bluuebunny/crossref_metadata_2025 huggingface dataset:
Pediatric Orthopaedic Surgeons Dissatisfied in On-Call Practices Despite Improving Call Conditions. The 2015 POSNA Membership Survey Regarding Trauma Care
Authors: Lind Allison , Latz Kevin , Sinclair Mark R. , Williams David D.
Published: November 2017

Background:

To examine the current trends in trauma call coverage of pediatric orthopaedic surgeons in North America and to identify predictors of surgeon on-call satisfaction.

Methods:

In 2015, ∼1200 active members of the Pediatric Orthopaedic Society of North America (POSNA) were surveyed regarding emergency room on-call practices. In total, 410 members completed the survey with a response rate of 35%. Information collected included call frequency, practice setting and satisfaction with call. This information was analyzed and compared with the 2006 and 2010 trauma call surveys of Pediatric Orthopaedic Society of North America membership using 2 sample difference in proportion, χ2 tests for trend and the Fisher exact tests. Logistic regression analyses were used to identify predictors of call satisfaction among pediatric orthopaedic surgeons.

Results:

In total, 47% of pediatric orthopaedic surgeons had access to a designated trauma operating room in 2015, up from 39% in 2010 and 24% in 2006. In total, 43% of pediatric orthopaedic surgeons currently receive a stipend for taking call, up from 35% in 2010 and 28% in 2006. Although 83% of pediatric orthopaedic surgeons believe that trauma call is an integral part of their practice, only 53% are satisfied with their call experience. Controlling for covariates, believing that call is integral to one’s practice doubles odds of call satisfaction. Having resident or fellow support and being financially compensated for orthopaedic trauma call also increases one’s odds of satisfaction. The odds of being satisfied with call decrease by 7% for each year of increase in age of the surgeon.

Conclusions:

Access to a designated trauma operating room and financial compensation for call coverage have steadily increased over the past decade. A sizable majority of respondents continue to believe that trauma care is an integral part of being a pediatric orthopedist. Despite this, 47% of respondents remain dissatisfied with their trauma call arrangements. The age and attitude of the individual surgeon and extent of hospital support predict satisfaction of surgeons providing trauma coverage.

Level of Evidence:

Level V—economic and decision analysis.
Characterization of American Football Injuries in Children and Adolescents
Authors: Smith Patrick J. , Hollins Anthony M. , Sawyer Jeffrey R. , Spence David D. , Outlaw Shane , Kelly Derek M.
Published: November 2017

Background:

As a collision sport, football carries a significant risk of injury, as indicated by the large number of pediatric football-related injuries seen in emergency departments. There is little information in the medical literature focusing on the age-related injury patterns of this sport. Our purpose was to evaluate the types of football-related injuries that occur in children and adolescents and assess which patient characteristics, if any, affect injury pattern.

Methods:

Retrospective chart review was performed of football-related injuries treated at a level 1 pediatric referral hospital emergency department and surrounding urgent care clinics between January 2010 and January 2014. Patients with e-codes for tackle football selected from the electronic medical record were divided into 4 age groups: younger than 8 years old, 8 to 11, 12 to 14, and 15 to 18 years. Data collected included diagnosis codes, procedure codes, and hospital admission status.

Results:

Review identified 1494 patients with 1664 football-related injuries, including 596 appendicular skeleton fractures, 310 sprains, 335 contusions, 170 closed head injuries, 62 dislocations, 9 spinal cord injuries, and 14 solid organ injuries. There were 646 (43.2%) athletes with upper extremity injuries and 487 (32.6%) with injuries to the lower extremity. Hospital admissions were required in 109 (7.3%) patients. Fracture was the most common injury in all four patient age groups, but occurred at a lower rate in the 15 to 18 years old age group. The rate of soft tissue injury was higher in the 15 to 18 years old age group. The rate of closed head injury, which included concussions, was highest in the younger than 8 years old age group.

Conclusions:

Age does influence the rates of certain football-related injuries in children and adolescents. Fractures decrease with increasing age, while the rate of soft tissue trauma increases with increasing age. Younger patients (younger than 8 y old) trended toward higher rates of closed head injury compared with other age groups. Awareness of these variations in injury patterns based on age could result in age-specific changes in equipment, training, and safety rules.

Level of Evidence:

Level IV—case series.
End Vertebra Versus Apical Vertebra: Where Are We More Likely to Misplace in Spine Deformity?
Authors: Sarwahi Vishal , Wendolowski Stephen F. , Lo Yungtai , Thornhill Beverly , Amaral Terry
Published: November 2017

Background Data:

Pedicle screws placement remains technically demanding. The thoracic curve apex is considerably difficult due to its unique morphology and severe rotation. In comparison the upper end vertebrae have smaller pedicles and limited soft tissue exposure. This study seeks to evaluate the likelihood of screw misplacement at the end vertebra and apex.

Methods:

A retrospective review of preoperative and postoperative computed tomographic (CT) scans of spinal deformity patients who underwent posterior spinal fusion with pedicle screw constructs between 2004 and 2011 was performed. Pedicles located at the upper instrumented vertebra (UIV) and lower instrumented vertebra (LIV), and the major and minor apices were evaluated. Pedicle morphology was studied on preoperative CT and screw placement on postoperative CT.

