bluuebunny/crossref_metadata_2025 huggingface dataset:
Our Obligation to Future Generations
Authors: Sen Amartya
Published: June 2018

Our reasoned sense of obligations to others can arise from at least three possible sources: cooperation, having caused harm, and effective power to improve suffering. The last source, this chapter argues, is particularly important in considering our obligations to future generations. It draws on a line of reasoning that takes us well beyond contractarian motivations to the idea of the “impartial spectator” as developed by Adam Smith. The interests of future generations come into the story because they are important in our attempt to be impartial spectators. The obligation of power contrasts with the mutual obligations for cooperation at the basic plane of motivational justification. In the context of climate concerns and intergenerational justice, this asymmetry-embracing approach seems to allow an easier entry for understanding our obligations.
Why Plato Lost Interest in the Socratic Method
Authors: Matthews Gareth
Published: June 2018

The Socratic elenchus is a method of philosophical analysis which Plato largely dropped in his middle and later writings, with two exceptions, Republic 1 and the Theaetetus. But it is a mistake to describe these as elenctic dialogues, which typically seek an analysis of a virtue in terms of necessary and sufficient conditions, by questioning some alleged expert about its essence. Republic 1 does not follow this pattern: Thrasymachus fundamentally objects to such a procedure and the presuppositions underlying it, while Glaucon and Socrates turn to developing their own theories of justice. The Theaetetus is likewise concerned with exploring and testing theories, in this case of knowledge. The Socratic elenchus cannot produce any philosophically interesting theories, let alone establish their truth, but at most refute them. As Plato increasingly sought out such theories, the kind of analysis at issue in the Socratic elenchus came to interest him less.
In Search of Thin Objects
Authors: Linnebo Øystein
Published: June 2018

Are there objects that are “thin” in the sense that their existence does not make a substantial demand on the world? First, some extant approaches to thin objects are surveyed, associated with mathematical structuralism and Fregean abstraction. The philosophical benefits of thin objects are then explained. Next, the idea of thin objects is clarified by articulating some logical and philosophical constraints that any account must satisfy in order to deliver the promised benefits. Finally, it is argued that these constraints favor an asymmetric conception of abstraction, where abstraction on “old” entities gives rise to “new” objects. This asymmetric conception allows the two sides of an abstraction principle to have different ontological commitments.
The association between body mass index, waist circumference, waist–hip ratio and cognitive disorder in older adults
Authors: Liu Zhizhen , Yang Hongqing , Chen Shiya , Cai Jing , Huang Zijie
Published: June 2018

Purpose

To examine the association between body mass index (BMI), waist circumference (WC), waist–hip ratio (WHR) and cognitive disorder in older adults.

Methods

Cross-sectional data from the mini-mental state examination questionnaire and physical examination of older adults (≥65, n = 1037) were collected and analyzed. Logistic regression examined the odds ratios (ORs) of cognitive performance according to BMI, WC and WHR.

Results

The prevalence of cognitive dysfunction in older adults was 13.0%. The BMI-based overweight rate, obesity rate and central obesity rate calculated by either WC or WHR were 39.6, 11.4% and 66.5, 65.6%, respectively. The risk of cognitive impairment was increased in elderly individuals ≥70 years old than in those <70 years old (OR = 1.738). In addition, gender, WHR and smoking habit were also significantly different between the two age groups (P < 0.05). We examined the effects of different BMI values and WC/WHR central obesity on cognition impairment in ≥70-year-old adults and found that BMI obesity and WC/WHR central obesity had a combined effect on the incidence of cognition impairment (OR = 3.076 and OR = 3.584).

Conclusions

BMI obesity and WC/WHR central obesity have a combined effect on cognitive impairment and WHR has a stronger association with cognitive impairment than WC.
Enhanced Control of Plant Wilt Disease by a Xylose-Inducible degQ Gene Engineered into Bacillus velezensis Strain SQR9XYQ
Authors: Xu Zhihui , Xie Jiyu , Zhang Huihui , Wang Dandan , Shen Qirong , Zhang Ruifu
Published: June 2018

Bacillus velezensis SQR9 (former B. amyloliquefaciens SQR9) is a plant-growth-promoting rhizobacterium (PGPR) that promotes plant growth and health. The colonization of PGPR strains along plant roots is a prerequisite for them to execute their specific functions. However, one problem of microbial introduction in practice is that the applied PGPR strains do not always successfully colonize the rhizosphere. In Bacillus spp., two-component signal transduction system (TCS) DegS/U regulates flagellar motility, biofilm formation and antibiotic production. Phosphorylation of DegU by DegS is positively affected by DegQ protein. In this study, we constructed a xylose-inducible degQ genetically engineered strain SQR9XYQ to improve the biocontrol activity. The results from in vitro, root in situ, greenhouse experiments and RT-qPCR studies demonstrate that (i) the phosphorylation of DegU in SQR9XYQ can be gradually activated by xylose, which is a component of both cucumber and tomato root exudates, and (ii) biofilm formation, antibiotic expression, colonization activity, and biocontrol efficiency were improved in SQR9XYQ compared with the wild-type strain SQR9. These results suggest that colonization trait is important to biocontrol strains for maintenance of plant health.
How Small Differences in Assessed Clinical Performance Amplify to Large Differences in Grades and Awards: A Cascade With Serious Consequences for Students Underrepresented in Medicine
Authors: Teherani Arianne , Hauer Karen E. , Fernandez Alicia , King Talmadge E. , Lucey Catherine
Published: June 2018

