bluuebunny/crossref_metadata_2025 huggingface dataset:
Propensity Score–matched Comparison of Postoperative Adverse Outcomes between Geriatric Patients Given a General or a Neuraxial Anesthetic for Hip Surgery
Authors: Chu Chin-Chen , Weng Shih-Feng , Chen Kuan-Ting , Chien Chih-Chiang , Shieh Ja-Ping , Chen Jen-Yin , Wang Jhi-Joung
Published: May 2015

AbstractAbstract

Using Taiwan’s in-patient claims database, the effect of anesthetic technique on in-hospital outcomes was assessed. Neuraxial techniques were found to have lower rates of in-hospital adverse outcomes of several types including mortality, stroke, and others.

Background:

The effects of the mode of anesthesia on major adverse postoperative outcomes in geriatric patients are still inconclusive. The authors hypothesized that a neuraxial anesthetic (NA) rather than a general anesthetic (GA) would yield better in-hospital postoperative outcomes for geriatric patients undergoing hip surgery.

Methods:

The authors used data from Taiwan’s 1997–2011 in-patient claims database to evaluate the effect of anesthesia on in-hospital outcomes. The endpoints were mortality, stroke, transient ischemic stroke, myocardial infarction, respiratory failure, and renal failure. Of the 182,307 geriatric patients who had hip surgery, a GA was given to 53,425 (29.30%) and an NA to 128,882 (70.70%). To adjust for baseline differences and selection bias, patients were matched on propensity scores, which left 52,044 GA and 52,044 NA patients.

Results:

GA-group patients had a greater percentage and higher odds of adverse in-hospital outcomes than did NA-group patients: death (2.62 vs. 2.13%; odds ratio [OR], 1.24; 95% CI, 1.15 to 1.35; P < 0.001), stroke (1.61 vs. 1.38%; OR, 1.18, 95% CI, 1.07 to 1.31; P = 0.001), respiratory failure (1.67 vs. 0.63%; OR, 2.71; 95% CI, 2.38 to 3.01; P < 0.001), and intensive care unit admission (11.03 vs. 6.16%; OR, 1.95; 95% CI, 1.87 to 2.05; P < 0.001), analyzed using conditional logistic regression. Moreover, patients given a GA had longer hospital stays (10.77 ± 8.23 vs. 10.44 ± 6.67 days; 95% CI, 0.22 to 0.40; P < 0.001) and higher costs (New Taiwan Dollars [NT$] 86,606 ± NT$74,162 vs. NT$74,494 ± NT$45,264; 95% CI, 11,366 to 12,859; P < 0.001).

Conclusion:

For geriatric patients undergoing hip surgery, NA was associated with fewer odds of adverse outcomes than GA.
Leuconostoc rapi sp. nov., isolated from sous-vide-cooked rutabaga
Authors: Lyhs Ulrike , Snauwaert Isabel , Pihlajaviita Seija , Vuyst Luc De , Vandamme Peter
Published: May 2015

A Gram-stain-positive, ovoid, lactic acid bacterium, strain LMG 27676T, was isolated from a spoiled sous-vide-cooked rutabaga. 16S rRNA gene sequence analysis indicated that the novel strain belongs to the genus Leuconostoc, with Leuconostoc kimchii and Leuconostoc miyukkimchii as the nearest neighbours (99.1 and 98.8 % 16S rRNA gene sequence similarity towards the type strain, respectively). Phylogenetic analysis of the 16S rRNA gene, multilocus sequence analysis of the pheS, rpoA and atpA genes, and biochemical and genotypic characteristics allowed differentiation of strain LMG 27676T from all established species of the genus Leuconostoc. Strain LMG 27676T ( = R-50029T = MHB 277T = DSM 27776T) therefore represents the type strain of a novel species, for which the name Leuconostoc rapi sp. nov. is proposed.
Rotation contour contrast reconstruction using electron backscatter diffraction in a scanning electron microscope
Authors: Kaboli Shirin , Demers Hendrix , Brodusch Nicolas , Gauvin Raynald
Published: May 2015

The microstructure of a deformed Mg–Al–Ca alloy was imaged using an electron-beam energy of 20 keV in a cold field-emission scanning electron microscope. The backscattered electron (BSE) micrographs showed a non-uniform contrast, the simplest being in the form of parallel contours inside a number of grains. This contrast is described as rotation contour contrast (RCC) and is attributed to local rotation of the crystal during the deformation of the grain. A model is presented to relate the rotation of crystal planes about one rotation axis to the channeling contrast in the channeling pattern and, consequently, to RCC in the BSE micrograph. This model was validated with the electron backscatter diffraction technique such that the RCCs in the BSE micrograph were reconstructed using the electron backscatter diffraction pattern intensities. The appearance of the RCCs was attributed to the change in the electron-beam position across a Kikuchi band due to local crystal rotation.
Error analysis of the crystal orientations and disorientations obtained by the classical electron backscatter diffraction technique
Authors: Ram Farangis , Zaefferer Stefan , Jäpel Tom , Raabe Dierk
Published: May 2015

