bluuebunny/crossref_metadata_2025 huggingface dataset:
Responsiveness of the Electrically Stimulated Cochlear Nerve in Children With Cochlear Nerve Deficiency
Authors: He Shuman , Shahsavarani Bahar S. , McFayden Tyler C. , Wang Haibo , Gill Katherine E. , Xu Lei , Chao Xiuhua , Luo Jianfen , Wang Ruijie , He Nancy
Published: July 2017

Objectives:

This study aimed to (1) investigate the responsiveness of the cochlear nerve (CN) to a single biphasic-electrical pulse in implanted children with cochlear nerve deficiency (CND) and (2) compare their results with those measured in implanted children with normal-size CNs.

Design:

Participants included 23 children with CND (CND1 to CND23) and 18 children with normal-size CNs (S1 to S18). All subjects except for CND1 used Cochlear Nucleus cochlear implants with contour electrode arrays in their test ears. CND1 was implanted with a Cochlear Nucleus Freedom cochlear implant with a straight electrode array in the test ear. For each subject, the CN input/output (I/O) function and the refractory recovery function were measured using electrophysiological measures of the electrically evoked compound action potential (eCAP) at multiple electrode sites across the electrode array. Dependent variables included eCAP threshold, the maximum eCAP amplitude, slope of the I/O function, and time-constants of the refractory recovery function. Slopes of I/O functions were estimated using statistical modeling with a sigmoidal function. Recovery time-constants, including measures of the absolute refractory period and the relative refractory period, were estimated using statistical modeling with an exponential decay function. Generalized linear mixed-effect models were used to evaluate the effects of electrode site on the dependent variables measured in children with CND and to compare results of these dependent variables between subject groups.

Results:

The eCAP was recorded at all test electrodes in children with normal-size CNs. In contrast, the eCAP could not be recorded at any electrode site in 4 children with CND. For all other children with CND, the percentage of electrodes with measurable eCAPs decreased as the stimulating site moved in a basal-to-apical direction. For children with CND, the stimulating site had a significant effect on the slope of the I/O functions and the relative refractory period but showed no significant effect on eCAP threshold and the maximum eCAP amplitude. Children with CND had significantly higher eCAP thresholds, smaller maximum eCAP amplitudes, flatter slopes of I/O functions, and longer absolute refractory periods than children with normal-size CNs. There was no significant difference in the relative refractory period measured in these two subject groups.

Conclusions:

In children with CND, the functional status of the CN varied along the length of the cochlea. Compared with children with normal-size CNs, children with CND showed reduced CN responsiveness to electrical stimuli. The prolonged CN absolute refractory period in children with CND might account for, at least partially, the observed benefit of using relatively slow pulse rate in these patients.
Prosthesis and Hybrid Strategy Consideration for Treating Two-level Cervical Disc Degeneration in Hybrid Surgery
Authors: Li Yang , Fogel Guy R. , Liao Zhenhua , Tyagi Rajnesh , Liu Weiqiang
Published: July 2017

Study Design.

Biomechanical analysis using a validated nonlinear finite element (FE) model.

Objective.

The aim of this study was to combine the strategy of two-level hybrid surgery (HS) to explore how prostheses affect cervical biomechanics.

Summary of Background Data.

Few FE studies have explored differences in biomechanical behavior between combined and stand-alone structured prostheses with HS. No FE studies have considered whether the prosthesis type and hybrid strategy influence two-level HS.

Methods.

Three prostheses—Prodisc-C, PCM, and DCI—were analyzed in flexion and extension during HS at C4-C6. There were two HS constructs: anterior cervical discectomy and fusion (ACDF) conducted at the C4-C5 levels and anterior cervical disc replacement (ACDR) conducted at C5-C6 levels (ACDF/ACDR); ACDR/ACDF.

Results.

Flexion motion at adjacent levels was greater than that of intact spine. A maximum increase of 80% was observed with PCM in the ACDF/ACDR group. Extension motion at adjacent levels for both hybrid strategies with PCM, however, was similar to that of intact spine (<10% change), whereas it increased by 14% to 32% with DCI. The strain energy-storing capability with DCI tended to be similar to that of normal discs. Facet stress at the infra-adjacent level, however, significantly increased with DCI in both groups, whereas it increased with PCM and Prodisc-C only in the ACDR/ACDF group. All prostheses produced overloads on cartilage at the arthroplasty level. Prodisc-C and PCM cores showed stress above the yield stress of ultrahigh-molecular-weight polyethylene.

Conclusion.

Each prosthesis had advantages and disadvantages. In extension, DCI (vs. Prodisc-C and PCM) exhibited more compensation at adjacent levels in terms of motion, moments, and facet stress. The biomechanical performance of Prodisc-C was easily affected by the hybrid strategy. Thus, if only a combined-structure prosthesis is available for two-level HS (C4-C6 level), the hybrid strategy should be carefully evaluated and the ACDF/ACDR construct is recommended to avoid accelerating degeneration of adjacent segments.

Level of Evidence: 5
The Role of Minimally Invasive Vertebral Body Stent on Reduction of the Deflation Effect After Kyphoplasty
Authors: Wang Dalin , Zheng Shengnai , Liu An , Xu Jie , Du Xiaotao , Wang Yijin , Wang Liming
Published: July 2017

Study Design.

Biomechanical investigation using cadaver spines.

Objective.

The aim of the present study was to assess the magnitude of the deflation effect after balloon kyphoplasty (BKP) or use of minimally invasive vertebral body stent (MIVBS) in in vitro biomechanical condition.

