bluuebunny/crossref_metadata_2025 huggingface dataset:
A Facile Route to the Preparation of Highly Uniform ZnO@TiO2 Core-Shell Nanorod Arrays with Enhanced Photocatalytic Properties
Authors: Zhao Yuanyuan , Tong Peifei , Ma Dong , Li Bing , Liu Qinzhuang , Chen San , Zhang Yongxing
Published: April 2017

Design and synthesis of ZnO@TiO2 core-shell nanorod arrays as promising photocatalysts have been widely reported. However, it remains a challenge to develop a low-temperature, low-cost, and environmentally friendly method to prepare ZnO@TiO2 core-shell nanorod arrays over a large area for future device applications. Here, a facile, green, and efficient route is designed to prepare the ZnO@TiO2 nanorod arrays with a highly uniform core-shell structure over a large area on Zn wafer via a vapor-thermal method at relatively low temperature. The growth mechanism is proposed as a layer-by-layer assembly. The photocatalytic decomposition reaction of methylene blue (MB) reveals that the ZnO@TiO2 core-shell nanorod arrays have excellent photocatalytic activities when compared with the performance of the ZnO nanorod arrays. The improved photocatalytic activity could be attributed to the core-shell structure, which can effectively reduce the recombination rate of electron-hole pairs, significantly increase the optical absorption range, and offer a high density of surface active catalytic sites for the decomposition of organic pollutants. In addition, it is very easy to separate or recover ZnO@TiO2 core-shell nanorod array catalysts when they are used in water purification processes.
Qualitative and Quantitative Characterization of Monosaccharide Components of Salvia miltiorrhiza, Liguspyragine Hydrochloride, and Glucose Injection
Authors: Ge Fa-huan , Ma Xian-peng , Ma Jin-fang , Bi Chang-qiong , Chen Tian-ling , Zhang Xiang-dong , Xiao Xue
Published: April 2017

Salvia miltiorrhiza, liguspyragine hydrochloride, and glucose injection (SLGI) was made of Salvia miltiorrhiza Bge., liguspyragine hydrochloride, glucose, and glycerin. There were many kinds of monosaccharide components in SLGI, which might be from the raw material and Salvia miltiorrhiza Bge. Separation was performed on a Phenomenex Luna C18 analytical column (250 mm × 4.6 mm i.d., 5 μm, AccuStandard Inc., USA) at 30°C. The mobile phase consisted of two solvents: 0.1 mol/L phosphate-buffered saline (pH 6.7) (solvent A) and acetonitrile (solvent B) with gradient elution. The flow rate was maintained at 1.0 mL/min. Five kinds of monosaccharide components, glucose, D-mannose, L-rhamnose monohydrate, galactose, and xylose, were detected by precolumn derivatization HPLC, and their contents were compared with each other. And finally, concentrations of glucose in SLGI were determined and they were higher than the values of marked amount, which showed that one source of glucose might be from Salvia miltiorrhiza Bge. in SLGI. The average concentration of glucose was 5.18 g/100 mL, which was near the average value at 5.25 g/100 mL detected by ultraviolet spectrophotometry and also close to the marked amount (5.00 g/100 mL) on the label.
Urothelial Carcinoma in a 22-Year-Old Female with Angelman Syndrome
Authors: Pugh Jessica , Huffaker R. Keith
Published: April 2017

A 22-year-old nulligravid white female with Angelman syndrome was noted to have a 4-month history of premenstrual nausea, vomiting, and abdominal pain. She had an echogenic focus in her bladder noted on ultrasound. She was diagnosed with low grade urothelial carcinoma after cystoscopic evaluation with biopsy and was sent to urology for further treatment. Urothelial carcinoma is rare in individuals younger than age 40. Patients may present with gross hematuria. There is often a delay in diagnosis in younger individuals with different genetic mutations noted upon diagnosis.
Extracellular Matrix/Integrin Signaling Promotes Resistance to Combined Inhibition of HER2 and PI3K in HER2+ Breast Cancer
Authors: Hanker Ariella B. , Estrada Mónica Valeria , Bianchini Giampaolo , Moore Preston D. , Zhao Junfei , Cheng Feixiong , Koch James P. , Gianni Luca , Tyson Darren R. , Sánchez Violeta , Rexer Brent N. , Sanders Melinda E. , Zhao Zhongming , Stricker Thomas P. , Arteaga Carlos L.
Published: April 2017

PIK3CA mutations are associated with resistance to HER2-targeted therapies. We previously showed that HER2+/PIK3CAH1047R transgenic mammary tumors are resistant to the HER2 antibodies trastuzumab and pertuzumab but respond to PI3K inhibitor buparlisib (TPB). In this study, we identified mechanisms of resistance to combined inhibition of HER2 and PI3K. TPB-resistant tumors were generated by treating HER2+/PIK3CAH1047R tumor-bearing mice long term with the drug combination. RNA sequencing of TPB-resistant tumors revealed that extracellular matrix and cell adhesion genes, including collagen II (Col2a1), were markedly upregulated, accompanied by activation of integrin β1/Src. Cells derived from drug-resistant tumors were sensitive to TBP when grown in vitro, but exhibited resistance when plated on collagen or when reintroduced into mice. Drug resistance was partially reversed by the collagen synthesis inhibitor ethyl-3,4-dihydroxybenzoate. Inhibition of integrin β1/Src blocked collagen-induced resistance to TPB and inhibited growth of drug-resistant tumors. High collagen II expression was associated with significantly lower clinical response to neoadjuvant anti-HER2 therapy in HER2+ breast cancer patients. Overall, these data suggest that upregulation of collagen/integrin/Src signaling contributes to resistance to combinatorial HER2 and PI3K inhibition. Cancer Res; 77(12); 3280–92. ©2017 AACR.
LncRNA GAS5 Inhibits Cellular Proliferation by Targeting P27Kip1
Authors: Luo Gang , Liu Dong , Huang Chao , Wang Miao , Xiao Xingyuan , Zeng Fuqing , Wang Liang , Jiang Guosong
Published: April 2017

