bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of Weight-Bearing in Conservative and Operative Management of Fractures of the Base of the Fifth Metatarsal Bone
Authors: Park Jae-Yong , Kim Hyong-Nyun , Hyun Yoon-Suk , Park Jun-Sik , Kwon Hwan-Jin , Kang Sae-Hyun , Kim Gab-Lae
Published: December 2017

Background. There is no established principle regarding weight-bearing in conservative and operative management of fifth metatarsal base fractures.Methods. We reviewed 86 patients with acute fifth metatarsal base fractures. Conservatively treated late or early weight-bearing patients were assigned to Group A or C, respectively. Operatively treated late or early weight-bearing patients were assigned to Group B or D, respectively. Results were evaluated by clinical union, bone resorption, and the American Orthopaedic Foot and Ankle Society (AOFAS) and Visual Analogue Scale (VAS) scores.Results. All 4 groups had bone union at a mean of 6.9 weeks (range, 5.1–15.0). There were no differences between the groups in the AOFAS and VAS scores. In the early weight-bearing groups, there were fewer cases of bone resorption, and the bone unions periods were earlier.Conclusions. Early weight-bearing may help this patient population. Moreover, conservative treatment could be an option in patients with underlying diseases.
CPSFS: A Credible Personalized Spam Filtering Scheme by Crowdsourcing
Authors: Liu Xin , Zou Pingjun , Zhang Weishan , Zhou Jiehan , Dai Changying , Wang Feng , Zhang Xiaomiao
Published: December 2017

Email spam consumes a lot of network resources and threatens many systems because of its unwanted or malicious content. Most existing spam filters only target complete-spam but ignore semispam. This paper proposes a novel and comprehensive CPSFS scheme: Credible Personalized Spam Filtering Scheme, which classifies spam into two categories: complete-spam and semispam, and targets filtering both kinds of spam. Complete-spam is always spam for all users; semispam is an email identified as spam by some users and as regular email by other users. Most existing spam filters target complete-spam but ignore semispam. In CPSFS, Bayesian filtering is deployed at email servers to identify complete-spam, while semispam is identified at client side by crowdsourcing. An email user client can distinguish junk from legitimate emails according to spam reports from credible contacts with the similar interests. Social trust and interest similarity between users and their contacts are calculated so that spam reports are more accurately targeted to similar users. The experimental results show that the proposed CPSFS can improve the accuracy rate of distinguishing spam from legitimate emails compared with that of Bayesian filter alone.
Behavior of Strengthened Composite Prestressed Concrete Girders under Static and Repeated Loading
Authors: Allawi Abbas AbdulMajeed
Published: December 2017

The use of external posttensioning technique for strengthening reinforced concrete girders has been considerably studied by many researchers worldwide. However, no available data are seen regarding strengthening full-scale composite prestressed concrete girders with external posttensioned technique under static and repeated loading. In this research, four full-scale composite prestressed I-shape girders of 16 m span were fabricated and tested under static and repeated loading up to failure. Accordingly, two girders were externally strengthened with posttensioned strands, while the other two girders were left without strengthening. The experimental tests include deflection, cracking load, ultimate strength and strains at midspan, and loading stages. Test results were compared with the design expressions mentioned in AASHTO LRFD specifications and ACI 318-2014 code. Also, a nonlinear analysis was conducted using the finite element method (FEM). The presented analysis models were verified by comparing the model results with test results. The general theme abstracted from both experimental tests and numerical analysis reflects that the performance and procedure of strengthening with external prestressing of girders were found to be effective in increasing the load carrying capacity of the strengthened girders.
Power Control for Passive QAM Multisensor Backscatter Communication Systems
Authors: Hu Shengbo , Mo Jinrong , Yan Tingting , Shi Yanfeng
Published: December 2017

To achieve good quality of service level such as throughput, power control is of great importance to passive quadrature amplitude modulation (QAM) multisensor backscatter communication systems. First, we established the RF energy harvesting model and gave the energy condition. In order to minimize the interference of subcarriers and increase the spectral efficiency, then, the colocated passive QAM backscatter communication signal model is presented and the nonlinear optimization problems of power control are solved for passive QAM backscatter communication systems. Solutions include maximum and minimum access interval, the maximum and minimum duty cycle, and the minimal RF-harvested energy under the energy condition for node operating. Using the solutions above, the maximum throughput of passive QAM backscatter communication systems is analyzed and numerical calculation is made finally. Numerical calculation shows that the maximal throughput decreases with the consumed power and the number of sensors, and the maximum throughput is decreased quickly with the increase of the number of sensors. Especially, for a given consumed power of sensor, it can be seen that the throughput decreases with the duty cycle and the number of sensors has little effect on the throughput.
Outcomes following Serial Intragastric Balloon Therapy for Obesity and Nonalcoholic Fatty Liver Disease in a Single Centre
Authors: Nguyen Vi , Li Jiawei , Gan Jaslyn , Cordero Paul , Ray Shuvra , Solis-Cuevas Alessandro , Khatib Mai , Oben Jude A.
Published: December 2017

