bluuebunny/crossref_metadata_2025 huggingface dataset:
Characterization of Emissions from a Desktop 3D Printer
Authors: Mendes Luís , Kangas Anneli , Kukko Kirsi , Mølgaard Bjarke , Säämänen Arto , Kanerva Tomi , Flores Ituarte Iñigo , Huhtiniemi Marika , Stockmann‐Juvala Helene , Partanen Jouni , Hämeri Kaarle , Eleftheriadis Konstantinos , Viitanen Anna‐Kaisa
Published: March 2017

3D printers are currently widely available and very popular among the general public. However, the use of these devices may pose health risks to users, attributable to air‐quality issues arising from gaseous and particulate emissions in particular. We characterized emissions from a low‐end 3D printer based on material extrusion, using the most common polymers: acrylonitrile‐butadiene‐styrene (ABS) and polylactic acid (PLA). Measurements were carried out in an emission chamber and a conventional room. Particle emission rates were obtained by direct measurement and modeling, whereas the influence of extrusion temperature was also evaluated. ABS was the material with the highest aerosol emission rate. The nanoparticle emission ranged from 3.7·108 to 1.4·109 particles per second (# s−1) in chamber measurements and from 2.0·109 to 4.0·109 # s−1in room measurements, when the recommended extruder temperature was used. Printing with PLA emitted nanoparticles at the rate of 1.0·107 # s−1 inside the chamber and negligible emissions in room experiments. Emission rates were observed to depend strongly on extruder temperature. The particles’ mean size ranged from 7.8 to 10.5 nanometers (nm). We also detected a significant emission rate of particles of 1 to 3 nm in size during all printing events. The amounts of volatile organic and other gaseous compounds were only traceable and are not expected to pose health risks. Our study suggests that measures preventing human exposure to high nanoparticle concentrations should be adopted when using low‐end 3D printers.
Educating Physicians for Rural America: Validating Successes and Identifying Remaining Challenges With the Rural Medical Scholars Program
Authors: Wheat John R. , Leeper James D. , Murphy Shannon , Brandon John E. , Jackson James R.
Published: March 2017

Purpose

To evaluate the Rural Medical Scholars (RMS) Program's effectiveness to produce rural physicians for Alabama.

Methods

A nonrandomized intervention study compared RMS (1997‐2002) with control groups in usual medical education (1991‐2002) at the University of Alabama School of Medicine's main and regional campuses. Participants were RMS and others admitted to regular medical education, and the intervention was the RMS Program. Measures assessed the percentage of graduates practicing in rural areas. Odds ratios compared effectiveness of producing rural Alabama physicians.

Findings

The RMS Program (N = 54), regional campuses (N = 182), and main campus (N = 649) produced 48.1% (odds ratio 6.4,P< .001), 23.8% (odds ratio 2.5,P< .001), and 11.2% (odds ratio 1.0) rural physicians, respectively.

Conclusions

The RMS Program, contrasted to other local programs of medical education, was effective in producing rural physicians. These results were comparable to benchmark programs in the Northeast and Midwest USA on which the RMS Program was modeled, justifying the assumption that model programs can be replicated in different regions. However, this positive effect was not shared by a disparate rural minority population, suggesting that models for rural medical education must be adjusted to meet the challenge of such communities for physicians.
Pharmacokinetics of intravenous and transdermal fentanyl in alpacas
Authors: Lovasz M. , Aarnes T. K. , Hubbell J. A. E. , Bednarski R. M. , Lerche P. , Lakritz J.
Published: March 2017

The purpose of the study was to determine pharmacokinetics of fentanyl after intravenous (i.v.) and transdermal (t.d.) administration to six adult alpacas. Fentanyl was administered i.v. (2 μg/kg) or t.d. (nominal dose: 2 μg kg−1 hr−1). Plasma concentrations were determined using liquid chromatography–mass spectrometry. Heart rate and respiratory rate were assessed. Extrapolated, zero‐time plasma fentanyl concentrations were 6.0 ng/ml (1.7–14.6 ng/ml) after i.v. administration, total plasma clearance was 1.10 L hr−1 kg−1(0.75–1.40 L hr−1 kg−1), volumes of distribution were 0.30 L/kg (0.10–0.99 L/kg), 1.10 L/kg (0.70–2.96 L/kg) and 1.5 L/kg (0.8–3.5 L/kg) forV1,V2, andVss, respectively. Elimination half‐life was 1.2 hr (0.5–4.3 hr). Mean residence time (range) after i.v. dosing was 1.30 hr (0.65–4.00 hr). After t.d. fentanyl administration, maximum plasma fentanyl concentration was 1.20 ng/ml (0.72–3.00 ng/ml), which occurred at 25 hr (8–48 hr) after patch placement. The area under the plasma fentanyl concentration‐vs‐time curve (extrapolated to infinity) after t.d. fentanyl was 61 ng*hr/ml (49–93 ng*hr/ml). The dose‐normalized bioavailability of fentanyl from t.d. fentanyl in alpacas was 35.5% (27–64%). Fentanyl absorption from the t.d. fentanyl patch into the central compartment occurred at a rate of approximately 50 μg/hr (29–81 μg/hr) between 8 and 72 hr after patch placement.
Men with biopsy‐confirmed hepatocellular adenoma have a high risk of progression to hepatocellular carcinoma: A nationwide population‐based study
Authors: Bossen Lars , Grønbæk Henning , Lykke Eriksen Peter , Jepsen Peter
Published: March 2017

Background & Aims

Hepatocellular adenoma is a benign liver tumour that may transform to hepatocellular carcinoma (HCC). We used data from Danish nationwide healthcare registries to investigate the incidence and prognosis of hepatocellular adenoma.