Recent studies have demonstrated that long noncoding RNAs (lncRNA) have important roles in cancer biology, and that the downregulation of lncRNA growth arrest–specific transcript 5 (GAS5) has been reported in a variety of human cancers. However, its role in prostate cancer is largely unknown. This study aims to investigate the biological role and underlying mechanism of GAS5 on proliferation in prostate cancer. The results demonstrate that GAS5 expression is significantly decreased in prostate cancer cells compared with prostate epithelial cells. Ectopic expression of GAS5 inhibited cell proliferation and induced a cell-cycle arrest in G0–G1 phase, whereas GAS5 knockdown promoted the G1–S phase transition. Subsequent analysis demonstrated that P27Kip1, a known regulator of cell cycle, was positively regulated by GAS5 and upregulation of GAS5 increased its promoter activity. E2F1, an important transcription factor, was shown to bind directly to and activate the P27Kip1 promoter. In addition, GAS5 interacted with E2F1 and enhanced the binding of E2F1 to the P27Kip1 promoter. Collectively, these findings determine that GAS5 functions as a tumor suppressor in prostate cancer development and progression via targeting P27Kip1.

Implications: This study reveals a molecular pathway involving lncRNA GAS5/E2F1/P27Kip1 which regulates cell proliferation and could be a potential therapeutic target in prostate cancer. Mol Cancer Res; 15(7); 789–99. ©2017 AACR.
Antacid Therapy and Disease Progression in Patients with Idiopathic Pulmonary Fibrosis Who Received Pirfenidone
Authors: Kreuter Michael , Spagnolo Paolo , Wuyts Wim , Renzoni Elisabetta , Koschel Dirk , Bonella Francesco , Maher Toby M. , Kolb Martin , Weycker Derek , Kirchgässler Klaus-Uwe , Costabel Ulrich
Published: April 2017

Background: Gastroesophageal reflux disease is a potential risk factor for idiopathic pulmonary fibrosis (IPF) progression; however, the impact of antacid therapy (AAT) is under debate. Objective: To evaluate the effect of AAT on IPF progression in pirfenidone-treated patients. Methods: This post hoc analysis included patients with IPF who received pirfenidone in 3 trials (CAPACITY [PIPF-004/PIPF-006] and ASCEND [PIPF-016]). Pulmonary function, exercise tolerance, survival, hospitalizations, and adverse events (AEs) over 52 weeks were analyzed by baseline AAT use. Disease progression was defined as a decrease in forced vital capacity (FVC) of ≥10%, a decrease in 6-min walking distance of ≥50 m, or death over 1 year. Results: Of 623 patients, 44% received AAT. No significant differences were found at 52 weeks (AAT versus non-AAT, respectively) in disease progression (24.9 vs. 30.6%; p = 0.12), all-cause mortality rate (2.9 vs. 4.0%; p = 0.47), IPF-related mortality rate (1.1 vs. 2.0%; p = 0.37), all-cause hospitalization rate (16.1 vs. 18.3%; p = 0.48), or mean change in percent FVC (-2.7 vs. -3.1%; p = 0.44). A relative, but not absolute, FVC decline of ≥10% favored AAT (15 vs. 22%; p = 0.03). Severe gastrointestinal AEs (3.7 vs. 0.9%; p = 0.015) and severe pulmonary infections (3.7 vs. 1.1%; p = 0.035) were more frequent with AAT. Conclusions: AAT and pirfenidone had outcomes comparable to those of pirfenidone alone in patients with IPF, underscoring the need for prospective trials to elucidate the role of AAT with or without antifibrotic drugs as a treatment for IPF.
Left Gastric Artery Reconstruction after Distal Pancreatectomy with Celiac Axis En-Bloc Resection: How We Do It
Authors: Okada Ken-ichi , Hirono Seiko , Kawai Manabu , Hayami Shinya , Asamura Shinichi , Wada Yoshitaka , Ueno Masaki , Miyazawa Motoki , Shimizu Atsushi , Kitahata Yuji , Yamaue Hiroki
Published: April 2017

Background/Aims: Ischemic gastropathy remains as a persistent problem after left gastric artery (LGA) resection in distal pancreatectomy with celiac axis en-bloc resection (DP-CAR). The middle colic artery (MCA) was found to be a useful vessel for compromised collateral flow. However, intraoperative gross evaluation of gastric ischemia is technically difficult even after artery reconstruction. Methods: We performed LGA reconstruction by MCA-LGA bypass after LGA-resecting DP-CAR assisted by intraoperative indocyanine green fluorescence imaging (ICG) blood flow evaluation in a clinical trial (UMIN000020414). The LGA was reconstructed with the MCA microscopically by plastic surgeons with an everting interrupted suture in end-to-end anastomosis. Results: We could evaluate ICG blood flow not only in the reconstructed artery, but also simultaneously in the gastric wall through a monitor connected to a detector. We could also assess the congestive status of the gastric wall by ICG disappearance from the gastric wall. Conclusion: We present LGA reconstruction by MCA-LGA bypass after LGA-resecting DP-CAR. We conducted a perioperative assessment of ischemic gastropathy to confirm the feasibility and safety of this procedure.
In utero Exposure to Germinated Brown Rice and Its GABA Extract Attenuates High-Fat-Diet-Induced Insulin Resistance in Rat Offspring
Authors: Adamu Hadiza Altine , Imam Mustapha Umar , Der-Jiun Ooi , Ismail Maznah
Published: April 2017

