bluuebunny/crossref_metadata_2025 huggingface dataset:
Science to the rescue or contingent progress? Comparing 10 years of public, expert and policy discourses on new and emerging science and technology in the United Kingdom
Authors: Smallman Melanie
Published: May 2017

Over the past 10 years, numerous public debates on new and emerging science and technologies have taken place in the United Kingdom. In this article, we characterise the discourses emerging from these debates and compare them to the discourses in analogous expert scientific and policy reports. We find that while the public is broadly supportive of new scientific developments, they see the risks and social and ethical issues associated with them as unpredictable but inherent parts of the developments. In contrast, the scientific experts and policymakers see risks and social and ethical issues as manageable and quantifiable with more research and knowledge. We argue that these differences amount to two different sociotechnical imaginaries or views of science and how it shapes our world – an elite imaginary of ‘science to the rescue’ shared by scientists and policymakers and public counter-imaginary of ‘contingent progress’. We argue that these two imaginaries indicate that, but also help explain why, public dialogue has had limited impact on public policy.
An Industrial Sector Analysis of the Factors Influencing FTA Negotiation Outcomes
Authors: Wood Jacob
Published: May 2017

This study examines the way in which economic and non-economic factors impact the outcome of international FTA negotiations from an industrial sector perspective. This study demonstrates that the result of negotiations, as measured by the share of duty free tariff lines, is significantly affected by both non-economic and economic factors. The results from the study showed that five of the eight variables tested were statistically significant, of which two were non-economic (union membership and ruling party ideology) and three were economic (import penetration, industrial sector unemployment rate and the most favoured nation rate of duty free tariff lines) in nature. This empirical study also draws a number of conclusions as to the implications of these findings.
Relationship among Service Quality, Customer Satisfaction and Customer Loyalty: With Special Reference to Wireline Telecom Sector (DSL Service)
Authors: Rajeswari S. , Srinivasulu Yarlagadda , Thiyagarajan S.
Published: May 2017

The last few decades have witnessed a greater transition in the communication sector due to the unpre- cedented innovations in technology. On the one hand, the emergence of broadband has rejuvenated and strengthened the wireline sector by making use of the existing wireline infrastructure. On the other hand, it has created an intense competition among the service providers. The competition has propelled the service providers to look beyond the idea of providing service and has forced them to consider other factors like establishing customer loyalty which stems out of customer satisfaction and service quality. Thus, the study aims to analyze the interrelationship among the above-mentioned factors with respect to digital subscriber line (DSL) service offered by the incumbent wireline operator in Puducherry. The study has found that customer satisfaction plays an intervening role between service quality and customer loyalty.
Deliberative Dialogues Between Policy Makers and Researchers in Canada and Australia
Authors: Boydell Katherine M. , Dew Angela , Hodgins Michael , Bundy Anita , Gallego Gisselle , Iljadica Alexandra , Lincoln Michelle , Pignatiello Antonio , Teshima John , Willis David
Published: May 2017

Knowledge translation (KT) and implementation science are growing fields in Canada, Australia, and worldwide. Many audiences are targeted as KT knowledge users—policy makers represent one key knowledge user in the health care field. The need for policy makers to understand research and for researchers to understand policy processes is commonly recognized. There is also increasing interest in health policy that focuses on KT as a framework for understanding the use of evidence and, in particular, describing the influence of research on policy along with concepts of coproduction and user involvement. With relationship building central to successful evidence-informed policy, this article explores deliberative dialogue as a potential approach to enhancing KT. It describes two examples of researcher efforts to cultivate relationships and contacts with policy and decision makers via such dialogues and illustrates the inherent opportunities and challenges of doing so.
Ambicultural Governance: Harmonizing Indigenous and Western Approaches
Authors: Nicholson Amber , Spiller Chellie , Pio Edwina
Published: May 2017

Indigenous and Western business practices and worldviews can be harmonized to create and enhance well-being through ambicultural governance practices. This article focuses on exploring, both theoretically and empirically, creative governance endeavors to bring together Indigenous and Western practices for the purposes of creating both wealth and well-being in the service of society. We emphasize the need to return to the idea of business as serving the well-being of communities and suggest this can be done through a relational kaitiakitanga, stewardship approach that is at the heart of our research. Through a qualitatively rich case study of a Māori business, we present a Strategy Model He Whenua Rangatira—A Balanced Landscape that serves to act as a decision-making tool that facilitates both tangible and intangible benefits for organizational success and collective well-being. We suggest that all businesses, both Indigenous and Western, can gravitate toward this approach, while contextualizing their ambicultural governance.
Optimal hybrid scheme of dynamic neural network and PID controller based on harmony search algorithm to control a PWM-driven pneumatic actuator position
Authors: Mazare Mahmood , Taghizadeh Mostafa , Kazemi Mohammad Ghasem
Published: May 2017

In this paper, the position of a pulse width modulation (PWM)-driven pneumatic actuator has been controlled using a dynamic neural network (DNN) and Proportional Integral Derivative (PID) controller. The harmony search algorithm (HSA) has been used to unravel the optimization problem. The DNN controller is optimally designed to control the position of the actuator. As to the performance of the PID controller, it can assist the DNN controller to give better results. Therefore, an optimal hybrid scheme with both DNN and PID controllers based on HSA is suggested. A pneumatic circuit containing a fast-switching valve is used to reduce the complexity of the PWM-driven servo pneumatic system along with its cost price.
Perceived somatic and affective barriers for self-efficacy and physical activity
Authors: Warner Lisa M , Wolff Julia K , Spuling Svenja M , Wurm Susanne
Published: May 2017

