bluuebunny/crossref_metadata_2025 huggingface dataset:
Anatomical Study of the Axillary Nerve: Description of a Surgical Blind Zone
Authors: Maldonado Andrés A. , Howe Benjamin M. , Lawton Rich , Bishop Allen T. , Shin Alexander Y. , Spinner Robert J.
Published: April 2016

Background:

The aim of this study was to quantify the length of the axillary nerve that is able to be dissected through a standard anterior (deltopectoral) and posterior approach. The authors hypothesize that a segment of the axillary nerve cannot be reached using both approaches simultaneously.

Methods:

Axillary nerves of five frozen cadavers were dissected using an anterior and posterior approach. A first surgical clip marked the most visible distal part of the nerve from the deltopectoral approach; a second surgical clip marked the most proximal part from the posterior approach. The two surgical clips were localized with a shoulder radiograph. The authors performed measurements of the different axillary nerve segments.

Results:

In all specimens, there were three zones of the axillary nerve: zone A (anterior), the nerve segment from the origin of the axillary nerve to the first surgical clip, located at the level of the triangle formed by the subscapularis muscle (medial), conjoined tendon (lateral), and axillary fat (inferior); zone B (blind), the nerve segment not reachable through both approaches, from the first to the second surgical clip; and zone C (circumflex), the nerve segment from the second surgical clip (located at the level of the quadrilateral space) to entry into the deltoid muscle. The mean length of the blind zone was 1.6 cm. This blind zone was found 1 to 2 cm from the glenohumeral joint.

Conclusion:

The authors have described a segment of the axillary nerve that cannot be evaluated through anterior and posterior combined approaches.
Multiplexing and Beyond in Biobehavioral Research
Authors: Mills Paul J. , Peterson Christine T.
Published: April 2016

In contrast to traditional singleplex assays that provide values for only a single analyte in a single biological sample, multiplex assays are a time- and resource-efficient high-throughput approach that provides the opportunity to determine numerous analytes within a single- and small-sample volume. In this editorial on an article by Dorn et al. in this issue of Psychosomatic Medicine, we provide a brief description of the advantages and challenges related to multiplex assays. Although the use of multiplexing as a tool has been relatively limited in biobehavioral research, more recent studies are taking advantage of this technology to obtain deeper insight into regulatory patterns in health and disease states. Multiplex approaches range from several targets to global target profiling that importantly enable unbiased biomarker and pathway discovery.
Behavioral Interventions for Tobacco Use in HIV-Infected Smokers: A Meta-Analysis
Authors: Keith Asheena , Dong Yuelei , Shuter Jonathan , Himelhoch Seth
Published: April 2016

Context:

Smoking is responsible for increased morbidity and mortality in HIV-infected smokers.

Objective:

To assess the efficacy of behavioral interventions for smoking cessation among HIV-infected smokers compared with the standard care.

Data sources:

PubMed, Cochrane, CINHAL, PsychINFO, and Google Scholar were searched for randomized controlled trials published in English.

Study selection:

Eligibility criteria were randomized controlled trials with targeted behavioral interventions compared with standard of care (or enhanced standard of care) aimed at promoting abstinence in HIV-infected smokers. A total of 17,384 articles were found and 17,371 were excluded; 13 full text articles were obtained and reviewed, and 8 met the eligibility criteria (Κ = 0.94).

Data extraction:

The primary outcome was expired carbon monoxide–verified 7-day point prevalence abstinence rates. Adequate sequence generation and freedom from incomplete or selective outcome reporting was used to assess study quality.

Results:

A total of 1822 subjects from 8 studies yielded a statistically significant effect of behavioral interventions in increasing abstinence in HIV-infected smokers with a moderate effect size (relative risk: 1.51; 95% confidence interval: 1.17 to 1.95). Those studies with interventions of 8 sessions or more had a large effect size for abstinence (relative risk: 2.88; 95% confidence interval: 1.89 to 4.61). When stratified by the number of sessions, there was no heterogeneity.

Conclusions:

Targeted behavioral smoking cessation interventions are efficacious. Interventions consisting of 8 sessions or more had the greatest treatment efficacy.
Brief Report: Enhanced Normalization of CD4/CD8 Ratio With Earlier Antiretroviral Therapy at Primary HIV Infection
Authors: Thornhill John , Inshaw Jamie , Kaleebu Pontiano , Cooper David , Ramjee Gita , Schechter Mauro , Tambussi Giuseppe , Fox Julie , Samuel Miriam , Miro Jose M. , Weber Jonathan , Porter Kholoud , Fidler Sarah ,   On behalf of UK Register of HIV Seroconverters and SPARTAC Trial Investigators
Published: April 2016

Background:

Total CD4+ T-cell counts predict HIV disease progression but do not necessarily reflect normalization of immune function. CD4/CD8 ratio is a marker of immune dysfunction, a prognostic indicator for non-AIDS mortality, and reflects viral reservoir size. Despite antiretroviral therapy (ART), recovery of CD4/CD8 ratio in chronic HIV infection is incomplete; we hypothesize enhanced CD4/CD8 ratio recovery with earlier treatment initiation in recently infected individuals.

