bluuebunny/crossref_metadata_2025 huggingface dataset:
Ocular Surface Workup With Automated Noninvasive Measurements for the Diagnosis of Meibomian Gland Dysfunction
Authors: Giannaccare Giuseppe , Vigo Luca , Pellegrini Marco , Sebastiani Stefano , Carones Francesco
Published: January 2018

Purpose:

To analyze diagnostic performance of an ocular surface workup based on automated noninvasive measurements in the diagnosis of meibomian gland dysfunction (MGD).

Methods:

Two hundred ninety-eight eyes of 149 patients with MGD and 54 eyes of 27 control patients were analyzed. Ocular Surface Disease Index (OSDI), noninvasive breakup time (BUT), lipid layer thickness, meibomian gland loss, and tear osmolarity were calculated. The correlations among variables in the MGD group were analyzed. The area under the curve (AUC) of receiver operating characteristic curves was calculated.

Results:

OSDI, noninvasive BUT, and meibomian gland loss were significantly different between MGD and control groups (respectively, 37.9 ± 19.6 vs. 7.1 ± 2.8; 8.8 ± 3.6 vs. 11.0 ± 3.0; 28.0 ± 17.6 vs. 21.2 ± 13.0; always P < 0.05). Positive correlations were found between lipid layer thickness and noninvasive BUT and between meibomian gland loss and OSDI (respectively, r = 0.169, P = 0.004; r = 0.187, P = 0.004). Noninvasive BUT had the highest diagnostic power as a single parameter, followed by meibomian gland loss (respectively AUC = 0.686, AUC = 0.598). When the diagnosis of MGD was made based on either noninvasive BUT or meibomian gland loss being abnormal, sensitivity was 86.2% and specificity 38.5%. When the diagnosis was made on both noninvasive BUT and meibomian gland loss being abnormal, sensitivity was 39.3% and specificity 85.6%.

Conclusions:

This automated noninvasive ocular surface workup may represent a useful screening tool for the diagnosis of MGD. In case of positivity of either noninvasive BUT or meibomian gland loss, subsequent qualitative clinical tests should be performed to achieve a reliable diagnosis and more precise characterization of MGD.
Socioeconomic status and incidence of cardiac arrest: a spatial approach to social and territorial disparities
Authors: Castra Laurent , Genin Michael , Escutnaire Joséphine , Baert Valentine , Agostinucci Jean-Marc , Revaux François , Ursat Cécile , Tazarourte Karim , Adnet Frédéric , Hubert Hervé
Published: January 2018

Objective

Cardiac arrest (CA) is considered a major public health issue. Few studies have focused on geographic variations in incidence and socioeconomic characteristics. The aim of this study is to identify clusters of municipalities with high or low CA incidence, and find socioeconomic factors associated with them.

Patients and methods

CA data from three Parisian counties, representing 123 municipalities, were extracted from the French CA registry. Socioeconomic data for each municipality were collected from the French national institute of statistics. We used a statistical approach combining Bayesian methods to study geographical CA incidence variations, and scan statistics, to identify CA incidence clusters of municipalities. Finally, we compared clusters of municipalities in terms of socioeconomic factors.

Results

Strong geographical variations were found among 123 municipalities: 34 presented a significantly increased risk of incidence and 37 presented a significantly low risk. Scan statistics identified seven significant spatial clusters of CA incidence, including three clusters with low incidence (the relative risk varied from 0.23 to 0.54) and four clusters with high incidence (the relative risk varied from 1.43 to 2). Clusters of municipalities with a high CA incidence are characterized by a lower socioeconomic status than the others (low and normal CA incidence clusters). Analysis showed a statistically significant relationship between social deprivation factors and high incidence.

Conclusion

This study shows strong geographical variations in CA incidence and a statistically significant relationship between over-incidence and social deprivation variables.
Development of the ANPD Discussion Paper on Academic Advisement
Authors: Woolforde Launette , Noble Michele
Published: January 2018

Nursing professional development practitioners regularly provide future nurses, and those advancing their nursing expertise, with mentorship and guidance on academic progression. However, we often wonder how we should approach advisement and what we should include in our discussions with those who have sought our expertise. An Association for Nursing Professional Development task force explored the many facets related to academic advisement and produced a must-have discussion paper as a resource for nursing professional development practitioners everywhere.
Using the Magnet® Criteria to Document New Graduate Nurses’ Transition to Practice
Authors: Cosme Sheryl , Yarbrough Carey , O’Brien Morgan , Chappell Kathy
Published: January 2018

Nursing professional development practitioners are partners in practice transitions for new graduate nurses. Organizations seeking Magnet® designation need to demonstrate how new graduate nurses transition in the written documentation submitted to the American Nurses Credentialing Center. This article explores current strategies used by Magnet®-designated organizations and connects the strategies to the six new elements of the new 2019 Magnet® criterion, Structural Empowerment 9.
Empowering Bedside Nurses to Lead Discussion Groups
Authors: Anspach Kelli M. , Bruce Laura , Rutberg Shannon
Published: January 2018

This article focuses on an approach three clinical nurse educators used to empower their Telemetry Education Nurse Team to grow professionally. The clinical nurse educators mentored the Telemetry Education Nurse Team, who were then able to facilitate successful discussion groups for their organization.
The Impact of Education on Certified Nursing Assistants' Identification of Strategies to Manage Behaviors Associated With Dementia
Authors: Pfeifer Pamela , Vandenhouten Christine , Purvis Suzanne , Zupanc Tamara
Published: January 2018