Methods

We included all patients with a hospital discharge diagnosis for benign liver tumour (ICD‐10: D13.4) in 1997‐2012 and a liver biopsy confirming the hepatocellular adenoma diagnosis. Follow‐up began 1 year after adenoma diagnosis, to minimise the possibility that the tumour was a misdiagnosed HCC. All patients were age‐ and gender‐matched with 50 random controls from the Danish population. We followed patients and controls with respect to HCC development, adenoma resection, and death without HCC (ie, death without having been diagnosed with HCC) through 2013. HCC diagnoses were identified in the Danish Cancer Registry.

Results

We included 67 patients with hepatocellular adenoma, and 58 (87%) were women. The overall incidence rate of histologically verified hepatocellular adenoma in the Danish general population was 0.07 (95% CI: 0.06‐0.09) per 100 000 population per year. Fifteen patients had their adenoma resected before follow‐up began, leaving 52 patients for follow‐up. Men with biopsy‐confirmed hepatocellular adenoma had a 10‐year cumulative HCC risk as high as 60.0% (95% CI: 15.3%‐87.0%). All men who developed HCC were older than 50 years at adenoma diagnosis. By contrast, none of the 44 women in the follow‐up analysis developed HCC.

Conclusion

Histologically verified hepatocellular adenoma is rare in Denmark. It is a minor concern for women, but men have a very high risk of progression to HCC.
In search of the Earth‐forming reservoir: Mineralogical, chemical, and isotopic characterizations of the ungrouped achondrite NWA 5363/NWA 5400 and selected chondrites
Authors: Burkhardt Christoph , Dauphas Nicolas , Tang Haolan , Fischer‐Gödde Mario , Qin Liping , Chen James H. , Rout Surya S. , Pack Andreas , Heck Philipp R. , Papanastassiou Dimitri A.
Published: March 2017

High‐precision isotope data of meteorites show that the long‐standing notion of a “chondritic uniform reservoir” is not always applicable for describing the isotopic composition of the bulk Earth and other planetary bodies. To mitigate the effects of this “isotopic crisis” and to better understand the genetic relations of meteorites and the Earth‐forming reservoir, we performed a comprehensive petrographic, elemental, and multi‐isotopic (O, Ca, Ti, Cr, Ni, Mo, Ru, and W) study of the ungrouped achondrites NWA 5363 and NWA 5400, for both of which terrestrial O isotope signatures were previously reported. Also, we obtained isotope data for the chondrites Pillistfer (EL6), Allegan (H6), and Allende (CV3), and compiled available anomaly data for undifferentiated and differentiated meteorites. The chemical compositions of NWA 5363 and NWA 5400 are strikingly similar, except for fluid mobile elements tracing desert weathering. We show that NWA 5363 and NWA 5400 are paired samples from a primitive achondrite parent‐body and interpret these rocks as restite assemblages after silicate melt extraction and siderophile element addition. Hafnium‐tungsten chronology yields a model age of 2.2 ± 0.8 Myr after CAI, which probably dates both of these events within uncertainty. We confirm the terrestrial O isotope signature of NWA 5363/NWA 5400; however, the discovery of nucleosynthetic anomalies in Ca, Ti, Cr, Mo, and Ru reveals that the NWA5363/NWA 5400 parent‐body is not the “missing link” that could explain the composition of the Earth by the mixing of known meteorites. Until this “missing link” or a direct sample of the terrestrial reservoir is identified, guidelines are provided of how to use chondrites for estimating the isotopic composition of the bulk Earth.
What is the Doctrine of the Trinity For? Practicality and Projection in Robert Jenson's Theology
Authors: East Brad
Published: March 2017

This articles engages the theology of Robert Jenson with three questions in mind: What is the doctrine of the Trinity for? Is it a practical doctrine? If so, how, and with what implications? It seeks, on the one hand, to identify whether Jenson's trinitarian theology ought to count as a “social” doctrine of the Trinity, and to what extent he puts it to work for human socio‐practical purposes. On the other hand, in light of Jenson's career‐long worries about Feuerbach and projection onto a God behind or above the triune God revealed in the economy, the article interrogates his thought with a view to recent critiques of social trinitarianism. The irony is that, in constructing his account of the Trinity as both wholly determined in and by the economy and maximally relevant for practical human needs and interests, precisely in order to avoid the errors of Feuerbachian “religion,” Jenson ends up engaging in a full‐scale project of projection. Observation of the human is retrojected into the immanent life of the Trinity as the prior condition of the possibility for the human; upon this “discovery,” this or that feature of God's being is proposed as a resolution to a human problem, bearing ostensibly profound socio‐practical import. The article is intended, first, as a contribution to the work, only now beginning, of critically receiving Jenson's theology; and, second, as an extension of general critiques of practical uses of trinitarian doctrine, such as Karen Kilby's or Kathryn Tanner's, by way of close engagement with a specific theologian.
Heat shock protein expression in cerebral X‐linked adrenoleukodystrophy reveals astrocyte stress prior to myelin loss
Authors: Görtz A. L. , Peferoen L. A. N. , Gerritsen W. H. , van Noort J. M. , Bugiani M. , Amor S.
Published: March 2017

Aims

X‐linked adrenoleukodystrophy (X‐ALD) is a genetic white matter disorder in which demyelination occurs due to accumulation of very long‐chain fatty acids. Inflammation in the brain white matter is a hallmark of the pathology of cerebral X‐ALD, but the underlying pathogenic mechanisms are still largely unknown. In other inflammatory demyelinating disorders, such as multiple sclerosis, the expression of heat shock proteins (HSPs) in combination with interferon‐γ (IFN‐γ) has been suggested to play a prominent role in the initiation of demyelination and inflammation. We therefore investigated these pathways in X‐ALD lesions.

