bluuebunny/crossref_metadata_2025 huggingface dataset:
A Call for Science Preparedness for Pregnant Women During Public Health Emergencies
Authors: Faherty L.J. , Rasmussen S.A. , Lurie N.
Published: November 2017

(Am J Obstet Gynecol. 2017;216(1):34.e1–34.e5)

The Zika virus epidemic raised many questions in relation to birth defects in infants born to mothers infected with Zika. This included whether the risk of adverse outcomes could be reduced after infection. During both the 2009 H1N1 pandemic and the 2014 to 2015 Ebola epidemic, there were missed opportunities to involve pregnant women in research to better understand poor neonatal outcomes or the effects of antiviral medications on pregnant women and neonates.
Asthma: personalized and precision medicine
Authors: Canonica Giorgio W. , Ferrando Matteo , Baiardini Ilaria , Puggioni Francesca , Racca Francesca , Passalacqua Giovanni , Heffler Enrico
Published: November 2017

Purpose of review

In this review, we herein describe the progress in management of severe asthma, evolving from a ‘blockbuster approach’ to a more personalized approach targeted to the utilization of endotype-driven therapies.

Recent findings

Severe asthma characterization in phenotypes and endotypes, by means of specific biomarkers, have led to the dichotomization of the concepts of ‘personalized medicine’ and ‘precision medicine’, which are often used as synonyms, but actually have conceptual differences in meaning. The recent contribute of the omic sciences (i.e. proteomics, transcriptomics, metabolomics, genomics, …) has brought this initially theoretic evolution into a more concrete level.

This step-by-step transition would bring to a better approach to severe asthmatic patients as the personalization of their therapeutic strategy would bring to a better patient selection, a more precise endotype-driven treatment, and hopefully to better results in terms of reduction of exacerbation rates, symptoms, pulmonary function and quality of life.
Pediatric Supracondylar Humerus Fractures: AAOS Appropriate Use Criteria Versus Actual Management at a Pediatric Level 1 Trauma Center
Authors: Wang Joanne H. , Morris William Z. , Bafus Blaine T. , Liu Raymond W.
Published: November 2017

Objectives:

The purpose of this study was to characterize management of supracondylar humerus fractures (SCHFs) at a level 1 trauma center and identify factors contributing to divergence in management from American Academy of Orthopedic Surgeons (AAOS) the Appropriate Use Criteria (AUC) recommendations.

Methods:

A query revealed 556 patients with diagnoses of SCHF between 2013 and 2015 at a pediatric level 1 trauma center. Patients were excluded if they were younger than 2 years of age, older than 12 years of age, were polytrauma patients, or if there was not sufficient clinical or radiographic documentation, resulting in 449 patients. Urgent/emergent intervention was defined as surgery within 8 hours of presentation. Binomial logistic regression assessed whether various factors predicted operative versus nonoperative management.

Results:

Operative management was undertaken in 0/208 (0%) type I fractures, 61/106 (57.0%) type II fractures, and 135/135 (100%) type III fractures. Comparison with AUC recommendations revealed disagreement in 31% (138/449) of cases. Among 449 patients, 44 were treated nonoperatively despite AUC recommendations for operative treatment. All 44 of these patients were type II SCHFs managed nonoperatively. There were no definitive cases of malalignment or loss of alignment in these nonoperative cases. Factors predictive of operative management were anterior humeral line not intersecting the capitellum (odds ratio, 200; P<0.001) and increasing age (odds ratio, 1.53; P=0.024). The AUC more frequently recommended urgent/emergent operative intervention (148/449, 33.0%) than was performed at our pediatric level 1 trauma center (50/449, 11.1%). The majority of this disagreement (94/98, 95.9%) consisted of uncomplicated type III SCHF treated operatively in >8 hours. None of these patients developed compartment syndrome or required an open reduction.

Conclusions:

The American Academy of Orthopedic Surgeons AUC recommended operative and urgent/emergent intervention more frequently than was performed at a level 1 pediatric trauma center. Patient age and alignment of the anterior humeral line with the capitellum, though not specifically addressed in the AUC, were most predictive of operative versus nonoperative management at our institution.
Trends in Management and Complications of Anterior Cruciate Ligament Injuries in Pediatric Patients: A Survey of the PRiSM Society
Authors: Popkin Charles A. , Wright Margaret L. , Pennock Andrew T. , Vogel Laura A. , Padaki Ajay , Redler Lauren H. , Ahmad Christopher S.
Published: November 2017

Background:

Anterior cruciate ligament (ACL) injuries have been recognized and treated with increasing frequency in children and adolescents. ACL reconstruction (ACLR) in skeletally immature patients has unique considerations and there is a large practice variation in the management of these injuries. The purpose of this study was to survey the members of the Pediatric Research in Sports Medicine (PRiSM) Society regarding their experience with the management and complications of pediatric ACL injuries.

Methods:

A 15-question survey was distributed to 71 orthopaedic members of the Pediatric Research in Sports Medicine study group.

Results:

Regarding treatment of an 8-year-old child with a complete ACL tear, 53% of respondents recommended iliotibial band reconstruction, 33% recommended all-epiphyseal reconstruction, and only 3% would treat nonoperatively in a brace. In adolescent patients with 2 years of growth remaining, 47% of respondents recommended a physeal “respecting” technique, 31% recommended a physeal-sparing technique, and 19% would perform an adult-style ACLR. There were 29 new cases of growth arrest reported.