According to Bandura’s social-cognitive theory, perceptions of somatic and affective barriers are sources of self-efficacy. This longitudinal study compares general indicators of health barriers with measures of perceived somatic and affective barriers to predict self-efficacy and accelerometer-assessed physical activity in a subsample of n = 153 (selected at random from N = 310) community-dwelling German older adults. Perceived somatic and affective barriers longitudinally predicted physical activity mediated by self-efficacy, whereas general health barriers did not. Perceived health barriers to physical activity might be more important than more objective health barriers for older adults’ physical activity levels.
Childhood family structure and women’s adult overweight risk: A longitudinal study
Authors: Chaparro M. Pia , de Luna Xavier , Häggström Jenny , Ivarsson Anneli , Lindgren Urban , Nilsson Karina , Koupil Ilona
Published: May 2017

Aim: The aim of this study was to investigate whether women’s adult overweight and obesity risk was associated with their childhood family structure, measured as their mothers’ marital status history, during the women’s first 18 years of life. Methods: Using linked register data, we analyzed 30,584 primiparous women born in Sweden in 1975 who were between 19–35 years of age when their height and pre-pregnancy weight was recorded. The outcomes were women’s overweight/obesity (body mass index (BMI) ≥ 25 kg/m2) and obesity (BMI ≥ 30 kg/m2) and the predictor was mothers’ marital status history, which was summarized using sequence analysis. We carried out nested logistic regression models adjusting for women’s age and maternal sociodemographic characteristics. Results: Mothers’ marital status history was summarized into six clusters: stable marriage, stable cohabitation, married then divorcing, cohabiting then separating, varied transitions, and not with father. In fully adjusted models and compared with women whose mothers belonged to the stable marriage cluster: (1) women whose mothers belonged to the other marital status clusters had higher odds of overweight/obesity (odds ratio (OR) ranging 1.15–1.19; p < 0.05); and (2) women whose mothers belonged to the stable cohabitation (OR = 1.31; 95% confidence interval (CI) = 1.14–1.52), cohabiting then separating (OR = 1.23; 95% CI = 1.01–1.49), varied transitions (OR = 1.24; 95% CI = 1.11–1.39), and not with father (OR = 1.24; 95% CI = 1.00–1.54) clusters had higher odds of obesity. Conclusions: Women whose mothers were not in stable marriage relationships had higher odds of being overweight or obese in adulthood. The finding that even women raised in the context of stable cohabitation had higher odds of being overweight or obese is intriguing as these relationships are socially accepted in Sweden.
Complications and Morbidity associated with Loop Ileostomies in Patients with Ulcerative Colitis
Authors: Park J. , Gessler B. , Block M. , Angenete E.
Published: May 2017

Background and Aims:

Loop ileostomies are frequently used as diversion of the fecal stream to protect a distal anastomosis. The aim of this study was to identify complications and morbidity related to loop ileostomies in patients with ulcerative colitis at a nonemergent setting.

Material and Methods:

Consecutive patients with ulcerative colitis who received a loop ileostomy at a tertiary referral center in Sweden from January 2006 until December 2012 were included and studied retrospectively.

Results:

In total, 71 patients were identified, and the median age was 39 years. A majority (94%) of the patients underwent proctectomy or proctocolectomy with primary construction of an ileal pouch–anal anastomosis. In total, 38 patients (54%) had one or more postoperative complications at index surgery. Stoma-related complications were seen in 49% where parastomal skin irritation was most common. In total, 18% of the patients were re-admitted due to morbidity related to the ileostomy, and the leading cause was high volume output. Complications related to closure were seen in 29% of the patients, and of these, 30% required surgical intervention. In total, five patients (7%) developed a symptomatic leakage in the ileo-ileal anastomosis. There was no mortality.

Conclusion:

Loop ileostomies in this young patient cohort resulted in considerable morbidity. Closure of the ileostomy was also associated with complications. Although the diverting loop ileostomy is constructed to decrease the clinical consequences of an anastomotic leakage, the inherent morbidity should be considered. Preventive measures for parastomal skin problems could improve results.
Opportunity is in the eye of beholder
Authors: Osiyevskyy Oleksiy , Tao Qingjiu Tom , Jiang Ruihua Joy , Santoro Michael D.
Published: May 2017

As the literature on organizational alliances has begun to shift from analyzing individual dyads to strategic alliance portfolios, the essential drivers of firms’ alliance portfolio characteristics remain largely unexplored and poorly understood. In particular, existing studies do not provide a clear understanding of how contextual factors determine essential characteristics of a firm’s strategic alliance portfolio—particularly with respect to the diversity of the portfolio. Treating firms’ alliance portfolios as bundles of search activities, we apply the behavioral strategy lens to explain the observed changes in strategic alliance portfolios’ diversity driven by factors of the external (environmental jolts) and internal (relative performance) environments. We test our proposed theoretical framework by tracing the evolution of telecommunication industry firms’ alliance portfolios before and after the 1996 Telecommunications Act and the 2000 market crash.
Benefits of higher education in mid-life: A life course agency perspective
Authors: Isopahkala-Bouret Ulpukka
Published: May 2017

