bluuebunny/crossref_metadata_2025 huggingface dataset:
Randomized, Double-Blinded, Sham-Controlled, Split-Hand Trial Evaluating the Safety and Efficacy of Triamcinolone Acetate Injection After Calcium Hydroxylapatite Volume Restoration of the Dorsal Hand
Authors: Wu Douglas C. , Goldman Mitchel P.
Published: February 2018

BACKGROUND

Calcium hydroxylapatite (CaHA) is currently the only FDA-approved soft-tissue filler indicated for augmentation of the dorsal hand. Although the treatment is generally safe and effective, adverse side effects such as swelling and edema postinjection are common and can sometimes be debilitating.

OBJECTIVE

In this study, the authors explore the utility of triamcinolone acetate coinjection with CaHA to the dorsal hands to mitigate adverse effects and improve patient experience.

PATIENTS AND METHODS

After obtaining informed consent, 20 subjects were enrolled in this double-blind, randomized, split-hand, sham-controlled clinical trial. Subject hands were randomized to receive either CaHA with triamcinolone acetate or CaHA with sham saline coinjection. Follow-up evaluations were performed by a blinded investigator at Days 7, 14, 30, 90, 180, 270, and 360 and consisted of the validated Merz Hand Grading Scale and assessments of erythema, edema, modules, bruising, and skin atrophy. Subjects also kept a daily diary for the first 30 days postinjection documenting bruising, itching, pain, redness, swelling, difficulty in performing activities with hands, and sensory alteration in hands.

RESULTS

There were no significant differences in treatment efficacy between the 2 groups. Post-treatment swelling was significantly reduced between Days 6 and 19 in the triamcinolone acetate coinjection group.

CONCLUSION

The addition of triamcinolone acetate coinjection with CaHA for dorsal hand augmentation did not negatively impact treatment efficacy but significantly reduced adverse side effects. This strategy represents a safe and effective way to improve patient experience and treatment tolerability.
Update on Animal Models of Exfoliation Syndrome
Authors: Anderson Michael G. , Meyer Kacie J. , Hedberg-Buenz Adam , Fingert John H.
Published: February 2018

Animal models are powerful tools for studying diseases that affect the eye, such as exfoliation syndrome (XFS). Two types of animal models have been used to investigate the pathophysiology of XFS and glaucoma. One class of models is engineered to have key features of a disease by alteration of their genome (genotype-driven animal models). LOXL1 is the first gene known to increase the risk for developing XFS in humans. Two transgenic mouse models with altered Loxl1 genes have been generated to study XFS. One strain of mice, Loxl1 deficient mice, also known as Loxl1 knockout mice, have had the Loxl1 gene removed from their genomes. Another strain has been engineered to produce excess amounts of the protein produced by the Loxl1 gene, or Loxl1 overexpression. A second class of animal models includes naturally occurring strains of mice that exhibit key clinical features of a disease. Studies of these phenotype-driven animal models may identify genes that cause disease and may also provide a valuable resource for investigating pathogenesis. One strain of mice, B6-Lyst

bg-J
, has several key features of human XFS, including ocular production of exfoliation-like material, and stereotypical iris abnormalities. Studies of this range of mice and other public mouse genetic resources have provided some important insights into the biology of XFS and may be useful for future studies to test the efficacy of drug therapies.
Malnutrition, Growth Response and Metabolic Changes Within the First 24 Months After ART Initiation in HIV-infected Children Treated Before the Age of 2 Years in West Africa
Authors: Jesson Julie , Dahourou Désiré L. , Amorissani Folquet Madeleine , Malateste Karen , Yonaba Caroline , N’Gbeche Marie-Sylvie , Ouédraogo Sylvie , Mea-Assande Véronique , Amani-Bossé Clarisse , Blanche Stéphane , Timité-Konan Marguerite , Leroy Valériane
Published: February 2018

Background:

There is limited information about malnutrition, growth evolution and metabolic changes among children initiated early on lopinavir-based antiretroviral therapy (ART) in Africa.

Methods:

HIV-1-infected children, age <2 years were initiated on ART, as part of the MONOD ANRS 12206 project, conducted in Burkina Faso and Côte d’Ivoire. Weight-for-age, height-for-age and weight-for-height Z scores defined malnutrition [Z score less than −2 standard deviations (SDs)] using World Health Organization growth references. Biologic data were collected every 6 months. Factors associated with baseline malnutrition were evaluated using multivariate logistic regression, and with growth evolution in the first 24 months on ART using linear mixed models.

Results:

Between 2011 and 2013, 161 children were enrolled: 64% were from Abidjan, 54% were girls. At ART initiation, median age was 13.7 months (interquartile range 7.7; 18.4), 52% were underweight (weight-for-age), 52% were stunted (height-for-age) and 36% were wasted (weight-for-height). Overall, baseline malnutrition was more likely for children living in Burkina Faso, with low birth weight, never breastfed and older age (12–24 months). Growth improved on ART, mainly within the first 6 months for weight, and was greater for the most severely malnourished children at baseline, but 8%–32% remained malnourished after 24 months. Over the 24-month period of ART, there was a significant increase of hypercholesterolemia and decrease of anemia and hypoalbuminemia.

