bluuebunny/crossref_metadata_2025 huggingface dataset:
Finite element analysis of the wheel–rail impact behavior induced by a wheel flat for high-speed trains: The influence of strain rate
Authors: Han Liangliang , Jing Lin , Zhao Longmao
Published: April 2017

The wheel–rail impact response induced by a wheel flat for high-speed trains is simulated numerically, based on the strain rate-dependent constitutive parameters of wheel–rail materials, using the finite element software LS-DYNA explicit algorithm. Influences of the speed of the train, the length of the wheel flat, and axle load on the wheel–rail impact behavior are discussed over a wide range, in terms of the vertical impact force, von Mises equivalent stress, shear stress, and equivalent plastic strain. The maximum wheel–rail impact forces are 2.6–4.4 times greater than the corresponding static axle loads due to the presence of a wheel flat. The maximum von Mises equivalent stress and equivalent plastic strain have occurred on the wheel–rail contact surface, while the maximum xy shear stress has often occurred on the subsurface of 4–6 mm below the contact surface. The wheel–rail impact responses induced by a wheel flat are sensitive to the speed of trains, flat length, and axle load. Besides, the strain rate effect of wheel–rail materials has a significant influence on the maximum von Mises equivalent stress, shear stress, and equivalent plastic strain, while it has no influence on the maximum vertical impact force. These findings are very helpful to guide the maintenance and repair of wheel–rail components in rail transport.
Pediatric Nandina domestica ingestions reported to poison centers
Authors: Forrester MB
Published: April 2017

Nandina domestica is grown as an ornamental plant in the United States but has also been reported as an invasive plant in a number of states. Parts of the plant, particularly the berries, contain cyanogenic glycosides that convert to hydrogen cyanide when ingested. This investigation characterized N. domestica ingestions involving patients of age 5 years and less reported to Texas poison centers during 2000–2015. There were 875 total N. domestica ingestions. A seasonal pattern was observed with the highest proportion of ingestions occurring in March (18.5%) and April (14.7%). The patients were male in 55.0% of the cases; 40.8% of the patients were of age 1 and 37.0% of age 2. Berries were specifically mentioned in 709 ingestions, of which 57.3% involved one berry and 28.5% an unknown number of berries. The ingestion occurred at the patient’s own residence in 92.9% of the cases, and the patient was managed on site in 97.0%. The most frequently reported clinical effects were vomiting (3.7%), abdominal pain (1.0%), diarrhea (0.9%), and nausea (0.7%). In conclusion, N. domestica ingestions among young children generally do not result in serious outcomes and can be managed successfully outside of a healthcare facility.
It’s not all about moral reasoning: Understanding the content of Moral Case Deliberation
Authors: Svantesson Mia , Silén Marit , James Inger
Published: April 2017

Background:

Moral Case Deliberation is one form of clinical ethics support described as a facilitator-led collective moral reasoning by healthcare professionals on a concrete moral question connected to their practice. Evaluation research is needed, but, as human interaction is difficult to standardise, there is a need to capture the content beyond moral reasoning. This allows for a better understanding of Moral Case Deliberation, which may contribute to further development of valid outcome criteria and stimulate the normative discussion of what Moral Case Deliberation should contain.

Objective:

To explore and compare the content beyond moral reasoning in the dialogue in Moral Case Deliberation at Swedish workplaces.

Methods:

A mixed-methods approach was applied for analysing audio-recordings of 70 periodic Moral Case Deliberation meetings at 10 Swedish workplaces. Moral Case Deliberation facilitators and various healthcare professions participated, with registered nurses comprising the majority.

Ethical considerations:

No objection to the study was made by an Ethical Review Board. After oral and written information was provided, consent to be recorded was assumed by virtue of participation.

Findings:

Other than ‘moral reasoning’ (median (md): 45% of the spoken time), the Moral Case Deliberations consisted of ‘reflections on the psychosocial work environment’ to a varying extent (md: 29%). Additional content comprised ‘assumptions about the patient’s psychosocial situation’ (md: 6%), ‘facts about the patient’s situation’ (md: 5%), ‘concrete problem-solving’ (md: 6%) and ‘process’ (md: 3%).

Conclusion:

The findings suggest that a restorative function of staff’s wellbeing in Moral Case Deliberation is needed, as this might contribute to good patient care. This supports outcome criteria of improved emotional support, which may include relief of moral distress. However, facilitators need a strategy for how to proceed from the participants’ own emotional needs and to develop the use of their emotional knowing to focus on the ethically difficult patient situation.
Do Long Format Advertisements Sell? Evidence from Indian Consumers
Authors: Trivedi Jay P.
Published: April 2017

Indian firms are engaging consumers with long format advertisements (ads longer than 60 seconds in duration). Television (TV) spot costs are escalating for high viewership programmes. Limited attempt has been made to explore the impact of long format ads (ads longer than 60 seconds in duration) on consumer behaviour. The researcher explores the types of long format ads which increases the audience involvement leading to formation of purchase intentions (PI). Descriptive research design was used to conduct the research. Data was collected from 364 respondents. The conceptual framework was tested using structural equation modelling. The findings reveal that entertaining and informative long format ads exhibit the strongest influence on audience involvement which leads to formation of PI. However, long format ads do not directly lead to formation of PI among the consumers. The mediation effect of message process involvement (MPI) and attitude towards the brand is statistically evident.
Study of Early Recruitment Activities and Employer Brand Knowledge and Its Effect on Organization Attractiveness and Firm Performance
Authors: Kashive Neerja , Khanna Vandana Tandon
Published: April 2017