Conclusions:

This study demonstrates that there have been major changes in the trends in pediatric ACLR over the past 15 years, and the most treatment variability is found among adolescent patients with about 2 years of growth remaining. The study also demonstrates that while the overall incidence of growth disturbance after ACLR remains low, new cases of growth disturbance continue to be identified.

Level of Evidence:

Level V—survey of expert opinion and experience.
Incidence of Fractures From Perioperative Blood Pressure Cuff Use, Tourniquet Use, and Patient Positioning in Osteogenesis Imperfecta
Authors: Sullivan Brian T. , Margalit Adam , Garg Vaibhav S. , Njoku Dolores B. , Sponseller Paul D.
Published: November 2017

Background:

Osteogenesis imperfecta (OI) is a rare connective tissue disease with varying severity. Patients with OI are highly susceptible to skeletal fractures. Optimal perioperative management of these patients is not well defined. We investigated the risks associated with intraoperative use of noninvasive blood pressure (NIBP) cuffs, tourniquets, and intra-arterial catheters, and patient positioning in children with OI.

Methods:

We retrospectively reviewed records of patients younger than 21 years with OI who underwent surgery with general anesthesia from 2010 to 2016 at our tertiary care center. The primary outcome of interest was iatrogenic fracture caused by NIBP cuff use, tourniquet use, or patient positioning. The secondary outcome of interest was complications associated with intra-arterial catheter use.

Results:

Thirty-seven patients (15 girls) with a mean age of 10±4.8 years underwent 96 orthopaedic procedures (lower extremity, upper extremity, and spine) and 2 nonorthopaedic procedures (myringotomy, dental rehabilitation). Blood pressure was monitored with NIBP cuffs in 81 surgeries and intra-arterial catheters in 17 surgeries. Tourniquets (all applied to the lower extremity at a pneumatic pressure of 250 mm Hg) were used to minimize bleeding in 30 surgeries. There were no iatrogenic fractures associated with NIBP cuff use. One patient had a left humerus fracture that occurred during preoperative patient positioning. There were no fractures associated with tourniquet use and no complications related to intra-arterial catheters.

Conclusions:

In pediatric patients with OI, intraoperative use of NIBP cuffs and tourniquets was not associated with iatrogenic fracture. There were no complications related to intra-arterial catheter use. Care should be used during the perioperative period to prevent fractures during body positioning.

Level of Evidence:

Level IV.
Guillain–Barré Syndrome Triggered by Immune Checkpoint Inhibitors: A Case Report and Literature Review
Authors: Supakornnumporn Songkit , Katirji Bashar
Published: November 2017

Immune checkpoint inhibitors, used as immunotherapy in the treatment of melanoma and refractory cancer, may trigger autoimmune disorders. We describe a case of Guillain–Barré syndrome (GBS) after the treatment with ipilimumab and nivolumab and review 4 other reported cases. We confirmed the diagnosis of GBS by electrodiagnostic and cerebrospinal fluid studies. Electrodiagnostic results showed findings consistent with acquired demyelinating polyneuropathy and cerebrospinal fluid showed albuminocytologic dissociation. All patients were treated with intravenous immunoglobulin or other immunomodulating therapy. Among 5 cases which include our patient, 2 did well, 1 did not improve, and 2 died of respiratory insufficiency and multiorgan failure. Enhancing T-cell activation from immune checkpoint inhibitors may trigger GBS which should be suspected when progressive weakness and areflexia occur after treatment with immune checkpoint inhibitors.
The Fine Wire Technique for Flexor Tenolysis
Authors: Rosenblum Matthew K. , Baltodano Pablo A. , Weinberg Maxene H. , Whipple Lauren A. , Gemmiti Amanda L. , Whipple Richard E.
Published: November 2017

Background:

Flexor tenolysis surgery for flexor digitorum profundus and superficialis adhesions is a common procedure performed by hand surgeons. Releasing these adhered tendons can greatly improve hand function and improve quality of life. Recent evidence, however, has shown that the outcomes of tenolysis surgeries are often suboptimal and can result in relapsing adhesions or even tendon ruptures.

Methods:

This article describes a new technique with potential for reduced complication rates: The Fine Wire Technique for Flexor Tenolysis (FWT).

Results:

Following FWT, the patient detailed in this article had an excellent recovery of function and no complications: including tendon rupture, infection, hematomas, or any other complications. She reported a major improvement from her preoperative functionality and continues to have this level of success. The wire’s thinness allows for a swift tenolysis.

Conclusions:

The FWT is a new option available to the hand surgeon associated with good functional results. The wire is readily available to the clinician and is also inexpensive.
CITROBACTER ENDOGENOUS ENDOPHTHALMITIS: A CASE REPORT AND REVIEW OF THE LITERATURE
Authors: Wong Daniel H. T. , Liu Candice C. H. , Tong Justin M. K. , Luk Wei-Kwang , Li Kenneth K. W.
Published: November 2017

Purpose:

We present a case of endogenous endophthalmitis because of an unusual bacterium, Citrobacter koseri.

