bluuebunny/crossref_metadata_2025 huggingface dataset:
Patient–provider communication over social media: perspectives of adolescents with psychiatric illness
Authors: van Rensburg Samuel H. , Klingensmith Katherine , McLaughlin Paige , Qayyum Zheala , van Schalkwyk Gerrit I.
Published: January 2015

Background

Social media is an increasingly dominant platform for communication, especially among adolescents. Statements from professional bodies and a growing body of empirical evidence support a role for social media in improving provider–patient interactions. In psychiatry, particular concerns exist about the suitability of this style of communication. Very limited data are available exploring how patients would like to incorporate social media into their communication with their psychiatric providers.

Methods

We conducted a qualitative study with 20 adolescents attending the Yale Psychiatric Hospital Intensive Outpatient Programme. Interviews were analysed using inductive thematic analysis.

Results

Participants highlighted how social media could allow for constant access to a mental health provider, provide a less anxiety‐provoking mode of communication, and allow for them to be monitored in a more on‐going fashion. However, participants also identified many potential risks associated with these applications, including the potential for anxiety if a provider was not able to respond immediately, and a sense that online interactions would be less rich overall.

Discussion

Our findings suggest that adolescents are open to the idea of communicating with mental health providers over social media and are able to describe a number of instances where this could be of value. The risks participants described, as well as concerns raised by existing literature, indicate the need for further work and protocol development in order for social media to be a feasible tool for communication between providers and adolescents with psychiatric illness.
A review of current practices to increase Chlamydia screening in the community – a consumer‐centred social marketing perspective
Authors: Phillipson Lyn , Gordon Ross , Telenta Joanne , Magee Chris , Janssen Marty
Published: January 2015

Background

Chlamydia trachomatis is one of the most frequently reported sexually transmitted infections (STI) in Australia, the UK and Europe. Yet, rates of screening for STIs remain low, especially in younger adults.

Objective

To assess effectiveness of Chlamydia screening interventions targeting young adults in community‐based settings, describe strategies utilized and assess them according to social marketing benchmark criteria.

Search strategy

A systematic review of relevant literature between 2002 and 2012 in Medline, Web of Knowledge, PubMed, Scopus and the Cumulative Index to Nursing and Allied Health was undertaken.

Results

Of 18 interventions identified, quality of evidence was low. Proportional screening rates varied, ranging from: 30.9 to 62.5% in educational settings (n = 4), 4.8 to 63% in media settings (n = 6) and from 5.7 to 44.5% in other settings (n = 7). Assessment against benchmark criteria found that interventions incorporating social marketing principles were more likely to achieve positive results, yet few did this comprehensively. Most demonstrated customer orientation and addressed barriers to presenting to a clinic for screening. Only one addressed barriers to presenting for treatment after a positive result. Promotional messages typically focused on providing facts and accessing a testing kit. Risk assessment tools appeared to promote screening among higher risk groups. Few evaluated treatment rates following positive results; therefore, impact of screening on treatment rates remains unknown.

Discussion

Future interventions should consider utilizing a comprehensive social marketing approach, using formative research to increase insight and segmentation and tailoring of screening interventions. Easy community access to both screening and treatment should be prioritized.
Prevention and treatment of pediatric obesity using mobile and wireless technologies: a systematic review
Authors: Turner T. , Spruijt‐Metz D. , Wen C. K. F. , Hingle M. D.
Published: January 2015

Mobile health (mHealth) is a relatively nascent field, with a variety of technologies being explored and developed. Because of the explosive growth in this field, it is of interest to examine the design, development and efficacy of various interventions as research becomes available. This systematic review examines current use of mHealth technologies in the prevention or treatment of pediatric obesity to catalogue the types of technologies utilized and the impact of mHealth to improve obesity‐related outcomes in youth. Of the 4021 articles that were identified, 41 articles met inclusion criteria. Seventeen intervention studies incorporated mHealth as the primary or supplementary treatment. The remaining articles were in the beginning stages of research development and most often described moderate‐to‐high usability, feasibility and acceptability. Although few effects were observed on outcomes such as body mass index, increases in physical activity, self‐reported breakfast and fruit and vegetable consumption, adherence to treatment, and self‐monitoring were observed. Findings from this review suggest that mHealth approaches are feasible and acceptable tools in the prevention and treatment of pediatric obesity. The large heterogeneity in research designs highlights the need for more agile scientific processes that can keep up with the speed of technology development.
Rat animal model for preclinical testing of microparticle urethral bulking agents
Authors: Mann‐Gow Travis K , Blaivas Jerry G , King Benjamin J , El‐Ghannam Ahmed , Knabe Christine , Lam Michael K , Kida Masatoshi , Sikavi Cameron S , Plante Mark K , Krhut Jan , Zvara Peter
Published: January 2015

Objectives

To develop an economic, practical and readily available animal model for preclinical testing of urethral bulking therapies, as well as to establish feasible experimental methods that allow for complete analysis of hard microparticle bulking agents.

Methods

Alumina ceramic beads suspended in hyaluronic acid were injected into the proximal urethra of 15 female rats under an operating microscope. We assessed overall lower urinary tract function, bulking material intraurethral integrity and local host tissue response over time. Microphotographs were taken during injection and again 6 months postoperatively, before urethral harvest. Urinary flow rate and voiding frequency were assessed before and after injection. At 6 months, the urethra was removed and embedded in resin. Hard tissue sections were cut using a sawing microtome, and processed for histological analysis using scanning electron microscopy, light microscopy and immunohistochemistry.

