bluuebunny/crossref_metadata_2025 huggingface dataset:
The role of occupational and physiotherapy in multi-modal approach to tackling delirium in the intensive care
Authors: Rains Jenny , Chee Nigel
Published: July 2017

The presence of delirium within critical care remains a long-standing challenge for patients and clinicians alike. A myriad of pre-disposing and precipitating factors lead to this patient cohort being high risk for developing delirium during their critical care stay. Until now, non-pharmacological management of these patients usually encompasses a ‘bundle’ of principles to reduce delirium days. These bundles have limited focus on the entire multi-disciplinary team (including occupational therapists and physiotherapists) who could assist with the reduction of delirium. The purpose of this analysis is to review the current literature and develop a mnemonic, which may help facilitate collaborative working for patients with delirium. Electronic databases were searched for non-pharmacological managements of delirium within intensive care settings, after 2006. Critical appraisal using Critical Appraisal Skills Programme methodology was completed by the author. Multi-intervention approaches and bundles are successful at reducing delirium days, and in some cases, reducing hospital length of stay. The key components of these bundles include spontaneous breathing trials, daily sedation holds, addressing pain relief, early mobilisation and to a small extent normalisation of a daily routine. There is limited research into the role of therapy within this patient group, but there is a role for cognitive therapy, functional tasks, and a greater rehab emphasis within other patient populations such as stroke and elderly care. The critical care population have similar rehabilitation needs to these groups, and therefore would benefit from similar treatment plans. Critical care patients with delirium may benefit from a range of additional therapeutic activities to reduce the duration of delirium. The D.E.L.I.R.I.U.M mnemonic has been developed to encompass all the key elements of current delirium research in a simplistic memorable fashion. Further work is needed to trial the usefulness of the mnemonic in clinical practice to enable the entire multi-disciplinary team work collaboratively to reduce delirium with the intensive care.
Determination of mechanical properties of artificial turf football pitches according to structural components
Authors: Sánchez-Sánchez Javier , Haxaire Pascal , García Unanue Jorge , Felipe José L , Gallardo Ana M , Gallardo Leonor
Published: July 2017

Structural components of artificial turf football pitches have been improved in the last decade. The aim of this study was to explore the influence of structural components on the in situ mechanical behaviour of third-generation artificial turf football pitches. In total, 21 pitches were analysed according to the specified FIFA procedures. The results revealed that each of the pitches complies with the requirements of FIFA regulations. Pile length sample, stabilising bulk density, tuft/m2 and sub-base material all demonstrated a significant influence on the mechanical properties of the surface ( p < 0.05). Finally, the selected structural parameters explained 77.9%, 59.8% and 54.3% of variance in rotational traction, vertical deformation and force reduction, respectively. These results show the importance of the selection of the structural components in the design of artificial turf football pitches.
Is cerebral microbleed prevalence relevant as a biomarker in amnestic mild cognitive impairment and mild Alzheimer’s disease?
Authors: Rabelo Ana GB , Teixeira Camila VL , Magalhães Thamires NC , Carletti-Cassani Ana Flávia MK , Amato Filho Augusto CS , Joaquim Helena PG , Talib Leda L , Forlenza Orestes , Ribeiro Patrícia AO , Secolin Rodrigo , Lopes-Cendes Iscia , Cendes Fernando , Balthazar Marcio LF
Published: July 2017

Introduction

The search for a reliable neuroimaging biomarker in Alzheimer’s disease is a matter of intense research. The presence of cerebral microbleeds seems to be a potential biomarker. However, it is not clear if the presence of microbleeds has clinical usefulness to differentiate mild Alzheimer’s disease and amnestic mild cognitive impairment from normal aging. We aimed to verify if microbleed prevalence differs among three groups: mild Alzheimer’s disease, amnestic mild cognitive impairment due to Alzheimer’s disease, and normal controls. Moreover, we studied whether microbleeds were associated with apolipoprotein E allele ɛ4 status, cerebrospinal fluid amyloid-beta, total and phosphorylated tau protein levels, vascular factors, and cognition.