Conclusions:

Prevalence of malnutrition was high before ART initiation. Even though growth improved on ART, some children remained malnourished even after 2 years of ART, highlighting the need for more active nutritional support.
Subtype-specific Clinical Presentation, Medical Treatment and Family Impact of Influenza in Children 1–5 Years of Age Treated in Outpatient Practices in Germany During Three Postpandemic Years, 2013–2015
Authors: Streng Andrea , Prifert Christiane , Weissbrich Benedikt , Sauerbrei Andreas , Schmidt-Ott Ruprecht , Liese Johannes G.
Published: February 2018

Background:

Limited data on the influenza burden in pediatric outpatients are available, especially regarding direct comparison of the cocirculating (sub)types A(H1N1)pdm09, A(H3N2) and B.

Methods:

Children 1–5 years of age, unvaccinated against influenza and presenting with febrile acute respiratory infections (ARIs), were enrolled in 33 pediatric practices in Germany from 2013 to 2015 (January–May). Influenza was confirmed by multiplex polymerase chain reaction from pharyngeal swabs and (sub)typed.

Results:

In 805 children with ARI, influenza was the most frequently detected respiratory virus (n = 305; 37.9%). Of 217 influenza patients included, 122 (56.2%) were infected with A(H3N2), 56 (25.8%) with A(H1N1)pdm09 and 39 (18.0%) with B. Median age was 3.7 years [interquartile range (IQR), 2.1–4.8]; 11% had underlying conditions. Median fever duration was 4 days (IQR, 3–5), and the disease duration was 9 days (IQR, 7–12). Most frequent diagnoses were pharyngitis (26%), bronchitis (18%) and acute otitis media (10%). Children received mainly antipyretics (86%) and adrenergic nasal drops/spray (53%); 9% received antibiotics and 3% oseltamivir. Thirty-six percent required at least 1 additional practice visit; 1% was hospitalized. Median absences from childcare were 5 days (IQR, 3–7); parents lost 4 workdays (IQR, 2–6). Symptoms, severity and impact on the family were largely unrelated to (sub)type. However, patients with A(H1N1)pdm09 had fewer underlying conditions (P = 0.017), whereas patients with B more often had pharyngitis (P = 0.022), acute otitis media (P = 0.012) and stenosing laryngotracheitis (P = 0.007).

Conclusions:

Influenza was the most frequently detected viral pathogen in outpatient children with febrile, mostly uncomplicated ARI. In this setting, clinical manifestations and severity were similar across the (sub)types prevalent during the postpandemic seasons.
No BRAF V600E Mutation Identified in 28 Periocular Pyogenic Granuloma
Authors: Li Guosheng , Adams Emily , Eshleman James R. , Eberhart Charles G.
Published: February 2018

Purpose:

BRAF V600E mutations were recently identified in some pyogenic granulomas of skin, particularly lesions arising in patients with port wine stains. In this study, the authors analyzed BRAF gene status in 28 periocular pyogenic granulomas to determine its role in their pathogenesis.

Methods:

Retrospective review of ophthalmic pathology archives from 2007 to 2016 was used to identify pyogenic granulomas of the conjunctiva, eyelid, and orbit. Three eyelid nevi were also analyzed as positive controls. BRAF V600E status was assessed by pyrosequencing of DNA extracted from excess formalin-fixed, paraffin-embedded surgical material.

Results:

Microscopic examination of the periocular pyogenic granuloma specimens revealed proliferative vascular lesions, with radiating capillary channels surrounded by variable degrees of acute and chronic inflammation. Sequencing did not identify a BRAF V600E mutation in any of the 28 sporadic pyogenic granulomas, including 13 on the eyelid. In contrast, mutation analyses performed in parallel in melanocytic nevi of the eyelid identified BRAF V600E alterations in all 3 cases.

Conclusions:

The lack of BRAF V600E mutations in 28 sporadic pyogenic granulomas of the conjunctiva and eyelid suggests that such alterations are not a common driver in the pathogenesis of these periocular vascular lesions.
Novel FOXC2 Mutation and Distichiasis in a Patient With Lymphedema-Distichiasis Syndrome
Authors: De Niear Matthew A. , Breazzano Mark P. , Mawn Louise A.
Published: February 2018

A 4 year-old-boy was referred for distichiasis of the upper and lower lids of both eyes that had been present since at least 1 year of age. The patient’s family history was notable for distichiasis and lymphedema affecting numerous family members. The patient was found to have a novel heterozygous variant (c.741_742insGG) in the FOXC2 gene. Mutations in the FOXC2 gene are associated with lymphedema-distichiasis syndrome. An important feature of lymphedema-distichiasis syndrome is that distichiasis is typically present prior to the onset of lymphedema.
Clinical practice guidelines from the French National Society of Coloproctology in treating chronic constipation
Authors: Vitton Veronique , Damon Henri , Benezech Alban , Bouchard Dominique , Brardjanian Sarah , Brochard Charlène , Coffin Benoit , Fathallah Nadia , Higuero Thierry , Jouët Pauline , Leroi Anne-Marie , Luciano Laure , Meurette Guillaume , Piche Thierry , Ropert Alain , Sabate Jean-Marc , Siproudhis Laurent
Published: February 2018