Background. The incidence of nonalcoholic fatty liver disease (NAFLD) continues to parallel the rise in obesity rates. Endobariatric devices such as the intragastric balloon (IGB) may provide an alternative treatment option.Methods. Outcomes following IGB treatment in 135 patients with obesity and NAFLD (mean baseline weight 117.9 kg; BMI 41.7 kg/m2; HOMA-IR 3.6) were retrospectively examined. Clinical, anthropometric, and biochemical changes were analysed at six months and after consecutive treatment with two and three serial IGBs.Results. After six months, significant changes were seen with weight and BMI (mean reductions of 11.3 kg and 4.1 kg/m2, resp.,p<0.01for both). Significant improvements were also seen with ALT, GGT, and HOMA-IR, with all changes corresponding with weight loss. Forty-eight patients received two IGBs, and 20 were treated with three serial IGBs. The greatest amount of total weight loss was observed after the first 6 months (mean weight lost 7.4 kg, versus 3.6 kg and 1.9 kg with two and three IGBs, resp.).Conclusions. IGB therapy is an effective, alternative nonsurgical means for weight loss in the management of obesity and NAFLD over the short term, with greatest outcomes observed after six months. Improvements in insulin resistance and hepatic transaminases correlated with weight change.
Dynamic Mechanical Properties of Vietnam Modified Natural Rubber via Grafting with Styrene
Authors: Dung T. A. , Nhan N. T. , Thuong N. T. , Viet D. Q. , Tung N. H. , Nghia P. T. , Kawahara S. , Thuy T. T.
Published: December 2017

The dynamic mechanical behavior of modified deproteinized natural rubber (DPNR) prepared by graft copolymerization with various styrene contents was investigated at a wide range of temperatures. Graft copolymerization of styrene onto DPNR was performed in latex stage using tert-butyl hydroperoxide (TBHPO) and tetraethylene pentamine (TEPA) as redox initiator. The mechanical properties were measured by tensile test and the viscoelastic properties of the resulting graft copolymers at wide range of temperature and frequency were investigated. It was found that the tensile strength depends on the grafted polystyrene; meanwhile the dynamic mechanical properties of the modification of DPNR meaningfully improved with the increasing of both homopolystyrene and grafted polystyrene compared to DPNR. The dynamic mechanical properties of graft copolymer over a large time scale were studied by constructing the master curves. The value of bT has been used to prove the energetic and entropic elasticity of the graft copolymer.
A Rare Case of Craniopharyngioma in the Temporal Lobe
Authors: Razmjoo Sasan , Jazayeri Seyed Nematollah , Bahadoram Mohammad , Barahman Maedeh
Published: December 2017

Herein, we report on a rare case of craniopharyngioma arising in the left temporal lobe with no prior history of head trauma or surgery. There was a solid-cystic mass in the left temporal lobe on MR images. To the best of our knowledge, this is the second case of a craniopharyngioma occurring in the temporal lobe.
In Vivo and In Vitro Evaluation of Pharmacological Potentials of Secondary Bioactive Metabolites of Dalbergia candenatensis Leaves
Authors: Anisuzzman Md. , Hasan Md. Mahedi , Acharzo Amit Kumar , Das Asish Kumar , Rahman Sinthia
Published: December 2017

Background. Dalbergia species has wide range of secondary metabolites and is traditionally used in treatment of painful micturition, swelling, and leprosy and as blood tonic. The study evaluates membrane stabilizing, anticoagulant, analgesic, cytotoxic, subacute anti‐inflammatory, and depression potentials of D. candenatensis leaves metabolites. Methods. Membrane stabilizing activity was evaluated by hypotonic induced hemolysis assay, whereas anticoagulant activity is done through extrinsic pathway by measuring prothrombin time. Analgesic action, cytotoxic effect, and subacute anti‐inflammatory activity were determined by acetic acid induced writhing model, brine shrimp lethality bioassay, and formaldehyde induced model, respectively. Depression activity was measured by the Open Field, Hole Cross, Hole Board, and thiopentone induced sleeping time measuring methods. Results. D. candenatensis contains phenolic, flavonoid, and tannin, quantified as 416.25 mg, 330.00 mg, and 432.22 mg Gallic Acid Equivalent/100 g of dry extract, respectively. Extract showed maximum inhibition of writhe, hemolysis, and edema, approximate to 57.14%, 36.62%, and 34.1%, respectively. LC50 value for nauplii was 151.499 μg/ml. Mean prothrombin time was approximate to 31.0 ± 2.31 seconds at 1.0 mg/ml. Extract showed depression activity, and maximum sleeping time was noted to be about 141 minutes. Conclusion. D. candenatensis leaves show dose dependent membrane stabilizing, anticoagulant, depression, analgesic, moderate cytotoxic, and subacute anti‐inflammatory activities.
Validation of Material Algorithms for Femur Remodelling Using Medical Image Data
Authors: Luo Shitong , Shen Xingquan , Bai Xin , Bai Jing , Han Jianning , Shang Yu
Published: December 2017

The aim of this study is the utilization of human medical CT images to quantitatively evaluate two sorts of “error-driven” material algorithms, that is, the isotropic and orthotropic algorithms, for bone remodelling. The bone remodelling simulations were implemented by a combination of the finite element (FE) method and the material algorithms, in which the bone material properties and element axes are determined by both loading amplitudes and daily cycles with different weight factor. The simulation results showed that both algorithms produced realistic distribution in bone amount, when compared with the standard from CT data. Moreover, the simulated L-T ratios (the ratio of longitude modulus to transverse modulus) by the orthotropic algorithm were close to the reported results. This study suggests a role for “error-driven” algorithm in bone material prediction in abnormal mechanical environment and holds promise for optimizing implant design as well as developing countermeasures against bone loss due to weightlessness. Furthermore, the quantified methods used in this study can enhance bone remodelling model by optimizing model parameters to gap the discrepancy between the simulation and real data.
Energy Efficiency Analysis of ICN Assisted 5G IoT System
Authors: Zhang Di , Zhou Zhenyu , Zhu Zhengyu , Mumtaz Shahid
Published: December 2017