This article explores the various dimensions of early recruitment activities (ERAs) such as publicity, sponsorship, word of mouth and advertisement, and its impact on employer brand knowledge (EBK) such as employer familiarity, employer image or job association and employer reputation. It further explores the impact of ERAs and EBK on organization attractiveness (OA) and firm performance (FP). The study shows that advertisement, publicity and word of mouth of ERAs impact all aspects of EBK such as employer familiarity, employer image or job association, and employer reputation. Employer reputation and job association are significant for most organization and does impact OA, while brand awareness and job association impact FP. The prominent sources of employment information were the Internet and networking.
Antecedents and Consequences of MNE Bribery: A Multilevel Review
Authors: Frei Christina , Muethel Miriam
Published: April 2017

As bribery constitutes a highly complex phenomenon, there is need for an integrative understanding to identify effective tackling tactics at multiple levels. In this vein, our literature review contributes to the research on bribery by depicting the multiple levels of analysis that collectively embrace the phenomenon of bribery. In particular, we depict multinational enterprises’ (MNEs) motivation to bribe as well as enabling factors within the MNEs but also within the target country that provide the ground for MNE bribery payments. Besides, we also discuss home country characteristics that contribute to MNE bribery in the target country. Considering outcomes of bribery, we discuss profits and costs for MNEs as well as for the target country. Thereby, we show that apart from negative effects for the target country, MNEs’ benefits are questionable and have to be seen in the context of additional unintended negative effects related to bribery.
Multiple-harmonic amplitude and phase control method for active noise and vibration reshaping
Authors: Liu Jinxin , Yang Liangdong , Yang Laihao , Zhang Xingwu , Chen Xuefeng
Published: April 2017

With the development of active noise and vibration control technology, there are increasing demands for active noise and vibration reshaping (ANVR) other than cancellation in the fields of active sound quality control, psychoacoustics, medical devices, military equipment, etc. The active noise equalizer (ANE) is one of the most popular ANVR methods. However, the ANE only controls (scales) the amplitude of the residual noise without considering the control of phase, and is unable to control frequency components that are excluded in primary noise. In this paper, we propose a more general and effective algorithm, called amplitude and phase control (APC), for ANVR, which can control amplitude and phase, simultaneously, of any interesting frequency component of the residual noise. Firstly, a modified active noise equalizer (MANE) algorithm with improved convergence is proposed based on the reference amplitude normalization and structure modification. Then, the APC algorithm is derived based on the MANE algorithm. Furthermore, numerical simulations and analytical investigations of the APC algorithm are conducted. Finally, case studies using experimental data are carried out. The multiple-harmonic primary noise was measured from a rotor test-platform and the secondary path model was identified according to a random vibration test on a shell structure. The results further verify the validity and robustness of the proposed APC algorithm.
The Social Dimension of Service Interactions
Authors: Henkel Alexander P. , Boegershausen Johannes , Rafaeli Anat , Lemmink Jos
Published: April 2017

Service interactions run a gamut from an instrumental self-focus to full social appreciation. Observing another customer’s incivility toward a frontline employee can emphasize social concerns as guiding principles for the observer’s own service interaction. Five studies test these dynamics; the results reveal that an incivility incident leads observers to prioritize social over market concerns. This reprioritization becomes manifest in a subsequent service interaction through increased feelings of warmth toward the employee who experienced incivility. In turn, feelings of warmth prompt observers to provide emotional support to the affected employee. Yet such prosocial inclinations are less likely when an employee is held responsible for or reciprocates incivility. Finally, this article also examines the effects of different employee reaction strategies on observers’ inferences about the employee and the service firm, showing that observers are most positively disposed toward the employee and the firm when the former reacts to incivility with a polite reprimand. Together, the results suggest that, contrary to past theorizing, observing customers may contribute to employee well-being, contingent on appropriate employee responses. Notably, the commonly prescribed polite, submissive employee reaction that requires emotional labor may not be the most desirable reaction—neither for the employee nor for the firm.
Yes, we fuck! Challenging the misfit sexual body through disabled women’s narratives
Authors: Santos Ana Cristina , Santos Ana Lúcia
Published: April 2017