Chronic constipation is a common symptom that regularly affects the quality of life of adult patients. Its treatment is mainly based on dietary rules, laxative drugs, perineal rehabilitation and surgical treatment. The French National Society of Coloproctology offers clinical practice recommendations on the basis of the data in the current literature, including those on recently developed treatments. Most are noninvasive, and the main concepts include the following: stimulant laxatives are now considered safe drugs and can be more easily prescribed as a second-line treatment; biofeedback therapy remains the gold standard for the treatment of anorectal dyssynergia that is resistant to medical treatment; transanal irrigation is the second-line treatment of choice in patients with neurological diseases, but it may also be proposed for patients without neurological diseases; and although interferential therapy may be a new promising treatment, it needs further evaluation.
Measurement framework for the Environmental influences on Child Health Outcomes research program
Authors: Blackwell Courtney K. , Wakschlag Lauren S. , Gershon Richard C. , Cella David
Published: February 2018

Purpose of review

Diverse methodological approaches pose significant challenges to assess environmental exposure effects on child health outcomes. Although transdisciplinary research efforts offer unique opportunities for understanding the complex and multidimensional facets of lifespan health and disease trajectories, a shared measurement strategy is necessary for ensuring cohesion and comprehensibility across disciplines and domains.

Recent findings

Exposure science often focuses on one life stage, one primary outcome domain and/or one environmental context without regard for understanding the complexity of exposome pathways and outcomes across a developmental continuum. As part of the National Institutes of Health Environmental influences on Child Health Outcomes Program, the Person Reported Outcomes Core developed a unifying measurement framework that takes a lifespan development approach to assess physical, mental and social health outcomes within the complex matrix of environmental exposure pathways.

The proposed framework offers a shared methodological approach to health outcome assessment, with a particular emphasis on person-reported outcomes. This framework will be instrumental for future large-scale consortia and transdisciplinary team science efforts by providing a common structure, measurement guidance and consistent terminology.
Oxygen and preterm infant resuscitation: what else do we need to know?
Authors: Oei Ju-Lee , Saugstad Ola D. , Vento Maximo
Published: February 2018

Purpose of review

To evaluate current evidence for the use of lower or higher oxygen strategies for preterm infant resuscitation

Recent findings

The equipoise for using higher fraction of inspired oxygen (FiO2) (>0.4) to initiate preterm infant respiratory stabilization has been lost. Recent meta-analyses of randomized controlled trials assessing outcomes after using higher (FiO2 ≥ 0.6) vs. lower (FiO2 ≤ 0.3) oxygen strategies to initiate preterm resuscitation shows no difference in the rates of death or major morbidities. However, not achieving pulse oximetry saturations of at least 80% by 5 min of age, whether it was due to iatrogenic oxygen insufficiency or poor infant pulmonary function, was associated with lower heart rates (mean difference −8.37, 95% confidence interval: −15.73, −1.01) and major intraventricular hemorrhage. There remains scarce neurodevelopmental data in this area and information about the impact of oxygen targeting strategies in low resourced areas. These knowledge gaps are research priorities that must be addressed in large, well designed randomized controlled trials.

Most clinicians now use lower oxygen strategies to initiate respiratory support for all infants, including preterm infants with significant lung disease. However, the impact of such strategies, particularly for neurodevelopmental outcomes and for lower resourced areas, remains uncertain and must be urgently addressed.
Immunohistochemical Expression of Different Subtypes of Cytokeratins by Endometrial Stromal Sarcoma
Authors: Rahimi Siavash , Akaev Iolia , Marani Carla , Chopra Mridula , Yeoh Chit Cheng
Published: February 2018

Endometrial stromal sarcomas (ESS) are rare and understudied gynecologic mesenchymal neoplasms. These tumors can be confused with many other gynecologic and nongynecologic tumors due to their variegated morphologic appearance and nonspecific immunohistochemical profile. ESS can express cytokeratin (CK) and, therefore, may be misdiagnosed as carcinoma especially in extrauterine locations and when recurrence/metastasis is present. In this study, we investigated the expression of a wide spectrum of CKs consisting of AE1/3, CAM 5.2, HMCK, MNF116, CK5, CK6, CK7, CK8/18, CK14, CK17, CK19, and CK20 in 6 low-grade and 5 high-grade ESS. In addition, staining for estrogen receptor, progesterone receptor, CD10, and cyclin D1 was performed. Our results showed that CKs AE1/3, CAM 5.2, MNF116, and CK8/18 are more expressed in low-grade ESS, whereas high-grade ESS express more AE1/3 and CAM 5.2. In problematic cases, especially in recurrences or metastases, the immunohistochemical panel of antibodies AE1/3, MNF116, CAM 5.2, and CK8/18, together with other classic immunohistochemical markers CD10, cyclin D1, estrogen receptor, and progesterone receptor, may be helpful in the differential diagnosis between ESS and other gynecologic and nongynecologic malignancies.
Blood Cultures Drawn From Arterial Catheters Are Reliable for the Detection of Bloodstream Infection in Critically Ill Children
Authors: Berger Itay , Gil Margolis Merav , Nahum Elhanan , Dagan Ovdi , Levy Itzhak , Kaplan Eytan , Shostak Eran , Shmuelov Esther , Schiller Ofer , Kadmon Gili
Published: February 2018

Objectives:

Arterial catheters may serve as an additional source for blood cultures in children when peripheral venipuncture is challenging. The aim of the study was to evaluate the accuracy of cultures obtained through indwelling arterial catheters for the diagnosis of bloodstream infections in critically ill pediatric patients.

Design:

Observational and comparative.

Setting:

General and cardiac ICUs of a tertiary, university-affiliated pediatric medical center.