Results

Microphotographs of the urethra showed complete volume retention of the bulking agent at 6 months. There was no significant difference between average urinary frequency and mean urinary flow rate at 1 and 3 months postinjection as compared with baseline. Scanning electron microscopy proved suitable for evaluation of microparticle size and integrity, as well as local tissue remodeling. Light microscopy and immunohistochemistry allowed for evaluation of an inflammatory host tissue reaction to the bulking agent.

Conclusions

The microsurgical injection technique, in vivo physiology and novel hard tissue processing for histology, described in the present study, will allow for future comprehensive preclinical testing of urethral bulking therapy agents containing microparticles made of a hard material.
Self‐efficacy in providing smoking‐cessation services among psychiatric nurses in central and southern Taiwan: An exploratory study
Authors: Guo Su‐Er , Wang Ai‐Ling , Shu Bih‐Ching
Published: January 2015

Smoking by psychiatric patients remains prevalent. The purpose of this cross‐sectional study was to understand the influence of self‐efficacy and its correlates among psychiatric nurses when providing smoking‐cessation services (SCS). A convenience sample of 193 nurses from psychiatric institutions was obtained. Surveys were conducted using self‐report measures regarding SCS provided by psychiatric nurses. The survey questions focused on self‐efficacy, attitude, practical experience, and smoke‐free policies, and their implementation in the workplace. The participants reported low self‐efficacy for providing SCS in their self‐assessment, as demonstrated by their scores of 55.3 ± 20.4, on a scale of 0 (low confidence) to 100 (high confidence). Using multiple linear regressions, statistically‐significant, relevant factors included perceived provider‐related barriers in providing SCS, environmental tobacco smoke exposure, the nurse's attitude towards a patient smoking, and the nurse's frequency and practical experience in providing SCS. The correlates of this self‐efficacy can serve as a reference for in‐service curriculum planning of SCS by psychiatric nurses. In addition, policies to limit exposure to second‐hand tobacco smoke should be explored.
Neurodevelopmental and behavioural paediatrics
Authors: McDowell Michael
Published: January 2015

One of the notable shifts in Paediatrics across the last 50 years has been towards disorders that are chronic and qualitative in nature. In addition to physical health, these impact on childhood development, behaviour and wellbeing. Understanding and management of these problems extends the traditional biological toolkit of paediatrics into the complexities of uncertainties of psychological and social context. In Australasia, the profession has responded with the development of Community Paediatrics as a recognised sub‐specialty, of which Neurodevelopmental and Behavioural Paediatrics is an important component. These developments are reviewed along with consideration of future challenges for this field of health care.
An explosion, a tsunami, a runaway train: Half a century of genetics
Authors: Kirk Edwin P
Published: January 2015

Let's face it. There is no way of writing about the last half century of genetics without getting a little bit excitable. All of the terms in the title of this piece have been used by otherwise level‐headed geneticists to describe the pace of change in genetics over the past few years. The thing is – they are right. Genetics is moving faster and faster. Five years ago, few people would have predicted that we would be where we are today. Five years from now, presumably, it will seem like 2015 was some kind of Dark Age when nothing much was happening. So it would be easy to lose perspective on the achievements of the past, or to assume that nothing much was happening in genetics until recently. However, everything that is happening in genetics now rests on the foundations built up over the past century, and particularly the past half century. And through that time, this journal has been a part of that story.
Hepatocellular carcinoma surveillance rates in commercially insured patients with noncirrhotic chronic hepatitis B
Authors: Goldberg D. S. , Valderrama A. , Kamalakar R. , Sansgiry S. S. , Babajanyan S. , Lewis J. D.
Published: January 2015

American association for the study of liver diseases (AASLD) and European Association for the Study of the Liver (EASL) guidelines recommend biannual hepatocellular carcinoma (HCC) screening for noncirrhotic patients with chronic hepatitis B infection (HBV), yet there are no data estimating surveillance rates or factors associated with surveillance. We performed a retrospective cohort study of US patients using the Truven Health Analytics databases from 2006 to 2010 and identified patients with noncirrhotic chronic HBV. Surveillance patterns were characterized using categorical and continuous outcomes, with the continuous measure of the proportion of time ‘up to date’ with surveillance (PUTDS), with the 6‐month interval following each ultrasound categorized as ‘up to date’. During a median follow‐up of 26.0 (IQR: 16.2–40.0) months among 4576 noncirrhotic patients with chronic HBV (median age: 44 years, IQR: 36–52), only 306 (6.7%) had complete surveillance (one ultrasound every 6‐month interval), 2727 (59.6%) incomplete (≥1 ultrasound) and 1543 (33.7%) none. The mean PUTDS was 0.34 ± 0.29, and the median was 0.32 (IQR: 0.03–0.52). In multinomial logistic regression models, patients diagnosed by a nongastroenterologist were significantly less likely to have complete surveillance (P < 0.001), as were those coinfected with HBV/HIV (P < 0.001). In linear regression models, nongastroenterologist provider, health insurance subtype, HBV/HIV coinfection, rural status and metabolic syndrome were independently associated with decreased surveillance. Patients with HIV had an absolute decrease in the PUTDS of 0.24, while patients in less populated rural areas had an absolute decrease of 0.10. HCC surveillance rates in noncirrhotic patients with chronic HBV in the United States are poor and lower than reported rates of HCC surveillance in cirrhotic patients.
Supraspinal Projection of Serotonergic and Noradrenergic Pathways Modulates Nociceptive Transmission in the Lower Urinary Tract of Rats
Authors: MITSUI Takahiko , KANNO Yukiko , KITTA Takeya , MORIYA Kimihiko , NONOMURA Katsuya
Published: January 2015

Objectives

To investigate the effect of descending serotonergic and noradrenergic pathways on nociception in the lower urinary tract (LUT).

