bluuebunny/crossref_metadata_2025 huggingface dataset:
Between Art and Commerce: Women, Business Ownership, and the Arts and Crafts Movement*
Authors: Thomas Zoë
Published: December 2019

In art-historical works and social and cultural histories the Arts and Crafts movement is portrayed as an anti-commercial design reform movement that revolved around the workshops of a cadre of elite male ‘craftsmen’. But a confluence of elements during this era — developments in print culture; urbanization; mass consumerism; the women’s movement; reactions against industrialization; widespread interest in medievalism and domestic crafts — created an environment in which many more people became involved in the movement than is traditionally recognized. This research offers the first history of the emergence of women’s ‘artistic’ businesses across England, c.1870–1939. The article argues that the persistent focus on institutional hierarchies in histories of skilled work has led to a failure to consider the importance of rhetorical self-fashioning and the built environment in the construction of new cultural roles. Engrained disciplinary divides have also led to discrete bodies of scholarship on the history of artistic culture, ‘professional society’ and business ownership, which belie the interwoven nature of these categories in lived experience. Tracing the gendered strategies implemented by women business owners ultimately reveals their democratization of the movement to incorporate greater reception of domestic consumerism, ‘popular’ culture, and a wider range of incomes and interests.
SPOT REGION OF INTEREST IMAGING: A NOVEL FUNCTIONALITY AIMED AT X-RAY DOSE REDUCTION IN NEUROINTERVENTIONAL PROCEDURES
Authors: Borota Ljubisa , Patz Andreas
Published: December 2019

Aim of the study: The aim of this study was to describe a new functionality aimed at X-ray dose reduction, referred to as spot region of interest (Spot ROI) and to compare it with existing dose-saving functionalities, spot fluoroscopy (Spot F), and conventional collimation (CC). Material and methods: Dose area product, air kerma, and peak skin dose were measured for Spot ROI, Spot F, and CC in three different fields of view (FOVs) 20 × 20 cm, 15 × 15 cm, and 11 × 11 cm using an anthropomorphic head phantom RS-230T. The exposure sequence was 5 min of pulsed fluoroscopy (7.5 pulses per s) followed by 7× digital subtraction angiography (DSA) runs with 30 frames per DSA acquisition (3 fps × 10 s). The collimation in Spot F and CC was adjusted such that the size of the anatomical area exposed was as large as the Spot ROI area in each FOV. Results: The results for all FOVs were the following: for the fluoroscopy, all measured parameters for Spot ROI and Spot F were lower than corresponding values for CC. For DSA and DSA plus fluoroscopy, all measured parameters for Spot ROI were lower than corresponding parameters for Spot F and CC. Conclusion: Spot ROI is a promising dose-saving technology that can be applied in fluoroscopy and acquisition. The biggest benefit of Spot ROI is its ability to keep the entire FOV information always visible.
DEVELOPMENT OF A NEW SECONDARY STANDARD FOR H*(10)
Authors: Bairlein K , Behnke B , Hupe O
Published: December 2019

A secondary standard for ambient dose equivalent, H*(10), is necessary for the dissemination of the unit Sievert (Sv), but there is no such standard commercially available currently. Furthermore, the measurement of H*(10) instead of calculating H*(10) from air kerma and conversion coefficients is needed for unknown radiation fields. We developed a prototype of a new secondary standard for H*(10) based on a spherical 1 l ionization chamber for air kerma. This chamber was modified with copper wires at the inner surface to adjust the response of the chamber according to H*(10). Additionally, a Makrolon shell and an aluminium coating were added to optimize the response at energies below 50 keV. The prototype fulfils the requirements given in ISO 4037-2 in the energy range from 12 keV to 7 MeV. In combination with an electrometer, it can be used as area dosemeter, suitable for pulsed fields and for low energy radiation.
Iatrogenic Nerve Palsy Occurs With Anterior and Posterior Approaches for Humeral Shaft Fixation
Authors: Streufert Benjamin D. , Eaford India , Sellers Thomas R. , Christensen Joseph T. , Maxson Benjamin , Infante Anthony , Shah Anjan R. , Watson David T. , Sanders Roy W. , Mir Hassan R.
Published: December 2019

Objective:

To determine if surgical approach impacts the rate of nerve palsy after plate fixation of humerus shaft fractures and whether or not iatrogenic nerve palsy recovers in similar ways to preoperative palsy.

Design:

Retrospective.

Setting:

Two trauma centers.

Patients:

Patients 18+ years of age with nonpathologic, extra-articular humerus shaft fractures (OTA/AO 12A/B/C and 13A2-3) treated with plate fixation.

Intervention:

Plate fixation of humerus shaft fractures, from 2008 to 2016.

Main Outcome Measurement:

Rate of iatrogenic nerve palsy by a surgical approach and injury characteristics.

