bluuebunny/crossref_metadata_2025 huggingface dataset:
Maternal Pulse Pressure and the Risk of Postepidural Complications
Authors: Lappen Justin R. , Myers Stephen A. , Bolen Norman , Mercer Brian M. , Chien Edward K. S.
Published: November 2017

OBJECTIVE:

To test the hypothesis that increasing the intravenous fluid bolus volume at the time of epidural placement in women with narrow pulse pressure would reduce postepidural fetal heart rate (FHR) abnormalities, hypotension, and resuscitative obstetric interventions.

METHODS:

We performed a single-center randomized controlled trial. Eligible participants were normotensive with a nonanomalous singleton gestation at or after 35 weeks and with a narrow pulse pressure (less than 45 mm Hg) on admission. Enrolled patients remained eligible for randomization at epidural request if they were within 6 hours of admission and the FHR remained category 1. Patients were allocated to a 500-mL (institutional standard) or 1,500-mL intravenous fluid bolus at epidural placement. A reference group with admission pulse pressure 50 mm Hg or greater was also evaluated. The primary outcome was a category 2 or 3 FHR pattern within 60 minutes after the epidural test dose. Evaluated secondary outcomes included maternal hypotension and composite resuscitative interventions to correct FHR abnormalities or hypotension. We calculated that 276 women (138/group) would provide 80% power to detect a relative 50% reduction in the occurrence of the primary outcome from 27% in the 500-mL group to 13.5% in the 1,500-mL group (two-sided α=0.05).

RESULTS:

From October 2015 to November 2016, 276 women were allocated to receive a 500-mL (n=139) or 1,500-mL (n=137) fluid bolus. One hundred thirty-eight women were evaluated in the reference group. Demographic, obstetric, and labor characteristics were similar between groups. The 1,500-mL group had significantly fewer postepidural FHR abnormalities (38.0% compared with 51.8%, relative risk 0.73, 95% CI 0.56–0.96, P=.02). Maternal systolic hypotension (10.2% compared with 34.5%, relative risk 0.30, 95% CI 0.17–0.51, P<.001) and composite postepidural interventions (18.3% compared with 44.2%, relative risk 0.42, 95% CI 0.28–0.62, P<.001) were also less frequent in the 1,500-mL group. Fetal heart rate abnormalities remained significantly less frequent in the reference group than among women with a narrow pulse pressure on admission for delivery.

CONCLUSION:

A 1,500-mL intravenous fluid bolus in women with a narrow pulse pressure decreases the risk of postepidural FHR abnormalities (number needed to treat=7), results in less frequent postepidural hypotension, and reduces the need for resuscitative interventions. Admission pulse pressure may be used to individualize intrapartum fluid management at the time of initiation of neuraxial labor analgesia.

CLINICAL TRIAL REGISTRATION:

ClinicalTrials.gov, NCT02565485.
Opioid Prescribing Patterns, Patient Use, and Postoperative Pain After Hysterectomy for Benign Indications
Authors: As-Sanie Sawsan , Till Sara R. , Mowers Erika L. , Lim Courtney S. , Skinner Bethany D. , Fritsch Laura , Tsodikov Alex , Dalton Vanessa K. , Clauw Daniel J. , Brummett Chad M.
Published: November 2017

OBJECTIVE:

To quantify physician prescribing patterns and patient opioid use in the 2 weeks after hysterectomy at an academic institution and to determine whether patient factors predict postsurgical opioid use and pain recovery.

METHODS:

We conducted a prospective quality initiative study by recruiting all English-speaking patients undergoing hysterectomy for benign, nonobstetric indications at a university hospital between August 2015 and December 2015, excluding those with major medical morbidities or substance abuse. Before hysterectomy, patients completed the Fibromyalgia Survey, a validated measure of centralized pain. After hysterectomy, opioid use (converted to oral morphine equivalents) and pain scores (0–10 numeric rating scale) were collected by a daily diary and a structured telephone interview 14 days after surgery. Primary outcomes were total opioid prescribed and consumed in the 2 weeks after hysterectomy. Secondary outcomes included daily opioid use and daily pain severity for 14 days after hysterectomy.

RESULTS:

Of 103 eligible patients, 102 (99%) agreed to participate, including 44 (43.1%) laparoscopic, 42 (41.2%) vaginal, and 16 (15.7%) abdominal hysterectomies. Telephone surveys were completed on 89 (87%) participants; diaries were returned from 60 (59%) participants. Diary nonresponders had different baseline characteristics than nonresponders. Median amount of opioid prescribed was 200 oral morphine equivalents (interquartile range 150–250). Patients reported using approximately half of the opioids prescribed with a median excess of 110 morphine equivalents (interquartile range 40–150). The best fit model of total opioid consumption identified preoperative Fibromyalgia Survey Score, overall body pain, preoperative opioid use, prior endometriosis, abdominal hysterectomy (compared with laparoscopic), and uterine weight as significant predictors. Highest tertile of Fibromyalgia Survey Score was associated with greater daily opioid consumption (13.9 [95% CI 3.0–24.8] greater oral morphine equivalents at baseline, P=.02).