The purpose of this study is to investigate the benefits of higher education in mid-life from the perspective of life course agency. Studies concerning the benefits of degree-oriented higher education have been mainly conducted using survey questionnaires and quantitative methods. In order to gain a more comprehensive picture, this qualitative analysis provides an insider perspective. It analyses which benefits are significant to older graduates and in what ways. The inquiry is based on the life history interviews of mid-life professionals who pursued Master’s degrees from well-established Finnish universities in their fifties. A thematic narrative approach is used to analyse the data. The findings indicate that older graduates enjoy obvious benefits from attaining higher education and pursuing a new Master’s degree. However, there is much variation between graduates. The significance of experienced benefits depends on the overall life plan and expectations of the person concerned. The conclusion considers higher education attainment in mid-life in a wider societal context and suggests directions for future research.
Adult student preferences: Instructor characteristics conducive to successful teaching
Authors: Phillips Lindsay A , Baltzer Carolyn , Filoon Lisa , Whitley Cynthia
Published: May 2017

Purpose

This study examined adult students’ perspectives on what characteristics make for successful teaching and learning environments in the adult student classroom.

Methodology

One hundred and thirty-two adult students (ranging in age from 22 to 70) participated in a mixed methods (quantitative and qualitative) survey.

Findings

Adult students seem to prefer instructors with knowledge and respect for adult learners, applied experience in the fields in which they teach, and those who have clear communication, and are fair and understanding. Participants viewed not understanding or respecting adult students and being arrogant or condescending as problematic characteristics for instructors to have.
Party–Group Ambivalence and Voter Loyalty: Results From Three Experiments
Authors: Shufeldt Gregory
Published: May 2017

Renewed emphasis on the group-based nature of political parties makes understanding the relationship between partisan and group identities essential. How do citizens respond to the internal disconnect between their partisan identity and their other politically salient identities? In addition, do differences in the group-based nature of each party lead to asymmetric effects of party–group ambivalence? Using data from an original survey experiment across three samples—the 2012 Cooperative Congressional Election Study, the 2012 Convention Delegate Study, and a 2015 sample from Amazon Mechanical Turk—I find that party–group ambivalence diminishes party loyalty, making respondents less likely to vote for, contribute to, or volunteer for their political party’s candidate. Moreover, the strength of this impact is consistently larger among Republican identifiers than Democratic identifiers. These results suggest that party asymmetry in party coalitions may have an impact on party loyalty.
The Indian news media industry: Structural trends and journalistic implications
Authors: Chadha Kalyani
Published: May 2017

Over the past two decades, India’s media sector has witnessed profound and transformative change reflected in the expansion of both outlets and audiences. According to recent estimates, the country has over a 100 news channels that reach 161 million TV households, about 94,067 newspapers, as well as over 200 million Internet users. These developments have engendered a growing discourse that emphasizes the growth and dynamism of Indian media. However, this predictably celebratory narrative does not focus on the more troubling structural trends that increasingly characterize the country’s media landscape. These include commercialism, rising levels of concentration and cross-media ownership, as well as the expansion of control by politicians and industrialists over the media. Employing a political economy perspective, this article explores the emergence and workings of these structural trends in depth. It challenges the popular perception that India represents a dynamic and pluralistic media landscape, and argues that contemporary trends in the Indian media landscape have significant and deeply negative implications for the production of news and the overall quality of journalism in the country.
Vocalization patterns in young children with Down syndrome: Utilizing the language environment analysis (LENA) to inform behavioral phenotypes
Authors: Parikh Chandni , Mastergeorge Ann M
Published: May 2017

Children with Down syndrome (DS) are at higher risk for both delayed expressive language and poor speech intelligibility. The current study utilized the quantitative automated language environment analysis (LENA) to depict mother and child vocalizations and conversational patterns in the home of 43 children with DS, chronologically aged 24–64 months. Children with DS displayed fewer utterances than typically developing children; however, there was wide variability. Furthermore, children with DS did not show increased vocalization counts across their chronological ages. In contrast to previous findings, this study found that the mothers of children with DS had a reduced number of vocalizations. However, the vocalizations increased with age in comparison to mothers of typically developing children. Implications for targeted interventions that facilitate learning opportunities in bidirectional contexts for children with DS and their parents are discussed, with particular attention to quantify behavioral phenotypes utilizing a novel expressive language assessment tool.
The Karbalization of Lebanon: Karbala as lieu de mémoire in Hezbollah’s Ashura narrative
Authors: Yazbeck Natacha
Published: May 2017

This article draws on the unique backdrop of Lebanese sociopolitical history to explore a lieu de mémoire that figures centrally in the rhetoric of Hezbollah around Ashura, the 10th night of the commemoration of Imam Hussein’s death at Karbala. Using an analysis of the speeches of Hezbollah Secretary General Hassan Nasrallah on Ashura, this article examines the party’s rhetoric around the battle of Karbala, and the revered leader’s death, through the three dimensions of lieux de mémoire as identified by Pierre Nora, paying particular attention to the role of mediatization in the materiality of memory. It shows that lieux de mémoire can in fact emerge in the absence of a nation-state, despite Nora’s testament to the contrary.
Development of a meso-scale cycloidal-rotor aircraft for micro air vehicle application
Authors: Shrestha Elena , Yeo Derrick , Benedict Moble , Chopra Inderjit
Published: May 2017