The fidelity – that is, the error, precision and accuracy – of the crystallographic orientations and disorientations obtained by the classical two-dimensional Hough-transform-based analysis of electron backscatter diffraction patterns (EBSPs) is studied. Using EBSPs simulated based on the dynamical electron diffraction theory, the fidelity analysis that has been previously performed using the patterns simulated based on the theory of kinematic electron diffraction is improved. Using the same patterns, the efficacy of a Fisher-distribution-based analytical accuracy measure for orientation and disorientation is verified.
Element-specific structural analysis of Si/B4C using resonant X-ray reflectivity
Authors: Nayak Maheswar , Pradhan P. C. , Lodha G. S.
Published: May 2015

Element-specific structural analysis at the buried interface of a low electron density contrast system is important in many applied fields. The analysis of nanoscaled Si/B4C buried interfaces is demonstrated using resonant X-ray reflectivity. This technique combines information about spatial modulations of charges provided by scattering, which is further enhanced near the resonance, with the sensitivity to electronic structure provided by spectroscopy. Si/B4C thin-film structures are studied by varying the position of B4C in Si layers. Measured values of near-edge optical properties are correlated with the resonant reflectivity profile to quantify the element-specific composition. It is observed that, although Si/B4C forms a smooth interface, there are chemical changes in the sputtered B4C layer. Nondestructive quantification of the chemical changes and the spatial distribution of the constituents is reported.
SCT: a suite of programs for comparing atomistic models with small-angle scattering data
Authors: Wright David W. , Perkins Stephen J.
Published: May 2015

Small-angle X-ray and neutron scattering techniques characterize proteins in solution and complement high-resolution structural studies. They are of particular utility when large proteins cannot be crystallized or when the structure is altered by solution conditions. Atomistic models of the averaged structure can be generated through constrained modelling, a technique in which known domain or subunit structures are combined with linker models to produce candidate global conformations. By randomizing the configuration adopted by the different elements of the model, thousands of candidate structures are produced. Next, theoretical scattering curves are generated for each model for trial-and-error fits to the experimental data. From these, a small family of best-fit models is identified. In order to facilitate both the computation of theoretical scattering curves from atomistic models and their comparison with experiment, the SCT suite of tools was developed. SCT also includes programs that provide sequence-based estimates of protein volume (either incorporating hydration or not) and add a hydration layer to models for X-ray scattering modelling. The original SCT software, written in Fortran, resulted in the first atomistic scattering structures to be deposited in the Protein Data Bank, and 77 structures for antibodies, complement proteins and anionic oligosaccharides were determined between 1998 and 2014. For the first time, this software is publicly available, alongside an easier-to-use reimplementation of the same algorithms in Python. Both versions of SCT have been released as open-source software under the Apache 2 license and are available for download from https://github.com/dww100/sct.
Crystal structure of dibenzyldimethylsilane
Authors: Knauer Lena , Golz Christopher , Kroesen Ulrike , Koller Stephan G. , Strohmann Carsten
Published: May 2015

In the title compound, C16H20Si, a geometry different from an ideal tetrahedron can be observed at the Si atom. The bonds from Si to the benzylic C atoms [Si—C = 1.884 (1) and 1.883 (1) Å] are slightly elongated compared to the Si—Cmethylbonds [Si—C = 1.856 (1) and 1.853 (1) Å]. The Cbenzyl—Si—Cbenzylbond angle [C—Si—C = 107.60 (6)°] is decreased from the ideal tetrahedral angle by 1.9°. These distortions can be explained easily by Bent's rule. In the crystal, molecules interact only by van der Waals forces.
Dynamics and noise radiation of multiple bubbles in compressible fluid using boundary integral equation
Authors: Ye Xi , Sun Longquan , Pang Fuzhen
Published: May 2015

Purpose

– The purpose of this paper is to research the interaction between multiple bubbles and their noise radiation considering the influence of compressibility. The influences of bubble spacing, initial inner pressure, buoyance and phase difference are presented with different bubbles arrangements.

Design/methodology/approach

– Based on wave equation, the new boundary integral equation considering the compressibility is given by the matching between prophase and anaphase approximation of bubble motion and solved with boundary element method. The time-domain characteristics of noise induced by multiple bubbles are obtained by the moving boundary Kirchhoff integral equation. With the surface discretization and coordinate transformation, the bubbles surface is treated as a moving deformable boundary and noise source, and the integral is implemented on the surface directly.

Findings

– Numerical results show the manner of jet generation will be affected by the phase difference between bubbles. With the increasing of phase difference, the directive property of noise becomes obvious. With the enlargement of initial inner pressure, the sound pressure will arise at the early stage of expanding, and the increasing of buoyance parameter will reduce the sound pressure after the generation of jet. Since the consideration of compressibility, the oscillation amplitude of bubbles will be weakened.

Originality/value

– The paper could provide the reference for the research about the dynamics and noise characteristics of multiple bubbles in compressible fluid. And the new method based on boundary integral equation to simulate the multiple bubbles motion and noise radiation is presented.
Heat transfer and fluid flow of a non-Newtonian nanofluid over an unsteady contracting cylinder employing Buongiorno’s model
Authors: Mahdy A. , Chamkha A
Published: May 2015

Purpose

– The purpose of this paper is to discuss a combined similarity-numerical approach that is used to study the unsteady two-dimensional flow of a non-Newtonian nanofluid over a contracting cylinder using Buongiorno’s model and the Casson fluid model that is used to characterize the non-Newtonian fluid behavior.