Patients:

The study group consisted of 138 patients admitted to the general or cardiac PICU in 2014–2015 who met the following criteria: presence of an indwelling arterial catheter and indication for blood culture.

Interventions:

Blood was drawn by peripheral venipuncture and through the arterial catheter for each patient and sent for culture (total 276 culture pairs).

Measurements and Main Results:

Two specialists blinded to the blood source evaluated each positive culture to determine if the result represented true bloodstream infection or contamination. The sensitivity, specificity, and positive and negative predictive values of the arterial catheter and peripheral cultures for the diagnosis of bloodstream infection were calculated. Of the 56 positive cultures, 41 (15% of total samples) were considered diagnostic of true bloodstream infection. In the other 15 (5%), the results were attributed to contamination. The rate of false-positive results was higher for arterial catheter than for peripheral venipuncture cultures (4% vs 1.5%) but did not lead to prolonged unnecessary antibiotic treatment. On statistical analysis, arterial catheter blood cultures had high sensitivity (85%) and specificity (95%) for the diagnosis of true bloodstream infection, with comparable performance to peripheral blood cultures.

Conclusion:

Cultures of arterial catheter–drawn blood are reliable for the detection of bloodstream infection in PICUs.
Pediatric Specialty Care Model for Management of Chronic Respiratory Failure: Cost and Savings Implications and Misalignment With Payment Models*
Authors: Graham Robert J. , McManus Michael L. , Rodday Angie Mae , Weidner Ruth Ann , Parsons Susan K.
Published: February 2018

Objective:

To describe program design, costs, and savings implications of a critical care–based care coordination model for medically complex children with chronic respiratory failure.

Design:

All program activities and resultant clinical outcomes were tracked over 4 years using an adapted version of the Care Coordination Measurement Tool. Patient characteristics, program activity, and acute care resource utilization were prospectively documented in the adapted version of the Care Coordination Measurement Tool and retrospectively cross-validated with hospital billing data. Impact on total costs of care was then estimated based on program outcomes and nationally representative administrative data.

Setting:

Tertiary children’s hospital.

Subjects:

Critical Care, Anesthesia, Perioperative Extension and Home Ventilation Program enrollees.

Interventions:

None.

Measurements and Main Results:

The program provided care for 346 patients and families over the study period. Median age at enrollment was 6 years with more than half deriving secondary respiratory failure from a primary neuromuscular disease. There were 11,960 encounters over the study period, including 1,202 home visits, 673 clinic visits, and 4,970 telephone or telemedicine encounters. Half (n = 5,853) of all encounters involved a physician and 45% included at least one care coordination activity. Overall, we estimated that program interventions were responsible for averting 556 emergency department visits and 107 hospitalizations. Conservative monetization of these alone accounted for annual savings of $1.2–2 million or $407/pt/mo net of program costs.

Conclusions:

Innovative models, such as extension of critical care services, for high-risk, high-cost patients can result in immediate cost savings. Evaluation of financial implications of comprehensive care for high-risk patients is necessary to complement clinical and patient-centered outcomes for alternative care models. When year-to-year cost variability is high and cost persistence is low, these savings can be estimated from documentation within care coordination management tools. Means of financial sustainability, scalability, and equal access of such care models need to be established.
Characteristics of Pediatric Patient Transferred From Hospital-Based General Emergency Departments to Acute-Care Facilities
Authors: Barata Isabel Araujo , Akerman Meredith , Mahmooth Zayan , Bradburn Kathryn , D'Angelo John
Published: February 2018

Study Objective

The objective of this study was to analyze the characteristics of pediatric patients transferred from a hospital-based general emergency department (ED) to an acute care facility.

Methods

Study data were abstracted from the 2010 Healthcare Cost and Utilization Project Nationwide Emergency Department Sample database. A multivariate logistic regression was constructed for pediatric patients (<18 years old) who require a transfer to an acute care facility from a general ED. Independent variables included in the model were age (<1, 1–4, 5–9, 10–14, 15–17 age in years), sex, insurance/payment method, and diseases/body systems using International Classification of Diseases, Ninth Revision, coding.

Results

In the Healthcare Cost and Utilization Project/Nationwide Emergency Department Sample, 5.5 million ED visits were for children less than 18 years. About 1.5% of visits resulted in transfer. Children younger than 1 year had higher transfer rates as compared with 15 to 17 year old group (odds ratio [OR], 1.17; 95% confidence interval [CI], 1.089–1.146). Patients with Medicaid and self-pay compared with private insurance/health maintenance organization had 4% (OR, 0.96; 95% CI, 0.944–0.976) and 9% (OR, 0.91; 95% CI, 0.886–0.945), respectively, lower likelihood of being transferred. Patients with circulatory (OR, 8.43; 95% CI, 7.8–9.1), endocrine (OR, 5.9; 95% CI, 5.6–6.2), mental (OR, 5.44; 95% CI, 5.3–5.6), nervous system (OR, 5.2; 95% CI, 4.9–5.5), congenital anomalies (OR, 5.14; 95% CI, 4.5–5.9), hematology-oncology (OR, 4.49; 95% CI, 4.2–4.8), digestive, (OR, 1.52; 95% CI, 1.5–1.6), and other disorders (OR, 1.33; 95% CI, 1.3–1.4) had a higher odds of being transferred as compared with trauma/injury and poisoning, whereas patients with disorders related to genitourinary (OR, 0.96; 95% CI, 0.91–1.0), respiratory (OR, 0.79; 95% CI, 0.77–0.81), musculoskeletal (OR, 0.63; 95% CI, 0.58–0.68), skin (OR, 0.47; 95% CI, 0.45–0.50), infectious and parasitic (OR, 0.23; 95% CI, 0.22–0.25), and eyes/ears/nose/throat (OR, 0.09; 95% CI, 0.079–0.094) had a lower odds of being transferred as compared with trauma/injury and poisoning.