Southern European society has been described in sociological literature as ableist, patriarchal and male-oriented. Under such conditions, many disabled women face multiple oppressions on grounds of gender, disability, class, age, sexual orientation, ‘race’ and ethnicity. The social construction of the impaired body as passive and dependent is conducive to a process of desexualization, presenting disabled people as inadequate for a full intimate life. The dominant biomedical model reinforces this process. This article draws on selected works in feminist disability studies to argue that rather than a body which is unfit, or does not fit, the ‘misfit’ is instead a cultural failure in accommodating and cherishing diversity. The authors also suggest that the desexualization of disabled women is replicating, as well as resulting from, historical tendencies to dehumanize and infantilize women. The empirical data is drawn from a larger project ‘Disabled Intimacies? Sexual and Reproductive Citizenship of Disabled Women in Portugal’. Biographical narrative interviews with disabled women are analyzed to explore the notion of ‘misfit’ sexual bodies. Theirs are stories of counter-norms and the struggle for sexual fulfilment and recognition. The women’s discussions of sexuality point to a need to change the ways that disability and intimacy are addressed in mainstream scholarly literature, institutions and the state. Narrow, heteronormative and ableist understandings of sexual intercourse and the linear character of mainstream stories of intimacy are shown as hindering the prospect of the recognition of disabled women as sexual citizens.
In-cylinder pressure sensor–based NOx model for real-time application in diesel engines
Authors: Cho Hoon , Fulton Brien , Upadhyay Devesh , Brewbaker Thomas , van Nieuwstadt Michiel
Published: April 2017

A real-time implementable, zero-dimensional model for predicting engine-out emissions of nitrogen oxides using in-cylinder pressure measurements is developed. The model is an extension of existing works in open literature that align well with the objectives of real-time implementation. The proposed model uses a simplified Zeldovich NOx mechanism that uses combustion-related parameters derived from simplified thermodynamic and combustion sub-models. The performance of the model is discussed for both a heavy-duty and a light-duty diesel engines. The model behavior is evaluated under input uncertainty so as to provide realistic performance bounds.
Biomarkers in adult posthemorrhagic hydrocephalus
Authors: Hua Cong , Zhao Gang
Published: April 2017

Posthemorrhagic hydrocephalus is a severe complication following intracranial hemorrhage. Posthemorrhagic hydrocephalus is often associated with high morbidity and mortality and serves as an important clinical predictor of adverse outcomes after intracranial hemorrhage. Currently, no effective medical intervention exists to improve functional outcomes in posthemorrhagic hydrocephalus patients because little is still known about the mechanisms of posthemorrhagic hydrocephalus pathogenesis. Because a better understanding of the posthemorrhagic hydrocephalus pathogenesis would facilitate development of clinical treatments, this is an active research area. The purpose of this review is to describe recent progress in elucidation of molecular mechanisms that cause posthemorrhagic hydrocephalus. What we are certain of is that the entry of blood into the ventricular system and subarachnoid space results in release of lytic blood products which cause a series of physiological and pathological changes in the brain. Blood components that can be linked to pathology would serve as disease biomarkers. From studies of posthemorrhagic hydrocephalus, such biomarkers are known to mutually synergize to initiate and promote posthemorrhagic hydrocephalus progression. These findings suggest that modulation of biomarker expression or function may benefit posthemorrhagic hydrocephalus patients.
Historic Leadership: One Courageous School Nurse’s Heroic Journey—Part 3
Authors: Johnsen Ellen F. , Pohlman Katherine J.
Published: April 2017

School nursing practice establishes itself in the midst of both education and nursing philosophies, ethics, standards, laws, and regulations. Treading these two worlds is difficult at times and requires that a school nurse possess a strong foundational knowledge base, seek professional collaboration, and navigate conflicting professional demands in order to promote student and public safety. This article is Part 3 of a four-part series that recounts the inspiring story of a school nurse, Ellen Johnsen, who did just that back in the 1980s in Broken Arrow, Oklahoma. Part 3 describes the publication of the Attorney General’s opinion validating the illegality of the school district’s medication administration policy, the lawsuit Ellen brought against the Broken Arrow Public Schools, and the appeal of the final decision in that lawsuit. The purpose of this series is to enhance understanding of the legal parameters governing school nurse practice, provide examples of ethical decision making, and review the challenges associated with serving as a leader.
Patient satisfaction and its potential impact on refugee integration into the healthcare system
Authors: Mkanta William N , Ibekwe Opuruiche , Mejia de Grubb Maria C , Korupolu Chakravarthi
Published: April 2017

Background:

Health care constitutes an important aspect of services in the resettlement processes for newly arriving and resettling refugees.

Objectives:

We conducted a study to investigate levels of satisfaction related to health services delivered to refugee populations in a resettlement community and its surrounding areas.

Methods:

We used the experience of 92 adult refugee patients to examine social-cultural, clinical and economic characteristics affecting satisfaction with health care. A cross-sectional study using the Patient Satisfaction Questionnaire (PSQ) was conducted. Item analysis was conducted by considering each question on the PSQ as an item and by developing dimensions of satisfaction. Chi-square analyses were used to assess the relationships between satisfaction and patient factors.

Results:

Patients were satisfied with the initial health assessment (90%) and overall quality (86%). Only 59% of the patients were satisfied with phone interpreters. The general satisfaction dimension had a score of 4.05 on a scale of 5, while time spent with the doctor had the lowest score of 2.98. Having pre-arrival medical conditions was associated with poor satisfaction with both the initial health assessment (χ2=10.260; p=.036) and regular health services (χ2=4.550; p=.033).