Background: Numerous studies have reported on the influence of diet on insulin resistance. Our study provides insight into the effect of germinated brown rice (GBR) and γ-aminobutyric acid (GABA) on early environment-driven programming and susceptibility to insulin resistance in rat offspring. Methods: Male rat offspring from female Sprague-Dawley rats fed with a high-fat diet (HFD) alone, HFD + GBR, or HFD + GABA extract throughout pregnancy and lactation were weaned 4 weeks after delivery and followed up for 8 weeks. A biochemical analysis and an assessment of the hepatic expression of insulin signaling genes were performed. Results: The results showed that intrauterine exposure to HFD caused metabolic perturbations in rat offspring which gravitated towards insulin resistance even though the rat offspring did not consume an HFD. GBR and GABA attenuated the HFD-induced changes by underlying regulation of the insulin signaling genes. Conclusions: The results suggest that intake of GBR and GABA during pregnancy and lactation can influence the programming of genes in rat offspring, thereby enhancing insulin sensitivity.
Validation and Modification of the Masood Scoring Index for the Diagnosis of Atypical Breast Lesions
Authors: Semwal Shruti , Joshi Deepti , Khare Akriti , Goel Garima , Kapoor Neelkamal
Published: April 2017

Introduction: Cytological diagnosis of borderline breast lesions remains challenging, and interobserver variability exists in their interpretation. The Masood scoring index (MSI) has been proposed to help in the subgrouping of breast lesions using objective criteria. Aim: The aim of the present study was to assess the interobserver variability in the scoring of breast lesions according to MSI and to see the utility of a modified scheme for discriminating benign and atypical lesions. Study Design: Papanicolaou-stained smears (100 cases) that underwent fine needle aspiration for a palpable breast lump were independently evaluated by 2 observers, and the cases were categorized as per MSI. Percent agreement beyond chance score between both observers was calculated. Sensitivity analysis was performed by comparing the scores using models containing different parameters of MSI. Results: The agreement amongst the 2 observers for scores was found to be 0.88 and it was 69% for category-wise diagnosis. Sensitivity analysis showed that the model with only 3 cytological parameters (cell arrangement, pleomorphism, and nucleoli) had similar discrimination ability in the classification of breast disease as benign or atypical as the standard MSI model. Conclusion: Further simplified models of MSI should be tested for improved diagnostic accuracy and wider acceptability.
Percutaneous Pericardial Resection
Authors: Borlaug Barry A. , Carter Rickey E. , Melenovsky Vojtech , DeSimone Christopher V. , Gaba Prakriti , Killu Ammar , Naksuk Niyada , Lerman Lilach , Asirvatham Samuel J.
Published: April 2017

Background—

People with heart failure and preserved ejection fraction develop increases in left ventricular (LV) end-diastolic pressures during exercise that contribute to dyspnea. In normal open-chest animal preparations, the pericardium restrains LV filling when central blood volume increases. We hypothesized that resection of the pericardium using a minimally invasive epicardial approach would mitigate the increase in LV end-diastolic pressure that develops during volume loading in normal and diseased hearts with the chest intact.

Methods and Results—

Invasive hemodynamic assessment was performed at baseline and after saline load before and after pericardial resection in normal canines with open (n=3) and closed chest (n=5) and in a pig model with features of human heart failure and preserved ejection fraction with sternum intact (n=4). In closed-chest animals, pericardiotomy was performed using a novel subxiphoid procedure. In both experimental preparations of normal dogs, pericardiotomy blunted the increase in LV end-diastolic pressure with saline infusion, while enhancing the saline-mediated increase in LV end-diastolic volume. With chest intact in the pig model, percutaneous pericardial resection again blunted the increase in LV end-diastolic pressure secondary to volume expansion (+4±3 versus +13±5 mm Hg;
P
=0.014), while enhancing the saline-mediated increase in LV end-diastolic volume (+17±1 versus +10±2 mL;
P
=0.016).

Conclusions—

This proof of concept study demonstrates that pericardial resection through a minimally invasive percutaneous approach mitigates the elevation in LV filling pressures with volume loading in both normal animals and a pig model with diastolic dysfunction. Further study is warranted to determine whether this method is safe and produces similar acute and chronic hemodynamic benefits in people with heart failure and preserved ejection fraction.
Asymptomatic Hyperuricemia Without Comorbidities Predicts Cardiometabolic Diseases
Authors: Kuwabara Masanari , Niwa Koichiro , Hisatome Ichiro , Nakagawa Takahiko , Roncal-Jimenez Carlos A. , Andres-Hernando Ana , Bjornstad Petter , Jensen Thomas , Sato Yuka , Milagres Tamara , Garcia Gabriela , Ohno Minoru , Lanaspa Miguel A. , Johnson Richard J.
Published: April 2017

