bluuebunny/crossref_metadata_2025 huggingface dataset:
Left Upper Quadrant Emergencies
Authors: Shenoy-Bhangle Anuradha , Abujudeh Hani H. , Kambadakone Avinash
Published: February 2016

The spleen and stomach contribute to left upper quadrant emergencies. Splenomegaly predisposes the spleen to easy injury, and spontaneous splenic rupture may be a reflection of this phenomenon. Splenic abscesses in isolation are a uncommon entities. These are commonly hematogenous in origin and often coexist with hepatic abscesses. The more ominous entities giving rise to left upper quadrant pain that requires emergency diagnosis are gastric volvulus and gastric perforation. These may present acutely in the background of longstanding hiatus herniae. Contrast-enhanced CT of the abdomen is a rapid and useful tool to differentiate above-mentioned entities from each other. The following chapter (17) discusses key clinical features and imaging findings in patients presenting to the emergency department with left upper quadrant pain.
Diffuse Abdominal Pain
Authors: Shenoy-Bhangle Anuradha , Abujudeh Hani H. , Kambadakone Avinash
Published: February 2016

Diffuse abdominal pain in adults in the non-traumatic acute setting can arise from various causes, ranging from medically treatable causes such as mesenteric lymphadenitis, to surgically treatable causes like bowel obstruction/perforation and or bowel ischemia. Mesenteric ischemia refers to a decrease in vascularity to bowel wall caused either by acute vascular occlusion or chronic arterial stenosis. Symptoms depend upon acuteness of presentation and may vary from recurrent post-prandial abdominal pain to an acute abdomen-like picture with peritoneal signs or GI hemorrhage.
Infections of the Genitourinary System
Authors: Uyeda Jennifer W. , Harisinghani Mukesh
Published: February 2016

Urinary tract infections are the most common urological disease in the United States. Most genitourinary tract infections are uncomplicated, involving only the urinary bladder. Infections can ascend to the upper urinary tract or be seeded hematogenously, resulting in both uncomplicated and complicated pyelonephritis.
Vascular Insults of the Genitourinary System
Authors: Uyeda Jennifer W. , Harisinghani Mukesh
Published: February 2016

Renal infarcts and renal vein thrombosis are the two most common vascular insults of the genitourinary system. Renal infarcts are commonly caused by an embolic phenomenon from cardiovascular disease, but they may also be secondary to infectious etiologies such as endocarditis, shock and hypoperfusion, renal artery dissection, and trauma. Renal vein thrombosis is most commonly caused by a hypercoagulable state induced by nephrotic syndrome, although this can also be secondary to renal cell carcinoma extending into the renal vein.
Traumatic Injuries of the Adrenal Gland and Diaphragm
Authors: Shaqdan Khalid , Al-Jandali Torki Frey , Nicola Refky , Abujudeh Hani H.
Published: February 2016

Diaphragmatic injury occurs in less than 1% of all traumatic injuries, and is usually associated with injuries of the thoracic and abdominal organs. A delayed diagnosis of diaphragmatic injury can be life-threatening due to herniation and strangulation of abdominal organs into the thoracic cavity. Therefore, urgent surgical intervention is recommended. Left visceral herniation is more common and occurs in 70-90% of cases.
Gynecological Emergencies
Authors: Shenoy-Bhangle Anuradha , Baliyan Vinit , Abujudeh Hani H. , Kambadakone Avinash
Published: February 2016

Women in the reproductive age group can present with a wide range of gynecological emergencies. These include conditions that are medically managed such as infections of the genitourinary tract, to complications that require emergency surgical intervention such as ovarian/adnexal torsion. Early accurate diagnosis by appropriate imaging is crucial. Pelvic ultrasound is the backbone of early screening for acute female pelvic emergencies, followed by MRI or occasionally CT in ambiguous cases. The following chapter describes in detail the imaging appearances of the range of pathologies affecting the uterus, fallopian tubes, and ovaries, including complications related to malpositioned contraceptive devices.
Obstetric First Trimester Emergencies
Authors: Attaya Hosam N. , Abujudeh Hani H.
Published: February 2016

The first trimester is defined as the first day of the last menstrual cycle to the end of the thirteenth post-menstrual week. First-trimester emergencies are common and include pathologies that must be identified early, as delayed diagnosis can be detrimental or fatal to the mother and/or embryo. These include ectopic pregnancy, heterotopic pregnancy, failed early pregnancy, subchorionic hemorrhage, gestational trophoblastic disease, and tubal rupture/abscess.
Testicular Emergencies
Authors: Uyeda Jennifer W. , Harisinghani Mukesh
Published: February 2016

Testicular emergencies encompass a wide range of pathological conditions, including testicular torsion, infarction, infections such as orchitis and abscess, and blunt and penetrating trauma. Many of these diagnoses are considered urological emergencies where accurate diagnosis and timely treatment are crucial for testicular salvage. In most cases, the patient presents with acute scrotal pain. Clinical history plays an important role in differentiating ischemic, infectious, and traumatic emergencies of the testicles.
Other Acute Male Genital Pathology
Authors: Uyeda Jennifer W. , Harisinghani Mukesh
Published: February 2016

