0.52).

Conclusions:

Choroidal vessel diameters are smaller in the affected eyes of patients with unilateral PXF and PXFG when compared with their contralateral unaffected eyes. These changes appear to be independent of the presence or absence of glaucoma. Future studies may identify the choroidal vascular changes and their relationship with the pathogenesis of these conditions.
Effect of surface neuromuscular electrical stimulation on labial and lingual muscles in healthy volunteers
Authors: Safi Mohammed F. , Wright-Harp Wilhelmina , Lucker Jay R. , Payne Joan C.
Published: February 2017

Neuromuscular electrical stimulation (NMES) may have potential as a treatment for muscle weakness as it may improve strength when applied to the orofacial muscles. However, before incorporating this procedure into clinical practice, research is needed to investigate its effects on lingual and facial muscles of speech and mastication. The aim of this study was to determine what effect(s) submental and labial NMES would have on lingual and labial muscle strength in healthy participants. Fourteen healthy adults (27–49 years old) were assigned to two groups (treatment and control). A pretreatment and post-treatment test using the Iowa Oral Performance Instrument was used to measure the strength of labial and lingual muscles in both groups. Participants in the treatment group received labial and submental NMES while performing a structured labial, buccal, and lingual exercise program. In contrast, participants in the control group completed the same oral motor exercise program without stimulation. Results: On comparing the total change in labial and lingual strength between the two groups, an increase in total labial strength was found in the treatment group compared with the control group. However, the control group showed an increase in total lingual strength compared with the treatment group. Results for all measurements were not statistically significant. This study concluded that NMES may be a promising modality to combine with labial and buccal exercises for improvement of muscle strength.
How Specialty Certification Influences Professional Practice
Authors: Vanairsdale Sharon
Published: February 2017

Certified Nurses Day (March 19) honors nurses worldwide who contribute to better patient outcomes through board certification in their specialty. In this month’s Magnet® Perspectives column, Sharon Vanairsdale, MS, APRN, ACNS-BC, NP-C, CEN, program director for Emory University Hospital’s Serious Communicable Diseases Unit, discusses the value of certification, what it means to her professional practice, and how it helps to champion her work. Ms Vanairsdale is triple certified as a certified emergency nurse, an adult clinical nurse specialist, and an adult nurse practitioner. She is also an adult clinical nurse content expert for the American Nurses Credentialing Center®. She received the 2016 National Magnet Nurse of the Year® Award in the Exemplary Professional Practice category for her development of Ebola treatment and preparedness protocols, as well as significant contributions to the education and training of American healthcare workers around Ebola and other emerging infectious disease threats.
Emotional Intelligence of Nurse Managers
Authors: Prufeta Patricia
Published: February 2017

OBJECTIVE

The purposes of this study are to determine the level of emotional intelligence (EI) among nurse managers (NMs) in an academic medical center and determine the relationship of EI and demographic variables.

BACKGROUND

Emotional intelligence is a concept that warrants further research in nursing because there is a huge gap in knowledge about nurse leaders’ EI.

METHODS

Data were collected from 38 NMs recruited from a large academic medical center in the Northeast.

RESULTS

Mean EI scores among NMs were average. Nurse managers with less than 2 years of experience had statistically significant lower “using emotions” branch score and strategic EI. Nurse managers with a masters’ degree in nursing scored significantly higher in using emotions branch score than did those with a masters’ degree in a related field.

CONCLUSION

Opportunities exist to enhance the EI of NMs.
Impact of Role Stressors on the Health of Nurse Managers
Authors: Udod Sonia A. , Cummings Greta , Care W. Dean , Jenkins Megan
Published: February 2017

OBJECTIVE

A qualitative exploratory inquiry was used to understand nurse managers’ (NMs’) perceptions of their role stressors, coping strategies, and self-health related outcomes as a result of frequent exposure to stressful situations in their role.

BACKGROUND

Strong nursing leadership is required for desirable staff, patient, and organizational outcomes. A stressed NM will negatively influence staff nurse satisfaction and retention, patient outcomes, and organizational performance. Stress can affect NMs’ mental and physical heath, leading to job dissatisfaction and turnover.

