bluuebunny/crossref_metadata_2025 huggingface dataset:
Improving heart failure patient outcomes utilizing guideline-directed therapy
Authors: Davidson Beth Towery , Allison Terri Lynn
Published: June 2017

There is no fee for this activity. To receive credit after reading this CME/CE activity in its entirety, participants must complete the posttest and evaluation. The posttest and evaluation can be completed online at www.mlicme.org/P17039.html.

Heart failure (HF) prevalence continues to rise and remains a significant burden to patients, caregivers, providers, and the healthcare system. Guideline-directed medical therapy with standard neurohormonal blockade has been the cornerstone of medical management for many years. Despite aggressive utilization of angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, beta-blockers, and aldosterone antagonists, HF hospitalizations and readmissions are common and residual mortality remains high. With the development of two novel medical therapies (sacubitril/valsartan and ivabradine), the American College of Cardiology, American Heart Association, and Heart Failure Society of America released a pharmacologic update to provide guidelines for incorporation of these agents into clinical practice. Although effective via different mechanisms of action, both agents now have a prominent role in risk reduction. HF medical regimens often become quite complex, especially when associated with comorbid conditions, and require frequent follow-up. Providers must be proficient in patient monitoring, medication dose titration, and therapy optimization. Individualized patient care strategies such as guideline-directed therapy can promote long-term adherence and quality of life.
Performing pediatric eye exams in primary care
Authors: Martin Elaine F.
Published: June 2017

Early vision care is critical for all children. If undetected, eye disorders such as amblyopia and strabismus may result in permanent vision loss. Vision exams should include a careful history and physical including fix and follow, red reflex, and cover/uncover testing. Photo screening and visual acuity exams should be administered whenever possible.
The rising prevalence of obesity: part A: impact on public health
Authors: Agha Maliha , Agha Riaz
Published: June 2017

Excessive fat accumulation in the body may impair health leading to a significant long-term health consequences including the development of diabetes, coronary heart disease, and osteoarthritis as well as increasing the risk of developing certain cancers and influencing their outcomes. England has some of the worst figures and trends in obesity compared with the rest of the Europe. In the majority of European countries the trend has increased from 10% to 40% in the last 10 years, whereas in England prevalence has more than doubled. This article outlines the public health impact of rising obesity levels.
Fulminant Sepsis Due to Granulibacter bethesdensis in a 4-Year-Old Boy With X-Linked Chronic Granulomatous Disease
Authors: Mayer Erick F. , Gialanella Philip , Munjal Iona , Cunningham-Rundles Charlotte , Dara Jasmeen
Published: June 2017

Granulibacter bethesdensis is a Gram-negative bacillus described as a pathogen exclusively in patients with chronic granulomatous disease, a phagocytic disorder that impairs the ability to clear catalase-producing organisms. Granulibacter usually causes chronic and recurrent lymphadenopathies. We report the fatal case of a 4-year-old boy with chronic granulomatous disease, who presented with sepsis after a few days of abdominal pain and diarrhea.
Cluster-like Headache Secondary to Focal Cervical Myelitis
Authors: Kim Dong-Eun , Park Ji-Yun , Ha Hyeonuk , Yoon Geum-Jin , Cho Bang-Hoon , Lee Seung-Han
Published: June 2017

Background:

Cluster headache (CH) is characterized by attacks of severe periorbital pain associated with autonomic symptoms. As with other forms of primary headache, structural lesions should be excluded, particularly if the headache presents with an atypical pattern.

Case:

We report a 41-year-old woman who had no previous history of primary headache and showed a poor response to medication for CH. The patient was finally diagnosed as secondary headache with CH feature due to focal myelitis at the cervical level of the spinal cord. A strong positive Enzyme-linked Immunosorbent Assay test for Toxocara canis antibodies helped us to make a diagnosis of cervical Toxocara myelitis. After starting treatment with intravenous methylprednisolone and albendazole, her headache gradually improved with abortive and preventive treatment for CH.

Conclusions:

We suggest that neuroimaging of the upper cervical cord as well as the brain is important when CH is showing an atypical clinical course. Cervical Toxocara myelitis might be a possible cause of secondary headache with CH feature.
Corneal Nerve Morphology and Tear Film Substance P in Diabetes
Authors: Markoulli Maria , You Jingjing , Kim Juno , Duong Carmen L. , Tolentino Jonathan B. , Karras Joshua , Lum Edward
Published: June 2017

Purpose

This work aims to characterize the relationship between tear film neuropeptide substance P and the structural integrity of the sub-basal nerve plexus in diabetes.

Methods

Seventeen healthy control participants and nine participants with diabetes were recruited in this cross-sectional study. Total protein content and substance P concentrations were determined in the flush tears of participants. Corneal nerve morphology was assessed by capturing the corneal sub-basal nerve plexus using the Heidelberg Retinal Tomograph II with the Rostock Corneal Module (Heidelberg Engineering GmbH, Heidelberg, Germany) in the central cornea. Corneal nerve fiber density (CNFD) was measured using ACCMetrics (M.A. Dabbah, Imaging Science and Biomedical Engineering, Manchester, UK) on eight captured images. Comparisons between groups were made using independent samples t-tests. Correlations between parameters were analyzed using Pearson’s correlations.