Conclusion:

Although patients were generally satisfied with health services, improvements are recommended in different aspects of care to create a favorable environment of care and increase levels of satisfaction and trust with the healthcare system among refugee populations.
Incidence and Outcomes of Acute Implant Extrusion Following Anterior Cervical Spine Surgery
Authors: Smith Gabriel A. , Pace Jonathan , Corriveau Mark , Lee Sungho , Mroz Thomas E. , Nassr Ahmad , Fehlings Michael G. , Hart Robert A. , Hilibrand Alan S. , Arnold Paul M. , Bumpass David B. , Gokaslan Ziya , Bydon Mohamad , Fogelson Jeremy L. , Massicotte Eric M. , Riew K. Daniel , Steinmetz Michael P.
Published: April 2017

Study Design:

Multi-institutional retrospective case series of 8887 patients who underwent anterior cervical spine surgery.

Objective:

Anterior decompression from discectomy or corpectomy is not without risk. Surgical morbidity ranges from 9% to 20% and is likely underreported. Little is known of the incidence and effects of rare complications on functional outcomes following anterior spinal surgery. In this retrospective review, we examined implant extrusions (IEs) following anterior cervical fusion.

Methods:

A retrospective multicenter case series study involving 21 high-volume surgical centers from the AOSpine North America Clinical Research Network. Medical records for 17 625 patients who received cervical spine surgery (levels from C2 to C7) between January 1, 2005, and December 31, 2011, were reviewed to identify occurrence of 21 predefined treatment complications.

Results:

Following anterior cervical fusion, the incidence of IE ranged from 0.0% to 0.8% across 21 institutions with 11 cases reported. All surgeries involved multiple levels, and 7/11 (64%) involved either multilevel corpectomies or hybrid constructs with at least one adjacent discectomy to a corpectomy. In 7/11 (64%) patients, constructs ended with reconstruction or stabilization at C7. Nine patients required surgery for repair and stabilization following IE. Average length of hospital stay after IE was 5.2 days. Only 2 (18%) had residual deficits after reoperation.

Conclusions:

IE is a very rare complication after anterior cervical spine surgery often requiring revision. Constructs requiring multilevel reconstruction, especially at the cervicothoracic junction, have a higher risk for failure, and surgeons should proceed with caution in using an anterior-only approach in these demanding cases. Surgeons can expect most patients to regain function after reoperation.
A Multicenter Study of the Presentation, Treatment, and Outcomes of Cervical Dural Tears
Authors: O’Neill Kevin R. , Fehlings Michael G. , Mroz Thomas E. , Smith Zachary A. , Hsu Wellington K. , Kanter Adam S. , Steinmetz Michael P. , Arnold Paul M. , Mummaneni Praveen V. , Chou Dean , Nassr Ahmad , Qureshi Sheeraz A. , Cho Samuel K. , Baird Evan O. , Smith Justin S. , Shaffrey Christopher , Tannoury Chadi A. , Tannoury Tony , Gokaslan Ziya L. , Gum Jeffrey L. , Hart Robert A. , Isaacs Robert E. , Sasso Rick C. , Bumpass David B. , Bydon Mohamad , Corriveau Mark , De Giacomo Anthony F. , Derakhshan Adeeb , Jobse Bruce C. , Lubelski Daniel , Lee Sungho , Massicotte Eric M. , Pace Jonathan R. , Smith Gabriel A. , Than Khoi D. , Riew K. Daniel
Published: April 2017

Study Design:

Retrospective multicenter case series study.

Objective:

Because cervical dural tears are rare, most surgeons have limited experience with this complication. A multicenter study was performed to better understand the presentation, treatment, and outcomes following cervical dural tears.

Methods:

Multiple surgeons from 23 institutions retrospectively identified 21 rare complications that occurred between 2005 and 2011, including unintentional cervical dural tears. Demographic data and surgical history were obtained. Clinical outcomes following surgery were assessed, and any reoperations were recorded. Neck Disability Index (NDI), modified Japanese Orthopaedic Association (mJOA), Nurick classification (NuC), and Short-Form 36 (SF36) scores were recorded at baseline and final follow-up at certain centers. All data were collected, collated, and analyzed by a private research organization.

Results:

There were 109 cases of cervical dural tears among 18 463 surgeries performed. In 101 cases (93%) there was no clinical sequelae following successful dural tear repair. There were statistical improvements ( P < .05) in mJOA and NuC scores, but not NDI or SF36 scores. No specific baseline or operative factors were found to be associated with the occurrence of dural tears. In most cases, no further postoperative treatments of the dural tear were required, while there were 13 patients (12%) that required subsequent treatment of cerebrospinal fluid drainage. Analysis of those requiring further treatments did not identify an optimum treatment strategy for cervical dural tears.

Conclusions:

In this multicenter study, we report our findings on the largest reported series (n = 109) of cervical dural tears. In a vast majority of cases, no subsequent interventions were required and no clinical sequelae were observed.
A Matched Cohort Analysis Comparing Stand-Alone Cages and Anterior Cervical Plates Used for Anterior Cervical Discectomy and Fusion
Authors: Overley Samuel C. , Merrill Robert K. , Leven Dante M. , Meaike Joshua J. , Kumar Abhishek , Qureshi Sheeraz A.
Published: April 2017

Study Design:

Retrospective cohort study.

Objective:

To compare perioperative characteristics of stand-alone cages and anterior cervical plates used for anterior cervical discectomy and fusion (ACDF).