While students entering medical schools are becoming more diverse, trainees in residency programs in competitive specialties and academic medicine faculty have not increased in diversity. As part of an educational continuous quality improvement process at the University of California, San Francisco, School of Medicine, the authors examined data for the classes of 2013–2016 to determine whether differences existed between underrepresented in medicine (UIM) and not-UIM students’ clinical performance (clerkship director ratings and number of clerkship honors grades awarded) and honor society membership—all of which influence residency selection and academic career choices.

This analysis demonstrated differences that consistently favored not-UIM students. Whereas the size and magnitude of differences in clerkship director ratings were small, UIM students received approximately half as many honors grades as not-UIM students and were three times less likely to be selected for honor society membership.

The authors use these findings to illustrate the amplification cascade, a phenomenon in which small differences in assessed performance lead to larger differences in grades and selection for awards. The amplification cascade raises concerns about opportunities for UIM students to compete successfully for competitive residency programs and potentially enter academic careers. Using a fishbone diagram, a continuous quality improvement root cause analysis tool, the authors contextualize their institutional results. They describe potential causes of group differences, drawing from the education disparities literature, and propose interventions and future research. They also share countermeasures adopted at their institution and encourage other medical schools to consider similar exploration of their institutional data.
Nurse Stressors and Satisfiers in the NICU
Authors: Fiske Elizabeth
Published: June 2018

Background:

Working in a neonatal intensive care unit (NICU) can be both rewarding and stressful. Stressors can outweigh satisfiers, leading to job dissatisfaction and turnover. Nurse retention remains a problem, particularly for nurses within the first year of employment.

Purpose:

The purpose of this study was to examine current nurse stressors, satisfiers, and coping processes in the NICU.

Methods:

Seventy-two neonatal nurses from 3 Magnet facilities in North Carolina completed the ICU Stressors Survey, the Ways of Coping Scale, demographic data questions, and free-text questions in Qualtrics, a secure online survey system. Questionnaires were analyzed using protocols developed and validated by instrument developers, and quantitative data were analyzed using SPSS statistical software. Free-text responses were analyzed using iterative coding and thematic grouping.

Results:

Most nurses thought that NICU nursing was stressful, but they coped well with work stress. Nurses felt confident in their knowledge and patient care abilities and were not stressed by the NICU environment. Inadequate staffing was the most common stressor. Coping strategies were aimed at task completion. Nurses wanted better teamwork on their units. Nurses felt more respected by their peers and families than by their immediate supervisors and physicians.

Implications:

Attention to staffing patterns is paramount. Team-building activities may help foster mutual respect and collegiality among the nursing staff and between disciplines. Research investigating creative staffing patterns would be helpful. Interprofessional research may also reduce stressors and enhance team performance.
Foam Padding in Postoperative Lower Extremity Casting: An Inexpensive Way to Protect Patients
Authors: Murgai Rajan R. , Compton Edward , Patel Akash R. , Ryan Deirdre , Kay Robert M.
Published: June 2018

Background:

Although postoperative cast immobilization is routinely used in children, it is not without complications. Few studies have focused on interventions to decrease their frequency. The purpose of this study was to determine if foam padding in postoperative lower extremity casts decreased the rate of cast complications.

Methods:

A retrospective review of patients who underwent lower extremity casting after elective surgery at a tertiary pediatric hospital from 2006 to 2013 was conducted. Postoperative casts were classified by type (A-frame, short leg, long leg, spica) and the presence of foam. Charts were reviewed for skin complications, cast splits for apparent neurovascular deficits, cast splits for patient complaints, unplanned outpatient returns for cast-related issues, and compartment syndrome.

Results:

In total, 920 patients with 2,481 casts were included. In total, 612 (24.7%) casts had foam placed during casting. The incidence of skin complications was significantly lower in A-frame casts with foam (4.5%, 5/112) than without (13.4%, 11/82) (P=0.03) and long leg casts with foam (0.9%, 2/225) than without (4.3%, 19/444) (P=0.02). Patients with static encephalopathy casted with foam had a lower incidence of skin complications (0.7%, 2/279) than those without (3.6%, 22/615) (P=0.01). There was no difference in the overall incidence of skin complications in casts with and without foam (P=0.44), short leg casts (P=0.37), and spica casts (P=0.34). Patients with skin complications (20.3±7.1 kg/m2) had a higher body mass index than those without (18.9±5.4 kg/m2) (P=0.04). Postoperative A-frame casts with foam (0.0%, 0/112) were split less often for apparent neurovascular deficits than those without foam (4.5%, 3/67) (P=0.05). The cast split rates for apparent neurovascular deficits in casts with and without foam (P=0.58), long leg casts (P=0.67), short leg casts (P=0.63), and spica casts (P=1.0) were comparable.

Conclusions:

The use of foam in postoperative lower extremity casting is an effective intervention to reduce the incidence of skin complications in patients with static encephalopathy, in an A-frame cast, or in a long leg cast.