Results:

Two hundred sixty-one humeral shaft fractures were included. The rate of preoperative palsy was 19%. Radial nerve palsy (RNP) was present in 18%. Iatrogenic RNP occurred in 12.2% and iatrogenic ulnar palsy in 1.2%. Iatrogenic palsy occurred in 15.6% of middle and 15% of distal fractures, with fracture location significantly different in those developing RNP (P= 0.009). Iatrogenic RNP occurred in 7.1% of anterolateral, 11.7% of posterior triceps-splitting, and 17.9% of posterior triceps-sparing approaches (P= 0.11). Follow-up data were available for 139 patients at an average of 12 months. Preoperative RNP resolved less often than iatrogenic RNP, in 74% versus 95% (P= 0.06). Time to resolution was longer for preoperative RNP, at 5.5 versus 4.1 months (P= 0.91). Twenty-two percent with preoperative RNP underwent tendon transfer or wrist fusion, versus 0% after iatrogenic RNP (P= 0.006).

Conclusion:

Iatrogenic RNP is not uncommon with humeral fracture fixation and occurs at similar rates in anterior and posterior approaches and with midshaft and distal fractures. Iatrogenic RNP had a high rate of recovery. Preoperative RNP more often requires surgery for unresolved palsy.

Level of Evidence:

Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Chemotherapy in Esthesioneuroblastoma/Olfactory Neuroblastoma
Authors: Cranmer Lee D. , Chau Bonny , Rockhill Jason K. , Ferreira Manuel , Liao Jay J.
Published: December 2019

Objective:

Chemotherapy has been proposed as an adjunct to primary local therapy in esthesioneuroblastoma (ENB)/olfactory neuroblastoma (ON), but its role has not been precisely defined. Here, we evaluated its role in ENB treatment.

Materials and Methods:

The Surveillance Epidemiology and End Results (SEER) database was queried for ENB/ON (International Classification of Diseases-3 9522). Cases met criteria for inclusion if they were unique, had a primary location in the nasal cavity, and had adequate information for Kadish staging derivation. Univariable and multivariable Cox analyses assessed chemotherapy treatment effect on disease-specific survival (DSS) and overall survival (OS). Multiple imputation addressed missing data. A P<0.05 was designated for statistical significance.

Results:

In adjusted multivariable analyses, chemotherapy treatment was associated with inferior DSS (hazard ratio [HR], 1.74; 95% confidence interval [CI], 1.21-2.51; P=0.003) and OS (HR, 1.71; 95% CI, 1.26-2.32; P=0.001). Among the subset with local or regional disease treated with surgery and/or radiation therapy, chemotherapy remained associated with inferior outcomes DSS (HR, 2.78; 95% CI, 1.63-4.74; P<0.001) and OS (HR, 2.18; 95% CI, 1.45-3.27; P<0.001). Chemotherapy treatment misclassification did not explain these findings.

Conclusions:

This analysis does not support chemotherapy to improve either DSS or OS in primary ENB/ON treatment, after controlling for known ENB prognostic factors available from SEER. Other prognostic and treatment selection factors could exist which were not controlled in these analyses. Chemotherapy could beneficially affect outcomes other than DSS or OS. Although the concerns have been expressed regarding chemotherapy treatment misclassification in SEER, their analyses did not identify such misclassification as an explanation for our findings.
Systemic Immunostimulatory Effects of Radiation Therapy Improves the Outcomes of Patients With Advanced NSCLC Receiving Immunotherapy
Authors: D’Andrea Mark A. , Reddy G. Kesava
Published: December 2019

The understanding of localized radiation therapy’s immunostimulatory properties combined with its well-known effects on the cell cycle and insights into the immunomodulation mechanisms that occur at the molecular and cellular levels has changed our traditional view of the anticancer effects of ionizing radiation. The potential interactions between the tumor’s immune system and radiation therapy have revealed that local radiation has the ability to induce systemic antitumor responses in patients with advanced cancers. The recognition of systemic antitumor effects of radiation therapy has allowed investigators to begin uncovering the integral players in these pathways. Parallel to this, there has been progress in understanding how tumor immunology leads to the development of novel immunotherapies using immune checkpoint blockade therapies in the treatment of advanced cancers. To date there has been limited success in this benefiting only a small fraction of patients. The concept of priming the body’s immune system by radiation to make less responsive tumors more responsive to immunotherapy provides an opportunity to explore the use of the combination of radiation therapy and immunotherapy for the treatment of advanced non–small cell lung cancer and other cancers. This article provides an overview of the current state of knowledge of the clinical experience using radiation therapy in combination with immune therapy and discusses the rationale for integrating these 2 modalities in the treatment of advanced non–small cell lung cancer. Available data supports the use of radiation therapy in combination with immunotherapy to achieve improved local and systemic tumor control. Evidence from the early clinical trials has shown that using radiation therapy and immune checkpoint blockade therapies together produces a greater clinical effect than using either modality alone. To maximize the clinical benefit and successful integration of these two modalities as well as optimizing radiation therapy dosing and its schedule, improvement in its field design and the development of reliable predictors of clinical tumor response needs to be established.
TOPOGRAPHIC ANALYSIS OF PHOTORECEPTOR LOSS CORRELATED WITH DISEASE MORPHOLOGY IN NEOVASCULAR AGE-RELATED MACULAR DEGENERATION
Authors: Riedl Sophie , Cooney Lewis , Grechenig Christoph , Sadeghipour Amir , Pablik Eleonore , Seaman John W. , Waldstein Sebastian M. , Schmidt-Erfurth Ursula
Published: December 2019

Purpose:

To quantify morphologic photoreceptor integrity during anti–vascular endothelial growth factor (anti-VEGF) therapy of neovascular age-related macular degeneration and correlate these findings with disease morphology and function.