Conclusions

Children younger than 1 year had relatively higher transfer rates. Patients covered by Medicaid and self-pay had the lowest likelihood of transfer. Transfer rates varied significantly by condition and the high-transfer diagnostic categories were related to circulatory, endocrine, nervous, hematology-oncology, and mental disorders as well as congenital anomalies, which may be related to a lack of ED or inpatient resources to care for children with problems that require more complex care.
Pediatric Emergency Provider Sexually Transmitted Infection Screening Practices in Adolescents With Oropharyngeal or Anorectal Chief Complaints
Authors: Gallagher Courtney , Lee Susan S. , Shofer Frances S. , Mollen Cynthia J. , Goyal Monika K. , Dowshen Nadia L.
Published: February 2018

Objectives

Sexually transmitted infections (STIs) may present with oropharyngeal or anorectal symptoms. Little is known about the evaluation of adolescents with these complaints in the pediatric emergency department (PED). This study aimed to determine the frequency of and factors associated with STI consideration and testing in this population.

Methods

Retrospective chart review of patients aged 13 to 18 years who presented to an urban PED with oropharyngeal or anorectal chief complaints between June 2014 and May 2015. Sexually transmitted infection consideration was defined as sexual history documentation, documentation of STI in differential diagnosis, and/or diagnostic testing. Multivariate logistic regression models were used to identify factors associated with consideration.

Results

Of 767 visits for oropharyngeal (89.4%), anorectal (10.4%), or both complaints, 153 (19.9%) had STI consideration. Of the 35 visits (4.6%) that included gonorrhea and/or chlamydia testing, 12 (34.3%) included testing at the anatomic site of complaint. Of those 12 tests, 50.0% were the incorrect test. Patients with older age (adjusted odds ratio [aOR] = 1.5, 95% confidence interval [CI] = 1.3–1.7), female sex (aOR = 1.6, 95% CI = 1.03–2.5), or anorectal complaints (aOR = 2.4, 95% CI = 1.3–4.3) were more likely to have STI consideration.

Conclusions

In an urban PED, only 20% of visits for adolescents with oropharyngeal or anorectal symptoms included STI consideration. Testing was performed in only 5% of cases and often at an inappropriate anatomic site or with the incorrect test. Interventions to increase awareness of appropriate STI consideration and testing for individuals presenting with possible extragenital complaints may help reduce STIs among adolescents.
Impaired Cognitive Performance in Endothelial Nitric Oxide Synthase Knockout Mice After Ischemic Stroke
Authors: Li Shanshan , Wang Yao , Jiang Ze , Huai Yaping , Liao James K. , Lynch Kaari A. , Zafonte Ross , Wood Lisa J. , Wang Qing Mei
Published: February 2018

Objectives

Cognitive dysfunction and dementia are common following ischemic stroke. Endothelial nitric oxide synthase (eNOS) has been found to play an important role in neurologic function and cognition. The purpose of the present study was to assess the specific role of eNOS in cognitive performance after stroke.

Design

Male wild-type and mice lacking eNOS (eNOS

−/−
) underwent middle cerebral artery occlusion or sham-surgery. Primary outcomes were repeated measures of neurologic score, limb asymmetry, sensory/motor function, and spatial memory/learning assessed at intervals up to 28 days postsurgery. Group differences in brain microglia activation and infiltration and levels of interferon-gamma were examined.

Results

There was no genotype × surgery interaction effect on the pattern of change in neurologic score, limb asymmetry, or sensory motor function across the 28 days postsurgery. In the Morris water maze, eNOS

−/−
middle cerebral artery occlusion mice displayed learning and memory deficits not evident in wild-type middle cerebral artery occlusion mice. Poorer spatial memory and learning in eNOS

−/−
middle cerebral artery occlusion mice was associated with a reduction in the number of activated microglia in the striatum on the lesion side and decreased brain tissue levels of interferon-gamma.

Conclusions

This study's data support a role for eNOS in cognitive performance after stroke. This finding may lead to the development of novel interventions to treat poststroke cognitive deficits.
Discharge prescription patterns of opioid and nonopioid analgesics after common surgical procedures
Authors: Nooromid Michael J. , Blay Eddie , Holl Jane L. , Bilimoria Karl Y. , Johnson Julie K. , Eskandari Mark K. , Stulberg Jonah J.
Published: February 2018

Abstract

Introduction:

Recent literature has shown a wide variation in the prescribing patterns of opioids after elective surgery. We conducted an evaluation of discharge opioid prescribing after elective surgical procedures to determine whether opioid-prescribing patterns varied at our institution.

Method:

A single academic medical center retrospective review of patients undergoing laparoscopic cholecystectomy, laparoscopic appendectomy, open umbilical hernia repair, simple mastectomy, or thyroidectomy between July 2015 and July 2016.