Methods

By immunohistochemistry, we examined the expression of small HSPs (HSPB1, HSPB5, HSPB6, HSPB8) and higher molecular weight HSPs (HSPA, HSPD1), and the expression of elements of the IFN‐γ pathway on autopsy material of five patients with X‐ALD.

Results

The expression of the larger HSPs, HSPA and HSPD1, as well as small HSPs is increased in X‐ALD lesions compared with normal‐appearing white matter. Such upregulation can already be detected before demyelination and inflammation occur, and it is predominant in astrocytes. The IFN‐γ pathway does not seem to play a leading role in the observed inflammation.

Conclusions

The finding that astrocytes show signs of cellular stress before demyelination suggests that they play a major role early in the pathogenesis of cerebral X‐ALD, and may therefore be involved in the initiation of inflammation and demyelination.
Intravascular T‐cell lymphoma: A rare, poorly characterized entity with cytotoxic phenotype
Authors: Sharma Tara L. , Yeaney Gabrielle A. , Soltanzadeh Payam , Li Yuebing , Cotta Claudiu V.
Published: March 2017

Intravascular T‐cell lymphomas are rare, poorly characterized lesions. We discuss the clinical, radiologic and especially the laboratory characteristics of a lesion which presented in a 62‐year‐old woman with a history of progressive CNS abnormalities. Throughout the course of the disease, radiologic findings consisted mainly of multifocal mixed areas of ischemia and vasogenic edema involving cortical and subcortical regions. A brain biopsy identified an abnormal T‐cell population confined to lumens of vessels. These T‐cells were abnormal cytotoxic cells, positive for CD3, CD8, and negative for CD2, CD4, CD5, CD7 and CD30. While flow cytometry and immunohistochemistry failed to identify a similar population in the blood or bone marrow, molecular studies showed a clonal T‐cell population in both the brain and the bone marrow. No other organs were involved. In spite of aggressive treatment, the patient's medical condition continued to progress and she passed away. In conclusion, this abnormal population of cytotoxic T‐cells with intravascular localization probably represents a specific type of T‐cell lymphoma with specific clinical, radiologic, molecular and immunophenotypic characteristics.
Prospective evaluation of same day versus next day colon manometry results in children with medical refractory constipation
Authors: Arbizu R. A. , Nurko S. , Heinz N. , Amicangelo M. , Rodriguez L.
Published: March 2017

Background

We evaluated the change in colon manometry (CM) parameters and interpretation comparing results when the study is performed the same day after the motility catheter is placed under anesthesia or the following day.

Methods

CM catheter was placed with colonoscopy under anesthesia and recorded on day 1 and repeated on day 2. Study parameters including motility index during fasting, post‐prandial and post‐Bisacodyl challenge phase; gastrocolonic response; number, presence and propagation of high amplitude propagating contractions (HAPCs); and, study interpretation were compared between both the days.

Key Results

Motility index (fasting, post‐Bisacodyl phase, P<.05), HAPC number (10.1 vs 6.6, P=.01) and the proportion of patients having HAPCs (92% vs 70%, P=.002) was significantly higher on day 2 vs day 1. HAPC propagation improved on day 2 vs day 1 (fully propagated, 49% vs 37%; partially propagated, 43% vs 33%; absent 8% vs 30%). Study interpretation changed from day 1 to day 2. On day 1, 37% had a normal study and 63% had an abnormal study. On day 2, all patients with a normal study on day 1 remained normal, and patients with an abnormal study on day 1, 53% remained abnormal and 47% had a normal study.

Conclusions & Inferences

CM parameters are affected the day the catheter is placed with colonoscopy under anesthesia. The number, presence, and propagation of HAPCs were significantly higher/improved on day 2 compared to day 1. Overall, CM interpretation changed from abnormal to normal from day 1 to day 2 in 47% of the patients.
Esophageal stasis in achalasia patients without symptoms after treatment does not predict symptom recurrence
Authors: van Hoeij F. B. , Smout A. J. P. M. , Bredenoord A. J.
Published: March 2017

Background

After achalasia treatment, a subset of patients has poor esophageal emptying without having symptoms. There is no consensus on whether to pre‐emptively treat these patients. We hypothesized that, if left untreated, these patients will experience earlier symptom recurrence than patients without stasis.

Methods

99 treated achalasia patients who were in clinical remission (Eckardt ≤3) at 3 months after treatment were divided into two groups, based on presence or absence of esophageal stasis on a timed barium esophagogram performed after 3 months.