Other than separately investing the energy efficiency (EE) merits of information-centric networking’s (ICN’s) caching and sharing (CS) mechanism in wireless communications, here we comprehensively compare the EE performances of ICN’s CS mechanism in different scenarios. A modified system model is first proposed while introducing the CS mechanism into the in-network router, base station (BS), and neighboring user sides. Afterwards, the system achievable sum rate as well as the power consumptions in wireless and wired sections is investigated. The EE performances of different scenarios are finally obtained by dividing the achievable sum rate by the consumed power. While comparing the three scenarios, numerical results demonstrate that the optimal place to cache the content is mainly determined by the distance and hub number of the core routers that passed.
Saquinavir Ameliorates Liver Warm Ischemia-Reperfusion-Induced Lung Injury via HMGB-1- and P38/JNK-Mediated TLR-4-Dependent Signaling Pathways
Authors: Yu Zhuang , Tong Yao , Zhang Renlingzi , Ding Xibing , Li Quan
Published: December 2017

Liver ischemia and reperfusion (I/R) induce local and distant tissue injuries, contributing to morbidity and mortality in a wider range of pathologies. This is especially seen under uncontrolled aseptic inflammatory conditions, leading to injury of remote organs, such as lung injury, and even failure. Saquinavir (SQV) is a kind of HIV protease inhibitor that possesses an anti-inflammatory property. In this study, we investigated whether SQV suppresses Toll-like receptor 4- (TLR4-) dependent signaling pathways of high-mobility group box 1 (HMGB1) and P38/JNK, conferring protection against murine liver I/R-induced lung injury. To investigate our hypothesis, C57BL/6 mice and TLR4 knockout mice (TLR4−/−) were used to perform the study. SQV administration markedly attenuated remote lung tissue injury after 1-hour ischemia and 6-hour reperfusion of the liver. To our expectation, SQV attenuated I/R-induced lung edema, hyperpermeability, and pathological injury. The beneficial effects of SQV were associated with decreased levels of circulating and lung tissue inflammatory cytokines, such as IL-6, IL-1β, TNF-α, and iNOS. The protective effect of SQV was also associated with decreased lung tissue expression of HMGB1, TLR-4, and p-P38/JNK, but not p-ERK in wild-type liver I/R mice. Overall, this study demonstrated a new role of SQV, facilitating negative regulation of HMGB1- and P38/JNK-mediated TLR-4-dependent signaling pathways, conferring protection against liver I/R-induced lung injury.
Adenoma and Polyp Detection Rates in Colonoscopy according to Indication
Authors: Boroff Erika S. , Disbrow Molly , Crowell Michael D. , Ramirez Francisco C.
Published: December 2017

Background. Adenoma detection rate (ADR) is a validated quality measure for screening colonoscopy, but there are little data for other indications. The distribution of adenomas is not well described for these indications. Aim. To describe ADR and the adenoma distribution in the proximal and distal colon based on colonoscopy indication. Methods. Outpatient colonoscopies are subdivided by indication. PDR and ADR for the entire colon and for proximal and distal colon. Data were compared using generalized estimating equations to adjust for clustering amongst endoscopists while controlling for patient age and gender. Results. 3436 colonoscopies were reviewed (51.2%: men (n=1759)). Indications are screening 49.2%, surveillance 29.3%, change in bowel habit 8.4%, bleeding 5.8%, colitides 3.0%, pain 2.8%, and miscellaneous 1.5%. Overall ADR was 37% proximal ADR 28%, and distal ADR 17%. PDR and ADR were significantly higher in surveillance than in screening (PDR: 69% versus 51%; ADR: 50% versus 33%; p=0.0001). Adenomas were more often detected in the proximal than in the distal colon, for all indications. Conclusions. Prevalence of polyps and adenomas differs based on colonoscopy indication. Adenoma detection is highest in surveillance and more commonly detected in the proximal colon. For quality assurance, distinct ADR and PDR targets may need to be established for different colonoscopy indications.
Quality of Experience Assessment of Video Quality in Social Clouds
Authors: Laghari Asif Ali , He Hui , Karim Shahid , Shah Himat Ali , Karn Nabin Kumar
Published: December 2017

Video sharing on social clouds is popular among the users around the world. High-Definition (HD) videos have big file size so the storing in cloud storage and streaming of videos with high quality from cloud to the client are a big problem for service providers. Social clouds compress the videos to save storage and stream over slow networks to provide quality of service (QoS). Compression of video decreases the quality compared to original video and parameters are changed during the online play as well as after download. Degradation of video quality due to compression decreases the quality of experience (QoE) level of end users. To assess the QoE of video compression, we conducted subjective (QoE) experiments by uploading, sharing, and playing videos from social clouds. Three popular social clouds, Facebook, Tumblr, and Twitter, were selected to upload and play videos online for users. The QoE was recorded by using questionnaire given to users to provide their experience about the video quality they perceive. Results show that Facebook and Twitter compressed HD videos more as compared to other clouds. However, Facebook gives a better quality of compressed videos compared to Twitter. Therefore, users assigned low ratings for Twitter for online video quality compared to Tumblr that provided high-quality online play of videos with less compression.
A Herbal Formula HT051, a Combination of Pueraria lobata and Rehmannia glutinosa, Prevents Postmenopausal Obesity in Ovariectomized Rats
Authors: Lee Yoon Hee , Jin Bora , Lee Sunghyun , Oh Jin-Young , Song Jungbin , Lee Donghun , Kim Young-Sik , Kim Hocheol
Published: December 2017