Methods

Twenty-eight mild Alzheimer’s disease patients, 34 with amnestic mild cognitive impairment and 36 cognitively normal elderly subjects underwent: magnetic resonance imaging with a susceptibility-weighted imaging sequence on a 3T scanner, apolipoprotein E genotyping and a full neuropsychological evaluation. Only amnestic mild cognitive impairment and mild Alzheimer’s disease underwent cerebrospinal fluid analysis. We compared the groups and verified if microbleeds were predicted by all other variables.

Results

Mild Alzheimer’s disease presented a higher prevalence of apolipoprotein E allele ɛ4 in relation to amnestic mild cognitive impairment and control group. No significant differences were found between groups when considering microbleed presence. Logistic regression tests failed to find any relationship between microbleeds and the variables. We performed three different regression models using different independent variables: Model 1 - amyloid-beta, phosphorylated tau protein, total tau, apolipoprotein E allele ɛ4 status, age, and sex; Model 2 - vascular risk factors, age, and sex; Model 3 - cognitive scores sex, age, and education.

Conclusion

Although microbleeds might be related to the Alzheimer’s disease process, their presence is not a good candidate for a neuroimaging biomarker of the disease, especially in its early phases.
The Discovery of the Venetian Blind Effect: A Translation of Münster (1941)
Authors: Larkin Edward T. , Stine Wm Wren
Published: July 2017

Münster, the first to discover the effects of a luminance disparity on perceived depth, described two: (1) The apparent displacement in depth of one of a pair of objects relative to the other when viewed with a luminance disparity, and (2) The apparent overall displacement of objects viewed with a luminance disparity away from the observer. The first, which is the Venetian blind effect, was ascribed to irradiation. Current evidence suggests that irradiation fails to account for the effect, implying that neural mechanisms are involved. The second was thought to be related to the perceived distance of a monocularly viewed stimulus embedded in a dichoptically viewed stimulus. However, the measured effect was probably due to aniseikonia. Münster offered a compelling and seemingly complete account of the Venetian blind effect using irradiation theory. Münster’s irradiation theory effectively inhibited further research by relegating the perceived depth displacement to largely non-neural mechanisms. It is now becoming clear that Münster’s measurement of the Venetian blind effect represents the discovery of one of several mechanisms supporting stereopsis, though he and many others failed to recognize that discovery at the time.
Time trends and socioeconomic differences in blood pressure levels: The Northern Sweden MONICA study 1994–2014
Authors: Eriksson Marie , Carlberg Bo , Pennlert Johanna , Söderberg Stefan , Eliasson Mats
Published: July 2017

Background

People with low socioeconomic status have higher blood pressure (BP), increasing their risk of myocardial infarction and stroke. We hypothesized that the gap in systolic (SBP) and diastolic (DBP) BP, according to educational level, has decreased over time but, that economical vulnerability would confer higher BP.

Methods

A total of 4564 women and 4363 men aged 25–74 years participated in five population-based surveys in the Northern Sweden MONICA study between 1994 and 2014 (participation rate 76.8–62.5%).

Results

SBP decreased by 10 mmHg in women and 4 mmHg in men, while DBP was unchanged. Treatment with antihypertensives increased in all but the youngest men. The prevalence of BP control in the population (<140/90 mmHg) increased and in 2014 reached 75% among women and 70% among men. The decrease in SBP was more pronounced in people without university education than in people with university education and DBP showed the same pattern, regardless of education.

After adjustment for confounding factors, age, male sex, higher body mass index, and being born in a Nordic country were related to higher SBP and DBP. University education was related to lower SBP, while variables mirroring economic vulnerability were not associated with BP levels.