This paper describes the design, controls system development, and hover testing of a 60 -g meso-scale cycloidal-rotor based (cyclocopter) micro air vehicle. The cycloidal rotor (cyclorotor) is a revolutionary vertical take-off and landing concept with a horizontal axis of rotation. The twin-cyclocopter utilizes two optimized cyclorotors and a horizontal tail rotor used to counteract the pitching moment generated by the cyclorotors. An innovative light-weight and high strength-to-weight ratio blade design significantly reduced cyclorotor weight and improved aerodynamic efficiency. In addition, increasing the virtual camber and incidence (by increasing chord-to-radius ratio) and using a symmetric pitching schedule with a maximum ± 45° pitching amplitude also improved rotor efficiency. Due to gyroscopic coupling and inherent instability of the cyclocopter, a closed-loop feedback control system was implemented using a custom autopilot weighing 1.5 g. The 60-g meso-scale twin-cyclocopter successfully demonstrated stable, sustained hover.
¿Pueden “viajar” las guías NICE? Reflexiones sobre su aplicabilidad en la Comunitat Valenciana en España
Authors: Paredes-Carbonell Joan J. , Morgan Antony
Published: May 2017

El artículo pretende reflexionar sobre las oportunidades que supone la adaptación de las Guías de Salud Pública del “National Institute for Health and Care Excellence” (NICE) al contexto de la Comunitat Valenciana en España. Los principales elementos para el éxito de esta adaptación serían: disponer de apoyo directivo; activar un proceso (partiendo de la metodología de NICE) mediante la creación de comités con actores claves dado el tema que se aborda; complementar la revisión de la evidencia con publicaciones y prácticas del entorno español; tener en cuenta las diferencias sociales y sanitarias entre Inglaterra y la Comunitat Valenciana; identificar responsables y escenarios para aplicar las recomendaciones, y evaluar su impacto. Se proponen unas etapas y requisitos para que una guía NICE de salud pública pueda viajar fuera de Inglaterra. Estas reflexiones pueden ser de utilidad para la adaptación y desarrollo de las guías NICE en otras regiones o países.
Regulating for Non-Price Discrimination: The Case of UK Fixed Telecoms
Authors: Cave Martin , Correa Lisa , Crocioni Pietro
Published: May 2017

In 2005, Ofcom accepted undertakings from BT, the vertically integrated provider of fixed telecoms services in the UK. These constitute the latest attempt to address discriminatory concerns infixed telecoms. This paper examines the incentives of vertically integrated operators with market power to discriminate using where possible empirical evidence relevant to the UK and considers possible regulatory responses to this behaviour. Finally, it briefly describes the remedy adopted by Ofcom to deal with this issue.
Profit Versus Prejudice
Authors: Stagnaro Michael N. , Dunham Yarrow , Rand David G.
Published: May 2017

We examine the possibility that self-interest, typically thought to undermine social welfare, might reduce in-group bias. We compared the dictator game (DG), where participants unilaterally divide money between themselves and a recipient, and the ultimatum game (UG), where the recipient can reject these offers. Unlike the DG, there is a self-interested motive for UG giving: If participants expect the rejection of unfair offers, they have a monetary incentive to be fair even to out-group members. Thus, we predicted substantial bias in the DG but little bias in the UG. We tested this hypothesis in two studies ( N = 3,546) employing a 2 (in-group/out-group, based on abortion position) × 2 (DG/UG) design. We observed the predicted significant group by game interaction, such that the substantial in-group favoritism observed in the DG was almost entirely eliminated in the UG: Giving the recipient bargaining power reduced the premium offered to in-group members by 77.5%.
Effect of atypical antipsychotics on body weight in geriatric psychiatric inpatients
Authors: Yeung Eugene YH , Chun Soojin , Douglass Alan , Lau Timothy E
Published: May 2017

Background:

Studies suggest that antipsychotic-induced weight gain is not a great concern in the elderly population. This study investigated the weight change in elderly patients with various treatment duration and antipsychotics. Part 1 of the study was to determine whether atypical antipsychotics induced weight change in elderly patients. Part 2 was to determine whether certain atypical antipsychotics induced more weight change in elderly patients.

Methods:

In Part 1, a retrospective chart review was done on 115 geriatric inpatients. After exclusion, patients were divided into four groups: control ( n = 17), new treatment ( n = 18), long-term treatment ( n = 13), and medication switch groups ( n = 8). In Part 2, a retrospective medication review was performed on 169 geriatric inpatients. After exclusion, patients were divided into three groups: aripiprazole ( n = 18), olanzapine ( n = 49), and risperidone ( n = 57). Body weights were obtained at two different time points.

Results:

No significant difference in weight change was observed among the control (1.5 kg), new treatment (0.8 kg), long-term treatment (−0.3 kg), and medication switch (1.9 kg) groups. No significant difference in weight change was observed between patients with and without dementia (0.8 and 1.1 kg, respectively). The weight change in the aripiprazole group (−2.0 kg; −2.30% from baseline) was significantly different from the weight change in the olanzapine group (0.7 kg; 1.87% from baseline; p < 0.05), but not from the risperidone group (−0.4 kg; −0.45% from baseline). Clinically significant weight gain (>7% increase in body weight) occurred in 14.3% of the olanzapine patients, a percentage significantly higher than the 3.5% in the risperidone group.

