bluuebunny/crossref_metadata_2025 huggingface dataset:
Health Information Exchange in Emergency Medical Services
Authors: Martin Thomas , Ranney Megan , Dorroh James , Asselin Nicholas , Sarkar Indra
Published: December 2018

Background The Office of the National Coordinator for Health Information Technology has outlined the benefits of health information exchange in emergency medical services (EMSs) according to the SAFR model—search, alert, file, and reconcile—developed in collaboration with the California Emergency Medical Services Authority.

Objective This scoping review aims to identify and characterize progress toward the adoption of prehospital health information exchange, as reported in the peer-reviewed literature.

Methods A structured review of literature in MEDLINE-indexed journals was conducted using the “Electronic Health Records” topic-specific query, the “Emergency Medical Services” Medical Subject Headings descriptor, and a prehospital identifier.

Results Our initial search yielded 368 nonduplicative, English-language articles; 131 articles underwent full-text review and 11 were selected for analysis according to pre-established inclusion criteria. Original research was thematically grouped according to the SAFR model.

Conclusion Within isolated systems, there has been limited progress toward the adoption of prehospital health information exchange. Interoperability, accurate match algorithms, security, and wireless connectivity have been identified as potential barriers to adoption. Additional research is required to evaluate the role of health information exchange within EMSs.
Ruptured Renal Artery Aneurysm in a Pregnant Woman: Case Report and Literature Review
Authors: Souza Adriane Castro de , Ueda Caio Henrique Yoshikatsu , Matsubara Denise Hiromi , Glir João Raphael Zanlorensi
Published: December 2018

Renal artery aneurysms (RAAs) are rare and usually asymptomatic; ∼ 90% of them are unilateral. Once diagnosed during pregnancy, they may rupture, presenting a high maternal-fetal risk. The present study reports the case of a 32-year-old pregnant woman with a 30-week gestational age and a ruptured unilateral RAA.
A Female Patient with Xq28 Microduplication Presenting with Myotubular Myopathy, Confirmed with a Custom-Designed X-array
Authors: Mitrakos Anastasios , Sofokleous Christalena , Papadimas George , Fryssira Helena , Kitsiou-Tzeli Sofia , Tzetis Maria , Kosma Konstantina
Published: December 2018

X-linked myotubular myopathy (XLMTM) is a rare inherited neuromuscular disorder associated with mutations in the MTM1 gene on the Xq28 region. We report a severely affected girl with XLMTM, caused by maternally inherited 661 kb Xq28 microduplication identified by chromosomal microarray analysis and confirmed also on DNA from muscle biopsy with a custom-designed X-chromosome-specific microarray. X-inactivation analysis revealed a skewed inactivation pattern on the proband's muscle biopsy. Muscle biopsy histopathology was indicative of increased variability in fiber diameter, marked and diffuse endomysial proliferation of adipose and connective tissues, as well as predominance of type 1 fibers.
Trigeminal Cave Brain Metastasis from Prostate Adenocarcinoma: Case Report and Review of the Literature
Authors: Zanatta João , Zanella Laisa , Kurtz Guilherme , Gabardo Bárbara , Roman Alex , Pastorello Júlia
Published: December 2018

The present study presents the case of a 66-year-old patient diagnosed with prostate adenocarcinoma 4 years earlier and treated with prostatectomy, radiotherapy, chemotherapy and hormone therapy but still displaying high prostate-specific antigen (PSA) levels. The patient complaints were double vision and headaches. Upon physical examination, he displayed 6th cranial nerve paresis and 5th cranial nerve paresthesia. A magnetic resonance imaging (MRI) exam was performed, which revealed a mass on the right trigeminal cave. The patient underwent surgical removal of the tumor, and the pathological analysis of the specimen established metastatic prostate cancer as the diagnosis.

Brain metastases from prostate cancer are extremely rare and mark advanced disease, with immune system failure and blood-brain barrier breach. Prostate-specific antigen levels do not correlate with the possibility of metastatic disease. Prostate adenocarcinoma is the histologic type most commonly associated with brain metastases, with the meninges being more frequently affected, followed by the brain parenchyma. The neurological symptoms more often displayed are non-focal, such as headaches and mental confusion. Surgery associated with radiotherapy is the most validated treatment.
Monogene Formen der Adipositas beim Menschen
Authors: Herrmann G. , Wabitsch M. , von Schnurbein J.
Published: December 2018

Es gilt Patienten mit sehr seltenen Formen der monogenen Adipositas zu identifizieren um ihnen eine optimierte oder bestenfalls sogar kausale Therapie anbieten zu können. Hinweise für eine monogene Adipositasform sind insbesondere extreme Adipositas, frühkindlicher Beginn der Adipositas, sowie auffälliges Essverhalten mit Hyperphagie, ausgeprägtem nahrungssuchendem Verhalten und fehlendem Sättigungsgefühl. Mutationen in Genen, die den Leptin-Melanocortin-Signalweg betreffen, verursachen die wichtigsten Formen der monogenen Adipositas. Dabei sind Mutationen im Melanocortin-4-Rezeptor Gen (MC4R) am häufigsten. Zu einer ausgeprägten frühkindlichen Adipositas kommt es bei autosomal rezessiv vererbten Mutationen in den Genen für Leptin (LEP), Leptinrezeptor (LEPR), Proopiomelanocortin (POMC) und Prohormonkonvertase 1/3 (PCSK1). Eine kausale Therapie ist bei biologisch inaktivem Leptin oder Leptinmangel durch die Gabe von humanem rekombinantem Leptin verfügbar. Zudem gibt es mit dem MC4R -Agonisten (Setmelanotide) eine kausale Therapieoption für Patienten mit POMC-Mutation. Für Patienten mit Mutationen in MC4R, LEPR, PCSK1 finden aktuell klinische Studien hierzu statt, so dass in Zukunft eine kausale Therapie denkbar ist.
A simple and practical jump error removal method for fringe projection profilometry based on self-alignment technique
Authors: Ma Mengchao , Yao Pengcheng , Deng Huaxia , Wang Yuyu , Zhang Jin , Zhong Xiang
Published: December 2018