Level of Evidence:

Level III—retrospective comparative study.
Determinants of Patient Satisfaction 2 Years After Spinal Deformity Surgery
Authors: Yang Jingyan , Lafage Virginie , Lafage Renaud , Smith Justin , Klineberg Eric O. , Shaffrey Christopher I. , Mundis Gregory , Hostin Richard , Burton Douglas , Ames Christopher P. , Bess Shay , Kim Han Jo , Schwab Frank
Published: June 2018

Study Design.

Retrospective review of prospective multicenter database.

Objective.

To investigate the determinants of patient satisfaction with respect to changes in functional limitations 2 years after spinal deformity surgery.

Summary of Background Data.

For operatively treated adult spine deformity (ASD), patient satisfaction has become an important component of evaluating quality of care.

Methods.

A total of 430 operative patients with ASD with 2-year follow-up were analyzed. Patient satisfaction was assessed using the Scoliosis Research Society 22-item. Latent class analysis was performed to assign individuals to classes based on the changes in pre- and 2-year postoperative functions, assessed using the Oswestry Disability Index (ODI). An ordered logistic regression was conducted to assess the association of class membership and satisfaction.

Results.

Latent class analysis identified four classes. The worsened-condition class (WC: 1.4%) consisted of patients who were likely to experience worsened function, particularly in lifting and pain intensity. The remained-same class (RS: 13.0%) included patients who remained the same, because the majority reported approximately no change in walking, standing, and sitting. The mild-improved class (mild-I: 40.2%) included patients with mildly enhanced conditions, specifically, in standing, social life, and employment. The most-improved class (most-I: 45.3%) included patients with great improvement after surgery mainly in standing, followed by social life and employment. The odds of being satisfied were significantly increased by 3.91- (P < 0.001) and 16.99-fold (P < 0.001), comparing patients in mild-I and most-I to the RS/WC class, respectively, after controlling for confounders.

Conclusion.

Improvement in standing, social life, and employment are the most important determinants of patient satisfaction postsurgery. Reduced pain intensity and enhanced walking ability also help to elevate patient satisfaction. However, lifting, personal care, sitting, sleeping, and travelling may be of less importance. Examining the heterogeneity of patient-reported outcome in patients with ASD allows the identification of classes with different patient characteristics and satisfaction, and thus, help to guide tailored provision of care.

Level of Evidence: 4
“As Black as Ink”
Authors: Donaldson Callum J. , Mitchell Stuart L. , Riley Lee H. , Kebaish Khaled M.
Published: June 2018

Study Design.

Case report and literature review.

Objective.

To characterize the rare presentation of myelopathy occurring secondary to alkaptonuria and to evaluate the available evidence regarding its treatment.

Summary of Background Data.

Alkaptonuria is an autosomal recessive genetic condition with an estimated incidence of 1 in 250,000 to 1 in 1,000,000 people. Mutation of the enzyme homogentisate 1,2-dioxygenase leads to the production of high levels of homogentisic acid, with subsequent deposition in ligaments, cartilage, and menisci. Involvement of the spine is termed “ochronotic spondyloarthropathy,” of which myelopathy is an uncommon presentation.

Methods.

We present the case of a 57-year-old man with alkaptonuria-associated myelopathy, who underwent surgical decompression. Ten additional cases were identified in the literature by a systematic search of PubMed and Google Scholar.

Results.

In a patient presenting with myelopathy, alkaptonuria may be suspected because of medical history, family history, symptoms (including darkened urine, pigmented ear cartilage, and sclera), or radiographic changes, such as multilevel disc collapse, progressive wafer-like disc calcification, extensive osteophyte formation, and spinal deformity. The diagnosis can be confirmed by urine homogentisic acid testing. Of the 11 patients presented here or identified in the literature, 2 were treated nonoperatively, 8 were treated with decompressive spinal surgery, and treatment of the myelopathy was not discussed for 1 patient. In all cases in which outcomes were reported, substantial improvement in the patient's condition was seen.

Conclusion.

Alkaptonuria is a rare cause of myelopathy, but one that clinicians should understand. Although no disease-modifying treatment currently exists for alkaptonuria, the use of symptomatic treatments and, particularly, surgical decompression is recommended to address myelopathy if it develops.

Level of Evidence: 4
Human Myocardium Has a Robust α1A-Subtype Adrenergic Receptor Inotropic Response
Authors: Janssen Paul M. L. , Canan Benjamin D. , Kilic Ahmet , Whitson Bryan A. , Baker Anthony J.
Published: June 2018

