bluuebunny/crossref_metadata_2025 huggingface dataset:
La Classe américaine
Authors: Labate Simon
Published: June 2017

On 31 December 1993, French pay TV channel Canal+ broadcast a 70-minute film called La Classe américaine, directed by
Michel Hazanavicius and Dominique Mézerette. They took excerpts from about fifty Warner Bros. productions, edited them to build a story and
had the characters (played by A-list actors such as John Wayne and James Stewart) dubbed over by well-known French voice actors, resulting
in what is known technically as a ‘détournement’, combining the techniques of film collage and dubbing. This paper sketches the origins and
the production context of this very unusual audiovisual object, relying on insights from film theory, with particular reference to
adaptation techniques like remixes and collages. The analysis also shows how meaning and humour are created through the montage of
originally completely disconnected scenes and the addition of funny or crude dialogues that one would not expect from cinema legends like
John Wayne. A final part highlights the film’s cult status and its influence on the creation of more détournements.
Travelling through the centuries
Authors: Steinke Carolin Crespo
Published: June 2017

The paper analyses the influence of John Madden’s biopicShakespeare in Love(GB/USA, 1998) onMolière(FR, 2007) andYoung Goethe in Love(GER, 2010) by having a closer look at the intertextual relationship between the films. For this, it considers external and internal connections, referring to intertexts for the promotion and marketing as well as the use of content-based conventions for biopics on writers, literary sources and anachronisms. The analysis reveals that, although the French and German films takeShakespeare in Loveas a source of inspiration, they rewrite the approach and transform it for an individual representation of their national subjects. This double effect points to a different, alternative strategy for adapting the literary life of the canonical author.
Key words and translated cohesion in Lovecraft’s At the Mountains of Madness and one of its Italian
translations
Authors: Mastropierro Lorenzo , Mahlberg Michaela
Published: June 2017

In this paper, we explore the potential of a corpus approach to study translated cohesion. We use key words as
starting points for identifying cohesive networks in Lovecraft’s At the Mountains of Madness and discuss how these networks
contribute to the construction of literary meanings in the text. We focus on the role of repetition as a key element in establishing
cohesive networks between lexical items. We specifically discuss the implications of our method for the analysis of cohesion in translated
texts. A comparison of Lovecraft’s original novel and a translation into Italian provides us with a nuanced understanding of the complex
nature of cohesive networks. Finally, we discuss the broader issue of applying models and methods from corpus linguistics to corpus
stylistic analysis.
Learning in-progress
Authors: Kimura Daisuke , Kazik Natalia
Published: June 2017

Though gesture is a growing area in second language research, its role in the teaching and learning of grammar remains on the
margins. Drawing from Sociocultural Theory, the present case study addresses this gap by offering a microgenetic analysis of an
ESL learner’s developing understanding of the progressive aspect. Our analysis is threefold. First, we observe how the learner’s
gesture reveals her initial understanding of the progressive aspect. This is followed by study of the learner’s appropriation of
the teacher’s gesture for the progressive aspect. Finally, we examine the crucial ways in which the learner’s gesture differs from
the teacher’s, arguing that the learner merged her initial understanding and the teacher’s gesture, instead of merely copying the
teacher. We contend that gesture should not be regarded as supplementary to speech but as an indispensable window into the
learning process that may not be accessible through the verbal channel alone.
The International Labour Organization and African trade unions: tripartite fantasies and enduring struggles
Authors: Bernards Nick
Published: June 2017

This article examines the complex and contradictory history of interactions between the International Labour Organization (ILO) and trade unions in Africa from 1960 to the present. The paper focuses in particular on ILO efforts to deliver technical assistance to trade unions. I highlight the tensions raised by the mismatch between ILO’s adherence to a particular view of industrial unionism rooted in northern European experience, which I label the ‘tripartite fantasy’ and the political and economic realities of labour in Africa. The article draws on original archival and interview evidence to trace out the subtle conflicts raised by these tensions. It focuses in particular on the difficulty in balancing the principle of freedom of association with efforts to promote ‘unity’ among African unions. These tensions played out most clearly in efforts to organise assistance to unions under apartheid. The article concludes by reflecting on the difficult position of the ILO in contemporary African politics.
Molecular model of fission yeast centrosome assembly determined by superresolution imaging
Authors: Bestul Andrew J. , Yu Zulin , Unruh Jay R. , Jaspersen Sue L.
Published: June 2017

Microtubule-organizing centers (MTOCs), known as centrosomes in animals and spindle pole bodies (SPBs) in fungi, are important for the faithful distribution of chromosomes between daughter cells during mitosis as well as for other cellular functions. The cytoplasmic duplication cycle and regulation of the Schizosaccharomyces pombe SPB is analogous to centrosomes, making it an ideal model to study MTOC assembly. Here, we use superresolution structured illumination microscopy with single-particle averaging to localize 14 S. pombe SPB components and regulators, determining both the relationship of proteins to each other within the SPB and how each protein is assembled into a new structure during SPB duplication. These data enabled us to build the first comprehensive molecular model of the S. pombe SPB, resulting in structural and functional insights not ascertained through investigations of individual subunits, including functional similarities between Ppc89 and the budding yeast SPB scaffold Spc42, distribution of Sad1 to a ring-like structure and multiple modes of Mto1 recruitment.
Doping β-Ga2O3 with europium: influence of the implantation and annealing temperature
Authors: Peres M , Lorenz K , Alves E , Nogales E , Méndez B , Biquard X , Daudin B , Víllora E G , Shimamura K
Published: June 2017