The code-based method is one of the frequently adopted fringe projection profilometry techniques because of its robustness and high speed. However, the abnormal jump errors caused by the misalignment between the wrapped phase and the fringe order impact the phase unwrapping quality and are more serious in binary defocusing measurement with significant defocusing. This paper proposes a self-alignment technique (SAT) with high speed, no additional patterns, and no accuracy loss to eliminate such jump errors. After analyzing the relation between the grating changes and the misalignment, we designed an assist-code that can perfectly align with the wrapped phase even in significant defocusing. After that, this assist-code is used to adjust the misalignment and eliminate the jump errors. The comparison between the median filter and the proposed SAT method in simulations and experiments demonstrates that the proposed SAT method has the ability to completely remove jump errors for complex textures and step-height objects, even in significant defocusing, indicating its potential to be applied to other phase unwrapping fields, e.g., color-based methods with color coupling problems.
New Formulation for the Viscosity of Isobutane
Authors: Herrmann Sebastian , Vogel Eckhard
Published: December 2018

A new viscosity formulation for isobutane, valid in the fluid region from the triple point to 650 K and to 100 MPa, is presented. It employs the reference equation of state by Bücker and Wagner [J. Phys. Chem. Ref. Data 35, 929 (2006)] and uses the residual quantity concept, in which the contributions for the zero-density viscosity and for the initial-density dependence were separately generated, while those for the critical enhancement and for the higher-density terms were pretreated. The contributions are formulated as a function of the reciprocal reduced temperature τ and the reduced density δ. The primary datasets used when developing the individual contributions were carefully evaluated. The final formulation includes 16 coefficients fitted with a state-of-the-art linear optimization algorithm. The expanded uncertainty (coverage factor k = 2) is estimated to be 0.5% at low pressures p ≤ 0.2 MPa and at temperatures 298 ≤ T∕K ≤ 627. In the vapor phase at subcritical temperatures T ≥ 298 K as well as in the supercritical region T ≤ 498 K at pressures p ≤ 30 MPa, the expanded uncertainty is given as 1.5%. It is increased to 4.0% and 6.0%, respectively, in regions where less reliable primary data exist. Moreover, it is assumed to amount to 6.0% in ranges in which primary viscosity datasets are not available, but the equation of state is valid. In the near-critical region, a value of the expanded uncertainty was not given because of a weakness of the reference equation of state and due to a possibly too small result for the critical enhancement of the viscosity experimentally found. Viscosity tables for the new formulation are given for the single-phase region, for the vapor-liquid phase boundary, and for the near-critical region.
Vortex spin-torque diode: The impact of DC bias
Authors: Skirdkov P. N. , Popkov A. F. , Zvezdin K. A.
Published: December 2018

We consider a vortex spin-torque diode represented by a magnetic tunnel junction with tilted magnetization in the fixed layer and vortex magnetization distribution in the free layer. Vortex dynamics and the corresponding spin-torque diode effect are analyzed using micromagnetic modelling for different input RF signal powers and different DC biases. The analytical model of the vortex spin-torque diode based on the Thiele equation is developed. We demonstrate that the considered spin-torque diode has sub-gigahertz resonant frequency, which can help to expand the frequency range of spintronic rectification. Relatively high sensitivity is observed in the case of ultra-low power even without the external magnetic field.
Synopsis of the genus Eriocaulon (Eriocaulaceae) for New Guinea
Authors: Leach Gregory J.
Published: December 2018

Twenty-nine taxa of Eriocaulon L. are recorded in this synopsis of the genus for the region of New Guinea. A key to the New Guinea species is provided. The widespread E. cinereum R.Br. is not recorded for New Guinea but is included in the key. Eriocaulon brevipedunculatum var. longipes Moldenke is determined as a synonym of E. novoguineense P.Royen. Issues of lectotypification are discussed for E. echinulatum Mart. (syntypes identified), E. hamiltonianum Mart., E. hookerianum Stapf, E. nepalense var. luzulifolium (Mart.) Praj. & J.Parn., E. truncatum Buch.-Ham. ex Mart. Species with extra New Guinea distributions are E. australe R.Br., E. depressum R.Br. ex Sm., E. echinulatum, E. hamiltonianum, E. hookerianum, E. nepalense var. luzulifolium, E. setaceum L., E. sexangulare L., E. truncatum, E. willdenovianum Moldenke and E. zollingerianum Körn. A high level of endemism is recorded, particularly in the alpine zone.
Australasian orchid diversification in time and space: molecular phylogenetic insights from the beard orchids (Calochilus, Diurideae)
Authors: Nargar Katharina , Molina Sarah , Wagner Natascha , Nauheimer Lars , Micheneau Claire , Clements Mark A.
Published: December 2018

