bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical Relevance and Treatment Selection of Ureteral Injury After Cesarean Section
Authors: Lo Tsia-Shu , Wijaya Tomy , Lo Liang-Ming , Kao Chuan-Chi , Wu Pei-Ying , Cortes Eileen Feliz M. , Huang Shih Yin , Lin Chih Hui
Published: April 2016

Introduction

The aim of this case series was to report the clinical relevance and management outcomes of ureteral injuries acquired secondary to cesarean section.

Methods

This was a retrospective case series from January 2007 to September 2014. Description of the patients' characteristics, diagnostic tools for investigation, management, and postoperative follow-up was conducted on postcesarean section patients who developed symptoms of urine leakage after cesarean section and necessitated secondary surgery for ureteral injury. Descriptive statistics was used for demographics and operative data.

Results

A total of 5619 cases were managed by cesarean section during the study period. Six (0.107%; 95% confidence interval [CI], 0.1069%–0.1071%) patients had ureteral injury related to the cesarean section. Of 6 cases, 3 (0.053%; 95% CI, 0.0529%–0.0531%) had ureterouterine fistula. Three cases were managed by ureteroneocystostomy, 1 by ureteroneocystostomy with Boari flap, 1 by transureteroureterostomy, and the other one by ureteral stenting via ureterocystoscopy. Three patients had immediate operation because of an acute abdomen and 3 patients had delayed operation. The left ureter was the most common site of ureteral injury (5/6). The postoperative course was uneventful for all cases.

Conclusions

Continuous urinary leakage and acute abdominal distention associated with fluid accumulation after emergency cesarean section should be considered as “red flag” symptoms of ureteral injury and ureterouterine fistulae complications. Delayed management for ureteral repair may not be associated with bad outcomes for management of ureterouterine fistula. Delayed management was associated with less blood loss, less operating time, and acceptable outcome among patients with ureterouterine fistulae when the renal function is not compromised.
The Impact of Obesity on Intraoperative Complications and Prolapse Recurrence After Minimally Invasive Sacrocolpopexy
Authors: Turner Lindsay , Lavelle Erin , Lowder Jerry L. , Shepherd Jonathan P.
Published: April 2016

Objective

Our objective was to compare the risk of intraoperative complications and prolapse recurrence among normal-weight, overweight, and obese women after minimally invasive sacrocolpopexy.

Methods

This is a retrospective study of all laparoscopic and robotic sacrocolpopexies performed at a large academic center from 2009 to 2014. Patient demographics and clinical and surgical data were compared between normal-weight, overweight, and obese women using χ2 test, analysis of variance (ANOVA), and logistic regression.

Results

Of the 556 subjects, 187 (33.6%) were normal weight, 248 (44.6%) were overweight, and 121 (21.8%) were obese. Compared with normal-weight and overweight women, obese women had more medical comorbidities (56.2% vs 29.4% and 39.5%, P < 0.001) and were more likely to undergo robotic surgery (odds ratio, 1.40; 95% confidence interval, 1.01–1.94). Obese women experienced greater blood loss compared with overweight women (82.4 [76.1] vs 63.8 [51.6] mL, P = 0.03) and longer operative times compared with both normal-weight and overweight women (250.7 [57.0] vs 233.8 [58.2] minutes, P = 0.04, and 250.7 [57.0] vs 233.8 [57.2] minutes, P = 0.03). Obesity was a significant predictor of intraoperative complications even after correcting for surgeon experience, estimated blood loss, and concomitant hysterectomy (adjusted odds ratio, 3.42; 95% confidence interval, 1.21-9.70). Few women (7.6%) experienced recurrence of prolapse. Obesity was not a significant predictor of prolapse recurrence.

Conclusions

In women undergoing minimally invasive sacrocolpopexy, obesity is associated with increased blood loss, longer operative times, and more intraoperative complications, specifically conversions to laparotomy. Even after correcting for blood loss, surgeon experience, and concomitant hysterectomy, obese women were 3 times as likely to have an intraoperative complication. Our data did not show that obesity was associated with increased risk of prolapse recurrence; however, postoperative follow-up was limited.
Transdermal Scopolamine and Acute Postoperative Urinary Retention in Pelvic Reconstructive Surgery
Authors: Propst Katie , O'Sullivan David M. , Tulikangas Paul K.
Published: April 2016

Objective

To evaluate the relationship between perioperative use of transdermal scopolamine and the rate of urinary retention after stress urinary incontinence and pelvic organ prolapse procedures in women.

Methods

This is a retrospective, cohort study; the primary outcome is the rate of acute postoperative urinary retention. Study candidates were adult female patients who underwent pelvic reconstructive surgery at a tertiary care center. Subjects were excluded if preoperative postvoid residual urine volume was greater than 150 mL, preoperative urodynamic testing was not performed, or if a postoperative trial of void was not performed. Subjects were grouped based on preoperative use of transdermal scopolamine. Patients were selected consecutively until 138 subjects per group was reached. Differences in rates of acute postoperative urinary retention were evaluated using a chi-square test. Group demographics were evaluated using t tests and χ2 tests.