Results:

In total, 188 patients met the inclusion criteria, 172 had preoperative CT scans and 133 had postoperative CT scans. The UIV had a significantly lower percentage of normal pedicles (type A) compared with apex major, apex minor, or LIV (59.1% vs. 76.1% vs. 77.3% vs. 98.7%; P<0.001). UIV had significantly the lowest percentage of normal normally placed screws compared with LIV, apex major, or apex minor (69.4% vs. 97.3% vs. 87.6% vs. 92.1%; P<0.001). In a logistic regression adjusted for preoperative Cobb angles, UIV was more likely to have screws misplaced (odds ratio =7.56; 95% confidence interval, 4.01-14.30; P<0.001) and abnormal pedicles (odds ratio=2.81; 95% confidence interval, 1.52-5.19; P=0.001) compared with any other location studied. In abnormal pedicles, 41 (39.8%) of the 103 UIV screws were misplaced, whereas 10 (16.4%) of the 61 apex major, apex minor, or LIV screws were misplaced (P=0.007).

Conclusions:

The UIV presents more of a risk for pedicle screw misplacement and abnormal morphology when compared with LIV and apical vertebra. We believe these findings can aid in the surgeon’s preoperative and intraoperative management to ensure increased success in accurate and safe pedicle screw placement.

Level of Evidence:

Level III.
Outcome of Guillain–Barré Syndrome in Tertiary Care Centers in Thailand
Authors: Kulkantrakorn Kongkiat , Sukphulloprat Puchit
Published: November 2017

Background:

Guillain–Barré syndrome (GBS), a common acute polyneuropathy, is seen worldwide with significant morbidity and mortality. GBS consists of a number of subtypes.

Objective:

The aim of this study is to identify clinical characteristics, electrophysiologic changes, clinical course, treatment, and outcome of GBS in Thailand.

Material and Methods:

Retrospective study of GBS patients aged 15 years or older, admitted to Thammasat University Hospital and Bangkok Hospital Medical Center between January 1, 2009 and November 30, 2014.

Results:

Thirty patients were found. Demographic characteristics were collected and described as follows; 60% male sex; average age 54 years; Asian 60%, European 20%, and others 10%. Disease subtypes consist of acute inflammatory demyelinating polyneuropathy 66.7%, acute motor axonal neuropathy 10%, and others 23.3%. Average GBS disability score at admission was 2.9. Immunotherapy was intravenous immunoglobulin 83.3%, plasma exchange 3.3%, and steroid 3.3%. Average length of stay was 14.2 days; assisted ventilation rate was 13.3%. After the average of 1-year follow-up, average GBS disability score was 1.8, good outcome (score <3) was 63.3% and no death.

Conclusions:

Our study suggests that most GBS patients in Thailand are acute inflammatory demyelinating polyradiculoneuropathy (AIDP) subtype and have a good outcome. Predictors of severe disability are older age, previous diarrhea, autonomic disturbances, severe limb or bulbar weakness at admission, or onset of treatment.
The Influence of Exercise on Cardiovascular Health in Sedentary Adults With Human Immunodeficiency Virus
Authors: Webel Allison R. , Perazzo Joseph , Longenecker Christopher T. , Jenkins Trevor , Sattar Abdus , Rodriguez Margaret , Schreiner Nate , Josephson Richard A.
Published: November 2017

Background:

Lifestyle physical activity (ie, moderate physical activity during routine daily activities most days of the week) may benefit human immunodeficiency virus (HIV)–positive adults who are at high risk for cardiovascular disease.

Objective:

The aims of this study were to describe lifestyle physical activity patterns in HIV-positive adults and to examine the influence of lifestyle physical activity on markers of cardiovascular health. Our secondary objective was to compare these relationships between HIV-positive adults and well-matched HIV-uninfected adults.

Methods:

A total of 109 HIV-positive adults and 20 control participants wore an ActiGraph accelerometer, completed a maximal graded cardiopulmonary exercise test, completed a coronary computed tomography, completed anthropomorphic measures, and had lipids and measures of insulin resistance measured from peripheral blood.

Results:

Participants (N = 129) had a mean age of 52 ± 7.3 years, 64% were male (n = 82), and 88% were African American (n = 112). On average, HIV-positive participants engaged in 33 minutes of moderate-to-vigorous physical activity per day (interquartile range, 17–55 minutes) compared with 48 minutes in controls (interquartile range, 30–62 minutes, P = .05). Human immunodeficiency virus–positive adults had poor fitness (peak oxygen uptake [VO2], 16.8 ± 5.2 mL/min per kg; and a ventilatory efficiency, 33.1 [4.6]). A marker of HIV disease (current CD4+ T cell) was associated with reduced peak VO2 (r = −0.20, P < .05) and increased insulin resistance (r = 0.25, P < .01) but not with physical activity or other markers of cardiovascular health (P ≥ 0.05). After controlling for age, gender, body mass index, and HIV status, physical activity was not significantly associated with peak VO2 or ventilatory efficiency.

Conclusion:

Human immunodeficiency virus–positive adults have poor physical activity patterns and diminished cardiovascular health. Future longitudinal studies should examine whether HIV infection blunts the beneficial effects of physical activity on cardiovascular health.
Transintestinal cholesterol excretion in humans
Authors: Reeskamp Laurens F. , Meessen Emma C.E. , Groen Albert K.
Published: November 2017

Purpose of review

To discuss recent insights into the measurement and cellular basis of transintestinal cholesterol excretion (TICE) in humans and to explore TICE as a therapeutic target for increasing reverse cholesterol transport.