Conclusions

BP levels as well as the socioeconomic gap in BP has decreased in Sweden but people with a lower level of education still have higher SBP. Lacking economic resources is not associated with high BP.
Non-Activism: Political Engagement and Facebook Through Ethnography in Trinidad
Authors: Sinanan Jolynna , Hosein Gabrielle Jamela
Published: July 2017

Despite scholarly and popular assertions that social media transforms the possibilities for political engagement, there is little investigation to the relationship between public life and political discussion on social media platforms in the everyday lives of people in different cultural contexts. Based on 15 months ethnographic inquiry in a Trinidadian town, this article examines a political event (the hunger strike of Dr Wayne Kublalsingh) as it unfolded and how those not directly involved with the issue or activism more generally engaged with the protest on Facebook. We find that confrontational political opinion and commentary risks unfavorable kinds of attention: the judgment of others and being the subject of gossip and scandal. We conclude that political engagement over social media needs to be better understood within public life and the cultural specificities of a given context.
The Role of Sociodemographic and Psychological Variables on Risk Perception of the Flu
Authors: Commodari Elena
Published: July 2017

Influenza is a source of mortality and morbidity, and vigilance of health authorities for flu viruses is high. The World Health Organization (WHO) highlighted that the first lines of defense against infectious diseases are behavioral, and risk perception affects behavioral measures. This study investigated risk perception of influenza and the role of sociodemographic and psychological variables on perceived risk. Participants were 442 adults. The research was conducted using three measures: an adjustment of the “Risk Perception of Infectious Disease Questionnaire,” the “General Self-Efficacy Scale,” and the short form of the “Italian Personality Inventory.” The results showed that age, education, self-efficacy, and personality influenced risk perception. The evidence that sociodemographic and psychological factors contribute to risk perception of a disease shows the need to take into account these variables in the planning of informative campaigns, with the aim to achieve favorable changes in public behavior. These issues might have implications for the ameliorating health communication efforts and successful response to new influenza outbreaks.
Spinal Instability Neoplastic Score (SINS): Reliability Among Spine Fellows and Resident Physicians in Orthopedic Surgery and Neurosurgery
Authors: Fox Shandy , Spiess Michael , Hnenny Luke , Fourney Daryl. R.
Published: July 2017

Study Design:

Reliability analysis.

Objectives:

The Spinal Instability Neoplastic Score (SINS) was developed for assessing patients with spinal neoplasia. It identifies patients who may benefit from surgical consultation or intervention. It also acts as a prognostic tool for surgical decision making. Reliability of SINS has been established for spine surgeons, radiologists, and radiation oncologists, but not yet among spine surgery trainees. The purpose of our study is to determine the reliability of SINS among spine residents and fellows, and its role as an educational tool.

Methods:

Twenty-three residents and 2 spine fellows independently scored 30 de-identified spine tumor cases on 2 occasions, at least 6 weeks apart. Intraclass correlation coefficient (ICC) measured interobserver and intraobserver agreement for total SINS scores. Fleiss’s kappa and Cohen’s kappa analysis evaluated interobserver and intraobserver agreement of 6 component subscores (location, pain, bone lesion quality, spinal alignment, vertebral body collapse, and posterolateral involvement of spinal elements).

Results:

Total SINS scores showed near perfect interobserver (0.990) and intraobserver (0.907) agreement. Fleiss’s kappa statistics revealed near perfect agreement for location; substantial for pain; moderate for alignment, vertebral body collapse, and posterolateral involvement; and fair for bone quality (0.948, 0.739, 0.427, 0.550, 0.435, and 0.382). Cohen’s kappa statistics revealed near perfect agreement for location and pain, substantial for alignment and vertebral body collapse, and moderate for bone quality and posterolateral involvement (0.954, 0.814, 0.610, 0.671, 0.576, and 0.561, respectively).

Conclusions:

The SINS is a reliable and valuable educational tool for spine fellows and residents learning to judge spinal instability.
Predictors for Non-Home Patient Discharge Following Elective Adult Spinal Deformity Surgery
Authors: Di Capua John , Somani Sulaiman , Lugo-Fagundo Nahyr , Kim Jun S. , Phan Kevin , Lee Nathan J. , Kothari Parth , Shin John , Cho Samuel K.
Published: July 2017

Study Design:

Retrospective cohort study.