Summary of Background Data.

BKP is a well-established minimally invasive treatment option for osteoporotic vertebral compression fractures. However, this technique can lead to a secondary height loss—known as the “deflation effect”—causing intrasegmental kyphosis and an overall alignment failure.

Methods.

The study was conducted on 24 human cadaveric vertebral bodies (T12-L5). After creating a compression fracture model, the fractured vertebral bodies were reduced by BKP (n = 12) or by MIVBS (n = 12) and then augmented with polymethyl methacrylate bone cement. Each step of the procedure was performed under fluoroscopic guidance and the results were analyzed quantitatively. Finally, the strength and stiffness of augmented vertebral bodies were measured by biomechanical tests.

Results.

Complete initial reduction of the fractured vertebral body height was achieved by both systems. Secondary loss of reduction after balloon deflation was significantly greater in the BKP group (2.36 ± 0.63 mm vs. 0.34 ± 0.43 mm in the MIVBS group; P < 0.05). Height gain was significantly higher in the MIVBS group (77.68% ± 11.46% vs. 34.87% ± 13.16% in the BKP group; P < 0.05). Increase in the kyphotic angle gain (relative to the preoperative kyphotic angle) was significantly more in the MIVBS group (95.60% ± 6.12% vs. 77.0% ± 4.94% in the BKP group; P < 0.05). Failure load was significantly higher in the MIVBS group (189% ± 16% vs. 146% ± 14%; P < 0.05). However, stiffness was not significantly different between the two groups.

Conclusion.

The deflation effect after BKP can be significantly decreased with the use of the MIVBS technique.

Level of Evidence: N/A
Intervertebral Disc Degeneration During Postoperative Follow-up More Than 10 Years After Corrective Surgery in Idiopathic Scoliosis
Authors: Nohara Ayato , Kawakami Noriaki , Tsuji Taichi , Ohara Tetsuya , Saito Toshiki , Kawakami Kazuki
Published: July 2017

Study Design.

A retrospective comparative study.

Objective.

The aim of this study was to evaluate the difference in trends of disc degeneration (DD) at lower unfused segments (LUS) for postoperative patients who have gone through spinal instrumentation at 10-year follow-up with the natural progression of idiopathic scoliosis.

Summary of Background Data.

Studies that used magnetic resonance imaging (MRI) state that DD rates at LUS are higher than in the normal population. However, current studies do not prove that surgery is the most effective clinical method to treat idiopathic scoliosis, as no existing report compares the rates of DD with the natural history of idiopathic scoliosis.

Methods.

Female patients diagnosed of scoliosis were divided into three groups: 1) surgical group: postoperative 10-year patients with severe scoliosis before operation; 2) mild scoliosis group: with comparatively equal scoliosis to postoperative patients of the same age at 10 years follow-up; 3) severe scoliosis group: without any record of corrective surgery under the assumption that the scoliosis of the surgical group have progressed according to natural history.

Results.

MRI findings of the surgical group show DD in 32 patients (62.7%) where the highest rate of DD occurred at L5/S. In the mild scoliosis group, 21 patients (47.7%) had DD, with higher rates at L4/5 and L5/S. DD was most common in L3/4 and L4/5 in the severe scoliosis group where 27 patients (81.8%) had DD. As such, DD rates were significantly higher in the severe scoliosis group than the surgical group at the same spinal level. The same was true for the existence of low back pain, where the severe scoliosis group had greater incidence of low back pain than the surgical group.

Conclusion.

Corrective surgeries were able to reduce the incidence of DD. Radiological analysis also suggests that surgical intervention is a clinically feasible treatment for idiopathic scoliosis patients.

Level of Evidence: 3
Therapeutic oncolytic viruses: clinical advances and future directions
Authors: Warner Susanne G. , O’Leary Michael P. , Fong Yuman
Published: July 2017

Purpose of review

The present review will highlight recent advances in the clinical application of oncolytic viral therapy.

Recent findings

Until recently, oncolytic viral researchers saw the immune system as an enemy that would clear the virus from the bloodstream. However, researchers now understand that sustained responses are seen in those patients with more robust antitumor immune responses. Much of the current focus in oncolytic viral research is trained on manipulation of the immune system to affect cancer cell killing in the tumor microenvironment and to facilitate durable systemic antitumor immunity. Many investigators have demonstrated synergistic effects of checkpoint inhibition and other immune therapies with viral administration. At the same time, insertion of various markers enables noninvasive deep tissue imaging. Finally, following regulatory approval in the United States and Europe, unbridled clinical use of T-VEC for patients with metastatic melanoma is also generating large volumes of patient data that will help elucidate strengths and weaknesses of oncolytic viral therapy. Perhaps the most telling sign of the field's future is a seismic shift in clinical trials with more investigators combining virus and immunotherapies.