Results

Two hundred seventy-six subjects were included in the analysis, 138 received a transdermal scopolamine patch in the perioperative period and 138 did not. The overall rate of acute postoperative urinary retention was 25.3%. There was no significant difference in the rate of acute postoperative urinary retention between the study groups (scopolamine, 26.8%; no scopolamine, 23.9%; P = 0.580). Demographics of the 2 groups were compared; patients who received scopolamine patch were younger (P = 0.001), received a greater amount of intravenous fluids (P = 0.007), and underwent a greater percentage of incontinence procedures (P = 0.048). Otherwise, there were no differences between the groups.

Conclusions

Transdermal scopolamine is not a risk factor for acute postoperative urinary retention after pelvic reconstructive procedures.
Providing Better-Matched Donors for HLA Mismatched Compatible Pairs Through Kidney Paired Donation
Authors: Ferrari Paolo , Cantwell Linda , Ta Joseph , Woodroffe Claudia , D'Orsogna Lloyd , Holdsworth Rhonda
Published: April 2016

Background

Participation of compatible pairs (CP) in kidney paired donation (KPD) could be attractive to CPs who have a high degree of HLA mismatch, if the CP recipient will gain a better HLA match. Because KPD programs were not designed to help CP, it is important to define allocation metrics that enable CP to receive a better-matched kidney, without disadvantage to incompatible pairs (ICP).

Methods

Simulations using 46 ICPs and 11 fully HLA-mismatched CPs were undertaken using the Australian KPD matching algorithm. Allocations were preformed adding 1 CP at a time or all 11 CPs at once, and with and without exclusion of unacceptable antigens selected to give a virtual calculated panel-reactive antibody ranging 70% to 80% to improve HLA matching in CP recipients.

Results

On average, most CP recipients could be matched and had a lower eplet mismatch (EpMM) with the matched donor (57 ± 15) than with their own donor (78 ± 19, P < 0.02). However, only recipients who had an EpMM to own donor greater than 65 achieved a significant reduction in the EpMM with the matched donor. The gain in EpMM was larger when CPs were listed with unacceptable antigens. Furthermore, inclusion of 1 CP at a time increased matching in ICP by up to 33%, and inclusion of all 11 CPs at once increased ICP matching by 50%.

Conclusions

Compatible pair participation in KPD can increase match rates in ICP and can provide a better immunological profile in CP recipients who have a high EpMM to their own donor when using allocation based on virtual crossmatch.
Links between fluid mechanics and quantum mechanics: a model for information in economics?
Authors: Haven Emmanuel
Published: April 2016

This paper tallies the links between fluid mechanics and quantum mechanics, and attempts to show whether those links can aid in beginning to build a formal template which is usable in economics models where time is (a)symmetric and memory is absent or present. An objective of this paper is to contemplate whether those formalisms can allow us to model information in economics in a novel way.
1−1=Counterfactual: on the potency and significance of quantum non-events
Authors: Elitzur A. C. , Cohen E.
Published: April 2016

We study the unique role played in quantum mechanics by non-events or ‘counterfactuals’. Our earlier analysis of ‘quantum oblivion’ has revealed some subtle stages in the measurement process, which may end up in self-cancellation. To these findings, we now add two insights derived by two time-symmetric interpretations of quantum mechanics. (i) Like all quantum interactions, the non-event is formed by the conjunction of forward-plus-backward-evolving wave functions. (ii) Then, it is another feature of such dual evolutions, namely the involvement of negative masses and energies, that enables Nature to make some events ‘unhappen’ while leaving causal traces.
Robust Generation of Transgenic Mice by Hypotonic Shock Mediated Transgene Delivery in Testicular Germ Cells
Authors: Usmani Abul , Ganguli Nirmalya , Jain Subodh K , Ganguli Nilanjana , Sarkar Rajesh Kumar , Choubey Mayank , Shukla Mansi , Sarkar Hironmoy , Majumdar Subeer S
Published: April 2016

Our ability to decipher gene sequences has increased enormously with the advent of modern sequencing tools but the ability to divulge functions of new genes have not increased correspondingly. This has caused a remarkable delay in functional interpretation of several newly found genes in tissue and age specific manner, limiting the pace of biological research. This is mainly due to lack of advancements in methodological tools for transgenesis. Predominantly practiced method of transgenesis by pronuclear DNA-microinjection is time consuming, tedious and requires highly skilled persons for embryo-manipulation. Testicular electroporation mediated transgenesis requires use of electric current to testis. To this end, we have now developed an innovative technique for making transgenic mice by giving hypotonic shock to male germ cells for the gene delivery. Desired transgene was suspended in hypotonic Tris-HCl solution (pH 7.0) and simply injected in testis. This resulted in internalization of the transgene in dividing germ-cells residing at basal compartment of tubules leading to its integration in native genome of mice. Such males generated transgenic progeny by natural mating. Several transgenic animals can be generated with minimum skill within short span of time by this easily adaptable novel technique.
Multiple scattering in grazing-incidence X-ray diffraction: impact on lattice-constant determination in thin films
Authors: Resel Roland , Bainschab Markus , Pichler Alexander , Dingemans Theo , Simbrunner Clemens , Stangl Julian , Salzmann Ingo
Published: April 2016