Results:

Among a total of 615 unique surgical cases, we found a wide variation in the number of pills and morphine milligram equivalents prescribed for each procedure evaluated. In addition, 94.8% of all patients discharged received a prescription for opioids, whereas only 15.6% of patients received a prescription for a nonopioid analgesic.

Conclusion:

The number and strength of opioids prescribed after surgery can vary widely at a single institution. Further research is needed to elucidate variations in prescribing.
Brief Report: HIV Assisted Partner Services Among Those With and Without a History of Intimate Partner Violence in Kenya
Authors: Goyette Marielle S. , Mutiti Peter M. , Bukusi David , Wamuti Beatrice M. , Otieno Felix A. , Cherutich Peter , Golden Matthew R. , Spiegel Hans , Richardson Barbra A. , Ng'ang'a Anne , Farquhar Carey
Published: February 2018

Background:

HIV assisted partner services (APS) are a notification and testing strategy for sex partners of HIV-infected index patients. This cluster-randomized controlled trial secondary data analysis investigated whether history of intimate partner violence (IPV) modified APS effectiveness and risk of relationship dissolution.

Setting:

Eighteen HIV testing and counseling sites in Kenya randomized to provide immediate APS (intervention) or APS delayed for 6 weeks (control).

Methods:

History of IPV was ascertained at study enrollment and defined as reporting ever experiencing physical or sexual IPV. Those reporting IPV in the month before enrollment were excluded. We tested whether history of IPV modified intervention effectiveness and risk of relationship dissolution using population-averaged Poisson and log-binomial generalized estimating equation models. Exploratory analyses investigated associations between history of IPV and events that occurred after HIV diagnosis using log-binomial generalized estimating equation models.

Results:

The study enrolled 1119 index participants and 1286 partners. Among index participants, 81 (7%) had history of IPV. History of IPV did not modify APS effectiveness in testing, newly diagnosing, or linking partners to care. History of IPV did not modify the association between receiving immediate APS and relationship dissolution during the study.

Conclusions:

Among participants who had not experienced IPV in the last month but had experienced IPV in their lifetimes, our results suggest that APS is an effective and safe partner notification strategy in Kenya. As APS is scaled up in different contexts, these data support including those reporting past IPV and closely monitoring adverse events.
Brief Report: Abacavir/Lamivudine and Tenofovir/Emtricitabine in Pregnant Women With HIV: Laboratory and Clinical Outcomes in an Observational National Study
Authors: Floridia Marco , Pinnetti Carmela , Ravizza Marina , Masuelli Giulia , Personeni Carlo , Sansone Matilde , Degli Antoni Anna , Guaraldi Giovanni , Spinillo Arsenio , Tassis Beatrice , Dalzero Serena , Liuzzi Giuseppina , Tamburrini Enrica ,   on behalf of The Italian Group on Surveillance on Antiretroviral Treatment in Pregnancy
Published: February 2018

Background:

Abacavir–lamivudine (ABC/3TC) and tenofovir–emtricitabine (TDF/FTC) represent in the guidelines of several countries, including Italy and United States, the preferred nucleoside/nucleotide backbones of antiretroviral regimens. We assessed their profile in pregnancy using data from a national observational study.

Methods:

Laboratory measures (CD4, HIV-RNA, lipid profile, glucose, hemoglobin, and alanine transferase) and pregnancy outcomes (preterm delivery, low birthweight, nonelective cesarean section, birthweight Z-score, congenital defects, HIV transmission, maternal weight gain, and pregnancy complications) were compared after prenatal exposure to ABC/3TC or TDF/FTC.

Results:

The study evaluated 913 pregnancies (ABC/3TC: 252; TDF/FTC: 661). At entry in pregnancy, women on TDF/FTC were older (33.6 vs. 32.4 years, P = 0.005), less frequently on treatment (66.9% vs. 80.2%, P < 0.001), and had lower CD4 counts (475/mm3 vs. 533/mm3, P = 0.003) and higher plasma HIV-RNA levels (2.48 vs. 2.22 log10 copies/mL, P = 0.003). Women on ABC/3TC had more commonly hypertension/nephropathy (5.2% vs. 2.0%, P = 0.013). No major differences were observed in the main pregnancy outcomes and in rates of undetectable HIV-RNA at third trimester. In a subgroup analysis that evaluated at third trimester only cases with regular 3-drug treatment during pregnancy, women on TDF/FTC had lower hemoglobin levels (median: 11.1 vs. 11.8 g/dL, P = 0.002) and women on ABC/3TC had higher levels of total cholesterol (median: 230 vs. 216 mg/dL, P = 0.023) and low-density lipoprotein–cholesterol (133 vs. 111 mg/dL, P = 0.030).