Menopause is strongly associated with an increased risk of metabolic dysfunctions due to the decline in estrogen. Here, we hypothesized that dietary HT051, containing the roots of Pueraria lobata and Rehmannia glutinosa, has beneficial effects on ovariectomized (OVX) rats by regulating lipid metabolism. Forty‐eight female Sprague‐Dawley rats were randomly divided into 4 groups: sham‐operated (Sham), OVX, OVX with low‐dose HT051 supplementation, and OVX with high‐dose HT051 supplementation. The rats were fed with a modified AIN‐93G diet or an HT051‐containing modified AIN‐93G diet for 8 weeks. Body weight, fat mass, and serum levels of total cholesterol, triglyceride, glucose, alanine transaminase, and aspartate transaminase decreased in HT051‐fed OVX rats. Dietary HT051 supplementation significantly decreased the mRNA expression of lipogenesis‐related genes, including sterol regulatory element‐binding protein 1c and fatty acid synthase, and increased the mRNA expression of β‐oxidation‐related genes, including peroxisome proliferator‐activated receptor and carnitine palmitoyl transferase 1 in the liver of OVX rats. Moreover, the expression of genes involved in adipogenesis and inflammation was significantly lower in the adipose tissue of OVX rats fed with HT051 than in the OVX group. These findings suggest that HT051 may be a potential natural alternative for the management of postmenopausal metabolic dysfunctions.
Effects of Various Extents of High-Frequency Hearing Loss on Speech Recognition and Gap Detection at Low Frequencies in Patients with Sensorineural Hearing Loss
Authors: Li Bei , Guo Yang , Yang Guang , Feng Yanmei , Yin Shankai
Published: December 2017

This study explored whether the time-compressed speech perception varied with the degree of hearing loss in high-frequency sensorineural hearing loss (HF SNHL) individuals. 65 HF SNHL individuals with different cutoff frequencies were recruited and further divided into mildly, moderately, and/or severely affected subgroups in terms of the averaged thresholds of all frequencies exhibiting hearing loss. Time-compressed speech recognition scores under both quiet and noisy conditions and gap detection thresholds within low frequencies that had normal thresholds were obtained from all patients and compared with data from 11 age-matched individuals with normal hearing threshold at all frequencies. Correlations of the time-compressed speech recognition scores with the extents of HF SNHL and with the 1 kHz gap detection thresholds were studied across all participants. We found that the time-compressed speech recognition scores were significantly affected by and correlated with the extents of HF SNHL. The time-compressed speech recognition scores also correlated with the 1 kHz gap detection thresholds except when the compression ratio of speech was 0.8 under quiet condition. Above all, the extents of HF SNHL were significantly correlated with the 1 kHz gap thresholds.
Germinal Centers Determine the Prognostic Relevance of Tertiary Lymphoid Structures and Are Impaired by Corticosteroids in Lung Squamous Cell Carcinoma
Authors: Siliņa Karīna , Soltermann Alex , Attar Farkhondeh Movahedian , Casanova Ruben , Uckeley Zina M. , Thut Helen , Wandres Muriel , Isajevs Sergejs , Cheng Phil , Curioni-Fontecedro Alessandra , Foukas Periklis , Levesque Mitchell P. , Moch Holger , Linē Aija , van den Broek Maries
Published: December 2017

In solid tumors, the presence of lymph node–like structures called tertiary lymphoid structures (TLS) is associated with improved patient survival. However, little is known about how TLS develop in cancer, how their function affects survival, and whether they are affected by cancer therapy. In this study, we used multispectral microscopy, quantitative pathology, and gene expression profiling to analyze TLS formation in human lung squamous cell carcinoma (LSCC) and in an experimental model of lung TLS induction. We identified a niche of CXCL13+ perivascular and CXCL12+LTB+ and PD-L1+ epithelial cells supporting TLS formation. We also characterized sequential stages of TLS maturation in LSCC culminating in the formation of germinal centers (GC). In untreated patients, TLS density was the strongest independent prognostic marker. Furthermore, TLS density correlated with GC formation and expression of adaptive immune response–related genes. In patients treated with neoadjuvant chemotherapy, TLS density was similar, but GC formation was impaired and the prognostic value of TLS density was lost. Corticosteroids are coadministered with chemotherapy to manage side effects in LSCC patients, so we evaluated whether they impaired TLS development independently of chemotherapy. TLS density and GC formation were each reduced in chemotherapy-naïve LSCC patients treated with corticosteroids before surgery, compared with untreated patients, a finding that we confirmed in the experimental model of lung TLS induction. Overall, our results highlight the importance of GC formation in TLS during tumor development and treatment.

