bluuebunny/crossref_metadata_2025 huggingface dataset:
International clinimetric evaluation of the MG‐QOL15, resulting in slight revision and subsequent validation of the MG‐QOL15r
Authors: Burns Ted M. , Sadjadi Reza , Utsugisawa Kimiaki , Gwathmey Kelly G. , Joshi Amruta , Jones Sarah , Bril Vera , Barnett Carolina , Guptill Jeffrey T. , Sanders Donald B. , Hobson‐Webb Lisa , Juel Vern C. , Massey Janice , Gable Karissa L , Silvestri Nicholas J. , Wolfe Gil , Cutter Gary , Nagane Yuriko , Murai Hiroyuki , Masuda Masayuki , Farrugia Maria Elena , Carmichael Caroline , Birnbaum Simone , Hogrel Jean‐Yves , Nafissi Shahriar , Fatehi Farzad , Ou Changyi , Liu Weibin , Conaway Mark
Published: May 2016

Introduction: The MG‐QOL15 is a validated, health‐related quality of life (HRQOL) measure for myasthenia gravis (MG). Widespread use of the scale gave us the opportunity to further analyze its clinimetric properties. Methods: We first performed Rasch analysis on >1,300 15‐item Myasthenia Gravis Quality of Life scale (MG‐QOL15) completed surveys. Results were discussed during a conference call with specialists and biostatisticians. We decided to revise 3 items and prospectively evaluate the revised scale (MG‐QOL15r) using either 3, 4, or 5 responses. Rasch analysis was then performed on >1,300 MG‐QOL15r scales. Results: The MGQOL15r performed slightly better than the MG‐QOL15. The 3‐response option MG‐QOL15r demonstrated better clinimetric properties than the 4‐ or 5‐option scales. Relative distributions of item and person location estimates showed good coverage of disease severity. Conclusions: The MG‐QOL15r is now the preferred HRQOL instrument for MG because of improved clinimetrics and ease of use. This revision does not negate previous studies or interpretations of results using the MG‐QOL15. Muscle Nerve 54: 1015–1022, 2016
A kinematic hardening based model for unsaturated soils considering different hydraulic conditions
Authors: Maleki Mohammad , Pouyan Hassan
Published: May 2016

At present, several of the existing elastoplastic constitutive models are adapted for describing the stress–strain behavior of unsaturated soils. However, most of them present certain limitations in this field. These limitations can be related to the basic model and/or added unsaturated state variables and formulations. In this regard, inability to model the hydro‐mechanical behavior in constant water (CW) conditions is an example of these limitations. In this paper, an advanced version of CJS model is selected for adaptation to the unsaturated states. Adaptation to unsaturated states is achieved in the framework of effective stress approach. Effective stress equation and unsaturated state variables are selected based on the recent research existing in the literature. The developed model is capable of describing the complex behavior of unsaturated soil in the CW condition in addition to predicting the behavior at failure and post–failure, nonlinear elastoplastic behavior at low levels of stress and strain (by selecting a very small elastic domain), as well as wetting and collapse behaviors. In order to validate the model, results of triaxial tests in CD and CW conditions are used. The validation results indicate the good capability of the proposed model. Behavior of the unsaturated soils during wetting is an important issue. For this reason, the model is also evaluated based on the results of wetting and collapse triaxial tests. A comparison between the tests and simulation results shows that the model is able to predict the soil behavior under the wetting path. Copyright © 2016 John Wiley & Sons, Ltd.
Efficacy and pregnancy outcomes of laparoscopic single sheet mesh sacrohysteropexy
Authors: Pandeva Ivilina , Mistry Minesh , Fayyad Abdalla
Published: May 2016

Aims

To evaluate outcomes following laparoscopic single sheet mesh sacrohysteropexy for the management of uterine prolapse.

Methods

One hundred and fifty‐nine women underwent the procedure between August 2010 and August 2014. One hundred and forty‐four patients completed the follow up assessment. At each visit, the prolapse symptoms were assessed using the prolapse quality‐of‐life (P‐QOL) questionnaire and objectively with the use of the Pelvic Organ Prolapse Quantification (POPQ) score. The subjective outcomes were also evaluated with the use of the Patient Global Impression of Improvement (PGII) questionnaires. Perioperative complications and further surgery for prolapse were evaluated. Women who conceived following the procedure were evaluated for pregnancy outcomes and prolapse recurrence.

Results

Pre‐operatively, 85% (135/159) had uterine prolapse ≥ stage 2. Postoperatively, 95.1% (137/144) of women had anatomical success rate defined as stage 0 uterine descent. Eighty‐two percent (118/144) of women reported cure of prolapse symptoms and feeling “much better” or “very much better” on postoperative PGII assessment. Eight women (5%) became pregnant following the laparoscopic sacrohysteropexy‐ seven had full term pregnancies and one had a miscarriage. Six out of the seven (86%) had stage 0 apical prolapse and PGII of “much better” at 6 months postpartum. One patient had symptomatic prolapse recurrence and underwent perineorrhaphy at 3 years.