Methods:

CD4+ count and CD4/CD8 ratio were analyzed using data from 2 cohorts: SPARTAC trial and the UK HIV Seroconverters Cohort where primary HIV infection (PHI) was defined as within 6 months from estimated date of infection. Using time-to-event methods and Cox proportional hazard models, we examined the effect of CD4/CD8 ratio at seroconversion on disease progression (CD4 <350 cells per cubic millimeter/ART initiation) and factors associated with time from ART initiation to CD4/CD8 normalization (ratio >1.0).

Findings:

Of 573 seroconverters, 482 (84%) had abnormal CD4/CD8 ratios at HIV seroconversion. Individuals with higher CD4/CD8 ratio at seroconversion were significantly less likely to reach the disease progression endpoint [adjusted hazard ratio (aHR) (95% CI) = 0.52 (0.32 to 0.82), P = 0.005]. The longer the interval between seroconversion and ART initiation [HR (95% CI) = 0.98 per month increase (0.97, 0.99), P < 0.001], the less likely the CD4/CD8 ratio normalization. ART initiation within 6 months from seroconversion was significantly more likely to normalize [HR (95% CI) = 2.47 (1.67 to 3.67), P < 0.001] than those initiating later.

Interpretation:

Most individuals presenting in PHI have abnormal CD4/CD8 ratios. The sooner the ART is initiated in PHI, the greater the probability of achieving normal CD4/CD8 ratio.
Attrition and Opportunities Along the HIV Care Continuum: Findings From a Population-Based Sample, North West Province, South Africa
Authors: Lippman Sheri A. , Shade Starley B. , El Ayadi Alison M. , Gilvydis Jennifer M. , Grignon Jessica S. , Liegler Teri , Morris Jessica , Naidoo Evasen , Prach Lisa M. , Puren Adrian , Barnhart Scott
Published: April 2016

Background:

Attrition along the HIV care continuum slows gains in mitigating the South African HIV epidemic. Understanding population-level gaps in HIV identification, linkage, retention in care, and viral suppression is critical to target programming.

Methods:

We conducted a population-based household survey, HIV rapid testing, point-of-care CD4 testing, and viral load measurement from dried blood spots using multistage cluster sampling in 2 subdistricts of North West Province from January to March, 2014. We used weighting and multiple imputation of missing data to estimate HIV prevalence, undiagnosed infection, linkage and retention in care, medication adherence, and viral suppression.

Results:

We sampled 1044 respondents aged 18–49. HIV prevalence was 20.0% (95% confidence interval: 13.7 to 26.2) for men and 26.7% (95% confidence interval: 22.1 to 31.4) for women. Among those HIV positive, 48.4% of men and 75.7% of women were aware of their serostatus; 44.0% of men and 74.8% of women reported ever linking to HIV care; 33.1% of men and 58.4% of women were retained in care; and 21.6% of men and 50.0% of women had dried blood spots viral loads <5000 copies per milliliter. Among those already linked to care, 81.7% on antiretroviral treatment (ART) and 56.0% of those not on ART were retained in care, and 51.8% currently retained in care on ART had viral loads <5000 copies per milliliter.

Conclusions:

Despite expanded treatment in South Africa, attrition along the continuum of HIV care is slowing prevention progress. Improved detection is critically needed, particularly among men. Reported linkage and retention is reasonable for those on ART; however, failure to achieve viral suppression is worrisome.
Idiopathic Pulmonary Fibrosis
Authors: Martin Maria D. , Chung Jonathan H. , Kanne Jeffrey P.
Published: April 2016

Idiopathic pulmonary fibrosis (IPF) is the most common fibrosing lung disease and is associated with a very poor prognosis. IPF manifests histopathologically as usual interstitial pneumonia (UIP) and as subpleural and basal predominant reticulation with honeycombing on high-resolution computed tomography (HRCT) of the chest. When a high-confidence radiologic diagnosis of UIP is made on HRCT, surgical biopsy is rarely required. Therefore, radiologists should recognize a UIP pattern on HRCT as well as recognize other patterns of fibrosing lung disease such as nonspecific interstitial pneumonia or chronic hypersensitivity pneumonitis, both of which can be mistaken for UIP. This article reviews the clinical, CT, and histopathologic features of IPF, discusses the impact of CT findings on prognosis, and describes complications associated with IPF.
Coronary Artery Variants and Anomalies in Patients With Bicuspid Aortic Valve
Authors: Michałowska Ilona M. , Hryniewiecki Tomasz , Kwiatek Paweł , Stokłosa Patrycjusz , Swoboda-Rydz Urszula , Szymański Piotr
Published: April 2016

Purpose:

The aim of this study was to assess the prevalence of variants and anomalies of the coronary arteries in patients with bicuspid aortic valve (BAV) and compare it with patients with tricuspid aortic valve (TAV).

Materials and Methods:

A total of 428 patients (193 with BAV, 235 with TAV) who underwent coronary computed tomography angiography were analyzed.

Results:

The right coronary artery was dominant in 360 (84.1%) cases, including 157 (81.34%) with BAV and 203 (86.38%) with TAV. Left dominance was observed in 51 (11.9%) patients, including 30 (15.54%) with BAV 21 (8.93%) with TAV (P=0.08), and codominance in 17 (4%). The mean length of the left main coronary artery (LMCA) in patients with BAV was 10.45±6.93 versus 12.02±5.12 mm in those with TAV (P=0.008). The absence of the LMCA with separate origins of the left artery descending and the left circumflex artery was observed in 18 cases, 14/193 (7.3%) with BAV and 4/235 (1.7%) with TAV (P=0.004). The ramus intermedius was present in 50 (11.7%) patients, 29 with BAV (15%) and 21 with TAV (8.9%) (P=0.05). Coronary artery anomalies were observed in 2.1% of all patients (5/193 with BAV vs. 4/235 with TAV, P=0.5).