Phylogenetic relationships in Calochilus (~30 species) were inferred based on a supermatrix of 81 loci including 22 species. To examine the spatio-temporal evolution of Calochilus, divergence-time estimations were conducted within a Bayesian framework using an uncorrelated relaxed molecular-clock model, followed by maximum-likelihood ancestral-range reconstructions comparing four biogeographic models. To trace the evolution of key floral and vegetative characters, maximum-likelihood ancestral-character reconstructions were carried out. The stem age of Calochilus was dated to ~12.0 million years ago in the mid-Miocene. Divergence of Calochilus into a tropical and a temperate clade was inferred to have occurred ~7.6 million years ago in the late Miocene. Northern Australia was reconstructed as the ancestral area of the tropical clade and the Euronotian region for the temperate clade. Range expansions from Australia to other Australasian regions, such as New Zealand and New Guinea, were inferred to have occurred only in recent geological times, commencing in the Pleistocene. The infrageneric classification for Calochilus was revised, erecting two subgenera, subgenus Calochilus and subgenus Tropichilus subgen. nov. Section Calochilus Szlach. was recircumscribed, and sect. Abrochilus sect. nov., and section Placochilus sect. nov. were erected. Identification keys to subgenera and sections and a taxonomic synopsis of the genus are provided.
Time-resolved ultrastructure of the cortical actin cytoskeleton in dynamic membrane blebs
Authors: Chikina Aleksandra S. , Svitkina Tatyana M. , Alexandrova Antonina Y.
Published: December 2018

Membrane blebbing accompanies various cellular processes, including cytokinesis, apoptosis, and cell migration, especially invasive migration of cancer cells. Blebs are extruded by intracellular pressure and are initially cytoskeleton-free, but they subsequently assemble the cytoskeleton, which can drive bleb retraction. Despite increasing appreciation of physiological significance of blebbing, the molecular and, especially, structural mechanisms controlling bleb dynamics are incompletely understood. We induced membrane blebbing in human HT1080 fibrosarcoma cells by inhibiting the Arp2/3 complex. Using correlative platinum replica electron microscopy, we characterize cytoskeletal architecture of the actin cortex in cells during initiation of blebbing and in blebs at different stages of their expansion–retraction cycle. The transition to blebbing in these conditions occurred through an intermediate filopodial stage, whereas bleb initiation was biased toward filopodial bases, where the cytoskeleton exhibited local weaknesses. Different stages of the bleb life cycle (expansion, pausing, and retraction) are characterized by specific features of cytoskeleton organization that provide implications about mechanisms of cytoskeleton assembly and bleb retraction.
cAMP binds to closed, inactivated, and open sea urchin HCN channels in a state-dependent manner
Authors: Idikuda Vinay , Gao Weihua , Su Zhuocheng , Liu Qinglian , Zhou Lei
Published: December 2018

Hyperpolarization-activated cyclic-nucleotide–modulated (HCN) channels are nonselective cation channels that regulate electrical activity in the heart and brain. Previous studies of mouse HCN2 (mHCN2) channels have shown that cAMP binds preferentially to and stabilizes these channels in the open state—a simple but elegant implementation of ligand-dependent gating. Distinct from mammalian isoforms, the sea urchin (spHCN) channel exhibits strong voltage-dependent inactivation in the absence of cAMP. Here, using fluorescently labeled cAMP molecules as a marker for cAMP binding, we report that the inactivated spHCN channel displays reduced cAMP binding compared with the closed channel. The reduction in cAMP binding is a voltage-dependent process but proceeds at a much slower rate than the movement of the voltage sensor. A single point mutation in the last transmembrane domain near the channel’s gate, F459L, abolishes inactivation and concurrently reverses the response to hyperpolarizing voltage steps from a decrease to an increase in cAMP binding. ZD7288, an open channel blocker that interacts with a region close to the activation/inactivation gate, dampens the reduction of cAMP binding to inactivated spHCN channels. In addition, compared with closed and “locked” closed channels, increased cAMP binding is observed in channels purposely locked in the open state upon hyperpolarization. Thus, the order of cAMP-binding affinity, measured by the fluorescence signal from labeled cAMP, ranges from high in the open state to intermediate in the closed state to low in the inactivated state. Our work on spHCN channels demonstrates intricate state-dependent communications between the gate and ligand-binding domain and provides new mechanistic insight into channel inactivation/desensitization.
Investigating Syntactic Complexity in EFL Learners' Writing across Common European Framework of Reference Levels A1, A2, and B1
Authors: Khushik Ghulam Abbas , Huhta Ari
Published: December 2018

The study investigates the linguistic basis of Common European Framework of Reference (CEFR) levels in English as a foreign language (EFL) learners’ writing. Specifically, it examines whether CEFR levels can be distinguished with reference to syntactic complexity (SC) and whether the results differ between two groups of EFL learners with different first languages (Sindhi and Finnish). This sheds light on the linguistic comparability of the CEFR levels across L1 groups. Informants were teenagers from Pakistan (N = 868) and Finland (N = 287) who wrote the same argumentative essay that was rated on a CEFR-based scale. The essays were analysed for 28 SC indices with the L2 Syntactic Complexity Analyzer and Coh-Metrix. Most indices were found to distinguish CEFR levels A1, A2, and B1 in both language groups: the clearest separators were the length of production units, subordination, and phrasal density indices. The learner groups differed most in the length measures and phrasal density when their CEFR level was controlled for. However, some indices remained the same, and the A1 level was more similar than A2 and B2 in terms of SC across the two groups.
Predicting Risk of Postoperative Disease Recurrence in Crohn’s Disease: Patients With Indolent Crohn’s Disease Have Distinct Whole Transcriptome Profiles at the Time of First Surgery
Authors: Cushing Kelly C , Mclean Richard , McDonald Keely G , Gustafsson Jenny K , Knoop Kathryn A , Kulkarni Devesha H , Sartor R Balfour , Newberry Rodney D
Published: December 2018