Various pathologies of the male genital system can cause acute pain, some of which requires urgent treatment to minimize future morbidity and mortality. Examples include Peyronie disease, Fournier gangrene, prostatitis, and inguinal scrotal hernia.
Emergencies of the Hip and Femur
Authors: Bolar Divya S. , Huang Ambrose J. , Abujudeh Hani H. , Chang Connie Y.
Published: February 2016

Hip and femur fractures are common injuries that present to the emergency department. Most are due to low-energy trauma and are a significant cause of morbidity in the elderly. Hip dislocations are typically seen only in severe trauma. Avulsions of the femur are generally seen only in the younger athlete. Conventional radiography is the imaging approach of choice for initial evaluation. This chapter provides a systematic approach for evaluating fractures and dislocations. A discussion of radiographic features for fractures and dislocations follows and is divided into intra-capsular and extra-capsular hip fractures, supracondylar fractures, hip dislocations, and avulsion injuries. Injury mechanisms, management strategies, associated complications, and the role of additional imaging with CT/MRI are also briefly discussed. Finally, “not to miss” injuries are highlighted, with emphasis on the associated imaging findings.
Emergencies of the Ankle
Authors: Pugmire Brian S. , Huang Ambrose J. , Abujudeh Hani H. , Chang Connie Y.
Published: February 2016

This chapter reviews the most important and most common acute ankle injuries, with a focus on their key imaging findings. Clinical and imaging evaluation of the foot can be difficult due to the complex anatomy, so knowledge of common injury patterns is essential for accurate image interpretation. This chapter begins with a review of clinically relevant ankle anatomy and a method to approach ankle radiographs. Common and clinically significant injuries of the ankle are discussed, with a focus on bony trauma. Key clinical features of various injuries are discussed, and important “not to miss” imaging findings are outlined. Common anatomical variants are reviewed briefly, as these can cause pain or be confused with fractures.
Emergencies of the Foot
Authors: Pugmire Brian S. , Huang Ambrose J. , Abujudeh Hani H. , Chang Connie Y.
Published: February 2016

This chapter reviews the most important and most common acute foot injuries, with a focus on their key imaging findings. Clinical and imaging evaluation of the foot can be difficult due to the complex anatomy, so knowledge of common injury patterns is essential for accurate image interpretation. This chapter begins with a review of clinically relevant foot anatomy and a method to approach foot radiographs. Common and clinically significant injuries of the foot are discussed with a focus on bony trauma. Key clinical features of various foot injuries are discussed and important “not to miss” imaging findings are outlined. Common anatomical variants are reviewed briefly, as these can cause pain or can be confused for fractures. After reviewing the material in this chapter, readers will have a better understanding of acute foot trauma and will be better equipped to accurately interpret foot imaging studies.
Emergencies of the Shoulder Girdle
Authors: Rutledge Geoffrey M. , Chang Connie Y. , Abujudeh Hani H. , Huang Ambrose J.
Published: February 2016

The shoulder girdle is composed of the scapula, clavicle, and multiple stabilizing ligaments. Injuries to the shoulder girdle include clavicle and scapula fractures, acromioclavicular (AC) joint separations, and sternoclavicular (SC) joint dislocations. Most injuries to the shoulder girdle result from high-energy, direct lateral impact on an adducted shoulder. This mechanism transmits a compressive force medially and can result in clavicle fracture, scapula fracture, AC joint separation, or SC joint dislocation. These patients present with point tenderness and deformity. Other fractures and soft-tissue injuries are often seen in the setting of shoulder-girdle trauma, including rib fractures, pneumothorax, and head trauma.
Emergencies of the Elbow and Forearm
Authors: Rutledge Geoffrey M. , Chang Connie Y. , Abujudeh Hani H. , Huang Ambrose J.
Published: February 2016

This chapter reviews the most important and most common traumatic injuries to the elbow and forearm, with a focus on their key imaging findings. It discusses the pertinent anatomy of the elbow and forearm, the clinical features associated with their traumatic injury, and an approach to radiographs of the elbow and forearm. Injuries discussed include radius-ulna combination fracture-dislocations, including Monteggia, Galeazzi, and Essex-Lopresti injuries; fractures of the distal humerus, radial head, olecranon, and coronoid process; and elbow dislocations. Key radiographic findings and their clinical significance are emphasized, including a section on “what not to miss” with each type of injury.
Neonatal Chest Emergencies
Authors: Shailam Randheer
Published: February 2016

Neonatal medical respiratory diseases include transient tachypnea of the newborn (TTN), meconium aspiration, respiratory distress syndrome (RDS), and neonatal pneumonia. Gestational age and prenatal and perinatal history are important in image interpretation and differential diagnosis. Infants born between 34 and 37 weeks’ gestation can have diseases occurring in both preterm and term infants. A systematic approach to the neonatal chest radiograph is helpful for image interpretation and an accurate diagnosis.
Child Abuse
Authors: Phewplung Teerasak , Shailam Randheer
Published: February 2016