Conclusion

Laparoscopic single sheet mesh sacrohysteropexy is associated with subjective and objective improvement in prolapse symptoms and QoL that is maintained up to 48 months. Laparoscopic sacrohysteropexy can be offered to women desiring future fertility; however, further research is needed to advise on best surgical approach in women of childbearing age. Neurourol. Urodynam. 36:787–793, 2017. © 2016 The Authors. Neurourology and Urodynamics Published by Wiley Periodicals, Inc.
Chemerin activation in human obesity
Authors: Chang Shwu‐Shin , Eisenberg Dan , Zhao Lei , Adams Christopher , Leib Ryan , Morser John , Leung Lawrence
Published: May 2016

Objective

Chemerin is an inflammatory adipokine, whose activity is regulated by successive proteolytic cleavages at its C‐terminus. It is secreted as an inactive precursor (chem163S); cleavage at Lys158 converts it to chem158K with modest activity. Chem157S is the most potent form and chem155A is inactive. The aim of this study was to determine if chemerin was activated in samples from patients with obesity.

Methods

Using specific ELISAs for different chemerin forms and a pan‐chemerin ELISA, chemerin forms in human obesity were characterized.

Results

Plasma chemerin from patients with obesity (BMI 44.3 ± 1.3 kg/m2, n = 29) was significantly higher than in lean controls (BMI 20.9 ± 0.7 kg/m2, n = 10) (160 ± 11 vs. 76.2 ± 5.5 ng/mL, respectively, P < 0.0001). This increase in chemerin was due to increased previously unattributed chemerin, with further C‐terminal truncation demonstrated by mass spectrometry, accounting for ∼35% of total plasma chemerin. Chemerin forms in adipose tissue showed a different profile, with minimal chem163S and significant levels of chem157S. Chem155A was present in omental but not in subcutaneous adipose tissue. Unattributed chemerin forms were undetectable in adipose tissue.

Conclusions

Chemerin is activated in adipose tissue of subjects with obesity, and further C‐terminal processing occurs during the disposition of chemerin from adipose tissue, resulting in substantial levels of novel degraded forms in plasma that correlate with obesity.
New benzodithiophene‐ and benzooxadiazole/benzothiadiazole‐based donor–acceptor π‐conjugated polymers for organic photovoltaics
Authors: Kranthiraja Kakaraparthi , Gunasekar Kumarasamy , Ho Park Sang , Kang In‐Nam , Yong Lee Jin , Song Myungkwan , Jin Sung‐Ho
Published: May 2016

A new set of push‐pull type 2D‐conjugated polymers (P1–P4) were designed and synthesized where A1, A2 (oxygen analogues) and A3, A4 (sulfur analogues) are electron deficient units used as co‐monomers. On introduction of new repeating units into the polymer backbone, significant changes were observed in optoelectronic properties. Furthermore, the heteroatom exchange in new repeating units has also brought notable changes in photophysical properties, in particular P1 and P2 (oxygen analogues) showed bathochromic shift in UV‐vis absorption spectra and deeper HOMO energy levels than P3, P4 (sulfur analogues). Interestingly P1, P3 absorption spectra shows a vibronic shoulder (659, 652 nm) peak in lower energy region, and this might originated from non‐covalent interactions between the electron rich and electron deficient units. In addition, the systematic investigation of these polymers with additive and solvent treatment, yielded in enhanced power conversion efficiency of 4.29% for P3‐based devices in bulk heterojunction organic solar cells. © 2016 Wiley Periodicals, Inc. J. Polym. Sci., Part A: Polym. Chem. 2016, 54, 2668–2679
Resilience of internal medicine house staff and its association with distress and empathy in an oncology setting
Authors: McFarland Daniel C. , Roth Andrew
Published: May 2016

Context

Resilience is a beneficial trait for resident physicians who are exposed to adversity through their work with patients. Inpatient hematology–oncology produces vicarious trauma for physicians in training. Physician distress and empathy influence patient care and may be associated with respectively lower and greater levels of resilience.

Methods

We collected measures of resilience (Connor–Davidson Resilience Scale), distress (Impact of Events Scale – Revised), and rotation‐specific information (e.g., number of death encounters, death stress, and meaning) at the end of a routine hematology–oncology ward rotation. Empathy (Interpersonal Reactivity Index) was measured both before and after the rotation.

Results

Fifty‐six out of 96 residents completed the study with an overall response rate of 58%. Resilience was negatively correlated with distress (r = −0.306, p = 0.023) but not with empathy (r = 0.172, p = 0.204) and nor with change in empathy over the course of the rotation (r = −0.122, p = 0.374). When separated by sex, male resilience was negatively correlated with distress (r = −0.389, p = 0.04), but female resilience was not. Resident distress levels were in a clinically significant (76%) or posttraumatic stress disorder range (17%), and resident empathy decreased during the rotation (p = 0.018). Resilience levels were similar in those who reported that death events were the most stressful experiences of the rotation and those who derived a sense of meaning from working with dying patients.

Conclusions

Resident physicians experienced clinically relevant distress and a decrease in empathy. Resilient resident physicians were less likely to experience distress. This study provides evidence for the salutary effects of resilience on physician distress. Copyright © 2016 John Wiley & Sons, Ltd.
The use of varenicline to treat nicotine dependence among patients with cancer
Authors: Price Sarah , Hitsman Brian , Veluz‐Wilkins Anna , Blazekovic Sonja , Brubaker Tarah R. , Leone Frank , Hole Anita , Wileyto E. Paul , Langer Corey , Kalhan Ravi , Patel Jyoti , Schnoll Robert
Published: May 2016

Background

Continuing to smoke after a cancer diagnosis can adversely influence the prognosis for patients with cancer. However, remarkably few studies have carefully examined the use of first‐line FDA‐approved medications for nicotine dependence in patients with cancer. This study evaluated the feasibility, safety, and effect on cessation of varenicline for smoking cessation in patients with cancer.