Background

Assessing risk of Crohn’s disease (CD) recurrence following ileocolic resection (ICR) is necessary to optimize medical management and prevent long-term complications. This study aimed to identify noninvasive markers that could predict postoperative disease activity.

Methods

Inclusion criteria were a diagnosis of CD, first ICR, interval colonoscopy, and whole transcriptome array meeting quality control standards. Demographic and clinical data were obtained from the electronic medical record. RNA extraction and human transcriptome microarray were performed on noninflamed ileal margins from operative specimens. Clinical data and random forest were analyzed in R. Principal components analysis, hierarchical clustering, and pathway enrichment were performed in Partek.

Results

Sixty-five patients completed the study, and 5 were excluded from analysis due to extreme variability on whole transcriptome analysis. Unsupervised hierarchical clustering revealed that patients with an i0 Rutgeerts score generally segregated from all others. In anti-TNF-naïve patients, unsupervised hierarchical clustering revealed complete segregation of patients with an i0 score. Reduced escalation in therapy and continued mucosal remission, consistent with indolent disease, were seen in the 4 years following surgery. Random forest identified 30 transcripts differentiating i0 patients from the other groups. Pathway enrichment highlighted toll-like receptor, NOD-like receptor, and TNF signaling. This transcriptome signature did not identify i0 anti-TNF-exposed patients. However, anti-TNF-exposed patients with indolent postoperative courses were found to have a transcriptome signature distinct from those with aggressive disease.

Conclusions

Anti-TNF-naïve and -exposed patients have unique expression profiles at the time of surgery, which may offer predictive value in assessing the risk of nonrecurrence.
Vaccination Guidelines for Patients with Immune-Mediated Disorders on Immunosuppressive Therapies—Executive Summary
Authors: Papp Kim A , Haraoui Boulos , Kumar Deepali , Marshall John K , Bissonnette Robert , Bitton Alain , Bressler Brian , Gooderham Melinda , Ho Vincent , Jamal Shahin , Pope Janet E , Steinhart A Hillary , Vinh Donald C , Wade John
Published: December 2018

The use of immunosuppressive therapies for immune-mediated disease (IMD) is associated with an elevated risk of infections and related comorbidities. While many infectious diseases can generally be prevented by vaccines, immunization rates in this specific patient population remain suboptimal, due in part to uncertainty about their efficacy or safety under these clinical situations. To address this concern, a multidisciplinary group of Canadian physicians with expertise in dermatology, gastroenterology, infectious diseases and rheumatology developed evidence-based clinical guidelines on vaccinations featuring 13 statements that are aimed at reducing the risk of preventable infections in individuals exposed to immunosuppressive agents.
Evaluating Lung Cancer Screening Uptake, Outcomes, and Costs in the United States: Challenges With Existing Data and Recommendations for Improvement
Authors: Rai Ashish , Doria-Rose V Paul , Silvestri Gerard A , Yabroff K Robin
Published: December 2018

The National Lung Screening Trial (NLST) reported substantial reduction in lung cancer mortality among high-risk individuals screened annually with low-dose helical computed tomography (LDCT). As a result, the US Preventive Services Task Force issued a B recommendation for annual LDCT in high-risk individuals, which requires private insurers to cover it without cost-sharing. The Medicare program also covers LDCT for high-risk beneficiaries without cost-sharing. However, the NLST findings may not be generalizable to the community setting because of differences in patients, providers, and practices participating in the NLST. Thus, examining uptake of LDCT screening in community practice is critical, as is evaluating the immediate and downstream outcomes of screening, including false-positive scans, follow-up examinations and adverse events, costs, stage of disease at diagnosis, and survival. This commentary presents an overview of the landscape of the data resources currently available to evaluate the uptake, outcomes, and costs of LDCT screening in the United States. We describe the strengths and limitations of existing data sources, including administrative databases, surveys, and registries. Thereafter, we provide recommendations for improving the data infrastructure pertaining to three overarching research areas: receipt of guideline-consistent screening and follow-up, weighing benefits and harms of screening, and costs of screening.
A Decision Tree Using Patient Characteristics to Predict Resistance to Commonly Used Broad-Spectrum Antibiotics in Children With Gram-Negative Bloodstream Infections
Authors: Sick-Samuels Anna C , Goodman Katherine E , Rapsinski Glenn , Colantouni Elizabeth , Milstone Aaron M , Nowalk Andrew J , Tamma Pranita D
Published: December 2018

Background

As rates of multidrug-resistant gram-negative infections rise, it is critical to recognize children at high risk of bloodstream infections with organisms resistant to commonly used empiric broad-spectrum antibiotics. The objective of the current study was to develop a user-friendly clinical decision aid to predict the risk of resistance to commonly prescribed broad-spectrum empiric antibiotics for children with gram-negative bloodstream infections.