Patient:

A 57-year-old woman without previous history of eye surgery or trauma presented with diabetic ketoacidosis and a painful right eye with the reduction of vision. C. koseri was identified in blood culture; thus, a diagnosis of right eye endogenous endophthalmitis was made. Intravenous and intravitreal antibiotics were both started, and vitreous culture further confirmed C. koseri as the causative organism. Computed tomography of the abdomen and pelvis revealed a right C-shaped perinephric abscess, which was drained under ultrasound guidance.

Results:

Because of rapid progression to corneal melting, evisceration was performed.

Conclusion:

Cases of endogenous endophthalmitis caused by Citrobacter are very limited, and a review of all published cases in the English literature and the present case revealed that endogenous Citrobacter endophthalmitis arose almost entirely from Citrobacter renal infection. Early recognition and drainage of renal abscess may lower the chance of uncontrolled infection and endogenous spread to the eyes. Despite prompt and intensive treatment, the clinical outcome of Citrobacter endogenous endophthalmitis seems to be poor.
Long-term outcome after the acute respiratory distress syndrome: different from general critical illness?
Authors: Bein Thomas , Weber-Carstens Steffen , Apfelbacher Christian
Published: November 2017

Purpose of review

To review the current research data on long-term outcome and health-related quality of life in survivors of the acute respiratory distress syndrome (ARDS) and to compare these findings with those from non-ARDS patients surviving critical illness.

Recent findings

Between 6 months and 2 years after discharge from ICU, survivors of ARDS present with substantial impairments of the levels of body function (muscle strength, walking capacity and/or physical activity (physical SF-36 score). In contrast to non-ARDS patients from surgical ICUs, a standardized intensified physical therapy during early course of illness in ARDS patients could not show an improvement of long-term physical function performance. Furthermore, a substantial part of further ARDS patients suffer from depression (26–33%), anxiety (38–44%) or posttraumatic stress disorder (22–24%). In general, the level of functional autonomy and daily life activities was reduced, and in one study, 6 months after ICU-discharge this level was significantly lower in ARDS patients compared with non-ARDS patients. In a recent study, 44% of ARDS survivors were jobless 1 year after critical illness, whereas half of previously employed patients returned to work within 4 months after hospital discharge. General health-related quality of life was significantly reduced compared with a matched population in all studies.

Surviving ARDS is associated with a long-term substantial reduction in health-related quality of life and such a reduction does not differ from findings in patients surviving other critical illness. In further research, a special attention should be paid to prevention measures of the ‘post intensive care syndrome’ as well as to patient important domains, which might better explain the patient's and families’ demands.
Waging the War on Clinical Grade Inflation
Authors: Seldomridge Lisa A. , Walsh Catherine M.
Published: November 2017

This study examined the presence of grade inflation in clinical courses 9 years after implementing strategies to improve grading precision. A comparison of clinical grades for cohort I (1997-2002) with cohort II (2009-2016) showed statistically lower grades in 2 courses (Adult 1 and Maternity) for cohort II. Suggestions for changing the way clinical experiences are planned, executed, and evaluated are provided.
Effects of a Peer Evaluation Technique on Nursing Students’ Anxiety Levels
Authors: Stewart Patricia , Greene Debbie , Coke Sallie
Published: November 2017

Techniques to help decrease students’ stress and anxiety during a nursing program can be beneficial to their overall health and mental well-being. A quasi-experimental design was used to examine if a peer evaluation technique during clinical skill practice sessions decreases anxiety prior to skill performance evaluation with nursing faculty. Participant feedback supports the integration of a peer evaluation technique when learning clinical skills.
A National Study of School Counselors’ Perceptions of the Nursing Profession
Authors: Williams Cheryl , Dickstein-Fischer Laurie
Published: November 2017

School counselors are uniquely poised to influence career development among middle and high school students interested in nursing. This study examined 204 school counselors’ perceptions about nursing and secondary educational preparation. Despite national and local efforts to increase enrollment in baccalaureate and higher nursing programs, counselors remain unaware of the need for increased education in nursing. Nurse educators need to align with school counselors to adequately prepare students interested in nursing as a health career.
Bilateral Patellar Tendon Rupture
Authors: Kamienski Mary
Published: November 2017

The knee is the most complex and largest joint in the body. Injuries to any part of this joint affect the entire body. There are multiple injuries that can occur to the knee, with the most common being ligament and meniscus tears. A not-so-common injury to the knee is a patellar tendon rupture. A bilateral patellar tendon rupture is extremely rare. A case study of a 43-year-old man who sustained a bilateral patellar tendon rupture while playing softball is used to present this devastating injury. This discussion includes the incidence and diagnosis of the tear, surgical repair, as well as a description of the comprehensive rehabilitation process necessary to allow the patient to return to normal physical activity. Risks and complications of this surgery and the expected outcomes are also presented.
A Cluster Randomized Evaluation of a Health Department Data to Care Intervention Designed to Increase Engagement in HIV Care and Antiretroviral Use
Authors: Dombrowski Julia C. , Hughes James P. , Buskin Susan E. , Bennett Amy , Katz David , Fleming Mark , Nunez Angela , Golden Matthew R.
Published: November 2017

Background

Many US health departments have implemented Data to Care interventions, which use HIV surveillance data to identify persons who are inadequately engaged in HIV medical care and assist them with care reengagement, but the effectiveness of this strategy is uncertain.