Methods

Data from 132 treatment‐seeking smokers who received 12 weeks of open‐label varenicline and five brief behavioral counseling sessions were used to evaluate the feasibility, safety, and impact on cessation of varenicline. The effects of abstinence on cognitive function and affect were also explored.

Results

Of 459 patients screened, 306 were eligible for the study (66.7%) and 132 entered treatment (43.1%). Retention was 84.1% over 12 weeks. The rate of biochemically verified abstinence at week 12 was 40.2%. Expected side effects were reported (e.g. sleep problems, nausea), but there were no reports of elevated depressed mood, suicidal thoughts, or cardiovascular events. Abstinence was associated with improved cognitive function and reduced negative affect over time (p < 0.05).

Conclusions

Although many patients with cancer who smoke did not enroll in treatment, the side effect profile of varenicline and its effect on short‐term cessation converge with what is seen in the general population. Further, as with the general population, abstinence while taking varenicline may lead to improved cognitive function and reduced negative affect. The present data support the use of varenicline to help patients with cancer to quit smoking.
Sublethal dose of phoxim and Bombyx mori nucleopolyhedrovirus interact to elevate silkworm mortality
Authors: Gu ZhiYa , Li FanChi , Hu JingSheng , Ding Chao , Wang Chaoqian , Tian JiangHai , Xue Bin , Xu KaiZun , Shen WeiDe , Li Bing
Published: May 2016

BACKGROUND

Silkworm (Bombyx mori) is an economically important insect. It is relatively less resistant to certain chemicals and environment exposures such as pesticides and pathogens. After pesticide exposures, the silkworms are more susceptible to microbial infections. The mechanism underlying the susceptibility might be related to immune response and oxidative stress.

RESULTS

A sublethal dose of phoxim combined with Bombyx mori nucleopolyhedrovirus (BmNPV) elevated the silkworm mortality at 96 h. We found a higher content of H2O2 and increased levels of genes related to oxidative stress and immune response after treatment with a sublethal dose of phoxim for 24 h or 48 h. However, such response decreased with longer pesticide treatment. Mortality increased by 44% when B. mori was exposed to combined treatment with BmNPV and phoxim rather than BmNPV alone. The level of examined immune‐related and oxidative‐stress‐related genes significantly decreased in the combined treatment group compared with the BmNPV group. Our results indicated that, with long‐term exposure to pesticides such as OPs, even at sublethal dose, the oxidative stress response and immune responses in silkworm were inhibited, which may lead to further immune impairment and accumulation of oxidative stress, resulting in susceptibility to the virus and harm to the silkworm.

CONCLUSION

Our study provided insights for understanding the susceptibility to pathogen after pesticide exposures, which may promote the development of better pesticide controls to avoid significant economic losses. © 2016 Society of Chemical Industry
Investigation of substituent effects in aerogen‐bonding interaction between ZO3(Z=Kr, Xe) and nitrogen bases
Authors: Esrafili Mehdi D. , Asadollahi Soheila , Vakili Mahshad
Published: May 2016

The substituent effects in aerogen bond interactions between ZO3(Z = Kr, Xe) and different nitrogen bases are studied at the MP2/aug‐cc‐pVTZ level of theory. The nitrogen bases include the sp bases NCH, NCF, NCCl, NCBr, NCCN, NCOH, NCCH3and the sp3bases NH3, NH2F, NH2Cl, NH2Br, NH2CN, NH2OH, and NH2CH3. The nature of aerogen bonds in these complexes is analyzed by means of molecular electrostatic potential, electron localization function, quantum theory atoms in molecules, noncovalent interaction index, and natural bond orbital analyses. The interaction energy (Eint) ranges from −4.59 to −9.65 kcal/mol in the O3Z···NCX complexes and from −5.30 to −13.57 kcal/mol in the O3Z···NH2X ones. The dominant charge‐transfer interaction in these complexes occurs across the aerogen bond from the nitrogen lone‐pair (nN) of the Lewis base to theσ*Z‐Oantibonding orbital of the ZO3. Besides, the formation of aerogen bond tends to decrease the83Kr or131Xe chemical shielding values in these complexes. © 2016 Wiley Periodicals, Inc.
The effect of different beverages on the color and translucency of flowable composites
Authors: Karadas Muhammet
Published: May 2016

This study examined the changes in color and translucency of flowable composites after immersion in different beverages. Thirty composite samples were prepared from four flowable composites (G‐aenial Universal Flo, Filtek Ultimate, Esthelite Flow Quick, and Clearfil Majesty ES Flow) and a microhybrid composite (Filtek Z‐250) and stored in distilled water at 37°C for 24 h. The samples were randomly divided into seven groups and then immersed in different beverages (Red Bull, coffee, black tea, Pepsi Cola, orange juice, and distilled water) for 7 days. The CIE L*a*b* values of each sample were measured against white and black backgrounds using a spectrophotometer before and after immersion. Data were analyzed using two‐way analysis of variance and Tukey's post‐hoc test (p < 0.05). The color changes were significantly different among the composite materials after immersion in beverages (p < 0.05). Filtek Ultimate and Esthelite Flow Quick exhibited less discoloration than did G‐aenial Universal Flo and Clearfil Majesty ES Flow. No significant difference was found between Filtek Z‐250 and either Filtek Ultimate or Esthelite Flow Quick (p > 0.05). Among the beverages, black tea and coffee caused the highest discoloration of all the materials. Immersion in coffee and black tea resulted in the highest negative changes in the translucency of the materials. The degree of discoloration for the composite resins depended on the material used and drinking beverage. SCANNING 38:701–709, 2016. © 2016 Wiley Periodicals, Inc.
Board reform versus profits: The impact of ratings on the adoption of governance practices
Authors: Rowley Timothy J. , Shipilov Andrew V. , Greve Henrich R.
Published: May 2016