Conclusions:

The prevalence of anomalies of coronary arteries was similar in both groups. Patients with BAV had a higher incidence of the absence of the LMCA and the presence of the ramus intrermedius. The mean length of the LMCA in patients with BAV was shorter than in patients with TAV. There was a trend for a higher incidence of left dominance in patients with BAV compared to those with TAV, but did not reach statistical significance.
Lung Ablation
Authors: Xiong Lillian , Dupuy Damian E.
Published: April 2016

Lung cancer had an estimated incidence of 221,200 in 2015, making up 13% of all cancer diagnoses. Tumor ablation is an important treatment option for nonsurgical lung cancer and pulmonary metastatic patients. Radiofrequency ablation has been used for over a decade with newer modalities, microwave ablation, cryoablation, and irreversible electroporation presenting as additional and possibly improved treatment options for patients. This minimally invasive therapy is best for small primary lesions or favorably located metastatic tumors. These technologies can offer palliation and sometimes cure of thoracic malignancies. This article discusses the current available technologies and techniques available for tumor ablation.
Comparison of Psychophysiological Stress in Physiotherapy Students Undertaking Simulation and Hospital-Based Clinical Education
Authors: Judd Belinda Karyn , Alison Jennifer Ailsey , Waters Donna , Gordon Christopher James
Published: April 2016

Introduction

Simulation-based clinical education often aims to replicate varying aspects of real clinical practice. It is unknown whether learners’ stress levels in simulation are comparable with those in clinical practice. The current study compared acute stress markers during simulation-based clinical education with that experienced in situ in a hospital-based environment.

Methods

Undergraduate physiotherapy students’ (n = 33) acute stress responses [visual analog scales of stress and anxiety, continuous heart rate (HR), and saliva cortisol] were assessed during matched patient encounters in simulation-based laboratories using standardized patients and during hospital clinical placements with real patients. Group differences in stress variables were compared using repeated measures analysis of variance for 3 time points (before, during the patient encounter, and after) at 2 settings (simulation and hospital).

Results

Visual analog scale stress and anxiety as well as HR increased significantly from baseline levels before the encounter in both settings (all P < 0.05). Stress and anxiety were significantly higher in simulation [mean (SD), 45 (22) and 44 (25) mm; P = 0.003] compared with hospital [mean (SD), 31 (21) and 26 (20) mm; P = 0.002]. The mean (SD) HR during the simulation patient encounter was 90 (16) beats per minute and was not different compared with hospital [mean (SD), 87 (15) beats per minute; P = 0.89]. Changes in salivary cortisol before and after patient encounters were not statistically different between settings [mean (SD) simulation, 1.5 (2.4) nmol/L; hospital, 2.5 (2.9) nmol/L; P = 0.70].

Conclusions

Participants’ experienced stress on clinical placements, irrespective of the clinical education setting (simulation vs. hospital). This study revealed that psychological stress and anxiety were greater during simulation compared with hospital settings; however, physiological stress responses (HR and cortisol) were comparable. These results indicate that psychological stress may be heightened in simulation, and health professional educators need to consider the impact of this on learners in simulation-based clinical education. New learners in their clinical education program may benefit from a less stressful simulation environment, before a gradual increase in stress demands as they approach clinical practice.
Standardized Patients' Perspectives on Workplace Satisfaction and Work-Related Relationships
Authors: Schlegel Claudia , Bonvin Raphael , Rethans Jan-Joost , Van der Vleuten Cees
Published: April 2016

Introduction

The use of standardized patients (SPs) in health care education has grown in the last 50 years. In addition, the requirements for SPs have increased steadily, and thus, the work of SPs has become more difficult and demanding. It has been claimed that SP programs are highly contextualized, having emerged from local, institutional, professional, and national conditions, but their effects on SPs have not been investigated. We have studied the effects of this job development on SPs and their programs.

Methods

The study was conducted using a qualitative research design, with semistructured individual in-depth interviews to understand the reactions, values, and perceptions that underlie and influence SP behavior. To cover SP perspectives from more than 1 SP program, a total of 15 SPs from 8 different nursing schools and medical schools in Switzerland were asked to participate.

Results

Standardized patients feel motivated, engaged, and willing to invest effort in their task and do not mind demands increasing as long as the social environment in SP programs is supportive. The role of the SP trainer and the use of feedback are considered very important.

Conclusions

Standardized patient programs require concepts in which the SP perspective has been integrated to better serve SPs' well-being. Standardized patients are valuable partners in the training of health professionals—we need to take care of them.
Creating a Simulated Pharmacy
Authors: Soto Cory , Stiner Jamie , Noji Daniel O. , Rusheen Jeffrey M. , Huang Yue Ming
Published: April 2016

Introduction

The acquisition and use of pharmaceuticals in simulation is a common challenge for many institutions and simulation centers. There are 2 major avenues of obtaining medications, namely, via expired drugs donated by manufacturers or via purchasing simulated medication vials filled with inactive ingredients. Neither option is ideal to keep pace with busy simulation centers or to meet the specialized requirements of many educational programs. We describe an alternative solution through internal production of simulated drugs using readily available materials from laboratory suppliers.