Key Results

Two years after initial treatment, patients with stasis after treatment still had a wider esophagus (3 cm; IQR: 2.2‐3.8) and more stasis (3.5 cm; IQR: 1.9‐5.6) than patients without stasis (1.8 cm wide and 0 cm stasis; both P<.001). In patients with stasis, the esophageal diameter had increased from 2.5 to 3.0 cm within 2 years of follow‐up. The symptoms, need for and time to retreatment were comparable between the two groups. Quality of life and reflux symptoms were also comparable between the two groups.

Conclusions & Inferences

Although patients with stasis initially had a wider esophagus and 2 years after treatment also had a higher degree of stasis and a more dilated esophagus, compared to patients without stasis, they did not have a higher chance of requiring retreatment. We conclude that stasis in symptom‐free achalasia patients after treatment does not predict treatment failure within 2 years and can therefore not serve as a sole reason for retreatment.
The BDNF polymorphism Val66Met may be predictive of swallowing improvement post pharyngeal electrical stimulation in dysphagic stroke patients
Authors: Essa H. , Vasant D. H. , Raginis‐Zborowska A. , Payton A. , Michou E. , Hamdy S.
Published: March 2017

Background

The aim of this study was to explore the effect of brain‐derived neurotrophic factor (BDNF) polymorphism rs6265 (Val66Met) in both “natural” and treatment induced recovery of swallowing after dysphagic stroke.

Methods

Sixteen dysphagic stroke patients that completed a single‐blind randomized sham controlled trial of pharyngeal electrical stimulation (PES) within 6 weeks of their stroke (N=38), were genotyped for the BDNF SNP Val66Met (rs6265) from saliva samples. These patients received active or sham PES according to randomized allocation. PES was delivered at a set frequency (5 Hz), intensity (75% of maximal tolerated), and duration (10 minutes) once a day for three consecutive days. Clinical measurements were taken from patients at baseline, 2 weeks and 3 months post entering the study. Changes in swallowing ability based on the dysphagia severity rating scale (DSRS) were compared between active and sham groups and associated with BDNF SNP status.

Key Results

In the active stimulation group, patients with the Met BDNF allele demonstrated significantly greater improvements in DSRS at 3 months compared to patients homozygous for the Val allele (P=.009). By comparison, there were no significant associations at the 2 week stage in either the active or sham group, or at 3 month in the sham group. Functional scores including the Barthel Index and modified Rankin scale were also unaffected by BDNF status.

Conclusions & Inferences

Our findings suggest an association between BDNF and stimulation induced swallowing recovery. Further work will be required to validate these observations and demonstrate clinical utility in patients.
Severely impaired gastric accommodation is a hallmark of post‐Nissen functional dyspepsia symptoms
Authors: Pauwels A. , Boecxstaens V. , Broers C. , Tack J. F.
Published: March 2017

Background

Laparoscopic Nissen fundoplication is a commonly performed antireflux surgery, after which reflux symptoms are well controlled, however, complications such as inability to belch or dyspeptic symptoms (mimicking those of functional dyspepsia [FD]) might occur. The aim of the study was to prospectively evaluate symptom pattern and underlying pathophysiological mechanisms in patients with post‐Nissen dyspepsia.

Methods

Twenty‐four patients (12 f, mean age 44.5±2.8 years) with post‐Nissen dyspepsia symptoms, five patients (3 f, mean age 38.8±3.2 years) with post‐Nissen dysphagia symptoms and 14 pre‐fundoplication patients (3 f, mean age 42.1±2.5 years) were evaluated. Patients filled out a Rome II‐based dyspepsia symptom severity score, performed a gastric emptying test, and a gastric barostat study was used to evaluate the function of the proximal stomach.

Key Results

Upper abdominal bloating scores were higher in post‐Nissen dyspepsia patients (P=.016) and symptoms of postprandial distress syndrome (PDS) were more present in post‐Nissen dyspepsia patients compared to the other two groups (P=.07). Weight loss was significantly higher in the post‐Nissen groups compared to the pre‐fundoplication (P=.02). Gastric emptying rates were similar in the three groups. Gastric accommodation (GA) was significantly impaired in the post‐Nissen dyspepsia group (dyspepsia −30[−86‐83] vs dysphagia 163[148‐203] vs pre‐fundoplication 147[75‐174] mL, P=.004) and the prevalence of patients with impaired GA was higher in the post‐Nissen group (P=.007). Postprandial fullness was more prevalent in patients with impaired GA compared to those with normal GA (P=.01).

Conclusions and Interferences

Patients with post‐Nissen dyspepsia show a symptom pattern similar to that in FD patients with PDS, and the main underlying mechanism seems to be impaired gastric accommodation to a meal.
Realised niche changes in a native herbivore assemblage associated with the presence of livestock
Authors: Traba Juan , Iranzo Esperanza C. , Carmona Carlos P. , Malo Juan E.
Published: March 2017

Habitat partitioning is a common ecological mechanism to avoid competition among coexisting species, and the introduction of new species into existing assemblages can increase competitive pressures. However, situations of species in allopatry and sympatry only differing in species presence but not in environmental conditions are scarce. Thus, discerning whether niche segregation arises from competition or from different habitat preferences is usually unfeasible.

Here, we analyse species’ habitat niches in an assemblage of native and introduced herbivores in southern Patagonia. We test if niche overlap is higher between native and domestic herbivores than among natives as expected from the relatively short time of coexistence, and we evaluate the effect of intra‐ and interspecific competition on niche breadth. We use a probabilistic multidimensional approach and null models to evaluate overlap and changes in niche dimensions.