Results

Substance P concentrations were significantly higher in the tears of the control group compared to participants with diabetes (4150 ± 4752 and 1473 ± 1671 pg/mL, respectively, P = .047). There was no significant difference in total protein content between the groups (3.4 ± 1.8 and 2.6 ± 1.7 mg/mL in the control and diabetes groups, respectively, P = .262). CNFD was significantly lower in the participants with diabetes compared to the control group (16.1 ± 5.7 and 21.5 ± 7.0 mm/mm2, respectively, P = .041). There was a moderate correlation between substance P and CNFD (r = 0.48, P = .01).

Conclusions

Substance P is expressed at a significantly lower level in the tears of people with diabetes compared with healthy controls. The positive correlation between substance P and corneal nerve density indicates that substance P may be a potential biomarker for corneal nerve health.
Social Network Clustering and the Spread of HIV/AIDS Among Persons Who Inject Drugs in 2 Cities in the Philippines
Authors: Verdery Ashton M. , Siripong Nalyn , Pence Brian W.
Published: June 2017

Introduction:

The Philippines has seen rapid increases in HIV prevalence among people who inject drugs. We study 2 neighboring cities where a linked HIV epidemic differed in timing of onset and levels of prevalence. In Cebu, prevalence rose rapidly from below 1% to 54% between 2009 and 2011 and remained high through 2013. In nearby Mandaue, HIV remained below 4% through 2011 then rose rapidly to 38% by 2013.

Objectives:

We hypothesize that infection prevalence differences in these cities may owe to aspects of social network structure, specifically levels of network clustering. Building on previous research, we hypothesize that higher levels of network clustering are associated with greater epidemic potential.

Methods:

Data were collected with respondent-driven sampling among men who inject drugs in Cebu and Mandaue in 2013. We first examine sample composition using estimators for population means. We then apply new estimators of network clustering in respondent-driven sampling data to examine associations with HIV prevalence.

Results:

Samples in both cities were comparable in composition by age, education, and injection locations. Dyadic needle-sharing levels were also similar between the 2 cities, but network clustering in the needle-sharing network differed dramatically. We found higher clustering in Cebu than Mandaue, consistent with expectations that higher clustering is associated with faster epidemic spread.

Conclusions:

This article is the first to apply estimators of network clustering to empirical respondent-driven samples, and it offers suggestive evidence that researchers should pay greater attention to network structure's role in HIV transmission dynamics.
Dexamethasone Prevents Lipopolysaccharide-Induced Epithelial Barrier Dysfunction in Rat Ileum
Authors: Ribeiro Aline Barbosa , Giusti Humberto , Souza Ana Paula Trevelin , Franci Celso Rodrigues , Saia Rafael Simone
Published: June 2017

Inflammatory mediators have been postulated as elementary inducing factors to the disruption of the intestinal tight junctions (TJ) and consequently, gut permeability and bacterial translocation. Corticosteroids are considered the mainstay in the treatment of septic shock; however, the impact of this therapy on the intestinal epithelial barrier dysfunction during septic shock remains unknown. Our aims were to demonstrate the role of low dexamethasone (DEX) doses in modulation of the inflammatory response, as well as the expression and the arrangement of TJ proteins in endotoxemic rats. One hour before the endotoxemia induction by lipopolysaccharide (LPS) administration, rats were pretreated with DEX at two low-doses (0.1 and 1.0 mg/kg). The parameters assessed included intestinal permeability, bacterial translocation, cytokines production, histology injury, localization, and expression of TJ proteins. Endotoxemic rats displayed intestinal epithelial barrier dysfunction, characterized by increased permeability and bacterial translocation, TJ disruption (opening and changes to its constituent proteins expression) and hyperactivation of the inflammatory response. On the other hand, the pretreatment with DEX attenuated the systemic and mucosal production of inflammatory mediators and also reverted the LPS-induced ileal injuries, increasing the expression of occludin and claudin-1, but also reducing claudin-2. Moreover, the histological damages and the morphology of the TJ were preserved by the DEX administration, therefore reducing their LPS-induced opening. The present study sheds light on the fact that early DEX treatment breaks the vicious cycle of local gut inflammation and barrier dysfunction in endotoxemia, especially preserving an essential structure of this monolayer epithelium, the TJ.
Development and Validation of a Quantitative Measure of Adaptive Behaviors in Women With Pelvic Floor Disorders
Authors: Wei John T. , Dunn Rodney , Nygaard Ingrid , Burgio Kathryn , Lukacz Emily S. , Markland Alayne , Wren Patricia A. , Brubaker Linda , Barber Matthew D. , Jelovsek J. Eric , Spino Cathie , Meikle Susie , Janz Nancy
Published: June 2017

Purpose

To establish validity for the Pelvic Floor Disorders Network (PFDN) self-administered Adaptive Behavior Index (ABI) and to assess whether ABI assesses known discordance between severity of pelvic floor symptoms and self-reported bother.