Design/methodology/approach

– Similarity transformations are employed to transform the unsteady Navier-Stokes partial differential equations into a system of ordinary differential equations. The transformed equations are then solved numerically by means of the very robust symbolic computer algebra software MATLAB employing the routine bvpc45.

Findings

– The effect of increasing values of the Casson parameter is to suppress the velocity field (in absolute sense), the temperature and concentration decrease as Casson parameter increase. The heat and mass transfer rates decrease with the increase of unsteadiness parameters and Brownian motion parameter. In addition, they increase as the Casson parameter and the thermophoresis parameter increase.

Originality/value

– The problem is relatively original and represents a very important contribution to the field of non-Newtonian nanofluids.
Thermally stratified stagnation point flow of Casson fluid with slip conditions
Authors: Hayat Tasawar , Farooq Muhammad , Alsaedi A.
Published: May 2015

Purpose

– The purpose of this paper is to focus on the stratified phenomenon through vertical stretching cylinder in the region of stagnation point with slip effects.

Design/methodology/approach

– Homotopy analysis method is used to find the series solutions of the governing equations.

Findings

– Velocity profile decreases with an increase in stratified parameters due to temperature and concentration. Velocity and thermal slips cause a reduction in the velocity profile. Thermally stratified and thermal slip parameters reduce the temperature field.

Originality/value

– The present analysis has not been existed in the literature yet.
On the Adomian decomposition method for solving the Stefan problem
Authors: Bougoffa Lazhar , Rach Randolph , Wazwaz Abdul-Majid , Duan Jun-Sheng
Published: May 2015

Purpose

– The purpose of this paper is concerned with a reliable treatment of the classical Stephan problem. The Adomian decomposition method (ADM) is used to carry out the analysis, Moreover, the authors extend the work to examine the Stefan problem with variable latent heat. The study confirms the accuracy and efficiency of the employed method.

Design/methodology/approach

– The new technique, as presented in this paper in extending the applicability of the ADM, has been shown to be very efficient for solving the Stefan problem.

Findings

– The Stefan problem with variable latent heat was examined as well. The ADM was effectively used for analytic treatment of the Stefan problem with and without variable latent heat.

Originality/value

– The paper presents a new solution algorithm for the Stefan problem.
Approximate analytical solution for the one-dimensional nonlinear Boussinesq equation
Authors: Aminikhah Hossein
Published: May 2015

Purpose

– The purpose of this paper is to provide closed-form approximate solutions to the one-dimensional Boussinesq equation for a semi-infinite aquifer when the hydraulic head at the source is an arbitrary function of time. Combination of the Laplace transform and homotopy perturbation methods (LTHPM) are considered as an algorithm which converges rapidly to the exact solution of the nonlinear Boussinesq equation.

Design/methodology/approach

– The authors present the solution of nonlinear Boussinesq equation by combination of Laplace transform and new homotopy perturbation methods. An important property of the proposed method, which is clearly demonstrated in example, is that spectral accuracy is accessible in solving specific nonlinear nonlinear Boussinesq equation which has analytic solution functions.

Findings

– The authors proposed a combination of Laplace transform method and homotopy perturbation method to solve the one-dimensional Boussinesq equation. The results are found to be in excellent agreement. The results show that the LTNHPM is an effective mathematical tool which can play a very important role in nonlinear sciences.

Originality/value

– The authors provide closed-form approximate solutions to the one-dimensional Boussinesq equation for a semi-infinite aquifer when the hydraulic head at the source is an arbitrary function of time. In this work combination of Laplace transform and new homotopy perturbation methods (LTNHPM) are considered as an algorithm which converges rapidly to the exact solution of the nonlinear Boussinesq equation.
Is double fit a sufficient condition for SHRM success?
Authors: Garcia-Carbonell Natalia , Martin-Alcazar Fernando , Sanchez-Gardey Gonzalo
Published: May 2015

Purpose

– This paper aims to discuss the association between human resource management and performance from a process perspective, differentiating intended and implemented vertical and horizontal fit. Although researchers have examined deeply the relationship between these constructs, extant literature demonstrates inconclusive results. Previous studies have stressed the strategic importance of vertical and horizontal fit from a prescriptive view. Nevertheless, a deeper understanding, focused on management processes, is needed.

Design/methodology/approach

– This paper reviews and integrates two streams of strategic human resources management (SHRM) literature: the fit perspective, drawing on Martín-Alcázaret al.’s (2005) model, and the system strength approach, proposed by Bowen and Ostroff (2004).

Findings

– The conceptual analysis developed in this paper concludes that HRM system strength mediates the effects of an aligned strategy on performance. In this sense, the paper argues that success in implementation of the HRM strategy depends on employees’ perceptions about the system of policies and practices through which it is carried out. Additionally, organizational communication is considered as the mechanism to create a shared HRM meaning to translate to employees.

Practical implications

– Drawing on the theoretical discussions in the paper, the following implications for HRM practice are identified: the usefulness of the system strength construct as a tool to measure employees’ perceptions and anticipate potential problems at the implementation stage, the importance of organizational communication mechanisms, the relevance of formal and informal connections between HR managers and top executives and the need for specific training to promote HR managers’ communicational skills.