The nursing care of hospitalized patients with dementia is planned and supervised by registered nurses. This care is delivered using a team approach, including certified nursing assistants, who may lack the knowledge and skills to properly provide care and manage the challenging behaviors associated with dementia. This article describes an innovative, multimodal education program designed to help certified nursing assistants acquire this knowledge and skill. Use of post-then-pre evaluation showed the positive results of this program.
A New Perspective on Nursing Retention
Authors: Hopson Michelle , Petri Laura , Kufera Joseph
Published: January 2018

Job embeddedness considers job satisfaction while incorporating the concepts of environment and community. This exploratory, mixed methods study used the Job Embeddedness Instrument to examine factors that influence retention of acute care nurses. Qualitative methods informed the survey results. Increasing age, ties to community, and peer relationships were found to be most indicative of job embeddedness. Nursing professional development practitioners can impact retention by focusing on factors that encourage nurses to stay in their positions.
Incremental Effect of Academic Predictors on Nursing Admission Assessment
Authors: Liu Xin , Codd Casey , Mills Christine
Published: January 2018

This study examined the incremental values of academic predictors that may be adopted as nursing school admission criteria. The findings revealed that using additional content areas of mathematics, reading, and English in conjunction with science contributes significantly to the prediction of early nursing school success. This study demonstrates an incremental validity approach that provides valuable guidelines to inform the selection of effective, accurate, and cost-effective admission tools for screening qualified nursing candidates.
Incidence and Risk Factors for Anastomotic Failure in 1594 Patients Treated by Transanal Total Mesorectal Excision
Authors: Penna Marta , Hompes Roel , Arnold Steve , Wynn Greg , Austin Ralph , Warusavitarne Janindra , Moran Brendan , Hanna George B. , Mortensen Neil J. , Tekkis Paris P.
Published: January 2018

Objective:

To determine the incidence of anastomotic-related morbidity following Transanal Total Mesorectal Excision (TaTME) and identify independent risk factors for failure.

Background:

Anastomotic leak and its sequelae are dreaded complications following gastrointestinal surgery. TaTME is a recent technique for rectal resection, which includes novel anastomotic techniques.

Methods:

Prospective study of consecutive reconstructed TaTME cases recorded over 30 months in 107 surgical centers across 29 countries. Primary endpoint was “anastomotic failure,” defined as a composite endpoint of early or delayed leak, pelvic abscess, anastomotic fistula, chronic sinus, or anastomotic stricture. Multivariate regression analysis performed identifying independent risk factors of anastomotic failure and an observed risk score developed.

Results:

One thousand five hundred ninety-four cases with anastomotic reconstruction were analyzed; 96.6% performed for cancer. Median anastomotic height from anal verge was 3.0 ± 2.0 cm with stapled techniques accounting for 66.0%. The overall anastomotic failure rate was 15.7%. This included early (7.8%) and delayed leak (2.0%), pelvic abscess (4.7%), anastomotic fistula (0.8%), chronic sinus (0.9%), and anastomotic stricture in 3.6% of cases. Independent risk factors of anastomotic failure were: male sex, obesity, smoking, diabetes mellitus, tumors >25 mm, excessive intraoperative blood loss, manual anastomosis, and prolonged perineal operative time. A scoring system for preoperative risk factors was associated with observed rates of anastomotic failure between 6.3% to 50% based on the cumulative score.

Conclusions:

Large tumors in obese, diabetic male patients who smoke have the highest risk of anastomotic failure. Acknowledging such risk factors can guide appropriate consent and clinical decision-making that may reduce anastomotic-related morbidity.
Medial Open Transversus Abdominis Plane (MOTAP) Catheters Reduce Opioid Requirements and Improve Pain Control Following Open Liver Resection
Authors: Karanicolas Paul Jack , Cleary Sean , McHardy Paul , Kiss Alex , Sawyer Jason , Behman Ramy , Ladak Salima , McCluskey Stuart A. , Srinivas Coimbatore , Katz Joel , Coburn Natalie , Law Calvin , Wei Alice C. , Greig Paul , Hallet Julie , Clarke Hance
Published: January 2018

Objective:

Conventional management of pain following open liver resection involves intravenous, patient-controlled analgesia (IV PCA) or epidural analgesia. The objective of this trial was to assess the efficacy of a regional technique called Medial Open Transversus Abdominis Plane (MOTAP) catheter analgesia compared with IV PCA.

Methods:

This was a blinded, randomized, controlled parallel-arm trial conducted at 2 high-volume centers. Patients undergoing liver resection through a subcostal incision were enrolled. Using a standardized technique, 2 catheters were placed after resection: one in the plane between internal oblique and transversus abdominis and the other in the posterior rectus sheath. Patients were randomized to receive ropivacaine 0.2% (ROP) or saline (NS) through both catheters for 72 hours. All patients received IV PCA with hydromorphone as part of a multimodality analgesia program. Primary outcome was opioid use over the first 48 hours.