Methods

In addition to the ABI questionnaire, participants in 1 of 6 Pelvic Floor Disorders Network trials completed condition-specific measures of pretreatment symptom severity (including Pelvic Floor Distress Inventory; PFDI) and health-related quality of life (Pelvic Floor Impact Questionnaire; PFIQ). The final survey was developed from an iterative process using subject and expert endorsement, factor analyses, and response distributions. Domains were created using a development cohort (n = 304 women), reliability and validity were established using a validation cohort (n = 596 women), and test-retest reliability was assessed (n = 111 women).

Results

Factor analyses supported an 11-item avoidance domain and a 6-item hygiene domain. Cronbach' alphas were 0.88 and 0.68, respectively. Test-retest reliability was 0.84 for both domains. Construct validity was demonstrated in correlations between the ABI domains and baseline PFDI and PFIQ (r values, 0.43–0.79 with all P values <0.0001). Moreover, the ABI accounted for 8% to 26% of unexplained variance between the symptoms severity measure and the impact on health related quality of life. After treatment, avoidance domain scores improved for urinary and fecal incontinence groups and hygiene scores improved for the fecal incontinence group.

Conclusions

The ABI is a reliable and valid measure in women with pelvic floor disorders. Adaptive behaviors account in part for discordance between pelvic floor symptom severity and bother.
Preserving the Pancreas Graft: Outcomes of Surgical Repair of Duodenal Leaks in Enterically Drained Pancreas Allografts
Authors: Al-Adra David , McGilvray Ian , Goldaracena Nicolas , Spetzler Vinzent , Laurence Jerome , Norgate Andrea , Marquez Max , Greig Paul , Sapisochin Gonzalo , Schiff Jeffrey , Singh Sunita , Selzner Markus , Cattral Mark
Published: June 2017

Background

Duodenal leak remains a major cause of morbidity and graft loss in pancreas transplant recipients. The role and efficacy of surgical and image-guided interventions to salvage enterically drained grafts with a duodenal leak has yet to be defined.

Methods

We investigated the incidence, treatment, and outcome of duodenal leak in 426 pancreas transplantation recipients from 2000 to 2015.

Results

Duodenal leak developed in 33 (7.8%) recipients after a median follow-up of 5.3 (range, 0.5-15.2) years. Most leaks occurred during the first year (n = 22; 67%), and most were located near the proximal and distal duodenal staple line. Graft pancreatectomy was performed in 8 patients as primary therapy because of unfavorable local and/or systemic conditions. Salvage was attempted in 25 patients using percutaneous drainage (n = 4), surgical drainage (n = 4), or surgical repair (n = 17). Percutaneous or surgical drainage failed to control the leak in 7 of these 8 patients, and all 7 ultimately required graft pancreatectomy for persistent leak and sepsis. Surgical repair salvaged 14 grafts, and 13 grafts continue to function after a median follow-up of 2.9 (range, 1.1-6.3) years after repair.

Conclusions

Our study shows that in selected patients a duodenal leak can be repaired successfully and safely in enterically drained grafts.
Deriving C4photosynthesis parameters by fitting intensive A/Cicurves
Authors: Zhou Haoran , Akçay Erol , Helliker Brent R.
Published: June 2017

Measurements of photosynthetic assimilation rate as a function of intercellular CO2(A/Cicurves) are widely used to estimate photosynthetic parameters for C3species, yet few parameters have been reported for C4plants, because of a lack of estimation methods. Here, we extend the framework of widely-used estimation methods for C3plants to build estimation tools by exclusively fitting intensiveA/Cicurves (6-8 more sampling points) for C4using three versions of photosynthesis models with different assumptions about carbonic anhydrase processes and ATP distribution. We use simulation-analysis, out-of-sample tests, existing in vitro measurements and chlorophyll-fluorescence-measurements to validate the new estimation methods. Of the five/six photosynthetic parameters obtained, sensitivity analyses show that maximal-Rubisco-carboxylation-rate, electron-transport-rate, maximal-PEP-carboxylation-rate and carbonic-anhydrase were robust to variation in the input parameters, while day-respiration and mesophyll-conductance varied. Our method provides a way to estimate carbonic anhydrase activity, a new parameter, fromA/Cicurves, yet also shows that models that do not explicitly consider carbonic anhydrase yield approximate results. The two photosynthesis models, differing in whether ATP could freely transport between RuBP and PEP regeneration processes yielded consistent results under high light, but they may diverge under low light intensities. Modeling results show selection for Rubisco of low specificity and high catalytic rate, low leakage of bundle sheath and high PEPC affinity, which may further increase C4efficiency.
Characterising the short-term habituation of event-related evoked potentials
Authors: Mancini Flavia , Pepe Alessia , Bernacchia Alberto , Di Stefano Giulia , Mouraux André , Iannetti Gian Domenico
Published: June 2017