Research summary: External stakeholders frequently attempt to influence organizations' adoption of new practices through the creation of public ratings. Based on the insights of performance feedback theory, we develop the theory of organizational reactions to external ratings to explain how firms' behaviors depend on their rating scores and their profitability. A central issue in our theory is the conflict between established internal goals and goals introduced by public ratings, with public ratings receiving lower priority than established profitability goals. Our theory suggests that, contrary to the expectations of the external stakeholders, firms targeted for criticism by ratings become less likely to adopt corresponding practices when their profitability is below aspirations. These arguments are supported in data on the diffusion of corporate governance practices in Canada.

Managerial summary: Firms and their products are rated and ranked by external agencies ranging from Consumer Reports to magazine rankings of admired, environmental, or well‐governed companies. We investigate whether such ratings affect firm behaviors, and especially whether they can incentivize poorly rated firms to improve their ranking when these firms' profitability is also low. Using the leading corporate governance ranking in Canada, we find that rankings could have adverse effects: when firms have both poor governance ranking and poor profitability they are less likely to adopt governance practices, contrary to the ranking creators' intentions. The findings show that there is a hierarchy of firms' goals, where the goal of profitability comes ahead of other goals imposed by external agencies through ratings and rankings. Copyright © 2016 John Wiley & Sons, Ltd.
Investigation on Improvement of Center Porosity with Heavy Reduction in Continuously Cast Thick Slabs
Authors: Xu Zhigang , Wang Xinhua , Jiang Min
Published: May 2016

The heavy reduction process of START (Solidification Terminal Advanced Reduction Technique) is developed mainly to improve the center porosity of slabs. According to the simulation results of heat transfer model, the distribution of solid fraction along the slab width can be equally divided into four parts, and the part in 1/4–1/8 width is the last solidifying region with the most serious porosity. START is implemented within two segments accounting for the uneven solidification. The heavy reduction is carried out in the first segment, which the optimum solid fraction ranges from 0.53 to 0.98 and the optimum reduction amount is 9 mm. The second segment is conducted with a 3 mm reduction amount to further improve the porosity of the slab from 1/4 to 1/8 width. Both the center porosity and segregation can be improved significantly by the START process, as well as the evenness of porosity and segregation along the slab width. In addition, the in‐strand Electro‐Magnetic Stirring (SEMS) is introduced to improve the internal cracks of slabs, and the results show that the cracks are greatly improved without deterioration of center porosity.
Stinting on sildenafil supply can prove costly
Authors: Hackett Geoffrey
Published: May 2016

Geoffrey Hackett presents a case report of a man with erectile dysfunction and describes how, despite the availability of sildenafil on the NHS to all men with erectile dysfunction, misguided limitations on supply can lead to unnecessary referrals and cost for the NHS and patients.
Generation of obese rat model by transcription activator-like effector nucleases targeting the leptin receptor gene
Authors: Chen Yuting , Lu Wenqing , Gao Na , Long Yi , Shao Yanjiao , Liu Meizhen , Chen Huaqing , Ye Shixin , Ma Xueyun , Liu Mingyao , Li Dali
Published: May 2016

The laboratory rat is a valuable mammalian model organism for basic research and drug discovery. Here we demonstrate an efficient methodology by applying transcription activator-like effector nucleases (TALENs) technology to generate Leptin receptor (Lepr) knockout rats on the Sprague Dawley (SD) genetic background. Through direct injection of in vitro transcribed mRNA of TALEN pairs into SD rat zygotes, somatic mutations were induced in two of three resulting pups. One of the founders carrying bi-allelic mutation exhibited early onset of obesity and infertility. The other founder carried a chimeric mutation which was efficiently transmitted to the progenies. Through phenotyping of the resulting three lines of rats bearing distinct mutations in the Lepr locus, we found that the strains with a frame-shifted or premature stop codon mutation led to obesity and metabolic disorders. However, no obvious defect was observed in a strain with an in-frame 57 bp deletion in the extracellular domain of Lepr. This suggests the deleted amino acids do not significantly affect Lepr structure and function. This is the first report of generating the Lepr mutant obese rat model in SD strain through a reverse genetic approach. This suggests that TALEN is an efficient and powerful gene editing technology for the generation of disease models.
Innovative Programs Promoting Careers in OR Nursing
Authors: Ceschini Donna
Published: May 2016

Much of the baby boomer workforce is approaching retirement, and nurses who are part of this generation will need to be replaced. The strain is especially notable in the perioperative nursing environment. To assist in recruiting new perioperative nurses, three programs were introduced at a rural academic medical center. Leaders at this facility developed a perioperative nursing course to train new graduate nurses and nurses without OR experience, an introduction to perioperative nursing course for junior and senior undergraduate nursing students, and an intraoperative learning experience for high school students interested in a career in nursing. These three programs provide an opportunity to expose new nurses, nursing students, and high school students to an OR nursing career path. The programs and their successful outcomes are shared as exemplars for enhancing the education of new OR nurses and generating interest in OR nursing as a career path.
Teoría de agencia: una revisión del origen biológico del delito
Authors: Araya Iván , Crespo Fernando A.
Published: May 2016