It is important for radiologists and other pediatric care providers to be aware of child maltreatment, including physical, sexual, and emotional abuse and neglect. Physical abuse is second most common after neglect and accounts for approximately 18.3% of child maltreatment. Fractures are the second most common injury caused by child physical abuse after bruises, which are the most common injury. Often a fracture is the only finding that suggests child abuse. Child abuse is also known as trauma-X, battered child syndrome, inflicted trauma, and non-accidental trauma. Physical abuse affects children of all ages, genders, ethnicities, and socioeconomic groups. Male and female children experience similar rates of abuse.
Lung Scintigraphy
Authors: Wang Yingbing , Abujudeh Hani H. , Oza Umesh
Published: February 2016

Pulmonary thromboembolism (PE) is the third most common cause of death from cardiovascular disease. Although anticoagulation and thrombolytics form the mainstays of treatment, these therapies independently increase the risk of hemorrhage and other side effects. Therefore, early recognition and judicious treatment of PE is essential to minimize patient morbidity and mortality.
Renal Scintigraphy in Transplant Kidneys
Authors: Wang Yingbing , Abujudeh Hani H. , Oza Umesh
Published: February 2016

Renal transplantation is one of the most common transplant procedures performed. Important advances have reduced short-term complications and improved long-term survival of renal allografts. Currently, the most common early transplant complication is ischemic nephropathy, also known as acute tubular necrosis (ATN).
C
Authors: Scarth Edward , Smith Susan
Published: February 2016

This chapter includes drugs beginning with the letter C, including carbamazepine, carbapenems, carbon dioxide, caspofungin, cephalosporins, chloroprocaine, chlorphenamine, chlorpromazine, cisatracurium, clomethiazole, clonidine, clopidogrel, cocaine, codeine, co-trimoxazole, and cyclizine.
K
Authors: Scarth Edward , Smith Susan
Published: February 2016

This chapter includes drugs beginning with the letter K, including ketamine and ketorolac.
O
Authors: Scarth Edward , Smith Susan
Published: February 2016

This chapter includes drugs beginning with the letter O, including omeprazole, ondansetron, oseltamivir, oxycodone, oxygen, and oxytocin.
T
Authors: Scarth Edward , Smith Susan
Published: February 2016

This chapter includes drugs beginning with the letter T, including teicoplanin, temazepam, terbutaline, tetracycline, thiopental, thrombolytics, tramadol, and trichloroethylene.
V
Authors: Scarth Edward , Smith Susan
Published: February 2016

This chapter includes drugs beginning with the letter V, including vasopressin, vecuronium, and verapamil.
Complications of ESKD: anaemia
Authors: Levy Jeremy , Brown Edwina , Lawrence Anastasia
Published: February 2016

This chapter describes the importance of anaemia as a complication of ESKD and its investigation, assessment, and management; the use of erythropoietins; initiating and managing therapy; use of intravenous iron and assessing iron stores; and non-erythropoietin adjuvants in managing anaemia.
Other complications of ESKD
Authors: Levy Jeremy , Brown Edwina , Lawrence Anastasia
Published: February 2016

This chapter describes various important complications of end-stage kidney disease not covered elsewhere and includes dialysis amyloid, renal cysts, renal carcinoma, neuropathies, depression, cognitive impairment, gastrointestinal bleeding, acidosis, sexual dysfunction, aluminium toxicity and its diagnosis and management, nephrogenic systemic fibrosis, issues around employment, and effects of end-stage kidney disease on tumour markers and biochemical results generally.
Drug dosing
Authors: Levy Jeremy , Brown Edwina , Lawrence Anastasia , Lawson Wendy , Betmouni Rania
Published: February 2016

This chapter describes both general and specific aspects of prescribing in end-stage kidney disease, from drug handling in renal failure to changes in pharmacokinetics and bioavailability, to detailed sections on drug dosing of commonly used drugs: antimicrobials, antifungals, antiretrovirals, antiviral drugs, antituberculous drugs, cardiovascular drugs, analgesics, central nervous system drugs, gastrointestinal drugs, immunosuppressants. It also includes drugs that do not require dosage change in end-stage kidney disease and drugs to be avoided.
Immunotherapy in Melanoma
Authors: Diller Maggie , Kudchadkar Ragini R.
Published: February 2016

Immune therapies have revolutionized the treatment of metastatic melanoma, and more patients are now long-term survivors of this disease. Questions still remain regarding the best sequencing and combination of treatments. Additionally, studies are underway to identify biomarkers that may serve as predictors of response and help further guide and individualize therapy. With regard to adjuvant treatment, interferon remains the standard of care. However, given the impact of immunomodulation on stage IV disease and early studies suggesting the efficacy of such medications as ipilimumab as adjuvant therapy, results from ongoing trials may change the way we treat patients in the adjuvant setting. Toxicities for the various medications can be expansive. Early recognition and management of adverse events is key to the safe and effective use of all therapies and in preventing long-term morbidity and mortality.
Management of Melanoma Brain Metastases
Authors: Sahebjam Solmaz , Rao Nikhil G. , Forsyth Peter A.
Published: February 2016

