bluuebunny/crossref_metadata_2025 huggingface dataset:
Curriculum making as professionalism‐in‐context: the cases of two elementary school teachers amidst curriculum change in Cyprus
Authors: Kontovourki Stavroula , Philippou Stavroula , Theodorou Eleni
Published: March 2018

In this paper, two case studies of elementary school teachers in the Republic of Cyprus are constructed to discuss how curriculum making relates to teacher biographies and sense of professionalism, as those are shaped at the intersection of their professional history and projections for the future, informed by and informing their constitution as professionals in local institutional and broader social contexts. Drawing on the ecological model of teacher agency, the two cases are utilised to examine how teachers’ narrated professional experiences in past and current schools were at interplay with their general sense of professional role and purpose as teachers. This complex interplay is simultaneously connected to the ways they perceived and constituted their pupils as well as to the ways they themselves were constituted by others as professionals. The examination of the two cases foregrounds the notions of teacher agency and of curriculum making as contingent, negotiated and negotiable, and opens up the space to consider the politics of both as those are permeated by micro‐processes of subjection and subjectivation.
The efficacy of downhill running as a method to enhance running economy in trained distance runners
Authors: Shaw Andrew J. , Ingham Stephen A. , Folland Jonathan P.
Published: March 2018

Running downhill, in comparison to running on the flat, appears to involve an exaggerated stretch‐shortening cycle (SSC) due to greater impact loads and higher vertical velocity on landing, whilst also incurring a lower metabolic cost. Therefore, downhill running could facilitate higher volumes of training at higher speeds whilst performing an exaggerated SSC, potentially inducing favourable adaptations in running mechanics and running economy (RE). This investigation assessed the efficacy of a supplementary 8‐week programme of downhill running as a means of enhancing RE in well‐trained distance runners. Nineteen athletes completed supplementary downhill (−5% gradient; n = 10) or flat (n = 9) run training twice a week for 8 weeks within their habitual training. Participants trained at a standardised intensity based on the velocity of lactate turnpoint (vLTP), with training volume increased incrementally between weeks. Changes in energy cost of running (EC) and vLTP were assessed on both flat and downhill gradients, in addition to maximal oxygen uptake (⩒O2max). No changes in EC were observed during flat running following downhill (1.22 ± 0.09 vs 1.20 ± 0.07 Kcal kg−1 km−1, P = .41) or flat run training (1.21 ± 0.13 vs 1.19 ± 0.12 Kcal kg−1 km−1). Moreover, no changes in EC during downhill running were observed in either condition (P > .23). vLTP increased following both downhill (16.5 ± 0.7 vs 16.9 ± 0.6 km h−1
,
P = .05) and flat run training (16.9 ± 0.7 vs 17.2 ± 1.0 km h−1, P = .05), though no differences in responses were observed between groups (P = .53). Therefore, a short programme of supplementary downhill run training does not appear to enhance RE in already well‐trained individuals.
SAC-1 ensures epithelial endocytic recycling by restricting ARF-6 activity
Authors: Chen Dan , Yang Chao , Liu Sha , Hang Weijian , Wang Xianghong , Chen Juan , Shi Anbing
Published: March 2018

Arf6/ARF-6 is a crucial regulator of the endosomal phosphatidylinositol 4,5-bisphosphate (PI(4,5)P2) pool in endocytic recycling. To further characterize ARF-6 regulation, we performed an ARF-6 interactor screen in Caenorhabditis elegans and identified SAC-1, the homologue of the phosphoinositide phosphatase Sac1p in yeast, as a novel ARF-6 partner. In the absence of ARF-6, basolateral endosomes show a loss of SAC-1 staining in epithelial cells. Steady-state cargo distribution assays revealed that loss of SAC-1 specifically affected apical secretory delivery and basolateral recycling. PI(4,5)P2 levels and the endosomal labeling of the ARF-6 effector UNC-16 were significantly elevated in sac-1 mutants, suggesting that SAC-1 functions as a negative regulator of ARF-6. Further analyses revealed an interaction between SAC-1 and the ARF-6-GEF BRIS-1. This interaction outcompeted ARF-6(guanosine diphosphate [GDP]) for binding to BRIS-1 in a concentration-dependent manner. Consequently, loss of SAC-1 promotes the intracellular overlap between ARF-6 and BRIS-1. BRIS-1 knockdown resulted in a significant reduction in PI(4,5)P2 levels in SAC-1-depleted cells. Interestingly, the action of SAC-1 in sequestering BRIS-1 is independent of SAC-1’s catalytic activity. Our results suggest that the interaction of SAC-1 with ARF-6 curbs ARF-6 activity by limiting the access of ARF-6(GDP) to its guanine nucleotide exchange factor, BRIS-1.
Günter Blobel: Pioneer of molecular cell biology (1936–2018)
Authors:   Blobel Laboratory Trainees
Published: March 2018

Günter Blobel was a scientific colossus who dedicated his career to understanding the mechanisms for protein sorting to membrane organelles. His monumental contributions established research paradigms for major arenas of molecular cell biology. For this work, he received many accolades, including the Nobel Prize in Medicine or Physiology in 1999. He was a scientist of extreme passion and a nurturing mentor for generations of researchers, imbuing them with his deep love of cell biology and galvanizing them to continue his scientific legacy. Günter passed away on February 18, 2018, at the age of 81.
Bioactive compounds from palm fatty acid distillate and crude palm oil
Authors: Estiasih T , Ahmadi K
Published: March 2018