Este trabajo aborda la causa del conflicto entre principal y agente, buscando respuestas en las disciplinas de la biología, particularmente en las ciencias de la antropología criminal. Se ha realizado un ensamble entre los hallazgos de la teoría de agencia y la teoría de los delitos de cuello blanco, reinterpretando las actuaciones del agente desde su configuración entre instinto, herencia y personalidad. Los resultados en las ciencias biológicas podrían aportar nuevas interpretaciones y explicaciones en las ciencias de la administración, avanzando hacia mejores conceptualizaciones del conflicto, mediante teorías con mayor contenido empírico. En general, pese al conflicto permanente entre las partes, su dinámica potencia los resultados perseguidos por el principal.
Randomized controlled trial comparing carbetocin, misoprostol, and oxytocin for the prevention of postpartum hemorrhage following an elective cesarean delivery
Authors: Elbohoty Ahmed E.H. , Mohammed Walid E. , Sweed Mohamed , Bahaa Eldin Ahmed M. , Nabhan Ashraf , Abd‐El‐Maeboud Karim H.I.
Published: May 2016

Objective

To compare the effectiveness and safety of carbetocin, misoprostol, and oxytocin for the prevention of postpartum hemorrhage following cesarean deliveries.

Methods

A double‐blind randomized controlled trial enrolled patients with a singleton pregnancy scheduled for an elective cesarean delivery at a maternity hospital in Cairo, Egypt, between October 1, 2012 and June 30, 2013. Participants were randomized using a computer‐generated sequence to receive treatment with carbetocin, misoprostol, or oxytocin. The primary outcome was the occurrence of uterine atony necessitating additional uterotonics. Per‐protocol analyses were performed. Patients, investigators, and data analysts were masked to treatment assignments.

Results

The present study enrolled 263 patients; data were analyzed from 88 patients treated with carbetocin, 89 treated with misoprostol, and 86 women treated with oxytocin. Further uterotonics were needed for the treatment of 5 (6%) patients who were treated with carbetocin, 20 (22%) patients treated with misoprostol, and 11 (13%) patients treated with oxytocin. In the prevention of uterine atony, carbetocin was comparable with oxytocin (RR 0.41, 95%CI 0.14–1.25) and superior to misoprostol (RR 0.21, 95%CI 0.07–0.58).

Conclusion

Additional uterotonics were needed less frequently by patients treated with carbetocin. Carbetocin was comparable to oxytocin and superior to misoprostol in the prevention of uterine atony following an elective cesarean delivery.

ClinicalTrials.gov: NCT02053922
Fetal and neonatal outcomes after term and preterm delivery following betamethasone administration in twin pregnancies
Authors: Braun Thorsten , Weichert Alexander , Gil Hannah C. , Sloboda Deborah M. , Tutschek Boris , Harder Thomas , Dudenhausen Joachim W. , Plagemann Andreas , Henrich Wolfgang
Published: May 2016

Objective

To investigate effects of betamethasone on fetal growth and neonatal outcomes in twins.

Methods

A retrospective cohort study was conducted of twins delivered at one center in Berlin, Germany, between 1993 and 2011. The betamethasone group included twin pregnancies with preterm labor, cervical shortening, preterm premature rupture of membranes, or vaginal bleeding, and exposure to betamethasone between 23+ 5 and 33+ 6 weeks. The control group included twin pregnancies with no betamethasone exposure matched for length at delivery. Fetal growth and neonatal anthropometric data were analyzed by twin‐pair structure, dose, and gestational age (linear mixed model).

Results

Overall, 1922 live‐born twin pairs (653 betamethasone group, 1269 controls) were included. Compared with controls, late‐preterm twins exposed to betamethasone were lighter (mean difference –126 g), had a smaller head circumference (–0.4 cm), and a shorter body length (–0.8 cm) after adjustment for confounders (P < 0.05). Female neonates from mixed or same‐sex twin pairs had a lower birth weight than controls (betamethasone ≤ 16 mg: –114 g; betamethasone 24 mg: –124 g; betamethasone > 24 mg: –187 g), with no detectable improvement in neonatal morbidity (hyperbilirubinemia, respiratory distress, asphyxia) or mortality.

Conclusion

Betamethasone reduced birth weight, head circumference, and length of female preterm neonates in twin pairs in a dose‐dependent manner. The neonatal mortality and morbidity were not improved by betamethasone.
Mesenteric cyst(s) presenting as acute intestinal obstruction in children
Authors: Makhija Deepa , Shah Hemanshi , Tiwari Charu , Jayaswal Shalika , Khedkar Kiran , Waghmare Mukta
Published: May 2016

Background and objectives:

Mesenteric cysts are rare in paediatric age group and usually present as asymptomatic abdominal lumps. Acute presentations are uncommon and their preoperative diagnosis is difficult.

Design and settings:

This is a retrospective observational study describing three children with mesenteric cysts who presented with symptoms and signs of acute intestinal obstruction.

Patients and methods:

Three children with mesenteric cysts who presented with acute abdomen are described as per their age, presenting symptoms and signs, investigations, management, and outcome.

Results:

The three children presented in emergency with symptoms and signs of acute intestinal obstruction. On exploration, all had mesenteric cyst and were managed by deroofing, marsupilisation and excision. All patients recovered uneventfully.