Methods

This was a longitudinal retrospective cohort study of children with gram-negative bacteria cared for at a tertiary care pediatric hospital from June 2009 to June 2015. The primary outcome was a bloodstream infection due to bacteria resistant to broad-spectrum antibiotics (ie, cefepime, piperacillin-tazobactam, meropenem, or imipenem-cilastatin). Recursive partitioning was used to develop the decision tree.

Results

Of 689 episodes of gram-negative bloodstream infections included, 31% were resistant to broad-spectrum antibiotics. The decision tree stratified patients into high- or low-risk groups based on prior carbapenem treatment, a previous culture with a broad-spectrum antibiotic resistant gram-negative organism in the preceding 6 months, intestinal transplantation, age ≥3 years, and ≥7 prior episodes of gram-negative bloodstream infections. The sensitivity for classifying high-risk patients was 46%, and the specificity was 91%.

Conclusion

A decision tree offers a novel approach to individualize patients’ risk of gram-negative bloodstream infections resistant to broad-spectrum antibiotics, distinguishing children who may warrant even broader antibiotic therapy (eg, combination therapy, newer β-lactam agents) from those for whom standard empiric antibiotic therapy is appropriate. The constructed tree needs to be validated more widely before incorporation into clinical practice.
Microneurosurgical Removal of a Cervical Intramedullary Tumor Via Hemilaminoplasty: 3-Dimensional Operative Video
Authors: Harput Mehmet Volkan , Parnian Fard Ayda , Türe Uğur
Published: December 2018

Intramedullary tumors of the spinal cord are rare and account for 2% to 8.5% of all central nervous system tumors. In adults, ependymomas are the most common intramedullary tumors. The primary choice of treatment should be radical surgical removal, as this is curative for most tumors. Adequate tumor exposure is crucial and mostly achieved through standard laminectomy followed by midline myelotomy. However, extensive removal of posterior spinal elements may lead to worsening kyphotic deformities.

 After obtaining patient consent, this 3-dimensional video publication was prepared to present microneurosurgical removal of a C3-C6 cervical intramedullary tumor using right-sided hemilaminoplasty. C3-C6 hemilaminae were lifted en bloc. After dural and arachnoid incision, midline myelotomy was performed. Using microneurosurgical technique, the tumor was removed totally. After the dural closure, C3-C6 hemilaminae were placed into the previous position and reconstructed with mini-plates and screws. Preserving contralateral paraspinal muscles, spinous processes, midline spinal ligaments and bilateral facet joints helped maintaining the alignment of the spinal column.

 Comparing to laminectomy, hemilaminoplasty, decreases the postoperative pain and the total blood loss as only one side muscle dissection is enough.

 In the presented case, postoperative MRI showed total removal of the tumor. The final histopathology report indicated an ependymoma (WHO-Grade 2). Successful bone healing was demonstrated by postoperative cervical radiographs and CT scans. The patient has no postoperative neurological deficit.

 In conclusion, hemilaminoplasty is an effective and a less-invasive method in removal of intradural-intramedullary tumors with its advantages such as preventing the instability and reduction of blood loss and postoperative pain.
Classifying and Measuring Human Resources for Health and Rehabilitation: Concept Design of a Practices- and Competency-Based International Classification
Authors: Jesus Tiago S , Landry Michel D , Dussault Gilles , Fronteira Inês
Published: December 2018

The burden of physical impairments and disabilities is growing across high-, middle-, and low-income countries, but populations across the globe continue to lack access to basic physical rehabilitation. Global shortages, uneven distributions, and insufficient skill mix of human resources for health and rehabilitation (HRH&R) contribute to such inequitable access. However, there are no international standards to classify HRH&R and to promote their global monitoring and development.

In this article, we conceptually develop an international classification of HRH&R based on the concept of monitoring HRH&R through their stock of practices and competencies, and not simply counting rehabilitation professionals such as physical or occupational therapists. This concept accounts for the varying HRH&R configurations as well as the different training, competencies, or practice regulations across locations, even within the same profession.

Our perspective specifically develops the concept of a proposed classification, its structure, and possible applications. Among the benefits, stakeholders using the classification would be able to: (1) collect locally valid and internationally comparable data on HRH&R; (2) account for the rehabilitation practices and competencies among nonspecialized rehabilitation workers (eg, in less resourced/specialized contexts); (3) track competency upgrades or practice extensions over time; (4) implement competency-based human resources management practices, such as linking remuneration to competency levels rather than to professional categories; and (5) inform the development of (inter-)professional education, practice regulation, or even task-shifting processes for the whole of HRH&R. The proposed classification standard, still in a concept-development stage, could help drive policies to achieve the “right” stock of HRH&R, in terms of practices and competencies.
A long-term comparative analysis of the direction and congruence of technological change
Authors: Antonelli Cristiano , Feder Christophe
Published: December 2018

Technological congruence identifies the coherence between the direction of technological change and input costs in an economy and measures its effects on Total Factor Productivity (TFP). The search for technological congruence is constrained by the systemic characteristics of the countries where it takes place with special attention to the types of industrial relations and the role of the labor force in the accumulation of technological knowledge. Constrained technological congruence enables to interpret the heterogeneous long-term evidence of five advanced countries. The analysis confirms that the direction of technological change and its effects are heterogeneous across countries and time and reflect the specific conditions of their internal and external labor markets and of their knowledge generation processes.
Chemical Activation of the Ethylene Signaling Pathway Promotes Fusarium graminearum Resistance in Detached Wheat Heads
Authors: Foroud Nora A. , Pordel Reyhaneh , Goyal Ravinder K. , Ryabova Daria , Eranthodi Anas , Chatterton Syama , Kovalchuk Igor
Published: December 2018