Conclusion:

Although atypical antipsychotics were generally weight neutral in the geriatric population, aripiprazole and olanzapine were associated with significant weight loss and weight gain, respectively.
Migrated Macroplastique in bladder wall – ‘Mickey Mouse’ sign in MRI
Authors: KandaSwamy Gokul V , Randhawa Kiran S , Dhanasekaran Anandha K
Published: May 2017

Macroplastique is an injectable urethral bulking agent used in stress incontinence. There is a paucity of studies beyond five years of follow-up looking into the long-term side effects of injecting this material. Here we present a female patient, who had Macroplastique injected multiple times 20 years ago for stress incontinence, and who presented with significant storage symptoms and non-visible haematuria. The symptoms were due to migration of Macroplastique and erosions, which looked like bladder tumour. Magnetic resonance imaging (MRI) scan showed circumferential migration of the Macroplastique material, mimicking the appearance of a ‘Mickey Mouse’.
Willing to share? Tax compliance and gender in Europe and America
Authors: D’Attoma John , Volintiru Clara , Steinmo Sven
Published: May 2017

Studies examining the effects of gender on honesty, deceptive behavior, pro-sociality, and risk aversion, often find significant differences between men and women. The present study contributes to the debate by exploiting one of the largest tax compliance experiments to date in a highly controlled environment conducted in the United States, the United Kingdom, Sweden, and Italy. Our expectation was that the differences between men’s and women’s behavior would correlate broadly with the degree of gender equality in each country. Where social, political and cultural gender equality is greater we expected behavioral differences between men and women to be smaller. In contrast, our evidence reveals that women are significantly more compliant than men in all countries. Furthermore, these patterns are quite consistent across countries in our study. In other words, the difference between men’s and women’s behavior is not significantly different in more gender neutral countries than in more traditional societies.
Places Change Minds: Exploring the Psychology of Urbanicity Using a Brief Contemplation Method
Authors: Corcoran Rhiannon , Mansfield Rosie , Giokas Trina , Hawkins Amy , Bamford Lauren , Marshall Graham
Published: May 2017

An accruing body of research suggests that urban environments negatively affect mental health and well-being. It is thought that some of this so-called “urbanicity effect” can be explained by the perceived quality of the living environment. The two studies reported here used online survey methods to explore changes to self-reported psychological mechanisms thought to underpin mental health and well-being before and after participants briefly contemplated urban/rural or desirable/undesirable residential images. Our findings demonstrate that even brief contemplation of places change how we consider our futures and that places deemed relatively undesirable appear to promote a threat-focused anticipatory set. Importantly, these changes were not found to be associated with perceived urbanity but rather with perceived desirability of place. These findings should be considered alongside increasing evidence that urban regeneration and place-making are matters of public health concern.
Barriers to the Use of Assistive Devices in Patient Handling
Authors: Noble Nancy L. , Sweeney Nancy L.
Published: May 2017

Work-related musculoskeletal disorders (WMSD) are a major safety concern in today’s health care environment due to the manual lifting of patients with higher acuity levels and obesity. Nurses move patients multiple times each day, incurring cumulative stress and trauma resulting in chronic pain and potential injury. The purpose of this study was to assess barriers to the use of assistive devices in safe patient handling and mobility (SPHM) that contribute to WMSD in health care workers. Interpersonal, situational, organizational, and environmental influences have both direct and indirect effects on workers’ commitment to use, or their actual likelihood of using, assistive devices. This study confirmed that time constraints contribute to fewer instances of assistive device use. Comprehensive ergonomic programs are needed to promote staff and patient safety. By providing safe environments for health care workers who engage in patient handling and mobility, the risk of injury can be significantly reduced.
An Employee With Undiagnosed Leprosy: Are Other Employees at Risk?
Authors: Lurati Ann R.
Published: May 2017

MJ is a janitor working in an office building for the past 5 years. He sustained a third-degree burn with a secondary infection and was sent to the county hospital. He was diagnosed with leprosy. The employees in the office building were concerned with the risk of transmission. This article reviews leprosy, and implications for occupational health nurses are discussed.
Prevalence of Rotator Cuff Atrophy and Fatty Infiltration in Patients Undergoing Total Shoulder Arthroplasty
Authors: Naimark Micah , Berliner Jonathan , Zhang Alan L , Davies Michael , Ma C Benjamin , Feeley Brian T
Published: May 2017

Background

Rotator cuff fatty infiltration and atrophy are risk factors for worse outcomes after total shoulder arthroplasty (TSA). The purpose of this study is to evaluate the prevalence of preoperative fatty infiltration and atrophy in TSA patients compared to control patients without glenohumeral osteoarthritis.

Methods

We retrospectively identified 30 patients undergoing TSA for primary glenohumeral arthritis who had preoperative magnetic resonance imaging. TSA patients were matched by age and sex with control patients without arthritis or full-thickness rotator cuff tears. Blinded observers graded fatty infiltration of the 4 rotator cuff muscles and measured supraspinatus atrophy by the occupation ratio. A multivariate analysis was used to correlate arthritis, age, sex, and body mass index with rotator cuff atrophy and fatty infiltration.