β-Ga2O3 bulk single crystals were doped by ion implantation at temperatures from room temperature to 1000 °C, using a 300 keV Europium beam with a fluence of 1  ×  1015 at cm−2. Rising the implantation temperature from room temperature to 400–600 °C resulted in a significant increase of the substitutional Eu fraction and of the number of Eu ions in the 3+  charge state as well as in a considerable decrease of implantation damage. Eu is found in both charge states 2+  and 3+  and their relative fractions are critically dependent on the implantation and annealing temperature, suggesting that defects play an important role in stabilizing one of the charge states. The damage recovery during post-implant annealing is a complex process and typically defect levels first increase for intermediate annealing temperatures and a significant recovery of the crystal only starts around 1000 °C. Cathodoluminescence spectra are dominated by the sharp Eu3+ related intra-ionic 4f transition lines in the red spectral region. They show a strong increase of the emission intensity with increasing annealing temperature, in particular for samples implanted at elevated temperature, indicating the optical activation of Eu3+ ions. However, no direct correlation of emission intensity and Eu3+ fraction was found, again pointing to the important role of defects on the physical properties of these luminescent materials.
Miro1-mediated mitochondrial positioning shapes intracellular energy gradients required for cell migration
Authors: Schuler Max-Hinderk , Lewandowska Agnieszka , Caprio Giuseppe Di , Skillern Wesley , Upadhyayula Srigokul , Kirchhausen Tom , Shaw Janet M. , Cunniff Brian
Published: June 2017

It has long been postulated, although never directly demonstrated, that mitochondria are strategically positioned in the cytoplasm to meet local requirements for energy production. Here we show that positioning of mitochondria in mouse embryonic fibroblasts (MEFs) determines the shape of intracellular energy gradients in living cells. Specifically, the ratio of ATP to ADP was highest at perinuclear areas of dense mitochondria and gradually decreased as more-peripheral sites were approached. Furthermore, the majority of mitochondria were positioned at the ventral surface of the cell, correlating with high ATP:ADP ratios close to the ventral membrane, which rapidly decreased toward the dorsal surface. We used cells deficient for the mitochondrial Rho-GTPase 1 (Miro1), an essential mediator of microtubule-based mitochondrial motility, to study how changes in mitochondrial positioning affect cytoplasmic energy distribution and cell migration, an energy-expensive process. The mitochondrial network in Miro1−/− MEFs was restricted to the perinuclear area, with few mitochondria present at the cell periphery. This change in mitochondrial distribution dramatically reduced the ratio of ATP to ADP at the cell cortex and disrupted events essential for cell movement, including actin dynamics, lamellipodia protrusion, and membrane ruffling. Cell adhesion status was also affected by changes in mitochondrial positioning; focal adhesion assembly and stability was decreased in Miro1−/−MEFs compared with Miro1+/+ MEFs. Consequently Miro1−/− MEFs migrated slower than control cells during both collective and single-cell migration. These data establish that Miro1-mediated mitochondrial positioning at the leading edge provides localized energy production that promotes cell migration by supporting membrane protrusion and focal adhesion stability.
Retinoschisin is linked to retinal Na/K-ATPase signaling and localization
Authors: Plössl Karolina , Royer Melanie , Bernklau Sarah , Tavraz Neslihan N. , Friedrich Thomas , Wild Jens , Weber Bernhard H. F. , Friedrich Ulrike
Published: June 2017

Mutations in the RS1 gene cause X-linked juvenile retinoschisis (XLRS), a hereditary retinal dystrophy. We recently showed that retinoschisin, the protein encoded by RS1, regulates ERK signaling and apoptosis in retinal cells. In this study, we explored an influence of retinoschisin on the functionality of the Na/K-ATPase, its interaction partner at retinal plasma membranes. We show that retinoschisin binding requires the β2-subunit of the Na/K-ATPase, whereas the α-subunit is exchangeable. Our investigations revealed no effect of retinoschisin on Na/K-ATPase–mediated ATP hydrolysis and ion transport. However, we identified an influence of retinoschisin on Na/K-ATPase–regulated signaling cascades and Na/K-ATPase localization. In addition to the known ERK deactivation, retinoschisin treatment of retinoschisin-deficient (Rs1h-/Y) murine retinal explants decreased activation of Src, an initial transmitter in Na/K-ATPase signal transduction, and of Ca2+signaling marker Camk2. Immunohistochemistry on murine retinae revealed an overlap of the retinoschisin–Na/K-ATPase complex with proteins involved in Na/K-ATPase signaling, such as caveolin, phospholipase C, Src, and the IP3 receptor. Finally, retinoschisin treatment altered Na/K-ATPase localization in photoreceptors of Rs1h-/Yretinae. Taken together, our results suggest a regulatory effect of retinoschisin on Na/K-ATPase signaling and localization, whereas Na/K-ATPase-dysregulation caused by retinoschisin deficiency could represent an initial step in XLRS pathogenesis.
Variation of Phenolics, Tocols, Antioxidant Activities, and Soluble Sugar Compositions in Red and Black Rice (Oryza sativa L.) During Boiling
Authors: Shao Yafang , Fang Changyun , Zhang Huali , Shi Yuping , Hu Zhanqiang , Zhu Zhiwei
Published: June 2017