CONCLUSION:

Gynecologists at a large academic medical center prescribe twice the amount of opioids than the average patient uses after hysterectomy. A personalized approach to prescribing opioids for postoperative pain should be considered.
Multiparous Ewe as a Model for Teaching Vaginal Hysterectomy Techniques
Authors: Kerbage Yohan , Cosson Michel , Hubert Thomas , Giraudet Géraldine
Published: November 2017

BACKGROUND:

Despite being linked to improving patient outcomes and limiting costs, the use of vaginal hysterectomy is on the wane. Although a combination of reasons might explain this trend, one cause is a lack of practical training. An appropriate teaching model must therefore be devised. Currently, only low-fidelity simulators exist. Ewes provide an appropriate model for pelvic anatomy and are well-suited for testing vaginal mesh properties. This article sets out a vaginal hysterectomy procedure for use as an education and training model.

METHOD:

A multiparous ewe was the model. Surgery was performed under general anesthesia. The ewe was in a lithotomy position resembling that assumed by women on the operating table.

EXPERIENCE:

Two vaginal hysterectomies were performed on two ewes, following every step precisely as if the model were human. Each surgical step of vaginal hysterectomy performed on the ewe and on a woman were compared side by side. We identified that all surgical steps were particularly similar. The main limitations of this model are costs ($500/procedure), logistic problems (housing large animals), and public opposition to animal training models.

CONCLUSION:

The ewe appears to be an appropriate model for teaching and training of vaginal hysterectomy.
What Is New in Recurrent Miscarriage?
Authors: Hansen Keith A.
Published: November 2017

This month we focus on current research in recurrent miscarriage. Dr. Hansen discusses five recent publications, which are concluded with a “bottom line” that is a take-home message. A complete reference for each can be found on Box 1 on this page along with direct links to abstracts.
VITREOUS TREPONEMAL ANTIBODY AS A SUPPLEMENTARY TEST TO SEROLOGY FOR THE CONFIRMATION OF SYPHILITIC CHORIORETINITIS
Authors: Silpa-Archa Sukhum , Preble Janine M. , Foster C. Stephen
Published: November 2017

Purpose:

To report the novel application of nontreponemal and treponemal antibody to confirm diagnosis of ocular syphilis from vitreous samples.

Methods:

Two distinct case reports emphasizing the importance of confirmatory vitreous treponemal antibody. Multimodal imaging of patients was also applied.

Results:

We report two distinct cases with positive serum treponemal antibody but opposing vitreous treponemal antibody results. One case with a positive vitreous test responded well to antisyphilitic treatment. By contrast, a case with a negative vitreous result was changed to serpiginous choroiditis, eventually cured by immunomodulatory treatment.

Conclusion:

Intraocular fluid analysis of nontreponemal and treponemal antibody may play an important role in ruling out suspected ocular syphilis in settings without a polymerase chain reaction facility, especially immunocompromised patients who are at risk of multiple infections. Further studies are needed to establish the sensitivity and specificity of nontreponemal and treponemal antibody test on vitreous samples.
PHOTODYNAMIC THERAPY WITH VERTEPORFIN PLUS INTRAVITREAL BEVACIZUMAB FOR CIRCUMSCRIBED CHOROIDAL HEMANGIOMA: 4 YEARS OF FOLLOW-UP
Authors: Lasave Andres F. , Serrano Martin A. , Arevalo J. Fernando
Published: November 2017

Purpose:

To report the anatomical and functional response of combined photodynamic therapy and intravitreal injection of bevacizumab in a patient with symptomatic circumscribed choroidal hemangioma.

Methods:

The patient received a single-session full-fluence photodynamic therapy immediately followed by an intravitreal injection of bevacizumab (1.25 mg/0.05 mL).

Results:

One week after combined therapy, an improvement of best-corrected visual acuity from count fingers to 20/60 and a significant decrease in subretinal fluid were noted. One month later, we observed decreased leakage on fluorescein angiography in all phases of the study. Three months after treatment, the best-corrected visual acuity improved to 20/25 and spectral domain optical coherence tomography scans showed return to normal foveal architecture with no subretinal fluid and completely flat tumor. These findings were maintained during 4 years of follow-up.

Conclusion:

Combination therapy was associated with a rapid and persistent resolution of subretinal fluid, improvement of best-corrected visual acuity, and visual stability at 4 years of follow-up.
High-Energy Collimator Is Preferable to Medium-Energy Collimator for Evaluating 223Ra Uptake in Bone Metastasis at 2 Weeks Postinjection
Authors: Ichimura Akira , Nakahara Tadaki , Owaki Yoshiki , Nakajima Kiyotaka , Jinzaki Masahiro
Published: November 2017

An 80-year-old man with castration-resistant prostate cancer received 223Ra injection to treat bone metastases. Two weeks after the injection, the patient underwent static 223Ra scan of the chest with medium-energy and high-energy collimators for 30 minutes each. Images obtained with the 2 collimators showed that uptake in metastatic lesions was visually clearer and semiquantitatively higher with the high-energy collimator. The use of HE collimator for 223Ra imaging in the early phase has been reported, and the present case suggests that in the late phase HE collimator would also be preferable to medium-energy collimator in terms of lesion-based evaluation.
The Impact of Repetitive Transcranial Magnetic Stimulation on Oxidative Stress in Subjects With Medication-Resistant Depression
Authors: Durmaz Onur , İspir Emre , Baykan Hayriye , Alişik Murat , Erel Özcan
Published: November 2017

Objectives

Recent studies have shown that oxidative stress is involved in the neurobiology of depression. We investigated the effects of repetitive transcranial magnetic stimulation (rTMS) on a novel oxidative stress marker, thiol-disulfide homeostasis, in subjects with medication-resistant major depression (MRD).