Fast-rising sensory events evoke a series of functionally heterogeneous event-related potentials (ERPs). Stimulus repetition at 1 Hz is known to induce a strong habituation of the largest ERP responses, the vertex waves, which are elicited by stimuli regardless of their modality7, provided that they are salient and behaviourally-relevant. In contrast, the effect of stimulus repetition on the earlier sensor)7components of ERl’s has been less explored, and the few existing results are inconsistent. To characterize how the different ERP waves habituate over time, we recorded the responses elicited by 60 identical somatosensory stimuli (activating either non-nociceptiveAβ or nociceptive A5 afferents), delivered at 1 Hz to healthy human participants. We show that the well-described spatiotemporal sequence of lateralised and vertex ERP components elicited by the first stimulus of the series is largely preserved in the smaller-amplitude, habituated response elicited by the last stimuli of the series. We also found that the earlier lateralised sensory waves habituate across the 60 trials following the same decay function of the vertex waves: this decay function is characterised by a large drop at the first stimulus repetition followed by smaller decreases at subsequent repetitions. Interestingly, the same decay functions described the habituation of ERPs elicited by repeated non-nociceptive and nociceptive stimuli. This study provides a neurophysiological characterization of the effect of prolonged and repeated stimulation on the main components of somatosensory ERPs. It also demonstrates that both lateralised waves and vertex waves are obligator}7components of ERPs elicited by non-nociceptive and nociceptive stimuli.

Significance statement

Our results provide a functional characterization of the decay of the different ERP components when identical somatosensory (nociceptive and non-nociceptive) stimuli are repeated at 1Hz. East-rising stimuli elicit ERPs obligator)7contributed by both early lateralised components and late vertex components, even when stimulus repetition minimizes stimulus relevance. This challenges the view that lateralised waves are not obligatorily elicited by nociceptive stimuli. Furthermore, the lateralised and vertex waves habituate to stimulus repetition following similar decay functions, which are unlikely explained in terms of fatigue or adaptation of skin receptors.
Hippocampal transcriptomic responses to cellular dissociation
Authors: Harris Rayna M. , Kao Hsin-Yi , Alarcón Juan Marcos , Hofmann Hans A. , Fenton André A.
Published: June 2017

Single-neuron gene expression studies may be especially important for understanding nervous system structure and function because of the neuron-specific functionality and plasticity that defines functional neural circuits. Cellular dissociation is a prerequisite technical manipulation for single-cell and single cell-population studies, but the extent to which the cellular dissociation process affects neural gene expression has not been determined. This information is necessary for interpreting the results of experimental manipulations that affect neural function such as learning and memory. The goal of this research was to determine the impact of chemical cell dissociation on brain transcriptomes. We compared gene expression of microdissected samples from the dentate gyrus (DG), CA3, and CA1 subfields of the mouse hippocampus either prepared by a standard tissue homogenization protocol or subjected to a chemical cellular dissociation procedure. We report that compared to homogenization, chemical cellular dissociation alters about 350 genes or 2% of the hippocampal transcriptome. While only a few genes canonically implicated in long-term potentiation (LTP) and fear memory change expression levels in response to the dissociation procedure, these data indicate that sample preparation can affect gene expression profiles, which might confound interpretation of results depending on the research question. This study is important for the investigation of any complex tissues as research effort moves from subfield level analysis to single cell analysis of gene expression.
Errors in action timing and inhibition facilitate learning by tuning distinct mechanisms in the underlying decision process
Authors: Dunovan Kyle , Verstynen Timothy
Published: June 2017

Goal-directed behavior requires integrating action selection processes with learning systems that adapt control using environmental feedback. These functions intersect in the basal ganglia (BG), which has at least two targets of plasticity: a dopaminergic modulation of striatal pathways and cortical modulation of the subthalamic nucleus (STN). Dual learning mechanisms suggests that feedback signals have a multifaceted impact on BG-dependent decisions. Using a hybrid of accumulation-to-bound decision models and reinforcement learning, we modeled the performance of humans in a stop-signal task where participants (N=75) learned the prior distribution of the timing of a stop signal through trial-and-error feedback. Changes in the drift-rate of the action execution process were driven by errors in action timing, whereas adaptation in the boundary height served to increase caution following failed stops. These findings highlight two interactive learning mechanisms for adapting the control of goal-directed actions based on dissociable dimensions of feedback error.

Author Summary

Many complex behavioral goals rely on one’s ability to regulate the timing of action execution while also maintaining enough control to cancel actions in response to “Stop” cues in the environment. Here we examined how these two fundamental components of behavior become tuned to the control demands of the environment by combining principles of reinforcement learning with accumulator models of decision making. The synthesis of these two theoretical frameworks is motivated by previous work showing that reinforcement learning and control rely on overlapping circuitry in the basal ganglia. Leveraging knowledge about the interaction of learning and control signals in this network, we formulated a computational model in which performance feedback is used to modulate key mechanisms of the decision process to facilitate goal acquisition. Model-based analysis of behavioral data collected on an adaptive stop-signal task revealed two critical learning mechanisms: one that adjusts the accumulation rate of the “Go” signal to errors in action timing and another that exercises caution by raising the height of the execution boundary after a failed Stop trial. We show how these independent learning mechanisms interact over the course of learning, shedding light on the behavioral effects plasticity in different pathways of the basal ganglia.
Preferential targeting of lateral entorhinal inputs onto newly integrated granule cells
Authors: Woods Nicholas I. , Vaaga Christopher E. , Chatzi Christina , Adelson Jaimie D. , Collie Matthew F. , Perederiy Julia V. , Tovar Kenneth R. , Westbrook Gary L.
Published: June 2017