Plant signaling hormones such as ethylene have been shown to affect the host response to various pathogens. Often, the resistance responses to necrotrophic fungi are mediated through synergistic interactions of ethylene (ET) with the jasmonate signaling pathway. On the other hand, ET is also an inducer of senescence and cell death, which could be beneficial for some invading necrotrophic pathogens. Fusarium graminearum, a causative agent in Fusarium head blight of wheat, is a hemibiotrophic pathogen, meaning it has both biotrophic and necrotrophic phases during the course of infection. However, the role of ET signaling in the host response to Fusarium spp. is unclear; some studies indicate that ET mediates resistance, while others have shown that it is associated with susceptibility. These discrepancies could be related to various aspects of different experimental designs, and suggest that the role of ET signaling in the host response to FHB is potentially dependent on interactions with some undetermined factors. To investigate whether wheat genotype can influence the ET-mediated response to FHB, the effect of chemical treatments affecting the ET pathway was studied in six wheat genotypes in detached-head assays. ET-inhibitor treatments broke down resistance to both initial infection and disease spread in three resistant wheat genotypes, whereas ET-enhancer treatments resulted in reduced susceptibility in three susceptible genotypes. The results presented here show that the ET signaling can mediate FHB resistance to F. graminearum in different wheat backgrounds.
Biomechanics of Femoral Neck Fractures and Implications for Fixation
Authors: Augat Peter , Bliven Emily , Hackl Simon
Published: December 2018

Fractures of the femoral neck can occur in young healthy individuals due to high loads occurring during motor vehicle accidents, impacts, or falls. Failure forces are lower if impacts occur sideways onto the greater trochanter as compared with vertical loading of the hip. Bone density, bone geometry, and thickness of cortical bone at the femoral neck contribute to its mechanical strength. Femoral neck fractures in young adults require accurate reduction and stable internal fixation. The available techniques for fracture fixation at the femoral neck (cannulated screws, hip screw systems, proximal femur plates, and cephallomedullary nails) are reviewed with respect to their competence to provide biomechanical stability. Mechanically unstable fractures require a load-bearing implant, such as hip screws, with antirotational screws or intramedullary nails. Subcapital or transcervical fracture patterns and noncomminuted fractures enable load sharing and can be securely fixed with cannulated screws or solitary hip screw systems without compromising fixation stability.
Treatment of Closed Femoral Shaft Fractures in Children Aged 6 to 10
Authors: Sigrist Emmalynn J. , George Nicole E. , Koder Adrienne M. , Gwam Chukwuweike U. , Etcheson Jennifer I. , Herman Martin J.
Published: December 2018

Background:

Management of pediatric femoral shaft fractures remains controversial, particularly in children between the ages of 6 and 10. In the current push toward cost containment, hospital type, and surgeon subspecialization have emerged as important factors influencing this treatment decision. Thus, in the present study, we use a nationwide pediatric inpatient database to compare the: (a) incidence; (b) demographic characteristics; (c) hospital costs; (d) length of stay; and (e) treatment method of pediatric closed femoral shaft fractures admitted to general versus children’s hospitals.

Methods:

The Kids’ Inpatient Database (KID) was queried for all patients aged 6 to 10 who sustained a closed femoral shaft fracture in 2009 or 2012, and patient records were stratified into children’s hospitals and general hospitals. Primary outcome measures included method of treatment, total hospital costs, and length of stay. Student/Welch t testing and χ2 analysis were utilized to compare continuous and categorical outcomes, respectively, between hospital types.

Results:

The total incidence of closed femoral shaft fractures decreased between 2009 and 2012 (1919 to 1581 patients; P=0.020), as did the proportion of patients treated in children’s hospitals (58.6% to 32.3%; P<0.001). In addition, patients treated at general hospitals were more likely to receive open reduction with internal fixation (45.3% vs. 41.1%) or external fixation (4.1% vs. 2.3%), and less likely to be managed with closed reduction with internal fixation (32.0% vs. 39.7%) than those treated at children’s hospitals (P<0.001 for all).

Conclusions:

The present study demonstrates a decrease in the incidence of closed femoral shaft fractures in 6- to 10-year old patients from 2009 to 2012, as well as decreased definitive management in children’s hospitals and increased selection of operative treatment. In addition, treatment in a nonchildren’s hospital was associated with decreased total inpatient costs and decreased treatment with closed reduction with internal fixation in favor of open reduction with internal fixation. Future studies should seek to identify the specific surgical procedures performed and match patients more closely based specific fracture pattern.

Level of Evidence:

Prognostic level II.
Anterior Guided Growth of the Distal Femur for Knee Flexion Contracture: Clinical, Radiographic, and Motion Analysis Results
Authors: Wang Kemble K. , Novacheck Tom F. , Rozumalski Adam , Georgiadis Andrew G.
Published: December 2018

Background:

Fixed knee flexion deformity is common in children with neuromuscular disorders. Anterior guided growth (AGG) of the distal femur can achieve gradual correction in patients who are skeletally immature. Little outcome data are available on this procedure.