Methods

Female Sprague–Dawley rats were used. Following intraperitoneal administration of Vehicle or Milnacipran (30 mg/kg), which is one of serotonin‐noradrenaline reuptake inhibitors (SNRI), 0.1% AA was infused into the bladder in normal (n = 4, each) and spinal cord injury (SCI) (n = 4, each) rats for 2 h on consciousness, and c‐Fos, 5‐HT and DβH were stained using immunohistochemistry at the L6 spinal cord as spinal areas associated with LUT.

Results

In SCI rats, 5‐HT or DβH‐positive fibers were not observed at the L6 spinal cord, while there were many 5‐HT and DβH‐positive fibers in normal rats. The total number of c‐Fos‐positive cells was significantly increased in SCI rats compared to Normal rats (209.4 ± 7.1 in Normal, 336.4 ± 28.9 in SCI, P < 0.05), which indicated that interruption of supraspinal modulation enhances nocieptive transmission in the LUT. Regarding the effect of Milnacipran administration, the number of c‐Fos‐positive cells was significantly decreased at all region of the L6 spinal cord in normal rats (P < 0.05), while this reduction was not observed in SCI rats. This result demonstrated that administration of SNRI attenuates nocieptive transmission in the LUT, indicating that 5‐HT and noradrenaline work as mediators of endogenous analgesic mechanisms through the supraspinal descending pain pathways.

Conclusions

Supraspinal projections of descending serotonergic and noradrenergic pathways to the lower lumbar spinal cord modulate nocieptive transmission in the LUT. Administration of SNRI attenuates nocieptive transmission in the LUT, which could result from enhancement of modulating descending serotonergic and noradrenergic pathways.
Lack of support for the time‐dependent molecular evolution hypothesis
Authors: Emerson Brent C. , Hickerson Michael J.
Published: January 2015

There is increasing momentum surrounding the hypothesis that rates of molecular evolution between individuals within contemporary populations are high, and that these rates decrease as a function of time, perhaps over several millions of years, before reaching stationarity. The implications of this are powerful, potentially reshaping our view of how climate history impacts upon both species distribution patterns and the geographic structuring of genetic variation within species. However, our assessment of the hypothesis reveals a lack of theoretical support and empirical evidence for hypothesized magnitudes of time‐dependent rates of molecular evolution, with much of the apparent rate changes coming from artefacts and biases inherent in the methods of rate estimation. Our assessment also reveals a problem with how serial sampling is implemented for mutation rate estimation using ancient DNA samples, rendering published estimates unreliable.
A single‐center strategy to minimize blood transfusion in neonates and children undergoing cardiac surgery
Authors: Naguib Aymen N. , Winch Peter D. , Tobias Joseph D. , Simsic Janet , Hersey Diane , Nicol Kathleen , Preston Thomas , Gomez Daniel , McConnell Patrick , Galantowicz Mark
Published: January 2015

Background

The transfusion of blood products in the setting of uncontrolled bleeding is unquestionably lifesaving. However, in many instances, the decision to transfuse is based on physician gestalt rather than medical evidence. When indications for transfusion are unclear, the benefits of blood products must be balanced against their significant risks and associated costs. As our institution is a referral center for patients of Jehovah's Witness faith, this population has pushed our development of techniques to achieve the goal of bloodless surgery. Our practices in caring for this population have become our standard practice for managing all patients undergoing congenital cardiac surgery.

Objectives

To evaluate our success in minimizing the use of blood products during pediatric cardiac surgery.

Methods

After IRB approval, we retrospectively reviewed all patients who underwent cardiac surgery utilizing cardiopulmonary bypass (CPB), for biventricular repair procedures. The study was conducted at a single institution (Nationwide Children's Hospital (NCH)) during the period: January 1, 2013 and December 31, 2013.

Results

A total of 209 patients were included. Overall, 81 patients (38.8%) and 81 of 136 (59.6%) weighing more than 6 kg received no blood products (bloodless) during their entire hospital stay. Bloodless surgery was most successful in patients weighing more than 18 kg, followed by patients weighing 6–18 kg. All 73 patients who weighed <6 kg received blood transfusion during their hospitalization.