Dynamical scattering effects are observed in grazing-incidence X-ray diffraction experiments using an organic thin film of 2,2′:6′,2′′-ternaphthalene grown on oxidized silicon as substrate. Here, a splitting of all Bragg peaks in the out-of-plane direction (z-direction) has been observed, the magnitude of which depends both on the incidence angle of the primary beam and the out-of-plane angle of the scattered beam. The incident angle was varied between 0.09° and 0.25° for synchrotron radiation of 10.5 keV. This study reveals comparable intensities of the split peaks with a maximum for incidence angles close to the critical angle of total external reflection of the substrate. This observation is rationalized by two different scattering pathways resulting in diffraction peaks at different positions at the detector. In order to minimize the splitting, the data suggest either using incident angles well below the critical angle of total reflection or angles well above, which sufficiently attenuates the contributions from the second scattering path. This study highlights that the refraction of X-rays in (organic) thin films has to be corrected accordingly to allow for the determination of peak positions with sufficient accuracy. Based thereon, a reliable determination of the lattice constants becomes feasible, which is required for crystallographic structure solutions from thin films.
4,4,5,5-Tetramethyl-2-[(Z)-1-(3-methylphenoxy)hex-1-en-2-yl]-1,3,2-dioxaborolane
Authors: Li Kai-Xiao , Wang Xiao-Juan
Published: April 2016

The title compound, C19H29BO3, was prepared by the reaction of 1-(hex-1-yn-1-yloxy)-3-methylbenzene in tetrahydrofuran with 4,4,5,5-tetramethyl-1,3,2-dioxaborolane under a nitrogen atmosphere. In the molecule, the butyl group adopts an extended conformation, with a torsion angle of 179.52 (19)°. The dioxaborolane ring has a twisted conformation on the C—C bond, and its mean plane is inclined to the 3-methylphenyl ring by 44.79 (19)°. In the crystal, there are no significant intermolecular interactions present.
The complexity of innovation: an assessment and review of the complexity perspective
Authors: Poutanen Petro , Soliman Wael , Ståhle Pirjo
Published: April 2016

Purpose

– The purpose of this paper is to provide a review of the innovation literature, with special focus on studies applying a complexity perspective. As a contribution in its own right to the innovation literature, the review clarifies the concept of complexity, explores possible points of relevance and the “added value” gained from complexity theory (CT) to the study of innovation, and identifies some of the applications of the theory.

Design/methodology/approach

– A literature search was conducted which yielded 20 relevant articles. These articles were analyzed by focusing on the key concepts of complexity and studying their applications in the context of innovation research.

Findings

– Based on the approach adopted, the literature was divided into three categories, namely research focusing on microdynamics, macrodynamics, and leadership and management. The key complexity concepts identified in the innovation literature were “edge of chaos”, “phase shift”, “emergence and self-organization”, “(co)evolution”, and “complexity regulation”. The articles reviewed differed in terms of their perspectives on complexity and, accordingly, their operationalization of the complexity concepts. Key areas of development suggested by the authors include forging a stronger link with existing innovation theory and giving greater weight to empirical evidence.

Research limitations/implications

– While a systematic review strategy was adopted to identify all relevant research on “open innovation” and complexity, a selective snowball strategy was deemed the only feasible approach to cover research conducted on “innovation” and complexity.

Practical implications

– Practitioners can learn to put CT-based research in context and also learn to recognize the value of CT for innovation management. The authors distilled three important lessons for practice from the research done: embracing complexity, embracing ambidexterity, and embracing failure.

Originality/value

– To the best of the authors’ knowledge no review has as yet been undertaken to encapsulate the current state of applications of CT to innovation research.
Effectuation, innovation and performance in SMEs: an empirical study
Authors: Roach David C. , Ryman Joel A. , Makani Joyline
Published: April 2016

Purpose

– Ever since Sarasvathy’s (2001) seminal article, scholars have sought to test effectuation’s affect on firm performance. Although recent work has begun the arduous process of testing effectuation’s effect on entrepreneurial performance, there is still much to learn about its impact on firm performance. One such area is the relationship between effectuation and innovation. The purpose of this paper is to first, propose a scale suitable to the explication of the effectuation construct relative to innovation. Second, it proposes a more parsimonious scale for the measurement of innovation. Third, these scales are tested relative to firm performance.

Design/methodology/approach

– This paper develops and tests a structural model, which investigates aspects of effectuation as mediators between innovation orientation and product/service innovation. This is accomplished using a sample of 169 electronic product manufacturing-based small and medium-sized enterprises (SMEs). Subjective measures of performance are used as the dependent variable.

Findings

– The three most widely used measures of innovativeness were found to break cleanly into two sub-constructs, namely innovation orientation and product/service innovation. Effectuation measures included means (who I know), leverage contingencies (experimentation), pre-commitments and affordable loss. Means and leverage contingencies were found to positively mediate innovation orientation and product/service innovation leading to increased firm performance. Affordable loss did not show a mediating role, but had a direct effect on firm performance.

Research limitations/implications

– This study establishes two distinct sub-constructs of firm-level innovation; namely innovation orientation and product/service innovation. Second, by testing an innovation-centric effectuation model, this research establishes an empirical relationship between effectuation, innovation and firm performance.

Practical implications

– Practical implications include establishing a relationship between means, leverage contingencies and innovation-performance, indicating that the ways through which small and medium-sized enterprises use their innovation networks may affect innovation outcomes and ultimately firm performance.