Results

Goutallier grade ≥ 2 fatty infiltration was seen in at least one muscle for 13/30 (43%) TSA patients and 1/30 (3%) control patients ( P < .01). The average supraspinatus fossa occupation ratio was 0.72 ± 0.24 in the TSA group compared to 0.92 ± 0.23 for controls ( P < .01). Moderate to severe supraspinatus muscle atrophy (occupation ration < 0.6) was observed in 10/30 (33%) TSA patients and 0/30 (0%) controls. Glenohumeral arthritis was an independent predictor of atrophy and fatty infiltration ( P < .01). Age, sex, and body mass index were not significantly correlated with atrophy or fatty infiltration.

Conclusion

Glenohumeral arthritis is associated with rotator cuff atrophy and fatty infiltration. In the absence of rotator cuff tendon tearing, glenohumeral arthritis may contribute to the pathophysiology of rotator cuff muscle degeneration.
Analysis of an Infectious Diseases Pharmacist on Call Pager Program to Inform Educational Efforts
Authors: Gilbert Elise M. , Rhodes Nathaniel J. , McLaughlin Milena M. , Cottreau Jessica M. , Scheetz Marc H. , Postelnick Michael , Barr Viktorija O.
Published: May 2017

Background: An on call infectious diseases (ID) pharmacist may be used as a resource for physicians, pharmacists, and other health care providers to help answer questions regarding anti-infective agents. Objective: To assess type, requestor, resources dedicated, and temporal trends of questions received through an ID pharmacist on call pager program. A secondary objective was to gather insight as to how this information was utilized to inform educational initiatives. Methods: This was a retrospective study of questions received by the ID pharmacist on call via pager at a large academic medical center. Question data were documented in a central database and analyzed to assess temporal trends and question type, and qualitatively analyzed to determine areas for targeted educational efforts. Results: The ID pharmacist on call recorded 545 questions during the 1-year study period; questions were composed of various antimicrobial agent–related queries, including antibiotic spectrum and selection (n = 251, 46.1%), dosing of antimicrobials (n = 195, 35.8%), and drug monitoring (n = 26, 4.8%). Targeted educational initiatives secondary to questions received included pharmacist education regarding the use of polymyxin antibiotics and antibiotic dosing protocol updates. Conclusions: An ID pharmacist on call pager program was utilized to inquire about antibiotic spectrum and selection for the majority of questions. Records of questions received may be utilized to direct educational efforts and create or revise targeted resources for pharmacists and other clinicians.
Clonal hematopoiesis, with and without candidate driver mutations, is common in the elderly
Authors: Zink Florian , Stacey Simon N. , Norddahl Gudmundur L. , Frigge Michael L. , Magnusson Olafur T. , Jonsdottir Ingileif , Thorgeirsson Thorgeir E. , Sigurdsson Asgeir , Gudjonsson Sigurjon A. , Gudmundsson Julius , Jonasson Jon G. , Tryggvadottir Laufey , Jonsson Thorvaldur , Helgason Agnar , Gylfason Arnaldur , Sulem Patrick , Rafnar Thorunn , Thorsteinsdottir Unnur , Gudbjartsson Daniel F. , Masson Gisli , Kong Augustine , Stefansson Kari
Published: May 2017

Key Points

Whole-genome sequencing of 11 262 Icelanders reveals that clonal hematopoiesis is very common in the elderly. Somatic mutation of some genes is strongly associated with clonal hematopoiesis, but in most cases, no driver mutations were evident.
Oophoropexy for ovarian torsion: a new easier technique
Authors: Hosny Tamer A.
Published: May 2017

Background

Oophoropexy for ovarian torsion is easy to be done by many tools either suturing to the lateral pelvic wall, plication of the ovarian ligament or even fixation to the back of the uterus, but it is little bit difficult to do it for pregnant women with less manipulation.

Objective

We propose that using trocar site closure needle can be easier and faster technique to do this. To assess the feasibility of using the trocar site closure needle to do oophoropexy in ovarian torsion and its possible applicability.

Patients

Seven patients presented with ovarian torsion; four of them were pregnant at 7, 15, 19 and 20 weeks of gestation, two patients with ovarian hyperstimulation in IVF cycles and one adolescent patient with hemorrhagic cyst. They were diagnosed by clinical presentation and ultrasound with Doppler analysis, and confirmed by laparoscopy where they underwent detorsion and fixation of the ovary using the trocar site closure needle.

Results

Follow up of all the cases after one week showed improvement of the symptoms and normal Doppler flow of the target ovary then after three weeks by ultrasonography which revealed normal Doppler flow in the previously torsioned ovary. Two pregnant women underwent cesarean delivery where the operated ovary was observed during the delivery and was normal in shape and freely mobile with no adhesions.

Conclusion

We propose that this technique is easier, faster and more comfortable especially in ovarian torsion in pregnant women and torsion in hyperstimulated ovaries.
Cochlear implant electrode sealing techniques and related intracochlear pressure changes
Authors: Todt Ingo , Utca Julica , Karimi Dania , Ernst Arne , Mittmann Philipp
Published: May 2017

Background

The inserted cochlear implanted electrode is covered at the site of the round window or cochleostomy to prevent infections and leakage. In a surgically hearing preservational concept, low intracochlear pressure changes are of high importance. The aim of this study was to observe intracochlear pressure changes due to different sealing techniques in a cochlear model.