Conclusion

The techniques that we have developed to initially care for our Jehovah's Witness families may be applied to other pediatric and adult surgical procedures.
Multidisciplinary Lung Cancer Meetings: Improving the practice of radiation oncology and facing future challenges
Authors: Campbell Belinda A. , Ball David , Mornex Françoise
Published: January 2015

Clinical guidelines widely recognize the importance of multidisciplinary meetings (MDM) in the optimal care of lung cancer patients. The published literature suggest that dedicated Lung Cancer MDM lead to increased treatment utilization rates and improved survival outcomes for patients with lung cancer. For radiation oncologists, Lung Cancer MDM have been proven to support evidence‐based practice and improve the utilization of radiotherapy. Lung Cancer MDM also allow for education and promotion of specialty radiotherapy services. The fast pace of modern medicine is also presenting new challenges for the multidisciplinary lung cancer team, and technological advances are likely to lead to new changes in the structure of traditional Lung Cancer MDM.
Sedimentology, three‐dimensional geobody reconstruction and carbon dioxide origin of Pleistocene travertine deposits in the Ballık area (south‐west Turkey)
Authors: Claes Hannes , Soete Jeroen , Van Noten Koen , El Desouky Hamdy , Marques Erthal Marcelle , Vanhaecke Frank , Özkul Mehmet , Swennen Rudy
Published: January 2015

The Denizli Basin in the West Anatolian Extensional Province in western Turkey is well‐known for its numerous travertine occurrences. A combined sedimentological, diagenetic and geochemical investigation is executed on the Ece and Faber travertines of the Ballık area, the largest travertine site in the Denizli Basin. The first aim of this study is the reconstruction of a three‐dimensional geo‐model in combination with a detailed sedimentological description from fabric to lithotype, lithofacies and geobody scale, with a focus on integrating pore‐typing. The second aim involves the delineation of the CO2‐origin of ancient travertine precipitating waters. Peloidal, phyto and dendritic lithotypes dominate the studied travertines and honeycomb and bacteriform shapes and encrusted bacterial or fungal filaments related to their fabrics suggest a microbial influence. The environment of travertine precipitation evolved from dominantly sub‐aqueous, as represented by the sub‐horizontal and biostromal reed travertine facies, to dominantly sub‐aerial in a thin water film, resulting in the cascade, waterfall and biohermal reed travertine facies. A general progradation of the travertine mound is indicated by the occurrence of stacked waterfall travertines. This results in sigmoidal clinoforms inside a general mound boundary configuration. Strontium and oxygen‐carbon isotope signatures of the travertines point to a mixing mechanism of palaeofluids with deeply originated, heavy carbon CO2 with lighter carbon CO2 of shallow origin. These deposits can thus be considered as endogenic travertines. Carbonates of the Lycian Nappes acted as main parent carbon source rocks. The relative contribution of the lighter carbon isotopes is most likely to have originated from organic matter or soil CO2. This study provides a unique three‐dimensional insight into the Ballık travertine architecture that potentially can be used as an analogue for subsurface travertine reservoirs worldwide and illustrates the importance of the combined use of δ13C and 87Sr/86Sr signatures in the delineation of the CO2‐origin of travertine precipitating waters.
Cryptosporidium infection after renal transplantation in an endemic area
Authors: Bhadauria D. , Goel A. , Kaul A. , Sharma R.K. , Gupta A. , Ruhela V. , Gupta A. , Vardhan H. , Prasad N.
Published: January 2015

Background

Cryptosporidium is one of the common causes of infective diarrhea in post‐transplant patients in endemic areas. However, data are limited on Cryptosporidium infection in recipients of solid organ transplantation. The aim of this study was to determine the incidence, disease manifestation, management, and outcome of Cryptosporidium infection in living‐donor renal transplant recipients (RTR).

Methods

We performed a detailed retrospective review of the data on all RTR who had diarrheal illness requiring evaluation and hospitalization, and Cryptosporidium infection.

Results

During the study period, 119/1235 (8.98%) RTR developed diarrhea, and Cryptosporidium was found in 34/119 (28.5%). Nine of 680 (1.3%) patients were on a cyclosporine (CSA)‐based regimen, and 25/643 (3.8%) patients were on a tacrolimus (Tac)‐based regimen. The relative risk of developing Cryptosporidium infection was lower on the CSA‐based regimen, compared with the Tac‐based regimen (odds ratio [OR]: 0.35, 95% confidence interval [CI]: 0.17–0.72, P = 0.003). Twelve of the 34 patients had acute graft dysfunction, mainly caused by combined Tac toxicity and dehydration. Mean serum creatinine and trough Tac level were 2.04 ± 0.65 mg/dL and 8.24 ± 1.19 ng/dL, respectively. Nitazoxanide alone was used in 13 patients, and nitazoxanide in combination with fluoroquinolone in 21 patients, with duration of treatment ranging from 16 to 60 days. Tac was changed to CSA in 8/11 patients. The clearance of cysts and response to nitazoxanide alone were significantly lower, compared with combination therapy (61.53% vs. 95.23%, P = 0.01, 38.46 vs. 85.71%, P = 0.004, respectively). The OR for cyst clearance and response was also significantly lower with nitazoxanide alone, in comparison with combination therapy (OR: 0.65, 95% CI: 0.34–0.92, P = 0.01, OR: 0.45, 95% CI: 0.21–0.81, respectively). Four (16%) of 24 patients with response had relapse.

Conclusion

Patients with Tac and mycophenolate mofetil combination therapy had a significantly high risk of Cryptosporidium infection. Cryptosporidial infection may require prolonged nitazoxanide therapy, either alone or in combination, with or without reduction in immunosuppression.
Practice variation in Aspergillus prophylaxis and treatment among lung transplant centers: a national survey
Authors: He S.Y. , Makhzoumi Z.H. , Singer J.P. , Chin‐Hong P.V. , Arron S.T.
Published: January 2015

Background

Fungal infections remain a substantial cause of mortality in lung transplant (LTx) recipients, yet no comprehensive consensus guidelines have been established for antifungal prophylaxis and treatment of Aspergillus infection in these patients.