Originality/value

– This research establishes an empirical relationship between effectuation, innovation and firm performance, extending effectuation theory from the entrepreneurship to the innovation literature.
Moving from elite international schools to the world’s elite universities
Authors: Lee Moosung , Wright Ewan
Published: April 2016

Purpose

– The purpose of this paper is to explore how elite International Baccalaureate Diploma Programme (IBDP) schools in China function as a channel for international student mobility to leading universities around the world.

Design/methodology/approach

– To achieve this, the authors conducted a mixed-methods study combining quantitative analysis of 1,622 students’ university destinations and qualitative analysis of interview data from five high performing and high tuition fee IBDP schools in China.

Findings

– Results indicate that the IBDP in China can be conducive to a form of “elite international student mobility” for some students with 30 percent of participants attending one of the top 50 ranked universities globally. As an explanation, interview data points to the strong reputation of the program, the provision of structured opportunities for students to demonstrate “additional skills,” and the abundant resources of elite schools.

Originality/value

– The authors provide a critical discussion about the implications of the IBDP’s function for “elite international student mobility” in connection with social contexts surrounding these international International Baccalaureate schools in China. In so doing, the discussion tackles two issues from a critical perspective: the role elite international schools in accelerating educational inequalities and challenges to authentic learning experience when elite schools play the “university admissions game.”
Self-employment
Authors: Schölin Tobias , Broomé Per , Ohlsson Henrik
Published: April 2016

Purpose

– The purpose of this paper is to examine the influence that family factors have on an individual’s intention to be self-employed.

Design/methodology/approach

– The authors selected, from Swedish national registers, all full siblings born between 1945 and 1960 and their biological children, who were born before 1985. The authors created one family database consisting of male individuals (n=1,204,436) and one family database consisting of female individuals (n=1,349,904). The authors defined the outcome variable during the years 2003-2010. Separate analyses were conducted for each of the four outcome variables: all self-employed individuals, owners of limited liability companies, sole traders and hybrids. The authors used multi-level logistic analysis for this study.

Findings

– The study demonstrates that the influence that family factors have on an individual’s choice of company type is strong; however, it varies depending on intentions transferred within the family.

Originality/value

– The authors divide self-employment into three distinct parts based on the company type, which enables a sophisticated analysis of self-employed individuals and of the transference of intentions to be self-employed within families. The authors contribute to the understanding of why individuals become self-employed by examining the impact of family factors on the intention of an individual to choose different types of company.
The impact of transitions into wage-employment for satisfied and unsatisfied entrepreneurs
Authors: Mattes Jochen
Published: April 2016

Purpose

– Should unsatisfied/satisfied entrepreneurs transition into wage-employment? The purpose of this paper is to investigate the financial, physical, social and emotional consequences of the decision.

Design/methodology/approach

– The paper uses an Australian, nationally representative panel for two Bayesian multivariate regressions.

Findings

– Unsatisfied entrepreneurs that transition from self- to wage-employment improve their income, life and job satisfaction. For satisfied entrepreneurs, continuing or transitioning makes little difference: job and life satisfaction develop similarly. The health of continuing entrepreneurs suffers regardless of whether they are satisfied or unsatisfied.

Research limitations/implications

– Unobserved heterogeneity is only addressed within cohorts, not across cohorts. It is possible, that transitioning entrepreneurs are inherently different from continuing entrepreneurs. Further research could include a more fine-grained study of entrepreneurship’s negative health implications or include work-family balance as return to self-employment.

Practical implications

– The findings offer clear advice to entrepreneurs that are unsatisfied with their venture: they will likely benefit from transitioning to wage-employment. In addition, it offers a warning to individuals with existing health issues who are considering self-employment.

Originality/value

– Academic interest in entrepreneurship exit is growing. This paper is the first to study the financial, physical, social and emotional life consequences of both satisfied and unsatisfied entrepreneurs. It contributes to the discussion of what motivates entrepreneurs to become and remain self-employed.
Practical Considerations in Trace Element Analysis of Bone by Portable X‐ray Fluorescence
Authors: Byrnes Jennifer F. , Bush Peter J.
Published: April 2016

Forensic anthropologists are more often turning to nondestructive methods to assist with skeletal analyses, specifically for trace elemental analyses. Portable XRF (pXRF) instruments are versatile and are able to be used in diverse settings or for specimens of a shape and size that cannot be accommodated by laboratory‐based instruments. Use of XRF requires knowledge of analysis parameters such as X‐ray penetration and exit depth. Analysis depth was determined by examining pure elements through known thicknesses of equine bone slices. Correlation between the element's X‐ray emission energy and the depth of reading was observed. Bone surfaces from a small unknown historic cemetery were analyzed before and after sanding of the periosteal surface to observe possible changes in XRF readings based on potential diagenesis. Results validate the pXRF device as a powerful and convenient instrument for nondestructive analysis, while highlighting limitations and considerations for the analysis of osseous materials.
Decrease of memory retention in a parasitic wasp: an effect of host manipulation by Wolbachia?
Authors: Kishani Farahani Hossein , Ashouri Ahmad , Goldansaz Seyed Hossein , Shapiro Martin S. , Pierre Jean‐Sebastien , van Baaren Joan
Published: April 2016