Methods

Cochlear implant electrode insertions were performed in an artifical cochlear model and the intracochlear pressure changes were recorded in parallel with a micro-pressure sensor positioned in the apical region of the cochlea model to follow the maximum amplitude of intracochlear pressure. Four different sealing conditions were compared: 1) overlay, 2) overlay with fascia pushed in, 3) donut-like fascia ring, 4) donut-like fascia ring pushed in.

Results

We found statistically significant differences in the occurrence of maximum amplitude of intracochlear pressure peak changes related to sealing procedure comparing the different techniques. While the lowest amplitude changes could be observed for the overlay technique (0.14 mmHg ± 0.06) the highest values could be observed for the donut-like pushed in technique (1.79 mmHg ± 0.69).

Conclusion

Sealing the electrode inserted cochlea can lead to significant intracochlear pressure changes. Pushing in of the sealing tissue cannot be recommended.
A phase III randomized clinical trial (RCT) of tandem myeloablative autologous stem cell transplant (ASCT) using peripheral blood stem cell (PBSC) as consolidation therapy for high-risk neuroblastoma (HR-NB): A Children's Oncology Group (COG) study.
Authors: Park Julie R. , Kreissman Susan G. , London Wendy B. , Naranjo Arlene , Cohn Susan Lerner , Hogarty Michael D. , Tenney Sheena Cretella , Haas-Kogan Daphne , Shaw Peter John , Geiger James Duncan , Doski John J , Gorges Sandra Wooton , Khanna Geetika , Voss Stephan D. , Maris John M. , Grupp Stephan A. , Diller Lisa
Published: May 2017

LBA3

Background: ASCT improves event-free survival (EFS) for HR-NB. Pilot studies suggest that intensification of myeloablative therapy using tandem ASCT further improves outcome for HR-NB. We conducted a multicenter RCT comparing tandem vs. single consolidation in patients with HR-NB. Methods: Between 11/2007 and 2/2012, 652 eligible patients (pts) with newly diagnosed HR-NB received induction therapy: 6 cycles of chemotherapy including initial 2 cycles of dose-intensive cyclophosphamide/topotecan followed by PBSC collection. Randomization occurred at end induction to single ASCT with carboplatin-etoposide-melphalan (CEM) or tandem ASCT with thiotepa–cyclophosphamide ASCT followed by a modified CEM (TC:CEM). HR pts with non-MYCN amplified Stage 3 (age>18mos) or Stage 4 (age 12-18 mos) tumors were non-randomly assigned to single ASCT (CEM). EFS and overall survival (OS) were analyzed as intent-to-treat. Results: Median age at study entry was 3.1 yrs, 88% (n=574 pts) had Stage 4 disease and 38.2% (n=249 tumors) had MYCN amplification. A total of 355 pts were randomized (CEM n=179 pts; TC:CEM n=176 pts) and 27 patients were non-randomly assigned to CEM. Of randomized pts, 249 patients received post-consolidation immunotherapy on COG trials. Treatment-related mortality was 2.6% (Induction n=7 [1%]; Consolidation n=10 [2.8%; n=8 CEM, n=2 TC:CEM]). Rates of severe mucosal, infectious or liver toxicities were similar between arms. 3-year EFS and OS from diagnosis were 51.1±2.0% and 68.2±1.9%, respectively. EFS and OS for randomized cohort are shown in the Table. Conclusions: Tandem myeloablative consolidation therapy improves survival probability in patients with high-risk neuroblastoma, especially in the setting in post-consolidative immunotherapy. Clinical trial information: NCT00567567. [Table: see text]
Barriers and Challenges to Treatment Alternatives for Early-Stage Cervical Cancer in Lower-Resource Settings
Authors: Wu Emily S. , Jeronimo Jose , Feldman Sarah
Published: May 2017

Cervical cancer is one of the most common cancers among women worldwide, and approximately 85% of new diagnoses occur in less-developed regions of the world. Global efforts in cervical cancer to date have focused on primary and secondary prevention strategies of human papillomavirus vaccination and cervical cancer screening. Cervical cancer screening is effective to reduce the incidence of cervical cancer and can result in diagnosis at earlier stages, but it will take time to realize its full impact. With expansion of screening programs, there is now a greater imperative to increase access to treatment for women who have cervical cancer, particularly in earlier stages of disease, when it is still curable. Resources for multimodality treatment can be limited—or even absent—in many less-developed regions of the world and may be associated with geographic, social, and financial barriers for the patient. However, there is evidence that, in many cases, less-invasive and less–resource-intensive treatment options are still effective. To this end, the National Comprehensive Cancer Network and American Society of Clinical Oncology have published guideline adaptations for specific resource constraints, and research about more conservative approaches to the treatment of cervical cancer continues. This review focuses on potential barriers and challenges to provision of safe and effective treatment of early-stage cervical cancer in lower-resource settings, and it suggests future directions for expansion of access to cervical cancer treatment around the world.
Akt3 is responsible for the survival and proliferation of embryonic stem cells
Authors: Wang Ling , Huang Delun , Jiang Zongliang , Luo Yan , Norris Carol , Zhang Ming , Tian Xiuchun , Tang Young
Published: May 2017