Melanoma commonly metastasizes to the brain and central nervous system (CNS); CNS metastases occur in more than half of patients with advanced melanoma. This remarkable neurotropism has not yet been explained. The prognosis of patients with melanoma brain metastasis remains grim, and the median overall survival after diagnosis of brain metastases is only two to nine months. This chapter asserts that the optimal management of melanoma brain metastasis patients requires the multidisciplinary collaboration of neurosurgeons, radiation oncologists, neuro-oncologists, and medical oncologists to tailor the treatment plan based on the clinical condition of the patient and the molecular characteristics of the tumor. Ideally this should be done in a dedicated melanoma brain metastases clinic. This chapter discusses each of the individual treatment modalities.
Minimal invasive intralesional excision of extremity-located osteoid osteomas in children
Authors: Erol Bulent , Topkar Mert O. , Tokyay Abbas , Sofulu Omer , Caliskan Emrah , Okay Erhan
Published: February 2016

In this retrospective study, we evaluated the efficiency of minimal invasive intralesional extended curettage in the treatment of osteoid osteomas of the extremities in children. Forty-seven children (29 males, 18 females; mean age 10.5 years; range 4–19 years) with osteoid osteoma of the extremities underwent minimal invasive intralesional extended curettage. The exact localization of the nidus was determined preoperatively by thin-section (1–1.5 mm) computed tomography scans, and complete excision of the nidus was performed using a modified burr-down technique. None of the procedures required bone grafting or internal fixation. The median follow-up duration was 59 months (range, 12–136 months). Histopathological confirmation of osteoid osteoma was achieved in all procedures. All patients experienced immediate and complete relief of lesional pain after surgery. Preoperative (a day before surgery) and postoperative (at the time of discharge) mean visual analogue scale scores, questioning the pain derived from osteoid osteoma, were 7.7±1.2 and 0.3±0.6, respectively, confirming complete removal of the nidus. Early motion of the involved extremities and mobilization of the patients were achieved within 2 days. The children resumed normal function within 3 weeks. Postoperative complication or recurrence was not encountered in any of the patients. Even though percutaneous radiofrequency thermoablation is accepted as the treatment of choice for extraspinal osteoid osteomas, this technique requires a regional reference institution. Minimal invasive intralesional extended curettage can be performed in conventional institutions, even those not specialized in bone tumor surgery, by orthopedic surgeons with high success and low morbidity rates, in addition to rapid functional recovery.
The Ponseti Method for Clubfoot Treatment in Low and Middle-Income Countries: A Systematic Review of Barriers and Solutions to Service Delivery
Authors: Johnson Rachel R. , Friedman James M. , Becker Andrew M. , Spiegel David A.
Published: February 2016

Background:

Use of the minimally invasive Ponseti method has been increasing in low and middle-income countries, where most of the world’s children with clubfoot are born. This method requires a system of service delivery involving screening, serial casting with or without a tenotomy to achieve correction, and long-term use of an orthosis to maintain correction. The goal of this systematic review is to evaluate the barriers to service delivery and the solutions that have been proposed or implemented to address these barriers.

Methods:

A literature search of Medline, Embase, and SCOPUS produced 3251 results. Twenty-four papers were selected for final review. Barriers and their attempted solutions were organized into a previously described health barrier model. We reported on high-impact, sustainable solutions that are feasible for organizations to implement, as opposed to solutions that require major policy or country-wide infrastructure changes.

Results:

Common barriers found to have the most impact on patient care included financial constraints, transportation, difficulties with brace and cast care, self-perceived health status, lack of physical resources, and provider’s lack of knowledge and skill. The most common solutions detailed were education of the provider or patient and financial assistance for patients.

Conclusions:

Recognizing that contextually relevant solutions to the challenges of setting up a system for clubfoot service delivery are required, several common barriers have emerged within this systematic review of papers from multiple countries, including spatial accessibility, affordability, and availability. Programs can best prepare for challenges by placing clinics close to population centers and/or allocating funds to subsidize transportation, ensuring that an adequate supply of materials are available for the casting and tenotomy, and enhancing the education of families and health providers. Strengthening communication and establishing partnerships between individuals and organizations promoting the Ponseti method will improve systems for service delivery.

Level of Evidence:

Level IV—prognostic study.
The Optic Nerve Head in Primary Open-Angle Glaucoma Eyes With High Myopia: Characteristics and Association With Visual Field Defects
Authors: Chen Li-Wei , Lan Yu-Wen , Hsieh Jui-Wen
Published: February 2016

Purpose:

To evaluate the morphologic characteristics of optic neuropathy and its association with visual field (VF) defects in primary open-angle glaucoma (POAG) eyes with high myopia.

Methods:

In this cross-sectional study, we reviewed data from 375 Taiwanese patients (375 eyes) of POAG, ages 20 to 60 years. Optic disc photographs were used for planimetric measurements of morphologic variables. The myopic refraction was divided into high myopia (<−6.0 D) and nonhigh myopia (moderate myopia to hyperopia). The optic disc area was classified as moderate (1.59 to 2.85 mm2), large, and small. Differences in characteristics between groups, correlations with the disc area, and factors associated with VF defects were determined.