Methods

We conducted a stepped-wedge, cluster-randomized evaluation of a Data to Care intervention in King County, Washington, 2011 to 2014. Persons diagnosed as having HIV for at least 6 months were eligible based on 1 of 2 criteria: (1) viral load (VL) greater than 500 copies/mL and CD4 less than 350 cells/μL at the last report in the past 12 months or (2) no CD4 or VL reported to the health department for at least 12 months. The intervention included medical provider contact, patient contact, and a structured individual interview. Health department staff assisted patients with reengagement using health systems navigation, brief counseling, and referral to support services. We clustered all eligible cases in the county by the last known medical provider and randomized the order of clusters for intervention, creating contemporaneous intervention and control periods (cases in later clusters contributed person-time to the control period at the same time that cases in earlier clusters contributed person-time to the intervention period). We compared the time to viral suppression (VL <200 copies/mL) for individuals during intervention and control periods using a Cox proportional hazards model.

Results

We identified 997 persons (intention to treat [ITT]), 18% of whom had moved or died. Of the remaining 822 (modified ITT), 161 (20%) had an undetectable VL reported before contact and 164 (20%) completed the individual interview. The hazard ratio (HR) for time to viral suppression did not differ between the intervention and control periods in ITT (HR, 1.21 [95% confidence interval, 0.85–1.71]) or modified ITT (HR, 1.18 [95% confidence interval, 0.83–1.68]) analysis.

Conclusions

The Data to Care intervention did not impact time to viral suppression.
A Population-Based Study to Compare Treatment Outcomes Among Women With Urogenital Chlamydial Infection in Washington State, 1992 to 2015
Authors: Khosropour Christine M. , Bell Teal R. , Hughes James P. , Manhart Lisa E. , Golden Matthew R.
Published: November 2017

Background

United States guidelines recommend azithromycin or doxycycline for chlamydia (Chlamydia trachomatis [CT]) treatment. These therapies are similarly efficacious for urogenital infections when outcomes are measured 7 to 42 days after treatment, although doxycycline may be superior for rectal infections. Some investigators have suggested that persistent rectal infections may lead to autoinfection of the urogenital tract, potentially resulting in higher rates of recurrent infection in azithromycin-treated women.

Methods

We used Washington State surveillance data to identify women 14 years or older with urogenital CT (1992–2015) treated with azithromycin or doxycycline. We defined persistent/recurrent CT as a repeat positive CT test result 14 to 180 days after treatment of the initial infection. We used log binomial regression to estimate the adjusted relative risk (aRR) of persistent/recurrent infection associated with treatment with azithromycin versus doxycycline.

Results

From 1992 to 2015, there were 268,596 reported cases of urogenital CT, including 168,301 (63%) who received azithromycin and 66,432 (25%) who received doxycycline. The risk of persistent/recurrent urogenital CT was 6.7% and 4.7% in azithromycin- and doxycycline-treated cases, respectively (P < 0.001). Adjusting for age, race/ethnicity, year, pregnancy status, jurisdiction reporting, reason for examination, and gonorrhea coinfection, azithromycin-treated women were significantly more likely to have persistent/recurrent urogenital CT than doxycycline-treated women (aRR, 1.24; 95% confidence interval [CI], 1.19–1.30). Adjusting the retesting window to 21 to 180 days (aRR, 1.24; 95% CI, 1.19–1.30) and 28 to 180 days (aRR, 1.25; 95% CI, 1.19–1.30) did not alter our primary findings.

Conclusions

Persistent/recurrent urogenital CT may be more common among women treated with azithromycin than with doxycycline. The reason for this difference is uncertain and is an important area of future investigation.
Leading Causes of Anesthesia-Related Liability Claims in Ambulatory Surgery Centers
Authors: Ranum Darrell , Beverly Anair , Shapiro Fred E. , Urman Richard D.
Published: November 2017

Objective

We present a contemporary analysis of patient injury, allegations, and contributing factors of anesthesia-related closed claims, which involved cases that specifically occurred in free-standing ambulatory surgery centers (ASCs).

Methods

We examined ASC-closed claims data between 2007 and 2014 from The Doctors Company, a medical malpractice insurer. Findings were coded using the Comprehensive Risk Intelligence Tool developed by CRICO Strategies. We compared coded data from ASC claims with hospital operating room (HOR) claims, in terms of injury severity category, nature of injury, nature of allegation, contributing factors identified, and contributing comorbidities and claim value.

Results

Ambulatory surgery center claims were more likely to be classified as medium severity than HOR claims, more likely to involve dental damage or pain than HOR claims, but less likely to involve death or respiratory or cardiac arrest. Technical performance was the most common contributing factor: 47% of ASCs and 48% of HORs. Only 7% of allegations relating to technical performance were judged to be a direct result of poor technical performance. The most common anesthesia procedures resulting in ASC claims were injection of anesthesia into a peripheral nerve (34%) and intubation (29%). Obesity was the most common contributing comorbidity in both settings. Mean closed claim value was significantly lower for ASC than HOR claims, averaging US $87,888 versus $107,325.