Conclusions:

In this study, use of TDF/FTC and ABC/3TC in pregnancy was associated with similar pregnancy outcomes and with some differences in laboratory measures that might guide physicians' prescriptions in mothers with hematologic or metabolic risk factors.
Euzebyella algicola sp. nov., a marine bacterium of the family Flavobacteriaceae, isolated from green algae
Authors: Kwon Yong Min , Kim Kyung Woo , Kim Jaoon Young Hwan , Choi Tae-Young , Yang Sung-Hyun , Oh Chul Hong , Kwon Kae Kyoung , Kim Sang-Jin
Published: February 2018

A Gram-negative, yellow-pigmented, non-flagellated, gliding, rod-shaped and aerobic bacterium, designated MEBiC 12267T, was isolated from green algae of Jeju Island. 16S rRNA gene sequence analysis revealed that the strain MEBiC 12267T was affiliated to the genus

Euzebyella

of the family Flavobacteriaceae and showed the highest similarity to

Euzebyella
marina KCTC 42440T (98.5 %). The DNA–DNA relatedness value of strain MEBiC 12267T with E. marina KCTC 42440T was 25 %. Growth was observed at 10–37 °C (optimum, 30–33 °C), at pH 6.0–9.5 (optimum, 8.0–8.5) and with 0.5–9.0 % (w/v) NaCl (optimum, 2.5–3.5 %). The predominant cellular fatty acids were iso-C15 : 0, iso-C15 : 1 G and iso-C17 : 0 3-OH. The major respiratory quinone was MK-6. Polar lipids included phosphatidylethanolamine, seven unidentified lipids and two unidentified aminolipids. The DNA G+C content was 40.7 mol%. On the basis of the data from the polyphasic taxonomic study, it was concluded that the strain MEBiC 12267T represents a novel species within the genus Euzebyella, for which the name

Euzebyella
algicola sp. nov. is proposed. The type strain of E. algicola is MEBiC 12267T (=KCCM 43264T=JCM 32170T).
How to distinguish between opposite faces of an a-plane sapphire wafer
Authors: Yunin Pavel Andreevich , Drozdov Yurii Nikolaevich
Published: February 2018

A method to distinguish between two symmetrically equivalent opposite (11{\overline 2}0) and ({\overline 1}{\overline 1}20) faces of an a-plane sapphire wafer is described. It is shown that use of conventional X-ray diffraction analysis makes it possible to determine the `sign' of the sapphire a face in contrast to the `sign' of the c, m or r faces. Correct determination of the a-plane wafer orientation is important for further growth and processing of heteroepitaxial structures.
An electrochemical cell with sapphire windows foroperandosynchrotron X-ray powder diffraction and spectroscopy studies of high-power and high-voltage electrodes for metal-ion batteries
Authors: Drozhzhin Oleg A. , Tereshchenko Ivan V. , Emerich Hermann , Antipov Evgeny V. , Abakumov Artem M. , Chernyshov Dmitry
Published: February 2018

A new multi-purposeoperandoelectrochemical cell was designed, constructed and tested on the Swiss–Norwegian Beamlines BM01 and BM31 at the European Synchrotron Radiation Facility. Single-crystal sapphire X-ray windows provide a good signal-to-noise ratio, excellent electrochemical contact because of the constant pressure between the electrodes, and perfect electrochemical stability at high potentials due to the inert and non-conductive nature of sapphire. Examination of the phase transformations in the Li1–xFe0.5Mn0.5PO4positive electrode (cathode) material at C/2 and 10C charge and discharge rates, and a study of the valence state of the Ni cations in the Li1–xNi0.5Mn1.5O4cathode material for Li-ion batteries, revealed the applicability of this novel cell design to diffraction and spectroscopic investigations of high-power/high-voltage electrodes for metal-ion batteries.
Correctness of aspect-oriented business process modeling
Authors: Wang Xu , Zhang Xuan , Li Tong , Liu Junhui , Chen Qingyi
Published: February 2018

Purpose

Business process models, while primarily intended for process documentation, communication, and improvement, are often also used as input for developing process-oriented software systems (Ouyang et al., 2009). Ensuring correctness, handling complexity, and improving reusability and maintainability of business process models are important for all these goals. The purpose of this paper is to propose an aspect-oriented business process modeling and correctness controlling method based on Petri nets to satisfy these goals.

Design/methodology/approach

The aspect-oriented paradigm provides a proper mechanism to modularization, and thus reduces the complexity of models, and also improves reusability and maintainability. However, weaving aspects into base processes may bring in mistakes or errors. To ensure correctness of modeling, this paper presents a formal approach to modeling aspect-oriented business processes and a method to ensure modeling correctness. Petri net is used as the process modeling language and its analysis techniques are applied to analyze the correctness of modeling. Two types of correctness, specifically, aspect-aspect correctness and base-aspect correctness are analyzed. A real banking process model is studied systematically in the case study to evaluate the approach and the performance assessments are conducted to show the cost and effect of the approach.

Findings

Designing aspect-oriented business process models help organizations reusing the model elements to reduce redundancy of their model repository, improving their maintainability, and supporting them to adapt to the changes of business requirements with flexible modeling. It is important to stress that the correctness of business process modeling is important in ensuring the quality of the models, especially in the safety-critical business domains, such as financial business domain.

Originality/value

In this paper, separation of concerns is used to separate the cross-cutting activities and core activities in accordance with the different functions of these activities, and an approach to modeling aspect-oriented business processes is proposed. First, the cross-cutting activities are encapsulated as aspects, while core business activities are modeled as base processes. Then, according to the correctness requirements of business process models, based on the weaving mechanisms of aspect-oriented approach, weaving correctness is defined. Weaving correctness controlling methods between multi-aspects and between aspects and base processes are designed. Errors or mistakes of aspect-oriented business process modeling are prevented during the procedure of modeling to ensure error-free business process modeling.
What do we know about business process management training? Current status of related research and a way forward
Authors: Thennakoon Dharshani , Bandara Wasana , French Erica , Mathiesen Paul
Published: February 2018

Purpose

There is wide acknowledgment that training people from all levels of an organization in process management activities and “process thinking” is a major contributor to the success or failure, and sustainability of business process management (BPM). BPM training is provided in almost all BPM initiatives and involves the investment of valuable financial, human, information and other resources. However, little research has focused on this area. As a result, there is a lack of guidance for organizations in conducting value adding BPM training. The purpose of this paper is to consolidate the current published knowledge on BPM training in the form of a descriptive literature review to paint a picture of the existing work, identify gaps and propose a program of work for the future.