Whether asymptomatic hyperuricemia in the absence of comorbidities increases the risk for cardiometabolic disorders and chronic kidney disease remains controversial. This study was conducted to clarify the association between asymptomatic hyperuricemia and cardiometabolic conditions. Subjects consisting of Japanese adults between 30 and 85 years of age were enrolled in the study at Center for Preventive Medicine, St Luke’s International Hospital, Tokyo, and were available at enrollment (2004) and at 5-year follow-up (2009). Subjects were excluded if they were overweight or obese, hypertensive, diabetic, and dyslipidemic, had a history of gout or hyperuricemia on medications, or had chronic kidney disease as estimated glomerular filtration rate <60 mL/min per 1.73 m
2
. Linear and logistic regression analyses were used to examine the relationship between hyperuricemia and development of hypertension, diabetes mellitus, dyslipidemia, chronic kidney disease, and overweight/obesity (unadjusted and adjusted for age, sex, smoking, drinking habits, baseline estimated glomerular filtration rate, and body mass index). Five thousand eight hundred and ninety-nine subjects without comorbidities (mean age of 47±10 years, 1864 men) were followed for 5 years. Hyperuricemia (defined as >7 mg/dL in men and ≥6 mg/dL in women) was associated with increased cumulative incidence of hypertension (14.9% versus 6.1%;
P
<0.001), dyslipidemia (23.1% versus 15.5%;
P
<0.001), chronic kidney disease (19.0% versus 10.7%;
P
<0.001), and overweight/obesity (8.9% versus 3.0%;
P
<0.001), while diabetes mellitus (1.7% versus 0.9%;
P
=0.087) showed a trend but did not reach statistical significance. In conclusion, asymptomatic hyperuricemia carries a significant risk for developing cardiometabolic conditions in Japanese individual without comorbidities.
Tragopogon erostris Boiss. & Hausskn. (Asteraceae: Cichorieae, Scorzonerinae), the correct name for T. maroofii Mahmoodi & Safavi and T. kurdicus Safavi & Maroofi
Authors: MAROOFI HOSEIN , RASTEGAR AZAD
Published: April 2017

The Eurasian genus Tragopogon Linnaeus (1753: 789) comprises approximately 150 species (Mavrodiev et al. 2012, Bell et al. 2012). Twenty six species of Tragopogon were treated in Flora Iranica (Rechinger 1977) as occurring in Iran, of which 10 species were considered endemic to Iran. The same number of species was retained in the new Flora of Iran (Safavi et al. 2013).
Two new species of Gastrodia (Gastrodieae, Epidendroideae, Orchidaceae) from Okinawa Island, Ryukyu Islands, Japan
Authors: SUETSUGU KENJI
Published: April 2017

Two new mycoheterotrophic orchids, Gastrodia nipponicoides and G. okinawensis, are described and illustrated from Okinawa Island, Ryukyu Islands, Japan. The outline floral shape of Gastrodia nipponicoides indicates a close affinity to G. nipponica, but it is easily distinguished from G. nipponica by several characteristics such as a shorter perianth tube, lack of rostellum and fewer ridges on its lip. Gastrodia okinawensis is similar to G. takeshimensis but is distinguished by having chasmogamous flowers, paler perianth tube and longer column.
Oberonia meegaskumburae (Orchidaceae: Epidendroideae: Malaxideae), a new species from Sri Lanka
Authors: PRIYADARSHANA THARAKA S. , WIJEWARDHANE ISHARA H. , ATTHANAGODA ANUSHA G. , ARANGALA NANDUN S. , JAYASOORIYA ASANKA , KUMAR PANKAJ
Published: April 2017

Oberonia meegaskumburae is described and illustrated from Adam’s Peak (Samanala) Nature Reserve, Sri Lanka and differentiated from its close ally, O. weragamaensis on the basis of larger flowers (3 mm long) in former against smaller (2 mm) in latter; longer floral bracts (1.9 mm) in former against shorter (1 mm) in latter; equal size (> 0.2 mm) of lobules of mid-lobe in former against shorter mid-lobule (< 0.1 mm) in latter; slender, terete and club-shaped tip of lateral lobe curved to face each other in former against sub-triangular, parallel and inflated in latter. Key to all species of genus Oberonia found in Sri Lanka is provided.
A new species of Acrophialophora from Guizhou Province, China
Authors: ZHANG YANWEI , WANG YAO , ZENG GUI-PING , CHEN WANHAO , XIAO ZOU , HAN YAN-FENG , QIU SHU-YI , LIANG ZONG-QI
Published: April 2017

Acrophialophora liboensis, a new fungus from soil samples in Libo County, Guizhou Province, China, is illustrated and described on the basis of morphological and molecular sequences data. Phylogenetic analysis based on internal transcribed spacer (ITS) and β-tubulin sequences demonstrated that A. liboensis is a distinct species closely related to A. cinerea and A. furcata. Morphologically, A. liboensis is characterized by solitary and lateral phialides tapering into thin necks and long chains of ellipsoidal or oval conidia. The ex-type living culture has been deposited in CGMCC, Beijing City, China.
Oritrophium yacuriense (Astereae, Compositae), an overlooked new species from southern Ecuador
Authors: ARNELAS ITZIAR , ARMIJOS-BARROS J.L. , CALVO JOEL
Published: April 2017

Oritrophium yacuriense is described as a new species from the Andes of southern Ecuador. Morphological characters are used in order to distinguish it from the closest species O. repens, which differs mainly in the leaf morphology. The new species occurs in wet herbaceous páramos of the lagoon complex of the Yacuri National Park.
Remarks on the type designation of two names in Rhamnus (Rhamnaceae)
Authors: FERRER-GALLEGO PEDRO PABLO , LAGUNA EMILIO
Published: April 2017

The genus Rhamnus Linnaeus (1753: 193) (Rhamnaceae Jussieu 1789: 376) contains more than 100 species (Medan & Schirarend 2004, Hauenschild et al. 2016) distributed in the temperate to tropical regions (North America south to Guatemala, temperate South America, Europe, Africa and Asia). Although this genus includes more than 700 published specific and subspecific names, several of these names represent local variations of more broadly distributed taxa (Grubov 1949, Tutin 1968, Johnston 1975, Johnston & Johnston 1978, Richardson et al. 2000a, b, Ruiz de la Torre 2006, Hauenschild et al. 2016).
Taxonomic and nomenclatural notes on neotropical Commelina (Commelinaceae), and an identification key for Brazil, Guyana, Paraguay, Suriname and Uruguay
Authors: HASSEMER GUSTAVO
Published: April 2017