Methods:

We reviewed 40 adult patients who received a stand-alone cage for elective ACDF and matched them with 40 patients who received an anterior cervical plate. We statistically compared operative time, length of stay, proportion of ambulatory cases, overall complications necessitating a trip to the ED, readmission, or reoperation related to index procedure.

Results:

There were 21 women and 19 men in the plate cohort with average ages of 53 years ± 12 and 20 women and 20 men in the stand-alone group with an average age of 52 years ± 11. With no statistical difference in total number, the plate group experienced 4 short-term (within 90 days of discharge) complications, including 3 patients who visited the emergency department for dysphagia and 1 who visited the emergency department for severe back pain, while the stand-alone group experienced 0 complications. There was no significant difference in operative time between the stand-alone group (75.35 min) and the plate group (81.35 min; P = .37). There was a significant difference between the proportion of ambulatory cases in the stand-alone group (25) and the plate group (6; P < .0001).

Conclusion:

Our results demonstrate that stand-alone cages have fewer complications compared to anterior plating, with a lower trend of incidence of postoperative dysphagia. Stand-alone cages may offer the advantage of sending patients home ambulatory after ACDF surgery.
Medial Patellar Instability: Treatment and Outcomes
Authors: Moatshe Gilbert , Cram Tyler R. , Chahla Jorge , Cinque Mark E. , Godin Jonathan A. , LaPrade Robert F.
Published: April 2017

Background:

Historically, a lateral retinacular release was one of the primary surgical interventions used to treat lateral patellar instability. However, disruption of the lateral structures during this procedure has been associated with medial instability of the patella.

Hypothesis:

We hypothesize that good to excellent outcomes can be achieved at midterm follow-up after lateral patellotibial ligament reconstruction.

Study Design:

Case series; Level of evidence, 4.

Methods:

Thirteen patients were treated for medial patellar instability with a lateral patellotibial ligament reconstruction between May 2011 and December 2013 by a single surgeon. All patients had previously undergone a lateral release procedure and had symptomatic medial patellar instability. Patients were evaluated using patient-reported outcome scores at a minimum of 2 years postsurgery.

Results:

The mean Lysholm score improved from 45.6 (range, 11-76) to 71.9 (range, 30-91). The median preoperative Tegner activity scale score was 3 (range, 1-7), while the median postoperative score was 4 (range, 1-9). The median Western Ontario and McMaster Universities Arthritis Index (WOMAC) total score improved from 38 (range, 1-57) preoperatively to 6 postoperatively (range, 0-52). The mean patient satisfaction postoperatively was 8.2 (range, 5-10).

Conclusion:

Significantly improved outcomes can be achieved at midterm follow-up with a low rate of complications when reconstructing the lateral patellotibial ligament in the setting of iatrogenic medial patellar instability.
European Stroke Organisation guidelines for the management of post-stroke seizures and epilepsy
Authors: Holtkamp Martin , Beghi Ettore , Benninger Felix , Kälviäinen Reetta , Rocamora Rodrigo , Christensen Hanne ,   For the European Stroke Organisation
Published: April 2017

Background

Following stroke, acute symptomatic seizures (manifestation within seven days) and epilepsy, i.e. occurrence of at least one unprovoked seizure (manifestation after more than seven days), are reported in 3–6% and up to 12% of patients, respectively. Incidence of acute symptomatic seizures is higher in intracranial haemorrhage (10–16%) than in ischaemic stroke (2–4%). Acute symptomatic seizures and unprovoked seizure may be associated with unfavourable functional outcome and increased mortality. In view of the clinical relevance, the European Stroke Organisation has issued evidence-based guidelines on the management of post-stroke seizures and epilepsy.

Method

A writing committee of six clinicians and researchers from five European countries and Israel identified seven questions relating to prevention of (further) post-stroke seizures and epilepsy and to amelioration of functional outcome and prevention of mortality. Recommendations are based on findings in randomised controlled trials and observational studies using the grading of recommendations assessment, development and evaluation approach.

Results

In the absence of adequately powered randomised controlled trials, evidence for all recommendations is very low. Based on findings in observational studies, some weak recommendations have been made. In most instances, we suggest not to administer antiepileptic drugs. Due to high incidence of seizure recurrence after one post-stroke unprovoked seizure, secondary antiepileptic drugs prophylaxis needs to be considered.

Conclusion

Due to very low evidence, these guidelines only give some weak recommendations on prevention of occurrence and recurrence of post-stroke acute symptomatic seizures and unprovoked seizure. Adequately powered randomised controlled trials are required to assess interventions for post-stroke seizure management.
A Duodenal SDH-Deficient Gastrointestinal Stromal Tumor in a Patient With a Germline SDHB Mutation
Authors: Elston Marianne S. , Sehgal Shekhar , Dray Michael , Phillips Elizabeth , Conaglen John V. , Clifton-Bligh Roderick J. , Gill Anthony J.
Published: April 2017

Context:

Gastrointestinal stromal tumors (GISTs) are mesenchymal tumors of the gastrointestinal tract arising from the interstitial cells of Cajal. Succinate dehydrogenase (SDH)–deficient GISTs are a unique class of GIST defined by loss of immunohistochemical expression of SDHB, indicating dysfunction of the mitochondrial complex 2; lack of driver mutations in KIT and PDGFRA; and distinctive morphologic features and natural history. To date, all reported SDH-deficient GISTs have arisen in the stomach. We report an SDH-deficient GIST arising in the gastrointestinal tract outside the stomach.