METHODS

A qualitative exploratory inquiry was conducted using semistructured interviews with 23 NMs and 1 focus group interview.

RESULTS

Findings suggest that coping strategies may be inadequate, given the intensity and demands of the manager role, and could negatively impact NMs’ long-term health.

CONCLUSIONS

Senior nurse leaders can significantly impact the health and productivity of NMs by minimizing the adverse effects of role stress and foster a positive work environment.
Multiple Organ Dysfunction in Children Mechanically Ventilated for Acute Respiratory Failure*
Authors: Weiss Scott L. , Asaro Lisa A. , Flori Heidi R. , Allen Geoffrey L. , Wypij David , Curley Martha A. Q.
Published: February 2017

Objectives:

The impact of extrapulmonary organ dysfunction, independent from sepsis and lung injury severity, on outcomes in pediatric acute respiratory failure is unclear. We sought to determine the frequency, timing, and risk factors for extrapulmonary organ dysfunction and the independent association of multiple organ dysfunction syndrome with outcomes in pediatric acute respiratory failure.

Design:

Secondary observational analysis of the Randomized Evaluation of Sedation Titration for Respiratory Failure cluster-randomized prospective clinical trial conducted between 2009 and 2013.

Setting:

Thirty-one academic PICUs in the United States.

Patients:

Two thousand four hundred forty-nine children mechanically ventilated for acute respiratory failure enrolled in Randomized Evaluation of Sedation Titration for Respiratory Failure.

Measurements and Main Results:

Organ dysfunction was defined using criteria published for pediatric sepsis. Multiple organ dysfunction syndrome was defined as respiratory dysfunction one or more extrapulmonary organ dysfunctions. We used multivariable logistic regression to identify risk factors for multiple organ dysfunction syndrome, and logistic or proportional hazards regression to compare clinical outcomes. All analyses accounted for PICU as a cluster variable. Overall, 73% exhibited extrapulmonary organ dysfunction, including 1,547 (63%) with concurrent multiple organ dysfunction syndrome defined by onset on day 0/1 and 244 (10%) with new multiple organ dysfunction syndrome with onset on day 2 or later. Most patients (93%) with indirect lung injury from sepsis presented with concurrent multiple organ dysfunction syndrome, whereas patients with direct lung injury had both concurrent (56%) and new (12%) multiple organ dysfunction syndrome. Risk factors for concurrent multiple organ dysfunction syndrome included older age, illness severity, sepsis, cancer, and moderate/severe lung injury. Risk factors for new multiple organ dysfunction syndrome were moderate/severe lung injury and neuromuscular blockade. Both concurrent and new multiple organ dysfunction syndrome were associated with 90-day in-hospital mortality (concurrent: adjusted odds ratio, 6.54; 95% CI, 3.00–14.25 and new: adjusted odds ratio, 3.21; 95% CI, 1.48–6.93) after adjusting for sepsis, moderate/severe lung injury, and other baseline characteristics.

Conclusions:

Extrapulmonary organ dysfunction was common, generally occurred concurrent with respiratory dysfunction (especially in sepsis), and was a major risk factor for mortality in pediatric acute respiratory failure.
Hearing Impairment and the Amelioration of Avoidable Medical Error: A Cross-Sectional Survey
Authors: Henn Patrick , O’Tuathaigh Colm , Keegan Darrelle , Smith Simon
Published: February 2017

Objectives

Hearing loss contributes to suboptimal medical treatment. We investigated the nature and magnitude of potential health-care harm of hearing loss alone on a patient’s understanding of medical consultations, investigations, and treatments of health conditions unrelated to their hearing loss.

Methods

A cross-sectional, questionnaire-based design of a convenience sample of students with hearing loss, registered with the institutional disability support service in 8 Irish and 15 UK third-level institutions. Content analysis of open-ended item responses identified and coded emergent themes. Closed-ended questionnaire items recorded demographic and clinically relevant characteristics.