This article reviews the current state of therapeutic oncolytic viruses in clinical use, and explores future directions of the field.
Tar, nicotine and carbon monoxide yield of UK cigarettes and the risk of non-muscle-invasive and muscle-invasive bladder cancer
Authors: van Osch Frits H.M. , Pauwels Charlotte G.G.M. , Jochems Sylvia H.J. , Fayokun Ranti , James Nicholas D. , Wallace D. Michael A. , Cheng Kar-keung , Bryan Richard T. , van Schooten Frederik J. , Zeegers Maurice P.
Published: July 2017

Cigarette smoking is a major risk factor for bladder cancer (BC); however, the impact of cigarette content remains unclear. This study aims to investigate tar, nicotine and carbon monoxide (TNCO) yields of different filtered cigarettes in relation to BC risk. From the Bladder Cancer Prognosis Programme 575 non-muscle-invasive bladder cancer (NMIBC) cases, 139 muscle-invasive bladder cancer (MIBC) cases and 130 BC-free controls with retrospective data on smoking behaviour and cigarette brand were identified. Independently measured TNCO yields of cigarettes sold in the UK were obtained through the UK Department of Health and merged with the Bladder Cancer Prognosis Programme dataset to estimate the daily intake of TNCO. BC risk increased by TNCO intake category for NMIBC cases (P <0.050 in all multivariate models), but only for the daily intake of tar for MIBC cases (P=0.046) in multivariate models. No difference in risk was observed between smokers of low-tar/low-nicotine and high-tar/high-nicotine cigarettes compared with never smokers, either for NMIBC (P=0.544) or MIBC (P=0.449). High daily intake of TNCO additionally increases the risk of both NMIBC and MIBC compared with low daily intake. However, as there is no difference in BC risk between low-tar/low-nicotine and high-tar/high-nicotine cigarette smokers, it remains unclear whether smoking behaviour or TNCO yield of cigarettes explains this association.
Resveratrol Ameliorates Cardiac Dysfunction by Inhibiting Apoptosis via the PI3K/Akt/FoxO3a Pathway in a Rat Model of Diabetic Cardiomyopathy
Authors: Wu Zhiye , Huang Anqing , Yan Jianyun , Liu Bei , Liu Qicai , Zhang Jianwu , Zhang Xiuli , Ou Caiwen , Chen Minsheng
Published: July 2017

The aim of this study was to explore the effect and mechanism of action of resveratrol (RSV) on cardiac function in diabetic cardiomyopathy (DCM). Hyperglycemia-induced apoptosis contributes to the pathogenic changes in DCM. RSV treatment inhibited high glucose–induced apoptosis of neonatal rat ventricular myocytes. Additionally, high glucose decreased cell viability, prevented serine–threonine kinase (Akt) and FoxO3a phosphorylation, and suppressed cytoplasmic translocation of FoxO3a. However, these effects of apoptosis were reversed by 10 μM of RSV. The PI3K inhibitor LY294002 abolished the RSV protective effect in vitro. RSV (5 or 50 mg·kg−1·d−1 orally for 8 weeks) prevented the deterioration of cardiac function and structural cardiomyopathy in a streptozotocin-induced rat model of diabetes and reduced apoptosis in diabetic myocardium. Furthermore, it restored streptozotocin-impaired phosphorylation of Akt and FoxO3a (p-Akt and p-FoxO3a) and suppressed nuclear translocation of FoxO3a in vivo. Together, these data indicate that RSV has therapeutic potential against DCM by inhibiting apoptosis via the PI3K/Akt/FoxO3a pathway.
Pelvic denervation procedures for dysmenorrhea
Authors: Ramirez Christina , Donnellan Nicole
Published: July 2017

Purpose of review

Chronic pelvic pain and dysmenorrhea are common conditions affecting reproductive-age women. Surgical pelvic denervation procedures may be a treatment option for women with midline dysmenorrhea, in which medical management is declined by the patient, ineffective at managing symptoms, or medically contraindicated. This review describes the surgical techniques and complications associated with pelvic denervation procedures as well as the current evidence for these procedures in women with primary dysmenorrhea and dysmenorrhea secondary to endometriosis.

Recent findings

Presacral neurectomy is the preferred pelvic denervation procedure in patients with primary dysmenorrhea and midline chronic pelvic pain associated with endometriosis. In patients with endometriosis presacral neurectomy is a useful adjunct to excision or ablation of all endometrial lesions to improve postoperative pain relief. There is no additional patient benefit of performing combined presacral neurectomy and uterine nerve ablation procedures.

Pelvic denervation procedures can be performed safely and quickly with a low risk of complication if the surgeon is knowledgeable and skilled in operating in the presacral space. Patients should be adequately counseled on expected success rates and potential complications associated with pelvic denervation procedures.
Salvage of Infected Nasal Reconstruction with a Polymethyl Methacrylate Spacer
Authors: Cavadas Pedro C. , Thione Alessandro , Pacheco Yvan D.
Published: July 2017

Total nasal reconstruction is a challenging multistage procedure. Infections can destroy the cartilage framework and seriously compromise the result. The use of polymethyl methacrylate with antibiotics as a spacer has been described in the treatment of skeletal infections. Using this same principle, the use of a polymethyl methacrylate with antibiotics spacer for an infected nasal reconstruction is reported in a clinical case.
Hearing health access in developing countries
Authors: Harris Michael S. , Dodson Edward E.
Published: July 2017

Purpose of review

The developing world carries a disproportionate burden of hearing loss. Individuals with hearing loss in austere settings worldwide are also potentially impacted by their impairment to a greater extent owing to underdeveloped or nonexistent hearing health infrastructure. The purpose of this review is to examine the state of the literature on hearing health access in developing countries and identify areas for improvement.

Recent findings

Over the last 10 years progress has been made in some areas, whereas other aspects of hearing health in developing countries have changed very little. There has been expansion of efforts to train primary care and local hearing healthcare providers to recognize and appropriately treat preventable causes of hearing loss in the developing world. Applications of telehealth to connect providers and patients in rural locales have grown. Adaptions of newborn hearing screening programs that better fit local resources and customs have been reported. There has been a considerable increase in interest, including cost–benefit analyses, with regard to the use of cochlear implants in the developing world.