Results:

One hundred fifty-three patients were included in the analysis (71 ROP, 82 NS). Patients receiving ROP used significantly less opioid than patients with NS at 48 hours (median 39.6 mg morphine-equivalent vs 49.2 mg, P = 0.033) and at 72 hours (median 50.0 vs 66.4 mg, P = 0.046). Pain scores at rest and with coughing were significantly lower at all time points in patients who received ROP (P = 0.002). Median length of hospital stay was 5 days in patients receiving ROP and 6 days in patients who received NS (P = 0.035). There was no difference between groups in complications [ROP 20 (28.2%) vs NS 26 (31.7%), P = 0.63].

Conclusion:

MOTAP catheter analgesia reduces opioid requirements, pain, and length of hospital stay compared with IV PCA following open liver resection with subcostal incisions.
Anterior Colporrhaphy With and Without Dermal Allograft: A Randomized Control Trial With Long-Term Follow-Up
Authors: Iyer Shilpa , Seitz Miriam , Tran Alexis , Scalabrin Reis Renata , Botros Carolyn , Lozo Svjetlana , Botros Sylvia , Sand Peter , Tomezsko Janet , Wang Chi , Gafni-Kane Adam
Published: January 2018

Objective

The objective of this study was to determine whether anterior colporrhaphy plus insertion of anterior dermal allograft reduces anterior prolapse recurrence at 1 and 7 to 10 years postoperatively compared with anterior colporrhaphy alone.

Methods

We present a nonblinded randomized controlled trial with 1- and 7- to 10-year follow-up. Subjects were randomized between 2005 and 2008 to anterior colporrhaphy or ultralateral anterior colporrhaphy plus insertion of a dermal allograft spanning the anterior compartment between the arcus tendineus fascia pelvis on each side. Eligible subjects had anterior prolapse to the hymen or beyond, were bothered by their prolapse, and were planning to undergo surgical correction. Subjects completed a pelvic organ prolapse quantification system (POPQ) examination and Pelvic Floor Distress Inventory (PFDI)/PFDI-20 before surgery; a POPQ, PFDI, and Pelvic Organ Prolapse/Incontinence Sexual Questionnaire at 1 year postoperatively; and a POPQ, PFDI-20, Pelvic Organ Prolapse/Incontinence Sexual Questionnaire, Revised, and Patient-reported Global Impression of Improvement Inventory at 7 to 10 years postoperatively. Our primary outcome was anatomic anterior prolapse recurrence at 1 or 7 to 10 years defined as Aa or Ba greater than or equal to −1. Our secondary outcome was a composite score of anterior prolapse recurrence at 1 or 7 to 10 years defined as anatomic recurrence (Aa or Ba ≥ 0), retreatment for cystocele, or answering yes to PFDI-20 question 3 (subjective report of vaginal bulge).

Results

A total of 114 subjects were randomized, 70 to anterior colporrhaphy and 44 to anterior colporrhaphy plus dermal allograft. About 92% of subjects underwent concomitant apical suspension, 98% in the graft group and 89% in the nongraft group. Eighty-nine subjects (32 graft [73%], 57 nongraft [81%]) returned for 1-year follow-up. Fifty-three patients (19 graft [48%], 34 nongraft [49%]) returned for 7- to 10-year follow-up. The primary outcome was met by 8 (18%) graft and 22 (31%) nongraft subjects at 1 year postoperatively (P = 0.26) and by 10 (23%) graft and 24 (34%) nongraft subjects at 7 to 10 years postoperatively (P = 0.37). The secondary outcome was met by 8 (18%) graft and 15 (21%) nongraft subjects at 1 year postoperatively (P = 0.74) and by 13 (30%) graft and 21 (30.0%) nongraft subjects at 7 to 10 years postoperatively (P = 0.99).

Conclusions

We cannot conclude whether there is a difference in anterior recurrence for anterior colporrhaphy with and without dermal allograft and do not recommend changes in clinical practice based on these results.
Peripartum Perineal Hernia: A Case Report and a Review of the Literature
Authors: Hines Katherine N. , Badlani Gopal H. , Matthews Catherine A.
Published: January 2018

Objectives

This article reviews the literature for the management and repair of perineal hernias and presents a previously undescribed case of perineal bladder herniation after intrapartum pubic symphysis rupture.

Methods

A review of the literature was completed through the PubMed database using the search terms “bladder,” “canal of Nuck,” “labial hernia,” “gynecology,” “hernia,” “obstetrics,” “perineal hernia,” “postpartum,” “pubic diastasis,” “pubic symphysis,” “vaginal delivery,” “symphyseal rupture,” and “symphyseal separation.” The electronic medical record for the patient was reviewed and used with the consent of the patient.

Results

There were no reports of peripartum perineal hernias in the English language literature on human subjects. Literature review with the previously mentioned search terms demonstrated that there is not a standardized approach to repair given the rarity of these defects. There are data to support the use of mesh as opposed to primary repair but no data to support abdominal versus perineal versus combined approach. We describe a successful repair of a complicated peripartum perineal hernia using a combined abdominal-perineal approach with mesh.