Recent findings

TICE is the net effect of cholesterol excretion by the enterocyte into the intestinal lumen and is the balance between input and output fluxes through the enterocytes. These fluxes are: cholesterol excretion into the intestinal lumen mainly via ATP-binding cassette (ABC) G5/8, cholesterol absorption from the intestine by Niemann-Pick C1 like protein 1, the uptake of plasma lipoproteins by enterocytes at the basolateral membrane, and the excretion of cholesterol in chylomicrons into the lymph. Multiple studies have shown that TICE contributes to fecal neutral sterol (FNS) excretion in humans. TICE can be targeted with plant sterols, liver X receptor agonists, bile acids, ezetimibe, and proprotein convertase subtilisin/kexin type 9 inhibitors.

TICE contributes significantly to FNS excretion in humans, independently of the biliary pathway. Knowledge about its underlying cellular mechanisms surges through in-vivo and in-vitro studies in mice and humans. TICE might be an interesting therapeutic target for increasing cholesterol disposal with the feces. Albeit multiple therapeutic options are available, studies showing clinical benefit are still needed.
Adolescents' Experiences of Scoliosis Surgery and the Trajectory of Self-Reported Pain
Authors: Rullander Anna-Clara , Lundström Mats , Östlund Ulrika , Lindh Viveca
Published: November 2017

Scoliosis surgery for adolescents is a major surgery with a difficult recovery. In this study, a mixed-methods design was used to broaden the scope of adolescents' experiences of surgery for idiopathic scoliosis and the trajectory of self-reported pain during the hospital stay and through the first 6 months of recovery at home. Self-reports of pain, diaries, and interviews were analyzed separately. The results were then integrated with each other. The trajectory of self-reported pain varied hugely between individuals. Adolescents experienced physical suffering and struggled to not be overwhelmed. The adolescents described the environmental and supportive factors that enabled them to cope and how they hovered between suffering and control as they strived toward normality. This study highlights areas of potential improvement in perioperative scoliosis care in terms of nursing support and pain management.
Organizational Learning in an Orthopaedic Unit
Authors: Lyman Bret , Shaw Lindsey , Moore Carly
Published: November 2017

The purpose of this study was to explore organizational learning in an orthopaedic hospital unit. Skill in organizational learning is necessary to achieve high reliability in a dynamic healthcare environment, yet organizational learning in hospital units is not well understood. A learning history was conducted with a high-performing orthopaedic unit. Findings were interpreted in the context of a previous learning history conducted with a critical care unit. Despite contextual differences, each unit progressed through the same four developmental stages to achieve its current state of high reliability. On both units, psychological safety and a healthy work environment proved essential for developmental progression. Hospital units may progress through distinct developmental stages to achieve their desired outcomes. Psychological safety and a healthy work environment appear foundational to organizational learning in hospital units. Nursing leaders should work with team members to evaluate their unit's development and use suggested strategies to facilitate organizational learning.
Genital Wart and Human Papillomavirus Prevalence in Men in the United States From Penile Swabs: Results From National Health and Nutrition Examination Surveys
Authors: Daugherty Michael , Byler Timothy
Published: November 2017

Introduction

Human papillomavirus (HPV) is a common sexually transmitted infection in the United States that can lead to both malignant (high-risk) and benign (low-risk) findings. These low-risk findings include both genital condyloma, anal warts, and adult or juvenile papillomatosis, which are directly attributable to subtypes HPV 6 and HPV 11. We aim to estimate the prevalence of genital wart infections in men in the US population using a nationwide sample.

Methods

The NHANES database was queried for all men aged 18 to 59 years during the years 2013 to 2014. During these years, the survey included penile swabs that were tested for HPV infection from 37 subtypes using PCR. Information was also obtained regarding patient reported history of having a genital wart infection previously.

Results

A total of 1757 men had information regarding HPV DNA. Fifty-three men tested positive for HPV 6 or HPV 11 DNA. This corresponds to an estimated prevalence of 2.9% (95% confidence interval, 2.2–3.8) of men aged 18–59 years. In addition, 2.2% (95% confidence interval, 1.5–3.3) of men reported a history of genital wart infection. There was no significant association with genital HPV DNA detection with age. Increasing number of sexual partners was associated with higher rates of both genital warts and HPV 6 and HPV 11 DNA.

Conclusions

The estimated prevalence of genital HPV DNA in the US male population is 2.9%. This burden of disease could potentially be lowered with increased usage of quadrivalent and nonavalent vaccinations.
Laparoscopic Versus Open Distal Pancreatectomy: Comparative Analysis of Clinical Outcomes at a Single Institution
Authors: Jarufe Nicolás , Soto Pedro , Ahumada Vanessa , Pacheco Sergio , Salinas José , Galindo José , Bächler Jean-Phillipe , Achurra Pablo , Rebolledo Rolando , Guerra Juan F. , Briceño Eduardo , Martínez Jorge
Published: November 2017

Purpose:

Undertake a comparison between laparoscopic distal pancreatectomy (LDP) and open distal pancreatectomy (ODP) for the management of benign and malignant lesions.