This study systematically examined hydrothermal effects of antioxidant substances, such as total phenolic (TPC), flavonoid (TFC), and proanthocyanidin (TPAC) contents, cyanidin‐3‐O‐glucoside (C3G), peonidin‐3‐O‐glucoside (P3G), α‐, γ‐, and δ‐tocopherols, and α‐, γ‐, and δ‐tocotrienols, as well as antioxidant activities, color parameters, and soluble sugar compositions in red and black rice. It showed that color differences (ΔE) of black rice were higher than those of red rice caused by boiling. The processed red and black rice exhibited significantly (P < 0.05) lower TPC, TFC, TPAC, C3G, P3G, and antioxidant activities compared with the raw rice except bound TPC and bound antioxidant activity. Interestingly, soluble free p‐coumaric and ferulic acids had higher contents in cooked red rice, and soluble free protocatechuic, vanillic, and sinapic acids had higher contents in cooked black rice. Boiling caused significant decreases of soluble conjugated phenolic acids and significant increases of insoluble bound phenolic acids in both red and black rice. Increases of total free tocol, glucose, and fructose contents were observed in most red and black rice. To increase the contents of some soluble free and insoluble bound phenolic acids, free vitamin E, and monosaccharides in red and black rice, boiled rice might be a good choice.
Effect of Pea Flours with Different Particle Sizes on Antioxidant Activity in Pan Breads
Authors: Davies‐Hoes Lisa D. , Scanlon Martin G. , Girgih Abraham T. , Aluko Rotimi E.
Published: June 2017

Pulses are good sources of vitamins and minerals as well as antioxidants. Current literature supports a role for antioxidants in reducing oxidative damage associated with many health disorders, including cardiovascular disease and cancer. The effects of substitution of 10% (w/w) yellow whole or split pea flour (various particle sizes) in white wheat flour (Canadian Wheat Red Spring) on the phenolic and antioxidant activity of the leavened bread were examined. Antioxidant activity was evaluated with four assays, which included 1,1‐diphenyl‐2‐picrylhydrazyl (DPPH) radical scavenging, ferric reducing antioxidant power (FRAP), metal chelation (MC), and superoxide (SO) radical scavenging assays. The bread samples had reduced DPPH (5–11% scavenging activity) and MC (5–10% scavenging activity) values compared with their respective raw flours. Decreased activity in both the DPPH and MC assays can be attributed to a reduction in the antioxidant capacity in the bread samples owing to dilution with white wheat flour. The MC values for bread samples showed little variability between the yellow whole and split pea flours (8–10% scavenging activity for yellow whole and 9% for split pea flours), which suggests that the antioxidant activity of bread samples is not dramatically affected by the seed coats. Most pea fractions increased the FRAP scavenging activity and decreased the SO scavenging activity values for the bread samples compared with their respective raw flours. We conclude that thermal processing enhanced the antioxidant activity of the bread samples, limiting the dilution effect associated with flour addition during dough make‐up.
Constipation in children
Authors: Ferrara Lucille R. , Saccomano Scott J.
Published: June 2017

Deviation from normal bowel function in the pediatric population is often a cause for concern for parents and caregivers, prompting numerous visits to a primary care provider. Constipation is a common and challenging issue in children that can have an adverse impact on their psychosocial and emotional well-being as well as quality of life. This article provides practical strategies for diagnosing, treating, and preventing constipation in children.
Pelvic pain in transgender men taking testosterone
Authors: Harris Miles , Kondel Lauren , Dorsen Caroline
Published: June 2017

Some guidelines on care for transgender men taking testosterone recommend oophorectomy to prevent ovarian cancer, while others recommend following guidelines for females. A review of the literature finds no strong evidence that transgender men are at increased risk for ovarian cancer. In transgender men taking testosterone without other risk factors, oophorectomy to prevent cancer is unnecessary.
Molecular aspects of allergens in atopic dermatitis
Authors: Campana Raffaela , Dzoro Sheron , Mittermann Irene , Fedenko Elena , Elisyutina Olga , Khaitov Musa , Karaulov Alexander , Valenta Rudolf
Published: June 2017

Purpose of review

Molecular allergology uses pure, mainly recombinant and structurally defined allergen molecules and allergen-derived epitopes to study mechanisms of IgE-associated allergy, to diagnose, and even predict the development of allergic manifestations and to treat and prevent IgE-associated allergies. Atopic dermatitis, a chronic inflammatory skin disease is almost always associated with IgE sensitization to allergens. However, also non-IgE-mediated pathomechanisms seem to be operative in atopic dermatitis and it is often difficult to identify the disease-causing allergens. Here we review recent work showing the usefulness of molecular allergology to study mechanisms of atopic dermatitis, for diagnosis and eventually for treatment and prevention of atopic dermatitis.

Recent findings

IgE sensitization to airborne, food-derived, microbial allergens, and autoallergens has been found to be associated with atopic dermatitis. Using defined allergen molecules and non-IgE-reactive allergen derivatives, evidence could be provided for the existence of IgE- and non-IgE-mediated mechanisms of inflammation in atopic dermatitis. Furthermore, effects of epicutaneous allergen administration on systemic allergen-specific immune responses have been studied. Multi-allergen tests containing micro-arrayed allergen molecules have been shown to be useful for the identification of culprit allergens in atopic dermatitis and may improve the management of atopic dermatitis by allergen-specific immunotherapy, allergen avoidance, and IgE-targeting therapies in a personalized medicine approach.

Molecular allergology allows for dissection of the pathomechanisms of atopic dermatitis, provides new forms of allergy diagnosis for identification of disease-causing allergens, and opens the door to new forms of management by allergen-specific and T cells-targeting or IgE-targeting interventions in a personalized medicine approach.
Retention Rates in New Contact Lens Wearers
Authors: Sulley Anna , Young Graeme , Hunt Chris , McCready Sarah , Targett Marie-Therese , Craven Ruth
Published: June 2017

Purpose:

To determine the retention rate (RR) for neophyte patients fitted with contact lenses (CLs) and to identify factors associated with retention and dropout.