Conclusions

Analysis of ASC and HOR claims demonstrates significant differences and several common sources of liability. These include improving strategies for thorough screening, preoperative assessment and risk stratifying of patients, incorporating routine dental and airway assessment and documentation, diagnosing and treating perioperative pain adequately, and improving the efficacy of communication between patients and care providers.
Patient Safety Activity Under the Social Insurance Medical Fee Schedule in Japan: An Overview of the 2010 Nationwide Survey
Authors: Hirose Masahiro , Kawamura Toshihiko , Igawa Mikio , Imanaka Yuichi
Published: November 2017

Objectives

Little is known about patient safety performance under the social insurance medical fee schedule in Japan. The Health Ministry in Japan introduced the preferential patient safety countermeasure fee (PPSCF) to promote patient safety in 2006 and revised the PPSCF system in 2010. This study aims to address the patient safety performance status at hospitals implementing the PPSCF.

Methods

A nationwide questionnaire survey targeting 2674 hospitals with the PPSCF was performed in 2010 to 2011. The 627 participant hospitals were divided into the following three groups: 178 hospitals implementing PPSCF 1 with 400 beds or more (group A), 286 hospitals implementing PPSCF 1 with 399 beds or fewer (group B), and 163 hospitals implementing PPSCF 2 (group C).

Results

The mean numbers (standard errors) of patient safety managers were 1.45 (0.07) in group A, 1.12 (0.04) in group B, and 0.37 (0.12) in group C (P < 0.001). The participation number and rates of all staff for the patient safety seminar were 1721 (167) and 1.64 (0.10) in group A, 580 (26) and 1.94 (0.09) in group B, and 349 (31) and 1.98 (0.17) in group C (P < 0.001, P = 0.105).

These results can be explained because hospitals with PPSCF 1 (groups A and B) must assign at least one full-time patient safety manager, whereas hospitals with PPSCF 2 (group C) are not required to do so. Patient safety performance at hospitals with PPSCF 1 was more active than that at hospitals with PPSCF 2. However, when the values were converted to per capita or per 100 beds, there were no differences across the three groups.

Conclusions

The PPSCF encourages hospitals to perform actions for patient safety by providing incentives under the social insurance medical fee schedule in Japan.
Does Peritoneal Suction Drainage Reduce Pain After Gynecologic Laparoscopy?
Authors: Asgari Zahra , Hosseini Reihaneh , Rastad Hadith , Hosseini Ladan
Published: November 2017

This study evaluated the effect of drain placement on pain intensity after gynecologic laparoscopy. This study enrolled 120 patients with benign gynecologic lesions who underwent laparoscopic surgery. Patients were randomly divided into a standard group or the modified group. The modified group received suction drains that remained in place until 12 hours after surgery. We assessed patients’ mean pain scores according to a visual analog scale at 12 and 24 hours after surgery. The mean pain score in the modified group was 6.01±1.96 at 12 hours after surgery and 3.86±1.57 at 24 hours after surgery. The standard group had a mean pain score of 5.43±1.7 at 12 hours after surgery and 3.51±1.27 at 24 hours after surgery. These findings did not significantly differ (P=0.6) even though the mean dose of parenteral analgesia was 0.68±0.83 in the standard group and 0.41±0.67 in the modified group (P=0.05). We observed no differences in complications and hospital stay between the groups. The data suggest that drainage may not reduce postoperative pain and should be used in its traditional role for potential bleeding or infections.
Cre-dependent Cas9-expressing pigs enable efficient in vivo genome editing
Authors: Wang Kepin , Jin Qin , Ruan Degong , Yang Yi , Liu Qishuai , Wu Han , Zhou Zhiwei , Ouyang Zhen , Liu Zhaoming , Zhao Yu , Zhao Bentian , Zhang Quanjun , Peng Jiangyun , Lai Chengdan , Fan Nana , Liang Yanhui , Lan Ting , Li Nan , Wang Xiaoshan , Wang Xinlu , Fan Yong , Doevendans Pieter A. , Sluijter Joost P.G. , Liu Pentao , Li Xiaoping , Lai Liangxue
Published: November 2017

Despite being time-consuming and costly, generating genome-edited pigs holds great promise for agricultural, biomedical, and pharmaceutical applications. To further facilitate genome editing in pigs, we report here establishment of a pig line with Cre-inducible Cas9 expression that allows a variety of ex vivo genome editing in fibroblast cells including single- and multigene modifications, chromosome rearrangements, and efficient in vivo genetic modifications. As a proof of principle, we were able to simultaneously inactivate five tumor suppressor genes (TP53, PTEN, APC, BRCA1, and BRCA2) and activate one oncogene (KRAS), achieved by delivering Cre recombinase and sgRNAs, which caused rapid lung tumor development. The efficient genome editing shown here demonstrates that these pigs can serve as a powerful tool for dissecting in vivo gene functions and biological processes in a temporal manner and for streamlining the production of genome-edited pigs for disease modeling.
Temporary agency workers stepping into a permanent position: social skills matter
Authors: Galais Nathalie , Moser Klaus
Published: November 2017

Purpose

Temporary agency work (TAW) has increased enormously in recent decades. Most temporary agency workers are pushed involuntarily into this work arrangement and prefer permanent work arrangements. Therefore, the motive to find a permanent job through TAW is predominant for the majority of temporary agency workers. However, little is known about what helps in obtaining a permanent job in a client organization. The purpose of this paper is to examine the role of social skills by simultaneously considering the human capital aspects and motivational background of the individuals for transition success.