Several factors, such as cold exposure, aging, the number of experiences and viral infection, have been shown to affect learning ability in different organisms. Wolbachia has been found worldwide as an arthropod parasite/mutualist symbiont in a wide range of species, including insects. Differing effects have been identified on physiology and behavior by Wolbachia. However, the effect of Wolbachia infection on the learning ability of their host had never previously been studied. The current study carried out to compare learning ability and memory duration in 2 strains of the parasitoid Trichogramma brassicae: 1 uninfected and 1 infected by Wolbachia. Both strains were able to associate the novel odors with the reward of an oviposition into a host egg. However, the percentage of females that responded to the experimental design and displayed an ability to learn in these conditions was higher in the uninfected strain. Memory duration was longer in uninfected wasps (23.8 and 21.4 h after conditioning with peppermint and lemon, respectively) than in infected wasps (18.9 and 16.2 h after conditioning with peppermint and lemon, respectively). Memory retention increased in response to the number of conditioning sessions in both strains, but memory retention was always shorter in the infected wasps than in the uninfected ones. Wolbachia infection may select for reduced memory retention because shorter memory induces infected wasps to disperse in new environments and avoid competition with uninfected wasps by forgetting cues related to previously visited environments, thus increasing transmission of Wolbachia in new environments.
Clinical inertia causing new or progression of diabetic retinopathy in type 2 diabetes: A retrospective cohort study
Authors: Osataphan Soravis , Chalermchai Thep , Ngaosuwan Kanchana
Published: April 2016

Background

Clinical inertia is a failure to intensify treatment according to evidence‐based guidelines, and can have both short‐ and long‐term adverse effects for type 2 diabetes (T2D). The aim of the present study was to demonstrate the effects of clinical inertia on glycemic control and diabetes‐related complications.

Methods

A retrospective cohort study was conducted at a university‐based hospital in Thailand. Medical records were evaluated retrospectively from January 2010 to December 2014. Patients were classified into two groups: clinical inertia and non‐inertia. Clinical inertia was defined as failure to initiate insulin within 3 months in patients with HbA1c ≥9 % who were already taking two oral antidiabetic agents.

Results

From 1206 records, 98 patients with mean HbA1c of 10.3 % were identified and enrolled in the study. The median follow‐up time of these patients was 29.5 months and 68.4 % were classified into the clinical inertia group. The mean (± SD) HbA1c decrement in the clinical inertia and non‐inertia groups was 0.82 ± 1.50 % and 3.02 ± 1.80 %, respectively, at 6 months (P < 0.001) and 1.46 ± 1.85 % and 3.04 ± 1.76 %, respectively, at the end of study (P < 0.001). Clinical inertia was associated with a significantly shorter median time to progression of diabetic retinopathy (DR); log rank test, P = 0.02 and a higher incidence of DR progression (10 vs 2.2 cases per 1000 person‐months; P = 0.003). The adjusted incidence rate ratio for DR progression in the clinical inertia group was 4.92 (95 % confidence interval 1.11–21.77; P = 0.036). Being treated by general practitioners was the strongest risk factor associated with clinical inertia.

Conclusions

Clinical inertia can cause persistently poor glycemic control and speed up the progression of DR in T2D.
Genetic diversity of aboriginal and invasive populations of four‐eyed fir bark beetle Polygraphus proximusBlandford (Coleoptera, Curculionidae, Scolytinae)
Authors: Kononov Alexandr , Ustyantsev Kirill , Blinov Alexandr , Fet Victor , Baranchikov Yuri N.
Published: April 2016

The four‐eyed fir bark beetle Polygraphus proximus Blandf., native in Far Eastern Eurasia and nearby islands, is an invasive pest of fir trees in Siberian and European parts of Russia. Its invasion has been overlooked and was only finally appreciated in 2008.

Subsequently, the scale and area of damage to the forests has increased catastrophically. Thus, extensive monitoring and population control are required to localize and stop any further spread of the invasion.

We used mitochondrial DNA markers to analyze the genetic diversity and population structure of invasive and aboriginal populations of P. proximus, aiming to establish the main sources and corridors of its spread and to infer the history of colonization.

Eighteen haplotypes clustered in five groups were identified. The aboriginal populations had the highest degree of haplotype variability, including almost all haplotypes found in the areas of invasion. The Siberian introduced populations had a sufficient reduction of genetic variation, and a strong geographical partitioning. The European populations mostly had the same haplotypes as the invasive Siberian populations.

The results of the present study support the scenario of P. proximus spreading from the Far East of Russia westward via timber transport along the major Russian railway network.
Low prevalence of human papillomavirus in oral cavity squamous cell carcinoma in Queensland, Australia
Authors: Emmett Sarah , Jenkins Glenn , Boros Samuel , Whiteman David C. , Panizza Benedict , Antonsson Annika
Published: April 2016

Background

While human papillomavirus (HPV) is an accepted risk factor for oropharyngeal squamous cell carcinoma (SCC), its aetiological role in oral cavity SCC remains unclear. This study aimed to determine the HPV prevalence in an Australian population.