Crude palm oil (CPO) and palm fatty acid distillate (PFAD) are rich sources of bioactive compounds. PFAD is a by-product of palm oil refinery that produce palm frying oil. Physical refining of palm oil by deodorization produces palm fatty acid distillate. CPO and PFAD contain some bioactive compounds such as vitamin E (tocopherol and tocotrienols), phytosterol, and squalene. Bioactive compounds of CPO and PFAD are vitamin E, phytosterols, and squalene. Vitamin E of CPO and PFAD mainly comprised of tocotrienols and the remaining is tocopherol. Phytosterols of CPO and PFAD contained beta sitosterol, stigmasterol, and campesterol. Tocotrienols and phytosterols of CPO and PFAD, each can be separated to produce tocotrienol rich fraction and phytosterol rich fraction. Tocotrienol rich fraction from PFAD has both antioxidant and cholesterol lowering properties. Bioactive compounds of PFAD silmultaneously have been proven to improve lipid profile, and have hepatoprotector effect, imunomodulator, antioxidant properties, and lactogenic effect in animal test experiment. It is possible to develop separation of bioactive compounds of CPO and PFAD integratively with the other process that utilizes fatty acid.
Reciprocal regulation of eNOS and caveolin-1 functions in endothelial cells
Authors: Chen Zhenlong , D. S. Oliveira Suellen , Zimnicka Adriana M. , Jiang Ying , Sharma Tiffany , Chen Stone , Lazarov Orly , Bonini Marcelo G. , Haus Jacob M. , Minshall Richard D.
Published: March 2018

We hypothesized that the maintenance of vascular homeostasis is critically dependent on the expression and reciprocal regulation of caveolin-1 (Cav-1) and endothelial nitric oxide synthase (eNOS) in endothelial cells (ECs). Skeletal muscle biopsies from subjects with type 2 diabetes showed 50% less Cav-1 and eNOS than those from lean healthy controls. The Cav-1:eNOS expression ratio was 200:1 in primary culture human ECs. Cav-1 small interfering RNA (siRNA) reduced eNOS protein and gene expression in association with a twofold increase in eNOS phosphorylation and nitrate production per molecule of eNOS, which was reversed in cells overexpressing Adv-Cav-1-GFP. Upon addition of the Ca2+ionophore A23187 to activate eNOS, we observed eNOS Ser1177 phosphorylation, its translocation to β-catenin-positive cell–cell junctions, and increased colocalization of eNOS and Cav-1 within 5 min. We also observed Cav-1 S-nitrosylation and destabilization of Cav-1 oligomers in cells treated with A23187 as well as insulin or albumin, and this could be blocked by L-NAME, PP2, or eNOS siRNA. Finally, caveola-mediated endocytosis of albumin or insulin was reduced by Cav-1 or eNOS siRNA, and the effect of Cav-1 siRNA was rescued by Adv-Cav-1-GFP. Thus, Cav-1 stabilizes eNOS expression and regulates its activity, whereas eNOS-derived NO promotes caveola-mediated endocytosis.
A polymorphism in the lysyl oxidase propeptide domain accelerates carcinogen-induced cancer
Authors: de la Cueva Ana , Emmerling Michael , Lim Sarah L , Yang Shi , Trackman Philip C , Sonenshein Gail E , Kirsch Kathrin H
Published: March 2018

The propeptide (LOX-PP) domain of the lysyl oxidase proenzyme was shown to inhibit the transformed phenotype of breast, lung and pancreatic cells in culture and the formation of Her2/neu-driven breast cancer in a xenograft model. A single nucleotide polymorphism (SNP, rs1800449) positioned in a highly conserved region of LOX-PP results in an Arg158Gln substitution (humans). This arginine (Arg)→glutamine (Gln) substitution profoundly impaired the ability of LOX-PP to inhibit the invasive phenotype and xenograft tumor formation. To study the effect of the SNP in vivo, here we established a knock in (KI) mouse line (LOX-PPGln mice) expressing an Arg152Gln substitution corresponding to the human Arg158Gln polymorphism. Breast cancer was induced in wild-type (WT) and LOX-PPGln female mice beginning at 6 weeks of age by treatment with 7,12-dimethylbenz(a)anthracene (DMBA) in combination with progesterone. Time course analysis of tumor development demonstrated earlier tumor onset and shorter overall survival in LOX-PPGln versus WT mice. To further compare the tumor burden in WT and LOX-PPGln mice, inguinal mammary glands from both groups of mice were examined for microscopic lesion formation. LOX-PPGln glands contained more lesions (9.6 versus 6.9 lesions/#4 bilateral). In addition, more DMBA-treated LOX-PPGln mice had increased leukocyte infiltrations in their livers and were moribund compared with DMBA-treated WT mice. Thus, these data indicate that the Arg→Gln substitution in LOX-PP could be an important marker associated with a more aggressive cancer phenotype and that this KI model is ideal for further mechanistic studies regarding the tumor suppressor function of LOX-PP.
Linear decline in red snapper (Lutjanus campechanus) otolith Δ14C extends the utility of the bomb radiocarbon chronometer for fish age validation in the Northern Gulf of Mexico
Authors: Barnett Beverly K , Thornton Laura , Allman Robert , Chanton Jeffrey P , Patterson William F
Published: March 2018