Originality/value

– This study examines the relationship between HRM and organizational performance by presenting a new model that integrates HRM strategy formulation and implementation, proposes employee perceptions concerning HRM are mediators of HRM strategy and firm performance, highlights the role of organizational communication in creating and managing shared HR messages and introduces system strength as an instrument to assess vertical and horizontal fit during implementation.
Leader roles, organization-based self-esteem, and employee outcomes
Authors: Norman Steven M. , Gardner Donald G. , Pierce Jon L.
Published: May 2015

Purpose

– The purpose of this paper is to examine the relationships between different managerial roles and organization-based self-esteem (OBSE), and employee job satisfaction, organization commitment, and turnover and absence intentions.

Design/methodology/approach

– Survey data were collected from 1,386 employees in a high technology industry. Employees described the roles their managers fulfilled, and then rated their own OBSE, satisfaction, commitment, and turnover and absence intent.

Findings

– Different managerial roles had different relationships with OBSE, which mediated the relationships between some of the management roles and employee outcomes.

Research limitations/implications

– This study used a cross-sectional design with single source data in a single industry. Future research should examine these relationships using longitudinal designs, multiple data sources, and a variety of industries.

Practical implications

– Managers should be aware that their behaviors affect employee self-esteem, which in turn has strong relationships with a variety of important outcomes. Managers should be trained to manifest behaviors that increase employee self-esteem.

Originality/value

– This is the first study to examine the effects of management roles on organization-based self-esteem, and ultimately employee satisfaction, commitment, and withdrawal intentions.
Development of cost effective soya extended whey incorporated chicken meat nuggets
Authors: Singh Veer Pal , Pathak Vikas , Nayak Narendra Kumar , Bharti Sanjay Kumar
Published: May 2015

Purpose

– This purpose of this paper was to conduct a study with an aim to reduce the cost of chicken nuggets by replacing part of lean meat with soy flakes. The suitability of chilled paneer whey was also assessed in place of ice water.

Design/methodology/approach

– In the development of chicken nuggets, water-soaked soya flakes at the rate of 20 per cent were used in the formulation. The chilled whey at the rate of 8 per cent of the formulation was used to prevent the rise of temperature during emulsion preparation.

Findings

– The product prepared in this way gave 5 per cent more yield than normal preparation in which ice water was used. The protein content in the preparation had gone significantly (p < 0.05) higher and moisture significantly (p < 0.05) lower than the normal control. The other proximate composition of chicken nuggets like fat and ash revealed no significant (p > 0.05) change in the product. Initially, thiobarbituric acid value and pH were observed lower in soya flakes-extended nuggets than the control. The overall acceptability was higher, that might be due to good binding and proper emulsion preparations.

Research limitations/implications

– Some experiments on amino acid profile and fatty acid profile are also required for further know-how about the actual nutritional status of chicken meat nuggets.

Practical implications

– The products will be of immense value for the nutritional supplement and utilization of by-products like whey. It may also be a cost-effective formulation.

Social implications

– The products will be acceptable to all commodities because it is made up of chicken meat.

Originality/value

– The cost of the formulation was also lower than the chicken nuggets used without soya flakes and whey because cost of meat was greater than the soya. The whey produced in paneer production costs less or by-product rich in protein materials can be better utilized into valuable products. The developed product seems to have great applications in the food industry and acceptability among consumers.
Not a Pronoun: A Transgender's Professional Journey
Authors: Gower Kim , Ritter Barbara A.
Published: May 2015

This case describes the journey of Karson as he transitions from female to male. Throughout his life, Karson experiences a great deal of anxiety trying to reconcile his identity with the expectations of society. The anxiety inherent in this situation is described in order to get the reader to more fully empathize with the issues faced by transgender individuals. The case then focuses on issues specific to the workplace as Karson begins his career with a counseling agency and experiences several instances of discriminatory behavior.
Making a Case for Historical Teaching Cases
Authors: Ward Cynthia V.L.
Published: May 2015

Development of legitimate teaching cases demands cases be factual, that is that they use “real people, real companies, real situations,” and, usually, present time. Rarely, do cases deal with historical happenings in which lives, as well as fortunes, could be lost to achieve desired ends. History provides rich material on which to build teaching cases with the added advantage of acquainting students with the past and the influence the past has in shaping the future. Answers to the question of “Why use historical teaching cases” are related to the more general question of “Why study history.” Both questions are addressed.
The William Penn: The End of the Line?
Authors: Carson Charles M. , Mosley Donald C. , Bishop John S. , Smith Douglas L.
Published: May 2015

This case involves the issues within an organization of growth, expansion, change, and a possible shift of focus from hobby to profit. The case also deals with important factors, which could potentially impact any company's operation. The owners are seeking to address two key issues. The first is a valuation issue prompted by one of the shareholders wishing to sell her interest in the railcar LLC. The second issue is one of expansion. A potential investment ($60,000-$135,000) would permit the company to lease the railcar to other operators who could run the railcar on Amtrak certified tracks nationwide but would remove the shareholders from the day to day operations of the train. The critical decision is whether the owners should invest more money in the business or maintain their current business model and operational structure.
Compartmentalized and contrasted response of ectomycorrhizal and soil fungal communities of Scots pine forests along elevation gradients in France and Spain
Authors: Rincón Ana , Santamaría‐Pérez Blanca , Rabasa Sonia G. , Coince Aurore , Marçais Benoit , Buée Marc
Published: May 2015