Methods:

This presents a post hoc analysis on spectral-domain optical coherence tomography data of 185 patients, acquired at baseline, Month 3, and Month 12 in a multicenter, prospective trial. Loss of the ellipsoid zone (EZ) was manually quantified in all optical coherence tomography volumes. Intraretinal cystoid fluid, subretinal fluid (SRF), and pigment epithelial detachments were automatically segmented in the full volumes using validated deep learning methods. Spatiotemporal correlation of fluid markers with EZ integrity as well as bivariate analysis between EZ integrity and best-corrected visual acuity was performed.

Results:

At baseline, EZ integrity was predominantly impaired in the fovea, showing progressive recovery during anti–vascular endothelial growth factor therapy. Topographic analysis at baseline revealed EZ integrity to be more likely intact in areas with SRF and vice versa. Moreover, we observed a correlation between EZ integrity and resolution of SRF. Foveal EZ integrity correlated with best-corrected visual acuity at all timepoints.

Conclusion:

Improvement of EZ integrity during anti-VEGF therapy of neovascular age-related macular degeneration occurred predominantly in the fovea. Photoreceptor integrity correlated with best-corrected visual acuity. Ellipsoid zone integrity was preserved in areas of SRF and showed deterioration upon SRF resolution.
Implantation of Presbyopia-Correcting Intraocular Lenses Staged After Descemet Membrane Endothelial Keratoplasty in Patients With Fuchs Dystrophy
Authors: Price Marianne O. , Pinkus Denisse , Price Francis W.
Published: December 2019

Purpose:

To assess outcomes of presbyopia-correcting intraocular lens (IOL) implantation after Descemet membrane endothelial keratoplasty (DMEK) in patients with Fuchs endothelial corneal dystrophy.

Methods:

This retrospective single-center study evaluated a consecutive series of patients with Fuchs endothelial corneal dystrophy who received presbyopia-correcting IOLs after DMEK. The main outcomes were corrected distance visual acuity, uncorrected distance visual acuity, uncorrected near visual acuity, and refractive error.

Results:

Fourteen extended depth of focus and 2 bifocal IOLs were implanted in 16 eyes of 8 patients (5 women and 3 men; age, 47–68 years). Fourteen IOLs were spherical and 2 were toric. Postoperatively, the median corrected distance visual acuity was 20/20 (range, 20/15–20/25), the median binocular uncorrected distance visual acuity was 20/25 (range, 20/15–20/25), the median binocular uncorrected near visual acuity was 20/20 (range, 20/20–20/50), and the median manifest spherical equivalent refraction was 0.05 diopters (D) (range, −0.75 to +0.75 D). Implantation of toric extended depth of focus lenses reduced refractive cylinder from 1 and 2.25 D preoperatively to 0 D in both eyes of 1 patient postoperatively. A comparison of biometry measurements taken before and after DMEK showed the median change in average keratometry was 0.26 D with a substantial range of −1.74 to +1.18 D. The median endothelial cell loss was 63 cells/mm2 (3%) after staged phacoemulsification.

Conclusions:

Favorable visual and refractive outcomes were obtained with presbyopia-correcting IOLs in patients with Fuchs dystrophy when the biometry measurements and IOL implantation were staged after DMEK had cleared the guttae and corneal edema.
The Role of Topical Azithromycin in the Treatment of Meibomian Gland Dysfunction
Authors: Ciloglu Emine , Özcan Altan Atakan , Incekalan Tugba , Unal Fikret
Published: December 2019

Purpose:

The efficacy of topical azithromycin (AZ) supplementation to systemic AZ has not been studied. This study evaluates the efficacy of topical AZ supplementation to systemic AZ, warm compresses, artificial tears, and lid scrubs for the treatment of meibomian gland dysfunction (MGD).

Methods:

Eighty-five patients with stage 4 MGD were enrolled in the study. The patients enrolled into the study were divided into 2 groups. Group 1 comprised 55 patients who received preservative-free topical 1.5% AZ administered as a unit dose, and group 2 comprised 30 patients who did not receive topical AZ. Both groups were prescribed artificial tear eye drops and systemic AZ. Fluorescein tear film breakup time (TBUT), corneal staining, Ocular Surface Disease Index (OSDI) symptom scores, and meibum quality were evaluated at baseline and after 1 and 3 months.

Results:

The mean age of patients in group 1 was 48.3 ± 13.4 years (25 men and 30 women) and in group 2 was 50.7 ± 10.2 years (12 men and 18 women). After treatment at the first and third month, group 1 showed significant improvement in mean TBUT, mean corneal staining score, meibum quality, and mean OSDI scores compared with baseline (P < 0.05). In group 2, only the OSDI score and meibum quality improved significantly after treatment compared with baseline (P < 0.05).