Design/methodology/approach

The paper is based on a questionnaire study of 151 temporary agency workers with two measurement points. The questionnaires were first administered at the very beginning of their work as a temp and again five months later.

Findings

The findings show that the social skills of temporary agency workers in contrast to various aspects of human capital and motives for temping had a significant impact on becoming a permanent worker in a client organization.

Research limitations/implications

The generalizability of the finding that social skills help temporary agency workers to find a permanent job in a client organization may be restricted due to the particularities of the work setting in the clerical sector. The incidences as well as the determinants of transition success may depend on the industry sector because of the respective assignment characteristics as well as the clients’ reasons of using temporary agency workers. Future research should investigate more thoroughly the role of assignment characteristics for the experiences of the workers.

Practical implications

Social skills seem to play a crucial role for transition success in TAW. Qualification measures should therefore include the training of interpersonal behavior. It would be desirable when the involved organizations would assume responsibility in this respect. Furthermore, policy makers should provide adequate training formats since they promote TAW as a stepping stone opportunity for unemployed people.

Originality/value

This paper suggests that career mobility in the context of flexible work arrangements may be driven by more informal processes of social integration into the existing permanent team. While TAW is seen as a temporary solution in Germany, this study focuses on the individual determinants of transition success of temporary agency workers that is still rare in studies on the topic.
How effective are disability sensitization workshops?
Authors: Kulkarni Mukta , Gopakumar K.V. , Patel Shivani
Published: November 2017

Purpose

Organizations are increasingly investing in disability-specific sensitization workshops. Yet, there is limited understanding about their hoped outcomes, that is, increased knowledge about disability-related issues and behavioral changes with respect to those with a disability. The purpose of this paper is to examine the effectiveness and boundaries of disability-specific sensitization training in organizations.

Design/methodology/approach

This is an interview-based study where 33 employees from five industries across India were interviewed over the span of a year.

Findings

The findings suggest that sensitization workshops are successful with regard to awareness generation. Paradoxically, the same awareness also reinforced group boundaries through “othering.” Further, workshops resonated more so with individuals who already had some prior experience with disability, implying that voluntary sensitization is likely attracting those who have the least need of such sensitization. The findings also suggest that non-mandated interventions may not necessarily influence organizational level outcomes, especially if workshops are conducted in isolation from a broader organizational culture of inclusion.

Originality/value

The present study helps outline effects of sensitization training initiatives and enhances our understanding about how negative attitudes toward persons with a disability can be overcome. The study also indicates how such training initiatives may inadvertently lead to “othering.” Finally, this study offers suggestions to human resource managers for designing impactful disability sensitization workshops.
Expanding social actor-based explanations in labour market dualisation research
Authors: Pulignano Valeria , Doerflinger Nadja
Published: November 2017

Purpose

The purpose of this paper is to contribute conceptually to debate on labour market dualisation by proposing a macro-micro and micro-macro (or macro-micro-macro) analytical approach to integrate actor-based explanations in the study of labour market dualisation.

Design/methodology/approach

This is a conceptual paper emphasising the need to combine qualitative and quantitative data and methods in studying the nature and incidence of labour market dualisation.

Findings

To study social divides – as a manifestation of labour market dualisation and, more generally, fragmentation – macro-micro and micro-macro (i.e. macro-micro-macro) relationships need to be established as part of an analytical approach to studying dualisation. This implies considering macro-level institutional and regulatory as well as micro-level workplace and organisational settings as factors in any analysis and interpretation of the determinants of labour market dualisation, i.e. integrating the dynamics of power and strategy as determinants of dualisation, fragmentation and more generally precariousness.

Originality/value

The paper points to the need to expand actor-based explanations within the labour market dualisation debate, which remains overly institutionalist in its approach. The authors propose a micro-macro-micro analytical approach as the way to systematise the study of concurrent macro-micro and micro-macro relationships shaping social divides in labour markets.
Correlates for the risk of specialist ID hospital admission for people with intellectual disabilities: development of the LDNAT inpatient index
Authors: Painter Jon , Ingham Barry , Trevithick Liam , Hastings Richard P. , Roy Ashok
Published: November 2017

Purpose

The purpose of this paper is to analyse ratings data from the recently developed Learning Disability Needs Assessment Tool (LDNAT) to identify factors associated with specialist intellectual disability (ID) hospital admissions.

Design/methodology/approach

Ratings from 1,692 individuals were analysed and the LDNAT items differing significantly between inpatients and non-inpatients were identified. Statistical analyses on total scores derived from these items were used to calculate an optimal cut-off. This LDNAT inpatient index score was also confirmed via an alternative statistical technique.

Findings

On average, 18 of the 23 LDNAT item ratings were significantly higher in people with ID assessed as inpatients compared to those rated in community settings. Using the total of these items, the resulting LDNAT inpatient index was analysed. A cut-off score of 22.5 was calculated to be the optimal balance between sensitivity (0.833) and specificity (0.750). This was confirmed by calculating the Youden index (j=0.583). At this level 68 per cent of inpatients and 81 per cent of non-inpatient cases were correctly identified.