Fungi are principal actors of forest soils implied in many ecosystem services and the mediation of tree's responses. Forecasting fungal responses to environmental changes is necessary for maintaining forest productivity, although our partial understanding of how abiotic and biotic factors affect fungal communities is restricting the predictions. We examined fungal communities of Pinus sylvestris along elevation gradients to check potential responses to climate change‐associated factors. Fungi of roots and soils were analysed at a regional scale, by using a high‐throughput sequencing approach. Overall soil fungal richness increased with pH, whereas it did not vary with climate. However, when representative sub‐assemblages, i.e. Ascomycetes/Basidiomycetes, and families were analysed, they differentially answered to climatic and edaphic variables. This response was dependent on where they settled, i.e. soil versus roots, and/or on their lifestyle, i.e. mycorrhizal or not, suggesting different potential functional weights within the community. Our results revealed a highly compartmentalized and contrasted response of fungal communities in forest soils. The different response of fungal sub‐assemblages indicated a range of possible selective direct and indirect (i.e. via host) impacts of climatic variations on these communities, of unknown functional consequences, that helps in understanding potential fungal responses under future global change scenarios.
The Guianese population of the fire ant Solenopsis saevissima is unicolonial
Authors: Lenoir Alain , Devers Séverine , Touchard Axel , Dejean Alain
Published: May 2015

In this study, conducted in French Guiana, a part of the native range of the fire ant Solenopsis saevissima, we compared the cuticular hydrocarbon profiles of media workers with previous results based on intraspecific aggressiveness tests. We noted a strong congruence between the two studies permitting us to delimit 2 supercolonies extending over large distances (up to 54 km), a phenomenon known as unicoloniality. Solenopsis geminata workers, taken as an out‐group for cluster analyses, have a very different cuticular hydrocarbon profile. Because S. saevissima has been reported outside its native range, our conclusion is that this species has the potential to become invasive because unicoloniality (i.e., the main attribute for ants to become invasive) was shown at least for the Guianese population.
Functionality of insect‐cell‐derived colorectal cancer vaccine candidate protein EpCAM‐Fc in human dendritic cells
Authors: Park Yo Seph , Lee Jeong‐Hwan , Park Jin‐Yeon , Hwang Han Sung , Zenke Martin , Han Dong Wook , Kang Young Sun , Ko Kisung , Ko Kinarm
Published: May 2015

The baculovirus–insect cell expression system is widely used to produce recombinant proteins for various biomedical applications. Our previous study demonstrated that EpCAM, a colorectal cancer vaccine candidate protein, can be expressed in the baculovirus–insect cell expression system. However, its functionality (the ability to elicit an immune response), which is important for its possible use as a colorectal cancer vaccine for immunotherapy, still needed to be confirmed. In this study, we examined the ability of recombinant EpCAM to induce maturation of immature dendritic cells (DCs) derived from CD34+ cells isolated from human umbilical cord blood. We demonstrated that EpCAM induces the expression of four DC maturation markers: CD80, CD83, CD86 and MHC II. These results suggest that EpCAM produced in the baculovirus–insect cell expression system is functional in terms of its ability to trigger maturation of human DCs.
Evaluation of Yogurt Microstructure Using Confocal Laser Scanning Microscopy and Image Analysis
Authors: Skytte Jacob L. , Ghita Ovidiu , Whelan Paul F. , Andersen Ulf , Møller Flemming , Dahl Anders B. , Larsen Rasmus
Published: May 2015

The microstructure of protein networks in yogurts defines important physical properties of the yogurt and hereby partly its quality. Imaging this protein network using confocal scanning laser microscopy (CSLM) has shown good results, and CSLM has become a standard measuring technique for fermented dairy products. When studying such networks, hundreds of images can be obtained, and here image analysis methods are essential for using the images in statistical analysis. Previously, methods including gray level co‐occurrence matrix analysis and fractal analysis have been used with success. However, a range of other image texture characterization methods exists. These methods describe an image by a frequency distribution of predefined image features (denoted textons). Our contribution is an investigation of the choice of image analysis methods by performing a comparative study of 7 major approaches to image texture description. Here, CSLM images from a yogurt fermentation study are investigated, where production factors including fat content, protein content, heat treatment, and incubation temperature are varied. The descriptors are evaluated through nearest neighbor classification, variance analysis, and cluster analysis. Our investigation suggests that the texton‐based descriptors provide a fuller description of the images compared to gray‐level co‐occurrence matrix descriptors and fractal analysis, while still being as applicable and in some cases as easy to tune.
Value of microwave ablation in treatment of large lesions of hepatocellular carcinoma
Authors: Medhat Eman , Abdel Aziz Ashraf , Nabeel Mohammed , Elbaz Tamer , Zakaria Zeinab , Shousha Hend , Amer Ayman , Fouad Fathalah Waleed , Maher Rabab , Musa Shereif
Published: May 2015

Objective

Thermal ablative therapies continue to be favored as a safe and effective treatment for patients with non‐resectable hepatocellular carcinoma (HCC). Percutaneous microwave ablative therapy, which is a relatively new technique, has the advantage in providing faster ablation of large tumors. This study aimed to evaluate microwave ablation in the treatment of large HCC (5–7 cm) and to assess its effect on local tumor progression, prognostic outcome and patients' survival.