Recent studies report that a single subtype of α1-adrenergic receptor (α1-AR), the α1A-subtype, mediates robust cardioprotective effects in multiple experimental models of heart failure, suggesting that the α1A-subtype is a potential therapeutic target for an agonist to treat heart failure. Moreover, we recently found that the α1A-subtype is present in human heart. The goal of this study was to assess the inotropic response mediated by the α1A-subtype in human myocardium, and to determine whether the response is downregulated in myocardium from failing human heart. We measured in vitro contractile responses of cardiac muscle preparations (trabeculae) isolated from the right ventricle from nonfailing and failing human hearts. Addition of the α1A-subtype agonist A61603 (100 nM) resulted in a large positive inotropic response (force increased ≈ 2-fold). This response represented ≈70% of the response mediated by the β-adrenergic receptor agonist isoproterenol (1 μM). Moreover, in myocardium from failing hearts, α1A-subtype responses remained robust, and only slightly reduced relative to nonfailing hearts. We conclude that α1A-subtype–mediated inotropy could represent a significant source of inotropic support in the human heart. Furthermore, the α1A-subtype remains functional in myocardium from failing human hearts and thus, might be a therapeutic target to support cardioprotective effects in patients with heart failure.
Size-Dependent Ability of Liposomes to Accumulate in the Ischemic Myocardium and Protect the Heart
Authors: Mukhamadiyarov Rinat A. , Senokosova Evgeniya A. , Krutitsky Sergey S. , Voevoda Darya V. , Pyshnaya Inna A. , Ivanov Vladimir V. , Lewis Martin J. , Khaliulin Igor
Published: June 2018

Liposomes have the potential to be used for drug delivery. Meanwhile, liposome size may affect their accumulation in the target tissue. We investigated the myocardial accumulation of 2 populations of liposomes (∼70 and 110 nm diameter) during ischemia and their effect on ischemia/reperfusion injury. Isolated rat hearts were subjected to 30 minutes of low-flow ischemia with the liposomes, followed by 30 minutes of liposome-free reperfusion. The liposomes were loaded with the fluorescent dye Nile Red to assess their accumulation in the myocardium. The cardiac functional recovery during reperfusion was evaluated using force–velocity characteristics and coronary flow (CF). Reperfusion injury was evaluated by lactate dehydrogenase release. In addition, CF and contractility were assessed in hearts perfused normally with 70 nm liposomes. There was a 6- and 4-fold greater accumulation of the small liposomes in the myocardium and mitochondria, respectively, compared with the large liposomes. Importantly, even without any incorporated drugs, both populations of liposomes improved functional recovery and reduced lactate dehydrogenase release. However, the smaller liposomes showed significantly higher protective and vasodilatory effects during reperfusion than the larger particles. These liposomes also increased CF and contractility during normal perfusion. We suggest that the protective properties of the liposomes could be related to their membrane-stabilizing effect.
Triamcinolone for the Treatment of Graves Ophthalmopathy Tested With Short Tau Inversion Recovery Magnetic Resonance
Authors: Ortiz-Basso Tomás , Vigo Rodolfo L. , Sidelnik Mariano , Vazquez-Durand Mariana S. , Shokida María F. , Prémoli Eduardo J. , García-Mónaco Ricardo
Published: June 2018

Purpose:

To evaluate if parabulbar triamcinolone reduces orbital swelling in patients with Graves ophthalmopathy.

Methods:

This is a prospective study of a series of patients with active and moderate Graves ophthalmopathy. Short tau inversion recovery magnetic resonance was used to evaluate the intensity of the extraocular rectus muscles and orbital fat, before and after the treatment with parabulbar triamcinolone.

Results:

The signal intensity ratio of the sum of the OD rectus muscles was 3.67 before treatment (95% CI, 3.26–4.09) and 2.83 after treatment (95% CI, 2.63–3.03) (p < 0.001), and of the muscles of the left orbit, 3.94 before treatment (95% CI, 3.50–4.38) and 2.85 after treatment (95% CI, 2.56–3.14) (p < 0.001). The signal intensity ratio of the fat decreased from 2.95 (95% CI, 2.69–3.21) to 2.33 (95% CI, 2.07–2.58) (p < 0.001). After treatment, there were no local or systemic complications.

Conclusion:

The use of parabulbar triamcinolone reduces orbital inflammation of patients with active and moderate Graves ophthalmopathy.
Expression of Surfactant Proteins in the Human Canaliculus: Evidence and Potential Insights Into the Tear Flow Dynamics
Authors: Ali Mohammad Javed , Kumar Nadimpalli Siva , Bräuer Lars , Paulsen Friedrich , Schicht Martin
Published: June 2018

Purpose:

To investigate the presence and distribution patterns of 6 surfactant proteins (SPs) in the human lacrimal canaliculus.

Methods:

The study was performed on fresh frozen cadaveric samples of canaliculi. Immunohistochemical labeling was performed for assessing the presence and distribution of SP: SP-A, SP-B, SP-C, SP-D, SP-G/SFTA2, and SP-H/SFTA3. Immunofluorescence double staining was performed using the respective fluorescein-conjugated antibodies and the results were scored as positive or negative and the distribution pattern within the canalicular system was assessed. Western blot analysis was performed on the protein content which was resolved by reducing 15% sodium dodecyl sulfate-polyacrylamide electrophoresis and bands were studied following staining with primary and secondary antibodies. Human lung tissues were used as controls.

Results:

Fluorescence double staining with 4,6-diamidino 2-pheynlindole and SPs showed strong immunostaining for SP-A, SP-B, SP-C, SP-D, and SP-H/SFTA3. The positive immunofluorescence was noticed across all the layers of the epithelium but not the subepithelial structures. The expression was noted on the surfaces and superficial cytoplasm of the superficial and deep epithelial cells. There was no expression of SP-G/SFTA2 across the canalicular system. Western blot analysis of the proteins confirmed and concurred with the immunofluorescence findings.