The phosphatidylinositol 3-kinase (PI3K)/protein kinase B (PKB/Akt) pathway plays an important role in regulating cell proliferation, metabolism, and survival. However, the distinct roles of Akt isoforms – Akt1, Akt2, and Akt3 in pluripotent stem cell maintenance are not fully defined. Using mouse embryonic stem cells (ESCs), we show that direct inhibition of Akt activity leads to ESC apoptosis. The Akt3, but not Akt1 or Akt2 activity specifically regulates this effect. Inhibiting Akt3 also leads to a cell cycle arrest at G1 phase. These regulatory roles of Akt3 are dependent on its kinase-activity. Blocking the expression of Akt1 plus Akt2 in ESCs does not affect cell survival or proliferation, although blocking Akt1 aggravates the apoptotic effect induced by depletion of Akt3. We further show that blocking Akt3 in ESCs results in significant nuclear accumulation of p53, as well as the activation of its downstream targets, such as Mdm2, p21, and Fas. Inhibiting p53 and its downstream targets partially rescued the effects caused by Akt3-depletion. Our results revealed an Akt3 isoform-specific mechanism for ESC survival and proliferation involving the control of p53 activity.
Imaging of viral neuroinvasion in the zebrafish reveals that Sindbis and chikungunya viruses favour different entry routes
Authors: Passoni Gabriella , Langevin Christelle , Palha Nuno , Mounce Bryan C. , Briolat Valérie , Affaticati Pierre , De Job Elodie , Joly Jean-Stéphane , Vignuzzi Marco , Saleh Maria-Carla , Herbomel Philippe , Boudinot Pierre , Levraud Jean-Pierre
Published: May 2017

Alphaviruses, such as chikungunya (CHIKV) and Sindbis virus (SINV), are vector‑borne pathogens that cause acute illnesses in humans and are sometimes associated with neuropathies, especially in infants and elderly patients. Little is known about their entry mechanism in the central nervous system (CNS), even for SINV, which has been used extensively as a model for viral encephalopathies. We previously established a CHIKV infection model in the optically transparent zebrafish larva; here we describe a new SINV infection model in this host. We imaged in vivo the onset and the progression of the infection caused by intravenous SINV inoculation. Similar to that described for CHIKV, infection in the periphery was detected early and was transient, while CNS infection started at later time points and was persistent or progressive. We then tested the possible mechanisms of neuroinvasion by CHIKV and SINV. Neither virus relied on macrophage-mediated transport to access the CNS. CHIKV, but not SINV, always infects endothelial cells of the brain vasculature. By contrast, axonal transport was much more efficient with SINV than CHIKV, both from periphery to the CNS or between neural tissues. Thus, the preferred mechanisms of neuroinvasion by these two related viruses are distinct, providing a powerful imaging-friendly system to compare mechanisms and prevention methods of encephalopathies.
The catalytic function of cytochrome P450 is entwined with its membrane-bound nature
Authors: Barnaba Carlo , Gentry Katherine , Sumangala Nirupama , Ramamoorthy Ayyalusamy
Published: May 2017

Cytochrome P450, a family of monooxygenase enzymes, is organized as a catalytic metabolon, which requires enzymatic partners as well as environmental factors that tune its complex dynamic. P450 and its reducing counterparts—cytochrome P450-reductase and cytochrome b5—are membrane-bound proteins located in the cytosolic side of the endoplasmic reticulum. They are believed to dynamically associate to form functional complexes. Increasing experimental evidence signifies the role(s) played by both protein-protein and protein-lipid interactions in P450 catalytic function and efficiency. However, the biophysical challenges posed by their membrane-bound nature have severely limited high-resolution understanding of the molecular interfaces of these interactions. In this article, we provide an overview of the current knowledge on cytochrome P450, highlighting the environmental factors that are entwined with its metabolic function. Recent advances in structural biophysics are also discussed, setting up the bases for a new paradigm in the study of this important class of membrane-bound enzymes.
Phylogeny of the tribes Juanulloeae and Solandreae (Solanaceae)
Authors: Orejuela Andrés , Wahlert Gregory A. , Orozco Clara Inés , Barboza Gloria , Bohs Lynn
Published: May 2017

The tribe Juanulloeae is composed of seven to nine Neotropical genera of lianas and epiphytic or terrestrial shrubs that exhibit a wide variety of floral morphologies and pollination syndromes. Their commonly epiphytic habit in the forest canopy and relatively infrequent flowering has resulted in few and fragmentary specimens and has complicated taxonomic study of the tribe so that many of its genera remain poorly understood. Solandra, currently included in the monotypic tribe Solandreae, is morphologically very similar to the Juanulloeae but its phylogenetic affinities are unclear. In this study, a phylogeny of the Juanulloeae and Solandra was inferred from maximum parsimony and Bayesian analyses of nuclear and plastid DNA sequences (ITS, waxy, trnT‐trnF, rps16‐trnK). Solandra was strongly supported as sister to the Juanulloeae and the two tribes are combined here under the older name Solandreae. Many genera within the group, notably Juanulloa, Markea, and Trianaea, are not monophyletic as currently circumscribed. We review the morphological characteristics of the genera and clades in light of the phylogenetic evidence presented here and highlight the need to re‐evaluate the morphological characters used to delimit genera of the tribe. On the basis of our results, we propose to (1) broaden the circumscription of tribe Solandreae to include tribe Juanulloeae, (2) recognize nine genera in the Solandreae, including the reinstatement of Poortmannia and Hawkesiophyton, and (3) make two new species‐level combinations, propose one new species‐level synonym, and designate a lectotype for Trianaea neovisae.