Radiocarbon (Δ14C) was analyzed in northern Gulf of Mexico (nGOM) red snapper (Lutjanus campechanus) otolith cores (n = 23), otolith edge samples (n = 12), and whole age-0 otoliths (n = 9), with edge samples and whole age-0 otoliths constituting known-age samples. There was no significant difference in the linear relationship of Δ14C versus year of formation between regional corals and known-age otolith samples, and a linear regression fit to the combined data from 1980 to 2015 extends the utility of the bomb radiocarbon chronometer for age validation. The entire regional coral and known-age otolith data set (1940 to 2015) was then utilized as a reference series to validate otolith-derived red snapper age estimates for cored otolith samples. A loess regression was fit to the reference data and then the sum of squared residuals (SSR) was computed from predicted versus observed birth years for cored adult otolith samples. This process was then repeated for ages biased ±1–4 years. Ages with no bias applied had the lowest SSR, thus validating red snapper age estimates and demonstrating the utility of the combined regional coral and known-age red snapper otolith Δ14C time series for age validation of nGOM marine fishes.
Random Lattice Vectors in a Set of Size O(n)
Authors: Kim Seungki
Published: March 2018

We adopt the sieve ideas of Schmidt [10, 11] and Södergren [14] in order to study the statistics of vectors of a random lattice of dimension n contained in a set of volume O(n). We also give some sporadic applications of our results to number theory.
Ramsey Graphs Induce Subgraphs of Quadratically Many Sizes
Authors: Kwan Matthew , Sudakov Benny
Published: March 2018

An n-vertex graph is called C-Ramsey if it has no clique or independent set of size $C\log n$. All known constructions of Ramsey graphs involve randomness in an essential way, and there is an ongoing line of research towards showing that in fact all Ramsey graphs must obey certain “richness” properties characteristic of random graphs. Motivated by an old problem of Erd̋s and McKay, recently Narayanan, Sahasrabudhe, and Tomon conjectured that for any fixed C, every n-vertex C-Ramsey graph induces subgraphs of $\varTheta (n^{2} )$ different sizes. In this paper we prove this conjecture.
Association of dairy intake with weight change in adolescents undergoing obesity treatment
Authors: Wrotniak Brian H , Georger Lesley , Hill Douglas L , Zemel Babette S , Stettler Nicolas
Published: March 2018

Background

The role of dairy products in obesity treatment for adolescents is unclear. The study purpose was to assess the association between dairy intake and changes in BMI z-score (zBMI) during adolescent obesity treatment.

Methods

Observational study nested within a randomized control trial. Linear mixed-effects regression models were adjusted for important non-lifestyle factors then further adjusted for dietary and physical activity variables. In total, 91 adolescents were studied.

Results

Each serving of total dairy (β = −0.0054, P < 0.01), unflavored milk (β = −0.012, P < 0.01), reduced fat (β = −0.0078, P < 0.05), and low fat/fat-free products (β = −0.0149, P < 0.01) was associated with a decrease in zBMI over 12 months. These associations were no longer significant after adjustment for other dietary and physical activity factors. Sugar-sweetened beverage intake was inversely associated with intake of total dairy (β = −0.186, P = 0.001), unflavored milk (β = −0.115, P = 0.003) and low fat/fat-free dairy (β = −0.125, P = 0.001).

Conclusions

Intakes of total dairy, unflavored milk, reduced fat dairy and low fat/fat-free dairy products are associated with improved obesity treatment outcomes among adolescents. This could be due to co-occurring healthy lifestyle behaviors or to replacement of other food and beverages associated with obesity, such as sugar-sweetened beverages, by dairy products.
Pressure Injury Prevention: Knowledge and Attitudes of Iranian Intensive Care Nurses
Authors: Tirgari Batool , Mirshekari Leili , Forouzi Mansooreh Azzizadeh
Published: March 2018

BACKGROUND:

Pressure injuries are the third most expensive condition after cancer and cardiovascular disease. Nurses are responsible for the direct and continuous care, treatment, and prevention of pressure injuries. To achieve optimal quality care, nursing knowledge and attitudes must be based on the best scientific evidence. This study aimed to examine the knowledge and attitudes of nurses working in intensive care units of hospitals affiliated with Zahedan Medical Sciences University regarding the prevention of pressure injuries.

METHODS:

This was a descriptive analytic study involving 89 critical care nurses. Data analysis was conducted using a 3-part questionnaire: demographic data, knowledge, and attitudes of intensive care nurses toward the prevention of pressure injuries. Collected data were analyzed with SPSS version 19 (IBM, Armonk, New York), using descriptive and inferential statistics (such as Pearson correlation coefficient, independent t test, and analysis of variance).

RESULTS:

The results showed that the mean ± SD score of pressure injury knowledge was 0.44 ± 0.12, and the attitude of participants toward pressure injury prevention was 2.69 ± 0.47. Scores varied widely; “nutrition” showed the highest mean score (0.71 ± 0.45), but “etiology and development” (0.42 ± 0.21) and “classification and observation” (0.42 ± 0.24) showed the lowest mean scores. Of the different aspects of attitudes toward pressure injury prevention, “the impact of pressure injuries” showed the highest mean score (2.95 ± 0.56), and “confidence in the effectiveness of prevention” showed the lowest mean score (2.56 ± 0.46). A statistically significant relationship was observed between pressure injury knowledge and attitudes toward pressure injury prevention (P < .001).

CONCLUSIONS:

Pressure injury prevention is one of many nursing care priorities and is a key indicator of the quality of nursing care. In order to achieve optimal quality care in this area, nurse managers and other administrators should make efforts to improve nursing knowledge and attitudes based on the latest scientific evidence for pressure injury prevention.
Food allergy trends at the crossing among socio-economics, history and geography
Authors: Fiocchi Alessandro , Dahdah Lamia , Fierro Vincenzo , Artesani Maria C. , Valluzzi Rocco
Published: March 2018

Purpose of review

The epidemiology of food allergy did inspire theories on the reasons for the recent surge of the disease. We offer here a reasoned review on the relationships between the trajectories of human development and the trend of the food allergy epidemics.