Results

Ninety-five responses were received and analyzed. Fifty-six (58.9%) indicated “yes” to mishearing a physician/nurse in a hospital. Approximately 60.7% identified this in relation to consultation content; 33.9% mishearing; and 21.4% misinterpreting what was said, including diagnosis, guidelines and advice, and matters relating to medications. Approximately 22.3% indicated physician/nurse-patient communication failures; 19.6% identified failure to initiate/maintain eye contact, turning away from the patient, speaking while wearing surgical masks, excluding the possibility of lip reading. Approximately 7.1% identified speaking in too low a volume or too fast. Concerning common words misheard or misinterpreted, 23.2% identified phonological similarity such as similar sounding words and numbers, 7.4% discrimination of unvoiced consonants. Similar findings emerged in GP clinics.

Conclusions

Most hearing-impaired students experienced difficulty in understanding health-care professionals in a hospital and general practice setting. This underscores the importance for health-care providers to identify hearing-impaired patients and to augment communication using visual aids, a quite environment and optimizing lip reading communication.
What is new in the management of skin and soft tissue infections in 2016?
Authors: Poulakou Garyphallia , Giannitsioti Efthymia , Tsiodras Sotirios
Published: February 2017

Purpose of review

Skin and soft tissue infections (SSTIs) are the most frequent infectious cause of referrals to emergency departments and hospital admissions in developed world, contributing to significant morbidity and healthcare expenditures. We sought to review recent literature covering epidemiology and management of SSTIs.

Recent findings

Incidence trends of SSTIs were increasing worldwide with Staphylococcus aureus and streptococci predominating and methicillin-resistant S. aureus (MRSA) posing additional challenges, because of high rates of treatment failure and relapse. Development of new antimicrobials was associated with an appraisal of regulatory definitions and endpoints. Prediction of clinical response can be very tricky, because of variable risk factors for recurrence or treatment failure, depending mostly on the host. Precise indications for new antimicrobials should be established; their integration into clinical practice algorithms may serve reduction of unnecessary admissions, overtreatment and total costs.

New antimicrobials with activity against MRSA have been recently launched. Long-acting agents, mainly oritavancin and dalbavancin, provide the opportunity of single-dose treatment and early discharge. Further outpatient treatment options include new per os antibiotics such as oxazolidinones. Validated assessment tools are urgently needed to support decision-making toward rational resource utilization and delivery of optimal treatment.
Use of Model-based Iterative Reconstruction to Improve Detection of Congenital Cardiovascular Anomalies in Infants Undergoing Free-breathing Computed Tomographic Angiography
Authors: Kligerman Seth , Bolster Ferdia , Mitchell Jason , Henry Travis , Jeudy Jean , White Charles S.
Published: February 2017

Purpose:

The aim of the study was to assess the detection of congenital cardiovascular anomalies (congenital heart disease) in neonates and infants using model-based iterative reconstruction (MBIR) algorithm compared with hybrid iterative reconstruction (HIR) and filtered back projection (FBP) reconstructions on axial computed tomography (CT) performed at minimum scanner dose.

Materials and Methods:

Over 1 year, all CT angiographies performed in infants below 3 months of age with congenital heart disease were assessed retrospectively. All were scanned on a 256-slice CT (Brilliance iCT) using single axial rotation at minimum allowable scanner dose (80 kV/10 mAs), with patients free-breathing. Intravenous contrast was 1 mL/kg. Scan reconstruction was 0.9 mm/0.45 mm overlap, reconstructed with FBP, HIR (iDose5), and MBIR (IMR2). The 3 reconstructions per study were anonymized and randomized. Four cardiac radiologists (23, 9, 7, and 6 y experience) evaluated each reconstruction on a workstation for presence of an atrial septal defect, a ventricular septal defect, patent ductus arteriosus, and surgical shunt or anomalies of the aorta, pulmonary arteries, and pulmonary veins. Unevaluable structures were classified as nondiagnostic. Gold standard was surgery or both echocardiogram and cardiac catheterization. The sensitivity, specificity, and accuracy were determined for each reconstruction.