Methods

DNA was extracted from 63 formalin‐fixed paraffin‐embedded tumour specimens histologically confirmed as SCC of the oral cavity, diagnosed during 2006–2012. Clinical data were extracted from medical records. HPV presence was determined by polymerase chain reaction. Positive samples were typed by sequencing. Immunohistochemistry was used to assess p16INK4A
, p53, pRB, Ki67, Cyclin D1 and p21WAF1
expression.

Results

Five of the 63 tumours (8%) were positive for HPV DNA (three HPV‐16 positive and two HPV‐18 positive). Two tumours overexpressed p16INK4A
(3%) and one of these was also HPV positive. Overexpression of Cyclin D1 correlated significantly with tumour recurrence (P = 0.029) and death (P = 0.002).

Conclusions

This study has identified a low prevalence of high‐risk HPV in Queensland, Australia.
Metastatic bone disease of the pelvis and extremities: rationalizing orthopaedic treatment
Authors: Kirkinis Maria N. , Spelman Tim , May Deborah , Choong Peter F. M.
Published: April 2016

Background

Choosing the appropriate treatment for patients presenting with impending or pathological fractures is difficult and understanding the prognosis based on certain characteristics can help inform the decision to treat and construct to use in a palliative setting. We retrospectively analysed patients presenting with metastatic bone disease in the extremities and pelvis.

Methods

Patients presenting with metastatic bone disease to the extremities or pelvis who underwent orthopaedic treatment from 1996 to 2012 were identified. Survival rates were calculated using life table analysis. Univariate and multivariate analysis was achieved with Cox proportional hazards regression.

Results

There were a total of 462 patients. An overall 1‐, 2‐ and 5‐year survival rate of 45%, 29% and 13% was identified, respectively. In the multivariate analysis, preoperative haemoglobin was found to be an independent predictor of better survival while lung histotype, age, pathological fracture and previous combined therapy were negative predictors of survival. Patients undergoing prosthetic replacement had a significantly longer period of hospitalization in comparison to those undergoing internal fixation.

Conclusion

This study has contributed to our understanding of the survival rate and survival prognostication for patients presenting for orthopaedic treatment of metastatic bone disease.
Induction infliximab levels among patients with acute severe ulcerative colitis compared with patients with moderately severe ulcerative colitis
Authors: Ungar B. , Mazor Y. , Weisshof R. , Yanai H. , Ron Y. , Goren I. , Waizbard A. , Yavzori M. , Fudim E. , Picard O. , Loebstein R. , Kopylov U. , Dotan I. , Chowers Y. , Eliakim R. , Ben‐Horin S.
Published: April 2016

Background

Infliximab is effective as salvage therapy for patients with steroid refractory acute severe ulcerative colitis (UC). Although current data suggest that the pharmacokinetics of infliximab are influenced by inflammatory burden in patients with acute severe UC, data comparing infliximab trough levels in patients with acute severe UC vs. moderately severe UC are scarce.

Aim

To compare infliximab trough and anti‐infliximab antibody levels at a standard fixed time‐point during induction between patients with acute severe and moderately severe UC.

Methods

A multi‐centre retrospective study comparing infliximab drug and antibody levels 14 days after the first infusion in hospitalised acute severe UC versus out‐patients with moderately severe UC was performed.

Results

Sixteen acute severe UC patients, hospitalised between 2010–2015 and refractory to intravenous corticosteroids, were treated with infliximab 5 mg/kg salvage therapy. They were compared to 16 moderately severe UC out‐patient controls. Mean infliximab trough levels at day 14 were significantly lower in patients with acute severe UC compared to moderately severe UC (7.15 ± 5.3 vs. 14.4 ± 11.2 μg/mL, P = 0.007). Seven patients (three acute severe and four moderate severe UC) were primary nonresponders to infliximab induction therapy. Infliximab level at day 14 did not differ between responders and nonresponders (9.8 ± 9 vs. 12.1 ± 10.6 μg/mL, respectively, P = N.S.). However, week 2 median antibody‐to‐infliximab levels were numerically higher among primary nonresponders (3.4 ± 5.7 vs. 1.2 ± 4 μg/mL‐eq, respectively, P = 0.06).

Conclusions

Infliximab trough levels at day 14 were lower in patients with acute severe UC compared to moderately severe UC, possibly due to a higher inflammatory burden and/or increased drug clearance. However, drug levels at day 14 were not lower among nonresponders compared with responders. Controlled trials are warranted to examine whether an a‐priori‐intensified infliximab induction protocol will lead to an improved outcome in acute severe UC.
Evaluation of the risk of cardiovascular events with clarithromycin using both propensity score and self‐controlled study designs
Authors: Root Adrian A. , Wong Angel Y. S. , Ghebremichael‐Weldeselassie Yonas , Smeeth Liam , Bhaskaran Krishnan , Evans Stephen J. W. , Brauer Ruth , Wong Ian Chi Kei , Navaratnam Vidya , Douglas Ian
Published: April 2016

Aim

Some previous studies suggest a long term association between clarithromycin use and cardiovascular events. This study investigates this association for clarithromycin given as part of Helicobacter pylori treatment (HPT).

Methods

Our source population was the Clinical Practice Research Datalink (CPRD), a UK primary care database. We conducted a self‐controlled case series (SCCS), a case–time–control study (CTC) and a propensity score adjusted cohort study comparing the rate of cardiovascular events in the 3 years after exposure to HPT containing clarithromycin with exposure to clarithromycin free HPT.