Methods:

This is a retrospective matched cohort study. Forty-two knees (26 patients) underwent AGG surgery at our institution between 2007 and 2017. All patients underwent instrumented 3-dimensional gait analysis (3DGA). A nonsurgical control group of 49 knees (43 patients) was selected that matched for age, severity of preoperative knee contracture, and 3DGA parameters. Clinical, radiographic, and 3DGA outcomes were assessed and compared.

Results:

Average preoperative knee flexion deformity in AGG group was 13±8 degrees. Following AGG, deformity improved by 8±7 degrees (P<0.001) as measured radiographically and by 7±7 degrees (P<0.001) as measured on physical examination. Average rate of correction was 0.7±0.6 degrees per month or 8±8 degrees per year. The 3DGA parameters such as minimum stance phase knee flexion and knee flexion at initial contact were also significantly improved following AGG. In contrast, flexion deformity as measured radiographically worsened by 3±3 degrees (P=0.002) in the control group. Twelve knees (29%) had failure of correction. Predictors of failure included older age, lower level of function, and greater severity of preoperative deformity. The age at time of surgery and the anteroposterior position of plate fixation relative to the distal femoral physis were associated with rate of correction.

Conclusions:

In children with neuromuscular disorders, AGG of the distal femur is effective in improving degree of fixed knee flexion deformity as well as objective gait parameters. A significant portion of knees experience inadequate correction. Addressing factors associated with correction failure (ie, age and plate placement) may improve the procedure’s success.

Level of Evidence:

Level III—case control study
Polymorphism of IL-12 gene (rs568408G/A) and susceptibility to chronic hepatitis B virus infection in the central area of Iran
Authors: Ayatollahi Jamshid , Heidari Faeze S. , Sharifyazdi Mohammad , Shooroki Vajihe K. , Hemati Sudabe , Shahcheraghi Seyed H.
Published: December 2018

Hepatitis B virus (HBV)-related chronicity infection, which is determined by inflammation, is the main etiological factor for this disease. Cytokines are a group of endogenous proteins which have a key role in regulating the inflammatory responses and defeating infectious diseases. IL-12 plays a main role in the clearance of infections especially by viruses such as HBV. Single nucleotide polymorphisms and genetic history have an important role about the level and function of cytokines. The aim of the present study was to investigate the association of IL-12A single nucleotide polymorphism (rs568408 G/A) with chronic HBV infection. In a case–control study, genomic DNA of 148 chronic HBV-infected patients and 80 healthy controls was extracted by salting out method and single nucleotide polymorphism (rs568408 G/A) was genotyped using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). The frequency of rs568408 G/A gene for GG, GA, AA genotypes was 70.94, 23.6 and 5.7% in chronic patients and 46.25, 42.5 and 11.25% in control group, respectively. After genotyping and statistical analysis, significant difference was seen between the patients with chronic HBV and healthy controls (P = 0.001). Our findings indicated that IL-12A rs568408 can possibly be a risk factor for chronic HBV infection among Iranian population in Yazd province.
Factors Predicting Adoption of the Nurses Improving Care of Healthsystem Elders Program
Authors: Stimpfel Amy Witkoski , Gilmartin Mattia J.
Published: December 2018

Background

Registered nurses are often underprepared with the knowledge and skills to care for hospitalized older adult patients. One strategy to bridge this gap is for hospitals to adopt the Nurses Improving Care for Healthsystem Elders (NICHE) program: A nurse-led interdisciplinary organizational intervention to improve care of hospitalized older adults.

Objectives

This study aimed to identify the market, organizational and managerial, and sociotechnical factors associated with the adoption of NICHE among U.S. hospitals in order to understand factors that promote and inhibit the adoption of models to improve care for elders and to provide a basis for future studies that evaluate the effects of NICHE participation on patient outcomes.

Methods

We used an observational, retrospective design, linking three national administrative data sources, in a secondary analysis. Data included the 2012–2013 American Hospital Association Annual Survey, NICHE database, and the American Nurses Credentialing Center Magnet database. Multivariate logistic regression models were completed at the hospital level (n = 3,506).

Results

Statistically significant variables associated with hospital adoption of the NICHE program include using a medical home model, being in a network, having a pain services program, being in an urban location, and having over 100 beds.

Discussion

Understanding factors that promote the adoption of organizational interventions like NICHE holds promise for accelerating the use of evidence-based clinical practices to promote health, function, and well-being for older hospitalized adults. Our results provide a foundation for assessing the effects of NICHE participation on patient outcomes by identifying factors that account for membership in NICHE.
A Draft Genome and High-Density Genetic Map of European Hazelnut (Corylus avellanaL.)
Authors: Rowley Erik R. , VanBuren Robert , Bryant Doug W. , Priest Henry D. , Mehlenbacher Shawn A. , Mockler Todd C.
Published: December 2018