Significance: Corticosteroid treatment during chemotherapy negatively affects the development of tertiary lymphoid structures and abrogates their prognostic value in patients with lung cancer. Cancer Res; 78(5); 1308–20. ©2018 AACR.
Late Ca
2+
Sparks and Ripples During the Systolic Ca
2+
Transient in Heart Muscle Cells
Authors: Fowler Ewan D. , Kong Cherrie H.T. , Hancox Jules C. , Cannell Mark B.
Published: December 2017

Rationale:

The development of a refractory period for Ca
2+
spark initiation after Ca
2+
release in cardiac myocytes should inhibit further Ca
2+
release during the action potential plateau. However, Ca
2+
release sites that did not initially activate or which have prematurely recovered from refractoriness might release Ca
2+
later during the action potential and alter the cell-wide Ca
2+
transient.

Objective:

To investigate the possibility of late Ca
2+
spark (LCS) activity in intact isolated cardiac myocytes using fast confocal line scanning with improved confocality and signal to noise.

Methods and Results:

We recorded Ca
2+
transients from cardiac ventricular myocytes isolated from rabbit hearts. Action potentials were produced by electric stimulation, and rapid solution changes were used to modify the L-type Ca
2+
current. After the upstroke of the Ca
2+
transient, LCSs were detected which had increased amplitude compared with diastolic Ca
2+
sparks. LCS are triggered by both L-type Ca
2+
channel activity during the action potential plateau, as well as by the increase of cytosolic Ca
2+
associated with the Ca
2+
transient itself. Importantly, a mismatch between sarcoplasmic reticulum load and L-type Ca
2+
trigger can increase the number of LCS. The likelihood of triggering an LCS also depends on recovery from refractoriness that appears after prior activation. Consequences of LCS include a reduced rate of decline of the Ca
2+
transient and, if frequent, formation of microscopic propagating Ca
2+
release events (Ca
2+
ripples). Ca
2+
ripples resemble Ca
2+
waves in terms of local propagation velocity but spread for only a short distance because of limited regeneration.

Conclusions:

These new types of Ca
2+
signaling behavior extend our understanding of Ca
2+
-mediated signaling. LCS may provide an arrhythmogenic substrate by slowing the Ca
2+
transient decline, as well as by amplifying maintained Ca
2+
current effects on intracellular Ca
2+
and consequently Na
+
/Ca
2+
exchange current.
Honoring 50 Years of Clinical Heart Transplantation in
Circulation
Authors: Stehlik Josef , Kobashigawa Jon , Hunt Sharon A. , Reichenspurner Hermann , Kirklin James K.
Published: December 2017

Heart transplantation has become a standard therapy option for advanced heart failure. The translation of heart transplantation from innovative experiments to long-term clinical success has married prescient insights with discipline and organization in the domains of surgical techniques, organ preservation, immunosuppression, organ donation and transplantation logistics, infection control, and long-term graft surveillance. This review explores the key milestones of the past 50 years of heart transplantation and discusses current challenges and promising innovations on the clinical horizon.
Two Pools of Epoxyeicosatrienoic Acids in Humans
Authors: Elijovich Fernando , Milne Ginger L. , Brown Nancy J. , Laniado-Schwartzman Michal , Laffer Cheryl L.
Published: December 2017

We measured epoxyeicosatrienoic acids (EETs) and dihydroxyeicosatrienoic acids (DHETs) in 21 normotensive subjects classified as salt resistant (13) or salt sensitive (8) with an inpatient protocol of salt loading (460 mEq Na
+
/24 hours, HiNa) and depletion (10 mEq Na
+
/24 hours+furosemide 40 mg×3, LoNa). No urine EETs were detected; hence, enzyme linked innumosorbent assay 14,15-DHETs (dihydroxyeicosatrienoic acids) were considered the total converted 14,15-urine pool. We report ultra-performance liquid chromatography/tandem mass spectrometry plasma EETs, DHETs, and their sum (plasma total pool) for the 3 regioisomers (8,9-, 11,12-, 14,15-) and their sum (08,15-). In salt-resistant subjects, urine total pool was unchanged by HiNa, decreased by LoNa, and correlated with urine sodium excretion, fractional excretion of Na
+
, and Na
+
/K
+
ratio for the 3 days of the experiment combined (
P
<0.03). In contrast, plasma total pool increased in LoNa and did not correlate with natriuresis or Na
+
/K
+
ratio but showed correlations between EETs, blood pressures, and catecholamines and between DHETs and aldosterone (
P
<0.03). Urine total pool of salt-sensitive was lower than that of salt-resistant subjects in certain phases of the experiment, lacked responses to changes in salt balance, and exhibited limited correlations with natriuresis and Na
+
/K
+
ratio during LoNa only. Plasma total pool of salt-sensitive was lower than in salt-resistant subjects and did not correlate with blood pressures or aldosterone but did with catecholamines. We conclude that the urine total pool reflects a renal pool involved in regulation of natriuresis, whereas the plasma total pools are of systemic origin, uninvolved in Na
+
excretion, perhaps contributing to regulation of vascular tone. Data suggest that abnormalities in EETs in salt-sensitive subjects participate in their renal or vascular dysfunction, which has potential therapeutic implications.
The Bachmanov Brothers’ Petitions: A Window into the Pomest’e System in the 1570s
Authors: Martin Janet
Published: December 2017

In the 1570s two military serving men in the Novgorod lands, Grigor’ii and Fedosei, sons of Boris Bachmanov, submitted a series of petitions to state secretaries in Moscow. The petitions, initially containing the brothers’ requests for pomest’e lands for themselves and then displaying their dispute over the manner in which the lands had been divided, provide insight into the personal lives of pomest’e-based military servicemen, the operations of the pomest’e system, and features of the system debated by scholars.
Law and Grace: The Seamless Faith of Ethiopian Orthodoxy
Authors: Miller David B.
Published: December 2017