Results:

Of the 142 highly myopic eyes, 33 (23%) had a large disc, 26 (18%) had a small disc, and 55 (39%) had a tilted disc. Large discs had a higher cup-to-disc (C/D) area ratio and a higher tilt ratio; small discs had a smaller rim area and a lower tilt ratio (all P<0.05). Characteristics associated with high myopia included a smaller rim area, a higher C/D area ratio, and a lower tilt ratio (all P<0.001). In logistic regression, the refraction, the C/D area ratio, the rim area, and the tilt ratio (all P<0.05) were associated with VF defects.

Conclusions:

In Taiwanese individuals with POAG, our study found that tilted, large, or small discs were prevalent in highly myopic eyes. Of these characteristics, only the disc tilt and high myopia by itself were associated with the severity of glaucomatous optic neuropathy.
Prospective Comparative Analysis of 4 Different Intraocular Pressure Measurement Techniques and Their Effects on Pressure Readings
Authors: Berk Thomas A. , Yang Patrick T. , Chan Clara C.
Published: February 2016

Purpose:

To compare intraocular pressure (IOP) measurement using the Goldmann applanation tonometry (GAT) without fluorescein, with fluorescein strips, with fluorescein droplets, and IOP measurement with Tono-Pen Avia (TPA).

Patients and Methods:

This was a prospective comparative clinical analysis. It was performed in clinical practice. The study population consisted of 40 volunteer patients, 1 eye per patient. All patients who were 18 years and older having routine ophthalmological examination were eligible to participate. Active corneal abrasions and/or ulcers, previous glaucoma surgery, or prostheses interfering with GAT measurement were excluded. GAT IOP was measured first without fluorescein, then with fluorescein strip, then with fluorescein droplet, and finally with the TPA device. The main outcome measure was central corneal IOP.

Results:

Mean±SD IOP measurements for GAT without fluorescein, with fluorescein strip, with fluorescein droplet, and for TPA groups were 12.65±3.01, 14.70±2.82, 15.78±2.64, and 16.33±3.08 mm Hg, respectively. Repeated-measures analysis of variance corrected with the Greenhouse-Geisser estimate (ɛ=0.732) showed that measuring technique had a significant effect on IOP measurements (F
2.20,85.59=34.66, P<0.001). The pairwise post hoc testing showed statistically significant mean differences (P≤0.001) between all techniques except when GAT with fluorescein droplet was compared with TPA (P=0.222). The Bland-Altman analyses showed 95% limits of agreement maximum potential discrepancies in measurement ranging from 5.89 mm Hg in the GAT with fluorescein strip versus droplet compared with 11.83 mm Hg in the GAT with fluorescein strip versus TPA comparison.

Conclusions:

IOP measurement technique significantly impacted the values obtained. The ophthalmologist should ensure consistent measurement technique to minimize variability when following patients.
Growth Pattern in Paediatric Crohn Disease Is Related to Inflammatory Status
Authors: Ley Delphine , Duhamel Alain , Behal Hélène , Vasseur Francis , Sarter Hélène , Michaud Laurent , Gower‐Rousseau Corinne , Turck Dominique
Published: February 2016

Objectives:

The respective role of disease activity and steroid therapy in growth impairment in paediatric‐onset Crohn disease (CD) is still debated. Our aim was to investigate whether the growth pattern of children with CD was correlated with the inflammatory status during the disease course, regardless the cumulative duration of steroid therapy.

Methods:

One hundred and seven patients with a diagnosis of CD <17 years, followed during ≥2 years and for whom ≥2 height measures were available during follow‐up, were identified between 1998 and 2010. Height, C‐reactive protein (CRP), orosomucoid, and steroid therapy duration were collected at each visit. The relationship between the evolution of growth velocity and inflammatory status during follow‐up was investigated using a linear mixed model with random coefficients.

Results:

Median age at diagnosis was 11.7 years (Q1–Q3: 9.8–13.5). Mean height for age (H/A) z score was 0.14 ± 1.29 at diagnosis and 0.05 ± 1.23 among the 75 patients who had reached their final height at maximal follow‐up (median: 4.9 years; Q1–Q3: 3.8–6.4). Growth failure (H/A z score <−2) was present in 7 (8%) patients at diagnosis and 5 (5%) at maximal follow‐up. Growth velocity was negatively correlated with the evolution of CRP (P < 0.0001) and orosomucoid (P < 0.0001) during follow‐up. After adjustment for the cumulative duration of steroid therapy, these 2 correlations remained significant (CRP: P = 0.0008; orosomucoid: P < 0.0001).

Conclusions:

Children with CD with uncontrolled inflammatory status have a lower growth velocity. The inflammatory status should be kept as close to normal as possible in paediatric‐onset patients with CD to optimize their growth pattern.
Pharmacokinetics of Rilpivirine in HIV-Infected Pregnant Women
Authors: Tran Anna H. , Best Brookie M. , Stek Alice , Wang Jiajia , Capparelli Edmund V. , Burchett Sandra K. , Kreitchmann Regis , Rungruengthanakit Kittipong , George Kathleen , Cressey Tim R. , Chakhtoura Nahida , Smith Elizabeth , Shapiro David E. , Mirochnick Mark ,   for the IMPAACT P1026s Protocol Team
Published: February 2016

Background:

Rilpivirine pharmacokinetics is defined by its absorption, distribution, metabolism, and excretion. Pregnancy can affect these factors by changes in cardiac output, protein binding, volume of distribution, and cytochrome P450 (CYP) 3A4 activity. Rilpivirine is metabolized by CYP3A4. The impact of pregnancy on rilpivirine pharmacokinetics is largely unknown.