Recent findings

The exponential trend of the frequency of food allergy paralleled the explosive acceleration of the human development over the last few decades. Dietary factors have been indicated as responsible for these trends and targeted for potential preventive strategies. Other socio-economic factors have been related to this evolution: solar exposure, climate changes, structure of societies, reproductive choices and societal inequalities.

The epidemiologic associations of food allergy suggest different causal theories. Future prevention strategies may be predicated not only on dietary interventions, but on wider programmes aimed to restore a human ecology promoting food tolerance.
How to manage food allergy in nursery or school
Authors: Oriel Roxanne C. , Wang Julie
Published: March 2018

Purpose of review

The aim of this review is to describe effective management strategies in nursery or school based upon research findings.

Recent findings

The prevalence of food allergy and number of emergency department visits for food-related anaphylaxis are increasing in children and adolescents. As there is currently no cure, the most effective strategy to decrease allergic reactions is food allergen avoidance. However, allergic reactions are inevitable in both food allergic children as well as in first-time reactors. Misconceptions exist on the safety of products with advisory labels and questions remain on whether school-wide bans decrease the risk of allergic reactions in school. Recent legislation has prompted schools to consider requiring unassigned epinephrine autoinjectors to better manage those who have allergic reactions in nursery or school.

A collective effort is required to keep children with food allergies safe at school. Families, healthcare providers, and school personnel should be informed on food allergen avoidance strategies, symptoms consistent with allergic reactions and anaphylaxis, how to respond to allergic reactions, and the impact the diagnosis of food allergy may have on quality of life for affected children and their families.
Do Multiple Mini-Interview and Traditional Interview Scores Differ in Their Associations With Acceptance Offers Within and Across Five California Medical Schools?
Authors: Jerant Anthony , Henderson Mark C. , Griffin Erin , Hall Theodore R. , Kelly Carolyn J. , Peterson Ellena M. , Wofsy David , Franks Peter
Published: March 2018

Purpose

In single-school studies, multiple mini-interview (MMI) and traditional interview (TI) scores are associated with acceptance offers. Unexamined is whether scores at one school are associated with acceptance at other schools; such analyses would mitigate single-school design biases and better estimate how well interviews capture desired applicant attributes. Using data from the 5 California Longitudinal Evaluation of Admissions Practices (CA-LEAP) medical schools, the authors examined associations of MMI and TI scores with acceptance offers within and across schools.

Method

The analyses included applicants who interviewed at ≥1 CA-LEAP school during the 2011–2013 admissions cycles. Three CA-LEAP schools employed TIs and 2 employed MMIs. Interview scores were standardized (z scores: mean = 0, SD = 1), and associations with acceptance offers were examined within and across schools in analyses stratified by school, adjusting for applicant sociodemographics, academic metrics, year, and total number of interviews.

Results

Of 4,993 applicants interviewed, 428 (8.6%) interviewed at both MMI schools, 681 (13.6%) at ≥2 TI schools, and 1,327 (26.6%) at ≥1 MMI and ≥1 TI school. For each school, acceptance was associated with interview score at that school and also with interview scores at the other 4 schools. Cross-school associations of MMI versus TI scores with acceptance did not differ statistically.

Conclusions

Interview score at a given school was associated with acceptance at the other 4 schools, with no significant differences in associations for MMIs versus TIs. The findings suggest both MMIs and TIs captured attributes valued by admissions teams across CA-LEAP schools.
Bodies for Anatomy Education in Medical Schools: An Overview of the Sources of Cadavers Worldwide
Authors: Habicht Juri L. , Kiessling Claudia , Winkelmann Andreas
Published: March 2018

The International Federation of Associations of Anatomists (IFAA) recommended in 2012 that only donated bodies be used for anatomy teaching and research. However, in many countries around the world, anatomists still depend on bodies that do not stem from voluntary donations by the deceased but, rather, are “unclaimed.” A broad search of the literature was conducted to produce a baseline overview of the sources of cadavers used for anatomy teaching in undergraduate medical curricula on a global scale. Information from the literature search was supplemented with data from a 2016–2017 survey of selected senior local anatomists. Of 165 countries with medical schools, information was gathered for 71. In 22 (32%) of the 68 countries that use cadavers for anatomy teaching, body donation is the exclusive source of bodies. However, in most other countries, unclaimed bodies remain the main (n = 18; 26%) or exclusive (n = 21; 31%) source. Some countries import cadavers from abroad, mainly from the United States or India. In one country, bodies of executed persons are given to anatomy departments. The heterogeneous geographical distribution of body sources cannot easily be accounted for, but religion, culture, and folk beliefs about what should happen to bodies after death seem to play a role. Implementation of the IFAA recommendations still has a long way to go, but it is encouraging that functioning body donation programs exist on all continents and that there are examples of recent rises in donations and of anatomists initiating new donation programs.
Orthopaedic Watercraft Injuries: Characterization of Mechanisms, Fractures, and Complications in 216 Injuries
Authors: Christensen Joseph , Spence Sean , Watson David , Shah Anjan , Maxson Benjamin , Infante Anthony , Sanders Roy , Mir Hassan R.
Published: March 2018

Objective:

To review the orthopaedic injuries from watercraft treated surgically at our institution and report the mechanisms, fractures, and complications encountered.

Design:

Retrospective case series.