Case description:

A 29-year-old man with a germline SDHB mutation (p.Arg90*) presented with acute upper gastrointestinal hemorrhage. Endoscopy identified a lesion in the second part of the duodenum, close to the distal common bile duct, consistent with a GIST. Endoscopic ultrasonography and magnetic resonance imaging did not demonstrate metastatic or nodal disease. Open transduodenal excision was performed to remove the tumor. Histologic evaluation confirmed the clinical diagnosis of a GIST, with positive staining for DOG1 and KIT. The mitotic count was low (1 per 50 high-power fields). Immunohistochemistry for SDHB was negative in the presence of an internal control. SDHA expression was retained. No somatic mutations were identified in KIT (exons 9, 11, 13, and 17) or PDGFRA (exons 12, 14, and 18). The germline SDHB mutation and loss of heterozygosity were confirmed on molecular testing of the tumor.

Conclusion:

We describe an SDH-deficient GIST occurring outside of the stomach. This case indicates that SDH-deficient GISTs may also arise in the small intestine.
Effects of Mixed Carotenoids on Adipokines and Abdominal Adiposity in Children: A Pilot Study
Authors: Canas J. Atilio , Lochrie Amanda , McGowan Amy Galena , Hossain Jobayer , Schettino Christopher , Balagopal P. Babu
Published: April 2017

Context:

Carotenoids have been implicated in the regulation of adipocyte metabolism.

Objective:

To compare the effects of mixed-carotenoid supplementation (MCS) versus placebo on adipokines and the accrual of abdominal adiposity in children with obesity.

Design and Setting:

Randomized (1:1), double-blind, placebo-controlled intervention trial to evaluate the effects of MCS over 6 months in a subspecialty clinic.

Participants:

Twenty (6 male and 14 female) children with simple obesity [body mass index (BMI) > 90%], a mean age (± standard deviation) of 10.5 ± 0.4 years, and Tanner stage I to V were enrolled; 17 participants completed the trial.

Intervention:

MCS (which contains β-carotene, α-carotene, lutein, zeaxanthin, lycopene, astaxanthin, and γ-tocopherol) or placebo was administered daily.

Main Outcome Measures:

Primary outcomes were change in β-carotene, abdominal fat accrual (according to magnetic resonance imaging), and BMI z-score; secondary outcomes were adipokines and markers of insulin resistance.

Results:

Cross-sectional analysis of β-carotene showed inverse correlation with BMI z-score, waist-to-height ratio, visceral adipose tissue, and subcutaneous adipose tissue (SAT) at baseline. MCS increased β-carotene, total adiponectin, and high-molecular-weight adiponectin compared with placebo. MCS led to a greater reduction in BMI z-score, waist-to-height ratio, and SAT compared with placebo. The percentage change in β-carotene directly correlated with the percentage change in SAT.

Conclusions:

The decrease in BMI z-score, waist-to-height ratio, and SAT and the concomitant increase in the concentration of β-carotene and high-molecular-weight adiponectin by MCS suggest the putative beneficial role of MCS in children with obesity.
Nonhuman Findings from the Laboratory of Speculative Sociology
Authors: de Freitas Elizabeth
Published: April 2017

This work of speculative fiction and commentary describes a laboratory focused on human sense and affect. The laboratory is alive with computational capacity, recursively elaborating and generating data. The very notion of recording data is radically reconceived through this speculative fiction, as it points toward a new materialist sens/ability and new forms of social science.
Excitatory neurons sculpt GABAergic neuronal connectivity in the C. elegans motor circuit
Authors: Barbagallo Belinda , Philbrook Alison , Touroutine Denis , Banerjee Navonil , Oliver Devyn , Lambert Christopher M. , Francis Michael M.
Published: April 2017

Establishing and maintaining the appropriate number of GABA synapses is key for balancing excitation and inhibition in the nervous system, though we have only a limited understanding of the mechanisms controlling GABA circuit connectivity. Here, we show that disrupting cholinergic innervation of GABAergic neurons in the C. elegans motor circuit alters GABAergic neuron synaptic connectivity. These changes are accompanied by reduced frequency and increased amplitude of GABAergic synaptic events. Acute genetic disruption in early development, during the integration of post-embryonic-born GABAergic neurons into the circuit, produces irreversible effects on GABAergic synaptic connectivity that mimic those produced by chronic manipulations. In contrast, acute genetic disruption of cholinergic signaling in the adult circuit does not reproduce these effects. Our findings reveal that GABAergic signaling is regulated by cholinergic neuronal activity, probably through distinct mechanisms in the developing and mature nervous system.
A neural basis for password-based species recognition in an avian brood parasite
Authors: Lynch Kathleen S. , Gaglio Annmarie , Tyler Elizabeth , Coculo Joseph , Louder Matthew I. M. , Hauber Mark E.
Published: April 2017