Methods

Twenty-six subjects with MRD underwent 15 rTMS sessions. Sociodemographic and baseline and post-rTMS Montgomery-Asberg Depression Rating Scale (MADRS) data were collected. Serum levels of native thiol, total thiol, and disulfide and their pairwise ratios were measured in baseline and post-rTMS blood samples.

Results

Serum levels of native and total thiol were significantly decreased after rTMS treatment (P < 0.05). Serum levels of thiol-disulfide and their ratios did not significantly differ (P > 0.05) between rTMS treatment responders (>50% reduction in MADRS score, n = 11) and rTMS treatment nonresponders (n = 15). The percentage MADRS score changes did not correlate with the changes in the levels of serum thiol-disulfide from baseline to post-rTMS treatment in any subject (P > 0.05).

Conclusions

Our results showed that rTMS treatment was effective in subjects with MRD and was associated with changes in serum thiol levels regardless of improvement in depression severity. Thus, the results did not support a possible therapeutic relationship between rTMS and thiol-disulfide homeostasis in subjects with MRD.
Salvaging mortgage loans and land title redemption with revolving funds in Thailand
Authors: Suwansin Ravivan , Kuwornu John K.M. , Datta Avishek , Jourdain Damien , Shivakoti Ganesh P.
Published: November 2017

Purpose

The purpose of this paper is to investigate the performance of the revolving fund (RF) regarding the ability of smallholder debtors to retrieve land title deeds, and also to examine the factors influencing the outstanding debts and percentage of outstanding interest of the smallholders in the Central and Northeastern regions of Thailand.

Design/methodology/approach

Primary data were collected from 430 debtors in the Central and Northeastern regions of Thailand in order to compare the differences in livelihood assets as well as their opinions on benefits derived from the operation of the RF. Secondary data were also collected from the RF administration, in order to evaluate the effectiveness and efficiency of the fund. Heteroskedasticity-corrected ordinary least squares and Tobit regression models were employed to examine the factors influencing the outstanding debts and percentage of outstanding interest of the smallholders, respectively. Furthermore, the student’st-test was used to examine the differences in the livelihood assets among debtors in the two regions; and one-way analysis of variance (ANOVA) was used to examine differences in livelihood indicator scores among the three types of debtors.

Findings

The empirical results revealed that the RF is effective as the fund could provide loan to smallholders to enable them redeem their land title deeds from their previous creditors. Thet-test results reveal significant differences in the livelihood assets among debtors in the two regions. One-way ANOVA indicates differences in livelihood indicator scores among the three types of debtors. The results of the heteroskedasticity-corrected ordinary least squares regression revealed that being married, low frequency of floods and less influence of third parties significantly reduced the outstanding debts. The results of the censored Tobit regression revealed that increased frequency of meeting with the RF administration, less influence of third parties, high land potential and interaction of age and experience significantly decreased the percentage of outstanding interest.

Practical implications

It is imperative to intensify information and education regarding the regulations, payment terms and modalities to clients in order to facilitate repayments of the loans disbursed. The organization of the RF should pay particular attention to the role of the committees involved, information administration and loan repayment monitoring. The RF should increase the frequency of meetings with smallholders, minimize the influence of third parties and give priority to old and experienced smallholders who possess land with high potential for earning incomes to enable them repay the loans.

Originality/value

To the best of the authors’ knowledge, this is the first study that examined the effectiveness of the RF to enable smallholders retrieve their land title deeds.
Investigation of stretch on air permeability of knitted fabric part I: effect of spinning system
Authors: K.V. Kumar , V.R. Sampath , C. Prakash
Published: November 2017

Purpose

Air permeability of knitted fabrics is normally measured for the samples in their unstretched state. But, this air permeability values indicate the ability of these garments to allow air through them when they are not in use. But, the real-time condition is different and certainly the knitted garments mentioned above will subject to a degree of stretch during their usage. So, the measurement of air permeability under stretch and the fabric properties which would influence the air permeability of weft-knitted fabrics in their stretched state is of paramount importance. The paper aims to discuss these issues.

Design/methodology/approach

The aim of this research work is to investigate the change in air permeability values under the incremental extension of cotton tubular weft-knitted fabrics produced from the yarns of different spinning systems.

Findings

From the results, it is evident that the pique fabric samples of compact spun yarn displayed the highest air permeability values during the incremental stretch at all the three relaxation states. It is followed by the pique samples of ring spun yarn. Next to pique samples, the jersey samples made from the compact yarn and ring spun yarn revealed more air permeability, respectively. The core spun pique samples and core spun jersey samples displayed the least air permeability values, respectively. But, the pique and jersey samples made up of ring yarn and compact yarn showed gradual reduction in their air permeability towards the incremental stretch and the core spun pique samples and core spun jersey samples were uniformly seen with gradual increase in their air permeability during the incremental stretch.