Conclusions:

These results demonstrate clinically and statistically greater improvement in MGD-associated signs and symptoms with the addition of topical AZ to the systemic treatment.
Modeling for Decision Making: The Case of Medical Equipment Replacement
Authors: Sherif Mona Mahmoud
Published: December 2019

Successful organizations outdecide their competitors in at least 3 ways: they make better decisions, they make decisions faster, and they implement decisions more” (E. F. Harrison. The Managerial Decision-Making Process, 1999). In the past 3 decades, Multiple Criteria Decision Aids methods and techniques were developed extensively to support managerial decision making. This article summarizes an MBA research project where multiattribute value analysis, one of the main Multiple Criteria Decision Aids techniques, was used to develop a decision model for planning equipment replacement. The project outcome is a model that can be automated and provides a budget planning tool for medical equipment replacement.
Benchmarking Comparison Between Beijing and American Hospitals
Authors: Wang Binseng , Deng Wenyan
Published: December 2019

The first clinical engineering (CE) benchmarking between Chinese and American hospitals was performed in 2014. At that time, only data from Zhejiang province were available. A new comparison was completed in 2018 with data collected from 11 hospitals from the capital city of Beijing. These data were compared with those from 270 acute care hospitals in the United States. First, comparisons were made with hospital data such as patient discharges, patient days, equipment quantity and cost, and operating costs. The CE benchmarking comparison was made in 3 categories: (a) operations, (b) finance, and (c) staffing/productivity. Within the operations category, the following metrics were compared: equipment amount/operating beds, annual repairs/equipment amount, and annual scheduled maintenance/equipment amount. Within the finance category, the following metrics were compared: total CE expense/total hospital operating expense, total CE expense/operating beds, and total CE expense/equipment cost. Within the staffing/productivity category, the following metrics were compared: total CE full-time equivalent (FTE)/equipment amount, total CE FTE/operating beds, and total CE FTE/total hospital operating expense. These comparisons showed the following: (1) Although still a bit lower than the United States, Beijing hospitals have more equipment than Zhejiang but a slightly lower amount of repairs and scheduled maintenance per equipment; (2) the total CE expense/total hospital operating expense ratio is around 1% in both Beijing and the United States, but slightly greater than in Zhejiang; however, the total CE expense/operating beds and total CE expense/equipment cost are still lower in Beijing and Zhejiang than in the United States; and (3) the CE FTE amount is lower in Beijing than in Zhejiang and closer to the United States relative to both equipment amount and total hospital operating expense, but still a bit lower than the United States relative to the number of operating beds. Some of the differences detected are likely caused by the same factors found in the previous study of Zhejiang hospitals, namely, higher length of stay in China than in the United States, lower wages and living costs in China, and different healthcare delivery methods in these countries. The differences found between Beijing and Zhejiang cannot be explained solely by inflation (~2%/year) or even higher cost of living in the capital but likely because of more equipment-intensive medical practice. Overall, these results confirm the outstanding progress and level of excellence of CE in China.
Tanshinone IIA protects mice against atherosclerotic injury by activating the TGF-β/PI3K/Akt/eNOS pathway
Authors: Wang Junyan , He Xinyong , Chen Wenna , Zhang Ni , Guo Junfu , Liu Jingjing , Zhang Lin , Sun Hongwei , Jia Lianqun , Yang Guanlin
Published: December 2019

Objective

Explored the mechanism of action of tanshinone IIA (TIIA) against atherosclerosis.

Methods

ApoE−/− mice were divided into two groups of 10: model and TIIA. A control group of 10 wild-type mice was created. ApoE−/− mice were fed a high-fat diet for 12 weeks. The TIIA group received TIIA once daily. Mice were anesthetized, blood collected by cardiac puncture, and the aortic sinus/arch collected for histology and molecular studies, respectively.

Results

Mice intima in the model group had large areas of plaque formation, serum levels of total cholesterol (TC), triglycerides, and low-density lipoprotein-cholesterol (LDL-C) increased significantly, and high-density lipoprotein-cholesterol (HDL-C) levels decreased significantly in the model group after 12 weeks. Staining [hematoxylin and eosin (H&E), Oil-Red-O] showed that the aorta had lesions, a higher degree of plaque formation, and considerable lipid deposition in model-group mice. After TIIA treatment, expression of HDL-C was increased significantly and that of TC, triglycerides and LDL-C decreased significantly, and plaque size and lipid deposition improved obviously. Analyses of protein phosphorylation in aortic tissue suggested that the transforming growth factor (TGF)-β/phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt)/endothelial nitric oxide synthase (eNOS) pathway was activated in TIIA-treated mice.

Conclusion

TIIA can lower levels of serum lipids, stabilize atherosclerotic plaques, reduce endothelial injury, and inflammatory damage by activation of the TGF-β/PI3K/Akt/eNOS pathway.
PD-1 and PD-L1 Expression in Osteosarcoma: Which Specimen to Evaluate?
Authors: Chen Sonja , Guenther Lillian M. , Aronhalt Amanda , Cardillo Lacey , Janeway Katherine A. , Church Alanna J.
Published: December 2019