Mature dentate granule cells in the hippocampus receive input from the entorhinal cortex via the perforant path in precisely arranged lamina, with medial entorhinal axons innervating the middle molecular layer and lateral entorhinal cortex axons innervating the outer molecular layer. Although vastly outnumbered by mature granule cells, adult-generated newborn granule cells play a unique role in hippocampal function, which has largely been attributed to their enhanced excitability and plasticity (Schmidt-Hieber et al., 2004; Ge et al., 2007). Inputs from the medial and lateral entorhinal cortex carry different informational content, thus the distribution of inputs onto newly integrated granules will affect their function in the circuit. Therefore we examined the functional innervation and synaptic maturation of newly-generated dentate granule cells using retroviral labeling in combination with selective optogenetic activation of medial or lateral entorhinal inputs. Our results indicate that lateral entorhinal inputs provide nearly all the functional innervation of newly integrated granule cells. Despite preferential functional targeting, the dendritic spine density of immature granule cells was not increased in the outer molecular layer compared to the middle molecular layer. However, chronic blockade of neurotransmitter release in medial entorhinal axons with tetanus toxin disrupted normal synapse development from both medial and lateral entorhinal inputs. Our results support a role for preferential lateral perforant path input onto newly generated neurons in mediating pattern separation, but also indicates that medial perforant path input is necessary for normal synaptic development.

Significance Statement

The formation of episodic memories involves the integration of contextual and spatial information. Newly integrated neurons in the dentate gyrus of the hippocampus play a critical role in this process, despite constituting only a minor fraction of total granule cells. Here we demonstrate that these neurons preferentially receive information thought to convey the context of an experience - a unique role that each newly integrated granule cell serves for about a month before reaching maturity.
PARP inhibition causes premature loss of cohesion in cancer cells
Authors: Kukolj Eva , Kaufmann Tanja , Dick Amalie E. , Zeillinger Robert , Gerlich Daniel W. , Slade Dea
Published: June 2017

Poly(ADP-ribose) polymerases (PARPs) regulate various aspects of cellular function including mitotic progression. Although PARP inhibitors have been undergoing various clinical trials and the PARP1/2 inhibitor olaparib was approved as monotherapy for BRCA-mutated ovarian cancer, their mode of action in killing tumour cells is not fully understood. We investigated the effect of PARP inhibition on mitosis in cancerous (cervical, ovary, breast and osteosarcoma) and non-cancerous cells by live-cell imaging. The clinically relevant inhibitor olaparib induced strong perturbations in mitosis, including problems with chromosome alignment at the metaphase plate, anaphase delay, and premature loss of cohesion (cohesion fatigue) after a prolonged metaphase arrest, resulting in sister chromatid scattering. PARP1 and PARP2 depletion suppressed the phenotype while PARP2 overexpression enhanced it, suggesting that olaparib-bound PARP1 and PARP2 rather than the lack of catalytic activity causes this phenotype. Olaparib-induced mitotic chromatid scattering was observed in various cancer cell lines with increased protein levels of PARP1 and PARP2, but not in non-cancer or cancer cell lines that expressed lower levels of PARP1 or PARP2. Interestingly, the sister chromatid scattering phenotype occurred only when olaparib was added during the S-phase preceding mitosis, suggesting that PARP1 and PARP2 entrapment at replication forks impairs sister chromatid cohesion. Clinically relevant DNA-damaging agents that impair replication progression such as topoisomerase inhibitors and cisplatin were also found to induce sister chromatid scattering and metaphase plate alignment problems, suggesting that these mitotic phenotypes are a common outcome of replication perturbation.
Transcriptome-wide analysis of roles for tRNA modifications in translational regulation
Authors: Chou Hsin-Jung , Donnar Elisa , Gustafsson H. Tobias , Garber Manuel , Rando Oliver J.
Published: June 2017

Covalent nucleotide modifications in noncoding RNAs such as tRNAs affect a plethora of biological processes, with new functions continuing to be discovered for even well-known tRNA modifications. To systematically compare the functions of a large set of ncRNA modifications in gene regulation, we carried out ribosome profiling and RNA-Seq in budding yeast for 57 nonessential genes involved in tRNA modification. Deletion mutants exhibited a range of translational phenotypes, with modifying enzymes known to modify anticodons, or non-tRNA substrates such as rRNA, exhibiting the most dramatic translational perturbations. Our data build on prior reports documenting translational upregulation of the nutrient-responsive transcription factor Gcn4 in response to numerous tRNA perturbations, and identify many additional translationally-regulated mRNAs throughout the yeast genome. Our data also uncover novel roles for tRNA modifying enzymes in transcriptional regulation ofTYretroelements, and in rRNA 2’-O-methylation. This dataset should provide a rich resource for discovery of additional links between tRNA modifications and gene regulation.
Hospital resilience in the aftermath of Typhoon Haiyan in the Philippines
Authors: Labarda Charlie , Labarda Meredith Del Pilar , Lamberte Exaltacion Ellevera
Published: June 2017

Purpose

Resilient health facilities, particularly hospitals, are critical for a responsive local health system in post-disaster settings. The purpose of this paper is to look at the experiences of two hospitals (public and private) in Tacloban City, Philippines in the aftermath of a super typhoon and their respective delivery of health services in such setting.