Obligate avian brood parasites are raised by heterospecific hosts and therefore, lack critical early exposure to relatives and other conspecifics. Yet, young brood parasites readily recognize and affiliate with others of their own species upon independence. One solution to this social recognition paradox is the ontogenetic password mechanism utilized by obligate parasitic brown-headed cowbirds (Molothrus ater), whereby conspecific identification is initially mediated through the cowbird chatter, a non-learned vocal cue. We explored the neural basis of such password-based species recognition in juvenile and adult male cowbirds. We found that cowbird auditory forebrain regions express greater densities of the immediate early gene ZENK in response to the password chatter call relative to control sounds of mourning dove (Zenaida macroura) coos. The chatter-selective induction of ZENK occurs in both the caudal medial nidopallium (NCM) and the caudal medial mesopallium (CMM) in adults, but only within NCM in juveniles. In contrast, we discovered that juvenile cowbirds exhibit neural selectivity to presentations of either conspecific or heterospecific songs but only in CMM and only after recent experience. Juvenile cowbirds that were not provided experience with song did not exhibit elevated activity-dependent gene induction. Thus, in juvenile male cowbirds there is early onset of species-specific selective neural representation of non-learned calls in NCM and recently experienced song in CMM. These results suggest that NCM is evolutionarily co-opted in parasitic cowbirds to selectively recognize the password chatter, allowing juvenile cowbirds to identify adult conspecifics and avoid mis-imprinting upon unrelated host species. These ontogenetic comparisons reveal novel insights into the neural basis of species recognition in brood parasitic species.
Hydrated Micellar Structure of Ethoxylated Nonyl Phenols from PGSE NMR
Authors: Bányai István , Lakatos István , Meier Gerhard , Nagy Zoltán , Vass Szabolcs
Published: April 2017

Solvent self-diffusion coefficients $D_{w}^{*}$ and Dw are respectively determined by PGSE NMR in the bulk solvent and in suitably prepared aqueous micellar solutions of a series of commercial ethoxylated nonyl phenols (ENPs) at 298 and 317 K. The capability of ENP micelles for obstructing the free diffusion of solvent molecules is characterized by the obstruction ratio $K = D_{w}/D_{w}^{*}$, which turns out to depend merely on the volume fraction of EO units present—regardless of significant changes in solute concentration, distribution of EO chain length, micellar aggregation number and temperature. The experiments are interpreted in terms of a renewed analytical model of ENP micellar structure, based on Tanford’s concept of hydrodynamic particle. The results from model fitting return the characteristic sizes of ENP monomers, support the ellipsoid shape of the micelles, indicate a stable EO shell, follow the trend in the variation of hydration number vs. the chain length predicted by thermal analysis in PEO solutions.
A Polytomous Item Response Theory Model for Measuring Near-Miss Appraisal as a Psychological Trait
Authors: Cui Jinshu , Rosoff Heather , John Richard S.
Published: April 2017

Near-miss experiences have been identified as a contributing factor in responses to risk of disaster events. Researchers have found that specific characteristics of a near-miss event could lead individuals to interpret the risk as either “vulnerable” or “resilient.” Moreover, these interpretations can lead to quite different decisions regarding future protective behavior. We developed the Near-Miss Appraisal Scale (NMAS) to assess an individual’s tendency to interpret near misses as vulnerable (or resilient). We developed an initial item pool of 21 items and recruited a sample of 298 respondents through Amazon Mechanical Turk. The final version of the NMAS is based on 10 of these items, following psychometric analysis for dimensionality, scale reliability, and item functioning. We establish discriminant validity of the NMAS by correlating the NMAS with scales of locus of control and risk taking, and predictive validity by using the NMAS to predict individual responses to a near-miss disaster scenario. The current study demonstrates that responses to near misses are not only determined by the nature of the event itself, but also related to decision makers' near-miss appraisal tendencies.
Foreigners vs. Natives: Bank Lending Technologies and Loan Pricing
Authors: Beck Thorsten , Ioannidou Vasso , Schäfer Larissa
Published: April 2017

Can distance-related information asymmetries in credit markets be overcome with contract design and credit scoring models? To answer this question, we explore differences in foreign and domestic banks' credit contract terms and pricing models. Using a sample of firms that borrow from both domestic and foreign banks in the same month, we show that foreign banks are more likely to demand collateral and grant shorter maturity loans than domestic banks. Foreign banks also base their pricing on internal credit ratings and collateral pledges, while domestic banks price according to the length, depth, and breadth of their relationship with a firm. These findings confirm that foreign banks can overcome informational disadvantages using contract design and credit scoring models. However, we also show that there are limitations, with foreign banks facing higher default rates and lower returns on lending if not using collateral and short maturity as disciplining tools.

This paper was accepted by Amit Seru, finance.
Are Immigrants Complements or Substitutes? Evidence from the Audit Industry
Authors: Aobdia Daniel , Srivastava Anup , Wang Erqiu
Published: April 2017

Extensive debate exists among policy makers and economists about the employment of highly skilled immigrants in the United States. It remains unclear whether these immigrants perform complementary tasks in addition to their substitutive role relative to native graduates. Empirical studies examining these questions in a focused setting are scarce, principally because of the nonavailability of data. We examine these questions using the audit industry as a setting because of the availability of client, city, and office characteristic data at each audit office. This setting also allows us to answer whether immigration can address the growing human capital constraint in the audit industry. We find evidence of a complementary role of highly skilled immigrants. In addition, our results indicate a reputational spillover of client restatements at the audit office level to the labor markets. Our findings have immigration and education policy implications.