In spite of progress, the developing world still shoulders a disproportionate amount of the world's hearing loss, in particular chronic ear disease, and there is a paucity of well trained local hearing healthcare professionals to deal with the challenge. The role of international humanitarian efforts, telemedicine, and education is highlighted.
Surgical Feeding Tubes in Pediatric and Adolescent Cancer Patients: A Single-institution Retrospective Review
Authors: Hamilton Emma C. , Curtin Thomas , Slack Rebecca S. , Ge Christine , Slade Austen D. , Hayes-Jordan Andrea , Lally Kevin P. , Austin Mary T.
Published: July 2017

The purpose of our study was to evaluate surgical enteric access in pediatric cancer patients to determine factors associated with postoperative complications. We performed a single-institution retrospective review of all patients below 21 years old with a primary cancer diagnosis who underwent surgical procedures for enteral access between 2004 and 2014. Multivariate logistic regression was performed to determine independent predictors of postoperative complications. During the study period, 122 patients had surgically placed feeding tubes, of whom 58% developed ≥1 complication(s) and 16% experienced a major complication. No single factor was significantly associated with developing any complication or major complication. Several trends were noted including increased complications associated with jejunostomy tubes, percutaneous endoscopic gastrostomy tubes, and abdominal radiation. Surgically placed enteric access in pediatric and adolescent cancer patients is associated with an extremely high complication rate emphasizing the importance of careful evaluation of these patients before embarking on surgical feeding access. Future work should evaluate mechanisms to decrease complications and/or explore alternative methods to provide supplemental nutrition in children and adolescents with cancer.
Leader Influence, the Professional Practice Environment, and Nurse Engagement in Essential Nursing Practice
Authors: Ducharme Maria P. , Bernhardt Jean M. , Padula Cynthia A. , Adams Jeffrey M.
Published: July 2017

OBJECTIVE

The purpose of this study was to examine relationships between leaders’ perceived influence over professional practice environments (PPEs) and clinical nurses’ reported engagement in essential professional nursing practice.

BACKGROUND

There is little empirical evidence identifying impact of nurse leader influence or why nursing leaders are not perceived, nor do they perceive themselves, as influential in healthcare decision making.

METHODS

A nonexperimental method of prediction was used to examine relationships between engagement in professional practice, measured by Essentials of Magnetism II (EOMII) tool, and nurse leaders' perceived influence, measured by Leadership Influence over Professional Practice Environment Scale (LIPPES). A convenience sample of 30 nurse leaders and 169 clinical nurses, employed in a 247-bed acute care Magnet® hospital, participated.

RESULTS

Findings indicated that leaders perceived their influence presence from “often” to “always,” with mean scores of 3.02 to 3.70 on a 4-point Likert scale, with the lowest subscale as “access to resources” for which a significant relationship was found with clinical nurses’ reported presence of adequate staffing (P < .004). Clinical nurses reported more positive perceptions in adequacy of staffing on the EOMII when nurse leaders perceived themselves to be more influential, as measured by the LIPPES, in collegial administrative approach (P = .014), authority (P = .001), access to resources (P = .004), and leadership expectations of staff (P = .039). Relationships were seen in the outcome measure of the EOMII scale, nurse-assessed quality of patient care (NAQC), where nurse leaders’ perception of their authority (P = .003) and access to resources (P = .022) positively impacted and was predictive of NAQC.

CONCLUSIONS

Findings support assertion that nurse leaders are integral in enhancing PPEs and their influence links structures necessary for an environment that supports outcomes.
Cross-continuum Care Continuity
Authors: Boston-Fleischhauer Carol , Rose Robert , Hartwig Laurie
Published: July 2017

As healthcare systems continue to design care models responsive to payment changes and the assumption of clinical and financial risk, the need exists for a comprehensive approach to address cross-continuum care transitions. This article will highlight key learnings from the Nurse Executive Center’s research on achieving care continuity. The business case for developing a cross-continuum care transition strategy will be discussed, as well as systemic enablers for the achievement of seamless care. A case study example of 1 system’s solution for supporting the multiple comorbid patient population as part of its cross-continuum care transition strategy will be examined.
Fatal Self-Poisoning With Massive Propranolol Ingestion in a Young Male Physician
Authors: Srettabunjong Supawon
Published: July 2017

Suicidal intoxication from massive propranolol ingestion is rare. Surprisingly, no reported cases have involved physicians. The author herein reports a case of self-poisoning death due to ingestion of propranolol by a young male physician. A 31-year-old man with major depressive disorder was found dead in his dormitory room. Fifteen empty packages, each having contained ten 40-mg propranolol tablets, were found without any tablets leftover in his room. A suicide note was also found in his room. He was thus alleged to have ingested 6 g of propranolol for self-poisoning. Autopsy findings revealed approximately 150 mL of pink fluid with some partially dissolved pink tablets in the stomach. No anatomic cause of death was found, except for mild dilatation of cerebral ventricles. Toxicologic analysis revealed propranolol in his blood and gastric contents. The cause of death was attributed to acute cardiac arrest due to severe acute propranolol intoxication from self-poisoning caused by major depressive disorder possibly secondary to organic brain syndrome.
Liver Metastases From Renal Oncocytoma With Vascular Extension
Authors: Cacciamani Giovanni , Cima Luca , Ficial Miriam , Novella Giovanni , Siracusano Salvatore , Tedeschi Umberto , Balzarro Matteo , Montin Umberto , Cerruto Maria A. , De Marco Vincenzo , Porcaro Antonio B. , Hes Ondrej , D'Errico Antonia , Martignoni Guido , Ghimenton Claudio , Zaza Gianluigi , Artibani Walter , Brunelli Matteo , Eccher Albino
Published: July 2017