Conclusions:

This study provides a proof of principle for the presence of SPs known from lungs in the canalicular system and hypothesizes their possible functions and also their potential role in the tear flow dynamics between the ocular surface and the lacrimal drainage system.
No Requirement for Targeted Theophylline Levels for Diuretic Effect of Aminophylline in Critically Ill Children
Authors: Park Katie , Trout Lindsay C. , Xu Cong , Wang Ming , Tamburro Robert F. , Halstead E. Scott
Published: June 2018

Objectives:

To determine the relationship between theophylline trough levels and urine output in critically ill children administered aminophylline as adjunctive diuretic therapy.

Design:

Retrospective cohort study.

Setting:

The PICU of a tertiary care children’s hospital.

Patients:

A mixed population of medical/surgical including postoperative cardiothoracic surgery patients less than 18 years old.

Interventions:

Electronic medical records of all PICU patients admitted from July 2010 to June 2015 were reviewed, and patients who received aminophylline as diuretic therapy were identified.

Measurements and Main Results:

Patient cohort data including demographics, daily aminophylline, furosemide and chlorothiazide dosing, theophylline trough levels, fluid intake, urine output and total fluid balance, blood urea nitrogen, and creatinine levels were abstracted. Multivariate analysis based on a generalized estimating equations approach demonstrated that aminophylline administration, when analyzed as a categorical variable, was associated with an increase in urine output and decreased fluid balance. However, aminophylline dosing, when analyzed as a continuous variable, was associated with neither an increase in urine output nor decreased fluid balance. Theophylline trough levels were not correlated with urine output at 24 hours (p = 0.78) and were negatively correlated with urine output at 48 hours (r
2 = 0.078; p < 0.005).

Conclusions:

Aminophylline administration provided a measure of increased diuresis, regardless of dosage, and theophylline trough levels. Therefore, achieving a prescribed therapeutic trough level may not be necessary for full diuretic effect. Because, as opposed to the diuretic effect, the side effect profile of aminophylline is dose-dependent, low maintenance dosing may optimize the balance between providing adjunctive diuretic effect while minimizing the risk of toxicity.
Logistics in Coordinating the First Adult Transatlantic Bilateral Hand Transplant: Lessons Learned
Authors: Ben-Amotz Oded , Kruger Erwin A. , McAndrew Christine , Lantieri Laurent , Bozentka David , Steinberg David , Chang Benjamin , Levin L. Scott
Published: June 2018

Hand transplantation requires precise preoperative planning and surgical execution. Coordinating a transplant team—including surgeons, anesthesiologists, nurses, and supporting staff—is a time-sensitive challenge when a donor-recipient match is confirmed. International human limb transplantation occurs when the recipient and donor are in separate countries. The authors describe the logistics behind the first transatlantic adult bilateral hand transplantation, which, to date, required the highest level of coordination and timing. The authors’ experience serves as a proof of concept that international limb transplantation or salvage is possible when the complex logistics of such an endeavor are carefully anticipated.
Comparison of Immediate versus Delayed DIEP Flap Reconstruction in Women Who Require Postmastectomy Radiotherapy
Authors: O’Connell Rachel L. , Di Micco Rosa , Khabra Komel , Kirby Anna M. , Harris Paul A. , James Stuart E. , Power Kieran , Ramsey Kelvin W. D. , Rusby Jennifer E.
Published: June 2018

Background:

The authors investigated aesthetic outcome and patient satisfaction in women who have undergone deep inferior epigastric artery perforator (DIEP) flap reconstruction in the setting of postmastectomy radiotherapy. Patients who underwent DIEP flap reconstruction without postmastectomy radiotherapy were the control group.

Methods:

Participants who had undergone DIEP flap reconstruction between September 1, 2009, and September 1, 2014, were recruited, answered the BREAST-Q, and underwent three-dimensional surface-imaging. A panel assessed the aesthetic outcome by reviewing these images.

Results:

One hundred sixty-seven women participated. Eighty women (48 percent) underwent immediate DIEP flap reconstruction and no postmastectomy radiotherapy; 28 (17 percent) underwent immediate DIEP flap reconstruction with postmastectomy radiotherapy; 38 (23 percent) underwent simple mastectomy, postmastectomy radiotherapy, and DIEP flap reconstruction; and 21 (13 percent) underwent mastectomy with temporizing implant, postmastectomy radiotherapy, and DIEP flap reconstruction. Median satisfaction scores were significantly different among the groups (p < 0.05). Post hoc comparison demonstrated that women who had an immediate DIEP flap reconstruction were significantly less satisfied if they had postmastectomy radiotherapy. In women requiring radiotherapy, those undergoing delayed reconstruction after a simple mastectomy were most satisfied, but there was no significant difference between the immediate DIEP flap and temporizing implant groups. Median panel scores differed among groups, being significantly higher if the immediate reconstruction was not subjected to radiotherapy. There was no significant difference in panel assessment among the three groups of women who had received radiotherapy.