Originality/value

Very limited quantity of research has been carried out in this area. So, a novel attempt has been made in this research work to investigate the influence of incremental stretch on air permeability of single knit structures.
Influence of the delamination loading velocity on textile bonds and sewn seams strength
Authors: Mikalauskaite Gerda , Daukantiene Virginija
Published: November 2017

Purpose

The purpose of this paper is to determine the influence of the loading velocity on textile bonds and sewn seam strength.

Design/methodology/approach

Commercially produced polyamide and polyester knitted fabric, and polyester woven fabrics as well as three commercially available monolayer urethane thermoplastic films were used in this research. Two layers of each fabric were laminated at 160°C temperature at 5.6 kPa for 20 seconds. Sewn specimens were joined applying (301) and (514) stiches for woven and knitted fabrics, respectively. The bond and sewn seam strength was investigated at different delamination loading velocities (50, 100, 150, 200, 300 mm/min). These values of velocities lies in the velocity interval which covers the different standard requirements for testing of the quality of textiles and their seams or were applied in the research works of previous scientists. As the influence of loading velocity was more significant for bond strength, the bond strength results were analyzed together with the analysis of bond rupture character.

Findings

The determined influence of the loading velocity on textile bonds strength has proved that the loading velocity in bond strength test is of high importance for the prediction of the behavior of clothing being in exploitation under different conditions. The opposite tendency was determined for the sewn seams, the strength of which was independent on loading velocity.

Originality/value

The influence of the loading velocity on textile bond and sewn seam strength was not analyzed in the previous research works published by other scientists. It was known that the standard velocity is 50 mm/min for seams and 100 mm/min for textiles strength testing. It was shown there that the real exploitation of a garment as a whole complicated heterogenic dynamic system could be simulated with changing loading velocities during their seam strength testing. It was also determined that the loading velocity makes different influence on bonded and sewn seams of textiles.
The current behavioural patterns witnessed of the customers/clients/players in the personal real estate market in Sri Lanka
Authors: Karunaratne Vidanage Pemananda
Published: November 2017

Purpose

Although the personal real estate market business seems to be an upcoming flourishing economic venture in Sri Lanka, the intellectual investigator could invariably visualize a magnitude of flaws and unethical practices in operation in its current behavioural patterns, on the one hand, displayed by the not-so-honest buyers who resort to various deceptions in duping the sellers and, on the other, by the unprofessional activities of the agents/brokers who act as middlemen or intermediaries in bringing the buyer and the seller together. Nevertheless, it is found through observational research and empirical evidence that such plethora of malpractices happening in this economic sphere could be obviated by inculcating the much-needed professionalism among the brokering community. In such a scenario, the brokers become capable of educating both the buyer and the seller in the ethical practices governing the personal real estate business. The paper aims to discuss these issues.

Design/methodology/approach

Observational research and empirical evidence are gathered from the relevant venues and scenarios.

Findings

In order to achieve this end, it is recommended that both the state sector and private sector in Sri Lanka should initiate immediate action in providing valuable study courses in the area of real estate marketing culminating in certificates and diplomas awarded to the qualified agents/brokers.

Research limitations/implications

In this research paper, the author opts to limit his study only to the personal real estate market in Sri Lanka. Said differently, the study will, inter-alia, explore the behavioural patterns of the individuals who are desirous of purchasing a land or a house property for their own personal use.

Originality/value

This type of research paper has never been presented in relation to the personal real estate market in Sri Lanka. Thus, it explores the behavioural patterns of the various players who are engaged in the personal real estate business in Sri Lanka currently.
Department vs discount retail store patronage: effects of self-image congruence
Authors: Sung Eunyoung (Christine) , Huddleston Patricia
Published: November 2017

Purpose

This paper explores the antecedents and consequences of consumers’ need for self-image congruence on their retail patronage of department (high-end) and discount (low-end) stores to purchase name-brand products in two product categories, apparel and home décor. It also compared online to offline shopping and considered two mediator variables, frugality and materialism.

Design/methodology/approach

The paper analyzed the hypothesized relationships using structural equation modeling (SEM) and MANOVA. Study 1 suggested the model using secondary data, and Study 2 measured and confirmed the relationships using scenario-based online survey data. An MANOVA test was used to compare the shopping behavior of consumers with high and low need for self-image congruence.

Findings

A strong causal link was found between concern with appearance and need for self-image congruence, and a positive relationship between need for self-image congruence and high- and low-end retail store patronage offline and online. While the group with high (vs low) need for self-image congruence was more likely to patronize department stores, unexpectedly, both the high and low self-image congruence groups were equally likely to shop at discount stores.

Practical implications

The findings suggest that marketing messages focusing on concern for appearance may succeed by tapping into consumers’ need for self-image congruence with brand product/retail store images. Results also showed that consumers with high self-image congruence often patronize discount retail stores, suggesting marketing opportunities for low-end retailers.

Originality/value

Because consumers with high need for self-image congruence patronize both department and discount stores, it is suggested that self-image congruity may be multi-dimensional. The current study is also the first to examine structural relationships to test patronage behavior between department and discount stores offline and online.
Temperature detection in cutting zone for different forms of chip shapes during machining process
Authors: Anicic Obrad , Jovic Srdjan , Tasic Srdan , Vulovic Aleksa , Jovanovic Milivoje
Published: November 2017

Purpose

This study aims to detect the temperature distribution in the cutting zone during the machining process. Furthermore, temperature influence in the cutting zone on the forms of chip shapes during the turning of Steel 30CrNiMo8 was evaluated. It is very important to use optimal machining parameters to get the best production results or for high control of the machining process.