Conclusions

Obstetric trauma is a previously unreported cause of perineal hernias. Perineal hernias are rare conditions that must be considered in any patient who presents with a bulging perineal mass. Puerperal pubic symphysis rupture can lead to a large bladder hernia. Our combined abdominal-perineal approach of repair resulted in minimal perioperative morbidity and short-term resolution of the hernia.
Randomized Controlled Trial to Assess the Impact of Intraurethral Lidocaine on Urodynamic Voiding Parameters
Authors: Kisby Cassandra K. , Gonzalez Eric J. , Visco Anthony G. , Amundsen Cindy L. , Grill Warren M.
Published: January 2018

Objectives

The aim of the study was to determine whether intraurethral anesthesia decreases voiding efficiency (VE; voided volume/(voided volume + residual volume)) and impacts other urodynamic parameters in healthy female volunteers during urodynamic studies.

Methods

This was a randomized double-blind placebo-controlled study of asymptomatic women aged 18 to 60 years. Subjects completed a visual analog scale and baseline questionnaires to assess pain and lower urinary tract symptoms, respectively. They performed an uninstrumented baseline uroflow, followed by physiologic filling to 250 mL or greater. Subjects were randomized to receive 5 mL of intraurethral aqueous gel or 2% lidocaine gel and then underwent a second uninstrumented uroflow. They then completed complex cystometry, urethral pressure profilometry, and pressure-flow studies.

Results

Twenty-three randomized subjects (12 placebo, 11 lidocaine) were included. Baseline uroflow VE was similar between the placebo and lidocaine groups. After study drug administration, VE was not different between groups (89.3 [85.9–93.9] vs 89.5 [82.5–91.7], P = 0.74). There were also no differences between groups in visual analog scale scores, sensation during cystometry, maximum urethral closure pressure, or micturition parameters (maximum detrusor pressure and detrusor pressure at maximum flow). The placebo group had a lower percentage of interrupted flow pattern (0% vs 36%, P = 0.02) and a lower rate of increased electromyographic activity during micturition (25% vs 73%, P = 0.02).

Conclusions

In this pilot study of 23 asymptomatic women, intraurethral administration of lidocaine did not decrease VE compared with placebo. The lidocaine group had a greater percentage of interrupted flow patterns and increased electromyographic activity during micturition.
Increased risk of fibrinolysis shutdown among severely injured trauma patients receiving tranexamic acid
Authors: Meizoso Jonathan P. , Dudaryk Roman , Mulder Michelle B. , Ray Juliet J. , Karcutskie Charles A. , Eidelson Sarah A. , Namias Nicholas , Schulman Carl I. , Proctor Kenneth G.
Published: January 2018

BACKGROUND

The association between tranexamic acid (TXA) and fibrinolysis shutdown is unknown. We hypothesize that TXA is associated with fibrinolysis shutdown in critically injured trauma patients.

METHODS

Two hundred eighteen critically injured adults admitted to the intensive care unit at an urban Level I trauma center from August 2011 to January 2015 who had thromboelastography performed upon intensive care unit admission were reviewed. Groups were stratified based on fibrinolysis shutdown, which was defined as LY30 of 0.8% or less. Continuous variables were expressed as mean ± standard deviation or median (interquartile range). Poisson regression analysis was used to determine predictors of shutdown.

RESULTS

Patients were age 46 ± 18 years, 81% male, 75% blunt trauma, Injury Severity Score of 28 ± 13, 16% received TXA, 64% developed fibrinolysis shutdown, and mortality was 15%. In the first 24 hours, 4 (2–9) units packed red blood cells and 2 (0–6) units fresh frozen plasma were administered. Those with shutdown had worse initial systolic blood pressure (114 ± 38 mm Hg vs. 129 ± 43 mm Hg, p = 0.006) and base deficit (−5 ± 6 mEq/L vs −3 ± 5 mEq/L, p = 0.013); received more packed red blood cells [6 (2–11) vs. 2 (1–5) units, p < 0.0001], and fresh frozen plasma [3 (0–8) vs. 0 (0–4) units, p < 0.0001]; and more often received TXA (23% vs. 4%, p <0.0001). After controlling for confounders, TXA (relative risk, 1.35; 95% confidence interval, 1.10–1.64; p = 0.004) and cryoprecipitate transfusion (relative risk, 1.29; 95% confidence interval, 1.07–1.56; p = 0.007) were independently associated with fibrinolysis shutdown.

CONCLUSION

Patients who received TXA were at increased risk of fibrinolysis shutdown compared with patients who did not receive TXA. We recommend that administration of TXA be limited to severely injured patients with evidence of hyperfibrinolysis and recommend caution in those with evidence of fibrinolysis shutdown.

LEVEL OF EVIDENCE

Therapeutic, level III.
Resuscitative endovascular balloon occlusion of the aorta for pelvic blunt trauma and life-threatening hemorrhage: A 20-year experience in a Level I trauma center
Authors: Pieper Audrey , Thony Frédéric , Brun Julien , Rodière Mathieu , Boussat Bastien , Arvieux Catherine , Tonetti Jérôme , Payen Jean-François , Bouzat Pierre
Published: January 2018

BACKGROUND

Resuscitative endovascular balloon occlusion of the aorta (REBOA) is increasingly used as a noninvasive clamp of the aorta after diverse posttraumatic injuries. Balloon inflation in zone 3 (from the lower renal artery to the aortic bifurcation) can be performed to stop ongoing bleeding after severe pelvic trauma with life-threatening hemorrhage. The aim of our study was to describe our 20-year experience with REBOA in terms of efficacy and safety in patients with a suspicion of severe pelvic trauma and extreme hemorrhagic shock.