Conclusions:

Patients who avoid having their immediate DIEP flap reconstruction irradiated are more satisfied and have better aesthetic outcome than those who undergo postmastectomy radiotherapy. In women requiring radiotherapy and who wish to have an immediate or “delayed-immediate” reconstruction, there were no significant differences in panel or patient satisfaction. Therefore, immediate DIEP flap reconstruction or mastectomy with temporizing implant then DIEP flap surgery are acceptable treatment pathways in the context of post-mastectomy radiotherapy.
Postural Disorders and Antiparkinsonian Treatments in Parkinson Disease: An Exploratory Case-Control Study
Authors: Ameghino Lucía , Bruno Verónica , Merello Marcelo
Published: June 2018

Objective

The aim of this study was to evaluate the relationship between antiparkinsonian treatments, especially dopamine agonist (DAs) and the development of postural disorders in patients with Parkinson's disease (PD).

Methods

We performed an exploratory case-control study. Cases were PD patients with camptocormia, Pisa syndrome, or anterocollis. Control subjects were PD patients without postural disorders matched by sex and age. Demographic and clinical data including pharmacologic treatments history were collected retrospectively. Characteristics of cases and control subjects were compared using parametric and nonparametric tests accordingly, and logistic regression models were used to analyze correlations.

Results

We included 63 patients with PD and postural disorders and 63 control subjects. Cases were more exposed to DAs (74.60% vs 58.73%, P = 0.05) and amantadine (30.16% vs 7.94%, P < 0.05) than control subjects. Cases showed longer disease duration (7.63 ± 7.83 vs 4.27 ± 3.87 years, P < 0.05), higher Hoehn and Yahr stage (2.83 ± 0.80 vs 2.15 ± 0.73, P < 0.05), higher Movement Disorder Society Unified Parkinson's Disease Rating Scale part III score (29.61 ± 1.39 vs 20.76 ± 10.94, P = 0.05), and more dyslipidemia (28.57% vs 12.70%, P < 0.05) than control subjects, as well as lower prevalence of depression (46.03% vs 28.57%, P < 0.05). We found no clinical predictors for the development of postural disorders after multivariable adjusted regression.

Conclusions

Our results suggest a possible association between the use of DAs and amantadine and the development of postural disorders in PD and suggest potential risk factors including advanced disease and more severe motor symptoms. These results support the need of a cautious use of these medications in patients with advanced disease due to the possibility of increasing the risk-benefit ratio.
ICTV Virus Taxonomy Profile: Papillomaviridae
Authors: Van Doorslaer Koenraad , Chen Zigui , Bernard Hans-Ulrich , Chan Paul K. S. , DeSalle Rob , Dillner Joakim , Forslund Ola , Haga Takeshi , McBride Alison A. , Villa Luisa L. , Burk Robert D. ,   ICTV Report Consortium
Published: June 2018

The Papillomaviridae is a family of small, non-enveloped viruses with double-stranded DNA genomes of 5 748 to 8 607 bp. Their classification is based on pairwise nucleotide sequence identity across the L1 open reading frame. Members of the Papillomaviridae primarily infect mucosal and keratinised epithelia, and have been isolated from fish, reptiles, birds and mammals. Despite a long co-evolutionary history with their hosts, some papillomaviruses are pathogens of their natural host species. This is a summary of the International Committee on Taxonomy of Viruses (ICTV) Report on the taxonomy of the Papillomaviridae, which is available at http://www.ictv.global/report/papillomaviridae.
Genomic variants among threatenedAcroporacorals
Authors: Kitchen S. A. , Ratan A. , Bedoya-Reina O. C. , Burhans R. , Fogarty N. D. , Miller W. , Baums I. B.
Published: June 2018

Genomic sequence data for non-model organisms are increasingly available requiring the development of efficient and reproducible workflows. Here, we develop the first genomic resources and reproducible workflows for two threatened members of the reef-building coral genusAcropora. We generated genomic sequence data from multiple samples of the CaribbeanA. cervicornis(staghorn coral) andA. palmata(elkhorn coral), and predicted millions of nucleotide variants among these two species and the PacificA. digitifera. A subset of predicted nucleotide variants were verified using restriction length polymorphism assays and proved useful in distinguishing the two Caribbean Acroporids and the hybrid they form (“A. prolifera”). Nucleotide variants are freely available from the Galaxy server (usegalaxy.org), and can be analyzed there with computational tools and stored workflows that require only an internet browser. We describe these data and some of the analysis tools, concentrating on fixed differences betweenA. cervicornisandA. palmata. In particular, we found that fixed amino acid differences between these two species were enriched in proteins associated with development, cellular stress response and the host’s interactions with associated microbes, for instance in the Wnt pathway, ABC transporters and superoxide dismutase. Identified candidate genes may underlie functional differences in the way these threatened species respond to changing environments. Users can expand the presented analyses easily by adding genomic data from additional species as they become available.