Conclusions:

presentation of mesenteric cyst as acute obstruction in paediatric age group is rare and preoperative diagnosis is difficult. The larger cysts are more likely to have an acute presentation.
CNS tau efflux via exosomes is likely increased in Parkinson's disease but not in Alzheimer's disease
Authors: Shi Min , Kovac Andrej , Korff Ane , Cook Travis J. , Ginghina Carmen , Bullock Kristin M. , Yang Li , Stewart Tessandra , Zheng Danfeng , Aro Patrick , Atik Anzari , Kerr Kathleen F. , Zabetian Cyrus P. , Peskind Elaine R. , Hu Shu‐Ching , Quinn Joseph F. , Galasko Douglas R. , Montine Thomas J. , Banks William A. , Zhang Jing
Published: May 2016

Introduction

Alzheimer's disease (AD) and Parkinson's disease (PD) involve tau pathology. Tau is detectable in blood, but its clearance from neuronal cells and the brain is poorly understood.

Methods

Tau efflux from the brain to the blood was evaluated by administering radioactively labeled and unlabeled tau intracerebroventricularly in wild‐type and tau knock‐out mice, respectively. Central nervous system (CNS)–derived tau in L1CAM‐containing exosomes was further characterized extensively in human plasma, including by single molecule array technology with 303 subjects.

Results

The efflux of Tau, including a fraction via CNS‐derived L1CAM exosomes, was observed in mice. In human plasma, tau was explicitly identified within L1CAM exosomes. In contrast to AD patients, L1CAM exosomal tau was significantly higher in PD patients than controls and correlated with cerebrospinal fluid tau.

Conclusions

Tau is readily transported from the brain to the blood. The mechanisms of CNS tau efflux are likely different between AD and PD.
Cultural Discrepancy and National Corruption: Investigating the Difference between Cultural Values and Practices and Its Relationship to Corrupt Behavior
Authors: Gelbrich Katja , Stedham Yvonne , Gäthke Daniel
Published: May 2016

The relationship between culture and corruption has been the focus of various studies, producing inconsistent results. We suggest that these inconsistencies might be due to the conceptualization and measurement of culture. Drawing on the possible value/fact dichotomy discussed in ethical philosophy, we introduce the construct of cultural discrepancy—the difference between cultural values (“ought”) and practices (“is”)—as a predictor of pervasive (i.e., fully institutionalized and predictable) and arbitrary (i.e., uncertain and relatively unorganized) corruption. Examining the relationship between the discrepancies observed in the GLOBE cultural dimensions and the Corruption Perception Index shows that in-group collectivism discrepancy is negatively related to pervasive corruption; future orientation discrepancy is positively related to arbitrary corruption. Further, we show that these relationships are contingent on national wealth. The negative relationship for in-group collectivism discrepancy is most pronounced in poor and moderately wealthy countries, and the positive relationship for future orientation discrepancy is most pronounced in rich countries.
Noise generation mechanisms for a supersonic jet impinging on an inclined plate
Authors: Brehm Christoph , Housman Jeffrey A. , Kiris Cetin C.
Published: May 2016

Noise generation mechanisms for a perfectly expanded supersonic Mach number $M=1.8$ turbulent jet impinging on a $45^{\circ }$ inclined plate are investigated for a Reynolds number of $1.6\times 10^{6}$ employing a large-eddy simulation. Excellent comparisons with experimental acoustic far-field measurements and pressure measurements on the impingement plate are obtained. Two local maxima are identified in the far-field overall sound pressure levels in the $75^{\circ }$ and $120^{\circ }$ observer directions, which are associated with different noise generation mechanisms. The peak frequencies in the spectra with Strouhal numbers of $St=0.2$ for $75^{\circ }$ and $St=0.5$ for $120^{\circ }$ match the experimental measurements. The jet-impingement region generates pressure waves that propagate predominantly in the $120^{\circ }$ observer direction. The noise generation in this region is attributed to vortex stretching and tearing during shear-layer impingement, and shock oscillations that are induced by the motion of downstream convected vortical flow structures. The second peak in the overall sound pressure distribution at $75^{\circ }$ is associated with noise sources located in the wall jet. The noise generation in the wall jet is associated with supersonically convecting large-scale coherent flow structures that also interact with tail shocks in the wall jet causing large localized pressure fluctuations. Strongly coherent flow structures are identified by applying proper orthogonal decomposition (POD) to the unsteady flow field. The frequency characteristics of the most energetic POD modes are distinctly different based on which energy norm is chosen. The most energetic entropy-based POD modes contain a peak frequency of approximately $St=0.4{-}0.6$, while the most energetic turbulent kinetic-energy-based POD modes appear to be dominated by lower-frequency content. The causality method, based on Lighthill’s acoustic analogy, is used to link the acoustic noise signature to the relevant physical mechanisms in the source region. A differentiation is made between the application of normalized and non-normalized cross-correlation functions for noise source identification and characterization.
Concentration of vorticity in a destabilized vortex due to selective decay
Authors: Hattori Yuji
Published: May 2016