The Ethiopian Church, established in 330, is the second earliest “national” church created on the model of Emperor Constantine’s conversion of the Roman Empire. Today Christianity comes in numerous variants. But Ethiopia’s church alone privileges Mosaic tradition as the bedrock of its theology. The rational for this is “The Glory of Kings,” a book inspired by 1Kings10: 1–13. It tells how a Queen of Sheba (Ethiopia) visited King Solomon in Jerusalem, and that their son brought the Ark of the Covenant to her capital. The Ethiopian Church identifies this site as the Church of Mary of Zion in Aksum. To this day it maintains that the Ark (in Ethiopian, the tabot) remains there in an adjacent chapel. Most important of its Mosaic traditions is that a church is not a church without a copy of the tabot on its altar. But historical explanations of when and how these traditions, and even the “Book of Kings,” came into being are beset by controversy owing to the dearth of contemporary sources.
Exploring the Origins of Snow Drought in the Northern Sierra Nevada, California
Authors: Hatchett Benjamin J. , McEvoy Daniel J.
Published: December 2017

The concept of snow drought is gaining widespread interest as the climate of snow-dominated mountain watersheds continues to change. Warm snow drought is defined as above- or near-average accumulated precipitation coinciding with below-average snow water equivalent at a point in time. Dry snow drought is defined as below-average accumulated precipitation and snow water equivalent at a point in time. This study contends that such point-in-time definitions might miss important components of how snow droughts originate, persist, and terminate. Using these simple definitions and a variety of observations at monthly, daily, and hourly time scales, the authors explore the hydrometeorological origins of potential snow droughts in the northern Sierra Nevada from water years 1951 to 2017. This study finds that snow droughts can result from extreme early season precipitation, frequent rain-on-snow events, and low precipitation years. Late-season snow droughts can follow persistent warm and dry periods with effects that depend upon elevation. Many snow droughts were characterized by lower snow fractions and midwinter peak runoff events. These findings can guide improved evaluations of historical and potential future snow droughts, particularly with regards to how impacts on water resources and mountain ecosystems may vary depending on how snow droughts originate and evolve in time.
The Interconnected Global Climate System—A Review of Tropical–Polar Teleconnections
Authors: Yuan Xiaojun , Kaplan Michael R. , Cane Mark A.
Published: December 2017

This paper summarizes advances in research on tropical–polar teleconnections, made roughly over the last decade. Elucidating El Niño–Southern Oscillation (ENSO) impacts on high latitudes has remained an important focus along different lines of inquiry. Tropical to polar connections have also been discovered at the intraseasonal time scale, associated with Madden–Julian oscillations (MJOs). On the time scale of decades, changes in MJO phases can result in temperature and sea ice changes in the polar regions of both hemispheres. Moreover, the long-term changes in SST of the western tropical Pacific, tropical Atlantic, and North Atlantic Ocean have been linked to the rapid winter warming around the Antarctic Peninsula, while SST changes in the central tropical Pacific have been linked to the warming in West Antarctica. Rossby wave trains emanating from the tropics remain the key mechanism for tropical and polar teleconnections from intraseasonal to decadal time scales. ENSO-related tropical SST anomalies affect higher-latitude annular modes by modulating mean zonal winds in both the subtropics and midlatitudes. Recent studies have also revealed the details of the interactions between the Rossby wave and atmospheric circulations in high latitudes. We also review some of the hypothesized connections between the tropics and poles in the past, including times when the climate was fundamentally different from present day especially given a larger-than-present-day global cryosphere. In addition to atmospheric Rossby waves forced from the tropics, large polar temperature changes and amplification, in part associated with variability in orbital configuration and solar irradiance, affected the low–high-latitude connections.
Dominant Circulation Patterns of the Deep Gulf of Mexico
Authors: Pérez-Brunius Paula , Furey Heather , Bower Amy , Hamilton Peter , Candela Julio , García-Carrillo Paula , Leben Robert
Published: December 2017

The large-scale circulation of the bottom layer of the Gulf of Mexico is analyzed, with special attention to the historically least studied western basin. The analysis is based on 4 years of data collected by 158 subsurface floats parked at 1500 and 2500 m and is complemented with data collected by current meter moorings in the western basin during the same period. Three main circulation patterns stand out: a cyclonic boundary current, a cyclonic gyre in the abyssal plain, and the very high eddy kinetic energy observed in the eastern Gulf. The boundary current and the cyclonic gyre appear as distinct features, which interact in the western tip of the Yucatan shelf. The persistence and continuity of the boundary current is addressed. Although high variability is observed, the boundary flow serves as a pathway for water to travel around the western basin in approximately 2 years. An interesting discovery is the separation of the boundary current over the northwestern slope of the Yucatan shelf. The separation and retroflection of the along-slope current appears to be a persistent feature and is associated with anticyclonic eddies whose genesis mechanism remains to be understood. As the boundary flow separates, it feeds into the westward flow of the deep cyclonic gyre. The location of this gyre—named the Sigsbee Abyssal Gyre—coincides with closed geostrophic contours, so eddy–topography interaction via bottom form stresses may drive this mean flow. The contribution to the cyclonic vorticity of the gyre by modons traveling under Loop Current eddies is discussed.
Modeling the Evolution and Life Cycle of Radiative Cold Pools and Fog
Authors: Wilson Travis H. , Fovell Robert G.
Published: December 2017