Methods

Serum vials, stoppers, and flip off vial caps can be purchased in 2-, 5-, 10-, and 20-mL volumes. Vials can be filled with substances such as 0.9% NaCl or table salt to mimic a variety of available injectable drugs. Labels can be produced using the free online Web application, Simulated Online Pharmaceutical Image Editor (SOPHIE) and printed on glossy adhesive photo paper for application onto completed vials.

Results

A wide range of simulated drugs, customized to the needs of each center, can be produced in an affordable and reliable manner. The appearance of the vials can be tailored for each program to meet educational objectives and enhance fidelity in simulation.

Conclusions

Low-cost production of simulated drug vials increases learning opportunities for participants to practice skills related to drug delivery and preparation. Further expansion can include nonintravenous drugs, code syringes, or reconstitution devices used for blood factors. Simulation centers should consider safety, availability, affordability, and fidelity concerns before integrating an in-house simulated pharmacy.
Optimizing the Timing of Expert Feedback During Simulation-Based Spaced Practice of Endourologic Skills
Authors: Lee Jason Young , McDougall Elspeth M. , Lineberry Matthew , Tekian Ara
Published: April 2016

Introduction

Provision of expert feedback is widely acknowledged to be an essential component of simulation-based training. However, little is known about the most effective and efficient ways to provide feedback to novices. Optimizing the timing of expert feedback may improve outcomes while reducing resource requirements. The main objective of this study was to determine the impact of providing early versus late expert feedback to novice learners engaged in a flexible ureteroscopy (fURS) training curriculum.

Methods

Senior medical students were recruited to participate in this study. Each student participated in a comprehensive fURS training curriculum that included 3 deliberate, independent practice sessions. Baseline and postcourse fURS skill was assessed for each student using a standardized fURS test task. Each student was randomized to either an early feedback group (EFG) or late feedback group (LFG). The EFG participants were provided expert feedback immediately after the baseline skill test, whereas LFG participants were given feedback before their final deliberate, independent practice session.

Results

Eighteen senior medical students completed the study (9 EFG and 9 LFG participants). There were no discernible demographic differences between the groups at baseline. When controlling for pretest performance, early rather than late feedback was associated with both shorter postcourse time to completion of the task (19.2 vs. 21.5 minutes, P < 0.01) and higher performance scores (13.1 vs. 10.5, P < 0.01).

Conclusions

This study offers preliminary evidence that novice learners may benefit more from early feedback when learning a novel skill. Further study is required.
Transanal Endoscopic Operation for Rectal Tumor: Short-term Outcomes and Learning Curve Analysis
Authors: Hur Hyuk , Bae Sung Uk , Han Yoon Dae , Kang Jeonghyun , Min Byung Soh , Baik Seung Hyuk , Lee Kang Young , Kim Nam Kyu
Published: April 2016

Purpose:

We aim to report outcomes and learning curve of transanal endoscopic operation (TEO) for rectal tumors, using standard laparoscopic instruments under a magnifying laparoscopic monitor view.

Materials and Methods:

From January 2012 to July 2014, local excision was performed using a TEO system in 46 consecutive patients with rectal tumors. Patient and tumor characteristics and perioperative outcomes were prospectively assessed.

Results:

The median patient age was 56 years for 15 women and 31 men. The mean tumor size was 1.8 cm, and the mean distance from the anal verge was 7.8 cm. The mean operative time was 85 minutes, and the mean postoperative hospital stay was 4.5 days. The postoperative pathologic diagnosis was adenocarcinoma for 17 patients (37%), adenoma for 4 patients (9%), carcinoid tumor for 23 patients (50%), and leiomyoma and lipoma for the 2 remaining patients (2%). A positive resection margin was documented for 4 patients (9%). No mortality was associated with the procedure although postoperative bleeding, leakage, perianal fistula, fecal incontinence, and voiding difficulty developed in 8 patients. According to the cumulative sum (CUSUM) analysis, the operation time and hospital stay significantly decreased after 17 case experiences.

Conclusions:

TEO is a feasible and safe treatment option for local excision of rectal tumors. TEO has the advantage of being a precise surgical procedure with a stable and magnifying endoscopic view. However, TEO requires a learning period and a careful selection of patients through proper indications and preoperative diagnostics.
Pessary Practices of Nurse-Providers in the United States
Authors: O’Dell Katharine , Atnip Shanna , Hooper Gwendolyn , Leung Katherine
Published: April 2016

Objectives

Our purposes were to describe pessary-care practices and education of a sample of nurse providers in the United States and identify a cohort of high-volume providers.

Methods

An e-mail survey was sent to members of 3 related nursing professional organizations. Questions addressed general pessary care within the respondent’s practice and specific pessary care choices of responding direct providers. Data were managed using REDCap electronic data capture tools.

Results

Of 323 respondents, 279 (86.4%) reported pessary care occurred in their office settings, 84.5% of which were urban or suburban, and 65.4% were private practices. Responders were evenly distributed through 4 regions of the United States and represented a variety of specialties. Physicians and advanced practice registered nurses provided the majority of care (up to 80%), along with registered and licensed practical nurses and medical assistants. Care routines varied, most often including 3-month-interval follow-up with speculum-assisted vaginal examinations and no routine use of vaginal products (eg, moisturizers, acidifiers, antimicrobials, or vaginal estrogens). On-the-job mentoring was the primary knowledge source (64%). Comparison of practice patterns suggested possible variation by region and certification.