The 2016 World Health Organization Renal Tumor Classification defines renal oncocytoma (RO) as a benign epithelial tumor; however, malignant histopathologic features have been documented. Rare cases with metastases have been reported. We describe the case of a 62-year-old woman who was referred to the Urology Clinic for a routine work-up. Magnetic resonance imaging and computerized tomography showed a 7-cm mass in the middle and lower portions of the left kidney and 2 suspected liver metastases. The patient underwent surgery. Microscopically both renal and liver lesions presented solid, solid-nested, and microcystic architecture, composed predominantly of large eosinophilic cells without any worrisome pattern except the vascular extension. The cells were positive for S100A1, CD117, and PAX-8 and negative for CAIX, CK7, and AMACR. Fluorescence in situ hybridization showed a disomic profile for the chromosomes 1, 2, 6, 7, 10, 17. No mutation of coding sequence of the SDHB, SDHC, SDHD, VHL, and BHD genes and no loss of heterozygosity at 3p were found. The final diagnosis was “RO” according to the 2016 World Health Organization Renal Tumor Classification with “liver metastases.” This report provides a wide clinical-pathologic, immunophenotypical and molecular documentation of a RO with liver metastases.
Cross-Platform Comparison of Computer-assisted Image Analysis Quantification of In Situ mRNA Hybridization in Investigative Pathology
Authors: Holzer Timothy R. , Hanson Jeffrey C. , Wray Erin M. , Bailey Jason A. , Kennedy Kim R. , Finnegan Patrick R. , Nasir Aejaz , Credille Kelly M.
Published: July 2017

Although availability of automated platforms has proliferated, there is no standard practice for computer-assisted generation of scores for mRNA in situ hybridization (ISH) visualized by brightfield microscopic imaging on tissue sections. To address this systematically, an ISH for peptidylprolyl isomerase B (PPIB) (cyclophilin B) mRNA was optimized and applied to a tissue microarray of archival non–small cell lung carcinoma cases, and then automated image analysis for PPIB was refined across 4 commercially available software platforms. Operator experience and scoring results from ImageScope, HALO, CellMap, and Developer XD were systematically compared with each other and to manual pathologist scoring. Markup images were compared and contrasted for accuracy, the ability of the platform to identify cells, and the ease of visual assessment to determine appropriate interpretation. Comparing weighted scoring approaches using H-scores (Developer XD, ImageScope, and manual scoring) a correlation was observed (R
2 value=0.7955), and association between the remaining 2 approaches (HALO and CellMap) was of similar value. ImageScope showed the highest R
2 value in comparison with manual scoring (0.7377). Mean-difference plots showed that HALO produced the highest relative normalized values, suggesting higher relative sensitivity. ImageScope overestimated PPIB ISH signal at the high end of the range scores; however, this tendency was not observed in other platforms. HALO emerged with the highest number of favorable observations, no apparent systematic bias in score generation compared with the other methods, and potentially higher sensitivity to detect ISH. HALO may serve as a tool to empower teams of investigative pathology laboratory scientists to assist pathologists readily with quantitative scoring of ISH.
A Scoping Review of Emergency Department Discharge Instructions for Children and Adolescents With Mental Disorders
Authors: Murphy Andrea L. , Curran Janet , Newton Amanda S. , Emberly Debbie , McRae Cecilia , MacPhee Shannon
Published: July 2017

Background

Although most young people under the age of 25 years with mental health presentations to the emergency department (ED) are discharged home, several studies suggest discharge instructions are inadequate. We conducted a scoping review to characterize and map the literature, identify research gaps, and prioritize targeted areas for future reviews for ED discharge instructions for young people with mental disorders.

Methods

Our review was conducted in an iterative approach with 6 stages including identifying the research question, identifying relevant studies, study selection, data extraction, collaring and summarizing, and stakeholder engagement. We characterized the available information on discharge instruction interventions using the Behavior Change Wheel.

Results

Of the 805 potential publications screened, 25 were included for extraction. Nine of the 25 articles focused on suicide or self-harm, 6 were on mental health in general or mixed groups, and 9 focused on alcohol, tobacco, or substance use in general. Five studies included younger children (ie, less than 12 years) but ages ranged significantly among studies. Education and persuasion were intervention functions most commonly reported in publications (n = 13 and n = 12, respectively). From the policy categories, recommendations regarding service provision were most frequently made from four publications. Descriptions of theory were limited in publications.

Conclusions

The available literature regarding discharge instructions in the ED for youth with mental disorders is focused on certain content areas (eg, self injurious behaviors, substance use) with more work required in chronic mental disorders that make up a significant proportion of ED visits. Research that extends beyond education and with theoretical underpinnings to explain how and why various interventions work would be useful for clinicians, policy-makers, and other researchers.
Pediatric Emergency Department and Primary Care Provider Attitudes on Assessing Childhood Adversity
Authors: Schilling Samantha , Murray Ashlee , Mollen Cynthia J. , Wedin Tara , Fein Joel A. , Scribano Philip V.
Published: July 2017

Objective

The purpose of this study was to understand pediatric emergency department (ED) and primary care (PC) health care provider attitudes and beliefs regarding the intersection between childhood adversities and health care.