Design/methodology/approach

Temperature distribution in the cutting zone during the machining process could affect the forms of chip shapes. Forms of chip shapes could be considered as the most important indicator for the quality of the machining process.

Findings

Therefore, in this study, the forms of chip shapes based on the temperature distribution in the cutting zone were examined.

Originality/value

It was found that the snarled chip type and the loose chip type have the highest temperature variation during the machining process.
A reduced rule-based expert system by the simplification of logic functions for determining the life expectancy of intensive care patients
Authors: Cizmeci Inayet Hakki , Basçiftçi Fatih
Published: November 2017

Purpose

Specialist physicians, specialist nurses and personnel in the intensive care unit (ICU) work to treat patients. Compared with other hospital units, ICUs are full-fledged and provide 24-h services. However, patients are admitted to this unit because of conditions such as severe trauma, organ failure or dysfunction and poisoning. The life expectancy of such patients is considerably low.

Design/methodology/approach

This study developed a reduced rule-based expert system to determine life expectancy. The purpose of this study is to determine the life expectancy of patients using ten variables. The rules were determined by evaluating 210 = 1,024 results. These rules were minimized using Boolean rules for simplification.

Findings

Conclusions were drawn by evaluating the minimized cases rather than evaluating 1,024 different cases. ICU patients were evaluated using this method, and the mean success rate was 63.75 per cent.

Originality/value

No rule-based expert system has been designed to determine the death risks of patients in the ICU.
High‐productivity vegetation is important for lessening bird declines during prolonged drought
Authors: Selwood Katherine E. , McGeoch Melodie A. , Clarke Rohan H. , Mac Nally Ralph
Published: November 2017

Locations in which ecological assemblages show high resistance to climate pressures, such as drought, are likely to be important refuges for biota in changing climates. We asked whether environmental characteristics of locations were associated with the capacity of bird assemblages to withstand prolonged drought.

We used a multispecies index to quantify trends in bird assemblages during a 13‐year drought at >500 locations (>18,000 surveys) in the Murray–Darling Basin, south‐eastern Australia, using data from the Atlas of Australian Birds. We investigated whether the resistance of bird assemblages was associated with (1) vegetation structure; (2) vegetation productivity (vegetation greenness); (3) landscape context (patch size, landscape vegetation cover); or (4) physical environment (elevation, terrain, topography, availability of surface water).

Vegetation productivity, measured by vegetation greenness (Normalized Difference Vegetation Index), was the only potential predictor with strong evidence of an effect, and was positively associated with the index of drought resistance. There was little evidence that variables characterizing landscape context, vegetation structure or the physical environment of sites were associated with drought resistance of bird communities.

Synthesis and applications. Bird assemblages in locations with high vegetation greenness are more resistant to severe drought. Prioritizing conservation investments in areas with locally high vegetation productivity is likely to be an effective strategy for increasing the resistance of bird assemblages to extreme drought, especially in areas where mean productivity is relatively low, such as arid and semi‐arid regions. Remotely sensed vegetation greenness may be a promising source of information for identifying drought refuges for birds and possibly other biota.
Metacommunities, metaecosystems and the environmental fate of chemical contaminants
Authors: Schiesari Luis , Leibold Mathew A. , Burton G. Allen
Published: November 2017

Although pollution is a major driver of ecosystem change, models predicting the environmental fate of contaminants suffer from critical uncertainties related to oversimplifying the dynamics of the biological compartment.

It is increasingly recognized that contaminant processing is an outcome of ecosystem functioning, that ecosystem functioning is contingent on community structure and that community structure is influenced by organismal dispersal. We propose a conceptual organization of the contribution of organismal dispersal to local contaminant fate. Direct dispersal effects occur when the dispersing organism directly couples contaminant stocks in spatially separate ecosystems by transporting contaminants in its biomass. Indirect dispersal effects occur when the dispersing organism indirectly influences contaminant fate via community assembly. This can occur either when the dispersing organism is a contaminant processor or when the dispersing organism alters, via species interactions, the abundance of contaminant biotransporters or processors already established in the ecosystem. The magnitude of direct and indirect dispersal effects is modulated by many factors, including other contaminants. These will influence population growth rates of the dispersing species in the donor ecosystem, or the probability that a dispersing individual reaches the recipient ecosystem.

We provide a review of pertinent literature demonstrating that these two mechanisms, and their chemical modulation, are well supported or likely to occur in many natural and human‐modified landscapes. The literature also demonstrates that they can operate in concert with each other.

Synthesis and applications. Managed ecosystems thought to be important contaminant and nutrient sinks, such as artificial ponds and constructed wetlands, should be monitored and controlled for in‐and‐out animal movement if contaminant export is found to be relevant. Uncontaminated fishing grounds linked to contaminated sites via movement of dispersing species should be monitored and resident species evaluated for health consumption advisories. Assessing the success of contaminated site remediation can be improved by better matching the spatial extent of site remediation and the home range of monitored species. Finally, interagency research fund programmes should be developed that narrow the current gap between the fields of ecology and ecotoxicology.
Understanding the lived experiences of Parkinson's disease and deep brain stimulation (DBS) through occupational changes
Authors: Liddle Jacki , Phillips Jessie , Gustafsson Louise , Silburn Peter
Published: November 2017

Background

Deep brain stimulation (DBS), a surgically based treatment for people living with Parkinson's disease (PD), can result in a significant improvement of motor symptoms. However, the broader impact of DBS and the changes it creates are not well understood. Greater understanding of the experiences and needs related to DBS would enable development of relevant outcome measures and supports.