Conclusions

This exploratory study provides data related to the pessary-care practices of nurse providers in the United States. The range of responses emphasizes a need for evidence-based guidelines for optimal care, based on patient outcomes, satisfaction, and costs of care. Findings also illustrate a need for effective, evidence-based educational programs and clinical mentorship options with experienced providers. A cohort of expert providers was identified to continue work toward these goals.
Outcomes in 450 Women After Minimally Invasive Abdominal Sacrocolpopexy for Pelvic Organ Prolapse
Authors: Mueller Margaret G. , Jacobs Kristin M. , Mueller Elizabeth R. , Abernethy Melinda G. , Kenton Kimberly S.
Published: April 2016

Objective

To report outcomes and complications in approximately 450 women who underwent isolated minimally invasive abdominal sacrocolpopexy (ASC) for the management of pelvic organ prolapse (POP).

Material and Methods

We retrospectively reviewed the electronic medical records of women who underwent minimally invasive ASC (laparoscopic ASC [LASC] or robotic ASC [RASC]) for symptomatic POP at Loyola University Chicago Medical Center from 2007 to 2012. Polypropylene mesh was used and the decision to reperitonealize the mesh was left to surgeon discretion. Data collected included demographics, Pelvic Floor Distress Inventory questionnaire, intraoperative and postoperative details, and POP quantification.

Results

Four hundred twenty-eight women underwent minimally invasive ASC—232 LASC and 226 RASC. Most women (86%) did not undergo reperitonealization of the mesh. Median follow-up was 13 weeks (range, 2–268 weeks) for complications and 13 weeks (range, 2–104 weeks) for anatomic outcomes.

Postoperatively, 88.6% of women had stage 0/I, 10.7% had stage II, and 2 women had stage III POP. Twelve (2.6%) underwent reoperation, 6 for POP (3 posterior repairs, 2 repeat ASC, 1 perineorrhaphy) and 6 for bowel complications. Fourteen women had postoperative bowel complications; half of which resolved with conservative treatment. There were no differences between anatomic and functional outcomes or bowel complications between LASC and RASC. Reoperation rates for bowel complications in women who underwent reperitonealization of the mesh were similar to those who did not (1.5% vs 1.0%, P = 0.86).

Conclusions

Minimally invasive ASC without concomitant vaginal repair is an effective and safe procedure for the surgical management of POP with low rates of reoperation and complications.
Long-Term Outcomes After Repair of Transurethral Perforation of Midurethral Sling
Authors: Colhoun Andrew , Rapp David E.
Published: April 2016

Objectives

The literature lacks long-term evaluation of outcomes after repair of transurethral midurethral sling (MUS) perforation.

Methods

We prospectively followed 5 patients undergoing repair of urethral perforation (International Continence Society–International Urogynecological Association classification 4B) after MUS (mean follow-up, 54 months). Outcomes assessment was composed of validated measures of urinary (International Consultation on Incontinence Questionnaire [ICIQ]-Female Lower Urinary Tract Symptoms), vaginal (ICIQ-Vaginal Symptoms), and quality of life (Incontinence Impact Questionnaire, Short Form) symptoms.

Results

Five patients underwent MUS (4 transobturator, 1 retropubic) with a mean of 41 months before referral. Primary referring complaints composed of hematuria (2), weak stream (2), and urgency (1). All but 1 patient reported transient urinary retention requiring catheterization after initial sling placement. Each patient underwent transvaginal sling excision and repair of urethral injury. Four of 5 patients experienced persistent postoperative stress urinary incontinence. Before final assessment, further treatment included observation, physical therapy, and autologous fascial sling in 1, 2, and 2 patients, respectively. ICIQ-Female Lower Urinary Tract Symptoms, ICIQ-Vaginal Symptoms, and Incontinence Impact Questionnaire, Short Form, assessment failed to demonstrate statistically significant improvements in comparison of baseline and multiple time point (6-week, 12-month, 54-month) assessments during long-term follow-up (P > 0.05).

Conclusions

Urethral perforation represents a significant complication after MUS placement. Many patients continue to have incontinence despite the use of physical therapy/salvage sling placement. Furthermore, subjective outcomes and quality of life do not seem to improve over time. Because of the rarity of urethral perforation, our small series is notable given the absence of reported data that include prospective, long-term follow-up with validated questionnaire evaluation.
Breakdown of Perineal Laceration Repair After Vaginal Delivery: A Case-Control Study
Authors: Jallad Karl , Steele Sarah E. , Barber Matthew D.
Published: April 2016

Objective

The aim of the study was to estimate risk factors associated with breakdown of perineal laceration repair after vaginal delivery.

Methods

This is a case-control study of women who sustained a breakdown of perineal laceration repair after vaginal delivery between 2002 and 2015. Cases were patients who sustained a perineal wound breakdown after vaginal delivery and repair of a second-, third-, or fourth-degree laceration. Controls, matched 1:1, were patients who either sustained a second-, third-, or fourth-degree perineal laceration and repair without evidence of breakdown and who delivered on the same day and institution as the case.