Here, I present a taxonomic and nomenclatural revision of some names within the neotropical Commelina (Commelinaceae), especially those published by Moritz August Seubert in Flora brasiliensis: C. agraria var. repens, C. guyanensis, C. martiana, C. platyphylla, C. platyphylla var. balansae, C. pohliana, C. rufipes, C. schomburgkiana, C. schomburgkiana var. brasiliensis and C. vestita, in addition to Commelinopsis glabrata (basionym of Commelina rufipes var. glabrata). The complicated nomenclatural status of names invalidly published by Moritz Richard Schomburgk in 1849 in his Versuch einer Fauna und Flora von Britisch-Guiana is discussed. Furthermore, I provide an identification key to the nine species of Commelina that occur in Brazil, Guyana, Paraguay, Suriname and Uruguay.
The identity of Eritrichium heterocarpum Y.S.Lian & J.Q.Wang (Boraginaceae)
Authors: HAO JIA-CHEN , AHMAD LATIF , ZHOU YU , LIU QUAN-RU
Published: April 2017

Based on consulting the original literature, examinations of specimens and field observations, Eritrichium heterocarpum Y.S.Lian & J.Q.Wang is shown to be conspecific with E. echinocaryum (I.M.Johnst.) Y.S.Lian & J.Q.Wang and is here formally treated as a synonym of the latter.
Global Social Norms and Environmental Behavior
Authors: Vesely Stepan , Klöckner Christian A.
Published: April 2017

We adopt a recently introduced incentivized method to elicit widely shared beliefs concerning (a) social norms, (b) environmental effect, and (c) difficulty of a wide range of environmental behaviors. We establish that these characteristics, as reflected in elicited beliefs recorded in one sample, predict (out-of-sample) environmental behaviors in a second separate sample. Pro-environmental behaviors perceived to be more socially appropriate and easier to perform, in particular, are more likely to be chosen. We show that subjective social norms mediate the effect of “global” (widely shared) social norms on behavior, which improves our understanding of the normative processes underlying pro-environmental action. Our use of an incentivized elicitation method might moreover mitigate problems associated with conventional surveys, such as social desirability bias, consistency bias, and inattentive responding, as discussed in the article.
The Interactive Candidate Assessment Tool: A New Way to Interview Residents
Authors: Platt Michael P. , Akhtar‐Khavari Vafa , Ortega Rafael , Schneider Jeffrey I. , Fineberg Tabitha , Grundfast Kenneth M.
Published: April 2017

The purpose of the residency interview is to determine the extent to which a well‐qualified applicant is a good fit with a residency program. However, questions asked during residency interviews tend to be standard and repetitive, and they may not elicit information that best differentiates one applicant from another. The iCAT (interactive Candidate Assessment Tool) is a novel interview instrument that allows both interviewers and interviewees to learn about each other in a meaningful way. The iCAT uses a tablet computer to enable the candidate to select questions from an array of video and nonvideo vignettes. Vignettes include recorded videos regarding some aspect of the program, while other icons include questions within recognizable categories. Postinterview surveys demonstrated advantages over traditional interview methods, with 93% agreeing that it was an innovative and effective tool for conducting residency program interviews. The iCAT for residency interviews is a technological advancement that facilitates in‐depth candidate assessment.
A Novel Patient Safety Event Reporting Tool in Otolaryngology
Authors: Vila Peter M. , Lewis Sean , Cunningham Gene , Brereton Jean , Espinel Alexandra G. , Roberson David W. , Shah Rahul K.
Published: April 2017

Objective

To report the results of a preliminary analysis of a quality improvement initiative aimed to identify potential latent systems defects.

Methods

A pilot study of an anonymous, voluntary, event reporting system made available to all members of the American Academy of Otolaryngology—Head and Neck Surgery was performed. The National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP) index was used to classify error types. Descriptive statistics were used to summarize submissions to the database.

Results

In the 53 cases reported to the database over 22 months, the majority involved errors that had resulted in harm (n = 34, 64%), followed by errors that occurred and did not result in harm (n = 7, 13%). Errors occurred predominantly in the hospital (n = 23, 44%) and operating room (n = 19, 35%). Most entries were classified as either technical (n = 21, 39%) or related to postoperative care (n = 15, 30%).

Discussion

This preliminary descriptive analysis of a novel otolaryngology patient safety event reporting tool shows that this platform brings unique value to the identification of errors and adverse events in our specialty. Most reported events were classified as errors resulting in harm. The most common type of reported event was a technical error, most often resulting in a nerve injury.

Implications for Practice

This reporting tool will likely allow for identification and prioritization of improvement opportunities. This example may serve as a guide for other societies to create similar platforms as we strive for a standardized process for event reporting.
Very Severe Obstructive Sleep Apnea in Children: Outcomes of Adenotonsillectomy and Risk Factors for Persistence
Authors: Isaiah Amal , Hamdan Hisham , Johnson Romaine F. , Naqvi Kamal , Mitchell Ron B.
Published: April 2017

Objectives

(1) To describe the clinical, demographic and polysomnographic (PSG) characteristics of children with very severe obstructive sleep apnea (OSA) without significant comorbidities; (2) to assess the outcomes following tonsillectomy and adenoidectomy (T&A); and (3) to determine predictors of persistence of OSA after T&A.

Study Design

Case series with chart review.

Setting

Tertiary‐level freestanding children’s hospital.

Subjects and Methods

Seventy‐four children aged 2 to 12 years who underwent T&A for very severe OSA (obstructive apnea‐hypopnea index [AHI] >30) were included. Children with significant comorbidities were excluded. PSG variables were compared pre‐ and post‐T&A using statistical tests. Factors affecting OSA resolution and persistence were studied.