Method:

This multisite, sponsor-masked registry study evaluated the 1-year status of neophyte CL wearers fitted in a representative range of UK practices. A total of 26 UK investigational sites each recruited up to 89 neophyte patients. The participants were requested to complete surveys at 1 month (±1 week from date of fitting), 3 months (±2 weeks), and 12 months (±3 weeks) online or through phone. Participants were contacted by email (or phone) and invited to complete an online survey that asked a range of questions regarding their CL wearing experience.

Results:

Of the 531 participants recruited, 65.3% (347/531) responded to at least one follow-up survey and 42.3% (225/531) responded to all three surveys. One in four patients showed discontinued CL wear by 12 months. Based on evaluable subjects at 12 months, the RR was 77.6% (194/250, 95% confidence interval: 72.0–82.3). The most common reason for discontinuation was problems with vision (41%), followed by discomfort (36%) and handling problems (25%). The factors affecting first-year RRs: sex, spherical refraction, lens usage (full time or part time), and supply method (collected or posted).

Conclusions:

In this prospective study, the first-year RR for neophyte CL wearers was 77.6%. This was consistent with that noted in a retrospective study: 74.0%. As with the previous study, the commonly cited reason for discontinuation was visual problems.
Eye Symptom Questionnaire to Evaluate Anterior Eye Health
Authors: Woodward Maria A. , Valikodath Nita G. , Newman-Casey Paula Anne , Niziol Leslie M. , Musch David C. , Lee Paul P.
Published: June 2017

Objectives:

Ophthalmologists assess eye complaints with a careful history and eye examination; however, other types of physicians have limited tools to evaluate anterior segment (AS) eye diseases. We identified the eye symptom questions that providers should ask to help determine the presence and urgency of AS eye diseases.

Methods:

Persons with and without AS disease completed a self-report eye symptom questionnaire (ESQ) based on the National Institutes of Health Toolbox symptom items in an academic center's corneal and comprehensive eye clinics. Gold standard ophthalmic examination determined the presence and urgency of AS disease. The association between reported symptom severity and the probability of AS disease, or urgent AS disease, was evaluated using logistic regression models, and sensitivity and specificity of the ESQ were also calculated.

Results:

A total of 324 eyes of 162 subjects were included in the study. Of these, AS disease was present in 255 eyes (79%); of which, 111 eyes showed urgent disease. Increasing symptom severity for eye pain (odds ratio [OR]=2.58; P<0.001), glare (OR=2.61; P=0.001), and blurry vision (OR=1.98; P<0.001) were associated with increased odds of AS disease. Increasing symptom severity for eye pain (OR=2.02; P<0.001), eye redness (OR=1.69; P=0.02), and blurry vision (OR=1.41, P=0.01) were associated with increased odds of urgent AS disease. For the primary analysis with mild symptoms considered relevant, the sensitivity of the ESQ to detect AS disease was 83% and to detect urgent AS disease was 92%.

Conclusion:

Symptoms of eye pain, glare, redness, and blurry vision indicate the presence and urgency of AS disease.
Comparative Analysis of Peripheral Corneal Geometry in Health and Keratoconus
Authors: Mas-Aixala Enric , Gispets Joan , Lupón Núria , Cardona Genís
Published: June 2017

Objectives:

To describe and compare corneal peripheral angles in normal and keratoconic eyes, to gain a better understanding of the topography of the periphery of the cornea in keratoconus and assist practitioners in the selection and fitting of large diameter contact lenses.

Methods:

Eighty-eight eyes were included in the study, divided into three groups: healthy (A0, 28 eyes), keratoconus at stage I according to the Amsler-Krumeich classification (AI, 33 eyes) and keratoconus at stages II to IV (AII, 27 eyes). The Pentacam Scheimpflug system was used to manually measure the corneal peripheral angles corresponding to a chord length range between 8.6 and 12.6 mm at 8 different peripheral locations.

Results:

The peripheral angle was influenced by ocular condition and by the peripheral location, with no interaction effect between both factors. Statistically significant differences were found in mean corneal peripheral angles between groups A0 (30.84°±2.33°) and AI (31.63°±2.02°) (P=0.001) and between A0 and AII (31.37°±2.11°) (P=0.030). The differences between AI and AII were not significant. In all eyes, the largest and smallest peripheral angles were found at the temporal inferior and temporal superior locations, respectively, with a mean difference between largest and smallest of 3.37°±1.42° in healthy eyes and 2.96°±1.54° in keratoconus (AI+AII).

Conclusion:

Clinically insignificant differences were found in peripheral angles between keratoconus and healthy eyes, giving support to the use of large diameter, intralimbal contact lenses with peripheral designs, and resting on the same corneal region, as those fitted on normal corneas.
How to organize a medical elective
Authors: Wellstead Georgina , Koshy Kiron , Whitehurst Katharine , Gundogan Buket , Fowler Alexander J.
Published: June 2017

The medical elective is often considered a major highlight of the medical school experience. However, organizing an elective can be a daunting experience. From selecting a destination, to securing bursaries, the road is fraught with uncertainty. In this article, we provide some guidance on how to successfully organize a medical elective. This includes the selection of the destination; options for research or clinical practice and tips for budgeting and acquiring travel bursaries.
How to study effectively
Authors: Fowler Alexander , Whitehurst Katharine , Al Omran Yasser , Rajmohan Shivanchan , Udeaja Yagazie , Koshy Kiron , Gundogan Buket
Published: June 2017