Overlap among native species is low as expected for species coexisting in evolutionary time. In native‐domestic species pairs, niche overlap was higher than among natives, although showing some niche segregation indicating niche differentiation in ecological time. Moreover, the presence of domestic species was associated with niche narrowing of both native and introduced species, revealing interspecific density‐dependent effects on their habitat niche during resource shortage periods.
Fibro‐Osseous Pseudotumor of the Digits Mimicking Pyogenic Granuloma
Authors: Gómez‐Zubiaur Alba , Pericet‐Fernández Laura , Vélez‐Velázquez María Dolores , Cabrera‐Hernández Alicia , Piteiro‐Bermejo Ana Belen , Beá‐Ardebol Sonia , Medina‐Montalvo Susana , Trasobares‐Marugán Lidia
Published: March 2017

Fibro‐osseous pseudotumor of the digits is a benign neoplasm that originates in the soft tissue adjacent to the short bones of the hands and feet. We present a case in a 13‐year‐old girl that was initially misdiagnosed as pyogenic granuloma. Familiarity with this entity and imaging and histologic studies are necessary to avoid incorrect diagnoses and aggressive surgical interventions.
Cutaneous and Systemic Findings in Mosaic Neurofibromatosis Type 1
Authors: Vázquez‐Osorio Igor , Duat‐Rodríguez Anna , García‐Martínez Francisco Javier , Torrelo Antonio , Noguera‐Morel Lucero , Hernández‐Martín Angela
Published: March 2017

Background/Objectives

Mosaic neurofibromatosis type 1 (MNF1) is a variant of neurofibromatosis type 1 (NF1) in which clinical manifestations are limited to one or several body segments. The objective was to characterize the cutaneous features and associated systemic findings in a cohort of children with MNF1.

Methods

We performed a retrospective study of 40 children diagnosed with MNF1 at the Department of Dermatology, Hospital Infantil Niño Jesús, Madrid, Spain, from January 1, 1986, to October 31, 2015.

Results

All patients had pigmentary changes, alone (n = 39) or in combination with neurofibromas (n = 1). Twenty‐four cases fulfilling the definition of MNF1 had six or more café au lait spots with or without freckling within the affected segment. They all lacked any other National Institutes of Health criteria of NF1. No patient had juvenile xanthogranuloma (JXG) or nevus anemicus (NA). Two children with MNF1 had epilepsy and two others developed malignancy (Hodgkin's lymphoma and ganglioneuroblastoma).

Conclusions

Pigmentary changes are the most frequent presentation of MNF1 in children. MNF1 must be considered with segmentary distribution of freckling and café au lait spots. Other frequent cutaneous findings in NF1, such as JXG or NA, seem to be exceptional in MNF1. Although the possibility of systemic complications and cancer risk seem to be low, patients must be followed up.
Effect of a Referral‐Only Policy on Wait Time for Outpatient Pediatric Dermatology Appointments
Authors: Herd Tiffany J. , Nopper Amy J. , Horii Kimberly A.
Published: March 2017

Decreasing wait time for pediatric dermatology appointments is important to patients. We retrospectively examined the effect of a referral‐only policy on patient wait time for an initial appointment in an academic pediatric dermatology clinic and found a statistically significant decrease in wait time after the policy was instituted.
Dermatomyofibromas Arising in Children: Report of Two New Cases and Review of the Literature
Authors: Ma Janice E. , Wieland Carilyn N. , Tollefson Megha M.
Published: March 2017

Dermatomyofibroma is a rare, benign mesenchymal proliferation not commonly reported in children. Two patients with biopsy‐proven dermatomyofibroma were identified (one female, one male) at our institution, both with rather atypical clinical presentations. The clinical and histopathologic findings and a review of the literature are presented here. Features of dermatomyofibroma should be recognized and differentiated from those of similar‐appearing entities since the prognosis of this benign tumor is favorable after complete excision.
Eosinophilic Pustular Folliculitis in Children after Stem Cell Transplantation: An Eruption Distinct from Graft‐Versus‐Host Disease
Authors: Theiler Martin , Oza Vikash S. , Mathes Erin F. , Dvorak Christopher C. , McCalmont Timothy H. , Yeh Iwei , Sidbury Robert , Cordoro Kelly M.
Published: March 2017

Eosinophilic pustular folliculitis (EPF) is a rare cutaneous disorder that typically occurs in three clinical contexts: men, individuals who are immunosuppressed or have human immunodeficiency virus, and infants. A fourth subtype occurring 2 to 3 months after hematopoietic stem cell transplantation (HSCT) has recently been described in several adults. We report two cases of EPF arising in children after HSCT. It is important to recognize this form of EPF after HSCT and differentiate it from graft‐versus‐host disease since it responds readily to topical steroids and appears to have an excellent prognosis.
Distance, Quality, or Relationship? Interhospital Transfer of Heart Attack Patients
Authors: Lu Lauren Xiaoyuan , Lu Susan Feng
Published: March 2017