There is a growing interest in immunotherapy in childhood cancers. Osteosarcoma is a compelling potential target as there are few targeted options available for this aggressive cancer. We provide a description of the landscape of programmed cell death-1 (PD-1), programmed cell death-ligand 1 (PD-L1) and relevant immune markers in serial samples from 15 osteosarcoma patients. PD-1 and PD-L1 expression was present in biopsy samples (47% and 53%, respectively), absent in resections, and present in metastases (40% and 47%). Both decalcified and nondecalcified specimens demonstrated expression of PD-1 and PD-L1. The results suggest that biopsy or metastatic specimens maybe most valuable in assessing expression of PD-1 and PD-L1.
Early Recovery of Height Velocity in Prepubertal Children With Acute Lymphoblastic Leukemia Treated by a Short Intensive Phase Without Cranial Radiation Therapy
Authors: Suenobu Souichi , Goto Hironori , Hirano Naoki , Sonoda Tomoko , Izumi Tatsuro , Ihara Kenji
Published: December 2019

Purpose:

There have been few reports on height disturbance in childhood acute lymphoblastic leukemia (ALL) patients treated without cranial radiation therapy (CRT). Our study aimed to clarify the critical period of growth in pediatric patients who were treated by the Japan Childhood Leukemia Study (JACLS) ALL-02 protocol, which involved short-term intensive treatment without CRT.

Patients and Methods:

A retrospective, cohort study was conducted for prepubertal children with B-precursor ALL who were diagnosed from July 2002 to November 2011 and treated by the JACLS ALL-02 protocol at Oita University Hospital. The heights were chronologically measured at pretreatment, after the intensive phase (INT), at the end of treatment (END), and at 1 to 5 year(s) posttreatment (POST 1 to 5).

Results:

Nine boys and 4 girls were enrolled. Z score of the height was reduced at INT and END. Delta Z scores of the height and Z score of height velocity were reduced from pretreatment to INT, and they demonstrated an early recovery during maintenance treatment in INT to END.

Conclusions:

Early recovery of delta Z scores of the height and Z score of height velocity was observed during the INT to END period. The shortened intensive phase without CRT may result in an adequate height in prepubertal ALL patients.
Adaptive and maladaptive coping strategies in older adults with chronic pain after lumbar surgery
Authors: Higuchi Daisuke
Published: December 2019

This study investigated whether adaptive and maladaptive coping strategies mediate the association between chronic pain and health-related quality of life among older adults experiencing chronic pain after lumbar surgery. Participants were 103 older adults with either or both of chronic lower back pain and leg pain after lumbar surgery (median age = 75 years, men = 44, women = 59). Intensity of chronic lower back and leg pain (11-point numerical rating scale), physical activities (Physical Activity Scale for the Elderly) as an adaptive coping strategy, maladaptive coping strategies (e.g. guarding, resting; Chronic Pain Coping Inventory), and health-related quality of life (12-item Short-Form Health Survey) were measured. Hypothetical models with adaptive and maladaptive coping strategies as mediators of pain intensity and health-related quality of life were tested using structural equation modeling. Model fitness was acceptable (adjusted goodness of fit index: 0.94–0.98, comparative fit index: 1.00, root mean square error of approximation: 0.00). The results showed that (1) the adaptive coping strategy of physical activity positively mediated the association between lower back and leg pain, and physical health but not mental and social health; (2) maladaptive coping strategies negatively mediated the association between pain and physical, mental, and social health; (3) physical activities were negatively associated with maladaptive coping strategies. This study demonstrated that adaptive and maladaptive coping strategies serve as mediators of the relationship between chronic pain and health-related quality of life in older adults after lumbar surgery.
A Pulse Check on Leadership and Teamwork
Authors: Grimsley Emily A. , Cochrane Niall H. , Keane Ryan R. , Sumner Brian D. , Mullan Paul C. , O'Connell Karen J.
Published: December 2019

Objectives

Effective leadership and teamwork are imperative during pediatric cardiopulmonary resuscitations (CPR). The initial phase of pediatric CPR, termed the “first 5 minutes,” has significant care delivery gaps in both leadership and team performance. The aim of the study was to describe the performance data of emergency department (ED) teams who performed CPR in a pediatric ED.

Methods

We conducted a retrospective video review of resuscitations involving pediatric patients younger than 21 years who presented in cardiac arrest to a tertiary pediatric ED. Descriptive statistics were used for data analysis.

Results

Twenty events met study inclusion criteria. Prearrival task completion included the following: estimated weight (90%), airway set-up (85%), epinephrine dose prepared (84%), defibrillator ready (75%), and intraosseous kit ready (50%). Median prearrival notification time was 5 minutes 34 seconds (interquartile range = 4:44–7:13) with no significant relationship between prearrival time and task completion. Within the first 5 minutes, the team leader provided a care summary in 84%, prioritized tasks in 95%, and assigned roles for airway management (90%), intravenous/intravenous access (63%), and CPR/pulse check (63%). Most critical tasks were completed within 1 minute; however, only 25% had defibrillator pads placed within the 5-minute window.

Conclusions

Our study of leadership and teamwork during the first 5 minutes of pediatric CPR care noted wide variation in team performance. Opportunities for improvements in CPR readiness can be incorporated into education and quality programs to drive improvements in the care of future pediatric patients experiencing cardiac arrest.
Mechanical Micronization of Lipoaspirates for the Treatment of Horizontal Neck Lines
Authors: Cai Junrong , Wang Jing , Hu Wansheng , Lu Feng
Published: December 2019

Background:

Horizontal neck wrinkles develop as a result of the aging process. Stromal vascular fraction (SVF) gel, which is rich in extracellular matrix and functional cells, can be produced by a series of simple mechanical processes, including intersyringe shifting and centrifugation. This study aimed to assess stromal vascular fraction gel in the treatment of horizontal neck wrinkles.