Practical implications

Currently there is a national (UK) programme to radically reduce the amount of specialist inpatient care for people ID. This will necessitate early identification of individuals most at risk of admission together with investment in improved, proactive community services if admissions to a diminishing bed-base are to remain manageable.

Originality/value

This study confirms the associations between mental health difficulties, challenging behaviour and specialist hospital admissions for people with ID, extending existing research by translating these findings into a clinically usable risk index.
Implicit Review Instrument to Evaluate Quality of Care Delivered by Physicians to Children in Emergency Departments
Authors: Marcin James P. , Romano Patrick S. , Dharmar Madan , Chamberlain James M. , Dudley Nanette , Macias Charles G. , Nigrovic Lise E. , Powell Elizabeth C. , Rogers Alexander J. , Sonnett Meridith , Tzimenatos Leah , Alpern Elizabeth R. , Andrews‐Dickert Rebecca , Borgialli Dominic A. , Sidney Erika , Casper Charlie , Dean Jonathan Michael , Kuppermann Nathan ,   the Pediatric Emergency Care Applied Research Network
Published: November 2017

Objective

To evaluate the consistency, reliability, and validity of an implicit review instrument that measures the quality of care provided to children in the emergency department (ED).

Data Sources/Study Setting

Medical records of randomly selected children from 12 EDs in the Pediatric Emergency Care Applied Research Network (PECARN).

Study Design

Eight pediatric emergency medicine physicians applied the instrument to 620 medical records.

Data Collection/Extraction Methods

We determined internal consistency using Cronbach's alpha and inter‐rater reliability using the intraclass correlation coefficient (ICC). We evaluated the validity of the instrument by correlating scores with four condition‐specific explicit review instruments.

Principal Findings

Individual reviewers' Cronbach's alpha had a mean of 0.85 with a range of 0.76–0.97; overall Cronbach's alpha was 0.90. The ICC was 0.49 for the summary score with a range from 0.40 to 0.46. Correlations between the quality of care score and the four condition‐specific explicit review scores ranged from 0.24 to 0.38.

Conclusions

The quality of care instrument demonstrated good internal consistency, moderate inter‐rater reliability, high inter‐rater agreement, and evidence supporting validity. The instrument could be useful for systems' assessment and research in evaluating the care delivered to children in the ED.
Certifying Death in the United States
Authors: Ruiz Leah , Posey Brianne M. , Neuilly Melanie‐Angela , Stohr Mary K. , Hemmens Craig
Published: November 2017

Accurately identifying death and its causes is integral to the compilation of mortality data and ultimately to the operation of the criminal justice and public health systems. A clear understanding of who is in charge of such processes is paramount to establishing the quality, or lack thereof, of the information provided in death certificates. Our study provides a comprehensive overview of all state statutes identifying death investigators charged with classifying and certifying death in the United States. We found that state statutes designate a broad range of individuals as responsible for the classification and certification of death. Those vary by state and set of circumstances and can include medical examiners, coroners, pathologists, other physicians, registered nurses, and more. Our findings highlight the important need for a unified standard of qualifications in the medico‐legal system, as well as, regulatory reform at the state level regarding who can complete and sign death certificates.
Microhaplotypes provide increased power from short‐read DNA sequences for relationship inference
Authors: Baetscher Diana S. , Clemento Anthony J. , Ng Thomas C. , Anderson Eric C. , Garza John C.
Published: November 2017

The accelerating rate at which DNA sequence data are now generated by high‐throughput sequencing instruments provides both opportunities and challenges for population genetic and ecological investigations of animals and plants. We show here how the common practice of calling genotypes from a single SNP per sequenced region ignores substantial additional information in the phased short‐read sequences that are provided by these sequencing instruments. We target sequenced regions with multiple SNPs in kelp rockfish (Sebastes atrovirens) to determine “microhaplotypes” and then call these microhaplotypes as alleles at each locus. We then demonstrate how these multi‐allelic marker data from such loci dramatically increase power for relationship inference. The microhaplotype approach decreases false‐positive rates by several orders of magnitude, relative to calling bi‐allelic SNPs, for two challenging analytical procedures, full‐sibling and single parent–offspring pair identification. We also show how the identification of half‐sibling pairs requires so much data that physical linkage becomes a consideration, and that most published studies that attempt to do so are dramatically underpowered. The advent of phased short‐read DNA sequence data, in conjunction with emerging analytical tools for their analysis, promises to improve efficiency by reducing the number of loci necessary for a particular level of statistical confidence, thereby lowering the cost of data collection and reducing the degree of physical linkage amongst markers used for relationship estimation. Such advances will facilitate collaborative research and management for migratory and other widespread species.
A retrospective cohort study of the health of children prenatally exposed to methadone, buprenorphine or naltrexone compared with non‐exposed control children
Authors: Kelty Erin , Hulse Gary
Published: November 2017

Background and Objectives

Little is known about the health of children exposed to opioid pharmacotherapies in utero. This study aims to examine the health of children from birth to 5 years of age, who were exposed to methadone, buprenorphine, or naltrexone with non‐exposed children.