Setting:

Level I trauma center.

Patients/Participants:

There were 216 fractures from watercraft in 146 patients. Average age was 33 years (range 4–78 years), there were 68% males (99/146), and 16% of the injuries occurred in children.

Intervention:

Operative fracture fixation.

Main Outcome Measurements:

After IRB approval, data were collected from January 1, 1998, to December 31, 2015, for patients including demographics, watercraft type, mechanism of injury, fracture pattern, infection, organisms, union, and amputation. Descriptive statistics were used.

Results:

There were 130 closed fractures (60%) and 86 open fractures (40%). There were 146 (67%) lower extremity injuries, 49 (23%) upper extremity injuries, and 21 (10%) pelvic injuries. The overall postoperative infection rate was 9% (20/216) and was commonly polymicrobial in nature. The postoperative infection rate in closed fractures was 4% (5/130) and the postoperative infection rate in open fractures was 17% (15/86). Open fractures also had a high proportion of nonunion (8%) and amputation (16%).

Conclusions:

This is the largest reported series of orthopaedic injuries from watercraft. These injuries can be devastating in nature and difficult to manage, particularly when they are open (40%). There is a high rate of postoperative infection (17%), nonunion (8%), and amputation (16%) associated with open orthopaedic watercraft fractures.

Level of Evidence:

Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Fatty acid-binding proteins 5 and 7 gene deletion increases sucrose consumption and diminishes forced swim immobility time
Authors: Hamilton John , Koumas Christopher , Clavin Brendan H. , Marion Matthew , Figueiredo Antonio , Gonzalez Steve , O’Rourke Joseph R. , Deutsch Dale , Kaczocha Martin , Haj-Dahmane Samir , Thanos Panayotis K.
Published: March 2018

Inhibition and genetic deletion of fatty acid-binding proteins (FABPs) 5 and 7 have been shown to increase the levels of the endocannabinoid anandamide as well as the related N-acylethanolamine’s palmitoylethanolamide and oleoylethanolamide. This study examined the role of these FABPs on forced-swim (FS) behavior and on sucrose consumption in two experiments: (experiment 1) using wild-type (WT) mice treated with the FABP inhibitor SBFI26 or vehicle and (experiment 2) using WT and FABP5/7 deficient mice. Results from experiment 1 showed that acute treatment with SBFI26 did not have any effect on sucrose intake or FS behavior in mice. In experiment 2, male and female FABP5/7 deficient mice showed significant increases in sucrose consumption (25 and 21%, respectively) compared with their WT counterparts. In addition, immobility time during the FS was decreased by 27% in both male and female FABP5/7 knockout mice compared with their WT counterparts. The fact that such differences were seen between the acute pharmacological approach and the genetic approach (gene deletion) of FABP needs to be further investigated. The function of FABPs and their specific effects on endocannabinoid anandamide, oleoylethanolamide, and palmitoylethanolamide may play an important role in the development of reward and mood behaviors and could provide opportunities for potential therapeutic targets.
Maternal Mortality in the United States: A Review of Contemporary Data and Their Limitations
Authors: CREANGA ANDREEA A.
Published: March 2018

This article provides a review of maternal mortality data and their limitations in the United States. National maternal mortality data, which rely heavily on vital statistics, document that the risk of death from pregnancy-related causes has not declined for >25 years and that striking racial disparities persist. State-based maternal mortality reviews, functional in many states, obtain detailed information on medical and nonmedical factors contributing to maternal deaths. Without this detailed knowledge from state-level data and without addressing recognized quality problems with vital statistics data at the national-level, we will have difficulty understanding maternal death trends and preventing future such deaths.
Invasive Fungal Infections in Neonates in Canada
Authors: Ting Joseph Y. , Roberts Ashley , Synnes Anne , Canning Roderick , Bodani Jaya , Monterossa Luis , Shah Prakesh S.
Published: March 2018

Background:

Neonatal fungemia is associated with adverse neonatal outcomes and higher overall healthcare expenditure. Our objective is to review the epidemiology of invasive fungal infections (IFIs) in neonates in Canada.

Methods:

A retrospective cohort study using data collected by the Canadian Neonatal Network (CNN) was conducted. Using a nested matched cohort study design, risk factors and outcomes of neonates born <33 weeks gestation (n = 39,305) during 2003–2013 were compared between neonates diagnosed with an IFI during their stay to infection-free controls.

Results:

Overall incidence of IFI among all admitted neonates was 0.22% (n = 286), while the incidence of IFI in the group of neonates born <33 weeks gestation was 0.64%. Of the isolates, 170 (59%) had Candida albicans and 59 (21%) had Candida parapsilosis. Risk factors for IFI were lower gestation, male sex, Apgar score <7 at 5 minutes, higher severity of illness score, maternal diabetes and vaginal birth. Neonates with IFI had higher odds of mortality [adjusted odds ratio (aOR): 1.60; 95% confidence interval (CI): 1.06–2.43], necrotizing enterocolitis (aOR: 2.97; 95% CI: 1.76–5.01) and severe retinopathy of prematurity (aOR: 2.15; 95% CI: 1.26–3.67).