Results

A total of 104,301 deliveries were assessed for breakdown of perineal laceration. One hundred forty-four met the inclusion criteria. These were matched with 144 controls. Logistic regression analysis demonstrated that smoking is associated with increased risk for breakdown of perineal laceration (adjusted odds ratio [adj. OR], 6.4; 95% confidence interval [CI], 1.2–38.5), whereas a previous vaginal delivery is protective (adj. OR, 0.14; 95% CI, 0.05-0.3). In addition, third- or fourth-degree laceration (adj. OR, 4.0; 95% CI, 1.1–15.7), presence of episiotomy at time of delivery (adj. OR, 11.1; 95% CI, 2.9–48.8), operative delivery (adj. OR, 3.4; 95% CI, 1.2–10.3), midwife performing the laceration repair (adj. OR, 4.7; 95% CI, 1.5–15.8), and use of chromic suture (adj. OR, 3.9; 95% CI, 1.6–9.8) were independent risk factors for breakdown of perineal laceration.

Conclusions

Smoking, nulliparity, episiotomy, operative delivery, third- or fourth-degree laceration, repair by a midwife, and use of chromic suture are independent risk factors for breakdown of perineal laceration repair after vaginal delivery.
Rituximab for Recurrence of Primary Focal Segmental Glomerulosclerosis After Kidney Transplantation: Clinical Outcomes
Authors: Garrouste Cyril , Canaud Guillaume , Büchler Mathias , Rivalan Joseph , Colosio Charlotte , Martinez Frank , Aniort Julien , Dudreuilh Caroline , Pereira Bruno , Caillard Sophie , Philipponnet Carole , Anglicheau Dany , Heng Anne Elisabeth
Published: April 2016

Background

Rituximab has shown encouraging results for the treatment of kidney transplantation recipients with focal segmental glomerulosclerosis (FSGS) recurrence. However, the correct, opportune, and safe use of rituximab for this indication remains to be determined.

Methods

This multicenter retrospective study reports on 19 new cases aged 35 (15-66) years who developed FSGS recurrence at 12 (1.5-27) days posttransplantation. Initial treatment consisted of plasma exchanges (PE), high doses of calcineurin inhibitors, and steroids. Rituximab was introduced either immediately (N = 6) or after failure of the initial treatment (N = 10) or failed attempted weaning from PE (N = 3).

Results

Overall, we observed 9 of 19 complete remissions and 3 of 19 partial remissions. Estimated glomerular filtration rates (Modification of Diet in Renal Disease 4) were significantly higher in the responding patients than in nonresponding patients at month (M)12, M36, and M60. Overall, kidney survival at 5 years was 77.4% (95% range, 41.9-92.7). The 5-year graft survival rates in the responding patients and the nonresponding patients were 100% and 36.5%, respectively (P = 0.01). A further course of rituximab was required for 4 patients as a result of FSGS relapse, with good results. During the first year after renal transplantation, 14 patients developed severe infections (16 bacterial, 4 viral, 1 parasitic).

Conclusions

In kidney transplantation recipients with recurrent FSGS, rituximab therapy may be a recommended treatment for cases that have failed either the initial treatment or weaning from PE.
Summertime Dyskinesia-Hyperpyrexia Syndrome: The “Dual Heat” Hypothesis
Authors: Herreros-Rodriguez Jaime , Sánchez-Ferro Álvaro
Published: April 2016

The dyskinesia-hyperpyrexia syndrome is a rare complication of Parkinson disease. Here, we present an exceptional case affected by this syndrome. Its singularity is 2-fold. On one hand, the patient presented periodic episodes of dyskinesia-hyperpyrexia during 3 consecutive summers. On the other, after unsuccessfully trying several therapies, she had an excellent response to an infusion of enteral L-dopa. Both features allow us to hypothesize that this complication is central in origin and propose a new potential mean of treating future refractory cases.
Geometric phases for mixed states of the Kitaev chain
Authors: Andersson Ole , Bengtsson Ingemar , Ericsson Marie , Sjöqvist Erik
Published: April 2016

The Berry phase has found applications in building topological order parameters for certain condensed matter systems. The question whether some geometric phase for mixed states can serve the same purpose has been raised, and proposals are on the table. We analyse the intricate behaviour of Uhlmann's geometric phase in the Kitaev chain at finite temperature, and then argue that it captures quite different physics from that intended. We also analyse the behaviour of a geometric phase introduced in the context of interferometry. For the Kitaev chain, this phase closely mirrors that of the Berry phase, and we argue that it merits further investigation.
Von Neumann was not a Quantum Bayesian
Authors: Stacey Blake C.
Published: April 2016

Wikipedia has claimed for over 3 years now that John von Neumann was the ‘first quantum Bayesian’. In context, this reads as stating that von Neumann inaugurated QBism, the approach to quantum theory promoted by Fuchs, Mermin and Schack. This essay explores how such a claim is, historically speaking, unsupported.
Darwinism in disguise? A comparison between Bohr's view on quantum mechanics and QBism
Authors: Faye Jan
Published: April 2016