Design/methodology/approach

A structured descriptive literature review was conducted to understand the current status of literature on training in the domain of BPM. Of an initial search of 90 publications, 64 publications, published between 1994 and 2015, were filtered and reviewed based on their relevance to answer the research question: What has BPM literature mentioned of training people for BPM? This study proposes a research agenda based on this. A grounded theory coding approach was employed, where NVivo 10 was used as a tool to support the analysis.

Findings

A total of 234 codes (representing emerging themes) were inductively identified from the data. These codes were further analyzed, resulting in eight core themes pertaining to training in the BPM context.

Research limitations/implications

The paper presents a vivid descriptive overview of the current status of research in BPM training identifying gaps in the literature and presents a research agenda which supports a call for action.

Originality/value

The paper is the first known of its kind to compile the status of literature focused on BPM training and recommend a research agenda based on such.
Equity crowdfunding across borders: a conjoint experiment
Authors: Niemand Thomas , Angerer Martin , Thies Ferdinand , Kraus Sascha , Hebenstreit René
Published: February 2018

Purpose

The purpose of this paper is to identify and disentangle the home bias in equity crowdfunding to better understand irrational decision making of investors.

Design/methodology/approach

A first choice-based conjoint (CBC) experiment with 217 participants was conducted in central Europe in order to single out different factors contributing to an apparent home bias of capital providers.

Findings

The authors find that investors show an avoidance of foreign currency, while payment methods seem to have no considerable influence on the decision making. Furthermore, participants significantly decided against national legislation in favor for EU legislation.

Research limitations/implications

This study predominantly helps to gain deeper insights into influencing factors in crowdfunding markets with a special concern on a cross-border context. For capital-seeking companies, the home bias of potential investor has to be taken into account, when designing a crowdfunding campaign. For legislators, the apparent influence of the legal framework should serve as a wake-up call to consolidate the regulation of crowdfunding in the EU.

Originality/value

This is the first CBC experiment application in a cross-border crowdfunding context. It provides deeper understanding of the importance of geographical proximity between crowdfunding projects and investors and calls for further research to examine how such an effect could be diminished.
Group identity and social closeness
Authors: Moskovich Yaffa , Liberman Ido
Published: February 2018

Purpose

The purpose of this paper is to study examine the social identity of Ultra-Orthodox students enrolled in institutions of higher learning in Israel, and specifically the ways in which the identity of Ultra-Orthodox students who interact with other groups on campus compares to the identity of self-segregated Ultra-Orthodox students. Traditionally, Ultra-Orthodox students have preferred self-segregated educational institutions. Today, however increasing numbers of Ultra-Orthodox Jews are enrolling in regular academic institutions. Although they study in separate, homogeneous classrooms, they interact with secular students within the framework of the institution.

Design/methodology/approach

A four-part questionnaire dealing with attributions, feelings, personal identities, and social proximity was administered to the Ultra-Orthodox students.

Findings

As hypothesized, the students in self-segregated institutions exhibited a different identity than the students in secular institutions. Contrary to the hypotheses, the self-segregated students had positive feelings toward secular Israeli students and a greater desire for social proximity than the more integrated group. Explanations center on structural identity theory.

Originality/value

In this naturalistic study, the encounters between Ultra-Orthodox students and other students in their academic institution were random, unplanned, and unmonitored, unlike previous studies of intergroup relations in institutions of higher education. These students were not involved in cooperative tasks, which theoretically could help improve the relationships between Ultra-Orthodox and secular students.
Experimental analysis of tribological properties of ultrasonically dispersed garnet nanoparticles in SN500 grade lubricating oil
Authors: R. Maheswaran , J. Sunil
Published: February 2018

Purpose

The optimal performance of the machinery is based on lubricants that require frequent monitoring and the analysis of characteristics such as chemical content, contamination and viscosity. The application of nanoparticles dispersed lubricant in tribology has received remarkable attention in recent years. This paper aims to investigate the tribological properties of SN500 grade lubricating oil containing garnet nanoparticles.

Design/methodology/approach

In this study, 45-nm-sized garnet particles are ultrasonically dispersed in SN500 grade base lubricant oil. The effects of viscosity and additive concentration on tribological properties are investigated using a four-ball tester.

Findings

Rolling, reinforcing and film-forming behaviour of dispersed nano-sized garnet additives in the rubbing zone were investigated using scanning electron microscopy equipped with energy dispersive spectroscopy. The results indicate that the garnet additives can improve the wear resistance and resistance to relative motion and decrease the friction coefficient of rubbing steel interface by surface polishing and formation of tribo-film containing Si, C and Mn.

Originality/value

Because of the complex two-phase solid–liquid mixture, there are still limited physical understandings of the friction and wear reduction mechanisms. Therefore, the present research was undertaken to interpret the possible phenomena.