Methods

In all, 26 patients with large HCC lesions (5–7 cm) were managed in the multidisciplinary clinic of Kasr Al Ainy University hospital using microwave ablation. The treatment was performed with the patient under conscious sedation and analgesia and ultrasonography‐guided using an HS AMICA microwave machine operating at frequency of 2450 MHz and a power up to 100 W. Multiple needle insertions were made in one or two sessions according to the size of the lesion. The complete ablation rate, local tumor progression and patients' overall survival were analyzed, and the efficacy and safety of MWA was evaluated.

Results

Complete ablation was achieved in 19/26 (73.1%). Local tumor progression was recorded in five treated lesions (19.2%). Distant tumor progression within the liver was recorded in six patients (23.1%), with a mean survival of 21.5 months. No procedure‐related major complications or deaths were observed.

Conclusions

Percutaneous microwave ablation is safe and effective in the treatment of large HCC tumors. Patients' survival and local tumor control were acceptable.
CCL2, CXCL8, CXCL9 and CXCL10 serum levels increase with age but are not altered by treatment with hydroxychloroquine in patients with osteoarthritis of the knees
Authors: Bonfante Herval de Lacerda , Almeida Caroline de Souza , Abramo Clarice , Grunewald Sabrine Teixeira Ferraz , Levy Roger Abramino , Teixeira Henrique Couto
Published: May 2015

Aim

Osteoarthritis (OA) is a major cause of morbidity and incapacity in the elderly. This study evaluates serum levels of the chemokines CCL2, CXCL8, CXCL9, and CXCL10 in 16 patients with primary OA of the knees, and investigates how treatment with hydroxychloroquine (HCQ) for 4 months affects these chemokine levels.

Method

Thirteen elderly patients received a placebo. Healthy control groups consisted of 10 elderly individuals (age > 60 years) with no clinical or radiological evidence of OA (CT‐O), and 10 young adult individuals, (CT‐Y group, age < 40 years).

Results

The CT‐Y group presented lower levels of all chemokines studied, in comparison to the other groups. HCQ treatment did not alter the serum levels of CCL2 (P = 0.80), CXCL8 (P = 0.76), CXCL9 (P = 0.95) and CXCL10 (P = 0.74) in OA patients.

Conclusion

Hydroxychloroquine treatment did not alter the serum levels of CCL2, CXCL8, CXCL9 or CXCL10 in patients with OA of the knees, although increased serum levels correlated with aging for all subjects, including controls.
The impact of medical errors on Swiss anaesthesiologists: a cross‐sectional survey
Authors: McLennan S. R. , Engel‐Glatter S. , Meyer A. H. , Schwappach D. L. B. , Scheidegger D. H. , Elger B. S.
Published: May 2015

Background

Clinicians involved in medical errors can experience significant distress. This study aims to examine (1) how medical errors impact anaesthesiologists in key work and life domains; (2) anaesthesiologists' attitudes regarding support after errors; (3) and which anaesthesiologists are most affected by errors.

Methods

This study is a mailed cross‐sectional survey completed by 281 of the 542 clinically active anaesthesiologists (52% response rate) working at Switzerland's five university hospitals between July 2012 and April 2013.

Results

Respondents reported that errors had negatively affected anxiety about future errors (51%), confidence in their ability as a doctor (45%), ability to sleep (36%), job satisfaction (32%), and professional reputation (9%). Respondents' lives were more likely to be affected as error severity increased. Ninety per cent of respondents disagreed that hospitals adequately support them in coping with the stress associated with medical errors. Nearly all of the respondents (92%) reported being interested in psychological counselling after a serious error, but many identified barriers to seeking counselling. However, there were significant differences between departments regarding error‐related stress levels and attitudes about error‐related support. Respondents were more likely to experience certain distress if they were female, older, had previously been involved in a serious error, and were dissatisfied with their last error disclosure.

Conclusion

Medical errors, even minor errors and near misses, can have a serious effect on clinicians. Health‐care organisations need to do more to support clinicians in coping with the stress associated with medical errors.
Trajectories of marijuana use from adolescence to adulthood predicting unemployment in the mid 30s
Authors: Lee Jung Yeon , Brook Judith S. , Finch Stephen J. , Brook David W.
Published: May 2015

Background and Objectives

Unemployment (5.5% as of 2015) is a serious social and economic problem in our society. Since marijuana use is an important factor related to unemployment, identifying the trajectory of the use of marijuana may aid intervention programs and research on unemployment.

Methods

Six hundred seventy‐four participants (53% African‐Americans, 47% Puerto Ricans) were surveyed (60% females) from ages 14 to 36. The first data collection was held when the participants were students attending schools in the East Harlem area of New York City.

Results

We found that the chronic marijuana use (OR = 4.07, p < .001; AOR = 2.58, p < .05) and the late marijuana quitter (OR = 2.91, p < .05) trajectory groups were associated with an increased likelihood of unemployment compared with the no marijuana use trajectory group.