Design/methodology/approach

It described the impact of Typhoon Haiyan on health services delivery capacity and the factors instrumental in the resilience of the case hospitals. Lessons learned from the hospitals’ experiences, both at the level of the hospital staff and the institution, were also drawn. Disaster preparedness of case hospitals were assessed along several domains of resilience. Key informant interviews among stakeholders were conducted with key themes on disaster resilience extracted.

Findings

Disaster preparedness scores for case hospitals were different from each other and were reflected in their experiences of health services delivery in the aftermath of the disaster.

Research limitations/implications

This study on hospital resilience of two case hospitals, in the aftermath of Typhoon Haiyan, is exploratory in nature. The retrospective design of the study made it prone to recall bias. Further, the use of self-report measures for hospital resilience needs to be validated by more objective measures. The lack of baseline pre-disaster resilience indicators and the unpredictability of disasters could perhaps be addressed by a longitudinal study on hospital resilience in disasters in the future.

Originality/value

This study revealed several key findings. Some of the themes that emerged were: public health in disaster is the responsibility of both public and private hospitals; need for flexibility in disaster preparedness and planning, disaster resilience is an emergent process not a static construct, chaos results from zeal without coordination, and the need for integration of disaster preparedness in daily processes and structures of hospital facilities.
Governmental duty of care for disaster-related science diplomacy
Authors: Kelman Ilan
Published: June 2017

Purpose

The purpose of this paper is to present a first exploration of governmental duty of care towards scientists involved in science diplomacy by focusing on disaster research.

Design/methodology/approach

The method is a conceptual exploration, using specific case studies and potential scenarios within theories and practices of science diplomacy and duty of care, to raise questions and to suggest policy recommendations for government. The focus on disaster research links the analysis to disaster diplomacy, namely, how and why disaster-related activities (in this case, science) do and do not influence peace and conflict.

Findings

From examining case studies of, and outputs and outcomes from, disaster-related science diplomacy, governments need to consider duty of care issues in advance and develop a science diplomacy strategy, rather than responding after the fact or developing policy ad hoc.

Practical implications

Policy recommendations are provided to try to ensure that governments avoid simply reacting after a crisis, instead being ready for a situation before it arises and drawing on others’ experience to improve their own actions.

Social implications

Improved interaction between science and society is discussed in the context of diplomacy, especially for disaster-related activities.

Originality/value

Governmental duty of care has not before been applied to science diplomacy. The focus on disaster-related science further provides a comparatively new dimension for science diplomacy.
Sharjah: a heritage destination in its growth and development
Authors: Saji Beena Salim
Published: June 2017

Subject area

This case facilitates students of tourism and marketing to use Kapferer’s brand prism model to analyse the case.

Study level/applicability

This case can be used for tourism undergraduate and marketing students to make them understand the processes for revitalising and developing a destination brand to increase the number of visitors and become more attractive to tourists and visitors. The case highlights the major strategies used by the Sharjah Investment and Development Authority team to develop Sharjah as a family, entertainment, eco-tourism and heritage destination among the seven emirates of the United Arab Emirates.

Case overview

Sharjah is one of the emirates which form the United Arab Emirates. The case describes how a young leader of Sharjah developed destination Al Qasba as a tourist attraction, which was earlier not frequented by family and investors. After that, he was vested with the responsibility of developing Sharjah into an investment and heritage destination in United Arab Emirates. The case details how the team used different strategies to attract investors to the destination to make it more attractive to tourists as well the dwellers of the emirates.

Expected learning outcomes

To understand the process of sustainable destination development or place development practices. To analyse the case using using existing models or frameworks such as Kapferer’s brand identity prism or Aaker’s theory and any other. To recommend suggestions in improving the destination development strategies.

Supplementary materials

Teaching Notes are available for educators only. Please contact your library to gain login details or email support@emeraldinsight.com to request teaching notes.

Subject code

CSS 12: Tourism and Hospitality.
How Media Exposure Relates to Laypersons’ Understanding of Psychopathy
Authors: Keesler Michael E. , DeMatteo David
Published: June 2017

While conceptualization of psychopathy has evolved, so too has the public's relationship with psychology changed. Concurrently, portrayal of psychopaths has made several shifts, both through nonfiction sources and in popular film and television. Psychopathic villains of the mid‐20th century have made space for a growing cast of protagonist psychopaths. This study examined whether a relationship existed between exposure to fictional psychopaths and how lay individuals conceptualize psychopathy. Specifically, this study explored conceptualization differences based on exposure to antagonist versus protagonist fictional psychopaths. Surveyed community participants supported earlier research suggesting mixed misunderstanding of psychopathy. Additionally, higher exposure to protagonist psychopaths was associated with higher endorsement of flattering distractor traits, reflecting a kind of romanticized psychopathy. These findings have legal, practical, and ethical implications, including the potential for biased jurors, confounded research about psychopathy's labeling effect, and questions about how psychologists should respond on an individual and systemic level.
Multiple Symmetric Lipomatosis
Authors: Prahlow Samuel P. , Kosciuk Patrick , Prahlow Joseph A.
Published: June 2017