We empirically investigate the pattern of where heart attack patients are transferred between hospitals. Using 2011 Florida State Emergency Department and Inpatient Databases, we demonstrate the relative importance of three key factors in determining transfer destinations: (1) the distance between sending and receiving hospitals, (2) publicly reported quality measures of receiving hospitals, and (3) the relationship between sending and receiving hospitals as indicated by whether they are affiliated with the same multihospital system. Our conditional logit analysis shows that hospital relationship plays a more dominant role in determining transfer destinations than distance and quality. This result is robust to three alternative specifications of choice sets using distance ranking, radius circles, and Hospital Referral Regions, and also robust to alternative measures of distance and quality. Using 30‐day readmission rate to evaluate the health outcome of transferred patients, we find that relationship‐based transfers led to worse outcome than distance‐based and quality‐based transfers. We also find that nonprofit hospitals are more likely to conduct quality‐based transfers and less likely to conduct relationship‐based transfers than their for‐profit counterparts. Our study calls for reevaluating the current practice of relationship‐driven routing of heart attack patients—selecting transfer destinations based on quality or distance can potentially decrease hospital readmission rate.
Creating shareholder value via collaborative innovation: the role of industry and resource alignment in knowledge exploration
Authors: Heil Sebastian , Bornemann Torsten
Published: March 2017

Collaborative innovation provides firms with a privileged opportunity to perform exploration in an externally oriented mode. The central challenges in exploration via collaborative innovation lie in the selection of relevant partners and in gaining access to potentially valuable external knowledge that the focal firm lacks. This article focuses on two aspects of inter‐organizational alignment that affect knowledge differences and may thus help explaining the shareholder value implications arising from collaborative innovation: industry and resource alignment. Relying on data covering 97 bilateral collaborative innovations (194 innovation partners) in R&D intensive high‐technology industries, we used event study methodology and follow‐up hierarchical regression analyses to test our conceptual framework. With regard to industry alignment, results suggest that investors value greater industry distance between collaborating partners, especially when the partner firm provides high‐level R&D resources. Furthermore, the results show a positive effect of supplementary resource alignment (i.e., a focal firm's R&D resources are supplemented by a partner firm's R&D resources) and, notably, a negative effect of complementary resource alignment (i.e., a focal firm's R&D resources are complemented by a partner firm's marketing resources) on investors' valuation of the collaboration's expected future performance. They, thus, contribute to research on shareholder value implications of collaborative innovation. From a managerial perspective, the study provides a better understanding of partner selection and shows how managers should position a collaboration to signal the shareholder value‐creating potential to investors.
Recent Research Developments Affecting Nonlife Insurance—The CAS Risk Premium Project 2014 Update
Authors: Eling Martin , Jia Ruo
Published: March 2017

This article discusses the main results of the Casualty Actuarial Society Risk Premium Project 2014 update. It reviews the recent research developments in the process of nonlife risk assessment. Of special note, systemic risk continuously attracts a great deal of attention. In the past year, reinsurance studies have increased significantly, driven by progress in optimal reinsurance design and reinsurance asymmetric information. Both topics show the academic reflection of financial crisis in the field of risk and insurance. The evaluation of reserves and the methods mitigating asymmetric information have also received a great deal of attention.
Periorbital melasma: Hierarchical cluster analysis of clinical features in Asian patients
Authors: Jung Y. S. , Bae J. M. , Kim B. J. , Kang J.‐S. , Cho S. B.
Published: March 2017

Background

Studies have shown melasma lesions to be distributed across the face in centrofacial, malar, and mandibular patterns. Meanwhile, however, melasma lesions of the periorbital area have yet to be thoroughly described.

Methods

We analyzed normal and ultraviolet light‐exposed photographs of patients with melasma. The periorbital melasma lesions were measured according to anatomical reference points and a hierarchical cluster analysis was performed.

Results

The periorbital melasma lesions showed clinical features of fine and homogenous melasma pigmentation, involving both the upper and lower eyelids that extended to other anatomical sites with a darker and coarser appearance. The hierarchical cluster analysis indicated that patients with periorbital melasma can be categorized into two clusters according to the surface anatomy of the face. Significant differences between cluster 1 and cluster 2 were found in lateral distance and inferolateral distance, but not in medial distance and superior distance. Comparing the two clusters, patients in cluster 2 were found to be significantly older and more commonly accompanied by melasma lesions of the temple and medial cheek.

Conclusion

Our hierarchical cluster analysis of periorbital melasma lesions demonstrated that Asian patients with periorbital melasma can be categorized into two clusters according to the surface anatomy of the face.
The use of low‐dose metronomic chemotherapy in dogs—insight into a modern cancer field
Authors: Gaspar T. B. , Henriques J. , Marconato L. , Queiroga F. L.
Published: March 2017

The era of chemotherapy, which started in the middle of the last century, has been ruled by the routine use of dose‐intense protocols, based on the “maximum‐tolerated dose” concept. By promoting a balance between patient's quality of life and the goal of rapidly killing as many tumour cells as possible, these protocols still play a prominent role in veterinary oncology. However, with the opening of a new millennium, metronomic chemotherapy (MC) started to be considered a possible alternative to traditional dose‐intense chemotherapy. Characterized by a long‐term daily administration of lower doses of cytotoxic drugs, this new modality stands out for its unique combination of effects, namely on neovascularization, immune response and tumour dormancy. This article reviews the rationale for treatment with MC, its mechanism of action and the main studies conducted in veterinary medicine, and discusses the key challenges yet to be solved.
Grass filter strip residence time‐trap efficiency relationship
Authors: Akan A. Osman , Atabay Serter
Published: March 2017