Conclusions:

The overall incidence of IFI in neonates was low in Canada in comparison to other large population cohort studies; however, the mortality and morbidity remained high.
Human Parechovirus Meningitis with Adverse Neurodevelopmental Outcome
Authors: Berk Mylene C. , Bruning Andrea H. L. , van Wassenaer-Leemhuis Aleid G. , Wolthers Katja C. , Pajkrt Dasja
Published: March 2018

Human parechovirus infections usually cause mild symptoms in children. Although their contribution to severe disease in young children—such as neonatal sepsis and meningoencephalitis—is increasingly recognized, data on long-term consequences are scarce. Here we present the case of a 5-year-old boy with severe long-term neurodevelopmental sequelae after human parechovirus-3 meningitis.
An 11-Year-Old Male With Vertebral Osteomyelitis and a Paraspinal Abscess
Authors: Kopsidas Ioannis , Margariti Rodanthi , Gavra Maria , Syngelou Angeliki , Zambakidis Christos , Tsolia Maria , Nikolaidis Nikolaos , Spyridis Nikos
Published: March 2018

We report the case of an 11-year-old immunocompetent patient presenting with a 2-week history of upper back pain, diagnosed with thoracic vertebral osteomyelitis and a paraspinal abscess caused by Bartonella henselae. He was treated with gentamicin and doxycycline followed by oral rifampicin and doxycycline with favorable outcome.
To intubate or not to intubate?
Authors: Gough Christopher J.R. , Nolan Jerry P.
Published: March 2018

Purpose of review

Cardiac arrest mortality remains high, and the impact on outcome of most advanced life support interventions is unclear. The optimal method for managing the airway during cardiac arrest remains unknown. This review will summarize and critique recently published evidence comparing basic airway management with the use of more advanced airway interventions [insertion of supraglottic airway (SGA) devices and tracheal intubation].

Recent findings

Systematic reviews generally document an association between advanced airway management and worse neurological outcome but they are subject to considerable bias. A recent observational study of tracheal intubation for in-hospital cardiac arrest that used time-dependent propensity matching showed an association between tracheal intubation during the first 15 min of cardiac arrest and a worse a neurological outcome compared with no intubation in the first 15 min. In a recent randomized clinical trial, tracheal intubation was compared with bag-mask ventilation (with intubation only after return of spontaneous circulation) in 2043 patients with out-of-hospital cardiac arrest. There was no difference in favorable neurological outcome at 28 days.

Most of the available evidence about airway management during cardiac arrest comes from observational studies. The best option for airway management is likely to be different for different rescuers, and at different time points of the resuscitation process. Thus, it is common for a single patient to receive multiple ‘stepwise’ airway interventions. The only reliable way to determine the optimal airway management strategy is to undertake properly designed, prospective, randomized trials. One randomized clinical trial has been published recently and two others have completed enrollment but have yet to be published.
The Development of the Working Alliance and Its Ability to Predict Outcome in Emotion-Focused Therapy for Social Anxiety Disorder
Authors: Adler Gilad , Shahar Ben , Dolev Tohar , Zilcha-Mano Sigal
Published: March 2018

The study focuses on the alliance of 12 patients receiving emotion-focused therapy for social anxiety. Anxiety symptoms and patient perception of the working alliance were examined weekly. The first eight sessions of each patient were coded for within- and between-sessions alliance levels (1008 segments were coded). At the sample level, the alliance shows linear development over time but high variability between individuals. More than half the patients showed alliance development consistent with the rupture-resolution pattern. Without accounting for the temporal relationship between alliance and symptoms, alliance significantly predicted symptoms across treatment. When we accounted for the temporal relationship between alliance and symptoms, we found that symptoms can predict alliance but alliance cannot predict symptoms. We obtained the same findings using patient-rated and coded alliance.
Meibomian Gland Dysfunction in a Youthful Clinical Sample in Ghana
Authors: Asiedu Kofi , Kyei Samuel , Dzasimatu Selassie K. , Morny Enyam K. A.
Published: March 2018

SIGNIFICANCE

This study showed a high frequency of nonobvious obstructive meibomian gland dysfunction, which can be detected only via the expression of the meibomian glands. The study advocates that meibomian gland expressibility should be a routine part of the clinical examination of patients especially those with dry eyes to avoid missing meibomian gland dysfunction among a youthful population.

PURPOSE

The aim of this study was to estimate the frequency of meibomian gland dysfunction including asymptomatic and symptomatic meibomian gland dysfunction and obvious and nonobvious obstructive meibomian gland dysfunction among a youthful population in Ghana.

METHODS

This was a clinic-based prospective cross-sectional study of consecutive patients visiting the University of Cape Coast Optometric clinic for comprehensive eye examination.

RESULTS

Two hundred fifteen clinical subjects consented to participate in the study. Mean age of the entire sample was 21.9 (±3.8) years with an age range of 17 to 40 years. One hundred five males and 107 females participated. Frequency of meibomian gland dysfunction among the sample was 25.5% (95% confidence interval [CI], 19.8 to 31.6%). Frequencies of asymptomatic and symptomatic meibomian gland dysfunction were 10.1% and 15.4%, respectively. Frequencies of obvious and nonobvious obstructive meibomian gland dysfunction were 0.9% and 24.6%, respectively. In univariate logistic regression analysis, age (odds ratio, 1.246; 95% CI, 1.037 to 1.496; P = .019) was significantly associated, but sex (odds ratio, 1.315; 95% CI, 0.707 to 2.446; P = .387) was not significantly associated, with meibomian gland dysfunction. There was a statistically significant difference in the mean corneal staining scores between meibomian gland dysfunction subjects and non–meibomian gland dysfunction subjects (t = 3.51, P = .01). There was also a statistically significant difference in the mean tear breakup time between meibomian gland dysfunction subjects and non–meibomian gland dysfunction subjects (t = 4.44, P < .001).