Results

The mean (95% confidence interval) age was 4.3 (3.8‐4.7) years with the majority black or Hispanic (64/74, 86%). The mean decrease in AHI after T&A was 49 (43‐58) (P <. 001). Complete resolution of OSA, defined by an AHI <1, or an AHI <5 was seen in 32% (24/74) and 80% (59/74), respectively. Total sleep time (TST) greater than 5 minutes with end‐tidal CO2 >50 mm Hg was strongly associated with persistent OSA. The decrease in AHI post‐T&A was best predicted by higher preoperative oxygen saturation (SpO2) nadir and lower TST with SpO2 <90% (R
2 = 0.24, P <. 001).

Conclusions

T&A is associated with a significant improvement but not resolution of very severe OSA. The severity of baseline hypercapnia and hypoxemia may best predict persistent OSA after T&A. The study supports obtaining routine post‐T&A PSG in children with very severe OSA.
Immunohistochemistry Analysis of CD44, EGFR, and p16 in Oral Cavity and Oropharyngeal Squamous Cell Carcinoma
Authors: Cohen Erin R. , Reis Isildinha M. , Gomez Carmen , Pereira Lutecia , Freiser Monika E. , Hoosien Gia , Franzmann Elizabeth J.
Published: April 2017

Objectives

We analyze the relationship between CD44, epidermal growth factor receptor (EGFR), and p16 expression in oral cavity and oropharyngeal cancers in a diverse population. We also describe whether particular patterns of staining are associated with progression‐free survival and overall survival.

Study Design

Prospective study, single‐blind to pathologist and laboratory technologist.

Setting

Hospital based.

Subjects and Methods

Immunohistochemistry, comprising gross staining and cellular expression, was performed and interpreted in a blinded fashion on 24 lip/oral cavity and 40 oropharyngeal cancer specimens collected between 2007 and 2012 from participants of a larger study. Information on overall survival and progression‐free survival was obtained from medical records.

Results

Nineteen cases were clinically p16 positive, 16 of which were oropharyngeal. Oral cavity lesions were more likely to exhibit strong CD44 membrane staining (P =. 0002). Strong CD44 membrane and strong EGFR membrane and/or cytoplasmic staining were more common in p16‐negative cancers (P =. 006). Peripheral/mixed gross p16 staining pattern was associated with worse survival than the universal staining on univariate and multivariate analyses (P =. 006, P =. 030). This held true when combining gross and cellular localization for p16. For CD44, universal gross staining demonstrated poorer overall survival compared with the peripheral/mixed group (P =. 039). CD44 peripheral/mixed group alone and when combined with universal p16 demonstrated the best survival on multivariate analysis (P =. 010).

Conclusion

In a diverse population, systematic analysis applying p16, CD44, and EGFR gross staining and cellular localization on immunohistochemistry demonstrates distinct patterns that may have prognostic potential exceeding current methods. Larger studies are warranted to investigate these findings further.
Why people helicopter parent? An actor–partner interdependence study of maternal and paternal prevention/promotion focus and interpersonal/self-regret
Authors: Rousseau Sofie , Scharf Miri
Published: April 2017

Helicopter parenting among parents of young adults has risen in the last few decades, especially in middle-class families, and is identified as a risk factor for offspring’s maladaptive adjustment. Using actor–partner interdependence modeling, this study investigated why mothers and fathers use helicopter parenting. More specifically, the study investigated how mothers’ and fathers’ characteristics (prevention focus, promotion focus, interpersonal regret, and self-regret) work together to predict their helicopter parenting. Questionnaires were collected from 96 families (mother, father, and young adults). The results revealed that higher levels of maternal and paternal prevention focus were related to higher levels helicopter parenting by mothers and fathers, respectively. In addition, higher levels of paternal interpersonal regret were associated with lower levels of helicopter parenting by fathers. Maternal prevention focus, promotion focus, and interpersonal regret were (indirectly) associated with paternal helicopter parenting. The results indicate that parental prevention and promotion focus may play a role in the etiology of helicopter parenting and may therefore be taken into account when addressing such parenting behavior. Further research is needed to deepen our understanding of the processes that shape the tendency to helicopter parent.
The Reliability of Assessing Radiographic Healing of Osteochondritis Dissecans of the Knee
Authors: Wall Eric J. , Milewski Matthew D. , Carey James L. , Shea Kevin G. , Ganley Theodore J. , Polousky John D. , Grimm Nathan L. , Eismann Emily A. , Jacobs Jake C. , Murnaghan Lucas , Nissen Carl W. , Myer Gregory D. ,   the Research in Osteochondritis of the Knee (ROCK) Group, Weiss Jennifer , Edmonds Eric W. , Anderson Allen F. , Lyon Roger M. , Heyworth Benton E. , Fabricant Peter D. , Zbojniewicz Andy
Published: April 2017

Background:

The reliability of assessing healing on plain radiographs has not been well-established for knee osteochondritis dissecans (OCD).

Purpose:

To determine the inter- and intrarater reliability of specific radiographic criteria in judging healing of femoral condyle OCD.

Study Design:

Cohort study (Diagnosis); Level of evidence, 3.

Methods:

Ten orthopedic sports surgeons rated the radiographic healing of 30 knee OCD lesions at 2 time points, a minimum of 1 month apart. First, raters compared pretreatment and 2-year follow-up radiographs on “overall healing” and on 5 subfeatures of healing, including OCD boundary, sclerosis, size, shape, and ossification using a continuous slider scale. “Overall healing” was also rated using a 7-tier ordinal scale. Raters then compared the same 30 pretreatment knee radiographs in a stepwise progression to the 2-, 4-, 7-, 12-, and 24-month follow-up radiographs on “overall healing” using a continuous slider scale. Interrater and intrarater reliability were assessed using intraclass correlations (ICC) derived from a 2-way mixed effects analysis of variance for absolute agreement.