Article Summary

We provide the first comprehensive genomic resources for two threatened Caribbean reef-building corals in the genusAcropora. We identified genetic differences in key pathways and genes known to be important in the animals’ response to the environmental disturbances and larval development. We further provide a list of candidate loci for large scale genotyping of these species to gather intra- and interspecies differences betweenA. cervicornisandA. palmataacross their geographic range. All analyses and workflows are made available and can be used as a resource to not only analyze these corals but other non-model organisms.
Using vocational education to provide development solutions in the Pacific: An emphasis on climate change and health
Authors: Havea Peni Hausia , Siga Amelia , Rabuatoka Titilia , Tamani Apenisa Tagivetaua , Devi Priya , Senikula Ruci , Hemstock Sarah L , Combes Helene Jacot Des
Published: June 2018

This article reports on the results of the EU PacTVET project, which explored the use of Technical Vocational Education and Training (TVET) to provide a better understanding on the development solution for the impact of climate change on human health in the region. It describes the findings of a 2014-2018 project on the use of vocational education to provide development solutions in the Pacific with an emphasis on climate change and health. An exploratory design was used to investigate how vocational education developed solutions for climate change and health in the 15 Pacific – African Caribbean and Pacific (P-ACP) countries: Cook Islands, Federated States of Micronesia (FSM), Fiji, Kiribati, Nauru, Niue, Palau, Papua New Guinea (PNG), Republic of Marshall Islands (RMI), Samoa, Solomon Islands, Timor-Leste, Tonga, Tuvalu and Vanuatu. Information collected via personal communication with relevant stakeholders, qualitative interviews, documents review, and survey (n=48) of youths and young women in Fiji. Data analysis was performed using thematic analytical strategy and frequency analysis. The study found that vocational education plays a significant role in building the capacity of people to become more sustainable and resilient in their life now and in the future. Also, getting an accredited qualification on health resilience and/or job in the health sector may help them to respond effectively and efficiently in the event of climate change and/or disasters caused by natural hazards. The same factors were explored quantitatively using descriptive analytical strategy, and concluded TVET education, to have a positive influence on climate change and health. As a result, vocational education could provide development solutions for health adaptation in the Pacific. These results indicate global actions for vocational education, that would perfect the course of resilience for these 15 P-ACP in the Pacific and alike in the U.S.
SmartCodes: functionalized barcodes that enable targeted retrieval of clonal lineages from a heterogeneous population
Authors: Rebbeck Clare , Raths Florian , Ben Cheik Bassem , Gouin Kenneth , Hannon Gregory J. , Knott Simon R. V.
Published: June 2018

Molecular barcoding has provided means to link genotype to phenotype, to individuate cells in single-cell analyses, to enable the tracking of evolving lineages, and to facilitate the analysis of complex mixtures containing phenotypically distinct lineages. To date, all existing approaches enable retrospective associations to be made between characteristics and the lineage harbouring them, but provide no path toward isolating or manipulating those lineages within the complex mixture. Here, we describe a strategy for creating functionalized barcodes that enable straightforward manipulation of lineages within complex populations of cells, either marking and retrieval of selected lineages, or modification of their phenotype within the population, including their elimination. These “SmartCodes” rely on a simple CRISPR-based, molecular barcode reader that can switch measurable, or selectable markers, on or off in a binary fashion. While this approach could have broad impact, we envision initial approaches to the study of tumour heterogeneity, focused on issues of tumour progression, metastasis, and drug resistance.
Crystal structure of cis-[1,2-bis(diphenylphosphanyl)ethene-κ2
P,P′]dichloridoplatinum(II) chloroform disolvate: a new polymorph
Authors: Mugemana Jimmy , Bender John , Staples Richard J. , Biros Shannon M.
Published: June 2018

The title compound, [PtCl2(C26H22P2)]·2CHCl3 (I), is the third monoclinic polymorph of this platinum(II) complex involving the bidentate ligand cis-1,2-bis(diphenylphosphanyl)ethylene (cis-dppe) [for the others, see: Oberhauser et al. (1998a). Inorg. Chim. Acta, 274, 143–154, and Oberhauser et al. (1995). Inorg. Chim. Acta, 238, 35–43]. The structure of compound (I) was solved in the space group P21/c, with one complex molecule in the asymmetric unit along with two solvate chloroform molecules. The PtII atom is ligated by two P and two Cl atoms in the equatorial plane and has a perfect square-planar coordination sphere. In the crystal, the complex molecule is linked to the chloroform solvate molecules by C—H...Cl hydrogen bonds and face-on C—Cl...π interactions. There are also weak offset π–π interactions present [intercentroid distances are 3.770 (6) and 4.096 (6) Å], linking the molecules to form supramolecular sheets that lie in the bc plane.
Understanding customer satisfaction in the UK quick service restaurant industry
Authors: Nguyen Quang , Nisar Tahir M. , Knox Dan , Prabhakar Guru Prakash
Published: June 2018

Purpose

The purpose of this paper is to examine the impact of the five dimensions of service quality on customer satisfaction in the UK fast food market and to indicate which factors among the five dimensions have a main role in driving overall customer satisfaction.

Design/methodology/approach

Primary data in the form of 147 questionnaire responses were been collected from a variety of quick service fast food restaurants in the UK. Likert seven-point rating scales were used to structure the questionnaire. Data were collected from the customers at two KFC restaurants, two McDonald’s restaurants, and one Burger King Restaurant.