Methods:

A case series study of 93 consecutive patients subjected to a distal pancreatectomy for pancreatic tumors between 2001 and 2015. In each patient, clinical and surgical characteristic, postoperative course, histopathologic examination, and survival were analyzed.

Results:

LDP was associated with significantly less operative blood loss (50 mL vs. 300 mL; P<0.01), higher spleen preservation rate (52.6% vs. 19.2%; P<0.01) and shorter hospital stay (5 d vs. 8 d; P<0.01). In patients with adenocarcinoma, survival at 1 and 5 years were 63.5% and 15.9% in the ODP group versus 66.7% and 33.3% in the LDP group (P=0.43).

Conclusions:

LDP is a safe and feasible procedure for DP resections. LDP offers advantages over ODP in terms of reduction of operative blood loss, higher spleen preservation rate, and shorter hospital stay.
Executive compensation: influence and reciprocity effects
Authors: Maloa Frans
Published: November 2017

Purpose

The purpose of this paper is to understand the effects of influence and reciprocity as the elements in the determination of executive compensation.

Design/methodology/approach

A purposive sample was drawn, which comprised of 13 respondents chosen for their expertise relating to the determination of executive compensation in state-owned enterprises (SOEs). A semi-structured interview guide was used as the data-gathering instrument. A thematic analysis technique was used for data analysis.

Findings

The findings in this study identified three themes resorting under influence as crucial in the process of determining executive compensation, namely an executive’s social capital, intellectual capital and social comparison. Two major themes emerged under reciprocity, namely the pay-performance relationship and role complexity. Finally, the political-symbolic role emerged as the main theme that described the relationship between influence and reciprocity.

Practical implications

The findings provide a more detailed description of the process involved in determining executive compensation in SOEs.

Originality/value

There has been limited if any, empirical study on the process involved in setting executive compensation. The limited focus has always been on accounting measures. Incorporating the socio-psychological view attempts to provide a more comprehensive and conclusive explanation of the process of determining executive pay in theory and practice.
Relationship between gender-sensitive practices and family support and its impact on psychological well-being of women employees in call centers in India
Authors: Verma Monica , Bhal Kanika T. , Vrat Prem
Published: November 2017

Purpose

The purpose of this paper is to examine the relationship of gender-sensitive practices and family support in predicting psychological well-being of women assessed as stress, job satisfaction, commitment and intent to leave. Using the crossover theory, it also examines how gender-sensitive practices lead to family support, which in turn leads to reduced stress leading to high satisfaction and commitment and reduced intention to leave.

Design/methodology/approach

Data were obtained from a sample of 302 women employees working in call centers in NCR, India on psychometrically sound scales.

Findings

Analysis revealed that gender-sensitive practices are positively related to family support through the mechanism of crossover. Amply supported by data, the study exhibits the complementary relationship between gender-sensitive practices and family support, and their impact on psychological well-being of women employees.

Research limitations/implications

The sample may reflect same source bias as the data are collected from a single source.

Practical implications

The implementation of effective gender-sensitive practices might invite strong family support and then, both can be a source of great happiness to women employees and can lead to reduction in stress and, hence, greater job satisfaction, commitment and lesser intent to leave.

Originality/value

Very few research exist which have taken up the issue together. So, this study is an endeavor toward understanding the relationship between gender-sensitive practices and family support and their effect on job outcomes in a novel socio-cultural environment.
A cybernetic perspective on determinability and design research
Authors: Fischer Thomas
Published: November 2017

Purpose

The scientific criterion of determinability (predictability) can be framed in realist or in constructivist terms. This can pose a challenge to design researchers who operate between scientific research (which favors a realist view of determinism/indeterminism) and design practice (which favors a constructivist view of determinability/indeterminability). This paper aims to develop a framework to navigate this challenge.

Design/methodology/approach

A critical approach to “scientific” design research is developed by examining the notion of (in)determinism, with particular attention to the observer-based projection of systemic boundaries, and the constructivist understanding of how such boundaries are constituted. This is illustrated using automata theory. A decision-making framework is then developed based on a diagram known as the epistemological triangle.

Findings

The navigation between determinism as a property of the observed, and determinability as a property of the observer follows the navigation between realist and constructivist perspectives, and thus has a bearing on the navigation of the kinds of design research distinguished by Frayling, and their implied primary evaluation criteria.

Research limitations/implications

The presented argument advocates a constructivist view, which, however, is not meant to imply a rejection of, but rather, an additional degree of freedom extending the realist view.

Originality/value

This discussion contributes to the establishment of observational determinability as observer-dependent. The proposed framework connects the navigation between deterministic observables and determining observers to the navigation between the design criteria form, meaning and utility. This may be of value within and beyond design research.
Perspective of zinc oxide based thin film transistors: a comprehensive review
Authors: Kandpal Kavindra , Gupta Navneet
Published: November 2017

Purpose

The purpose of this paper is to present a comprehensive review on development and future trends in zinc oxide thin film transistors (ZnO TFTs). This paper presents the development of TFT technology starting from amorphous silicon, poly-Si to ZnO TFTs. This paper also discusses about transport and device modeling of ZnO TFT and provides a comparative analysis with other TFTs on the basis of performance parameters.