Methods:

This single-center study included female patients with horizontal neck wrinkles (Fitzpatrick types II to IV) treated with either SVF gel or botulinum toxin type A (BTX A) injection. SVF gel was first diffusely distributed subcutaneously along the neck line and then injected in a diluted way intracutaneously at points 0.5 cm apart along the horizontal lines. BTX A was injected at points 1.5 cm apart (2 U in each injection site). Satisfaction and improvement scores were compared between the two groups, and the collagen content of the neck wrinkle was compared by histologic evaluation before and after treatment.

Results:

Twenty-eight patients received SVF gel and 22 received BTX A. In patients with type II neck wrinkles, BTX A and SVF gel treatment resulted in similar improvement scores and patient satisfaction in the first 3 months. In patients with type III and IV neck wrinkles, SVF gel resulted in significantly higher improvement scores and better patient satisfaction. A longer duration of adverse events was seen in the SVF gel treatment group. Histologic assessment suggested that SVF gel increased the collagen density of neck wrinkles.

Conclusion:

SVF gel is an effective treatment for horizontal neck wrinkles, particularly in patients with type III and IV wrinkles.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, II.
Lip Reconstruction after Mohs Cancer Excision: Lessons Learned from 615 Consecutive Cases
Authors: Sanniec Kyle , Harirah Muhammad , Thornton James F.
Published: December 2019

Background:

The lips provide key functional and aesthetic features of the face. From social interactions and speech to swallowing and oral competence, a functional dynamic structure is required. This interaction with surrounding landmarks presents a challenge for reconstruction. There are a myriad of ways reported to reconstruct these defects; however, as the authors’ practice has evolved, a more refined approach was developed to optimize results and minimize the complexity of each patient’s surgery.

Methods:

A retrospective review from 2004 to 2018 was performed of consecutive patients who underwent lip reconstruction following Mohs cancer resection performed by a single surgeon. Each case was evaluated for key patient characteristics, defect location, defect size, defect composition, reconstructive modality, and complications. In addition, the evolution of treatment types over those 14 years was evaluated.

Results:

Six hundred fifteen patients underwent lip reconstruction. Defects most commonly involved the upper lateral lip, and 247 (40 percent) involved both the skin and vermillion. A significant majority of the patient’s defects were repaired using either linear closure or V-wedge excision and closure. A complication rate of 10.2 percent (n = 63) was found, ranging from oral incompetence to cancer recurrence. There was no significant difference in complication rates in patients older than 75 years, in smokers, or in patients who were on anticoagulation.

Conclusions:

The authors’ techniques have evolved from more invasive advancement and rotation flaps to a more reliable linear closure method over the past 14 years. This study shows that lip reconstruction is safe in elderly patients, smokers, and patients who are on anticoagulation.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, IV.
Reconstruction of Craniomaxillofacial Bone Defects With Customized Prosthesis of Hydroxyapatite/Epoxide Acrylate Maleic Compound Designed by Computer-Aided Technique
Authors: Xu Ye , Yan Xin , Hua Chao , Wang Shuqin , Wu Jie , Tan Qian
Published: December 2019

The purpose of this study is to evaluate the clinical technique of reconstruction of craniomaxillofacial bone defects by using hand-made customized prosthesis of hydroxyapatite (HA)/epoxide acrylate maleic (EAM) compound with computer-aided technique. Between 2008 and 2015, eleven patients underwent computed tomography, three-dimensional (3D) imaging and reconstruction surgery. These customized HA/EAM compound artificial implants were hand-made, guided by computer-aided solid 3D reconstruction models of pre-operation structures of the patients. The artificial implants had to match the bone loss area accurately and be fixed stable with titanium screws and titanium meshes. For all patients and their surgeons, the post-operative aesthetics and functionality of the prosthesis were satisfactory. Only one patient felt a prominent edge of the prosthesis, but without any discomfort. In this case, a small groove was observed through CT scan. During the follow-up period (6–87 months), none of the 11 patients experienced any other complications, nor did they need secondary operation for adjusting or removing the prosthesis. In conclusion, this reconstruction technique of craniomaxillofacial bone defects by using hand-made customized HA/EAM compound artificial implants can achieve ideal results in both appearance and functionality.
Electromagnetic Navigation in Craniofacial Surgery Based on Automatic Registration of Dental Splints
Authors: Lin Li , Gao Yuan , Chai Gang , Xu Haisong , Xie Le
Published: December 2019

Optical navigation method cannot be used in partial craniofacial surgery due to light blocking. At present, electromagnetic navigation method can be used instead. The occlusal splint obtained from the patient's dental mold is used in the traditional electromagnetic navigation registration. Then, marker points are selected manually for registration through imaging data during the operation, which leads to the deviation of selection. In this study, the self-developed registration software was used to perform automatic registration in the intraoperative registration. Experimental results showed that it has higher accuracy and faster speed, and is suitable for the actual operation process in clinical environment compared with the traditional manual registration.
Finite-Element Biomechanical-Simulated Analysis of the Nasolabial Fold
Authors: Chen Guocheng , Lu Xiaona , Yin Ningbei
Published: December 2019

Background:

Nasolabial fold (NLF) is an important anatomic sign of facial aging. However, the dynamic biomechanical relationships between the facial mimetic muscles (FMMs) and the NLF remain unclear.