European hazelnut (Corylus avellanaL.) is of global agricultural and economic significance, with genetic diversity existing in hundreds of accessions. Breeding efforts have focused on maximizing nut yield and quality and reducing susceptibility to diseases such as Eastern filbert blight (EFB). Here we present the first sequenced genome among the order Fagales, the EFB-resistant diploid hazelnut accession ‘Jefferson’ (OSU 703.007). We assembled the highly heterozygous hazelnut genome using an Illumina only approach and the final assembly has a scaffold N50 of 21.5kb. We captured approximately 91 percent (345 Mb) of the flow-cytometry-determined genome size and identified 34,910 putative gene loci. In addition, we identified over 2 million polymorphisms across seven diverse hazelnut accessions and characterized t heir effect on coding sequences. We produced t wo high-density genetic maps with 3,209 markers from an F1 hazelnut population, representing a five-fold increase in marker density over previous maps. These genomic resources will aide in the discovery of molecular markers linked to genes of interest for hazelnut breeding efforts, and are available to the community athttps://www.cavellanagenomeportal.com/.
Tissue-specific dysregulation of mitochondrial respiratory capacity and coupling control in colon-26 tumor-induced cachexia
Authors: Khamoui Andy V , Halle Jessica L , Pena Gabriel S , Paez Hector G , Rossiter Harry B , Visavadiya Nishant P , Whitehurst Michael A
Published: December 2018

In addition to skeletal muscle dysfunction, recent frameworks describe cancer cachexia as a systemic disease involving remodeling of non-muscle organs such as adipose and liver. Impairment of mitochondrial function is associated with multiple diseases. The tissue-specific control of mitochondrial function in cancer cachexia is not well-defined. This study determined mitochondrial respiratory capacity and coupling control of skeletal muscle, white adipose tissue (WAT), and liver in colon-26 (C26) tumor-induced cachexia. Tissues were collected from PBS-injected weight-stable mice, C26 mice that were weight-stable, and C26 mice with moderate (10% weight loss) and severe cachexia (20% weight loss). WAT showed high non-phosphorylating LEAK respiration and reduced respiratory control ratio (RCR, index of OXPHOS coupling efficiency) during the induction of cachexia. Liver RCR decreased early due to cancer, and further declined with severe cachexia, where Ant2 but not Ucp2 expression was increased. Ant2 also related inversely with RCR in the liver (r=-0.547, p<0.01), suggesting a role for Ant2 in uncoupling of liver OXPHOS. Increased liver cardiolipin occurred during moderate cachexia and remained elevated in severe cachexia, suggesting this early event may also contribute to uncoupling. Impaired skeletal muscle mitochondrial respiration occurred predominantly in severe cachexia. These findings suggest that mitochondrial function is subject to tissue-specific control during cancer cachexia, whereby remodeling in WAT and liver arise early and could contribute to altered energy balance, followed by impaired skeletal muscle respiration. We highlight an underrecognized role of liver mitochondria in cancer cachexia, and suggest mitochondrial function of multiple tissues to be targets for therapeutic intervention.
Viperin binds STING and enhances the type-I interferon response following dsDNA detection
Authors: Crosse Keaton M. , Monson Ebony A. , Dumbrepatil Arti B. , Smith Monique , Tseng Yeu-Yang , Van der Hoek Kylie H. , Revill Peter A. , Tscharke David C. , Marsh E. Neil. G. , Beard Michael R. , Helbig Karla J.
Published: December 2018

Viperin is an interferon-inducible protein that is pivotal for eliciting an effective immune response against an array of diverse viral pathogens. Here we describe a mechanism of viperin’s broad antiviral activity by demonstrating the protein’s ability to synergistically enhance the innate immune dsDNA signalling pathway to limit viral infection. Viperin co-localised with the key signalling molecules of the innate immune dsDNA sensing pathway, STING and TBK1; binding directly to STING and inducing enhanced K63-linked polyubiquitination of TBK1. Subsequent analysis identified viperin’s necessity to bind the cytosolic iron-sulphur assembly component 2A, to prolong its enhancement of the type-I interferon response to aberrant dsDNA. Here we show that viperin facilitates the formation of a signalling enhanceosome, to coordinate efficient signal transduction following activation of the dsDNA signalling pathway; which results in an enhanced antiviral state. We also provide evidence for viperin’s radical SAM enzymatic activity to self-limit its immunomodulatory functions. This data further defines viperin’s role as a positive regulator of innate immune signalling, offering a mechanism of viperin’s broad antiviral capacity.
Rapid active zone remodeling consolidates presynaptic potentiation
Authors: Böhme Mathias A. , McCarthy Anthony W. , Grasskamp Andreas T. , Beuschel Christine B. , Goel Pragya , Jusyte Meida , Laber Desiree , Huang Sheng , Rey Ulises , Petzold Astrid G. , Lehmann Martin , Göttfert Fabian , Haghighi Pejmun , Hell Stefan W. , Owald David , Dickman Dion , Sigrist Stephan J. , Walter Alexander M.
Published: December 2018

Synaptic transmission is mediated by neurotransmitter release at presynaptic active zones (AZs) followed by postsynaptic neurotransmitter detection. Plastic changes in transmission maintain functionality during perturbations and enable memory formation. Postsynaptic plasticity targets neurotransmitter receptors, but presynaptic plasticity mechanisms directly regulating the neurotransmitter release apparatus remain largely enigmatic. Here we describe that AZs consist of nano-modular release site units and identify a molecular sequence adding more modules within minutes of plasticity induction. This requires cognate transport machinery and a discrete subset of AZ scaffold proteins. Structural remodeling is not required for the immediate potentiation of neurotransmitter release, but rather necessary to sustain this potentiation over longer timescales. Finally, mutations in Unc13 that disrupt homeostatic plasticity at the neuromuscular junction also impair shot-term memory when central neurons are targeted, suggesting that both forms of plasticity operate via Unc13. Together, while immediate synaptic potentiation capitalizes on available material, it triggers the coincident incorporation of modular release sites to consolidate stable synapse function.