The formation of concentrated vortices like tornadoes and tropical cyclones in rotating fluids is of much interest in atmospheric flows. It is shown by direct numerical simulation that the selective decay of inviscid invariants leads to concentration of vorticity in a destabilized vortex. By selective decay we mean here that the circulation of the mean flow decays faster than the angular momentum or energy. Initially localized disturbances are superimposed onto the two-dimensional flattened Taylor–Green vortices to trigger the elliptic instability. In the later stage of nonlinear evolution of the disturbance circulation decays faster than angular momentum and energy, giving rise to a sharp peak in the vorticity distribution of the mean flow. During the selective decay vortex pairs reconnect and eventually annihilate at the cell boundaries of the Taylor–Green vortices. By evaluating the weight function of the inviscid invariants it is shown that the loss of angular momentum is much smaller than that of circulation when vorticity is lost at the cell boundary by reconnection or annihilation. Thus the reconnection and subsequent annihilation of vortex pairs is responsible for the selective decay and concentration of vorticity. The relevance of the mechanism to previous experiments and general cases is also discussed.
Leishmania mexicana: promastigotes and amastigotes secrete protein phosphatases and this correlates with the production of inflammatory cytokines in macrophages
Authors: ESCALONA-MONTAÑO A. R. , ORTIZ-LOZANO D. M. , ROJAS-BERNABÉ A. , WILKINS-RODRIGUEZ A. A. , TORRES-GUERRERO H. , MONDRAGÓN-FLORES R. , MONDRAGÓN-GONZALEZ R. , BECKER I. , GUTIÉRREZ-KOBEH L. , AGUIRRE-GARCIA M. M.
Published: May 2016

Phosphatase activity ofLeishmaniaspp. has been shown to deregulate the signalling pathways of the host cell. We here show thatLeishmania mexicanapromastigotes and amastigotes secrete proteins with phosphatase activity to the culture medium, which was higher in the Promastigote Secretion Medium (PSM) as compared with the Amastigote Secretion Medium (ASM) and was not due to cell lysis, since parasite viability was not affected by the secretion process. The biochemical characterization showed that the phosphatase activity present in PSM was higher in dephosphorylating the peptide END (pY) INASL as compared with the peptide RRA (pT)VA. In contrast, the phosphatase activity in ASM showed little dephosphorylating capacity for both peptides. Inhibition assays demonstrated that the phosphatase activity of both PSM and ASM was sensible only to protein tyrosine phosphatases inhibitors. An antibody against a protein phosphatase 2C (PP2C) ofLeishmania majorcross-reacted with a 44·9 kDa molecule in different cellular fractions ofL. mexicanapromastigotes and amastigotes, however, in PSM and ASM, the antibody recognized a protein about 70 kDa. By electron microscopy, the PP2C was localized in the flagellar pocket of amastigotes. PSM and ASM induced the production of tumor necrosis factor alpha, IL-1β, IL-12p70 and IL-10 in human macrophages.
Functional characterization of X-prolyl aminopeptidase from Toxoplasma gondii
Authors: YANG MINGFA , ZHENG JUN , JIA HONGLIN , SONG MINGXIN
Published: May 2016

In the present study, a recombinant aminopeptidase P (rTgAPP) from Toxoplasma gondii was expressed in Escherichia coli to evaluate its enzyme parameters. The rTgAPP showed strong activity against a synthetic substrate for aminopeptidase P at pH 8·0 with a Km value of 0·255 µm and a kcat value of 35·6 s−1. The overall catalytic efficiency (kcat/Km) of the rTgAPP was 139·6 × 105 M−1 s−1. The activity of rTgAPP was enhanced by the addition of divalent cations and inhibited by bestatin. Deletion of TgAPP gene in the parasite through a CRISPR/Cas9 system resulted in inhibition of growth indicating the importance of TgAPP. Thus our findings reveal that TgAPP is an active enzyme in T. gondii and provide an insight into the function of TgAPP.
Expérience de fréquentation des lieux publics par des personnes âgées ayant subi un TCC en présence d’un accompagnateur-citoyen: projet pilote
Authors: Levert Marie-Josée , Lefebvre Hélène , Gélinas Isabelle , McKerall Michelle , Roy Odette , Proulx Michelle
Published: May 2016

This pilot project aims to test and see the relevance of the direct observation method to collect data on the barriers and facilitators to attending public places by seniors with TBI. The study is based on the conceptual framework VADA WHO which focuses on the development of friendly built and technological environments for seniors. Three elderly people participated in the study, recruited from an ongoing project, The Citizen Intervention in Community Living (APIC), in the presence of their personalized attendant. The study shows the feasibility of the method in terms of its acceptability and resources mobilized. It shows its relevance to access additional data that would have been difficult to obtain using others methods (e.g., semi-structured interview), such as the identification of the strategies used by the participants to address the obstacles encountered (avoidance, travel planning, use of physical and preventative support of the personalized attendant).
Primary Trauma Triage Performed by Bystanders: An Observation Study
Authors: Nordberg Martin , Castrén Maaret , Lindström Veronica
Published: May 2016

Objective

The aim of this study was to evaluate whether bystanders with no training in triage can correctly prioritize three injured patients by using a triage instrument.

Method

An observational study was conducted. Participants performed a primary triage on three paper-based patient cases and answered 11 questions during a public event in the center of Stockholm, Sweden.

Results

A total of 69 persons participated in the study. The success rate among all the participants for correct triage of the three patient cases was 52 percent. The female participants and younger participants (<55 years of age) performed correct triage to a greater extent. The over-triage was 12.5 percent and under-triage was 6.3 percent.

Conclusion

Participants with no prior knowledge of triage instruments may be capable of triaging injured patients with the help of an easy triage instrument. The over- and under-triage percentages were low, and this may indicate that the developed triage instrument is relatively easy to use. It may also indicate that bystanders can identify a severely injured patient.