This paper investigates the relationship between trap efficiency and residence time in vegetative filter strips under unsteady flow conditions. A mathematical model, based on a kinematic‐wave formulation of overland flow and a mass balance equation for suspended sediments, is employed. An empirical equation is used to estimate sediment removal. The governing equations are written and solved numerically in terms of a set of dimensionless variables. The results indicate that the relationships between the trap efficiency and residence time depend on the shape of the inflow hydrograph. Further analysis of results identified another non‐dimensional parameter that can predict the trap efficiency if only the volume and the peak rate of inflow are known. While the mathematical model employed includes many elements of the sophisticated vegetative filter strip models previously reported, the resulting charts are as easy to use as the oversimplified design methods currently in use
Barriers to innovation in human rabies prophylaxis and treatment: A causal analysis of insights from key opinion leaders and literature
Authors: van de Burgwal L. H. M. , Neevel A. M. G. , Pittens C. A. C. M. , Osterhaus A. D. M. E. , Rupprecht C. E. , Claassen E.
Published: March 2017

Rabies is an essentially 100% fatal, zoonotic disease, caused by Lyssaviruses. Currently, the disease is vaccine‐preventable with pre‐ and post‐exposure prophylaxis (PrEP and PEP). Still, rabies virus is estimated to cause up to 60,000 human deaths annually, of which the vast majority occurs in rural Asia and Africa, due to the inaccessibility of prophylaxis and non‐existence of treatment. Despite these unmet clinical needs, rabies control mainly focuses on the sylvatic reservoir and drug innovation receives relatively little attention compared to other neglected tropical diseases (NTDs). As such, the lag of innovation in human rabies prophylaxis and treatment cannot be explained by limited return on investment alone. Strategies countering rabies‐specific innovation barriers are important for the acceleration of innovation in human rabies prophylaxis and treatment. Barriers throughout society, science, business development and market domains were identified through literature review and 23 semi‐structured interviews with key opinion leaders worldwide. A subsequent root cause analysis revealed causal relations between innovation barriers and a limited set of root causes. Finally, prioritization by experts indicated their relative importance. Root causes, which are fundamental to barriers, were aggregated into four types: market and commercial, stakeholder collaboration, public health and awareness, and disease trajectory. These were found in all domains of the innovation process and thus are relevant for all stakeholders. This study identifies barriers that were not previously described in this specific context, for example the competition for funding between medical and veterinary approaches. The results stress the existence of barriers beyond the limited return on investment and thereby explain why innovation in human rabies medication is lagging behind NTDs with a lower burden of disease. A re‐orientation on the full spectrum of barriers that hinder innovation in rabies prophylaxis and treatment is necessary to meet unmet societal and medical needs.
Estimating Optimal Level of Taxation for Growth Maximization in Asia
Authors: Amgain Jeeban
Published: March 2017

What level of tax revenue in GDP is suitable for a country to maximize the growth rate in Asia? To address this question, this paper estimates the optimal size of taxes which maximizes growth rate, using Scully and quadratic models, from the unbalanced panel data of 32 Asian countries. Both methods approve that tax revenue around 18 percent of GDP maximizes the growth rate. However, quadratic model provides more consistent result than the Scully model. Most importantly, the findings clearly show the existence of inverse U-shaped relationship between taxes and growth.
School Administrators Skills in Organizing the Parent Participation Studies
Authors: Albez Canan , Ada Şükrü
Published: March 2017

The objective of this study is to ascertain administrator, teacher and parent opinions on the level of school administrators’ skills of organising parent participation efforts. The study group of the study conducted according to the descriptive survey model using the quantitative method consists of 273 school administrators, 916 teachers and 395 parents from primary schools, secondary schools and high schools, determined according to the stratified sampling method. The quantitative data of the research were obtained through the ‘scale for school administrators’ skills of organising parent participation efforts' applied to school administrators, teachers and parents after the validity - reliability studies were conducted. The study reached the conclusion that school administrators’ skills in organising parent participation efforts and the parent participation efforts conducted were inadequate.
Branches Investigation of the Religious Beliefs in Various Terms of Variables of the Turkish National Team Athletes in Individual
Authors: Altungül Oğuzhan
Published: March 2017

In general, and broadest sense, the word religion; “No matter what submission to a higher authority, to accept orders and provisions that arising from this authority as the rules that must be followed, when the prize comply with these rules will be taken when the penalty point against is the general name of a living system into believing the area. The study’s population is the athletes participating in the competition in individual branches of the Turkish national team. The sample of the study is 50 females and 102 males totally 152 national athletes who representing Turkish National Team in individual branches such as Boxing (46), Taekwondo (30), Wrestling (76). Personal Information Survey and Religious Belief Scale were used in collecting the data. When the data analyzed statistically, it is determined that there is significant differences in terms of gender, marital status and level of education. As a result, it is emerged that, religious is known by everyone unheeded by someone but believed to be in every respect and worshipping in availability by the elite athletes and in terms of sports and athletes it is different in normal people.
Computational Modeling and Comparative Tissue Damage Analysis of Angioplasty and Orbital Atherectomy Interventional Procedures
Authors: Deokar Rohit R. , Klamecki Barney E.
Published: March 2017