Design/methodology/approach

It highlights the need of high–k dielectrics for low leakage and low threshold voltage in ZnO TFTs. This paper also explains the effect of grain boundaries, trap densities and threshold voltage shift on the performance of ZnO TFT. Moreover, it also addresses the challenges like requirement of stable p-type ZnO semiconductor for various electronic applications and high value of ZnO mobility to meet growing demand of high-definition light emitting diode TV (HD-LED TV).

Findings

This review will motivate the readers to further investigate the conduction mechanism, best alternate for gate-dielectric and the deposition technique optimization for the enhancement of the performance of ZnO TFTs.

Originality/value

This is a literature review. The technological evolution of TFT in general and ZnO TFT in particular is presented in this paper.
The bounds of liberty: lessons learnt from treating a man with alcohol use disorder, autism and learning disability
Authors: Drake Alexander C.L. , Hank Dietmar , Edwards Richard , Ensum Ian , Bateman Lee
Published: November 2017

Purpose

A man in his 40s with alcohol use disorder, learning disability and autism was referred to the learning disability team due to anxiety and low mood. He had been abstinent from alcohol for ten years prior to a recent relapse. The purpose of this paper is to describe his case.

Design/methodology/approach

Treatment was person centred, followed standard practice for clients with alcohol use disorder and targeted harm minimisation. Initially, alcohol consumption reduced; however, at month three, he relapsed. Thereafter, he was repeatedly admitted to inpatient settings, drank excessively and engaged in risky behaviours.

Findings

Conventional approaches to treating alcohol dependence may not be entirely appropriate for this client group. The client’s alcohol consumption was only curtailed with the use of restrictions to his liberty agreed by him and incorporated into his tenancy agreement.

Originality/value

To the best of the authors’ knowledge, this is the first paper to discuss issues pertaining to people with co-occurring learning disability, autism and alcohol dependence. The authors discuss the use of restrictions, reasonable adjustments and policy issues relevant to treating this complex client group.
CQC inspection reports for acute NHS trusts: are there relationships between the comments in inspection reports regarding people with learning disabilities and CQC hospital/trust ratings?
Authors: Baines Susannah , Hatton Chris
Published: November 2017

Purpose

People with learning disabilities are at risk of poor health and premature death. Due to these inequalities, NHS trusts are required to make reasonable adjustments to their care, such as longer appointment times, with the legal duty on them being “anticipatory”. The paper aims to discuss these issues.

Design/methodology/approach

Secondary analysis of CQC acute hospital inspection reports asking the following research questions: Do CQC inspection reports mention people with learning disabilities? Where issues concerning people with learning disabilities are reported in CQC hospital inspection reports, what issues and reasonable adjustments are reported? Are there any relationships between comments made in the inspection reports and CQC ratings of the trusts?

Findings

In total, 29 of the 30 trust-wide inspection reports (97 per cent) and 58 of the 61 specific site reports (95 per cent) included at least one mention of people with learning disability/ies. Most comments about practices for people with learning disabilities were positive across all CQC inspection output types and across all CQC overall ratings, although the proportion of positive comments decreased and the proportion of negative comments increased as CQC ratings became less positive.

Research limitations/implications

Overall the authors found that CQC inspection reports routinely contained some information regarding how well the hospitals were working for people with learning disabilities. The depth of information in reports varied across trusts, with the potential for CQC reports to more consistently report information collected during inspections.

Originality/value

The report updates and extends a report published by the Public Health England Learning Disabilities Observatory in 2015.
Transforming care: problems and possible solutions
Authors: Sinclair Neil
Published: November 2017

Purpose

The purpose of this paper is to raise issues about Transforming Care (TC) and discuss possible solutions.

Design/methodology/approach

Reflections and commentary on Transforming Care following Painter et al.’s article on correlates for the risk of admission to specialist hospitals.

Findings

Concerns are raised about the initial assumptions of TC, in particular the composition of the inpatient group and impact of the existing legal framework on reducing this population. The lack of cohesion between Care and Treatment Reviews and Care Programme Approach reviews is noted, and combining meetings is suggested.

Originality/value

The relevance of Wolfensberger’s social devaluation analysis is explored and O’Brien’s Personal Futures Planning is recommended as a potential way of drawing these currently disparate approaches together around the individual client.
Staged‐scale restoration: Refining adaptive management to improve restoration effectiveness
Authors: Bakker Jonathan D. , Delvin Eric G. , Dunwiddie Peter W.
Published: November 2017

Adaptive management (AM) was proposed as a rigourous and structured approach to natural resource management that increases learning and reduces uncertainty. It has been adopted as a guiding principle by agencies world‐wide, yet its usefulness for guiding management continues to be debated. We propose a new strategy, which we term staged‐scale restoration (SSR), to implement AM in a restoration setting while enhancing the scientific rigour, ecological effectiveness and overall efficiency of restoration efforts compared to traditional applications of AM.

The SSR approach includes three aspects: (1) experimentally assessing alternative restoration techniques directly on‐site in replicated plots using operational‐scale equipment, (2) staging, or the successive establishment and evaluation of treated areas over time and (3) scaling, whereby the most successful techniques identified during earlier stages are applied to increasingly larger areas in later stages. A case study illustrates how SSR was used to improve prairie restoration in western Washington, USA.