A significant number of medicolegal deaths involve ethanol. Deaths may be related to the acute, intoxicating effects of ethanol, either in decedents or within persons responsible for causing the deaths of others. Additionally, deaths may be related to chronic alcoholism. A chronic alcoholic may display characteristic external features which allow an observer, such as a forensic pathologist or other physician, to conclude that he/she is probably an alcoholic. Herein, the authors report two decedents with a rare condition known as “multiple symmetric lipomatosis” (MSL), which has a strong correlation with chronic alcoholism. Identification of the peculiar features associated withMSLshould prompt the forensic pathologist to consider chronic alcoholism as a probable diagnosis.
Experimental Study on the Postmortem Redistribution of the Substituted Phenethylamine, 25B‐NBOMe
Authors: Shintani‐Ishida Kaori , Saka Kanju , Nakamura Mami , Yoshida Ken‐ichi , Ikegaya Hiroshi
Published: June 2017

2‐(4‐Bromo‐2,5‐dimethoxyphenyl)‐N‐(2‐methoxybenzyl)ethanamine (25B‐NBOMe) is a substituted phenethylamine, which has become highly prevalent worldwide since 2014. Recently, in an autopsy case involving fatal 25B‐NBOMe intoxication, we found the postmortem increase of 25B‐NBOMe concentration in the cardiac blood approximately 2 days after death. The aim of this study was to investigate the distribution of 25B‐NBOMe and reproduce the postmortem redistribution using a rat model. Sprague‐Dawley rats were killed 30 min after intraperitoneal injection of 25B‐NBOMe (0.5 mg/kg) and left for 0, 3, 6, 9, 15, or 24 h (six rats at each time point). Postmortem 25B‐NBOMe concentrations in the cardiac blood increased by more than 10‐fold at 6‐h postmortem. 25B‐NBOMe accumulated primarily in the lung. Moreover, this postmortem redistribution occurred even in rats that had died 1 week following the 25B‐NBOMe administration. These findings indicate that attention should be paid to sample collection and data interpretation in the toxicological analysis of 25B‐NBOMe.
Comparison of 10‐day levofloxacin bismuth‐based quadruple therapy and levofloxacin‐based triple therapy for Helicobacter pylori
Authors: Wu Tzung‐Shiun , Hsu Ping‐I , Kuo Chao‐Hung , Hu Huang‐Ming , Wu I‐Chen , Wang Sophie S.W. , Chen Yen‐Hsu , Wu Deng‐Chyang , Su Wei‐Wen , Kuo Fu‐Chen
Published: June 2017

OBJECTIVE

This was a prospective study aiming to investigate whether levofloxacin plus bismuth‐based quadruple therapy was more effective than levofloxacin‐based triple therapy after failed first‐line eradication therapies for Helicobacter pylori (H. pylori) infection.

METHODS

Sixty‐seven patients infected with H. pylori were randomly assigned to two groups; the levofloxacin plus bismuth‐based quadruple therapy group (RBAL [n = 33]; rabeprazole 20 mg twice daily, bismuth subcitrate 120 mg four times daily, amoxicillin 1 g twice daily and levofloxacin 500 mg once daily, for 10 days) and the levofloxacin‐based triple therapy group (RAL [n = 34]; rabeprazole 20 mg twice daily, amoxicillin 1 g twice daily and levofloxacin 500 mg once daily, for 10 days). Endoscopy was performed 4–8 weeks after H. pylori eradication to assess treatment response. We followed up patient response and compliance and checked their resistance to antibiotics.

RESULTS

Intention‐to‐treat analysis revealed that both groups had similar eradication rates (RBAL vs RAL: 84.8% [95% confidence interval {CI} 72.6–97.1%] vs 67.6% [95% CI 51.9–83.4%], P = 0.0987). No significant differences in compliance or adverse events were found (P = 0.9829 and 0.0720). Epsilometer test showed that most eradication failure cases were levofloxacin‐resistant.

CONCLUSIONS

Adding bismuth subcitrate to levofloxacin‐based triple therapy was not more effective than not doing so, but no further side effects were noted. Both eradication therapies were equally safe and patients had the same tolerance to both regimens. Resistance rate to levofloxacin may be important when choosing second‐line therapy.
Postconditioning with metformin attenuates apoptotic events in cardiomyoblasts associated with ischemic reperfusion injury
Authors: Ramachandran Rajesh , Saraswathi Mini
Published: June 2017

Aim

Ischemic postconditioning is considered as a potent method to combat ischemic reperfusion injury than preconditioning and rapid initiation of reperfusion with potent antioxidant compounds can be one of the most effective treatments to reduce the infarct size and behavioral deficits as a result of ischemic insult. The present study aims to determine the postconditioning effects of metformin in experimental ischemia.

Methods

H9C2 cells were subjected to experimental ischemia and reperfused with metformin. Viability, oxidative stress and apoptotic events were determined.

Results

Postconditioning with Metformin effectively maintained cell viability and membrane stability of H9C2 cardiomyoblast cells from ischemic injury at a concentration of 2.5 µg/mL. Decrease in cell death was established viz fluorescent staining and Annexin V‐FITC flow cytometric analysis. In metformin treated ischemic cells the DNA fragmentation and comet length were significantly reduced (p=.0001) affirming antiapoptotic activity of metformin. There was an increase in protein carbonyl content and decrease in nitrate levels after ischemic injuries which were alleviated with metformin treatment. Wound closure was enhanced by metformin treatment. Metformin synchronized the apoptotic proteins such as FasL and antiapoptotic proteins such as Bcl2, Bcl‐xL and p21 which can be attributed as the major mechanism of cardioprotection.