The ability to study effectively is an essential part of completing a medical degree. To cope with the vast amount of information and skills needed to be acquired, it is necessary develop effective study techniques. In this article we outline the various methods students can use to excel in upcoming examinations.
Central Nervous System Varicella Zoster Virus Vasculopathy in Human Immunodeficiency Virus Patients
Authors: Panichpisal Kessarin , Vongveeranonchai Nuttawan , Plengsombat Wassana , Janjua Nazli , Nugent Kenneth
Published: June 2017

Central nervous system varicella zoster virus (CNS-VZV)–related vasculopathy can be severe and fatal. Delayed diagnosis impedes recovery. We reviewed case reports and case series in the literature. Fifty-five patients were identified. Forty patients (85%) had CD4 counts of less than 200 cells/μL. Eight patients (15%) had VZV vasculopathy secondary to CNS immune reconstitution inflammatory syndrome (IRIS). A quarter of the patients never had a history of VZV rash. Eighty-five percent of the reported angiographic studies were abnormal. Cerebrospinal fluid (CSF) pleocytosis was found in 58% (21/36). Eighty-six percent (24/28) of patients had VZV DNA in their CSF, and 71% of patients (12/17) had anti-VZV immunoglobulin G antibodies. Eighty-nine percent of the patients without CNS-IRIS who received acyclovir with corticosteroids had a good recovery. Only 30% of patients who received acyclovir alone had good outcomes. All CNS-IRIS patients except 1 had a good outcome whether they received corticosteroids. The mortality in patients without CNS-IRIS was 55%; it was 12% in CNS-IRIS patients. A history of VZV rash, abnormal vascular imaging, and CSF studies usually make the diagnosis of VZV vasculopathy in human immunodeficiency virus patients, but negative studies do not rule it out in some cases. A combination of acyclovir and corticosteroids seems to improve the outcome in patients without CNS-IRIS.
No to Pip-Tazo
Authors: Furukawa Daisuke , Graber Christopher J.
Published: June 2017

Background

Overuse of broad-spectrum antibiotics for the treatment of skin and soft tissue infections (SSTIs) is common. The objective of this study is to identify inappropriate use of piperacillin-tazobactam in the setting of SSTIs to help enhance future stewardship efforts to promote guideline concordant treatments of SSTIs at our institution.

Methods

Pharmacy records of all piperacillin-tazobactam orders from October 2013 to June 2015 were retrospectively reviewed at a tertiary Veterans Affairs (VA) medical center. Empiric piperacillin-tazobactam use for patients admitted with SSTIs was identified and evaluated for inappropriateness according to infection type (diabetic foot infection, nonpurulent, purulent, surgical site infection) and severity (mild, moderate, severe) based on institutional and national guidelines.

Results

Piperacillin-tazobactam was ordered empirically in 212 SSTI episodes, 166 of which were started in the emergency department. One hundred fifty-two patients had piperacillin-tazobactam orders continued or started on admission; of these, only 40 uses (26.3%) were appropriate, with use in severe infection associated with the highest rate of appropriateness compared with moderate or mild infection (severe, 50.0%; moderate, 12.5%; mild, 15.3%; P < 0.01). When inappropriate, the median duration of piperacillin-tazobactam use was 2 days (interquartile range, 1–3 days). Among the 166 episodes in which piperacillin-tazobactam was started in the emergency department, admitting physicians made an appropriate decision to continue or discontinue piperacillin-tazobactam in 90 episodes (54.2%).

Conclusions

Most empiric piperacillin-tazobactam use for SSTIs is inappropriate at our institution and is thus a good target for future stewardship efforts.
Vancomycin-Resistant Enterococcal Meningitis, Disseminated Strongyloidiasis, and Hypogammaglobulinemia
Authors: Uyemura Trevor M. , Siegel Marc O. , Lucar Jose , Simon Gary L.
Published: June 2017

The role of immunoglobulins in control of strongyloidiasis has not been well appreciated. This case of disseminated strongyloidiasis with vancomycin-resistant Enterococcus faecium meningitis illustrates the critical role of immunoglobulins in preventing the Strongyloides hyperinfection syndrome.
A Complete Guide on Crushing Tablets and/or Opening Capsules of Human Immunodeficiency Virus Medications
Authors: Patel Sonal , Spence James William , Veean Sohini , Gonzales-Zamora Jose , Vazquez Jose
Published: June 2017

There are limited data regarding the ability to crush tablets or open capsules for antiretroviral agents. This lack of data is problematic when encountering patients who cannot swallow these tablets or capsules, especially for patients who are mechanically ventilated. Furthermore, many antiretroviral agents do not have an oral or intravenous solution available. The authors address this issue by reviewing all commercially available antiretroviral agents to determine whether they could crush tablets or open capsules.
Sensitization of TRPV1 and TRPA1 via peripheral mGluR5 signaling contributes to thermal and mechanical hypersensitivity
Authors: Honda Kuniya , Shinoda Masamichi , Kondo Masahiro , Shimizu Kohei , Yonemoto Hisashi , Otsuki Katsuhiko , Akasaka Ryuta , Furukawa Akihiko , Iwata Koichi
Published: June 2017