The Copenhagen interpretation is first and foremost associated with Niels Bohr's philosophy of quantum mechanics. In this paper, I attempt to lay out what I see as Bohr's pragmatic approach to science in general and to quantum physics in particular. A part of this approach is his claim that the classical concepts are indispensable for our understanding of all physical phenomena, and it seems as if the claim is grounded in his reflection upon how the evolution of language is adapted to experience. Another, recent interpretation, QBism, has also found support in Darwin's theory. It may therefore not be surprising that sometimes QBism is said to be of the same breed as the Copenhagen interpretation. By comparing the two interpretations, I conclude, nevertheless, that there are important differences.
The future (and past) of quantum theory after the Higgs boson: a quantum-informational viewpoint
Authors: Plotnitsky Arkady
Published: April 2016

Taking as its point of departure the discovery of the Higgs boson, this article considers quantum theory, including quantum field theory, which predicted the Higgs boson, through the combined perspective of quantum information theory and the idea of technology, while also adopting anon-realistinterpretation, in ‘the spirit of Copenhagen’, of quantum theory and quantum phenomena themselves. The article argues that the ‘events’ in question in fundamental physics, such as the discovery of the Higgs boson (a particularly complex and dramatic, but not essentially different, case), are made possible by the joint workings of three technologies: experimental technology, mathematical technology and, more recently, digital computer technology. The article will consider the role of and the relationships among these technologies, focusing on experimental and mathematical technologies, in quantum mechanics (QM), quantum field theory (QFT) and finite-dimensional quantum theory, with which quantum information theory has been primarily concerned thus far. It will do so, in part, by reassessing the history of quantum theory, beginning with Heisenberg's discovery of QM, in quantum-informational and technological terms. This history, the article argues, is defined by the discoveries of increasingly complex configurations of observed phenomena and the emergence of the increasingly complex mathematical formalism accounting for these phenomena, culminating in the standard model of elementary-particle physics, defining the current state of QFT.
Chm7 and Heh1 form a nuclear envelope subdomain for nuclear pore complex quality control
Authors: Webster Brant M. , Thaller David J. , Jäeger Jens , Ochmann Sarah E. , Lusk C. Patrick
Published: April 2016

Mechanisms that ensure the integrity of the nuclear envelope rely on membrane remodeling proteins like the ESCRTs and the AAA ATPase Vps4, which help seal the nuclear envelope at the end of mitosis and prevent the formation of defective nuclear pore complexes (NPCs). Here, we show that the integral inner nuclear membrane proteins Heh1 and Heh2 directly bind the ESCRT-III, Snf7, and the ESCRT-II/III chimera, Chm7, in their ‘open’ forms. Moreover, Heh1 is required for Chm7-recruitment to the nuclear envelope. As Chm7 accumulates on the nuclear envelope upon blocks to NPC assembly, but not to nuclear transport, interactions between ESCRTs and the Heh proteins might form a biochemically distinct nuclear envelope subdomain that delimits regions of assembling NPCs. Interestingly, deletion ofCHM7suppresses the formation of the storage of improperly assembled NPC compartment prevalent invps4Δstrains. Thus, our data support that the Heh1-dependent recruitment of Chm7 is a key component of a quality control pathway whose local regulation by Vps4 and the transmembrane nup, Pom152, prevents loss of nuclear compartmentalization by defective NPCs.
Heat*seq: an interactive web tool for high-throughput sequencing experiment comparison with public data
Authors: Devailly Guillaume , Mantsoki Anna , Joshi Anagha
Published: April 2016

Better protocols and decreasing costs have made high-throughput sequencing experiments now accessible even to small experimental laboratories. However, comparing one or few experiments generated by an individual lab to the vast amount of relevant data freely available in the public domain might be limited due to lack of bioinformatics expertise. Though several tools, including genome browsers, allow such comparison at a single gene level, they do not provide a genome-wide view. We developed Heat*seq, a web-tool that allows genome scale comparison of high throughput experiments (ChIP-seq, RNA-seq and CAGE) provided by a user, to the data in the public domain. Heat*seq currently contains over 12,000 experiments across diverse tissue and cell types in human, mouse and drosophila. Heat*seq displays interactive correlation heatmaps, with an ability to dynamically subset datasets to contextualise user experiments. High quality figures and tables are produced and can be downloaded in multiple formats.

Availability

Web application:www.heatstarseq.roslin.ed.ac.uk/. Source code:https://github.com/gdevailly.

Contact

Guillaume.Devailly@roslin.ed.ac.uk;Anagha.Joshi@roslin.ed.ac.uk
4-Bromo-N-(4-bromophenyl)benzenesulfonamide
Authors: Rodrigues Vinola Z. , Naveen S. , Lokanath N. K. , Suchetan P. A.
Published: April 2016

The molecule of the title compound, C12H9Br2NO2S, is U shaped with the central C—S—N—C segment having a torsion angle of 63.2 (4)°. Further, the dihedral angle between the benzene rings is 38.5 (2)°. The crystal structure features strong N—H...O hydrogen bonds that form infinite [100]C(4) chains. Molecules in adjacent chains are interlinkedviaC—H...O interactions which run along thebaxis, formingC(7) chains. This results in a two-dimensional network in theabplane; adjacent networks are connected by short Br...Br contacts [3.5092 (8) Å] propagating along the diagonal of theacplane, so that a three-dimensional supramolecular architecture ensues.
How do idiosyncratic deals contribute to the employability of older workers?
Authors: Oostrom Janneke K. , Pennings Martine , Bal P. Matthijs
Published: April 2016

Purpose

– The purpose of this paper is to examine the relationships of i-deals with the employability of older workers, and introduce two distinct theoretical processes through which these effects occur. On the one hand, a self-enhancement perspective postulates that i-deals enhance self-efficacy through which older workers become more employable. On the other hand, a lifespan perspective postulates that i-deals enhance older workers’ future time perspective through which they become more employable.