Methods

A cross‐sectional study surveyed the directors from 27 of 64 (45.5%) active LTx centers in the United States to examine clinical practice variations in Aspergillus prophylaxis and treatment of colonization and invasive aspergillosis (IA) in LTx recipients.

Results

Antifungal prophylaxis increased from 52.3% in 2011 to 77.8% in 2013, with the most common agent being inhaled amphotericin B (61.9%), followed by oral voriconazole (51.9%). A total of 74.1% of centers treat Aspergillus airway colonization, with 80.0% of centers using oral voriconazole. All centers treat IA, with 92.6% using oral voriconazole. The duration of Aspergillus prophylaxis and treatment of colonization or IA varied widely across centers from 3 months to >1 year. A total of 51.9% of centers reported internal practice variations in the treatment of IA. Factors guiding treatment decisions included microbiologic culture and sensitivity (74.1%), ease of administration (59.3%), interaction with other medications (55.5%), side effect profile (51.8%), and center guidelines (48.1%). Although 85.2% of LTx centers recommended routine skin cancer screening for LTx recipients, only 44.4% of LTx centers reported having a dedicated transplant dermatologist.

Conclusion

Most active US LTx centers currently employ antifungal prophylaxis and treat Aspergillus colonization and IA, although choice of agent, route of administration, and duration of therapy across and within centers continue to differ substantially. The number of transplant dermatologists available among US LTx centers is limited. Overall, a strong need exists for more comprehensive consensus guidelines to direct antifungal prophylaxis and treatment of Aspergillus infection in LTx recipients.
Safety and tolerability of clofazimine as salvage therapy for atypical mycobacterial infection in solid organ transplant recipients
Authors: Cariello P.F. , Kwak E.J. , Abdel‐Massih R.C. , Silveira F.P.
Published: January 2015

Background

The treatment of Mycobacterium avium complex (MAC) requires prolonged, multidrug therapy, which is often not well tolerated. In solid organ transplant (SOT) recipients, drug–drug interactions complicate treatment further. Failure or intolerance requires the use of salvage regimens, and clofazimine is one of the drugs that can be used. No data are available on the safety and tolerability of clofazimine for the treatment of MAC in SOT recipients.

Methods

Retrospective review of all SOT recipients treated for MAC infection with clofazimine at a large transplant center between 2006 and 2013.

Results

Five SOT recipients received clofazimine as salvage therapy. Transplanted organs were lungs in 3 patients, and kidney and liver in 1 patient each. Infection was diagnosed at a median of 22 months (range 4–57) post transplant. Sites of infection were the lungs in 2 patients, and septic arthritis, mesenteric, and disseminated disease in 1 patient each. All patients received standard anti‐MAC therapy for a median of 26 weeks (range 18–45) before starting clofazimine. Indications for use of clofazimine included a lack of response to previous therapy (3 patients), and poor tolerance of other regimens (3 patients). All patients received at least 2 additional drugs besides clofazimine. Median duration of clofazimine‐containing regimen was 8 months (range 2–18). Clofazimine was discontinued because of gastrointestinal intolerance in 1 of the 5 patients. The most common adverse event from clofazimine was skin discoloration, in 60% of patients. No hepatotoxicity or hematologic toxicity occurred. Microbiological clearance and resolution of clinical disease was documented in 2 of 5 patients; and 2 of the 5 patients died of other causes while on therapy.

Conclusions

Clofazimine appears safe and may be considered as a salvage therapeutic option in SOT recipients with MAC infection who are intolerant or unresponsive to standard therapy. The small sample size does not allow conclusions regarding efficacy.
Cerebral toxoplasmosis in an adolescent post allogeneic hematopoietic stem cell transplantation: successful outcome by antiprotozoal chemotherapy and CD4+ T‐lymphocyte recovery
Authors: Kerl K. , Ehlert K. , Brentrup A. , Schiborr M. , Keyvani K. , Becker K. , Rossig C. , Groll A.H.
Published: January 2015

Toxoplasmosis is a rare opportunistic infection in pediatric allogeneic hematopoietic stem cell transplant (allo‐HSCT) recipients and associated with severe T‐cell deficiency. Here, we report the successful management of cerebral toxoplasmosis in a 15‐year‐old adolescent 4 months post allo‐HSCT for non‐Hodgkin lymphoma through rapid invasive diagnostics, long‐term antiprotozoal chemotherapy, and an hematopoietic stem cell boost for persistently poor graft function. While supportive care and antiprotozoal chemotherapy achieved stabilization, definite improvement only occurred following recovery of CD4+ T lymphocytes to >100 cells/μL. At 5 years after the diagnosis of toxoplasmosis, the patient is in continuing remission with normalized clinical and imaging findings.
The role of SDF‐1 in homing of human adipose‐derived stem cells
Authors: Stuermer Ewa K. , Lipenksy Alexandra , Thamm Oliver , Neugebauer Edmund , Schaefer Nadine , Fuchs Paul , Bouillon Bertil , Koenen Paola
Published: January 2015