Methods:

International Maternal Pediatric Adolescent AIDS Clinical Trials P1026s is a multicenter, nonblinded, prospective study evaluating antiretroviral pharmacokinetics in HIV-infected pregnant women that included a cohort receiving rilpivirine 25 mg once daily as part of their combination antiretrovirals for clinical care. Thirty-two women were enrolled in this study. Intensive pharmacokinetic sampling was performed at steady state during the second trimester, the third trimester, and postpartum. Maternal and umbilical cord blood samples were obtained at delivery. Plasma rilpivirine concentration was measured using liquid chromatography–mass spectrometry; lower limit of quantitation was 10 ng/mL.

Results:

Median (range) AUC0–24 were 1969 (867–4987, n = 15), 1669 (556–4312, n = 28), and 2387 (188–6736, n = 28) ng·h/mL in the second trimester, the third trimester, and postpartum, respectively (P < 0.05 for either trimester vs postpartum). Median (range) C24 were 63 (37–225, n = 17), 56 (<10–181, n = 30), and 81 (<10–299, n = 28) ng/mL (P < 0.05 for either trimester vs postpartum). High variability in pharmacokinetic parameters was observed between subjects. Median (range) cord blood/maternal concentration ratio was 0.55 (0.3–0.8, n = 21). Delivery HIV-1 RNA was ≤50 copies per milliliter in 70% and ≤400 copies per milliliter in 90% of women. Cmin were significantly lower at 15 visits with detectable HIV-1 RNA compared with 61 visits with undetectable HIV-1 RNA, 29 (<10–93) vs 63 (15–200) ng/mL (P = 0.0001). Cmin was below the protein binding–adjusted EC90 concentration (12.2 ng/mL) at 4 visits in 3 of 31 women (10%).

Conclusions:

Rilpivirine exposure is lower during pregnancy compared with postpartum and highly variable. Ninety percent of women had minimum concentrations above the protein binding–adjusted EC90 for rilpivirine.
The Mexican consumer, reluctant or receptive to new foods?
Authors: Salgado Beltrán Lizbeth , Camarena Gómez Dena M. , Díaz León Jonathan
Published: February 2016

Purpose

– The purpose of this paper is to measure the relative degree of rejection or reluctance to try new foods of the Mexican consumers.

Design/methodology/approach

– To measure the degree of acceptance or rejection that individuals have for foods that are unusual in their diets, a phobia scale was used to new foods developed by Pliner and Hobden (1992) Food Neophobia Scale (FNS). The authors also distinguished between individuals’ predisposition to taste new foods, “neo-phobic” (lower bias) and “neo-philic” (predisposition). Additionally social and demographic variables such as age, gender, monthly income level and marital status to discuss relations with the FNS scale were incorporated.

Findings

– The results have shown that Mexican consumers show relatively low levels of phobia toward new foods, but there may be differences in accordance with the characteristics of the environment, the proximity of another culture or urbanization level have a significant influence on consumer attitudes.

Originality/value

– In Mexico the development of new foods has increased, in a recent study 83 percent of respondents indicated they are interested in buying new foods on the market. Studies of novel foods phobia have been made in various international contexts, in Mexico, however, the exploration and understanding of consumer attitudes toward foods that are unusual in their diets is incipient. This study represents one of the first contributions in this regard and more so to focus specifically on the Mexican consumer.
Urban agriculture: connecting producers with consumers
Authors: Dimitri Carolyn , Oberholtzer Lydia , Pressman Andy
Published: February 2016

Purpose

– Urban farming is becoming more common in the USA, as food-based entrepreneurs seek to make money farming in the city. Yet many urban farms are concerned with other factors in addition to food production, and thus have incorporated social goals into their missions. The purpose of this paper is to identify the social missions of urban farms in the USA, their extent, and explores differences and similarities among farms with varying missions.

Design/methodology/approach

– The authors use primary data collected from a 2012 national survey of urban farmers in the USA. In total, 35 questions, covering the 2012 farm year, targeted production and marketing practices, risks and challenges, information and technical assistance needs, farm size and location, age of primary farmer, and farm characteristics. A multinomial logistic model was used to analyze the social missions of urban farms in the sample.

Findings

– The authors find that food production is an essential part of the mission for all urban farms. Some farms have social missions, as well, which the survey results indicate are related to food security, education, and community building. The authors find that all urban farms, regardless of their mission, are relatively small and face similar challenges in terms of providing the primary farmer with a living. Farms with explicit social missions, relative to those with a strict market orientation, donate a higher share of food from their farm and are less likely to own farmland. Urban farms located in with lower median income are more likely to have social goals related to building community or improving security food security.