This research was directed toward quantitatively characterizing the effects of arterial mechanical treatment procedures on the stress and strain energy states of the artery wall. Finite element simulations of percutaneous transluminal angioplasty (PTA) and orbital atherectomy (OA) were performed on arterial lesion models with various extents and types of plaque. Stress fields in the artery were calculated and strain energy density was used as an explicit description of potential damage to the artery. The research also included numerical simulations of changes in arterial compliance due to orbital atherectomy. The angioplasty simulations show that the damage energy fields in the media and adventitia are predominant in regions of the lesion that are not protected by a layer of calcification. In addition, it was observed that softening the plaque components leads to a lower peak stress and therefore lesser damage energy in the media and adventitia under the action of a semicompliant balloon. Orbital atherectomy simulations revealed that the major portion of strain energy dissipated is concentrated in the plaque components in contact with the spinning tool. The damage and peak stress fields in the media and adventitia components of the vessel were significantly less. This observation suggests less mechanically induced trauma during a localized procedure like orbital atherectomy. Artery compliance was calculated pre- and post-treatment and an increase was observed after the orbital atherectomy procedure. The localized plaque disruption produced in atherectomy suggests that the undesirable stress states in angioplasty can be mitigated by a combination of procedures such as atherectomy followed by angioplasty.
Case of lymphadenopathy with lytic bone lesions
Authors: Kalantri Siddhesh Arun , Nath Uttam Kumar , Banerjee Debasis , Bhattacharyya Maitreyee
Published: March 2017

Plasmablastic lymphoma, a rare highly aggressive non-Hodgkin's lymphoma subtype, often associated with HIV infection, is a close differential diagnosis of plasmablastic myeloma. The 2 conditions may be morphologically and immunophenotypically identical. However, differentiating between the 2 conditions is critical for adequate patient management. Herein, we describe an unusual case of plasmablastic myeloma with biclonal gammopathy which was initially diagnosed as plasmablastic lymphoma based on lymph node biopsy and immunohistochemistry (IHC) results. The incidental finding of lytic bone lesion on imaging prompted further investigations. The presence of multiple osteolytic lesions, biclonal gammopathy on serum protein electrophoresis and immunofixation, negative Epstein-Barr virus-encoded small RNAs on IHC led to revision of the diagnosis to plasmablastic variant of multiple myeloma. The patient was initially started on bortezomib plus dose-adjusted EPOCH chemotherapy for plasmablastic lymphoma. Subsequently, he was treated with RVD (lenalidomide, bortezomib, dexamethasone) regimen for plasmablastic myeloma and he achieved stringent complete response after 4 cycles.
Application of curing compounds on concrete pavements
Authors: Tiznobaik M. , Bassuoni M.T.
Published: March 2017

The concrete hardening process should take place in a manner that provides optimum hydration development, which can be achieved through proper curing practices. Since curing of concrete is essential at controlling its mechanical and durability performance during service, the aim of this research was to assess the effect of different curing compound applications on the behavior of field pavement, and thus projecting its long-term durability. The study involved experiments on cores extracted from recently constructed pavement sections in comparison to corresponding specimens produced from similar concrete under laboratory conditions. Absorption, rapid chloride penetrability, thermogravimetry, mercury intrusion porosimetry, and scanning electron microscopy tests were conducted on cores and specimens to study the effect of the different curing compound applications. The overall trends indicate that applying a thorough coat of curing compound is essential to ensure moisture retention in concrete for efficient hydration reactions and microstructural development.
Null and timelike geodesics of the Schwarzschild black hole with string cloud background
Authors: Batool Mahwish , Hussain Ibrar
Published: March 2017

The trajectories of the time-like and null geodesics for radial and circular motion of the Schwarzschild black hole with string cloud background are investigated and compared with the Schwarzschild case without string clouds. It is found that in the presence of the string cloud parameter, the radius of the orbits is larger than the radius of the orbits in the case of the Schwarzschild black hole without string cloud parameter. Effective potential is calculated and it is observed that as the value of string cloud parameter increases the particle can more easily escape to infinity. Stability of the circular orbits is also discussed.
On a quasilinear nonlocal Benney system
Authors: Dias João-Paulo , Oliveira Filipe
Published: March 2017

We study a quasilinear nonlocal Benney system and establish the existence and uniqueness of strong local in time solutions to the corresponding Cauchy problem. We also show, under certain conditions, the blow-up of such solutions in finite time. Furthermore, we prove the existence of global weak solutions and exhibit bound-state solutions to this system.
HOW DID BANGALORE EMERGE AS A GLOBAL HUB OF TECH START-UPs IN INDIA? ENTREPRENEURIAL ECOSYSTEM — EVOLUTION, STRUCTURE AND ROLE
Authors: BALA SUBRAHMANYA MH
Published: March 2017

Of late, technology entrepreneurship and ecosystem for technology based start-ups are attracting the attention of policy makers and empirical researchers alike, across the world. In India, Bangalore has been receiving increased global recognition as a tech start-up hub; as of now, Bangalore is considered to be the home for the largest number of tech start-ups in the country and third largest in the world. An important factor that contributed to this “status and recognition” of Bangalore is the emergence of a unique entrepreneurial ecosystem, which supports and promotes tech start-ups. Given this, it is important to understand how a favorable entrepreneurial ecosystem for tech start-ups emerged in Bangalore. What are its major components? What role do these components play in different stages of the life cycle of tech start-ups in Bangalore? How mature is the ecosystem of Bangalore to support the emergence, sustenance and growth of tech start-ups to nurture them? What are the key lessons that can be derived out of the Bangalore tech hub experience? This article is an attempt to shed light on these issues.