CONCLUSIONS

Because of the high frequency of nonobvious obstructive meibomian gland dysfunction, reliance on overt posterior lid margin abnormalities for the diagnosis of meibomian gland dysfunction may lead to underdiagnosis of meibomian gland dysfunction among clinicians in a youthful population.
Saccades under Mental Load in Infantile Nystagmus Syndrome and Controls
Authors: Salehi Fadardi Marzieh , Abel Larry Allen
Published: March 2018

SIGNIFICANCE

This study compares saccades and visual task performance in patients with infantile nystagmus syndrome (INS) with that in normally sighted individuals under mental load. The results highlighted that to more completely evaluate INS therapies recognition time should also be measured with mental load, resembling real-world conditions.

PURPOSE

Patients with INS may complain of “being slow to see.” Stress is reported to worsen nystagmus and to prolong visual recognition time. We hypothesized that the effects of mental load on timing indices of visual recognition, for example, saccade latency, target acquisition time, target viewing time, and subjects' reaction time, differ between the INS and control groups.

METHODS

Eye movements were recorded when participants (INS group, n = 15; controls, n = 25) reported the direction of tumbling-E targets presented randomly across ±25°. The task was repeated with both mental arithmetic and time restriction to impose high mental load, confirmed through subjective ratings and heart rate measurement.

RESULTS

Mental load increased saccade latency (mean, 32.69 milliseconds; 95% confidence interval [CI], 21.17 to 44.20 milliseconds; P < .001) and target acquisition time (57.00 milliseconds; 95% CI, 34 to 81 milliseconds; P < .001). Patients with INS showed longer saccade latency (39.79 milliseconds; 95% CI, 23.98 to 55.62 milliseconds; P < .001) and target acquisition time (134.00 milliseconds; 95% CI, 96 to 172 milliseconds; P < .001) compared with controls. The interaction between task and group was significant for saccade gain (0.11; 95% CI, 0.02 to 0.19; P = .015), target acquisition time (37.93 milliseconds; 95% CI, 36.91 to 38.96 milliseconds; P = .011), and subjects' reaction time (95.37 milliseconds; 95% CI, 65.91 to 124.84 milliseconds; P = .043). There was an inverse correlation between the changes in subjects' response errors and target viewing time with mental load only for controls (r = −0.484, P = .014). Total foveation exposure time and target viewing time remained unchanged.

CONCLUSIONS

Mental load worsens “being slow to see” in INS because of delayed target acquisition and possibly because efficiency of visual processing decreases more in patients with INS compared with controls. To investigate outcomes of INS therapies, visual recognition time should be also measured with mental load.
Contrast Sensitivity in Eyes with Central Scotoma: Effect of Stimulus Drift
Authors: Lewis Peter , Venkataraman Abinaya Priya , Lundström Linda
Published: March 2018

SIGNIFICANCE

In the field of visual rehabilitation of patients with central visual field loss (CFL), knowledge on how peripheral visual function can be improved is essential. This study presents measurements of peripheral dynamic contrast sensitivity (with optical correction) for off-axis viewing angles in subjects with CFL.

PURPOSE

Subjects with CFL rely on a peripheral preferred retinal locus (PRL) for many visual tasks. It is therefore important to ascertain that contrast sensitivity (CS) is maximized in the PRL. This study evaluates the effect of stimulus motion, in combination with optical correction, on CS in subjects with CFL.

METHODS

The off-axis refractive errors in the PRL of five young CFL subjects were measured with a COAS open-view Hartmann-Shack aberrometer. Low-contrast (25% and 10%) and high-contrast resolution acuity for stationary gratings was assessed with and without optical correction. High-contrast resolution was also measured for gratings drifting at 7.5 Hz (within a fixed Gaussian window). Furthermore, resolution CS was evaluated for both stationary and moving gratings with optical correction for a total of two to three spatial frequencies per subject.

RESULTS

High-contrast resolution acuity was relatively insensitive to stimulus drift motion of 7.5 Hz, whereas CS for gratings of 0.5 cycles per degree improved with drift for all subjects. Furthermore, both high- and low-contrast static resolution improved with optical correction.

CONCLUSIONS

Just as for healthy eyes, stimulus motion of 7.5 Hz enhances CS for gratings of low spatial frequency also in the PRL of eyes with CFL. Concurrently, high-contrast resolution is unaffected by the 7.5-Hz drift but improves with off-axis optical correction. This highlights the importance of providing optimal refractive correction for subjects with CFL and that stimulus motion can be used to further enhance CS at low spatial frequencies.
Novel Technique for Quantifying Retinal Nerve Fiber Bundle Abnormality in the Temporal Raphe
Authors: Ashimatey Bright S. , King Brett J. , Malinovsky Victor E. , Swanson William H.
Published: March 2018

SIGNIFICANCE

Glaucomatous nasal visual field abnormalities correspond to damage in the temporal raphe—where individual nerve bundles can be visualized. The ability to quantify structural abnormality in the raphe, with a clinically applicable protocol, sets the stage for investigating the raphe as a potential site for assessing early glaucoma.

PURPOSE

To develop a clinically applicable imaging and analysis technique for identifying retinal nerve fiber bundle abnormalities in the temporal raphe.

METHODS

Spectralis optical coherence tomography scans customized for the temporal raphe were gathered from 30 younger controls, 30 older controls, and 29 patients with glaucoma. An analysis technique was developed based on the reflectance of the nerve fiber bundles. The technique was first developed in the younger controls, and then applied to the older controls to generate normative data for quantifying nerve fiber bundle reflectance abnormalities in the patients with glaucoma. Matrix perimetric data were gathered in the patients with glaucoma to evaluate the reflectance technique’s findings. Reflectance abnormality in the patients was defined when the fraction of enface area showing reflectance abnormality was greater than the 95th percentile estimated from controls. Spearman’s rho was used to quantify the relation between the total deviation at the perimetric testing locations and the fraction of corresponding enface area showing reflectance abnormality.