Objective:

This study aimed to investigate the dynamic biomechanical relationships between the FMM and various NLF by finite-element analysis (FEA).

Methods:

The 3-dimentional computer-aided design (3D CAD) model of the skin-muscle-maxillofacial bone in the NLF was established by using the engineering design module of the Computer-Aided 3-dimensional Interactive Application (CATIA) software. This CAD model was then imported into the Hypermesh software to set element type, mesh, and material properties. Finally, the 3D FEA model of the skin-muscle-maxillofacial bone in the NLF was generated, and then exported and uploaded into the Abaqus software with HM format for mechanical force loading and biomechanical analysis.

Results:

A 3D FEA model of the skin-muscle-maxillofacial bone in the NLF was successfully established by using the Mimics, Geomagic Studio, CATIA, Hypermesh, and Abaqus softwares. This FEA model had a good geometrical resemblance and good biomechanical properties. This provided an ideal biomechanical model for the study of deformation and the biomechanics of soft tissues, such as the NLF. The FEA was applied to the biomechanical simulation of the NLF. We established five effective FEA models to study the dynamic biomechanical relationships between the NLF and the FMM. The dynamic biomechanical relationships between the NLF and the FMM were preliminarily determined by computer simulating different types of mechanical force loadings.

Conclusion:

The FEA is an effective method to simulate the dynamic biomechanical relationships between the NLF and the FMM. Through the FEA simulation described in this study, we could preliminarily conclude that the formation of different types of NLF is mainly due to the coordinated contraction of various FMM. Moreover, not all FMM are involved in all types of NLF. According to the results of the FEA simulations in this study, it is worthwhile considering investigating the role of botulinum toxin in improving the morphology of the NLF in the near future.
Renal Arteriovenous Fistula in a Renal Transplant Recipient: A Case Report and Literature Review
Authors: Schwing Justine , Piveteau Arthur , Ernandez Thomas , Hansen-Pham Catrina , Toso Christian , Hadaya Karine
Published: December 2019

Background.

Renal arteriovenous fistula (rAVF) is a rare complication after a total nephrectomy, with only 72 cases reported in the last literature review published in 1997. AVF has never been described in a renal transplant recipient, and the possible consequences of hemodetournement on the graft function are unknown.

Methods.

We hereby reported the first case of rAVF occurring in a renal transplant recipient and analyzed all cases of postnephrectomy rAVF reported between 1997 and 2017.

Results.

A 75-year-old woman who underwent a right nephrectomy and kidney transplant 16 years earlier, and complaining of mild exercise dyspnea, was discovered with a lumbar continuous murmur. Echocardiography showed a moderate to severe dilatation of the left ventricle, with a decreased ejection fraction. Serum creatinine was slightly raised but returned to normal value with hydration. An injected computed tomography scan demonstrated a communication between the stump of the right renal artery and inferior vena cava. Total occlusion of the rAVF was obtained with Amplatzer plug and coils placed in the distal renal stump, just upstream of rAVF. Exercise dyspnea disappeared immediately, and regression of left ventricular dilatation was objectified at 6-month echocardiography follow-up.

Conclusions.

Postnephrectomy rAVF is rare, frequently diagnosed late, and may be responsible for high-output heart failure by left-to-right shunt, with abdominal/lumbar bruit being the only manifestation. Renal complications concern 15% of the patients. Endovascular procedure is nowadays the treatment of choice. Occluding rAVF permits cardiac hemodynamic features and heart failure symptoms resolution.
Does 5-HTTLPR moderate the effect of the quality of environmental context on maternal sensitivity? Testing the differential susceptibility hypothesis
Authors: Baião Rita , Fearon Pasco , Belsky Jay , Teixeira Pedro , Soares Isabel , Mesquita Ana
Published: December 2019

Evidence documenting associations between 5-HTTLPR and parenting behavior led to testing the hypothesis that this polymorphism moderates the effect of the quality of environmental context on maternal sensitivity. Participants were 210 Portuguese mothers and their preschool children, recruited from the community. An index reflecting the quality of the environmental context was derived based on nine markers (e.g. single parenthood; parental education, economic difficulties, family conflict, maternal psychopathology). Maternal sensitivity was measured observationally. Maternal saliva was collected with OraGene kits for genetic analysis. Results revealed a gene-X-environment interaction, such that short-allele homozygotes proved more sensitive to the family context than long-allele carriers (i.e. sL/LL), displaying the highest and lowest levels of maternal sensitivity, depending on, respectively, low and high quality levels of the environmental context. Because even mothers carrying the long allele evinced similar responsiveness to the environmental context, but to a lesser extent, findings proved consistent with the weak differential susceptibility model of person-X-context interaction. Results are discussed in light of prior and related gene-X-environment findings.
The effects of aversive-to-appetitive counterconditioning on implicit and explicit fear memory
Authors: Keller Nicole E. , Dunsmoor Joseph E.
Published: December 2019