METHODS

We performed a retrospective study from 1996 to 2017 in a French Level I trauma center. All consecutive patients who underwent a REBOA procedure were included. REBOA indication relied on (1) extreme hemodynamic instability (systolic arterial blood pressure [SBP] < 60 mm Hg on admission, SBP < 90 mm Hg despite initial resuscitation in the trauma bay or posttraumatic cardiac arrest) and (2) positive pelvic X-ray. Efficacy endpoints were vital signs and coagulation parameters before and after balloon inflation. Safety endpoints were REBOA-related complications: vascular events, acute renal failure, and rhabdomyolysis.

RESULTS

Within the study period, 32 patients underwent a REBOA procedure. Only two patients had technical failure and balloon was not inflated in one patient. Nineteen patients did not survive at day 28. The REBOA significantly improved SBP from 60 (35–73) mm Hg to 115 (91–128) mm Hg (p < 0.001). We also reported a high rate of vascular complications (19%, n = 5 patients) but no amputation. Renal replacement therapy was initiated in 11 patients, and 15 patients had severe rhabdomyolysis.

CONCLUSION

The REBOA is safe and effective in improving hemodynamics after severe pelvic trauma and life-threatening hemorrhage. Our study supports the use of REBOA as a bridge to definitive hemostatic treatment after severe pelvic trauma.

LEVEL OF EVIDENCE

Therapeutic, level IV.
The Association Between the Severity and Level of Understanding of Depression Among Patients Treated With Antidepressants: A Survey of 424 Outpatients in Japan
Authors: Tomita Tetsu , Yasui-Furukori Norio , Kudo Shuhei , Sugawara Norio , Fujii Akira , Tsuruga Koji , Sato Yasushi , Ishioka Masamichi , Nakamura Kazuhiko
Published: January 2018

Objectives

The present study investigated the association between the severity and knowledge of depression and attempted to reveal the specific aspects of understanding associated with severity.

Methods

A total of 424 outpatients were enrolled in this study. We used an original self-administered questionnaire: (a) the symptoms of depression, (b) the course of depression, (c) the cause of depression, (d) the treatment plan, (e) the duration of antidepressant use, (f) how to discontinue antidepressant use, (g) the adverse effects of antidepressants, and (h) psychotherapy. Each category consisted of the following questions: “How much do you understand about your treatment?” The level of understanding was rated on an 11-point scale ranging from 0 to 10. The following scales were administered: the Quick Inventory of Depressive Symptomatology, Japanese version (QIDS-J); the Global Assessment of Functioning; and the Clinical Global Impression, Severity scale. Subjects were divided in 5 groups according to severity of QIDS-J. Clinical characteristics were also investigated.

Results

Based on an analysis of variance, significant differences were found among the 5 groups with regard to age at onset, duration of disease, and duration of antidepressant use. A multiple regression analysis revealed that item B significantly and negatively predicted the QIDS-J scores, whereas item C significantly and positively predicted these scores. Some multiple logistic regression models seeking to distinguish severity found that all but items E to H were significantly associated with severity.

Conclusions

Items B and C were significantly negatively and positively associated with depression severity, respectively. Sufficient and suitable psychoeducation in and knowledge of depression might improve the treatment responses in patients with depression.
Newly Developed Skin Picking After Methylphenidate Treatment in Attention Deficit Hyperactivity Disorder: Possible Mechanisms
Authors: Kara Tayfun , Akaltun İsmail
Published: January 2018

Dermatillomania is characterized by excessive and repeated skin picking sufficient to damage cutaneous tissue, but with no underlying dermatological disease. The condition appears as an independent diagnosis in the Obsessive-Compulsive and Related Disorders category in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. A psychiatric pathology is generally reported to accompany this symptom. Attention deficit hyperactivity disorder (ADHD) is a potentially lifelong condition involving inattentiveness, hyperactivity, and impulsiveness. Attention deficit hyperactivity disorder is one of the most common childhood psychiatric disorders. Treatment includes medication, psychotherapy, and psychosocial therapies. Psychostimulants constitute the basis of treatment of children with ADHD worldwide. We describe a case of skin picking developing after methylphenidate therapy for ADHD. Possible explanations of methylphenidate and skin picking are reviewed in the light of the current literature.
Electrophysiology of Cranial Nerve Testing: Auditory Nerve
Authors: Legatt Alan D.
Published: January 2018

The electrocochleogram and brainstem auditory evoked potentials (BAEPs) are electrophysiologic signals used to assess the auditory nerve. The electrocohleogram includes the cochlear microphonic, the cochlear summating potential, and the eighth nerve compound action potential. It is used predominantly for hearing assessment and for diagnosis of Ménière disease and auditory neuropathy. Brainstem auditory evoked potentials are used for hearing assessment, diagnosis of dysfunction within the cochlea, the auditory nerve, and the brainstem auditory pathways up to the level of the mesencephalon, and intraoperative monitoring of these structures. The earliest BAEP component, wave I, and the eighth nerve compound action potential reflect the same process—the initial depolarization in the distal auditory nerve. Brainstem auditory evoked potential wave II receives contributions from the region of the cochlear nucleus and from the second depolarization in the distal auditory nerve. Wave III and later components are entirely generated rostral to the auditory nerve. Interpretation of BAEP studies is based on waves I, III, and V; auditory nerve dysfunction is manifested as prolongation of the I–III interpeak interval or absence of waves III and V. Eighth nerve tumors can cause a variety of BAEP abnormalities depending on which structures they affect. Adverse intraoperative BAEP changes can have many etiologies, including direct mechanical or thermal injury of tissue, ischemia (including cochlear ischemia or infarction due to compromise of the internal auditory artery), eighth nerve stretch, systemic or localized hypothermia, and artifactual BAEP changes due to technical factors.
Clinical Evaluation of the Vestibular Nerve Using Vestibular Evoked Myogenic Potentials
Authors: Bogle Jamie M.
Published: January 2018