Results:

Overall healing of the OCD lesions from pretreatment to 2-year follow-up radiographs was rated with excellent interrater reliability (ICC = 0.94) and intrarater reliability (ICC = 0.84) when using a continuous scale. The reliability of the 5 subfeatures of healing was also excellent (interrater ICCs of 0.87-0.89; intrarater ICCs of 0.74-0.84). The 7-tier ordinal scale rating of overall healing had lower interrater (ICC = 0.61) and intrarater (ICC = 0.68) reliability. The overall healing of OCD lesions at the 5 time points up to 24 months had interrater ICCs of 0.81-0.88 and intrarater ICCs of 0.65-0.70.

Conclusion:

Interrater reliability was excellent when judging the overall healing of OCD femoral condyle lesions on radiographs as well as on 5 specific features of healing on 2-year follow-up radiographs. Continuous scale rating of OCD radiographic healing yielded higher reliability than the ordinal scale rating. Raters showed substantial to excellent agreement of OCD overall radiographic healing measured on a continuous scale at 2, 4, 7, 12, and 24 months after starting treatment.
Magnetic Resonance Imaging Predictors of Failure in the Nonoperative Management of Ulnar Collateral Ligament Injuries in Professional Baseball Pitchers
Authors: Frangiamore Salvatore J. , Lynch T. Sean , Vaughn Michael D. , Soloff Lonnie , Forney Michael , Styron Joseph F. , Schickendantz Mark S.
Published: April 2017

Background:

A medial ulnar collateral ligament (UCL) injury of the elbow is an increasingly common injury in professional baseball pitchers. Predictors of success and failure are not well defined for the nonoperative management of these injuries.

Purpose:

To evaluate the efficacy of objective measures to predict failure of the nonoperative management of UCL injuries.

Study Design:

Case-control study; Level of evidence, 3.

Methods:

Thirty-two professional pitchers (82%) met inclusion criteria and underwent an initial trial of nonoperative treatment for UCL tears based on clinical and radiological findings. Age, preseason physical examination results, magnetic resonance imaging (MRI) characteristics, and performance metrics were analyzed for these pitchers. Successful nonoperative management was defined as a return to the same level of play or higher for >1 year. Failure was defined as recurrent pain or weakness requiring a surgical intervention after a minimum of 3 months’ rest when attempting a return to a throwing rehabilitation program.

Results:

Thirty-two pitchers (mean age, 22.3 years) who underwent initial nonoperative treatment of UCL injuries were evaluated. Thirty-four percent (11/32) failed and required subsequent ligament reconstruction. Sixty-six percent (21/32) successfully returned to the same level of play for 1 year without a surgical intervention. There was no significant difference seen in physical examination findings or performance metrics between these patients. When comparing MRI findings between the groups, 82% (9/11) ( P < .001) who failed nonoperative management had distal tears, and 81% (17/21) who did not fail had proximal tears ( P < .001). When adjusting for age, location, and evidence of chronic changes on MRI, the likelihood of failing nonoperative management was 12.40 times greater ( P = .020) with a distal tear. No other variable alone or in combination reached significance. When combining the parameters of a high-grade tear and distal location, 88% (7/8) failed nonoperative management.

Conclusion:

In professional pitchers, distal UCL tears showed significantly higher odds of failure with nonoperative management compared with proximal tears. Thus, tear location should be considered when deciding between operative and nonoperative management.
Comparative study of reactive flame retardants based on 9,10-dihydro-9-oxa-10-phosphaphenanthrene 10-oxide
Authors: Zilberman Joseph , Yoffe David , Piotrowski Andrew , Singh Mayank Pratap , Suryadevara Kali , Levchik Sergei
Published: April 2017

Two new 9,10-dihydro-9-oxa-10-phosphaphenanthrene 10-oxide (DOPO)-containing compounds, (6,6′-(1-methylethylidene)-bis(9,10-dihydro-9-oxa-10-phosphaphenantrene-10-oxide)) (bis-DOPO) and 2,4,6-tris-(9,10-dihydro-9-oxa-10-phosphaphenanthrene 10-oxide)-1,3-diacetoxybenzene (DOPO-RA), were synthesized and characterized by nuclear magnetic resonance and Fourier transform infrared spectroscopy. These new flame retardants were incorporated into epoxy formulations to produce a copper-clad laminate. When fully cured, the DOPO-groups of bis-DOPO become a part of the epoxy chains, whereas the DOPO-groups of DOPO-RA remain pendant to the epoxy polymer network. Despite their higher phosphorus content, bis-DOPO-based laminates showed a poorer flame-retardant performance compared to the DOPO-RA laminates. It is believed that the pendant position of the DOPO group with respect to the polymer chains is essential for a gas-phase flame-retardant action.
A composite likelihood approach to predict the sex of the baby
Authors: Tiberi Simone , Scarpa Bruno , Sartori Nicola
Published: April 2017