Objectives

To explore the lived experiences of people undergoing DBS for Parkinson's disease.

Methods

A descriptive phenomenological study was undertaken exploring experiences, perspectives and outcomes with key stakeholders. Semi‐structured, audiotaped interviews were undertaken with people with PD who have had DBS, their family members and health professionals across four states and territories in Australia.

Results

Perspectives and experiences of 14 people with PD undergoing DBS, 10 family members and 11 health professionals were analysed. Occupations emerged as a key aspect throughout the DBS experience. Two major themes captured the role of occupation in relation to DBS: Occupations as a barometer, where occupational experiences and performances shaped people's understanding of their condition, the impact of treatments and their overall adjustment; and Shifting occupational identity where the life transition of DBS altered the occupational experiences of relationships, volition, roles and responsibilities of people with PD and their family members.

Conclusion

Occupational experiences and changes served as an important way for people with PD and their families to understand and communicate their experiences of PD and related treatments. There is an identified need for outcome measures and clinical education and interventions to reflect this.
Expression of DCUN1D1 in laryngeal squamous cell carcinoma and its inhibiting effect on TU‐177 cells after interfered by RNA
Authors: Liu Jing , Shuang Yu , Li Chao , Zhou Xuan , Huang Yongwang , Zhang Lun
Published: November 2017

Expression of DCUN1D1 in laryngeal squamous cell carcinoma (LSCC) and its inhibition by small interfering RNA (siRNA) target in the TU‐177 cells was investigated. Immunohistochemistry was used to detect the expression level of DCUN1D1 in LSCC tissue in 140 cases and to analyze its relationship with clinical pathological characteristics. siRNA expression plasmid targeting DCUN1D1 was constructed and transferred into TU‐177 cells. The effect of siRNA target DCUN1D1 gene silencing on proliferation, invasion and migration of TU‐177 cells were observed by MTS assay and Transwell experiment. The expression levels of focal adhesion kinase (FAK) and matrix metalloproteinase‐2(MMP‐2) were detected by western blot. Expression level of DCUN1D1 protein increased significantly in T3 + T4, N+, and III + IV stages of LSCC patients (P < .05). After DCUN1D1 was targeted by siRNA, the DCUN1D1 protein level decreased 67% in siRNA‐3 group, where average absorbance value was lower than the control and blank group with significant difference(F = 6.076, P < .05) in MTS assay, meantime migration, and invasion cells in each vision were the same (F = 19.851, F = 25.454, P < .01) in the Transwell experiment. The expression level of FAK and MMP‐2 was significantly down‐regulated in siRNA‐3 group (F = 28.896, F = 40.240, P < .01). DCUN1D1 is associated with progression and prognosis of LSCC. After siRNA based target on DCUN1D1, TU‐177 cells growth was inhibited and invasion of malignant tumour was diminished by reducing the expression of FAK and MMP‐2. DCUN1D1 is could become a potential new target for the treatment of LSCC.
Moderators of response to sertraline versus placebo among recently abstinent, cocaine dependent patients: A retrospective analysis of two clinical trials
Authors: Bashiri Maryam , Mancino Michael J. , Stanick Virginia A. , Thostenson Jeff , Kosten Thomas R. , Oliveto Alison H.
Published: November 2017

Background and Objectives

Moderators of treatment response to serotonin reuptake inhibitor sertraline (SRT) for cocaine dependence were assessed in two randomized, double blind, placebo‐controlled clinical trials.

Methods

Generalized estimating equation modeling was performed on data from cocaine‐dependent volunteers randomized to receive SRT or placebo (N = 126) who completed >2‐week drug‐free residential portions of the 12‐week trials, in which subsequent outpatient treatment (weeks 3–12) included weekly cognitive behavioral therapy and thrice‐weekly supervised urine toxicology. Primary Outcome Measure: Relapse (2 consecutive cocaine‐positive or missing urines) following residential stay. Potential moderators included treatment, sex, age, race, depression measures, baseline cocaine urine result, and alcohol dependence diagnosis (ADDx).

Results

Odds ratios (OR) for relapse showed placebo‐treated participants were significantly more likely to relapse than SRT participants. Regardless of treatment condition, participants more likely to relapse were male, and those with lower Hamilton depression ratings, or baseline cocaine‐negative urines. Older subjects or those with current ADDx had higher relapse risk than those without ADDx; however, treating older or ADDx participants with SRT reduced cocaine relapse more than placebo.

Discussion and Conclusions

Women or those with more severe cocaine use or depressive symptoms may have fewer cocaine relapses regardless of medication treatment. SRT at 200 mg reduced cocaine relapse more than placebo, especially in older participants or in those with comorbid ADDx.