Vestibular evoked myogenic potentials are currently the most clinically accessible method to evaluate the otolith reflex pathways. These responses provide unique information regarding the status of the utriculo-ocular and sacculo-collic reflex pathways, information that has previously been unavailable. Vestibular evoked myogenic potentials are recorded from tonically contracted target muscles known to be innervated by these respective otolith organs. Diagnosticians can use vestibular evoked myogenic potentials to better evaluate the overall integrity of the inner ear and neural pathways; however, there are specific considerations for each otolith reflex protocol. In addition, specific patient populations may require protocol variations to better evaluate atypical function of the inner ear organs, vestibular nerve transmission, or subsequent reflex pathways. This is a review of the clinical application and interpretation of cervical and ocular vestibular evoked myogenic potentials.
Electrophysiology of Cranial Nerve Testing: Cranial Nerves IX and X
Authors: Martinez Alberto R. M. , Martins Melina P. , Moreira Ana Lucila , Martins Carlos R. , Kimaid Paulo A. T. , França Marcondes C.
Published: January 2018

The cranial nerves IX and X emerge from medulla oblongata and have motor, sensory, and parasympathetic functions. Some of these are amenable to neurophysiological assessment. It is often hard to separate the individual contribution of each nerve; in fact, some of the techniques are indeed a composite functional measure of both nerves. The main methods are the evaluation of the swallowing function (combined IX and X), laryngeal electromyogram (predominant motor vagal function), and heart rate variability (predominant parasympathetic vagal function). This review describes, therefore, the techniques that best evaluate the major symptoms presented in IX and X cranial nerve disturbance: dysphagia, dysphonia, and autonomic parasympathetic dysfunction.
Different effects of two mutations on the infectivity of Ebola virus glycoprotein in nine mammalian species
Authors: Kurosaki Yohei , Ueda Mahoko Takahashi , Nakano Yusuke , Yasuda Jiro , Koyanagi Yoshio , Sato Kei , Nakagawa So
Published: January 2018

Ebola virus (EBOV), which belongs to the genus Ebolavirus, causes a severe and often fatal infection in primates, including humans, whereas Reston virus (RESTV) only causes lethal disease in non-human primates. Two amino acids (aa) at positions 82 and 544 of the EBOV glycoprotein (GP) are involved in determining viral infectivity. However, it remains unclear how these two aa residues affect the infectivity of Ebolavirus species in various hosts. Here we performed viral pseudotyping experiments with EBOV and RESTV GP derivatives in 10 cell lines from 9 mammalian species. We demonstrated that isoleucine at position 544/545 increases viral infectivity in all host species, whereas valine at position 82/83 modulates viral infectivity, depending on the viral and host species. Structural modelling suggested that the former residue affects viral fusion, whereas the latter residue influences the interaction with the viral entry receptor, Niemann–Pick C1.
Methylation of E. coli Class I Release Factors Increases the Accuracy of Translation Termination in vitro
Authors: Korkmaz Gürkan
Published: January 2018

Ribosomal protein synthesis (translation) is a highly accurate process. Translation termination, in particular, must be accurate to prevent truncated proteins. How this accuracy is achieved is not fully understood in all its details. Using an E. coli in vitro system, I explore novel mechanisms that contribute to the high accuracy of translation termination. By comparing the Michaelis-Menten parameters of methylated and non-methylated release factors on cognate and non-cognate codons. Post-translational methylation of a strictly conserved GGQ motif in class I release factors increases the accuracy of termination by up to 5-fold. This happens by increasing both the maximum rate of peptide release (kcat) and Michaelis-Menten constant (KM). Further, I demonstrate here that a non-methylated release factor acts like an uncompetitive inhibitor of enzyme reactions. Overall, this study shows that the methylation of class I release factors is a novel mechanism contributing to highly accurate translation termination.