Originality/value

– Urban agriculture is becoming more prevalent in many developed nations. At the same time, social entrepreneurship is gaining traction. Given the limited ability of urban farms in terms of food production, the social mission of urban farms arises as a possible explanation for the recent growth. This paper provides insight into a new phenomenon, and uses new data to provide insight into size, types of farms, and farmer well-being and address the social missions of urban farms in the USA.
Temporal dominance of sensations and dynamic liking evaluation of polenta sticks
Authors: Di Monaco Rossella , Miele Nicoletta Antonella , Volpe Stefania , Masi Paolo , Cavella Silvana
Published: February 2016

Purpose

– Temporal dominance of sensation (TDS) is a sensory method developed by Pineau et al. (2003) which studies the sequence of dominant sensations of a product during its consumption. TDS is believed to be more appropriate to explain consumer responses than static descriptive analysis due to its temporal element. The purpose of this paper is to define the temporal sensory profile of a new product: polenta stick. In particular, TDS method was used to measure the dominance of sensory attributes in polenta stick samples and dynamic consumer tests were performed in order to verify if the acceptability changed over time during sample consumption.

Design/methodology/approach

– Eight polenta sticks, different in terms of storage conditions, cooking procedures and serving temperatures, were analysed by means of TDS with 13 assessors. During two preliminary sessions, the attributes list, constituted by the nine most cited sensations, was generated. Five replications were carried out. In dynamic consumer tests, 50 subjects were asked to give their liking on a seven-category scale for the frozen samples, in different five moments during the evaluation.

Findings

– TDS results showed a significant effect of the experimental conditions on dominant attribute perception of polenta sticks. For the oven-cooked samples, more flavour attributes were perceived as dominant, whereas for the fried samples, the attributes crispness and oiliness overcame with a high panel dominance rate and for a long time. For the chilled samples, crispness had the highest panel dominance rate; whereas for the frozen samples, creaminess was the most dominant attribute. Consumer liking scores did not significantly change over time during consumption for all the samples. The fried samples received the highest liking scores, at both serving temperatures.

Practical implications

– The chosen sensory methods gave the authors important information about the real perception of the products during consumption. A lot of foodstuffs show several sensory properties that appear in different times during evaluation and/or consumption. These properties could affect overall liking so they should be taken into account.

Originality/value

– New dynamic sensory methods were used to characterize a new food product, i.e. polenta-based sticks. The procedure used to evaluate the liking by consumers was completely innovative, whereas the sensory method used to characterize the samples was recently developed. The new food product was developed as an aim of an Italian research project funded by MiSE (Ministero dello Sviluppo Economico) for the valorization of maize flour (MAISFOOD, Industria 2015).
Applying the demand-control-support model on burnout in managers and non-managers
Authors: Blom Victoria , Bodin Lennart , Bergström Gunnar , Svedberg Pia
Published: February 2016

Purpose

– The purpose of this paper is to study the demand-control-support (DCS) model on burnout in male and female managers and non-managers, taking into account genetic and shared family environmental factors, contributing to the understanding of mechanisms of how and when work stress is related to burnout.

Design/methodology/approach

– A total of 5,510 individuals in complete same-sex twin pairs from the Swedish Twin Registry were included in the analyses. Co-twin control analyses were performed using linear mixed modeling, comparing between-pairs and within-pair effects, stratified by zygosity and sex.

Findings

– Managers scored higher on demands and control in their work than non-managers, and female managers seem to be particularly at risk for burnout facing more demands which are not reduced by a higher control as in their male counterparts. Co-twin analyses showed that associations between control and burnout as well as between demands and burnout seem to be affected by shared family environmental factors in male non-managers but not in male managers in which instead the associations between social support and burnout seem to be influenced by shared family environment.

Practical implications

– Taken together, the study offers knowledge that shared environment as well as sex and managerial status are important factors to consider in how DCS is associated to exhaustion.

Originality/value

– Using twin data with possibilities to control for genetics, shared environment, sex and age, this study offers unique insight into the DCS research, which focusses primarily on the workplace environment rather than individual factors.
Social capital and health and job related outcomes: the case of a large municipality
Authors: Løkke Ann-Kristina
Published: February 2016

Purpose

– The purpose of this paper is to investigate the relationship between workplace social capital and health and job related outcomes in a large Danish municipality.

Design/methodology/approach

– Data used in this cross-sectional study are based on an electronic employee survey conducted in 2012 in a large municipality. Of the total population of 5,672 individuals, the number of participants amounted to 4,162, leading to a response rate of 73.4 percent. Binary logistic regression analysis is used as a statistical method, and odds ratios and their corresponding 95 percent confidence intervals have been estimated.

Findings

– The level of social capital is fairly high in the municipality (3.75 on a five-point scale). Social capital is related to health (OR=0.420) and psychological distress (OR=0.282) but has an even stronger relationship to job satisfaction and commitment (OR is 9.889 and 7.800, respectively). The study contributes with the conclusion that different sub-dimensions of social capital are related to health and job related outcomes. Therefore, managers need to be specific about what exactly they want to achieve with the implementation of social capital in municipalities.