Scientific Significance

SRT may be efficacious to support relapse prevention among cocaine‐dependent patients in the context of brief residential followed by outpatient treatment, especially in older participants or those with comorbid alcohol/cocaine dependence. (Am J Addict 2017;26:807–814)
Risk of preterm birth in women with cervical intraepithelial neoplasia grade one: a population‐based cohort study
Authors: Heinonen Annu , Gissler Mika , Paavonen Jorma , Tapper Anna‐Maija , Jakobsson Maija
Published: November 2017

Introduction

In this population‐based register study our objective was to explore the association of cervical intraepithelial neoplasia, grade 1 and loop electrosurcigal excision procedure with preterm birth.

Material and methods

Our population consisted of 4759 women diagnosed with cervical intraepithelial neoplasia, grade 1 during 1997–2009 and their 3021 subsequent deliveries analyzed by loop electrosurcigal excision procedure and parity. Hospital Discharge Register was used to identify women diagnosed for cervical intraepithelial neoplasia, grade 1 and these data were linked with the Medical Birth Register data. We calculated odds ratios with 95% confidence intervals.

Results

Cervical intraepithelial neoplasia, grade 1 patients with loop electrosurcigal excision procedure had 54 (6.7%) subsequent preterm births and the corresponding figure among cervical intraepithelial neoplasia, grade 1 patients without loop electrosurcigal excision procedure was 116 (5.2%). This results in odds ratios 1.31 (95% confidence interval 0.94–1.83). We assessed the risk before and after diagnosis of cervical intraepithelial neoplasia, grade 1 both for patients with loop electrosurcigal excision procedure (odds ratios 1.47, 95% confidence interval 1.05–2.06) and without loop electrosurcigal excision procedure (odds ratios 0.90, 95% confidence interval 0.71–1.13). An increased risk for preterm birth after diagnosis of cervical intraepithelial neoplasia, grade 1 and loop electrosurcigal excision procedure was observed. We also compared both groups to the background population in the Medical Birth Register. For cervical intraepithelial neoplasia, grade 1 patients without loop electrosurcigal excision procedure the risk for preterm birth was not increased (odds ratios 0.95, 95% confidence interval 0.76–1.21) whereas for cervical intraepithelial neoplasia, grade 1 patients treated with loop electrosurcigal excision procedure the risk for preterm birth was increased (odds ratios 1.45, 95% confidence interval 1.02–1.92).

Conclusions

Loop electrosurcigal excision procedure itself increases the risk for preterm birth. Cervical intraepithelial neoplasia, grade 1 as such does not increase the risk for preterm birth.
Neurocognition and subjective experience following acute doses of the synthetic cannabinoid JWH‐018: a phase 1, placebo‐controlled, pilot study
Authors: Theunissen Eef L , Hutten Nadia R P W , Mason Natasha L , Toennes Stefan W , Kuypers Kim P C , de Sousa Fernandes Perna Eliza B , Ramaekers Johannes G
Published: November 2017

Background and Purpose

Synthetic cannabinoids (often sold as Spice or K2) have become a very popular alternative to cannabis due to their easy access and portrayed safety. Controlled studies on the behavioural effects of synthetic cannabinoids are currently lacking, which hampers risk assessments of these compounds.

Experimental Approach

This is a first attempt to assess the influence of a synthetic cannabinoid, JWH‐018, on neurocognition and subjective experience in humans after controlled administration. JWH‐018, 2 and 3 mg, was administered to six healthy cannabis‐experienced volunteers in a placebo‐controlled, cross‐over study following an escalating dosing schedule. Participants were monitored for 12 h after drug administration, and several neurocognitive measures and subjective questionnaires were taken.

Key Results

Serum concentrations of JWH‐018 were highest after the 2 mg dose but generally low after administration of both doses. Both doses of JWH‐018 were well tolerated, and no serious side effects were reported. Participants reported feeling more ‘high’ at 1 and 2 h after administration, particularly after the 2 mg dose. Behavioural impairments also emerged despite the low serum concentrations of JWH‐018. The low dose of JWH‐018 impaired performance on the tracking, divided attention and stop signal task.

Conclusion and Implications

JWH‐018 dosing in the present study resulted in drug concentrations that were generally low and not fully representative of common use. Yet initial impairments of neurocognitive function and subjective feelings of high did emerge despite low levels of JWH‐018 in serum. Higher doses are needed to obtain a more representative risk profile of JWH‐018.
RNA-sequencing study of peripheral blood mononuclear cells in sporadic Ménière's disease patients: possible contribution of immunologic dysfunction to the development of this disorder
Authors: Sun Y , Zhang D , Sun G , Lv Y , Li Y , Li X , Song Y , Li J , Fan Z , Wang H
Published: November 2017