Methods

Children were identified by linking the treatment records of women treated with one of the three opioid pharmacotherapies with midwife notifications. Live‐born children exposed to methadone (n = 198), buprenorphine (n = 122), naltrexone (n = 67) in utero, and neonates not prenatally exposed to opioids (n = 387) born between 2001 and 2011 in Western Australia were included in the study. The children were then linked to state mortality, hospital, emergency department (ED), mental health, cancer, and reportable diseases from birth up to their 5th birthday.

Results

Overall rates of hospital admission were elevated in all three treatments as compared with the control children, while rates of ED attendances were only significantly elevated in the methadone (p = .002) and naltrexone (p = .044) exposed children. In terms of both hospital and ED attendances, the differences between the exposed and control children was most apparent in the neonatal period. Rates of mental health out‐patient attendances were elevated in buprenorphine‐exposed children as compared with the control (p = .005).

Discussion and Conclusions

The study provides evidence to suggest a disparity in the health of children exposed to opioid pharmacotherapies in utero compared with non‐exposed control children.

Scientific Significance

Exposure to opioid pharmacotherapies in utero may influence the health of children beyond the neonatal period. (Am J Addict 2017;26:845–851)
Relationship between testosterone in serum, saliva and urine during treatment with intramuscular testosterone undecanoate in gender dysphoria and male hypogonadism
Authors: Lood Y. , Aardal‐Eriksson E. , Webe C. , Ahlner J. , Ekman B. , Wahlberg J.
Published: November 2017

Long‐term testosterone replacement therapy is mainly monitored by trough levels of serum testosterone (S‐T), while urinary testosterone (U‐T) is used by forensic toxicology to evaluate testosterone doping. Testosterone in saliva (Sal‐T) may provide additional information and simplify the sample collection. We aimed to investigate the relationships between testosterone measured in saliva, serum and urine during standard treatment with 1,000 mg testosterone undecanoate (TU) every 12th week during 1 year. This was an observational study. Males with primary and secondary hypogonadism (HG; n = 23), subjects with gender dysphoria (GD FtM; n = 15) and a healthy control group of men (n = 32) were investigated. Sal‐T, S‐T and U‐T were measured before and after TU injections. Sal‐T was determined with Salimetrics® enzyme immunoassay, S‐T with Roche Elecsys® testosterone II assay and U‐T by gas chromatography‐mass spectrometry. Sal‐T correlated significantly with S‐T and calculated free testosterone in both controls and patients (HG men and GD FtM), while Sal‐T to U‐T showed weaker correlations. Trough values of Sal‐T after 12 months were significantly higher in the GD FtM group (0.77 ± 0.35 nmol/L) compared to HG men (0.53 ± 0.22 nmol/L) and controls (0.46 ± 0.15 nmol/L), while no differences between S‐T and U‐T trough values were found. Markedly elevated concentrations of salivary testosterone, 7–14 days after injection, were observed, especially in the GD FtM group. This study demonstrates that Sal‐T might be a useful clinical tool to monitor long‐term testosterone replacement therapy and might give additional information in forensic cases.
Psychological Flexibility at Work and Employees' Proactive Work Behaviour: Cross‐Level Moderating Role of Leader Need for Structure
Authors: Kuo Che‐Chun , Ye Yun‐Ci , Chen Mei‐Yen , Chen Lung Hung
Published: November 2017

How to promote employees to be proactive behaviourally is a significant issue in the literature because it would benefit organisations in several ways. Drawing on the acceptance and commitment model, we proposed a new antecedent, psychological flexibility that might contribute to employees' proactive work behaviour. Furthermore, we investigated how the contextual role of supervisor need for structure exhibits a cross‐level moderating effect on the relationship between employee psychological flexibility at work and proactive work behaviour based on interactionism. Data from 241 full‐time employees and their corresponding 45 managers indicated that employee psychological flexibility was positively associated with proactive work behaviour. More importantly, the supervisor need for structure played a moderating role, suggesting that employees would demonstrate greater proactive work behaviour especially when the supervisors have a high need for structure. Implications for psychological flexibility, proactivity, and person‐situation interactional research are discussed.
Interleukin‐12 and its procoagulant effect on erythrocytes, platelets and fibrin(ogen): the lesser known side of inflammation
Authors: Page Martin J. , Bester Janette , Pretorius Etheresia
Published: November 2017

Inflammation, with its associated inflammatory molecules, is integral to most chronic diseases, including the various cardiovascular diseases. Interleukin 12 (IL12) is one of the inflammatory cytokines that is upregulated during inflammation; however, we know very little about its exact effect on red blood cells (RBCs), platelets and fibrin(ogen). IL12 is an important pleiotropic cytokine in early inflammatory responses and has potent immunomodulatory, antitumour and anti‐infection activity. Here we investigate how low levels of circulating IL12, comparable to levels found during chronic inflammation, affect coagulation parameters, platelets and RBCs. We used thromboelastography, scanning electron microscopy, refractometery and wide‐field microscopy. Our results show that IL12 caused hypercoagulation, platelet activation and spreading, as well as RBC agglutination. This phenomenon has far‐reaching implications for treatment of the plethora of conditions where IL12 is upregulated, since it suggests aberrant haemorheology as agglutination affects blood flow. This information might be used in future to target the lowering of IL12 in inflammatory conditions, as well as address RBC agglutination.