Methods

We conducted in-depth, semistructured interviews in 2 settings (ED and PC) within an urban health care system. Purposive sampling was used to balance the sample among 3 health care provider roles. Interview questions were based on a modified health beliefs model exploring the “readiness to act” among providers. Interviews were recorded, transcribed, and coded. Interviews continued until theme saturation was reached.

Results

Saturation was achieved after 26 ED and 19 PC interviews. Emergency department/primary care providers were similar in their perception of patient susceptibility to childhood adversity. Childhood mental health problems were the most frequently referenced adverse outcome, followed by poor childhood physical health. Adult health outcomes because of childhood adversity were rarely mentioned. Many providers felt that knowing about childhood adversity in the medical setting was important because it relates to provision of tangible resources. There were mixed opinions about whether or not pediatric health care providers should be identifying childhood adversities at all.

Conclusions

Although providers exhibited knowledge about childhood adversity, the perceived effect on health was only immediate and tangible. The effect of childhood adversity on lifelong health and the responsibility and potential accountability health systems have in addressing these important health determinants was not recognized by many respondents in our study. Addressing these provider perspectives will be a critical component of successful transformation toward more accountable health care delivery systems.
Methodology and Demographics of a Brief Adolescent Alcohol Screen Validation Study
Authors: Bromberg Julie R. , Spirito Anthony , Chun Thomas , Mello Michael J. , Casper T. Charles , Ahmad Fahd , Bajaj Lalit , Brown Kathleen M. , Chernick Lauren S. , Cohen Daniel M. , Fein Joel , Horeczko Tim , Levas Michael N. , McAninch Brett , Monuteaux Michael , Mull Colette C. , Grupp-Phelan Jackie , Powell Elizabeth C. , Rogers Alexander , Shenoi Rohit P. , Suffoletto Brian , Vance Cheryl , Linakis James G.
Published: July 2017

Objective

The aim of this study was to determine the psychometric properties of the National Institute on Alcohol Abuse and Alcoholism (NIAAA) 2-question alcohol screen within 16 Pediatric Emergency Care Applied Research Network pediatric emergency departments. This article describes the study methodology, sample characteristics, and baseline outcomes of the NIAAA 2-question screen.

Methods

Participants included 12- to 17-year-olds treated in one of the participating pediatric emergency departments across the United States. After enrollment, a criterion assessment battery including the NIAAA 2-question screen and other measures of alcohol, drug use, and risk behavior was self-administered by participants on a tablet computer. Two subsamples were derived from the sample. The first subsample was readministered the NIAAA 2-question screen 1 week after their initial visit to assess test-retest reliability. The second subsample is being reassessed at 12 and 24 months to examine predictive validity of the NIAAA 2-question screen.

Results

There were 4834 participants enrolled into the study who completed baseline assessments. Participants were equally distributed across sex and age. Forty-six percent of the participants identified as white, and 26% identified as black. Approximately one quarter identified as Hispanic. Using the NIAAA 2-question screen algorithm, approximately 8% were classified as low risk, 12% were classified as moderate risk, and 4% were classified as highest risk. Alcohol use was less likely to be reported by black participants, non-Hispanic participants, and those younger than 16 years.

Discussion

This study successfully recruited a large, demographically diverse sample to establish rates of the NIAAA screen risk categories across age, sex, ethnicity, and race within pediatric emergency departments.
Primary Omental Torsion in a Pediatric Patient
Authors: Madha Emad S. , Kane Timothy D. , Manole Mioara D.
Published: July 2017

Primary omental torsion is a rare cause of acute abdominal pain with a clinical presentation resembling acute appendicitis. Here, we report the case of a 7-year-old child presenting with right lower quadrant pain. Primary omental torsion was discovered upon laparoscopy, and the torsed omentum was excised without postoperative complications. Potential causes, contributing factors, diagnosis, and treatment are discussed.
Ovarian Torsion in a Pediatric Patient
Authors: Skappak Christopher , Thurston Jackie L. , Kam April J.
Published: July 2017

A previously healthy 10-year-old girl presented to the emergency department with a 1-day history of abdominal pain. She was afebrile with an elevated white blood cell count and a negative pelvic ultrasound. The pain resolved while in hospital, and the patient was discharged home. The patient returned 10 days later, and the pain now migrated from the left flank to the subumbilical region. The patient now had an elevated white blood cell count and C-reactive protein. On pelvic ultrasound, the patient had a large midline mass and a normal right ovary. The patient was taken to the operating room where she was found to have a torted and necrotic left ovary and fallopian tube, which were removed. There are few instances where pediatric ovarian torsion presents as intermittent episodes of abdominal pain. Emergency physicians should always have a high index of suspicion for ovarian torsion in any case of abdominal/pelvic pain in young girls with previous negative imaging.
Protection Against Lipopolysaccharide-Induced Immunosuppression by IgG and IgM
Authors: Kyvelidou Christiana , Sotiriou Dimitris , Zerva Ioanna , Athanassakis Irene
Published: July 2017