To date, the pathogenesis of Ménière's disease (MD) remains unclear. This study aims to investigate the possible relationship between potential immune system-related genes and sporadic MD. The whole RNA-sequencing (RNA-seq) technology was used to analyse the transcriptome of peripheral blood mononuclear cells of three MD patients and three control individuals. Of 366 differentially expressed genes (DEGs), 154 genes were up-regulated and 212 genes were down-regulated (|log2 fold change| > 1 and P < 0·05). Gene ontology (GO) enrichment analysis illustrated that immune relevant factors played a key role in the pathogenesis of MD. Of 366 DEGs, we focused upon analysing the possible immune-related genes, among which the significantly up-regulated genes [glutathione S-transferase mu 1 (GSTM1), transmembrane protein 176 (TMEM176)B, TMEM176A] and down-regulated genes [solute carrier family 4 member (SLC4A)10 and SLC4A1] especially drew our attention. The mRNA expression levels of GSTM1, TMEM176B, TMEM176A, SLC4A1 and SLC4A10 were analysed by quantitative reverse transcription–polymerase chain reaction (qRT–PCR). The serum concentration of GSTM1, TMEM176B and SLC4A10 proteins were measured by enzyme-linked immunosorbent assay (ELISA). Considering the results of qRT–PCR and ELISA, it was noteworthy that GSTM1 exhibited the highest fold change between two groups, which was consistent with the deep sequencing results by RNA-seq. In conclusion, our study first offers a new perspective in MD development on the basis of RNA expression patterns, suggesting that immune factors might be involved in the MD pathogenesis. Remarkably, GSTM1 might be a possible candidate gene for the diagnostic biomarker of MD and provides the basis for further biological and functional investigations.
Collaborative Translation of Knowledge to Protect Infants During Sleep: A Synergy of Discovery and Practice
Authors: Middlemiss Wendy , Cowan Stephanie , Kildare Cory , Seddio Kaylee
Published: November 2017

The impact of discoveries from scientific research is manifested in its timely application to real‐world conditions, with a goal of improving life. This is the desired research‐to‐practice transition for new knowledge, yet it is not always achieved. Where knowledge is simply transferred in its discovered form, there can be unintended consequences and harmful delays in achieving desired changes if there is not also a cultural and contextual fit with targeted populations. This has been the case, for example, in the failure of the “don't bedshare” message in protecting African American infants, a message derived from the discovery of heightened risk of death for infants who sleep in the same bed as others. Knowledge transfer implies movement in one direction: from researchers to end‐users. Family scientists, who work with families, understand that knowledge in its discovered form needs to be translated, and not just transferred, if it is to be useful to families and fit with their values, preferences, and circumstances. Unlike knowledge transfer, knowledge translation is bidirectional, with multiple informants, including but not limited to the new discoveries themselves. In this article, we examine the history of discovery and practice as it relates to preventing sudden infant death. Using safer infant sleep as an example, this review demonstrates the importance of collaborative translation between discovery and practice for developing health policies, interventions and messaging that are enabling for all families.
Treatment of severe drug reactions by hemodialysis
Authors: el‐Azhary Rokea A. , Wang Michael Z. , Wentworth Ashley B. , Hickson LaTonya J.
Published: November 2017

Background

Extracorporeal treatments such as hemodialysis and plasma exchange are lifesaving measures in the treatment of drug poisoning. This treatment method generally is not used for severe cutaneous and systemic drug reactions.

Methods

Here, we describe three cases wherein hemodialysis therapy was instrumental in reversing the adverse drug reaction.

Results

In the cases of severe cutaneous drug reactions reviewed, patients presented with linear immunoglobulin A bullous dermatosis, acute generalized exanthematous pustulosis, and toxic epidermal necrolysis. Salvage treatment with hemodialysis therapy drastically influenced the course of disease, resulting in remission.

Conclusions

This novel and highly effective treatment option is not considered in current algorithms for adverse drug reactions. Hence, in addition to the rarity of these reactions, the main limitation of the study is the small number of patients. Hemodialysis can substantially alter the prognosis and, in some cases, be a lifesaving treatment for patients with severe adverse cutaneous drug reaction associated with systemic toxicity.
Regulation of T helper cell responses during antigen presentation by norepinephrine‐exposed endothelial cells
Authors: Xu Linghui , Ding Wanhong , Stohl Lori L. , Zhou Xi K. , Azizi Shayan , Chuang Ethan , Lam Jimmy , Wagner John A. , Granstein Richard D.
Published: November 2017

Dermal blood vessels and regional lymph nodes are innervated by sympathetic nerves and, under stress, sympathetic nerves release norepinephrine (NE). Exposure of primary murine dermal microvascular endothelial cells (pDMECs) to NE followed by co‐culture with Langerhans cells (LCs), responsive CD4+ T‐cells and antigen resulted in modulation of CD4+ T‐cell responses. NE‐treatment of pDMECs induced increased production of interleukin (IL)‐6 and IL‐17A while down‐regulating interferon (IFN)‐γ and IL‐22 release. This effect did not require contact between pDMECs and LCs or T‐cells and depended upon pDMEC production of IL‐6. The presence of NE‐treated pDMECs increased the proportion of CD4+ T‐cells expressing intracellular IL‐17A and increased IL‐17A mRNA while decreasing the proportion of IFN‐γ‐ or IL‐22‐expressing CD4+ T‐cells and mRNA levels for those cytokines. Retinoic acid receptor‐related orphan receptor gamma (ROR‐γt) mRNA was significantly increased in CD4+ T‐cells while T‐box transcription factor (T‐bet) mRNA was decreased. Intradermal administration of NE prior to hapten immunization at the injection site produced a similar bias in draining lymph node CD4+ T‐cells towards IL‐17A and away from IFN‐γ and IL‐22 production. Under stress, release of NE may have significant regulatory effects on the outcome of antigen presentation through actions on ECs with enhancement of inflammatory skin disorders involving IL‐17/T helper type 17 (Th17) cells.