Results:

Fifteen scans in 14 infants met the inclusion criteria, with a total of 48 anomalies. Pooled sensitivity for MBIR of 0.82 (range, 0.75 to 0.9) was significantly better than those for FBP (0.58; range, 0.54 to 0.6; P<0.001) and HIR (0.67; range, 0.60 to 0.79; P<0.001). Pooled accuracy of MBIR, HIR, and FBP was 0.91, 0.84, and 0.81, respectively. Readers deemed 39 and 15 structures nondiagnostic with FBP and HIR, respectively, versus 2 with MBIR (MBIR-FBP, MBIR-HIR, P<0.0001). The CTDIvol, DLP, and estimated dose for all cases was 0.52 mGy, 4.2 mGy×cm, and 0.16 mSv.

Conclusions:

MBIR significantly improves the detection of congenital anomalies in neonates and infants undergoing CT angiography at minimum allowable dose.
Nitrosopersulfide (SSNO
−
) decomposes in the presence of sulfide, cyanide or glutathione to give HSNO/SNO
−
: consequences for the assumed role in cell signalling
Authors: Wedmann Rudolf , Ivanovic-Burmazovic Ivana , Filipovic Milos R.
Published: February 2017

The emergence of hydrogen sulfide (H
2
S) as a new signalling molecule able to control vasodilation, neurotransmission and immune response, prompted questions about its possible cross-talk with the other gasontransmitter, nitric oxide (NO). It has been shown that H
2
S reacts with NO and its metabolites and several potentially biologically active species have been identified. Thionitrous acid (HSNO) was proposed to be an intermediate product of the reaction of
S
-nitrosothiols with H
2
S capable of crossing the membranes and causing further trans-nitrosation of proteins. Alternatively, formation of nitrosopersulfide (SSNO
−
) has been proposed in this reaction. SSNO
−
was claimed to be particularly stable and inert to H
2
S, thiols and cyanides. It is suggested that this putative SSNO
−
slowly decomposes to give NO, HNO and polysulfides. However, the chemical studies with pure SSNO
−
salts showed some conflicting observations. In this study, we work with pure PNP
+
SSNO
−
to show that contrary to everything that is claimed for the yellow reaction product of GSNO with H
2
S, pure SSNO
−
decomposes readily in the presence of cyanide, H
2
S and glutathione to form SNO
−
. Based on literature overview and chemical data about the structures of HSNO/SNO
−
and SSNO
−
we discuss the biological role these two species could have.
Chemical biology of mitochondria
Authors: Murphy Michael P.
Published: February 2017

On 26–28 September 2016, the Theo Murphy (no relation) international scientific meeting on ‘Chemical biology approaches to assessing and modulating mitochondria’ was held at the Kavli Royal Society Centre, Chicheley Hall, Buckinghamshire, UK. Mike Murphy organized the meeting and it was enabled through the Royal Society scientific programme. The purpose of the conference was to bring together biologists, chemists and clinicians to discuss how to apply chemical biology to mitochondria to capitalize on the many new opportunities arising from the recent developments in mitochondrial biology.
mTORC1 controls phase-separation and the biophysical properties of the cytoplasm by tuning crowding
Authors: Delarue M. , Brittingham G.P. , Pfeffer S. , Surovtsev I.V. , Ping-lay S. , Kennedy K.J. , Schaffer M. , Gutierrez J.I. , Sang D. , Poterewicz G. , Chung J.K. , Plitzko J. , Groves J.T. , Jacobs-Wagner C. , Engel B.D. , Holt L.J.
Published: February 2017

Summary (Abstract)

Macromolecular crowding has a profound impact on reaction rates and the physical properties of the cell interior, but the mechanisms that regulate crowding are poorly understood. We developed Genetically Encoded Multimeric nanoparticles (GEMs) to dissect these mechanisms. GEMs are homomultimeric scaffolds fused to a fluorescent protein. GEMs self-assemble into bright, stable fluorescent particles of defined size and shape. By combining tracking of GEMs with genetic and pharmacological approaches, we discovered that the mTORC1 pathway can tune the effective diffusion coefficient of macromolecules ≥15 nm in diameter more than 2-fold without any discernable effect on the motion of molecules ≥5 nm. These mTORCI-dependent changes in crowding and rheology affect phase-separation bothin vitroandin vivo.Together, these results establish a role for mTORCI in controlling both the biophysical properties of the cytoplasm and the phase-separation of biopolymers.
The kinetics of pre-mRNA splicing in theDrosophilagenome: influence of gene architecture
Authors: Pai Athma A. , Henriques Telmo , McCue Kayla , Burkholder Adam , Adelman Karen , Burge Christopher B.
Published: February 2017