One of the putative pathophysiological mechanisms of chronic wounds is a disturbed homing of stem cells. In this project, the stromal cell‐derived factor 1 (SDF‐1)/C‐X‐C chemokine receptor (CXCR) 4 and SDF‐1/CXCR7 pathway were focused in human adipose‐derived stem cells (ASCs). ASCs were incubated with acute (AWF) or chronic wound fluid (CWF) to analyze their effects by quantitative real‐time polymerase chain reaction (SDF‐1, CXCR4, CXCR7, TIMP3), enzyme‐linked immunosorbent assay (SDF‐1 in WFs and supernatant), and transwell migration assay with/without antagonization. Whereas SDF‐1 amounted 73.5 pg/mL in AWF, it could not be detected in CWF. Incubation with AWF led to a significant enhancement (129.7 pg/mL vs. 95.5 pg/mL), whereas CWF resulted in a significant reduction (30 pg/mL vs. 95.5 pg/mL) of SDF‐1 in ASC supernatant. The SDF‐1 receptor CXCR7 was detected on ASCs. AWF but not CWF significantly induced ASC migration, which was inhibited by CXCR4 and CXCR7 antagonists. Expressions of SDF‐1, CXCR4, and CXCR7 were significantly stimulated by AWF while TIMP3 expression was reduced. In conclusion, an uncontrolled inflammation in the chronic wound environment, indicated by a reduced SDF‐1 expression, resulted in a decreased ASC migration. A disturbed SDF‐1/CXCR4 as well as SDF‐1/CXCR7 pathway seems to play an important role in the impaired healing of chronic wounds.
Recent Advances in Physics of Fluid Parametric Sloshing and Related Problems
Authors: Ibrahim Raouf A.
Published: January 2015

Liquid parametric sloshing, known also as Faraday waves, has been a long standing subject of interest. The development of the theory of Faraday waves has witnessed a number of controversies regarding the analytical treatment of sloshing modal equations and modes competition. One of the significant contributions is that the energy is transferred from lower to higher harmonics and the nonlinear coupling generated static components in the temporal Fourier spectrum, leading to a contribution of a nonoscillating permanent sinusoidal deformed surface state. This article presents an overview of different problems of Faraday waves. These include the boundary value problem of liquid parametric sloshing, the influence of damping and surfactants on the stability and response of the free surface, the weakly nonlinear parametric and autoparametric sloshing dynamics, and breaking waves under high parametric excitation level. An overview of the physics of Faraday wave competition together with pattern formation under single-, two-, three-, and multifrequency parametric excitation will be presented. Significant effort was made in order to understand and predict the pattern selection using analytical and numerical tools. Mechanisms for selecting the main frequency responses that are different from the first subharmonic one were identified in the literature. Nontraditional sources of parametric excitation and Faraday waves of ferromagnetic films and ferrofluids will be briefly discussed. Under random parametric excitation and g-jitter, the behavior of Faraday waves is described in terms of stochastic stability modes and spectral density function.
Epigenetic Changes During Mechanically Induced Osteogenic Lineage Commitment
Authors: Chen Julia C. , Chua Mardonn , Bellon Raymond B. , Jacobs Christopher R.
Published: January 2015

Osteogenic lineage commitment is often evaluated by analyzing gene expression. However, many genes are transiently expressed during differentiation. The availability of genes for expression is influenced by epigenetic state, which affects the heterochromatin structure. DNA methylation, a form of epigenetic regulation, is stable and heritable. Therefore, analyzing methylation status may be less temporally dependent and more informative for evaluating lineage commitment. Here we analyzed the effect of mechanical stimulation on osteogenic differentiation by applying fluid shear stress for 24 hr to osteocytes and then applying the osteocyte-conditioned medium (CM) to progenitor cells. We analyzed gene expression and changes in DNA methylation after 24 hr of exposure to the CM using quantitative real-time polymerase chain reaction and bisulfite sequencing. With fluid shear stress stimulation, methylation decreased for both adipogenic and osteogenic markers, which typically increases availability of genes for expression. After only 24 hr of exposure to CM, we also observed increases in expression of later osteogenic markers that are typically observed to increase after seven days or more with biochemical induction. However, we observed a decrease or no change in early osteogenic markers and decreases in adipogenic gene expression. Treatment of a demethylating agent produced an increase in all genes. The results indicate that fluid shear stress stimulation rapidly promotes the availability of genes for expression, but also specifically increases gene expression of later osteogenic markers.
A Framework for Explicating Formal Geometrical and Dimensional Tolerances Schema From Manufacturing Process Plans for Three-Dimensional Conformance Analysis
Authors: Haghighi Payam , Mohan Prashant , Shah Jami J. , Davidson Joseph K.
Published: January 2015