Outcomes were first incident diagnosis of myocardial infarction (MI), arrhythmia and stroke. For the cohort analysis we included secondary outcomes all cause and cardiovascular mortality.

Results

Twenty‐eight thousand five hundred and fifty‐two patients were included in the cohort. The incidence rate ratio of first MI within 1 year of exposure to HPT containing clarithromycin was 1.07 (95% CI 0.85, 1.34, P = 0.58) and within 90 days was 1.43 (95% CI 0.99, 2.09 P = 0.057) in the SCCS analysis. CTC and cohort results were consistent with these findings.

Conclusions

There was some evidence for a short term association for first MI but none for a long term association for any outcome.
The complexities of cultural support planning for Indigenous children in and leaving out‐of‐home care: the views of service providers in Victoria, Australia
Authors: Baidawi Susan , Mendes Philip , Saunders Bernadette J.
Published: April 2016

Indigenous children and young people are over‐represented at all stages of the Australian child protection system. Policy and legislative initiatives exist in the state of Victoria, Australia aiming to support the connection between Indigenous children and young people in state care and their culture and community. This exploratory research involved focus group consultations with seven child and family welfare agencies to investigate the impacts, barriers, benefits and limitations of cultural support planning for Indigenous young people in, and leaving care in, Victoria. Findings indicated that cultural planning was of value when it could be completed. However, various shortcomings of current systems were identified including limited resourcing of Aboriginal Community Controlled Organisations to generate plans and provide direct and secondary consultation services to implement plans, difficulty gathering information for plans and some Indigenous young people expressing disinterest in connecting to their culture and community. Complexities in the relationships between the Indigenous and non‐Indigenous agencies that aimed to support Indigenous young people in care were also acknowledged. Participants identified a number of strategies to improve outcomes, such as facilitating better relationships between agencies, promoting opportunities for ongoing cultural training for staff in mainstream agencies and improving the resourcing of Aboriginal Community Controlled Organisations to deliver planning and to support cultural connections.
High Le Fort I osteotomy for correction of mid‐face deformity in Crouzon syndrome
Authors: Nakajima Yasumichi , Nakano Hiroyuki , Sumida Tomoki , Yamada Tomohiro , Inoue Kazuya , Sugiyama Goro , Mishima Katsuaki , Mori Yoshihide
Published: April 2016

An 18‐year‐old woman with mild Crouzon syndrome was referred with malocclusion and mandibular protrusion. Examination revealed Class III canine and molar relationships, hypoplastic maxilla, 1‐mm overbite, and −2‐mm overjet. Analysis showed 69° sella‐nasion‐A, 73.6° sella‐nasion‐B, and −4.6° A point‐nasion‐B point angles. Polysomnography revealed respiratory disturbance and 6.3% oxygen desaturation indices of 5.4/h and 9.0/h. We performed double‐jaw surgery using high Le Fort I osteotomy and bilateral sagittal split ramus osteotomy for midfacial deformity correction. Twelve months post‐surgery, her measures were 70.8°, 72°, −1.2°, 3.0/h, and 6.1/h, respectively. Esthetics were satisfactory. High Le Fort I osteotomy is effective for midfacial deformity correction in patients with Crouzon syndrome.
Single‐staged vs. two‐staged implant placement in vertically deficient alveolar ridges using bone ring technique ‐ Part 2: implant osseointegration
Authors: Nakahara Ken , Haga‐Tsujimura Maiko , Sawada Kosaku , Kobayashi Eizaburo , Schaller Benoit , Saulacic Nikola
Published: April 2016

Objectives

The aim of this study was to evaluate the osseointegration of implants placed in a single‐staged compared to two‐staged procedure using bone ring technique.

Material and Methods

In this study were used standardized, vertical alveolar bone defects in dogs. In the test group, dental implants (Straumann BL®, Basel, Switzerland) were inserted simultaneously with bone ring technique. As control group served implants inserted 6 months following grafting. Implants of both groups were left for an osseointegration period of 3 and 6 months. The peri‐implant bone loss and bone‐to‐implant contact within the bone ring and native bone were analyzed morphometrically. An explorative statistical analysis was performed.

Results

The peri‐implant bone level remained relatively stable within groups and between groups per given time period. Most of bone apposite on the implant surface in two groups was composed of newly formed bone. A nonparametric analysis of variance (ANOVA) revealed no significant advantage for two‐staged implant placement for new and total bone, except for residual bone (P = .0084). Furthermore, two groups of implants performed similarly in bone ring and in native bone throughout the observation period.