Conclusions and Scientific Significance

The results suggest that those who use marijuana chronically are at greater risk for being unemployed. Consequently, these individuals should have access to and participate in marijuana cessation treatment programs in order to reduce their risk of unemployment. Unemployment intervention programs should also consider focusing on the cessation of the use of marijuana to decrease the likelihood of later unemployment. (Am J Addict 2015;24:452 –459)
Decreased levels of autoantibodies against apolipoprotein B-100 antigens are associated with cardiovascular disease in systemic lupus erythematosus
Authors: Svenungsson Elisabet , Engelbertsen Daniel , Wigren Maria , Gustafsson Johanna T , Gunnarsson Iva , Elvin Kerstin , Jensen-Urstad Kerstin , Fredrikson Gunilla Nordin , Nilsson Jan
Published: May 2015

Increased production of autoantibodies is a characteristic feature of systemic lupus erythematosus (SLE) and there is evidence that several of these autoantibodies may contribute to increased cardiovascular disease (CVD) in SLE. Autoantibodies against the apolipoprotein (apo) B-100 peptides p45 and p210 have been associated with a lower CVD risk in non-SLE cohorts. The aim of the present study was to investigate how SLE affects the occurrence of these potentially protective autoantibodies. The study cohort consisted of 434 SLE patients and 322 age- and sex-matched population controls. Antibodies against native and malondialdehyde (MDA)-modified p45 and p210 were measured by enzyme-linked immunosorbent assay (ELISA). SLE patients had significantly lower levels of p210 immunoglobulin (Ig)G and p45 IgM (both the native and malondialdehyde (MDA)-modified forms). SLE patients with manifest CVD (myocardial infarction, ischaemic cerebrovascular disease or peripheral vascular disease) had lower levels p210 IgG and p45 IgM than SLE patients without CVD. Decreased levels of these autoantibodies were also observed in SLE patients with permanent organ damage, as assessed by the Systemic Lupus International Collaborating Clinics/American College of Rheumatology (ACR) Damage Index (SDI). The present findings show that patients with SLE, a condition generally characterized by abundance of autoantibodies of multiple specificities, have reduced levels of antibodies against the apo B-100 antigens p45 and p210 and that the levels of these antibodies are reduced further in SLE patients with CVD. These observations suggest the possibility that an impaired antibody-mediated removal of damaged LDL particles may contribute to the development of vascular complications and organ damage in SLE.
GROWTH OPPORTUNITIES, STRATEGIC SAVINGS, AND THE DOT‐COM BOOM AND BUST
Authors: Arnold Nathaniel , Dagher Jihad C.
Published: May 2015

Data from the dot‐com boom‐bust episode suggest that growth opportunities played an important role in explaining firms' financing strategy during this understudied episode. The low leverage of this sector was mainly driven by high growth firms which increased their leverage following the crash despite suffering a much larger fall in their market value. We present a parsimonious dynamic firm financing model where growth opportunities alone can generate the heterogeneous patterns in the financing and performance between high and low growth information technology firms prior to and following the market crash. The calibrated model also sheds light on the role played by monetary policy during that episode. (JEL G32, E22, E5)
Canine status epilepticus treated with fosphenytoin: A proof of principle study
Authors: Patterson Edward E. , Leppik Ilo E. , Coles Lisa D. , Podell Michael , Vite Charles H. , Bush William , Cloyd James C.
Published: May 2015

Objectives

There are a limited number of marketed intravenous antiepileptic drugs (AEDs) available to treat status epilepticus (SE). All were first developed for chronic therapy of epilepsy, not specifically for SE. Epilepsy and canine SE (CSE) occur naturally in dogs, with prevalence, presentation, and percentage of refractory cases similar to human epilepsy. The objective of this study was to determine if CSE treated with fosphenytoin (FOS) results in a similar responder rate as for people.

Methods

A randomized clinical trial was performed for dogs with CSE. Dogs who presented during a seizure or who had additional seizures after enrolling received intravenous (i.v.) benzodiazepine (BZD) followed immediately by intravenous infusion of 15 mg/kg phenytoin equivalent (PE) of fosphenytoin (FOS) or saline placebo (PBO). If seizures continued, additional AEDs were administered per the standard of care for veterinary patients. Total and unbound plasma phenytoin (PHT) concentrations were measured.

Results

Consent was obtained for 50 dogs with CSE. Thirty‐one had additional motor seizures and were randomized to the study intervention (22 FOS and 9 PBO). There was a statistically significant difference in the 12 h responder rate, with 63% in the FOS group versus 22% in the placebo group (p = 0.043) having no further seizures. The unbound PHT concentrations at 30 and 60 min were within the therapeutic concentrations for people (1–2 μg/ml) with the exception of one dog. There was mild vomiting in 36% of the FOS group (7/22) within 20 min of FOS administration and none of the placebo group (0/9) (p = 0.064).