Staged‐scale restoration provides several key advantages. It includes a robust experimental design and thus improves the scientific rigour of AM. It is conducted on‐site using operational‐scale equipment and thus increases the effectiveness of treatments while also providing a platform for refining existing treatments. SSR facilitates collaboration among researchers and managers. By promoting advanced planning and deferring much of the area to be treated to the latter years of a project, SSR reduces the risk of restoration failure. Finally, it is extremely flexible: it can be implemented at multiple sites or years, the number and types of treatments to be assessed can be customized and the pace of restoration can be varied.

Synthesis and applications. Staged‐scale restoration addresses many of the criticisms that have been directed at conventional adaptive management (AM) and provides a scientifically rigourous strategy to improve restoration while customizing treatments for individual sites. It explicitly enables restoration projects to be conducted within an adaptive management framework, and clearly and intentionally integrates ecological research into restoration efforts. We urge the restoration community to explore the utility of staged‐scale restoration in diverse socioeconomic circumstances and ecosystems.
MicroRNA‐26a inhibits proliferation and tumorigenesis via targeting CKS2 in laryngeal squamous cell carcinoma
Authors: Wu Zhiyan , Lu Baocai , Li Xiao , Miao Wenjie , Li Jin , Shi Yongjuan , Yu Wenfa
Published: November 2017

Laryngeal squamous cell carcinoma (LSCC) is one of the most common head and neck cancers, with high mortality and incidence. MicroRNA‐26a (miR‐26a) is involved in the development and progression of several tumours. However, the roles of miR‐26a and its target CKS2 in LSCC progression are not yet clear. The mRNA and protein expression was determined using RT‐PCR and Western blotting assay, respectively. Cell proliferation was detected using a Cell Counting kit‐8 assay (CCK‐8). Transwell assay was used to evaluate cell migration and invasion. Dual‐luciferase reporter assay was applied to determine the relationship between miR‐26a and CKS2. In addition, a tumour xenograft model in nude mice was established to further determine the effects of miR‐26a on tumourigenesis. In this study, we found that miR‐26a level was down‐regulated in LSCC tissues and cell lines, while CKS2 expression was increased. Cell proliferation, migration, invasion and the expression of MMP2 and MMP9 was suppressed by miR‐26a overexpression, but enhanced by inhibition of miR‐26a. Dual‐luciferase reporter assay demonstrated that CKS2 is a direct target of miR‐26a in AMC‐HN‐8 cells. Overexpression of miR‐26a caused a significant reduction in CKS2 expression, and reinforced expression of CKS2 abolished the tumour‐suppressive function of miR‐26a. Moreover, miR‐26a inhibited tumour growth in vivo. Taken together, miR‐26a inhibited proliferation and tumourigenesis of LSCC via targeting CKS2 in vitro and in vivo.
Identification of a pyridine derivative inducing senescence in ovarian cancer cell lines via P21 activation
Authors: Shang Dongsheng , Wu Yanfang , Ding Ya , Lu Ziwen , Shen Yanting , Zhu Feifei , Liu Hanqing , Zhu Chunyin , Tu Zhigang
Published: November 2017

Cellular senescence is a state of irreversible cell growth arrest. Increasing evidence suggests that cellular senescence contribute to tumour suppression in vivo. However, only a few anti‐cancer drugs have been discovered to induce cellular senescence. Searching for new compounds which can inhibit cancer cell growth by inducing senescence is becoming one of the most attractive research fields. To test the effects of candidate compounds on cancer cell growth, cell proliferation assays, senescence‐associated β‐galactosidase (SA‐β‐gal) staining, and flow cytometry assay were performed. Immunofluorescence, western blot, and qRT‐PCR experiments were used to further study the molecular mechanisms of the candidate compounds. We demonstrated that a pyridine derivative, 4‐(4‐fluorophenyl)‐2‐phenyl‐5, 6, 7, 8‐tetrahydroquinoline (FPTHQ), from a pool of 46 compounds can induce senescence of ovarian cancer cells in a dose‐dependent manner. FPTHQ caused growth inhibition by inducing G0/G1 cell cycle arrest in A2780 cells. Increased activities of SA‐β‐gal were observed in FPTHQ‐treated A2780, OVCAR‐3 and SKOV‐3 cell lines. In addition, FPTHQ treatment increased the protein levels of MMP3 and the mRNA levels of IL‐6 and IL‐8 in A2780 cells, indicating the appearance of senescence‐associated secretary phenotype (SASP) in the cells. Furthermore, we found that p21 was up‐regulated and DNA damage was accumulated in FPTHQ‐treated ovarian cancer cells. So far, our data suggest that FPTHQ can induce senescence in multiple ovarian cancer cell lines through activation of p21 signalling pathway by causing excessive DNA damage.
Estimation of the spillover effect between patents and innovation using the GARCH–BEKK model
Authors: Mumtaz Muhammad Z. , Smith Zachary A.
Published: November 2017