RESULTS

Twenty-five of the 29 patients had reflectance abnormalities. Eight of these had mild to no perimetric mean deviation abnormality. Similar results were found when perimetric total deviations were compared to reflectance abnormalities in the corresponding enface locations. Spearman’s rho comparing the total deviations to reflectance abnormalities found rs(174) = −0.72, P < .001.

CONCLUSIONS

The technique typically identified reflectance abnormality when perimetric abnormality was present. It also identified reflectance abnormalities even when perimetric abnormality was mild or absent. The findings support the potential of raphe imaging in detecting early glaucomatous damage.
ASCA (Anti-Saccharomyces cerevisiae Antibody) in Patients With Scleroderma
Authors: Fedrigo Aiessa , Skare Thelma L. , Bortoluzzi André Luiz , Nisihara Renato
Published: March 2018

Objectives

The majority of scleroderma (SSc) patients present gastrointestinal involvement. Motility is usually compromised but few studies address permeability changes in the intestinal wall. ASCA (anti-Saccharomyces cerevisiaeantibodies) positivity is associated with increased intestinal permeability. In this study we aimed to investigate ASCA positivity in SSc patients and its association with clinical, serological and epidemiological data.

Methods

Seventy-four SSc patients and 57 healthy controls were studied for ASCA (IgG and IgA) positivity by ELISA. ASCA positivity was associated with demographic, clinical severity index (by Medsger score) and serological data in SSc patients.

Results

ASCA-IgG was positive in 32/74 (43.2%) patients of the SSc group and 1/57 (1.7%) of controls (p< 0.0001); ASCA-IgA was positive in 12/74 (16.2%) of the SSc group and 3/57 (5.2%) of controls (p= 0.05). In univariate analysis, ASCA-IgG presence was associated positively with African ethnic background (p< 0.001) and negatively associated with anticentromere antibodies (p= 0.013); ASCA-IgA had a negative association with Medsger score (p= 0.05). In multivariate analysis ASCA-IgG associated independently only with African ethnic background.

Conclusion

Positivity for ASCA-IgG and ASCA-IgA is higher among scleroderma patients than controls. African descendants have more positivity for ASCA-IgG. ASCA-IgA is less frequent in patients with a more severe disease.
Assessment of Atlanto-Axial and Mandibular Rotation by Cone Beam Computed Tomography
Authors: Galli Massimo , Papini Andrea , Buffoli Barbara , Ferrari Marco , Labanca Mauro , Rezzani Rita , Migliario Mario , Lucchina Alberta Greco , Rodella Luigi F.
Published: March 2018

The cranial portion of the vertebral segment together with the atlanto-occipital joint represents a very complex area. Since this system could be influenced by different atlas and mandibular position, the aim of this work was to assess atlanto-axial and mandibular rotation. Scanora 3-dimensional cone bean computed tomography images from 205 patients without signs or symptoms of temporomandibular disorder were evaluated. Using a digitalized images analyzer, the axial rotations of atlas and mandible rotation were calculated, measuring the angle with respect to the frontal plane. The same direction for the axial rotation of the mandible and for the atlanto-axial rotation (consistent group) was observed in 80.98% of the patients; opposite directions (inconsistent group) were observed in 19.02%. Among the consistent group, the left rotation was observed in 71.08% of the patients and the right rotation in 28.92%. Absolute values showed a more marked rotation for atlas than mandible and higher values for the left rotation were reported for both.

Taking together these data represents important starting points for the knowledge of atlas and mandible relationship and its functional and clinical implication.
Isolated Post-Shunt Metopic Synostosis and Neural Tube Defects
Authors: Abouhassan William , Chao John An Kuang , Murthy Ananth S.
Published: March 2018

Background:

Craniosynostosis is an uncommon complication after shunting procedures for congenital hydrocephalus. We report a case of a child with myelomeningocele and normocephaly at the time of birth. She underwent ventricular shunting for Chiari malformation and hydrocephalus at 3 days of age. An immediate postoperative CT scan confirmed all sutures were open. Serial CT scans document an open metopic suture at 2 months, closed metopic suture at 5 months, and trigonocephaly at 11 months with concomitant slit ventricle syndrome, and collapsed lateral and third ventricles.

Methods:

An Ovid MEDLINE search within the dates of 1948 through 2017, using the keywords “synostosis AND shunt” was carried out. A tabulation of all patients and their respective synostosis patterns were recorded.

Results:

We identified 8 case series and 2 case reports during 43 years (1966–2017). Seventy-eight patients with 79 suture synostosis patterns were identified (one patient underwent a second cranial reconstruction for identification of a separate, newly formed synostosis). Eighteen (30.5%) cases were associated with a neural tube defect (NTD). Patients with NTD and secondary craniosynostosis had on average earlier age of shunt placement (P = 0.001), craniosynostosis presentation (P = 0.146), and cranioplasty (P = 0.325) than secondary craniosynostosis patients without NTD.

Conclusions:

Ventricular shunt drainage in treating hydrocephalus rarely may lead to early synostosis and cranial deformity, especially in patients with NTDs. Early shunt placement poses significant risk in patients with NTD. Close follow-up may be necessary to evaluate overdrainage and cranial deformity after shunting procedures.