Findings

The results of the analysis indicate that tangibles, responsiveness and assurance play the most important role in driving customer satisfaction in the UK fast food industry, followed by reliability and empathy. Results of correlation and regression analysis show that physical attributes (tangible) of service quality are key to customer satisfaction. In a nutshell, the tangibles variable is the most important factor driving customer satisfaction in the context of the UK fast food market.

Originality/value

This research incorporates unique and original insights in relation to the British fast food restaurants market and the results constitute novel findings pertaining to the importance of physical facilities and attributes. This account of the relative importance of service quality dimensions in fast food restaurants in the UK adds value to the field. The findings of this research have contributed to a better understanding of the main factors that influence service quality and customer satisfaction and have implications from a managerial point of view in the highly competitive UK fast food and wider foodservice industry.
“Fit in” fitness point
Authors: Saxena Stuti
Published: June 2018

Subject area

Marketing management.

Study level/applicability

Undergraduate/Postgraduate.

Case overview

The present case is a disguised one and is meant to enable students to critically analyse the operations and functioning of a fitness centre located in a city. Despite a runaway success, “Fit in” was facing problems of time-management and members’ management. Thus, catering to the members was becoming unwieldy, especially with respect to providing the personalized experience to the members, which was their forte. Thus, Mukesh and Naina faced the challenge of motivating their existing members and getting fresh referrals. Should they cut some of their services? Should they make some changes in manpower management? Or, should they change the operating strategy for their business?

Expected learning outcomes

Expected learning outcomes are as follows: how to ensure customer loyalty in service organization settings and how to enhance motivation among the service customers.

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: 3: Entrepreneurship.
An adaptive approach for prediction of propellant feedline dynamics in fluid network
Authors: Ravindran Sivaguru S. , Majumdar Alok K.
Published: June 2018

Purpose

This paper aims to propose an adaptive unstructured finite volume procedure for efficient prediction of propellant feedline dynamics in fluid network.

Design/methodology/approach

The adaptive strategy is based on feedback control of errors defined by changes in key variables in two subsequent time steps.

Findings

As an evaluation of the proposed approach, two feedline dynamics problems are formulated and solved. First problem involves prediction of pressure surges in a pipeline that has entrapped air and the second is a conjugate heat transfer problem involving prediction of chill down of cryogenic transfer line. Numerical predictions with the adaptive strategy are compared with available experimental data and are found to be in good agreement. The adaptive strategy is found to be efficient and robust for predicting feedline dynamics in flow network at reduced CPU time.

Originality/value

This study uses an adaptive reduced-order network modeling approach for fluid network.
Numerical simulation of flow field in the pneumatic compact spinning systems using Finite Element Method
Authors: Su Xuzhong , Liu Xinjin , Liu Xiaoyan
Published: June 2018

Purpose

Pneumatic compact spinning is the most widely used compact spinning method at present, in which the negative pressure airflow is used to condense the fiber in order to decrease the spinning triangle and improve the yarn qualities. Therefore, the research on flow field in the condensing zone is always the emphasis for pneumatic compact spinning. The paper aims to discuss these issues.

Design/methodology/approach

By using finite element method (FEM), the flow field in two kinds of pneumatic compact spinning was studied. Taking three kinds of cotton yarns as examples, with the help of high-speed camera system OLYMPUS i-SPEED3, the motion trajectory of fiber strand in the condensing zone was obtained. Three-dimensional physical models of the condensing zone of the two compact spinning systems were obtained according to the measured parameters of practical spinning systems.

Findings

It is shown that on the both left edge of B1 line and right edge of B2 line, the airflow inflows to the center line of suction slot, and the condensed effects are produced, correspondingly. In the condensing zone, there are three condensing processes acting on the fiber strand, including the rapid condensing effects in the front condensing zone, the adequately condensing effects in the middle condensing zone, and stable output effects in the back condensing zone.

Originality/value

By using FEM, numerical simulations of three-dimensional flow field in condensing zone for two kinds of pneumatic compact spinning with lattice apron were presented, and corresponding spun yarn qualities were analyzed.
Exploration of the efficacy of the case method of teaching
Authors: Reed Marlene M. , Brunson Rochelle Reed
Published: June 2018

Synopsis

The purpose of this research is to identify studies that had been undertaken to determine the efficacy of the case method of teaching as compared to the lecture method in an academic setting. An extensive search of secondary sources to identify research was undertaken to determine the effectiveness of case teaching as compared to the lecture method. The findings of this study indicate within the research reviewed the following positive results of case teaching noted by students: enhanced learning of the subject; heightened student engagement in the classroom; and the receipt of higher grades in some disciplines. The following negative results are also found: lack of understanding of course content and the method is more challenging and time consuming. In a national survey of faculty using the case method for the first time, the following positive outcomes of utilizing the case method were found: develops strong critical-thinking skills, greater retention of course material and more active engagement in the classroom. The limitations are the inconsistency of variables measured in the study and the small sample sizes. “Recommendations for further study include the use of larger sample sizes and a control group using the lecture method of teaching.”

Research methodology

An extensive search for all studies is performed in the classroom to evaluate and compare the use of the case method as compared to the lecture method of teaching.

Relevant courses and levels

The courses evaluated in the study are from a variety of disciplines in universities.

Theoretical bases

A review of research studies is performed to evaluate the efficacy of the case method of teaching as compared to the lecture method.