Peripheral tissue inflammation or injury causes glutamate release from nociceptive axons, keratinocytes, and Schwann cells, resulting in thermal hypersensitivity. However, the detailed molecular mechanisms underlying glutamate-induced thermal hypersensitivity are unknown. The aim of this study was to clarify the involvement of peripheral transient receptor potential (TRP) TRP vanilloid 1 (TRPV1), TRP ankyrin 1 (TRPA1), and protein kinase C epsilon (PKCε) in glutamate-induced pain hypersensitivity. The amount of glutamate in the facial tissue was significantly increased 3 days after facial Complete Freund's adjuvant injection. The head-withdrawal reflex threshold to heat, cold, or mechanical stimulation was significantly decreased on day 7 after continuous glutamate or metabotropic glutamate receptor 5 (mGluR5) agonist (CHPG) injection into the facial skin compared with vehicle-injected rats, and glutamate-induced hypersensitivity was significantly recovered by mGluR5 antagonist MTEP, TRPA1 antagonist HC-030031, TRPV1 antagonist SB366791, or PKCε translocation inhibitor administration into the facial skin. TRPV1 and TRPA1 were expressed in mGluR5-immunoreactive (IR) trigeminal ganglion (TG) neurons innervating the facial skin, and mGluR5-IR TG neurons expressed PKCε. There was no significant difference in the number of GluR5-IR TG neurons among glutamate-injected, saline-injected, and naive rats, whereas that of TRPV1- or TRPA1-IR TG neurons was significantly increased 7 days after continuous glutamate injection into the facial skin compared with vehicle injection. PKCε phosphorylation in TG was significantly enhanced following glutamate injection into the facial skin. Moreover, neuronal activity of TG neurons was significantly increased following facial glutamate treatment. The present findings suggest that sensitization of TRPA1 and/or TRPV1 through mGluR5 signaling via PKCε is involved in facial thermal and mechanical hypersensitivity.
Brain Tumor Segmentation From Magnetic Resonance Imaging Scans
Authors: Toum Kawther M. , Mustafa Zeinab A. , Ibraheem Banazier A. , Hamza Alnazier O.
Published: June 2017

The segmentation of brain tumor from magnetic resonance imaging scans is a vital process for treatment planning and for studying the differences of healthy subjects and subjects with tumor. A computer-aided diagnosis algorithm has been designed so as to increase the accuracy of brain tumor detection and classification and thereby replace conventional invasive and time-consuming techniques. This article introduces an efficient method of brain tumor segmentation that is a combination of 3 existing techniques: threshold, watershed segmentation, and morphological operation. Detection and extraction of tumors from magnetic resonance imaging scans of the brain are done by using MATLAB 2015a software.
Impact of Parent-Targeted eHealth on Parent and Infant Health Outcomes
Authors: Anwar Siani Sheren , Dol Justine , Campbell-Yeo Marsha
Published: June 2017

Improved communication, education, and parental involvement in infant care have been demonstrated to enhance parental well-being and neonatal health outcomes. eHealth has the potential to increase parental presence in the neonatal intensive care unit (NICU). There has been no synthesized review on the direct impact of eHealth use on parental and neonatal health outcomes. The aim of this scoping review is to explore eHealth utilization by families of high-risk newborn infants in the NICU and/or postdischarge on health outcomes. PubMed, CINAHL, and EMBASE were searched from 1980 to October 2015 using key terms for “neonatal,” “parents,” “eHealth,” and “patient education.” Criteria of peer-reviewed empirical studies published in English, targeting parents of NICU infants regardless of diagnosis, and eHealth utilization during NICU stay or postdischarge yielded 2218 studies. Extracted data were synthesized using thematic content analysis. Ten studies met inclusion, and 5 themes emerged: usability and feasibility, parental perceived benefits, infant's hospital length of stay, knowledge uptake, and predictors of variations in use. eHealth utilization was found to be desired by parents and promotes positive change in parental experience in the NICU. Actual and perceived benefits of eHealth for parents included ease of use, higher confidence in infant care, satisfaction, and knowledge uptake.
The Lifestyle Information and Intervention Preferences of Teenage and Young Adult Cancer Survivors
Authors: Pugh Gemma , Hough Rachael , Gravestock Helen , Haddrell Jessica B. , Beeken Rebecca J. , Fisher Abigail
Published: June 2017

Background:

Little is currently known about how best to promote healthy lifestyle choices among teenage and young adult (TYA) cancer survivors. Such data gathered from a patient-centered perspective are instrumental for the development of health behavior change interventions for young people with cancer.

Objective:

This study aimed to explore the lifestyle information needs of TYA cancer survivors and their preferences regarding lifestyle information and intervention delivery. Lifestyle behaviors of interest were physical activity, diet, smoking, alcohol consumption, and sun safety.

Methods:

A total of 13 TYA cancer survivors (mean age, 22.9 years) participated in 10 individual interviews and 1 focus group (n = 3). Each interview and focus group followed the same semistructured interview guide, which was designed to explore young peoples’ motivation behind leading a healthy lifestyle, their past experience of searching for lifestyle information, and their preferences relating to lifestyle information delivery.

Results:

Three core themes emerged: cancer as a catalyst to lifestyle behavior change, factors influencing health behavior change, and health behavior information preferences. Social support emerged as facilitator of both health behavior change and self-efficacy.

Conclusion:

Young people with cancer want age-appropriate lifestyle information on a range of topics delivered in multiple formats at various time points.

Implications for Practice:

Health professionals working with TYA cancer survivors should address young peoples’ lifestyle information needs throughout the cancer care pathway and support young people to foster the confidence to make, and sustain, positive lifestyle behavior changes.
Mycoplasma genitalium Macrolide and Fluoroquinolone Resistance: Prevalence and Risk Factors Among a 2013–2014 Cohort of Patients in Barcelona, Spain
Authors: Barberá María-Jesús , Fernández-Huerta Miguel , Jensen Jørgen-Skov , Caballero Estrella , Andreu Antonia
Published: June 2017

Background

Macrolide and fluoroquinolone resistance is alarmingly emerging in M. genitalium worldwide. This article provides the first estimates of the current prevalence of macrolide and fluoroquinolone resistance–mediating mutations in Barcelona, Spain, and identifies risk factors associated with the acquisition of these resistances.