Production of most eukaryotic mRNAs requires splicing of introns from pre-mRNA. The splicing reaction requires definition of splice sites, which are initially recognized in either intron-spanning (“intron definition”) or exon-spanning (“exon definition”) pairs. To understand how exon and intron length and splice site recognition mode impact splicing, we measured splicing rates genome-wide inDrosophila, using metabolic labeling/RNA sequencing and new mathematical models to estimate rates. We found that the modal intron length range of 60-70 nt represents a local maximum of splicing rates, but that much longer exon-defined introns are spliced even faster and more accurately. Surprisingly, we observed low variation in splicing rates across introns in the same gene, suggesting the presence of gene-level influences, and we identified multiple gene level variables associated with splicing rate. Together our data suggest that developmental and stress response genes may have preferentially evolved exon definition in order to enhance rates of splicing.
Spodoptera exigua caterpillar feeding induces rapid defense responses in maize leaves
Authors: Tzin Vered , Hojo Yuko , Strickler Susan R. , Bartsch Lee Julia , Archer Cairo M. , Ahern Kevin R. , Christensen Shawn A. , Galis Ivan , Mueller Lukas A. , Jander Georg
Published: February 2017

Insects such as beet armyworm caterpillars (Spodoptera exigua) cause extensive damage to maize (Zea mays) by consuming foliar tissue. Maize plants respond to such insect attack by triggering defense mechanisms that involve large changes in gene expression and the biosynthesis of specialized metabolites and defense signaling molecules. To investigate dynamic maize responses to herbivore feeding, leaves of maize inbred line B73 were infested with S. exigua caterpillars for 1 to 24 hours, followed by comprehensive transcriptomic and metabolomic characterization. Our results show that the most significant gene expression responses of maize to S. exigua feeding occur at early time points, within 4 to 6 hours after caterpillar infestation. However, both gene expression and metabolite profiles continued changing during the entire 24-hour experiment while photosynthesis genes were gradually decreased. The primary and specilaze metabolism shift maught be temporal and dynamic processes in the infested leaf tissue. We analyzed the effects of mutating genes in two major defense-related pathways, benzoxazinoids (Bx1 and Bx2) and jasmonic acid (Lox8), using Dissociation (Ds) transposon insertions in maize inbred line W22. Together, these results show that maize leaves shift to implementation of chemical defenses within one hour after the initiation of caterpillar attack. Thus, the induced biosynthesis of specialized metabolites can have major effects in maize-caterpillar interactions.

HIGHLIGHT

A comprehensive transcriptic and metabolomic profiling time course of maize foliar responses to caterpillar feeding identifies genes for the synthesis of benzoxazinoids and phytohormones.
Developmental Downregulation of LIS1 Expression Limits Axonal Extension and Allows Axon Pruning
Authors: Kumamoto Kanako , Iguchi Tokuichi , Uemura Takuya , Sato Makoto , Hirotsune Shinji
Published: February 2017

The robust axonal growth and regenerative capacities of young neurons decrease substantially with age. This developmental downregulation of axonal growth may facilitate axonal pruning and neural circuit formation but limits functional recovery following nerve damage. While external factors influencing axonal growth have been extensively investigated, relatively little is known about the intrinsic molecular changes underlying the age-dependent reduction in regeneration capacity. We report that developmental downregulation of LIS1 is responsible for the decreased axonal extension capacity of mature dorsal root ganglion (DRG) neurons. In contrast, exogenous LIS1 expression or endogenous LIS1 augmentation by calpain inhibition restored axonal extension capacity in mature DRG neurons and facilitated regeneration of the damaged sciatic nerve. The insulator protein CTCF suppressed LIS1 expression in mature DRG neurons, and this reduction resulted in excessive accumulation of phosphoactivated GSK-3β at the axon tip, causing failure of the axonal extension. Conversely, sustained LIS1 expression inhibited developmental axon pruning in the mammillary body. Thus, LIS1 regulation may coordinate the balance between axonal growth and pruning during maturation of neuronal circuits.