Design/methodology/approach

– Data were gathered among 244 employees via an online questionnaire that had been sent to employees of 45 years or older at eight companies in the Netherlands.

Findings

– Results showed that task and work responsibilities i-deals are strongly related to older workers’ employability, and that this relationship is mediated by future time perspective and self-efficacy. Location flexibility i-deals were positively related to employability. Financial i-deals and schedule flexibility i-deals were unrelated to employability.

Research limitations/implications

– This study introduces two novel ways through which i-deals for older workers can be studied: a self-enhancement and a future time perspective. Both can explain how older workers may enhance their employability by negotiating i-deals.

Practical implications

– As the percentage of older workers will increase, there is a great need for organizations to focus on the employability of older workers. The present study shows that organizations are able to increase the employability of older workers by individual arrangements.

Originality/value

– Individualization of work arrangements has been theorized to facilitate older workers’ employability, but the present study is the first to investigate how i-deals may contribute to greater employability.
School leadership styles among educators in Abu Dhabi
Authors: Litz David , Juma Qusay Abu , Carroll Kevin S.
Published: April 2016

Purpose

– The purpose of this paper is to report on an examination of the perceptions of two principals and two lead teachers regarding their own leadership styles, including how they define and perform their roles as leaders.

Design/methodology/approach

– The research employed a case study design whereby two principals and two lead teachers (one of each from a government school (GS) and a private school in Abu Dhabi UAE) were interviewed over the course of one semester.

Findings

– Results suggest that the two principals viewed themselves as succeeding in six domains – school climate, school leadership, personnel management, administration and school management, student management, and relationships with parents and the community – but that they desired to improve with regard to curriculum development and professional and in-service development. The two lead teachers primarily defined their leadership roles as providing assistance to others and modeling best practice and flexibility, and considered themselves bridges between other teachers and the administration, as well as task facilitators and task achievers.

Originality/value

– The paper reveals that both principals and teachers in Abu Dhabi engage in a number of activities consistent with much of the literature on effective school leadership styles. However, the findings also shed light on several marked differences between private and GSs in the Emirate, a lack of genuine collaboration between principals and teachers, and possible constraints on school leadership caused by top-down administrative practices.
Entrepreneurship and liminality: the case of self-storage based businesses
Authors: Daniel Elizabeth , Ellis-Chadwick Fiona
Published: April 2016

Purpose

– The purpose of this paper is to apply the theoretical lens of liminality to a consideration of non-traditional entrepreneurial locations. The study exemplifies such locations by empirically exploring self-storage based businesses: that is, businesses that operate for a significant number of hours each week from self-storage facilities.

Design/methodology/approach

– The study draws on interviews with entrepreneurs operating self-storage based businesses and operators of self-storage facilities. The interview data is supported by site visits, businesses’ websites, promotional and marketing materials and press coverage.

Findings

– Consistent with the liminal lens, entrepreneurs view their time operating from self-storage as a transitional phase. They do not suffer the high levels of uncertainty and unsettledness usually associated with liminality. However, they experience anxiety related to perceptions of operating from a business location outside the mainstream. Whilst the entrepreneurs benefit from additional services provided by the self-storage operators, this may be at the expense of extra “liminal” work and anxiety experienced by the storage operators’ staff.

Originality/value

– The study contributes to entrepreneurship by answering Steyaert and Katz’s (2004) call for studies in unfamiliar places and spaces. The authors identify a number of ways in which liminality can arise when considering entrepreneurial locations. Drawing on extant entrepreneurial studies, the authors theorise that idiosyncratic characteristics of such spaces attract entrepreneurs with particular personal characteristics and needs, who will in turn be influenced by those spaces. In the case of self-storage facilities, the liminal space allows trepidatious entrepreneurs to “try on” (Hawkins and Edwards, 2015, p. 39) operating a new venture.
The effect of gaze on consumers’ encounter evaluation
Authors: Andersson Pernille , Wästlund Erik , Kristensson Per
Published: April 2016

Purpose

– The research concerns the effect of frontline employees’ averted or direct gaze on consumers’ evaluation of the encounter. The purpose of this paper is to demonstrate that in normal interactions, a direct or averted gaze affects people’s evaluation of others. The question was whether this finding would hold true in commercial interactions.

Design/methodology/approach

– The authors conducted three experiments using a written scenario with a photograph among a total sample of 612 participants.

Findings

– This research showed that consumers’ social impression of the frontline employees mediated the effect of the employees’ gazing behaviour on consumers’ emotions and satisfaction with the encounters. The findings also showed that averting gaze had a negative effect on consumers’ first impression of the frontline employee, which affected consumers’ satisfaction with the encounter. The findings also showed that a direct gaze had a negative effect on encounter satisfaction when consumers sought to purchase embarrassing products.

Originality/value

– The research demonstrated that the effect of gaze on encounter satisfaction was mediated by the social impression and moderated by consumers’ approach/avoidance motivation.