Despite an increased understanding of the physical processes involved, forecasting radiative cold pools and their associated meteorological phenomena (e.g., fog and freezing rain) remains a challenging problem in mesoscale models. The present study is focused on California’s tule fog where the Weather Research and Forecasting (WRF) Model’s frequent inability to forecast these events is addressed and substantially improved. Specifically, this was accomplished with four major changes from a commonly employed, default configuration. First, horizontal model diffusion and numerical filtering along terrain slopes was deactivated (or mitigated) since it is unphysical and can completely prevent the development of fog. However, this often resulted in unrealistically persistent foggy boundary layers that failed to lift. Next, changes specific to the Yonsei University (YSU) planetary boundary layer (PBL) scheme were adopted that include using the ice–liquid-water potential temperature to determine vertical stability, a reversed eddy mixing K profile to represent the consequences of negatively buoyant thermals originating near the fog (PBL) top, and an additional entrainment term to account for the turbulence generated by cloud-top (radiative and evaporative) cooling. While other changes will be discussed, it is these modifications that create, to a sizable degree, marked improvements in modeling the evolution and life cycle of fog, low stratus clouds, and adiabatic cold pools.
Targeted Tonsillar Biopsy for Unilateral Tonsillar Enlargement
Authors: Pham Truong An , Berkowitz Robert G
Published: December 2017

Background:

Unilateral tonsillar enlargement (UTE) is not an uncommon incidental finding. Lymphoma is the most common malignancy of the tonsils in children and presents with tonsillar enlargement.

Methods:

This is a retrospective case series of all cases of histopathological analysis of tonsillectomy specimens at a single pediatric tertiary hospital between 1996 and 2015. Patients either had a preoperative indication (n = 53) for pathological testing or indications based on intraoperative findings (n = 88). Of the preoperative group, 17 patients had tonsillectomy for UTE alone. In 72% of cases, the side of perceived unilateral enlargement was confirmed at histopathological assessment.

Results:

Zero cases of suspected malignancy were identified on testing.

Conclusion:

There is a very low prevalence of unsuspected and suspected malignancy in routine and targeted examination of tonsillar specimens. It is reasonable to test based on other clinical findings and risk factors such as immunosuppression.
Applying Objectification Theory to the Relationship Between Sexual Victimization and Disordered Eating
Authors: Holmes Samantha C. , Johnson Dawn M.
Published: December 2017

There is an established relationship between sexual victimization (SV) and disordered eating (DE); however, few theory-based studies exist that adequately examine this relationship. Previous research on objectification theory has insufficiently tested the theory’s application to extreme objectifying experiences such as SV. To address this gap in the literature, we evaluated objectification theory as a means for clarifying the relationship between SV and DE. Specifically, we examined how self-surveillance, a proxy for self-objectification, and two of its psychological correlates, body shame and interoceptive deficits, may clarify the association between SV and DE. Participants were 389 undergraduate women. Path analysis of the model largely supports the application of objectification theory to this relationship but also suggests potential modifications to the theory. Further, the extent to which SV may be uniquely related to DE, above and beyond everyday objectification (e.g., leering, unwanted sexual comments), was explored. Implications are discussed.
Power to Engage, Power to Resist: A Structuration Analysis of Barriers to Parental Involvement
Authors: Goss Adrienne C.
Published: December 2017

Parents face varying degrees of difficulty with getting involved in their children’s schools. Using data from a study of parent members of a community organization and structuration theory, I examined how and why parents encountered resistance to their attempts to be more involved and to advocate for their children. This work can broaden our conception of barriers to parental involvement and serve as an alert to parent advocates, parents of children of color, and parents of children in special education, as they tend to experience the most challenges. I hope that it will also inspire educators to reconsider their actions within this system and be more courageous in their own advocacy for children.
Outcome evaluation of ‘Cool and Clean’, a sports-based substance use prevention programme for young people in Switzerland
Authors: Wicki Matthias , Kuntsche Sandra , Stucki Stephanie , Marmet Simon , Annaheim Beatrice
Published: December 2017

Aims:

The aim of this study was to evaluate the outcomes of Cool and Clean, Switzerland’s largest substance use prevention programme, targeted specifically at 10- to 20-year-olds who belong to a sports club and train as part of a team.

Method:

Based on a representative sample of young people who belong to a sports club and train as part of a team (both participants and non-participants in ‘cool and clean’), a post-test–only static group comparison was used to analyse data on 1,887 individuals from 179 teams (mean age: 13.8; 33.5% girls). Outcome variables included sports-related aspects (achievement motivation, fair play); attitudes towards tobacco, cannabis and alcohol use, and doping; and substance use (tobacco, cannabis and alcohol use).

Results:

Cool and Clean participants self-reported beneficial effects of the programme in all outcome areas. They also had a more critical attitude towards doping and substance use in general and had a lower reported frequency of cannabis use than non-participants. We found no significant group differences in terms of sports-related variables, tobacco and alcohol use. However, in each of these areas, better outcomes were found among Cool and Clean participants who trained with teams that implemented the programme more comprehensively.