Abbreviations

RF

release factor

RC

release complex
Cross-Modal Cue Effects in Motion Transparency Processing
Authors: Hanada G.M. , Ahveninen J. , Calabro F.J. , Yengo-Kahn A. , Vaina L.M.
Published: January 2018

The everyday environment brings about many competing inputs from different modalities to our sensory systems. The ability to filter these multisensory inputs in order to identify and efficiently utilize useful spatial cues is necessary to detect and process the relevant information. In the present study, we investigate how feature-based attention affects the detection of motion across sensory modalities. We were interested to determine how subjects use intramodal, crossmodal auditory, and combined audiovisual motion cues to attend to specific visual motion signals. The results show that in most cases, both visual and auditory cues enhance feature-based orienting to a visual motion pattern that is presented among distractor patterns. Furthermore, in many cases, detection of transparent motion patterns was significantly more accurate after combined visual-auditory than unimodal attention cues. Whereas previous studies have shown crossmodal effects of spatial attention, our results demonstrate a spread of crossmodal feature-based attention cues, which have been matched for the detection threshold of the visual target. These effects were evident in comparisons between cued and uncued conditions, as well as in analyses comparing the effects of valid vs. invalid cues.
DNA barcodes and insights into the phylogenetic relationships of butterflies of the genusEurema(Pieridae) from Uttarakhand, India
Authors: Rajpoot Ankita , Kumar Ved Prakash , Bahuguna Archana
Published: January 2018

In DNA barcoding, mitochondrial gene cytochromecoxidase I recommended as a tool for the rapid identification and discovery of species. GenusEurema, Family Pieridae is a highly diverse and distributed along wide geographic ranges in the world as well as India including approximately 70 species throughout the world. The present study is preliminary approach, we included n=12 specimen (3 samples per species) of four differentEuremaspecies, listed in IUCN as Least concern species, were collected from Uttarakhand (India), to give the DNA barcodes and examine patterns of gene evolution through molecular phylogenetics with publicly available sequences of other 17Euremaspecies present in different countries.

The generated (n=12) COI sequences compared with the sequences of the con-specifics submitted from different geographic regions, all four species were correctly identified. The obtained COI barcodes clearly showed the intraspecific and interspecific distance among fourEuremaspecies by using a K2P technique. In spite NJ, clustering analysis also successfully discriminated all four species.

In phylogenetic topology, included 21Euremaspecies in the Bayesian and Maximum Likelihood analysis recovered all species in two monophyletic clades with strong support and resolved taxonomic position within species groups. Although higher-level relationships among otherEuremaspecies groups require additional study.
Glycolytic repression and reduced GLP-1 secretion by active Farnesoid X Receptor in enteroendocrine L cells achieved via PKLR
Authors: Niss Kristoffer , Brunak Søren
Published: January 2018

Rise in intestinal glucose increases GLP-1 secretion by enteroendocrine L cells. GLP-1, in turn, stimulates insulin secretion. Farnesoid X Receptor (FXR) represses this pathway by manipulating the L cell glycolysis, thus reducing insulin- and GLP-1 secretion. The mechanism by which FXR manipulates the L cell glycolysis is unclear. In this study, we construct an L cell specific protein-protein interactome and identify all significantly active protein complexes, inferred by co-expression scores, in FXR-activated and control L cells. Contrary to previous reports, we find extensive glycolytic enzyme activity in FXR-activated L cells. We present how FXR’s repression of the glycolytic enzyme, pyruvate kinase (PKLR), is causing the reduction in glycolytic activity. This mechanistic insight may aid development of drugs targeting the GLP-1 pathway.
Viral gain-of-function experiments uncover residues under diversifying selection in nature
Authors: Maddamsetti Rohan , Johnson Daniel T. , Spielman Stephanie J. , Petrie Katherine L. , Marks Debora S. , Meyer Justin R.
Published: January 2018

Viral gain-of-function mutations are commonly observed in the laboratory; however, it is unknown whether those mutations also evolve in nature. We identify two key residues in the host recognition protein of bacteriophage λ that are necessary to exploit a new receptor; both residues repeatedly evolved among homologs from environmental samples. Our results provide evidence for widespread host-shift evolution in nature and a proof of concept for integrating experiments with genomic epidemiology.
Tracing the History of LINE and SINE Extinction in Sigmodontine Rodents
Authors: Yang Lei , Wichman Holly A
Published: January 2018

Background

L1 retrotransposons have co-evolved with their mammalian hosts for the entire history of mammals and currently make up to 20% of a typical mammalian genome. B1 retrotransposons are dependent on L1 for retrotransposition and span the evolutionary history of rodents since their radiation. L1s were found to have lost their activity in a group of South American rodents, the Sigmodontinae, and B1 inactivation preceded the extinction of L1 in the same group. Consequently, a basal group of sigmodontines have active L1s but inactive B1s and a derived clade have both inactive L1s and B1s. It has been suggested that B1s became extinct during a long period of L1 quiescence and that L1s subsequently reemerged in the basal group.

Results

Here we investigate the evolutionary histories of L1 and B1 in the sigmodontine rodents and show that L1 activity continued until after the split of the L1-extinct clade and the basal group. After the split, L1s had a small burst of activity in the former group, followed by extinction. In the basal group, activity was initially low but was followed by a dramatic increase in L1 activity. We found the last wave of B1s retrotransposition was large and probably preceded the split between the two rodent clades.

Conclusions

Given that L1s had been steadily retrotransposing during the time corresponding to B1 extinction and that the burst of B1 activity preceding B1 extinction was large, we conclude that B1 extinction was not a result of L1 quiescence. Rather, the burst of B1 activity may have contributed to L1 extinction both by competition with L1 and by putting strong selective pressure on the host to control retrotransposition.
The challenge of ensuring gender equality in Vietnamese and English high schools
Authors: Brundrett Mark , Thuy Dung Mai Thi
Published: January 2018

Purpose

The purpose of this paper is to comparatively examine the issue of gender equality in high schools in Vietnam and England.