Conclusions

The results envisage therapeutic potential of metformin at lower concentrations as an effective postischemic conditioning agent.
Critical role of TNF inhibition in combination therapy for elderly mice with atherosclerosis
Authors: Park Kyung‐Yeon , Heo Tae‐Hwe
Published: June 2017

Aims

We have previously shown that the combination of pravastatin and sarpogrelate is synergistically beneficial for atherosclerosis. In this study, we investigated whether the pravastatin‐sarpogrelate combination was sufficient for treatment in an old mouse model of atherosclerosis or if additional intervention would be needed to address the newly included aging factor and its complex pathophysiological impact on the atherosclerogenic state. We added an anti‐TNF biological to the combination treatment cocktail because of the known pathologic roles of TNF in the aging process.

Methods

Sixty‐week‐old low‐density lipoprotein receptor knockout mice were fed a high‐fat, high‐cholesterol diet and treated with the sarpogrelate and pravastatin combination, etanercept alone, or the triple combination.

Results

Although, etanercept alone did not significantly reduce aortic root and atherosclerotic plaque areas, the pravastatin‐sarpogrelate combination, and pravastatin‐sarpogrelate‐etanercept triple therapy significantly reduced the plaque areas. Surprisingly, TNF inhibition was critically required to reduce the plaque areas of aortic roots and the expression of ICAM‐1, MOMA‐2, and TNF. More importantly, a lipid‐lowering effect by pravastatin was observed only in the triple therapy group and not in the pravastatin and sarpogrelate combination group.

Conclusions

These results suggest that TNF‐inhibitory intervention should be added to the conventional therapy as a novel strategy for treating the elderly patients with atherosclerosis.
To take or not to take: the association between perceived addiction risk, expected analgesic response and likelihood of trying novel pain relievers in self‐identified chronic pain patients
Authors: Tompkins D. Andrew , Huhn Andrew S. , Johnson Patrick S. , Smith Michael T. , Strain Eric C. , Edwards Robert R. , Johnson Matthew W.
Published: June 2017

Background and aims

Probability discounting refers to the effect of outcome uncertainty on decision making. Using probability discounting, we examined the degree to which self‐identified chronic pain patients (CPP) were likely to try a novel analgesic medication given increasing addiction risk. We postulated that propensity for opioid misuse, trait impulsivity and previous opioid experience would be associated positively with likelihood of risky medication use.

Design

This cross‐sectional on‐line study determined state/trait associations with addiction‐related medication decisions in CPP.

Setting

US‐based CPP participated via Amazon Mechanical Turk; data were collected and analyzed in Baltimore, Maryland.

Participants

A total of 263 CPP (70.6% female) participated in the study from 12–13 December 2014.

Measurements

CPP responded to the Benefit versus Addiction Risk Questionnaire (BARQ) assessing likelihood of taking a hypothetical once‐daily oral analgesic medication as a function of two factors: risk of addiction (0–50%) and duration of expected complete pain relief (3, 30 or 365 days). The primary outcome was the BARQ, quantified as area under the curve (AUC). Grouping of CPP at high or low risk for opioid misuse was based on the Screener and Opioid Assessment for Patients with Pain–Revised (SOAPP‐R). Predictors included previous experience with opioids, as well as various measures of chronic pain and mental health.

Findings

Across hypothetical addiction risk assessed in the BARQ, the likelihood of taking a novel analgesic medication was elevated significantly in patients with high (≥18; n = 137) versus low (<18; n = 126) SOAPP‐R scores [P < 0.001; 3‐day: Cohen's d = 0.66, 95% confidence interval (CI) = 0.63, 0.69; 30‐day: d = 0.74, 95% CI = 0.71, 0.78; 365‐day: d = 0.75, 95% CI = 0.72, 0.79].

Conclusions

In the United States, self‐identified chronic pain patients (CPP) at higher risk for opioid misuse were more likely to report willingness to try a novel analgesic despite increasing addiction risk than CPP with low risk of opioid misuse.
Role of art centres for Aboriginal Australians living with dementia in remote communities
Authors: Lindeman Melissa , Mackell Paulene , Lin Xiaoping , Farthing Annie , Jensen Heather , Meredith Maree , Haralambous Betty
Published: June 2017

Objective

To explore the role art centres in remote communities play for Aboriginal and Torres Strait Islander Australians living with dementia.

Methods

A comprehensive literature search was undertaken, with no restrictions on articles regarding year of publication.

Results

Art programmes have been found to be of benefit to both people living with dementia and their carers, particularly when programmes are administered in environments that are culturally revered. Findings indicate remote art centres play a key role in maintaining traditions, culture and practices unique to Aboriginal and Torres Strait Islanders, but there is a gap in knowledge regarding how they cater for the needs of people with dementia.

Conclusion

Addressing this gap will be helpful in remote areas where prevalence of dementia is up to five times that of non‐Aboriginal people, and there are limited health and support services. Further research is required to explore strengths and gaps of current practices.