Conclusions:

There is cross-sectional evidence for the effectiveness of the Cool and Clean programme. Moreover, the level of impact of the programme depends not only on participation per se but also, and more decisively, on how comprehensively the programme is implemented.
PPD and Flu Vaccine: Don't Get Stuck with this Mix-Up; FDA and the Pharmaceutical Industry must be More Responsive for a Safer Health Care System
Authors: Cohen Michael R.
Published: December 2017

These medication errors have occurred in health care facilities at least once. They will happen again—perhaps where you work. Through education and alertness of personnel and procedural safeguards, they can be avoided. You should consider publishing accounts of errors in your newsletters and/or presenting them in your inservice training programs.

Your assistance is required to continue this feature. The reports described here were received through the USP Medication Errors Reporting Program (MERP), which is presented in cooperation with the Institute for Safe Medication Practices. If you have encountered medication errors and would like to report them, you may call USP toll-free, 24 hours a day, at 800-233-7767 (800-23-ERROR).

Any reports published by ISMP will be anonymous. Comments are also invited; the writers’ names will be published if desired. ISMP may be contacted at the address shown below.

Errors, close calls, or hazardous conditions may be reported through the ISMP ( www.ismp.org ) or USP ( www.usp.org ) web sites or communicated directly to ISMP by calling 1-800-FAIL SAFE or via e-mail at ismpinfo@ismp.org . ISMP guarantees the confidentiality and security of the information received and respects reporters’ wishes as to the level of detail included in publications.
Can We Prevent Heparin-Induced Thrombocytopenia?
Authors: Fraser Gilles L. , Riker Richard R.
Published: December 2017

This feature examines the impact of pharmacologic interventions on the treatment of the critically ill patient — an area of health care that has become increasingly complex. Recent advances in drug therapy for adult ICU patients (including evolving and controversial data) will be reviewed and assessed in terms of clinical, humanistic, and economic outcomes. Direct questions or comments to Gil Fraser, PharmD, at fraseg@mmc.org .
“Well Read”
Authors: Teagarden J. Russell
Published: December 2017

Managed care pharmacists are involved formally with the interface between the delivery and financing of health care; their work thus entails an accountability for both elements. Interpreted broadly managed care pharmacists are pharmacists working within the sphere of a health care system, health care purchaser, health insurer, managed care organization, or benefit administration agency. Patients, the pharmacy profession, and society are best served by this broad interpretation, because the interdependency of financing and delivery is inextricably linked to the achievement of good health outcomes. This continuing feature will explore contemporary issues facing managed care pharmacists.
Maximizing and Matching PDA Expansion Memory
Authors: Felkey Bill G. , Fox Brent I.
Published: December 2017

In this installment, we focus on the importance of memory management as it relates to your professional practice.
Managed Care Pharmacy and Medication Safety: The Fourth Estate
Authors: Teagarden J. Russell
Published: December 2017

Managed care pharmacists are involved formally with the interface between the delivery and financing of health care; their work thus entails an accountability for both elements. Interpreted broadly, managed care pharmacists are pharmacists working within the sphere of a health care system, health care purchaser, health insurer, managed care organization, or benefit administration agency. Patients, the pharmacy profession, and society are best served by this broad interpretation, because the interdependency of financing and delivery is inextricably linked to the achievement of good health outcomes. This continuing feature will explore contemporary issues facing managed care pharmacists.
Recent Publications on Medications and Pharmacy
Authors: Generali Joyce
Published: December 2017

Hospital Pharmacy presents a new feature to keep pharmacists abreast of new publications in the medical/pharmacy literature. Articles of interest will be abstracted monthly regarding a broad scope of topics.
The A-HeFT Trial: More Questions than Answers
Authors: Howard Patricia A.
Published: December 2017

This continuing feature will update readers on recent developments in cardiovascular pharmacotherapy. Cardiovascular disease remains the number one killer in the US, and more clinical outcome trials have been conducted in cardiology than in any other field of medicine. Given this rapidly expanding knowledge base, pharmacists can have a significant impact on prevention and treatment — if they keep current with developments in drug therapy.
Collaboratively Designed Practice Guidelines Promote Appropriate Use of Intravenous Proton Pump Inhibitors
Authors: Skledar Susan J. , Culley Colleen M.
Published: December 2017

Objective

To determine the effectiveness of practice guidelines for proton pump inhibitor use at an academic medical center.

Methods

Patients initiated on intravenous (IV) pantoprazole therapy between July 2001 and May 2002 were evaluated prospectively for appropriateness of therapy. Pharmacists assessed clinical use, dosing strategy, administration route, and prescribing patterns.

Results

A total of 85 patients were evaluated. Only 25% of the patients were prescribed IV pantoprazole according to established institutional guidelines. The majority of therapy meeting guideline criteria were initiated on pantoprazole by the Gastroenterology service. Due to overuse of pantoprazole, prescribing guidelines were revised to specify indications with proven efficacy (erosive GERD, Zollinger-Ellison or other hypersecretory conditions, and upper gastrointestinal bleeding). Patients who received pantoprazole for stress ulcer prophylaxis, an unapproved indication, had therapy automatically switched to a histamine receptor antagonist. For patients who tolerated oral medications or enteral feedings, therapy was automatically converted to the oral dosage form.

Conclusions

Evaluation of institutional pantoprazole utilization revealed usage extending beyond indications with proven efficacy. Pharmacists and physicians collaboratively developed evidence-based practice guidelines; adherence to appropriate indications showed a 50% improvement.