Methods

The study was conducted retrospectively with specimens submitted between February 2013 and March 2014 to the microbiology department of the Vall d'Hebron Hospital, Barcelona, where M. genitalium was detected using nucleic acid amplification methods. DNA sequencing of 23S ribosomal RNA gene and parC was performed in the Statens Serum Institut, Copenhagen, to detect genotypic macrolide and fluoroquinolone resistance markers, respectively.

Results

Macrolide resistance–mediating mutations were detected in 35% (95% confidence interval, 24%-47%) of the M. genitalium–positive episodes, whereas 8% (95% confidence interval, 3%-17%) carried fluoroquinolone resistance mutations. Of them, three cases harbored multidrug resistance to both classes of antibiotics. Men who had sex with men (P = 0.002) and treatment with azithromycin within the previous 12 months (P = 0.006) were strongly associated with macrolide resistance.

Conclusion

The widespread appearance of resistances, also in Spain, makes imperative the implementation of combined diagnostic-resistance detection assays for M. genitalium to facilitate the optimization of antibiotic treatment in the management of nongonococcal urethritis and potentially reduce the transmission of resistances.
Trends in Adult Chlamydia and Gonorrhea Prevalence, Incidence and Urethral Discharge Case Reporting in Morocco over 1995–2015—Estimates Using the Spectrum-Sexually Transmitted Infection Model
Authors: El-Kettani Amina , Mahiané Guy , Bennani Aziza , Abu-Raddad Laith , Smolak Alex , Rowley Jane , Nagelkerke Nico , El-Rhilani Houssine , Alami Kamal , Hançali Amina , Korenromp Eline
Published: June 2017

Background

Evolving health priorities and resource constraints mean that countries require data on sexually transmitted infections (STI) trends to inform program planning and resource allocation.

Methods

The Spectrum modeling tool estimated prevalence and incidence of gonorrhea and chlamydia in Morocco's 15- to 49-year-old population, based on prevalence surveys. Incident cases, broken down between symptomatic and asymptomatic, and treated versus untreated, were compared with urethral discharge (UD) case reports, to estimate reporting completeness among treated UD cases.

Results

Gonorrhea prevalence was estimated at 0.37% (95% confidence interval [CI], 0.14–1.0%) in women and 0.32% (0.12–0.87%) in men in 2015; chlamydia prevalences were 3.8% (95% CI, 2.1–6.4%) and 3.0% (95% CI, 1.7–5.1%). Corresponding estimated numbers of new cases in women and men in 2015 were 79,598 (95% CI, 23,918–256,206) and 112,013 (95% CI, 28,700–307,433) for gonorrhea, and 291,908 (95% CI, 161,064–524,270) and 314,032 (95% CI, 186,076–559,133) for chlamydia. Gonorrhea and chlamydia prevalence had declined by an estimated 41% and 27%, respectively, over 1995 to 2015. Prevalence declines probably related to improved STI treatment coverage, and decreasing risk behaviors. Reporting completeness among treated UD cases was estimated at 46% to 77% in 2015. Reported UD cases corresponded to 13% of all estimated (symptomatic and asymptomatic) gonorrhea and chlamydia cases.

Conclusions

STI declines and improvements in treatment coverage are consistent with Morocco’s introduction of syndromic management in 2000, scale-up of prevention, and declining human immunodeficiency virus incidence. While gonorrhea is four-fold more common as cause of clinical UD cases than chlamydia, Morocco continues to suffer a large, untreated burden of chlamydia. Reliable monitoring of both STIs requires new periodic surveys and/or novel forms of affordable surveillance beyond high-risk populations.
Men Who Have Sex With Men Seek Timely Human Immunodeficiency Virus Confirmation and Care After Rapid Human Immunodeficiency Virus Self-Test: Data From Partner Services Program, New York City
Authors: Udeagu Chi-Chi N. , Shah Sharmila , Molochevski Marina
Published: June 2017

Background

The rapid human immunodeficiency virus (HIV) self-test in the United States has expanded opportunities for HIV testing in nonclinical settings which may increase early diagnosis of HIV infection. However, broad application may be limited by the cost of the test and concerns that self-testers who test positive will not seek timely HIV care.

Methods

We used data from HIV partner services program to compare the sociodemographic characteristics, transmission risk, and clinical stage of persons diagnosed with HIV by report of rapid self-test. Among self-tested persons, we assessed timeliness of seeking definitive testing after self-test and linkage to care.

Results

From January 2013 to August 2016, 8032 HIV-positive persons were interviewed. Compared with the 7905 persons who did not self-test, self-tested persons were significantly (all P = <0.0001) male (96% vs 78%), white/non-Hispanic (46% vs 16%), men who have sex with men (92% vs 58%), college educated (67% vs 35%), and residing in medium-high income NYC neighborhoods (51% vs 44%). Higher proportions of self-tested (91%) than non–self-tested persons (81%) linked to care within three months of diagnosis. Significantly (P = <0.0001) more persons that self-tested positive (39/44, 89%) than persons that self-tested negative (14/36, 39%) sought laboratory-based HIV test within 1 month of last self-testing; and negative than positive self-tested persons were diagnosed with acute HIV infection (44% vs. 9%, P = <0.0001).