This study examines the mean and variance spillovers between patents filed and total factor productivity in Pakistan during the period lasting from 1964 to 2015. Using the multivariate generalized autoregressive conditionally heteroskedastic–Baba, Engle, Kraft and Kroner (GARCH–BEKK) model, we find no evidence of mean spillover effects between patents filed and productivity growth. However, the results support the existence of the variance spillover effect, which illustrates that the innovations may affect productivity in the long‐run. Moreover, bidirectional causality in the mean and variance between innovation and productivity growth is non‐existent. We find that R&D/GDP, skilled labour force and economic freedom are the significant factors affecting technological advancements in the country. We also determine that R&D/GDP and economic freedom are the important factors affecting patent activities in Pakistan. Our findings suggest that the government needs to emphasize the regulations of the patent system to safeguard the interests of investors, which ultimately promotes economic growth.
Association between smoking and glycemic control in diabetic patients: Results from the Risk Evaluation of cAncers in Chinese diabeTic Individuals: A lONgitudinal (REACTION) study
Authors: Peng Kui , Chen Gang , Liu Chao , Mu Yiming , Ye Zhen , Shi Lixin , Zhao Jiajun , Chen Lulu , Li Qiang , Yang Tao , Yan Li , Wan Qin , Wu Shengli , Wang Guixia , Luo Zuojie , Tang Xulei , Huo Yanan , Gao Zhengnan , Su Qing , Wang Youmin , Qin Guijun , Deng Huacong , Yu Xuefeng , Shen Feixia , Chen Li , Zhao Liebin , Xu Yu , Xu Min , Chen Yuhong , Lu Jieli , Lin Lin , Du Rui , Dai Meng , Li Mian , Wang Tiange , Zhao Zhiyun , Zhang Di , Bi Yufang , Li Donghui , Wang Weiqing , Ning Guang ,   on behalf of the REACTION Study Group
Published: November 2017

Background

A number of primary studies suggested that active smoking could be independently associated with incident diabetes. However less is known about the effect of active smoking and smoking cessation on glycemic control in patients with diabetes. The aim of this study was to evaluate the associations of active smoking and smoking cessation with glycemic control in diabetic patients.

Methods

The present was a cross‐sectional study of 10 551 men and 15 297 women with diabetes from the Risk Evaluation of cAncers in Chinese diabeTic Individuals: a lONgitudinal (REACTION) study. Risk factors for glycemic control and the association of active smoking with glycemic control were evaluated using logistic regression models. Poor glycemic control was defined as HbA1c ≥7.0%.

Results

Current smokers have an increased risk of poor glycemic control, and the multivariable‐adjusted odds ratio (OR) and 95% confidence intervals (CI) of HbA1c ≥7.0% with current smoking were 1.49 (1.35–1.66) in men and 1.56 (1.13–2.15) in women. Further analysis demonstrated a dose‐dependent relationship between active smoking and the risk of poor glycemic control in men. Former smokers who quit smoking for <10 years remained at increased risk of poor glycemic control, with the risk leveling off after 10 years of smoking cessation compared with non‐smokers, but risk in former smokers was significantly lower than that in current smokers.

Conclusions

Active smoking is a modifiable risk factor for poor glycemic control in Chinese diabetic patients.
Detection and monitoring of driver mutations by next‐generation sequencing in squamous cell lung cancer patient and possible predictive biomarker of third generation EGFR‐tyrosine kinase inhibitors
Authors: Shen Xiaoyan , Shen Jie , Zhang Hang , Cheng Yuxin , Yang Yang , Gao Jiahui , Zhang Yu , Li Rutian , Liu Baorui , Wang Lifeng
Published: November 2017

Driver mutation detection and the development of targeted drugs have significantly improved survival of advanced lung adenocarcinoma patients with driver mutations. However, we still lack understanding of druggable mutations in patients with advanced squamous cell lung cancer (SQCLC). Less than 10% of SQCLC patients have EGFR gene mutations, thus we have limited knowledge of biological molecular changes with first generation EGFR‐tyrosine kinase inhibitor (TKI) resistance. We report a case of an SQCLC patient treated with first‐line platinum‐doublet chemotherapy. After disease progression, the patient was administered first generation EGFR‐TKI gefitinib based on next generation sequencing results. After five months, a second biopsy was performed and both the tumor and plasma samples indicated an acquired EGFR exon 20 T790M mutation. The patient was subsequently administered AZD9291, which resulted in disease control for a time. Our results indicate that a TP53 exon 8 mutation might act as a negative predictive biomarker for third generation EGFR‐TKIs.
Cellular aging dynamics after acute malaria infection: A 12‐month longitudinal study
Authors: Asghar Muhammad , Yman Victor , Homann Manijeh Vafa , Sondén Klara , Hammar Ulf , Hasselquist Dennis , Färnert Anna
Published: November 2017

Accelerated cellular aging and reduced lifespan have recently been shown in birds chronically infected with malaria parasites. Whether malaria infection also affects cellular aging in humans has not been reported. Here, we assessed the effect of a single acute Plasmodium falciparum malaria infection on cellular aging dynamics in travelers prospectively followed over one year in Sweden. DNA and RNA were extracted from venous blood collected at the time of admission and repeatedly up to one year. Telomere length was measured using real‐time quantitative PCR, while telomerase activity and CDKN2A expression were measured by reverse transcriptase (RT)–qPCR. Our results show that acute malaria infection affects cellular aging as reflected by elevated levels of CDKN2A expression, lower telomerase activity, and substantial telomere shortening during the first three months postinfection. After that CDKN2A expression declined, telomerase activity increased and telomere length was gradually restored over one year, reflecting that cellular aging was reversed. These findings demonstrate that malaria infection affects cellular aging and the underlying cellular mechanism by which pathogens can affect host cellular aging and longevity need to be elucidated. Our results urge the need to investigate whether repeated malaria infections have more pronounced and long‐lasting effects on cellular aging and lifespan (similarly to what was observed in birds) in populations living in malaria endemic areas.
White matter maturation during 12 months in individuals at ultra‐high‐risk for psychosis
Authors: Krakauer K. , Nordentoft M. , Glenthøj B. Y. , Raghava J. M. , Nordholm D. , Randers L. , Glenthøj L. B. , Ebdrup B. H. , Rostrup E.
Published: November 2017

Objective

The neurodevelopmental hypothesis of psychosis suggests that disrupted white matter (WM) maturation underlies disease onset. In this longitudinal study, we investigated WM connectivity and compared WM changes between individuals at ultra‐high‐risk for psychosis (UHR) and healthy controls (HCs).