This paper was accepted by Shivaram Rajgopal, accounting.
Assessment of Direct Oral Anticoagulant Prescribing and Monitoring Pre- and Post-Implementation of a Pharmacy Protocol at a Community Teaching Hospital
Authors: Miele Christina , Taylor Mary , Shah Aditi
Published: April 2017

Background

Direct oral anticoagulants (DOACs) have become popular alternatives to vitamin K antagonists for the treatment and prevention of thromboembolic diseases; however, there are limited data regarding the appropriate use of DOACs in clinical practice. To ensure safety and efficacy of these medications, it is important that decisions regarding their use in patients rely on the available evidence.

Objective

The purpose of this study was to evaluate the appropriateness of DOAC prescribing in adult patients before and after the implementation of a pharmacist-driven DOAC protocol.

Methods

Data were collected on adult patients admitted to a community teaching hospital who received DOAC therapy for at least 2 days between January and March 2015 (pre-intervention group) and between January and March 2016 (post-intervention group). These data were analyzed to measure inappropriately prescribed DOACs, defined based on DOAC indication, renal function, drug interactions, and other pertinent patient-specific factors. Prior to the start of data collection for the post-intervention group, a pharmacist-driven protocol was developed and implemented. DOAC education was provided to pharmacists, including an evidence-based prescribing table to guide appropriate DOAC therapy. Comparisons were made between the pre-intervention and post-intervention groups to determine the impact of the pharmacist-driven service on appropriate DOAC prescribing.

Results

Fifty patients were analyzed in the pre-intervention group compared with 85 patients in the post-intervention group, with a total of 333 and 816 doses administered, respectively. Of the total doses administered, 32.4% were considered inappropriate in the pre-intervention group compared with 13.8% in the post-intervention group (adjusted odds ratio [OR], 0.42, 95% CI, 0.19-0.96; p = 0.039).

Conclusions

Implementing a pharmacist-driven DOAC service significantly improved appropriate prescribing of these agents. Provider education regarding DOAC use is essential to further increase appropriate prescribing of DOACs, optimize patients' therapy, and prevent adverse drug events.
Small chests and jointed boxes: Material texts and the play of resemblance in early modern print
Authors: Razzall Lucy
Published: April 2017

This article explores the material and metaphorical interactions between books and boxes in early modern English print culture. Building on ideas articulated by book historians Walter Ong, Jeffrey Todd Knight and Tessa Watt about the book as a material and metaphorical container, this article uses two case studies to explore some of the ways in which early modern print culture playfully engaged with the resemblances between book and box, as objects that both have the potential to contain and condense. Focusing on a version of scripture for children and a collection of Elizabethan epigrams, two printed texts that aspire to the neatness and the convenience that a box offers, the article considers how the book’s identity as a ‘container’ for ‘content’ was not merely functional but a symptom of the imaginative connections between the textual and material realms embodied in the book.
Ligatures of the early modern book
Authors: Scott-Warren Jason
Published: April 2017

This article proposes that the early modern book was constituted of numerous forms of stringing, tying and binding. Exploring ligatures at the level of the printed or handwritten letter-form, the stitching, the binding and the clasps or ties that served to open and close the book, I argue that books were not merely bound in to their containing volumes but were also bound outwards to material environments and social networks. The interlaced designs on decorative bookbindings are read as meditations on a connectedness that was actualized in shared ownership or giftgiving. Clasps turned the book into a box, and an apt metaphor for the human heart, while silk ties connected the book into the worlds of clothing and textiles. While our experience of connective communication is now dominated by the Internet, there are some signs that the material book is fighting back.
Boundaries to protocols: Conceptions of the ‘book’ in a networked environment
Authors: Drucker Johanna
Published: April 2017

The concept of the codex book is deeply imprinted on scholarly and literary traditions. It bears within it assumptions about bounded-ness and stability as defining features of the form. Works conceived in a networked environment are referred to as books, but may not exist within the same structural conditions. This article reviews some of the ways the conceptions of the physical codex are linked to production and poses questions about the identity of artefacts produced by processes and protocols in a networked environment. It argues that these unbounded and contingently configured documents do not merely extend the traditional codex, with its apparatus of footnotes, bibliographical citations, and other paratexts, but that these are substantively different types of textual productions because of their fluid instability.
Climb the Mountain
Authors: King Eleanor , Svec Henry Adam
Published: April 2017

This piece explores the recent transformations undertaken by the rock band Roch Commune, which in its most recent incarnation has found itself moving past cultural production per se and towards a diversity of entrepreneurial, tactical media practices. The paper discusses the group’s origins and justifies their current course of action.
Writing as Praxis: Catherine Ryan Interviews Nina Power
Authors: Power Nina , Ryan Catherine
Published: April 2017

A discussion between British philosopher, writer and activist, Nina Power, and Australian artist and writer, Catherine Ryan, about topics including: writing as a praxis; the political capacity of the polemical form; the politics of debate; the need to return to grand, structural terms for socio-political analysis; the role of the public intellectual; the effects of the Internet on the role of the public intellectual; and the relation between art and politics.