Lipopolysaccharide (LPS) is commonly used in murine sepsis models, which are largely associated with immunosuppression and collapse of the immune system. After adapting the LPS treatment to the needs of locally bred BALB/c mice, the present study explored the potential role of IgG and IgM in reversing LPS endotoxemia. The established protocol consisted of five daily intraperitoneal injections of 0.2 μg/g LPS, which was tolerable by half of the manipulated animals. Such a protocol allowed longer survival, necessary in the prospect of therapeutic treatment application. This treatment significantly decreased CD4+, CD8+, CD3z+, and CD19+ cells, while increasing myeloid-derived suppressor cells (MDSCs; CD11b+Gr1+), CD25+ and Foxp3+ cells. These results were accompanied by increased arginase-1 activity in spleen cell lysates and production of IL-6, TNF-α, IL-18, and C-reactive protein (CRP) in the serum. The applied LPS protocol did not alter serum procalcitonin levels. MDSCs isolated from the spleen of LPS-treated animals (LPS-MDSCs) decreased proliferation of naive T cells in coculture experiments. The application of IgG and IgM to the naive T cell/LPS-MDSCs cocultures significantly decreased CD25+, Foxp3+, and CD3z+ cells, indicating an anti-suppressive effect of immunoglobulins. The in vivo application of IgG and IgM significantly decreased the percent of CD11b+Gr1+, CD25+, Foxp3+ cells, and arginase-1 activity in the spleen of LPS-treated animals, while decreasing IL-6, TNF-α, and CRP levels in the serum, allowing survival to all animals tested. In conclusion, these results reveal a novel mode of action of IgG/IgM in LPS endotoxemia, strengthening thus the use of immunoglobulin treatment is septic patients.
Reduction in Mortality Rates of Postinjury Multiple Organ Dysfunction Syndrome: A Shifting Paradigm? A Prospective Population-Based Cohort Study
Authors: van Wessem Karlijn J.P. , Leenen Luke P.H.
Published: July 2017

Introduction:

The incidence of multiple organ dysfunction syndrome (MODS) has decreased in the last decade by improvement in trauma care. However, it still remains a major cause of morbidity and mortality. This study investigated the current incidence and mortality of MODS in polytrauma patients.

Patients and Methods:

A 3-year prospective study included consecutive trauma patients admitted to a Level-1 Trauma Center Intensive Care Unit (ICU). Isolated head injuries, drowning, asphyxiation, and burns were excluded. Demographics, Injury Severity Score (ISS), physiologic parameters, resuscitation parameters, and Denver multiple organ failure (MOF) scores were prospectively collected. Data are presented as median (interquartile range [IQR]), P < 0.05 was considered significant.

Results:

One hundred fifty-seven patients were included. Median age was 45 (26–61) years, 118 males (75%), ISS was 29 (22–37), 151 (96%) patients had blunt injuries. Thirty-one patients developed MODS (20%). Twenty-seven patients (17%) died, 24 due to brain and/or spinal cord injuries (89%). Only one patient (3%) died of MODS. Median highest Denver MOF score was 4 (4–5). Median time to MODS onset was 3 (3–4) days after injury with a length of 2 (1–3) days. Only seven patients (23%) had MODS for more than 3 consecutive days. Patients who developed MODS were older, needed more blood products in the emergency department, more platelets  < 8 h and <24 h, stayed longer on the ventilator, longer in ICU and developed more often adult respiratory distress syndrome. There was however no difference in mortality between both groups.

Conclusions:

In this polytrauma population mortality was predominantly caused by brain injury. Even though MODS was still present in severely injured polytrauma patients, its presentation was only early onset, less severe during a shorter time period, and accompanied by lower mortality.
Improving Patient Selection for Refractory Out of Hospital Cardiac Arrest Treated with Extracorporeal Life Support
Authors: Chouihed Tahar , Kimmoun Antoine , Lauvray Adrien , Laithier Francois-Xavier , Jaeger Deborah , Lemoine Simon , Maureira Juan Pablo , Nace Lionel , Duarte Kevin , Albizzati Stéphane , Girerd Nicolas , Levy Bruno
Published: July 2017

Background:

Despite recent management improvement, including Extracorporeal Life Support (ECLS), refractory out of hospital cardiac arrest (ROHCA) survival remains dramatically low.

Methods:

We assessed an innovative strategy (Out of hoSpital Cardiac ARrest–ExtraCorporeal Life Support—“OSCAR-ECLS”) to optimize access to ECLS of ROHCA patients and reduce the delay between recognition and ECLS implantation.

Methods:

This study, conducted in a tertiary teaching hospital, compared the survival and delay times of ROHCA patients treated by ECLS before and after OSCAR-ECLS implementation. This procedure included an early recognition of ROHCA 10 min after initiation of advanced cardiopulmonary resuscitation; the optimization of patient selection and reduction in time from collapse to ECLS initiation.

Results:

Fourteen patients before and 32 patients after OSCAR-ECLS implementation were identified between 2013 and 2016. Time to ECLS initiation was 99 (90–107) min before OSCAR-ECLS vs. 80 (65–94) min during the OSCAR-ECLS period (P = 0.0007), mostly due to a reduction in time spent on site: 48 (40.0–54.0) min vs. 24 (20.0–28.0) min (P = 0.0001). Survival at hospital discharge was 7% (1/14) before OSCAR-ECLS and 25% (8/32) during the OSCAR-ECLS period (P = 0.20). Only one patient survived with a Glasgow Pittsburgh Cerebral Performance Category (CPC) score = 1 before the OSCAR-ECLS procedure while during the OSCAR-ECLS procedure, eight patients (25%) survived, six with a CPC score = 1, one with a CPC score = 2, and one with a CPC score = 3.