A process plan is an instruction set for the manufacture of parts generated from detailed design drawings or computer-aided design (CAD) models. While these plans are highly detailed about machines, tools, fixtures, and operation parameters, tolerances typically show up in less formal manner, if at all. It is not uncommon to see only dimensional plus/minus values on rough sketches accompanying the instructions. On the other hand, design drawings use standard geometrical and dimensional tolerances (GD&T) symbols with datums and datum reference frames (DRFs) clearly specified. This is not to say that process planners do not consider tolerances; they are implied by way of choices of fixtures, tools, machines, and operations. Process planners do tolerance charting in converting design tolerances to the manufacturing datum flow based on operation sequence, but the resulting plans cannot be audited for conformance to design specification. In this paper, we present a framework for explicating the GD&T schema implied by machining process plans. The first step is to derive DRFs from the fixturing method in each setup. Then, basic dimensions for features machined in the setup are determined with respect to the extracted DRF. Using shop data for the machines and operations involved, the range of possible geometric variations are estimated for each type (form, size, orientation, and position). The sequence of operations determines the datum flow chain. Once we have a formal manufacturing GD&T schema, we can analyze and compare it to design specification using the T-map math model.
Nonlinear Analytical Modeling and Characteristic Analysis of a Class of Compound Multibeam Parallelogram Mechanisms
Authors: Hao Guangbo , Li Haiyang
Published: January 2015

This paper deals with nonlinear analytical models of a class of compound multibeam parallelogram mechanisms (CMPMs) along with the static characteristic analysis. The CMPM is composed of multiple compound basic parallelogram mechanisms (CBPMs) in an embedded parallel arrangement. First, nonlinear analytical models for the CBPM are derived using the free-body diagram method through appropriate approximation strategies. The nonlinear analytical models of the CMPM are then derived based on the modeling results of the CBPM. Nonlinear finite element analysis (FEA) comparisons, experimental testing, and detailed stiffness analysis for the CBPM are finally carried out. It is shown that the analytical primary motion model agrees with both the FEA model and the testing result very well but the analytical parasitic motion model deviates from the FEA model over the large primary motion/force. It is also shown from the analytical characteristic analysis that the primary translational stiffness increases with the primary motion but the parasitic motion stiffness decreases with the primary motion, and the stiffness ratio of the parasitic motion stiffness to the primary translation stiffness also decreases with the primary motion. It is found that the larger the beam slenderness ratio is, the larger the stiffness or stiffness ratio is, and the more apparent the change of the stiffness or stiffness ratio is. The varied stiffness ratio indicates the mobility change of the CBPM.
Quantifying Product Favorability and Extracting Notable Product Features Using Large Scale Social Media Data
Authors: Tuarob Suppawong , Tucker Conrad S.
Published: January 2015

Some of the challenges that designers face in getting broad external input from customers during and after product launch include geographic limitations and the need for physical interaction with the design artifact(s). Having to conduct such user-based studies would require huge amounts of time and financial resources. In the past decade, social media has emerged as an increasingly important medium of communication and information sharing. Being able to mine and harness product-relevant knowledge within such a massive, readily accessible collection of data would give designers an alternative way to learn customers' preferences in a timely and cost-effective manner. In this paper, we propose a data mining driven methodology that identifies product features and associated customer opinions favorably received in the market space which can then be integrated into the design of next generation products. Two unique product domains (smartphones and automobiles) are investigated to validate the proposed methodology and establish social media data as a viable source of large scale, heterogeneous data relevant to next generation product design and development. We demonstrate in our case studies that incorporating suggested features into next generation products can result in favorable sentiment from social media users.
The Effect of Cryogenic Treatment on Microstructure and Mechanical Response of AISI D3 Tool Steel Punches
Authors: Arslan Y. , Uygur I. , Jazdzewska A.
Published: January 2015

Recently, deep cryogenic treatment is performed to improve the mechanical responses (wear, hardness, fatigue, and thermal conductivity) of various steel components. Researchers have tried to evaluate the eco-friendly and nontoxic process to optimize the parameters. Cold-shearing punches used to manufacture various holes that undergo severe impact loading and wear in the metal forming process. This study concerns the effect of soaking time (24 hr, 36 hr) at liquid nitrogen temperature (−145 °C) during the deep cryogenic treatment on the microstructural changes which are carbide distribution and retained austenite percentage of AISI D3 tool steel punches. It was shown that the deep cryogenic treatment reduces retained austenite and enhanced uniform distribution of carbide particles. It is concluded that for significantly improved punch life and performance, it is an advisable application of 36 hr deep cryogenic treatment.
In-situ nitrogen plasma passivation of Al2O3/GaN interface states
Authors: Son Junwoo , Chobpattana Varistha , McSkimming Brian M. , Stemmer Susanne
Published: January 2015

The authors report on in-situ nitrogen plasma cleaning, consisting of alternating cycles of nitrogen plasma and trimethylaluminum prior to the dielectric deposition, as an effective method to passivate Al2O3/GaN interface states. The nitrogen plasma pretreatment reduces the frequency dispersion in capacitance–voltage and the conductance peak in conductance–voltage measurements, compared to interfaces cleaned with a hydrogen plasma pretreatment. It is shown that the decrease of the trap density (Dit) below the conduction band is correlated with the suppression of Ga-O bonding and the formation of an aluminum oxynitride interfacial layer.
Does interprofessional simulation increase self-efficacy: a comparative study
Authors: Watters Colm , Reedy Gabriel , Ross Alastair , Morgan Nicola J , Handslip Rhodri , Jaye Peter
Published: January 2015

Objectives

In this work, we have compared uniprofessional and interprofessional versions of a simulation education intervention, in an attempt to understand more about whether it improves trainees’ self-efficacy.

Background

Interprofessionalism has been climbing the healthcare agenda for over 50 years. Simulation education attempts to create an environment for healthcare professionals to learn, without potential safety risks for patients. Integrating simulation and interprofessional education can provide benefits to individual learners.