Counterconditioning (CC) is a form of retroactive interference that inhibits expression of learned behavior. But similar to extinction, CC can be a fairly weak and impermanent form of interference, and the original behavior is prone to relapse. Research on CC is limited, especially in humans, but prior studies suggest it is more effective than extinction at modifying some behaviors (e.g., preference or valence ratings) than others (e.g., physiological arousal). Here, we used a within-subjects design to compare the effects of aversive-to-appetitive CC versus standard extinction on two separate tests of long-term memory in human adults: implicit physiological arousal and explicit episodic memory. Participants underwent Pavlovian fear conditioning to two semantic categories (animals, tools) paired with an electric shock. Conditioned stimuli (i.e., category exemplars) from one category were then extinguished, while stimuli from the other category were paired with a positive outcome. Participants returned 24-h later for a test of skin conductance responses (SCR) to the conditioned exemplars, as well as a surprise recognition memory test for stimuli encoded the previous day. Results showed reduced SCRs at a test for unique stimuli from a category that had undergone CC, relative to stimuli from a category that had undergone standard extinction. Additionally, participants selectively remembered more stimuli encoded during CC than extinction. These results provide new evidence that aversive-to-appetitive CC, as compared to extinction, strengthens memory for items directly associated with a positive outcome, which may provide stronger retrieval competition against a fear memory at test to help diminish fear relapse.
Rising cost of labor and transformations in grain production in China
Authors: Tian Xu , Yi Fujin , Yu Xiaohua
Published: December 2019

Purpose

The purpose of this paper is to investigate Chinese farmers’ adaptation behavior in the context of the rising cost of labor in agriculture. As the cost of labor increases, farmers will either reallocate their budget to different inputs or change the structure of agricultural production to maximize profit.

Design/methodology/approach

The Rural Fixed Point Observation data set between 2004 and 2010 is employed in the empirical analysis of this study. Both the compensated and uncompensated demand elasticities with respect to wages are estimated by adopting the translog cost function and the profit function.

Findings

The results show that labor input will drop down significantly as a response to rising wages. Land, fertilizer and intermediate inputs are net complements of labor, whereas machinery appears to be net substitute for labor. In addition, the authors also separate the expansion effect from the substitution effect and find that farmers will shift to grain production with intensive use of fertilizer and from wheat and corn to rice as a response to the rising cost of labor.

Originality/value

This study adopts the classical household model to incorporate various adaptation behaviors of farmers into one framework and decomposes the total effect of the rising cost of labor on input demand into an expansion effect and a substitution effect, which provides a better understanding of farmers’ adaptation behavior.
Networks of complicity: social networks and sex harassment
Authors: Cunningham Peggy , Drumwright Minette E. , Foster Kenneth William
Published: December 2019

Purpose

The purpose of this paper is to explore the question of why sex harassment persists in organizations for prolonged periods – often as an open secret.

Design/methodology/approach

In-depth interviews were conducted with 28 people in diverse organizations experiencing persistent sex harassment. Data were analyzed using standard qualitative methods.

Findings

The overarching finding was that perpetrators were embedded in networks of complicity that were central to explaining the persistence of sex harassment in organizations. By using power and manipulating information, perpetrators built networks that protected them from sanction and enabled their behavior to continue unchecked. Networks of complicity metastasized and caused lasting harm to victims, other employees and the organization as a whole.

Research limitations/implications

The authors used broad, open-ended questions and guided introspection to guard against the tendency to ask for information to confirm their assumptions, and the authors analyzed the data independently to mitigate subjectivity and establish reliability.

Practical implications

To stop persistent sex harassment, not only must perpetrators be removed, but formal and informal ties among network of complicity members must also be weakened or broken, and victims must be integrated into networks of support. Bystanders must be trained and activated to take positive action, and power must be diffused through egalitarian leadership.

Social implications

Understanding the power of networks in enabling perpetrators to persist in their destructive behavior is another step in countering sex harassment.

Originality/value

Social network theory has rarely been used to understand sex harassment or why it persists.
“Not our class darling”: networking – privilege or penalty in large hotels?
Authors: Ryan Irene , Mooney Shelagh Karin
Published: December 2019

Purpose

The purpose of this paper is to show how the social categories of gender, age and class influence networking practices and career progression in the 4–5-star hotel sector in Australia and New Zealand. It argues that in this type of workplace the practice of networking is so normalized that it is assumed an inclusive, gender-neutral activity.

Design/methodology/approach

This paper draws on 18 semi-structured interviews. Inductive analysis was used uncover themes, sub-themes and emergent patterns. An intersectionally sensitive approach was followed.

Findings

The significance of networking processes for career progression in the 4–5-star hotel sectors was a recurring theme. Networking reflects historically embedded gendering practices that heighten existing class-based structural privilege for groups of men.

Research limitations/implications

The focus is on hotel employees in Australia and New Zealand with the findings are not implicitly generalizable.

Practical implications

Networks are important for women as their “merit” may not be immediately visible. Well-structured mentoring schemes need to be adopted as part of the affirmative action required to tilt the “skewed playing field”.

Originality/value

Studies that indicate how the gendering of networking practices reinforce career privilege and penalty in specific organizations have been lacking, as have studies favouring an intersectional approach. This study seeks to redress these omissions.