Conclusions

In terms of osseointegration, both techniques are likely equally efficient in the present defect model. The single‐staged implant placement with cortical bone grafts warrants further documentation in clinical studies.
LONG‐RUN EFFECTS OF YOUTH TRAINING PROGRAMS: EXPERIMENTAL EVIDENCE FROM ARGENTINA
Authors: Alzúa María laura , Cruces Guillermo , Lopez Carolina
Published: April 2016

We study the effect of a job training program for low‐income youth in Cordoba, Argentina. The program included life‐skills and vocational training, as well as internships with private sector employers. Participants were allocated by means of a public lottery. We rely on administrative data on formal employment, employment spells, and earnings, to establish the effects of the program in the short term (18 months), but also—exceptionally for programs of this type in Latin America and in developing countries in general—in the medium term (33 months) and in the long term (48 months). The results indicate sizable gains of about 8 percentage points in formal employment in the short term (about 32% higher than the control group), although these effects dissipate in the medium and in the long term. Contrary to previous results for similar programs in the region, the effects are substantially larger for men, although they also seem to fade in the long run. Program participants also exhibit earnings about 40% higher than those in the control group, and an analysis of bounds indicates that these gains result from both higher employment levels and higher wages. The detailed administrative records also allow us to shed some light on the possible mechanisms underlying these effects. A dynamic analysis of employment transitions indicates that the program operated through an increase in the persistence of employment rather than from more frequent entries into employment. The earnings effect and the higher persistence of employment suggest that the program was successful in increasing the human capital of participants, although the transient nature of these results may also reflect better matches from a program‐induced increase in informal contacts or formal intermediation. (JEL J08, J24, J68, O15)
Insect immune priming: ecology and experimental evidences
Authors: CONTRERAS‐GARDUÑO JORGE , LANZ‐MENDOZA HUMBERTO , FRANCO BERNARDO , NAVA ADRIANA , PEDRAZA‐REYES MARIO , CANALES‐LAZCANO JORGE
Published: April 2016

1. Immune priming refers to improved protection of the host after a second encounter with the same parasite or pathogen. This phenomenon is similar to that of adaptive immunity in vertebrates.

2. There is evidence to suggest that this improved protection can be species/strain‐specific and can protect organisms for a lifetime. These two attributes, along with a biphasic immune response, are essential characteristics of immune priming and form the basis for the effectiveness of resistance to parasites and pathogens.

3. This paper considers the effect of immune priming within and across generations, the influence of a heterologous challenge during immune priming and the importance of testing the immune response with natural pathogens.

4. The analysis presented takes into account the multifaceted nature of the invertebrate immune response. The lack of evidence suggesting that the bacterial microbiome plays a complementary role in the immune priming outcome is discussed.

5. Finally, the cost of immune priming is explored. This is a poorly investigated issue, which could help to explain why there is a paucity of evidence in support of immune priming.
Functional analysis of a novel missense mutation in AXIN2 associated with non‐syndromic tooth agenesis
Authors: Yue Haitang , Liang Jia , Yang Kai , Hua Bo , Bian Zhuan
Published: April 2016

Tooth agenesis is a congenital anomaly frequently seen in humans. Several genes have been associated with non‐syndromic tooth agenesis, including msh homeobox 1 (MSX1), paired box 9 (PAX9), axis inhibition protein 2 (AXIN2), ectodysplasin A (EDA), and wingless‐type MMTV integration site family member 10A (WNT10A). In this study, we investigated a Chinese family with non‐syndromic tooth agenesis. A novel missense mutation (c.C1978T) in AXIN2 was identified in affected members. The mutation results in a His660Tyr substitution located between the Axin beta‐catenin binding domain and the DIX domain of the axis inhibition protein 2 (AXIN2). We analysed this novel AXIN2 mutant, together with two reported AXIN2 mutants [c.1966C>T (p.Arg656Stop) and c.1994delG (p.Leu688Stop)] that cause colorectal cancer with and without oligodontia, to study the effect of the mutant p.His660Tyr on the Wnt/β‐catenin signaling pathway and to compare the molecular pathogenesis of different AXIN2 mutants in tooth agenesis and carcinogenesis. Further in vitro experiments indicated that the mutant p.His660Tyr caused inhibition of the Wnt/β‐catenin pathway, and the mutants p.Arg656Stop and p.Leu688Stop resulted in over‐activation of the Wnt/β‐catenin pathway. In line with previous AXIN2 mutation studies, we suggest that AXIN2 mutations with different levels of severity may have distinct effects on the Wnt pathway and the phenotype of disease. Our study provides functional evidence supporting the notion that both inhibition and over‐activation of the Wnt pathway may lead to tooth agenesis.
Association of current employment status with oral health‐related behaviors: findings from the Finnish Health 2000 Survey
Authors: Al‐Sudani Fouad Y. H. , Vehkalahti Miira M. , Suominen Anna L.
Published: April 2016

The aim of this study was to compare the oral health‐related behaviors of unemployed people with those of employed people and to assess whether they differ according to the length of unemployment. This study is part of the Health 2000 Survey in Finland. The cross‐sectional data were based on interviews and questionnaires. The present study comprised dentate participants, 30–63 yr of age (n = 4,670). Current employment status (employed vs. unemployed) and length of current unemployment (≤1, >1–2, >2–5, and >5 yr) were used as exposures. Binary logistic regression models were fitted separately for the oral health‐related behaviors, and latent class analysis (LCA) was used to form behavioral clusters. Current unemployment and being unemployed for longer than 5 yr were inversely associated with regular use of dental services. Current unemployment indicated non‐regular dental attendance, infrequent use of xylitol, daily smoking, and risky use of alcohol. Findings from the LCA supported the assumption that unemployed people could be considered as a risk group for poor oral health‐related behaviors.