Couples with diseases associated with the sexual chromosomes, as well as families in countries where the desire for a male is extreme, are interested in influencing the sex of the baby. We propose an original composite likelihood approach to analyse the relation between sex of the newborn and timing of the intercourse which leads to conception. Although there exist numerous works on this relation, only few studies have been carried out on independent datasets to validate the existing theories. Since the sex of the newborn is only known in case of conception, the full likelihood of the data is not easily defined without strong assumptions. A composite likelihood is a pseudo likelihood defined as the product of likelihood functions relative to subsets of the data. In particular, we consider two such likelihoods, one modelling the day-specific probabilities of conception and the other modelling the sex of the newborn given a conception has occurred. The methodology is applied to a dataset from a European fecundability study. The results show no significant dependence of the sex of the newborn on the time of intercourse. The method developed may be applied to other situations when data are affected by selective sampling.
Institutional trust and the provision of public goods: When do individual costs matter? The case of recycling
Authors: Rompf Stephan , Kroneberg Clemens , Schlösser Thomas
Published: April 2017

This research asks whether and how institutional trust—trust in the reliability, effectiveness, and legitimacy of public institutions—promotes the provision of public goods. To understand the underlying mechanisms, we apply three choice models to the example of recycling behavior: a standard rational choice model, the low-cost hypothesis, and a dual-process theory. The models carry competing hypotheses about the interplay of trust and incentives in recycling behavior. Using survey data collected in four countries (Sweden, Denmark, the United States, and the United Kingdom), we find a positive and significant interaction effect of institutional trust and recycling costs on self-reported recycling behavior. No such interaction was found using generalized social trust as a second measure of trust. Our results support a dual-process perspective and indicate that high levels of institutional trust can suppress the inhibiting effect of individual costs on cooperation in a collective action dilemma.
Qualitative Comparison of Barriers to Antiretroviral Medication Adherence Among Perinatally and Behaviorally HIV-Infected Youth
Authors: Fields Errol L. , Bogart Laura M. , Thurston Idia B. , Hu Caroline H. , Skeer Margie R. , Safren Steven A. , Mimiaga Matthew J.
Published: April 2017

Medication adherence among youth living with HIV (28%–69%) is often insufficient for viral suppression. The psychosocial context of adherence barriers is complex. We sought to qualitatively understand adherence barriers among behaviorally infected and perinatally infected youth and develop an intervention specific to their needs. We conducted in-depth interviews with 30 youth living with HIV (aged 14–24 years) and analyzed transcripts using the constant comparative method. Barriers were influenced by clinical and psychosocial factors. Perinatally infected youth barriers included reactance, complicated regimens, HIV fatigue, and difficulty transitioning to autonomous care. Behaviorally infected youth barriers included HIV-related shame and difficulty initiating medication. Both groups reported low risk perception, medication as a reminder of HIV, and nondisclosure, but described different contexts to these common barriers. Common and unique barriers emerged for behaviorally infected and perinatally infected youth reflecting varying HIV experiences and psychosocial contexts. We developed a customizable intervention addressing identified barriers and their psychosocial antecedents.
Validity of the Youth Psychopathic Traits Inventory–Short Version in Justice-Involved and At-Risk Adolescents
Authors: Gillen Christopher T. A. , MacDougall Emily A. M. , Forth Adelle E. , Barry Christopher T. , Salekin Randall T.
Published: April 2017

The current study examined the reliability and validity of the Youth Psychopathic Traits Inventory–Short Version (YPI-S) in two different samples of at-risk adolescents enrolled in a residential program ( n = 160) and at a detention facility ( n = 60) in the United States. YPI-S scores displayed adequate internal consistency and were moderately associated with concurrent scales on other self-report psychopathy measures and externalizing behaviors. YPI-S scores were moderately related to interviewer-ratings of the construct using the four-factor model of the Psychopathy Checklist: Youth Version. Findings suggest that the YPI-S may be a clinically useful and valid tool for the assessment of psychopathic traits in juvenile settings. This may be particularly true given the differential predictive utility of each of its dimensions.
Aspects of interface elasticity theory
Authors: Javili Ali , Ottosen Niels Saabye , Ristinmaa Matti , Mosler Jörn
Published: April 2017

Interfaces significantly influence the overall material response especially when the area-to-volume ratio is large, for instance in nanocrystalline solids. A well-established and frequently applied framework suitable for modeling interfaces dates back to the pioneering work by Gurtin and Murdoch on surface elasticity theory and its generalization to interface elasticity theory. In this contribution, interface elasticity theory is revisited and different aspects of this theory are carefully examined. Two alternative formulations based on stress vectors and stress tensors are given to unify various existing approaches in this context. Focus is on the hyper-elastic mechanical behavior of such interfaces. Interface elasticity theory at finite deformation is critically reanalyzed and several subtle conclusions are highlighted. Finally, a consistent linearized interface elasticity theory is established. We propose an energetically consistent interface linear elasticity theory together with its appropriate stress measures.
Doctor Shopping Behavior and the Diversion of Prescription Opioids
Authors: Simeone Ronald
Published: April 2017

Objectives:

“Doctor shopping” as a means of prescription opioid diversion is examined. The number and percentage of prescriptions and morphine-equivalent milligrams diverted in this manner are estimated by state and molecule for the period 2008-2012.

Methods:

Eleven billion prescriptions with unique patient, doctor, and pharmacy identifiers were used to construct diversion “events” that involved between 1 and 6 unique doctors and between 1 and 6 unique pharmacies. Diversion thresholds were established based on the probability of each contingency.

Results:

A geographically widespread decline occurred between 2008 and 2012. The number of prescriptions diverted fell from approximately 4.30 million (1.75% of all prescriptions) in 2008 to approximately 3.37 million (1.27% of all prescriptions) in 2012, and the number of morphine-equivalent milligrams fell from approximately 6.55 metric tons (2.95% of total metric tons) in 2008 to approximately 4.87 metric tons (2.19% of total metric tons) in 2012.

Conclusions:

Diversion control efforts have likely been effective. But given increases in opioid-related deaths, opioid-related drug treatment admissions, and the more specific resurgence of heroin-related events, it is clear that additional public health measures are required.