Method

Thirty UHR individuals and 23 HCs underwent MR diffusion tensor imaging before and after 12 months of non‐manualized standard care. Positive and negative symptoms and level of functioning were assessed. Tract‐based spatial statistics were employed.

Results

During 12 months, none of the UHR individuals transitioned to psychosis. Both UHR individuals and HCs increased significantly in fractional anisotropy (FA). UHR individuals showed significant FA increases predominantly in the left superior longitudinal fasciculus (SLF) (P = 0.01), and HCs showed significant FA increases in the left uncinate fasciculus (P = 0.03). Within UHR individuals, a significant positive correlation between FA change and age was observed predominantly in the left SLF (P = 0.02). Within HCs, no significant correlation between FA change and age was observed. No significant correlations between baseline FA and clinical outcomes were observed; however, FA changes were significantly positively correlated to changes in negative symptoms (P = 0.04).

Conclusion

As normal brain maturation occurs in a posterior to frontal direction, our findings could suggest disturbed WM maturation in UHR individuals.
Assessment of risk behaviors in patients with opioid prescriptions: A study of indiana's inspect data
Authors: Greene Marion S. , Chambers Robert Andrew , Yiannoutsos Constantin T. , Wright Eric R. , Steele Gregory K. , Zollinger Terrell W.
Published: November 2017

Background and Objectives

Prescription Drug Monitoring Programs (PDMPs) can serve as screening tools and support the clinical decision‐making process in patients receiving opioids. The objective of the study was to utilize 2014 INSPECT (Indiana's PDMP) data to identify factors that increase patients’ likelihood to engage in opioid‐related risk behaviors.

Methods

Based on a literature review, four risk behaviors were identified: Receiving >90 morphine milligram equivalents (MME), having >4 opioid prescribers, obtaining opioids from >4 pharmacies, and concurrent use of opioids and benzodiazepines. Two binary logistic regression analyses (engaging in at least one risk behaviors; engaging in all four risk behaviors) and an ordinal regression analysis (engaging in 0–4 risk behaviors) were conducted to identify factors associated with these opioid‐related risk behaviors.

Results

Of the 1,538,120 unique opioid patients included in the study, 18.4% engaged in one, 5.3% in two, 1.6% in three, and .4% in all four risk behaviors. Depending on the model, prescribing a second monthly opioid increased patients’ odds to engage in risk behaviors by a factor of 10 or more and prescribing two or more benzodiazepines annually increased the odds at least 13‐fold.

Conclusions and Scientific Significance

About one‐fourth of all patients consuming opioids engaged in one or more risk behaviors; higher number of opioid prescriptions and addition of even a small number of benzodiazepine prescriptions dramatically increased these odds. PDMPs can be helpful in identifying opioid users at high‐risk for misuse. This information could be used to target efforts to reduce the prescription drug epidemic. (Am J Addict 2017;26:822–829)
Buprenorphine‐naloxone treatment responses differ between young adults with heroin and prescription opioid use disorders
Authors: Romero‐Gonzalez Mauricio , Shahanaghi Abtin , DiGirolamo Gregory J. , Gonzalez Gerardo
Published: November 2017

Background and Objectives

Opioid use disorder among young adults is rising sharply with an increase in morbidity and mortality. This study examined differences in treatment response to a fixed dose of buprenorphine‐naloxone between heroin (HU) and prescriptions opioids (POU) users.

Methods

Eighty opioid dependent young adults (M = 22 years) were treated with buprenorphine‐naloxone 16–4 mg/day for 8 weeks. Differences between HU (N = 17) and POU (N = 63) on changes in weekly opioid use, opioid craving, withdrawal, and depression symptoms were analyzed with mixed‐effects regression models.

Results

The HU had an overall mean proportion of weekly opioid use of .32 (SD = .14) compared to POU's weekly mean of .24 (SD = .15) showing a significant main effect (Z = 2.21, p = .02). Depressive symptoms (CES‐D scores) were elevated at baseline for both groups (HU: M = 23.1, SD = 11.9; PO: M = 22.2, SD = 9.4), but only POU improved significantly to a score of 9.88 (SD = 7.4) compared to HU's score of 18.58 (SD = 10.3) at week 8 (Z = 2.24, p = .02). There were no significant differences in treatment retention, craving, or withdrawal symptoms.

Discussion and Conclusions

Treatment response to 16‐4 mg/day of buprenorphine–naloxone was significantly diminished for heroin users relative to opioid prescription users in weekly opioid use. Heroin users also had persistent depressive symptoms suggesting the need for close monitoring.

Scientific Significance

These data suggest that young heroin users might require higher doses of buprenorphine. (Am J Addict 2017;26:838–844)