Summary Statement

Developmental downregulation of LIS1 coordinates the balance between axonalelongation and pruning, which is essential for proper neuronal circuit formation but limits nerve regeneration.
Translation efficiency is maintained at elevated temperature inE. coli
Authors: Morgan Gareth J , Burkhardt David H , Kelly Jeffery W , Powers Evan T
Published: February 2017

Cellular protein levels are dictated by the balance between gene transcription, mRNA translation and protein degradation, among other factors. Cells must manage their proteomes during stress; one way in which they may do so, in principle, is by differential translation. We used ribosome profiling to directly monitor translation inE. coliat 30 °C and investigate how this changes after 10-20 minutes of heat shock at 42 °C. Translation is controlled by the interplay of several RNA hybridization processes, which are expected to be temperature sensitive. However, translation efficiencies are robustly maintained after thermal heat shock and after mimicking the heat shock response transcriptional program at 30 °C. Several gene-specific parameters correlated with translation efficiency, including predicted mRNA structure and whether a gene is cotranslationally translocated into the inner membrane. Genome-wide predictions of the temperature dependence of mRNA structure suggest that relatively few genes show a melting transition between 30 °C and 42 °C, consistent with our observations. A linear model with five parameters can predict 33% of the variation in translation efficiency between genes, which may be useful in interpreting transcriptome data.
Innovative tools and techniques to ensure effective employee engagement
Authors: Rao M.S.
Published: February 2017

Purpose

The purpose of this paper is to offer innovative tools and techniques to ensure employee engagement.

Design/methodology/approach

The paper outlines the reasons for employee disengagement and enlightens the advantages of employee engagement for both employees and organizations. It unfolds several research findings on employee engagement and illustrates with the examples of global companies including Cummins, DHL Express, Southwest Airlines, Google, and Virgin.

Findings

It concludes that employee engagement is a two-way street.

Practical implications

The tools and techniques adopted by leaders can be applied in any industry and in any size of organization.

Social implications

The social implications of this research suggest that leaders can ensure employee engagement by following these innovative tools and techniques.

Originality/value

It implores both employers and employees to take ownership of their roles and responsibilities to achieve organizational excellence and effectiveness.
More than just a green building
Authors: Jones Louise , Wong Winky
Published: February 2017

Purpose

The slogan “Go Green” has been embraced by a range of organizations including businesses and universities in recent decades. Within higher education academic libraries, as a key service unit in their parent institution, have an important role to play in supporting this mission. The authors have seen many academic libraries strive to “Go green” by designing a green library, whether a new build or renovation. The paper aims to discuss these issues.

Design/methodology/approach

This paper discusses how the Chinese University of Hong Kong (CUHK) Library formulates, develops and implements its green strategy and how the strategy has gradually reshaped its services. First, the authors consider how the concept of sustainability has affected services provided by academic libraries, and why green strategies are a practical and feasible approach. The authors then use CUHK Library as a case study, siting the development of its green strategies in the context of, the University’s approach to sustainability and the wider CUHK community, and ultimately the Library’s overall strategic plan. The third section describes how the library implements its green strategies in different areas, from the daily operation of library offices and services offered to users, to the planning of a library extension and broader sustainability initiatives. Issues of evaluation are discussed and the authors conclude the paper with future plans.

Findings

There are very few academic libraries in the USA that are Leadership in Energy and Environmental Design certified.

Originality/value

The authors argue that pursuing a green building may not be the strategic focus for many academic libraries. In taking a more holistic approach to sustainability through practical measures, academic libraries need to formulate and develop wider green strategies beyond a green building. “Go Green” impacts not only the attitudes towards the environment but also changes the way academic libraries serve their users and community.
Managed earnings
Authors: Meyer Heather M. , Ujah Nacasius U.
Published: February 2017

Purpose

The decisions marketing managers make on advertising expenditures are vital to maintaining the sales and profitability of a firm. However, these decisions have not been taken into account to a great enough extent when determining a firm’s performance. The purpose of this paper is to better understand the marketing-finance interface and to reveal the effect marketers’ discretionary advertising expenditures can have on firm performance. In particular, the real activities method of managed earnings (ME) will be used to study this phenomenon.