Setting

The intervention took place in a high-fidelity simulation facility located on the campus of a large urban hospital. The centre provides educational activities for an Academic Health Sciences Centre. Approximately 2500 staff are trained at the centre each year.

Participants

One hundred and fifteen nurses and midwives along with 156 doctors, all within the early years of their postgraduate experience participated. All were included on the basis of their ongoing postgraduate education.

Methods

Each course was a one-day simulation course incorporating five clinical and one communication scenarios. After each a facilitated debriefing took place. A mixed methods approach utilised precourse and postcourse questionnaires measuring self-efficacy in managing emergency situations, communication, teamwork and leadership.

Results

Thematic analysis of qualitative data showed improvements in communication/teamwork and leadership, for doctors and nurses undergoing simulation training. These findings were confirmed by statistical analysis showing that confidence ratings improved in nurses and doctors overall (p<0.001). Improved outcomes from baseline were observed for interprofessional versus uniprofessional trained nurses (n=115; p<0.001). Postcourse ratings for doctors showed that interprofessional training was significantly associated with better final outcomes for a communication/teamwork dimension (n=156; p<0.05).

Conclusions

This study provides evidence that simulation training enhances participants’ self-efficacy in clinical situations. It also leads to increases in their perceived abilities relating to communication/teamwork and leadership/management of clinical scenarios. Interprofessional training showed increased positive effects on self-efficacy for nurses and doctors.
An examination of the nutrient content and on-package marketing of novel beverages
Authors: Dachner Naomi , Mendelson Rena , Sacco Jocelyn , Tarasuk Valerie
Published: January 2015

Changing regulatory approaches to fortification in Canada have enabled the expansion of the novel beverage market, but the nutritional implications of these new products are poorly understood. This study assessed the micronutrient composition of energy drinks, vitamin waters, and novel juices sold in Canadian supermarkets, and critically examined their on-package marketing at 2 time points: 2010–2011, when they were regulated as Natural Health Products, and 2014, when they fell under food regulations. We examined changes in micronutrient composition and on-package marketing among a sample of novel beverages (n = 46) over time, compared micronutrient content with Dietary Reference Intakes and the results of the 2004 Canadian Community Health Survey to assess potential benefits, and conducted a content analysis of product labels. The median number of nutrients per product was 4.5, with vitamins B6, B12, C, and niacin most commonly added. Almost every beverage provided at least 1 nutrient in excess of requirements, and most contained 3 or more nutrients at such levels. With the exception of vitamin C, there was no discernible prevalence of inadequacy among young Canadian adults for the nutrients. Product labels promoted performance and emotional benefits related to nutrient formulations that go beyond conventional nutritional science. Label graphics continued to communicate these attributes even after reformatting to comply with food regulations. In contrast with the on-package marketing of novel beverages, there is little evidence that consumers stand to benefit from the micronutrients most commonly found in these products.
Stratigraphy, thickness, tectonic environment, and economic implications of the giant Suwar – Wadi Qutabah layered mafic complex in northwestern Yemen
Authors: Venturi Chantal M. , Greenough John D. , Ulansky Chad , Fipke Charles
Published: January 2015

The Wadi Qutabah layered mafic intrusion in northwestern Yemen, considered part of a giant (>250 km2), Neoproterozoic (∼638.5 Ma) intrusion referred to as the Suwar – Wadi Qutabah Complex, has significant potential for economic platinum-group element and Ni–Cu–Co mineralization. A search for platinum-group element mineralization at Wadi Qutabah yielded cores from 14 drillholes along two east and west lines. Stratigraphically, they reveal ∼500 m of interlayered norites with subordinate gabbros, anorthosites, pyroxenites, and massive sulphide layers showing modal and cryptic layering that can be correlated between individual holes and between the east and west areas. Energy dispersive spectrometry major element analyses on mineral phases show gradual upward changes in plagioclase composition from An52 (lowest level drilled) to An44, and En61 to En57 in orthopyroxene, up to a distinctive, ilmenite-rich unit termed 5a (augite norite). Above 5a, minerals show a dramatic shift to more primitive An57 and En69 compositions. The gradual changes are typical of layered mafic intrusions and reflect progressive crystallization of magma upward. The dramatic changes, such as above 5a, are also common and reflect magma chamber recharge. In addition to the 500 m reported here, mineral exploration data from more-mafic rocks at Suwar suggest 400 m of layered rocks below those at Wadi Qutabah (total 900 m). A regression analysis plot of the cumulus mineral (plagioclase and orthopyroxene) compositional change versus thickness for seven well-known, giant, layered mafic intrusions suggests that the Suwar – Wadi Qutabah Complex is >2 km thick and one of the largest (thickness and area) intrusions on Earth. Comparison of the stratigraphy and mineral compositions at Wadi Qutabah with intrusions bearing PGE deposits suggests prospective areas for mineral exploration to the north and south of the study area. Recent reviews identify many similar-aged, mafic–ultramafic intrusive complexes across the Arabian–Nubian Shield. The large size of the Suwar – Wadi Qutabah Complex, its noritic composition, and subcontinental lithospheric mantle signature are characteristics typical of mafic rocks formed in extension-related, continental rift settings. Thus, the Suwar – Wadi Qutabah Complex may be part of a previously unrecognized large igneous province associated with a late Proterozoic magmatic event and preserved in what is today, the Arabian Shield.