Originality/value

– Research of the relationship between social capital and health and job related outcomes based on a case study approach of a municipality are limited. This paper makes an original contribution in providing evidence of the importance of social capital for Danish municipal sector employees’ health, job satisfaction, and commitment in a work context.
Enhancing building maintenance cost performance with proper management of spare parts
Authors: Au-Yong Cheong Peng , Ali Azlan Shah , Ahmad Faizah
Published: February 2016

Purpose

– Scheduled building maintenance requires appropriate and adequate spare parts to replace existing parts on a regular basis. Management of spare parts is seen as an important criterion to ensure the efficiency of scheduled maintenance. The purpose of this paper is to identify the contributors of spare parts management and investigate the relationship between these contributors and maintenance cost performance.

Design/methodology/approach

– This research adopted a quantitative approach, which utilised questionnaire surveys to study the relationship between the contributors of spare parts management and maintenance cost performance. The data were analysed through descriptive analysis, correlation, and regression analysis. Additionally, a case study was examined to validate the results obtained from the survey.

Findings

– The results of this research demonstrated that the quality of spare parts (QSP), budget allocation for acquisition of spare parts, and level of stocks were significantly correlated to the maintenance cost variance (MCV). Moreover, the results of the regression analysis indicated that the QSP was the significant predictor of MCV.

Originality/value

– This research highlights the importance of spare parts management in building maintenance. It recommends that maintenance management set up a spare parts management department for updating stocks frequently. Meanwhile, the management should avoid ad-hoc acquisition of spare parts, as this is always more expensive. The management should also select spare parts based on quality instead of lowest cost. In addition, building managers should also apply the developed regression model in practice to predict and improve maintenance performance.
Ranking of barriers for effective maintenance by using TOPSIS approach
Authors: Singh Rajesh Kumar , Gupta Ayush , Kumar Ashok , Khan Tasmeem Ahmad
Published: February 2016

Purpose

– In present context of globalization, maintenance of production systems is very important. Many of the organizations are facing a lot of problems in maintenance management. Therefore the purpose of this paper is to identify the main barriers in maintenance management and to rank them for effective maintenance strategies.

Design/methodology/approach

– To rank the main barriers in maintenance management, technique for order preference by similarity to ideal solution is used. For giving score to different factors a team of three experts was made. All experts were having more than ten years of experience in area of maintenance management.

Findings

– Lack of top management support, lack of measurement of overall equipment effectiveness (OEE) and lack of strategic planning and implementation have emerged as top three barriers in implementation of maintenance systems in industries.

Research limitations/implications

– Findings imply that for successful maintenance, top management should be very supportive for taking different initiatives, training programmes, etc. Organizations should try to improve overall performance of machines known as OEE rather than only machines productivity.

Originality/value

– These findings will be highly useful for professionals from manufacturing sector in implementing effective maintenance management system.
Detection of Hantaan virus RNA from anti‐Hantaan virus IgG seronegative rodents in an area of high endemicity in Republic of Korea
Authors: No Jin Sun , Kim Won‐keun , Kim Jeong‐Ah , Lee Seung‐Ho , Lee Sook‐Young , Kim Ji Hye , Kho Jeong Hoon , Lee Daesang , Song Dong Hyun , Gu Se Hun , Jeong Seong Tae , Kim Heung‐Chul , Klein Terry A. , Song Jin‐Won
Published: February 2016

Hantaan virus (HTNV), of the family Bunyaviridae, causes hemorrhagic fever with renal syndrome (HFRS) in humans. Although the majority of epidemiologic studies have found that rodents are seropositive for hantavirus‐specific immunoglobulin, the discovery of hantavirus RNA in seronegative hosts has led to an investigation of the presence of HTNV RNA in rodents captured in HFRS endemic areas. HTNV RNA was detected in seven (3.8%) of 186 anti‐HTNV IgG seronegative rodents in Republic of Korea (ROK) during 2013–2014. RT‐qPCR for HTNV RNA revealed dynamic virus–host interactions of HTNV in areas of high endemicity, providing important insights into the epidemiology of hantaviruses.
Perceptual ratings of subgroups of ataxic dysarthria
Authors: Spencer Kristie A. , France Ashley A.
Published: February 2016

Background

The speech characteristics of ataxic dysarthria are known to be quite diverse. The varied presentation of this dysarthria challenges researchers and clinicians alike, and brings into question whether it is a single entity. While the possibility of subtypes of ataxic dysarthria has been suggested, the nature of these putative groups remains unclear.

Aims

The purpose of this pilot study was to determine if perceptual speech characteristics would align with a pattern of unusual variability or unusual consistency across speech subsystems and speaking tasks.

Methods & Procedures

A framework of speech characteristics was created from the existing literature that clustered speech attributes according to notions of instability (unusual variability) or inflexibility (unusual consistency). These speech features were used to develop a perceptual rating form. Ten experienced speech–language pathologists listened to pre‐recorded, exemplary samples of 10 speakers with ataxic dysarthria and rated the perceptual speech features.

Outcomes & Results

Results suggested that five speakers fit the pattern of instability, one speaker aligned with inflexibility and four speakers had a mixed presentation. Intra‐rater reliability was satisfactory.

Conclusions & Implications

This study adds to the sparse, yet growing, literature to support the existence of subgroups in ataxic dysarthria. The more frequent occurrence of the instability profile is consistent with primary disruption to the timing function of the cerebellar circuit. Identification of subgroups has important clinical and research implications and further research is warranted.