Design/methodology/approach

Data gathering consisted of interviews with teachers in two high schools and the staff of a pedagogic university in Vietnam and staff of one high school and of the initial teacher training department of a university in England. Data were analysed using a combination of grounded theory, cross-cultural study and narrative analysis within a liberal feminist framework.

Findings

The main findings from Vietnam include that despite a strong commitment to gender equality by the central government, both pedagogy and curriculum in Vietnamese high schools fail to promote gender equality, and that gender equality is, therefore, espoused rather than enacted. Findings from England revealed considerable success had been achieved in gaining equality of both opportunity and outcomes, but that a more sophisticated discourse on gender in education needed to emerge.

Practical implications

Implications of the study include recommendations that more extensive training on gender equality is provided in both countries, but especially in Vietnam, in relation to curriculum, pedagogy and school leadership.

Originality/value

This paper provides analysis and commentary on the issue of gender equality in both Vietnam and England. No such study has previously taken place in the context of Vietnam, and a comparison is offered with the more “developed” situation in the UK.
Credentialism and demand for private supplementary tutoring
Authors: Ghosh Pubali , Bray Mark
Published: January 2018

Purpose

Private supplementary tutoring is expanding fast around the world. Recognising that examination boards are major shapers of curricular load, the purpose of this paper is to identify the roles of examination boards at Grades 8, 9 and 10 in Bengaluru, India. Two boards were chosen, with one having a heavier perceived curricular load than the other.

Design/methodology/approach

The study used mixed methods with a questionnaire survey of 687 students in Grades 8, 9 and 10, and 51 face-to-face, semi-structured interviews.

Findings

Perhaps surprisingly, the findings did not reveal significant differences in tutoring demand by students. Both groups viewed the board examinations as having high stakes, and accordingly invested in extensive private tutoring. Competition emanating from credentialism was the main driver of the decision to receive tutoring among both cohorts.

Originality/value

Although previous studies have explored various components of demand for tutoring, to the authors’ knowledge, this is the first to explore the impact of examination boards on demand for tutoring. Since the system of schools being affiliated to examination boards is common not only in India but also in many other countries, the study has broad international relevance.
Climate change mitigation: resilience indicators for roof solutions
Authors: Lassandro Paola , Cosola Teresa
Published: January 2018

Purpose

This paper aims to increase the resilience of building systems, especially roofs, in relation to climate changes. The focus is on Mediterranean cities, where, often, there is no regulation about these issues. Therefore, it is necessary to define resilience indicators through comparative studies of adaptive roof solutions to mitigate overheating in summer.

Design/methodology/approach

Through software simulations and data comparison, a specific methodological approach is used to analyze the resilience levels of different roof solutions (phase change materials, aerogel, green and cool roof), starting from energy efficiency as a prerequisite of resilience. Moreover, a case study of a historic existing building in a southern Italian town is examined.

Findings

The findings show the best strategies for building systems, especially for roofs, to decrease urban heat island effects according to the defined resilience indicators against overheating mitigation.

Research limitations/implications

Other building systems, such as facades, also have to be investigated in relation to climate change mitigation.

Practical implications

The implementation of resilient solutions that can also affect neighborhood for urban heat island mitigation.

Social implications

Because of resilience indicators definition, it is easier to introduce economic incentives according to reference thresholds and to increase community involvement.

Originality/value

The paper provides a new approach for the evaluation of technological solutions for a building from a resilience point of view, which has energy efficiency as pre-condition.
Vulnerability and buildings service life applied to preventive conservation in cultural heritage
Authors: Ortiz Rocío , Macias-Bernal Juan Manuel , Ortiz Pilar
Published: January 2018

Purpose

The purpose of this paper is to present research on vulnerability and service life indexes applied to cultural heritage buildings. The construction and rehabilitation industry is concerned with the maintenance of monuments and reducing the economic costs of urgent interventions by taking preventive conservation action in historic cities. By applying a vulnerability index or analyzing the service life of buildings, it is possible to reduce risk and optimize the identification, evaluation and prioritization of urgent monument restoration tasks in a city or a region to establish preventive conservation policies.

Design/methodology/approach

This research sets out the concepts of vulnerability and service life, focusing on their methodologies in comparison with other techniques for building diagnosis, discussing the differences between indexes that measure the vulnerability and service life of buildings.

Findings

The vulnerability of three churches in Seville (Spain) was studied by means of their vulnerability index, based on Delphi analysis, and the service life of these buildings was also assessed, based on artificial intelligence tools. Delphi and artificial intelligence tools allow us to compare and dovetail different scenarios and expert opinions. The degree of each monument’s conservation is defined as its vulnerability index, which is an indirect function of deterioration levels. The service life of buildings, on the other hand, includes the assessment of vulnerability and hazards.

Practical implications

This study is useful for stakeholders, including small and medium enterprises (SMEs) and policymakers, as an important reference on diagnosis, including updated, inexpensive and sustainable methodologies to manage the conservation of monuments, which are easy to implement in developed and developing countries. The application of vulnerability and/or service life indicators is crucial to ensuring the sustainability and improvement of maintenance carried out on cultural heritage buildings.

Originality/value

This study details new approaches based on artificial intelligence and Delphi analysis to prioritize preventive conservation actions in a city or region.