Conclusions

Our findings suggest that men who have sex with men sought timely HIV confirmatory testing and linkage to care after self-test. However, the cost of self-test kit may be an important barrier to its wide adoption across sociodemographic groups.
Low Prevalence of Urethral Lymphogranuloma Venereum Infections Among Men Who Have Sex With Men: A Prospective Observational Study, Sexually Transmitted Infection Clinic in Amsterdam, the Netherlands
Authors: de Vrieze Nynke H.N. , Versteeg Bart , Bruisten Sylvia M. , van Rooijen Martijn S. , van der Helm Jannie J. , de Vries Henry J.C.
Published: June 2017

In contrast to anorectal lymphogranuloma venereum (LGV), few urogenital LGV cases are reported in men who have sex with men. Lymphogranuloma venereum was diagnosed in 0.06% (7/12,174) urine samples, and 0.9% (109/12,174) anorectal samples. Genital-anal transmission seems unlikely the only mode of transmission. Other modes like oral-anal transmission should be considered.
Paucicellular Fibrointimal Proliferation Characterizes Pediatric Pulmonary Vein Stenosis
Authors: Kovach Alexandra E. , Magcalas Philip M. , Ireland Christina , McEnany Kerry , Oliveira Andre M. , Kieran Mark W. , Baird Christopher W. , Jenkins Kathy , Vargas Sara O.
Published: June 2017

Pulmonary vein stenosis (PVS) is a luminal narrowing of extrapulmonary pulmonary veins. In pediatric patients, it arises following repair of congenital heart disease, particularly anomalous pulmonary venous return; in lung disease, especially prematurity; and rarely in isolation. The etiology is unknown and the course often fatal without lung transplantation. We hypothesized that systematic clinicopathologic review of pediatric PVS could provide further pathogenic insight. We included patients who underwent first resection of pulmonary venous tissue for symptomatic PVS at our pediatric referral center from 1995 to 2014. Clinical records and hematoxylin and eosin slides were reviewed. Subsets were immunostained for smooth muscle actin, Ki-67, β-catenin, estrogen receptor, and other markers and analyzed forUSP6gene rearrangement. A total of 97 patients (57% male; median age: 6 mo) were identified. Overall, 59 (61%) had prior congenital heart disease repair, 35 involving pulmonary vein manipulation. Samples included 213 separate anatomic sites (median: 2/patient). Histologically, all showed sparsely cellular intimal expansion composed of haphazardly arranged fibroblasts with slender nuclei in myxoid matrix. This tissue merged with underlying collagen. Most samples had a variably continuous sheath of cardiomyocytes. Ancillary tests supported a reactive fibroblastic proliferation; in particular, fibroblasts showed cytoplasmic β-catenin localization, no estrogen receptor expression, and noUSP6rearrangement. At last follow-up (mean: 2.3 y), 46% of patients had died of disease. Pediatric PVS uniformly consists of a paucicellular fibrointimal proliferation, irrespective of clinical scenario. It may be best conceived of as a form of reactive hyperplasia. As with other forms of vascular remodeling, trauma (iatrogenic or occult) is likely an inciting factor. A comprehensive understanding of the surgical pathology of PVS may further inform therapeutic strategies in this lethal disease.
Gastric Emphysema
Authors: Murnan Sean D. , Miller Jill , Kuhn Anne
Published: June 2017

The radiographic finding of gastric emphysema with portal venous gas is classically an ominous finding, associated with a high rate of mortality. Although classically the case, this imaging finding must be quickly correlated with the overall clinical picture, allowing for the essential differentiation between the highly lethal emphysematous gastritis and the much more benign gastric emphysema, each of which has drastically different management strategies. We report a case of gastric emphysema with portal venous gas likely attributable to a gastric outlet obstruction and gastric mucosal defect in a 17-year-old girl with a chief complaint of syncope that was diagnosed in the emergency department and treated conservatively.
Academic Productivity, Knowledge, and Education in Plastic Surgery: The Benefit of the Clinical Research Fellow
Authors: Carney Martin J. , Weissler Jason M. , Koltz Peter F. , Fischer John P. , Wu Liza C. , Serletti Joseph M.
Published: June 2017

Background:

Academic research productivity is limited by strenuous resident and faculty schedules but nevertheless is imperative to the growth and success of our discipline. The authors report institutional experience with their clinical research fellowship model, providing two positions per year.

Methods:

A critical analysis of research productivity was performed for all trainees, faculty, and research fellows from 2000 to 2015. Academic productivity was determined by the number of peer-reviewed publications, podium presentations, and h-index. Academic fate of previous research fellows was also noted. During the 16-year timeframe, 484 articles were published in print. Notably, 92 articles were published from 2000 to 2007 and 392 articles were published from 2008 to 2015 (p = 0.0066), demonstrating linear growth after instituting the research fellowship. In addition, 33 articles were published from 2002 to 2004 before leadership change, 47 from 2005 to 2007 after leadership change but before fellowship, and 58 from 2008 to 2010 in the first few years of the fellowship (p = 0.0204).

Results:

Overall, 39.9 percent of publications appeared in Plastic and Reconstructive Surgery, with a total of 77 different peer-reviewed journal inclusions. American Association of Plastic Surgeons, American Society of Plastic Surgeons, and Northeastern Society of Plastic Surgeons podium presentations totaled 143 between 2005 and 2015. Of the eight previous fellows who applied into integrated and independent programs, 100 percent have matched.

Conclusion:

Incorporation of a formalized research fellowship into a plastic surgery program can drastically increase clinical research contribution in a reproducible fashion.