Significance

This proof of concept study provides the first evidence that FOS is tolerated and effective in canine SE at PHT concentrations clinically relevant for human SE. Furthermore, naturally occurring CSE can be utilized as a translational platform for future studies of novel SE compounds.
Characteristics and role in outcome prediction of continuous EEG after status epilepticus: A prospective observational cohort
Authors: Alvarez Vincent , Drislane Frank W. , Westover M. Brandon , Dworetzky Barbara A. , Lee Jong Woo
Published: May 2015

Objective

Continuous electroencephalography (cEEG) is important for treatment guidance in status epilepticus (SE) management, but its role in clinical outcome prediction is unclear. Our aim is to determine which cEEG features give independent outcome information after correction for clinical predictor.

Methods

cEEG data of 120 consecutive adult patients with SE were prospectively collected in three academic medical centers using the 2012 American Clinical Neurophysiology Society's Standardized Critical Care EEG Terminology. Association between cEEG features and two clinical outcome measures (mortality and complete recovery) was assessed.

Results

In the first 24 h of EEG recording, 49 patients (40.8%) showed no periodic or rhythmic pattern, 45 (37.5%) had periodic discharges, 20 (16.7%) had rhythmic delta activity, and 6 (5%) had spike‐and‐wave discharges. Seizures were recorded in 68.3% of patients. After adjusting for known clinical predictive factors for mortality including the STatus Epilepticus Severity Score (STESS) and the presence of a potentially fatal etiology, the only EEG features (among rhythmic and periodic patterns, seizures, and background activity) that remained significantly associated with outcome were the absence of a posterior dominant rhythm (odds ratio [OR] 9.8; p = 0.033) for mortality and changes in stage II sleep pattern characteristics (OR 2.59 for each step up among these categories: absent, present and abnormal, present and normal; p = 0.002) for complete recovery.

Significance

After adjustment for relevant clinical findings, including SE severity and etiology, cEEG background information (posterior dominant rhythm and sleep patterns) is more predictive for clinical outcome after SE than are rhythmic and periodic patterns or seizures.
Driving continuity in cognitively impaired older drivers
Authors: Shimada Hiroyuki , Tsutsumimoto Kota , Lee Sangyoon , Doi Takehiko , Makizako Hyuma , Lee Songchul , Harada Kazuhiro , Hotta Ryo , Bae Seongryu , Nakakubo Sho , Uemura Kazuki , Park Hyuntae , Suzuki Takao
Published: May 2015

Aim

Cognitive impairment can negatively affect driving performance and increase the risk of driving errors, leading to vehicle crashes. We used a population‐based survey to identify the prevalence of cognitive impairments in older drivers.

Methods

A total of 10 073 older adults were enrolled in the National Center for Geriatrics and Gerontology – Study of Geriatric Syndromes. We characterized general cognitive impairment using the Mini‐Mental State Examination (MMSE). We also used the National Center for Geriatrics and Gerontology‐Functional Assessment Tool, which includes six tasks to assess word list memory, logical memory, attention and executive function, processing speed, and visuospatial skill.

Results

Just 15% of older women with moderate cognitive decline (MMSE ≤20) drove, whereas 61% of older men with moderate cognitive decline drove. Cognitively normal participants (MMSE score 27 and over) scored significantly better on six cognitive tests compared with those with mild (MMSE score 21–26) or moderate cognitive decline, and those in the mild cognitive decline group scored significantly better on six cognitive tests than those in the moderate cognitive decline group.

Conclusion

A total of 61% of older men with moderate cognitive decline did not cease driving. These older drivers showed poor cognitive performance in multiple domains compared with those with normal and mild cognitive decline. Further studies are required to clarify the relationships between cognitive decline and car crashes in these high‐risk populations. Geriatr Gerontol Int 2016; 16: 508‐514.
Resolving quandaries: basaloid adenoid cystic carcinoma or breast cylindroma? The role of massively parallel sequencing
Authors: Fusco Nicola , Colombo Pierre‐Emmanuel , Martelotto Luciano G , De Filippo Maria R , Piscuoglio Salvatore , Ng Charlotte K Y , Lim Raymond S , Jacot William , Vincent‐Salomon Anne , Reis‐Filho Jorge S , Weigelt Britta
Published: May 2015

Aims

The aims of this study were to perform a whole‐exome sequencing analysis of a breast cylindroma and to investigate the role of molecular analyses in the differentiation between breast cylindroma, a benign tumour that displays MYB expression, and CYLD gene mutations, and its main differential diagnosis, the breast solid‐basaloid adenoid cystic carcinoma, a malignant tumour that is characterized by the presence of the MYB–NFIB fusion gene and MYB overexpression.

Methods and results

A 66‐year‐old female underwent quadrantectomy after an irregular dense shadow was discovered in the right breast at the screening mammogram. Histologically, the tumour displayed features suggestive of a solid‐basaloid variant of adenoid cystic carcinoma with a differential diagnosis of cylindroma. Fluorescence in situ hybridization, reverse transcription–polymerase chain reaction, immunohistochemistry and whole‐exome sequencing revealed absence of the MYB–NFIB fusion gene, low levels of MYB protein expression and a clonal somatic CYLD splice site mutation associated with loss of heterozygosity of the wild‐type allele.

Conclusions

The results of the histological, immunohistochemical and molecular analyses were consistent with a diagnosis of breast cylindroma, providing a proof‐of‐principle that the integration of histopathological and molecular approaches can help to differentiate between a low‐malignant potential and a benign breast tumour of triple‐negative phenotype.