Conclusions:

The use of a new paradigm of ROHCA dramatically shortened the time to ECLS initiation by reducing the time spent on site by more than 20 min. Survival improved from 7% to 25% after implementation of OSCAR-ECLS.
Mapping transcription factor occupancy using minimal numbers of cells in vitro and in vivo
Authors: Tosti Luca , Ashmore James , Tan Boon Siang Nicholas , Carbone Benedetta , Mistri Tapan K , Wilson Valerie , Tomlinson Simon R. , Kaji Keisuke
Published: July 2017

The identification of transcription factor (TF) binding sites in the genome is critical to understanding gene regulatory networks (GRNs). While ChIP-seq is commonly used to identify TF targets, it requires specific ChIP-grade antibodies and high cell numbers, often limiting its applicability. DNA adenine methyltransferase identification (DamID), developed and widely used in Drosophila, is a distinct technology to investigate protein-DNA interactions. Unlike ChIP-seq, it does not require antibodies, precipitation steps or chemical protein-DNA crosslinking, but to date it has been seldom used in mammalian cells due to technical impediments. Here we describe an optimised DamID method coupled with next generation sequencing (DamID-seq) in mouse cells, and demonstrate the identification of the binding sites of two TFs, OCT4 and SOX2, in as few as 1,000 embryonic stem cells (ESCs) and neural stem cells (NSCs), respectively. Furthermore, we have applied this technique in vivo for the first time in mammals. Oct4 DamID-seq in the gastrulating mouse embryo at 7.5 days post coitum (dpc) successfully identified multiple Oct4 binding sites proximal to genes involved in embryo development, neural tube formation, mesoderm-cardiac tissue development, consistent with the pivotal role of this TF in post-implantation embryo. This technology paves the way to unprecedented investigations of TF-DNA interactions and GRNs in specific cell types with limited availability in mammals including in vivo samples.
Diaquabis[3-(4-methylphenyl)-5-(pyridin-2-yl-κN)-1H-1,2,4-triazolato-κN
1]cadmium trihydrate
Authors: Fan Wen-Tao , Zhang Ze-Yu , Kou Jun-Feng , Liu Feng-Yi
Published: July 2017

In the title compound, [Cd(C14H11N4)2(H2O)2]·3H2O, the CdII cation is chelated by two 3-(4-methylphenyl)-5-(pyridin-2-yl)-1H-1,2,4-triazolate anions and coordinated by two water molecules in a distorted N4O2 octahedral geometry. Within the organic ligands, the methylphenyl rings are twisted with respect to the mean planes of chelating rings by 18.31 (16) and 14.89 (15)°. In the crystal, extensive O—H...O and O—H...N hydrogen bonds and weak C—H...O interactions link the molecules into a three-dimensional supramolecular architecture.
The leaders’ emotional intelligence
Authors: Dartey-Baah Kwasi , Mekpor Benjamin
Published: July 2017

Purpose

The purpose of this paper is to determine the extent to which leaders’ emotional intelligence (EI) predict the voluntary work behaviors (i.e. organizational citizenship behavior (OCB) and counterproductive workplace behavior (CWB)) of employees in the Ghanaian banking sector.

Design/methodology/approach

Quantitative approach was adopted to collect data from 234 respondents working in both high- and low-performing banks in Ghana. Both purposive and simple random sampling techniques were used for the selection of the respondents.

Findings

The findings of the study revealed that the leaders’ EI positively predicted the OCB of employees while a negative relationship was found between leaders’ EI and its prediction of employees’ CWB. Thus, emotionally intelligent leaders are able to evoke citizenship behaviors while mitigating CWBs of employees in the Ghanaian banking sector.

Research limitations/implications

The research addresses the gap in literature on how leaders’ EI influence employees’ tendency to exhibit either OCB or CWB specifically in the Ghanaian context.

Practical implications

The findings suggest that organizational leaders especially in the Ghanaian banking sector should be trained to be emotionally intelligent in their relationship with employees as such skills boost positive voluntary behaviors and have the tendency to alleviate the negative behaviors by employees.

Originality/value

The study provides an in-depth account on how the leaders’ EI influence both employees’ OCB and CWB and how to appropriately evoke or alleviate them, respectively.
The use of big data in corporate communication
Authors: Wiencierz Christian , Röttger Ulrike
Published: July 2017

Purpose

The purpose of this paper is to illustrate the current state of research on the significance of big data in and for corporate communication and to introduce a framework which provides specific connecting points for future research. This is achieved by summarizing and reviewing the insights provided by relevant articles in the most significant scholarly journals. The paper also investigates trends in the literature.

Design/methodology/approach

On the basis of a systematic literature review, 53 key articles from 2010 to 2015 were further analyzed.

Findings

The literature review illustrates the potentialities of big data for corporate communication, especially with regard to the field of marketing communication. It also reveals a dramatic lack of research in the fields of public relations and internal communication with respect to big data applications.

Research limitations/implications

The online databases used in this paper comprised of refereed scientific journals with the highest impact factor in the respective disciplines. Journals with a lower impact factor and books were not included in the search process for this thematic analysis.

Practical implications

This paper provides a conceptual framework that describes four phases of strategic big data usage in corporate communication. The results show how big data is able to highlight stakeholders’ insights so that more effective communication strategies can be created.

Originality/value

This paper brings together previously disparate streams of work in the fields of communication science, marketing, and information systems with respect to big data applications in corporate communication. It represents the first attempt to undertake a systematic and comprehensive interdisciplinary overview of this kind.