NordbergM, CastrénM, LindströmV. Primary trauma triage performed by bystanders: an observation study. Prehosp Disaster Med.2016;31(4):353–357.
The Broselow and Handtevy Resuscitation Tapes: A Comparison of the Performance of Pediatric Weight Prediction
Authors: Lowe Calvin G. , Campwala Rashida T. , Ziv Nurit , Wang Vincent J.
Published: May 2016

Objectives

To assess the performance of two pediatric length-based tapes (Broselow and Handtevy) in predicting actual weights of US children.

Methods

In this descriptive study, weights and lengths of children (newborn through 13 years of age) were extracted from the 2009-2010 National Health and Nutrition Examination Survey (NHANES). Using the measured length ranges for each tape and the NHANES-extracted length data, every case from the study sample was coded into Broselow and Handtevy zones. Mean weights were calculated for each zone and compared to the predicted Broselow and Handtevy weights using measures of bias, precision, and accuracy. A sub-sample was examined that excluded cases with body mass index (BMI)≥95th percentile. Weights of children longer than each tape also were examined.

Results

A total of 3,018 cases from the NHANES database met criteria. Although both tapes underestimated children’s weight, the Broselow tape outperformed the Handtevy tape across most length ranges in measures of bias, precision, and accuracy of predicted weights relative to actual weights. Accuracy was higher in the Broselow tape for shorter children and in the Handtevy tape for taller children. Among the sub-sample with cases of BMI≥95th percentile removed, performance of the Handtevy tape improved, yet the Broselow tape still performed better. When assessing the weights of children who were longer than either tape, the actual mean weights did not approximate adult weights; although, those exceeding the Handtevy tape were closer.

Conclusions

For pediatric weight estimation, the Broselow tape performed better overall than the Handtevy tape and more closely approximated actual weight.

LoweCG, CampwalaRT, ZivN, WangVJ. The Broselow and Handtevy resuscitation tapes: a comparison of the performance of pediatric weight prediction. Prehosp Disaster Med. 2016;31(4):364–375.
The Curse of 300? Popular Culture and Teaching the Spartans
Authors: Stafford Emma
Published: May 2016

I teach Spartan history at the University of Leeds both as part of an introductory course about the Greek World and also as part of a range of more closely-focused Special Subject modules for second and third year undergraduates, includingImage of SpartaandClassics on Screen. I use the film300, and other modern popular culture material, in different ways in each of these modules: as a subject in its own right forClassics on Screen, focusing on questions around what the material says about contemporary culture; and, inImage of Sparta, as a coda to the course's survey of ancient ‘images’, which allows for reflection back over the ancient material. Blanshard and Shahabudin suggest that cinematic output can be ‘…an important vehicle for discussing the values, history, and cultural politics of the classical past. It demands that we think about what are the key elements that make the cultures of the ancient Mediterranean so distinctive and worthy of study’ (Blanshard & Shahabudin, 2011, p. 1). While modern popular receptions of ancient Greek history are not actually on the AS or A Level specifications (perhaps they should be!), they have some potential for teaching at this level if a teacher wants their students to get to grips with the particular topic of Sparta.
Disguised Foods, Pole-Dancing, and Homeric Muddles: the Challenges of Teaching Dinner with Trimalchio to Sixth-Form Students
Authors: Bragg Edward
Published: May 2016

We have been delivering the A Level Classical Civilisation unit ‘Roman Society and Thought’ on the OCR specification for a number of years at Peter Symonds College. This paper focuses on the delivery of one of the four set texts for this AS unit, Petronius' Dinner with Trimalchio. It points out some of the challenges teaching this translated text and then explains a number of the teaching methods and resources that we employ to enable our students to understand and learn this tricky piece of ancient literature. Petronius is one of the texts on the draft proposal for the new A Level Classical Civilisation under the section ‘Literature written in Latin’ under the sub-section ‘Novel & Fable’ and therefore this paper should aid teachers considering it as a unit option.
In Vivo Visualization of Stromal Macrophages via label-free FLIM-based metabolite imaging
Authors: Szulczewski Joseph M. , Inman David R. , Entenberg David , Ponik Suzanne M. , Aguirre-Ghiso Julio , Castracane James , Condeelis John , Eliceiri Kevin W. , Keely Patricia J.
Published: May 2016

Macrophage infiltration and recruitment in breast tumors has been correlated with poor prognosis in breast cancer patients and has been linked to tumor cell dissemination. Much of our understanding comes from animal models in which macrophages are labeled by expression of an extrinsic fluorophore. However, conventional extrinsic fluorescence labeling approaches are not readily applied to human tissue and clinical use. We report a novel strategy that exploits endogenous fluorescence from the metabolic co-factors NADH and FAD with quantitation from Fluorescence Lifetime Imaging Microscopy (FLIM) as a means to non-invasively identify tumor-associated macrophages in the intact mammary tumor microenvironment. Macrophages were FADHI and demonstrated a glycolytic-like NADH-FLIM signature that was readily separated from the intrinsic fluorescence signature of tumor cells. This non-invasive quantitative technique provides a unique ability to discern specific cell types based upon their metabolic signatures without the use of exogenous fluorescent labels. Not only does this provide high resolution temporal and spatial views of macrophages in live animal breast cancer models, this approach can be extended to other animal disease models where macrophages are implicated and has potential for clinical applications.