Design/methodology/approach

The initial sample consisted of all the companies that appear in the North American COMPUSTAT files over the period 1970-2014. Since the focus here is on the effect of discretionary advertising expenses on firm performance, the authors restricted the samples to only include observations with advertising expenses. Therefore, the sample included 14,732 firms.

Findings

OLS regressions revealed a negative relationship between marketers’ discretionary advertising expenditures and firm performance using return on assets as a proxy for firm performance. Additional regressions displayed similar results for return on sale and return on cash adjusted asset proxies. Fixed effect and Tobit regressions also confirmed these findings. Finally, this effect was especially true for low performing firms. The economic significance of these findings on firm performance is also discussed.

Originality/value

The decisions made by marketing managers on advertising promotional efforts impact sales directly and brand equity indirectly, but they can also have an impact on firm performance. Therefore, it is important for investors to understand the level of ME in relation to marketing and advertising decisions that are taking place at their firm.
It’s my choice! Investigating barriers to pro-social blood donating behaviour
Authors: Pentecost Robin , Arli Denni , Thiele Sharyn
Published: February 2017

Purpose

The purpose of this paper is to investigate barriers to pro-social behaviour in the form of blood donating using self-determination theory.

Design/methodology/approach

Respondents were recruited through intercepts at a major international university and at points within the community in a capital city in Australia. Sampling was conducted over a three-week period resulting in a sample of 617 respondents.

Findings

Results show intrinsic motivations positively influence intentions towards blood donation, self-identity, and locus of control. Further, despite positively influencing other factors, external regulation positively influenced amotivation indicating the more likely people feel pressured to donate blood, the less likely they will be motivated to donate blood.

Originality/value

This would suggest one way to influence more people to become donors is to place greater focus on the positive emotional feelings they derive from the act of donating blood and the control they have over that donation. Using external regulation strategy which often suggests people “must” or “have-to” donate blood may be limiting blood donation numbers.
Responsible brands vs active brands? An examination of brand personality on brand awareness, brand trust, and brand loyalty
Authors: Molinillo Sebastian , Japutra Arnold , Nguyen Bang , Chen Cheng-Hao Steve
Published: February 2017

Purpose

There is a rise in interest on the topic of consumer-brand relationships (CBRs) among practitioners and academics. Consumers are said to build relationships with brands that have a personality congruent with their own. The purpose of this paper is to investigate two types of brand personality traits, namely, responsible brands and active brands to predict prominent CBR constructs, including brand awareness, brand trust, and brand loyalty.

Design/methodology/approach

This study was based on an electronic survey of 339 respondents. Structural equation modeling was used to analyze the data.

Findings

The results show that brand personality positively affects the three CBR constructs. Specifically, the focus is shifted to the two major personality dimensions, responsible and active, respectively. The results indicate that an active brand is a stronger predictor of brand awareness compared to a responsible brand. However, a responsible brand is a stronger predictor of brand trust as well as brand loyalty compared to an active brand. Surprisingly, the results display that active brands lower brand trust and brand loyalty.

Practical implications

This finding informs brand managers that projecting active brand personality leads to higher awareness. However, projecting more responsible brand leads to greater trust and loyalty. The study highlights that having one personality may not be sufficient to develop an enduring CBR, but a brand personality must “evolve” and progress as the relationship develops over time. Such dynamic brand personality may provide a more long-lasting brand strategy and a greater source of competitive advantage.

Originality/value

The present study contributes to the marketing literature in three different ways. First, this study adds to the body of knowledge on the relationship between brand personality and CBR constructs using the new measure of BPS. Second, this study assesses the individual level of the new BPS, particularly responsibility and activity, on the three CBR constructs, and in doing so, the study responds to previous studies’ calls to assess the individual capacity of the brand personality dimensions to get consumer preference or loyalty. Third, the study displays which ones of the two dimensions in the new BPS (i.e. responsible and active) may be better predictors to the three CBR constructs.