Objectives:

Adult spinal deformity (ASD) surgery encompasses a wide variety of spinal disorders and is associated with a morbidity rate between 20% and 80%. The utilization of spinal surgery has increased and this trend is expected to continue. To effectively deal with an increasing patient volume, identifying variables associated with patient discharge destination can expedite placement and reduce length of stay.

Methods:

The 2013-2014 American College of Surgeons National Surgical Quality Improvement Program database was queried using Current Procedural Terminology and International Classification of Diseases, Ninth Revision diagnosis codes relevant to ASD. Patients were divided based on discharge destination. Bivariate and multivariate logistic regression analyses were employed to identify predictors for patient discharge destination and hospital length of stay.

Results:

A total of 4552 patients met inclusion criteria, of which 1102 (24.2%) had non-home discharge. Multivariate regression revealed total relative value unit (odds ratio [OR] = 1.01, 95% confidence interval [CI] = 1.00-1.01); female sex (OR = 1.54, 95% CI = 1.32-1.81); American Indian, Alaska Native, Asian, Native Hawaiian, or Pacific Islander versus black race (OR = 0.52, 95% CI = 0.35-0.78, P = .002); age ≥65 years (OR = 3.72, 95% CI = 3.19-4.35); obesity (OR = 1.18, 95% CI = 1.01-1.38, P = .034); partially/totally functionally dependent (OR = 2.11, 95% CI = 1.49-2.99); osteotomy (OR = 1.42, 95% CI = 1.12-1.80, P = .004) pelvis fixation (OR = 2.38, 95% CI = 1.82-3.11); operation time ≥4 hours (OR = 1.74, 95% CI = 1.47-2.05); recent weight loss (OR = 7.66, 95% CI = 1.52-38.65; P = .014); and American Society of Anesthesiologists class ≥3 (OR = 1.80, 95% CI = 1.53-2.11) as predictors of non-home discharge. P values were <.001 unless otherwise noted. Additionally, multivariate regression found non-home discharge to be a significant variable in prolonged length of stay.

Conclusions:

The authors suggest these results can be used to inform patients preoperatively of expected discharge destination, anticipate patient discharge needs postoperatively, and reduce health care costs and morbidity associated with prolonged LOS.
Book Review: Legislative Drafting: Step-by-Step. By Arthur J. Rynearson
Authors: Jaja Tonye Clinton
Published: July 2017

Legislative Drafting: Step-by-Step. By Arthur J. Rynearson, International Law Institute and Carolina Academic Press, Durham, North Carolina, USA, 2013, 235 Pp., US$45.00, ISBN 978-1-61163-380-1, Library of Congress Cataloguing Number (LCCN) 2013000071
Adenocarcinoma of Lung Presenting as Lambert-Eaton Myasthenic Syndrome
Authors: Bukhari Sumera , Soomro Rabia , Fawwad Shaikh , Alvarez Chikezie , Wallach Sara
Published: July 2017

Lambert-Eaton myasthenic syndrome (LEMS) is a paraneoplastic neuromuscular junction disorder. LEMS presents with muscular weakness and fatigability, mainly involving the proximal lower limbs. There are 2 types of LEMS depending on the etiology: paraneoplastic and idiopathic. The paraneoplastic form, which constitutes more than a half of the cases, is mostly associated with intrathoracic neoplasms. Most cases are seen in patients with small cell lung cancer; other subtypes of lung cancer are extremely rare. In this article, we report a case of LEMS as a rare association with adenocarcinoma of the lung.
Infection Rates in Arthroscopic Versus Open Rotator Cuff Repair
Authors: Hughes Jonathan D. , Hughes Jessica L. , Bartley Justin H. , Hamilton William P. , Brennan Kindyle L.
Published: July 2017

Background:

The prevalence of rotator cuff repair continues to rise, with a noted transition from open to arthroscopic techniques in recent years. One reported advantage of arthroscopic repair is a lower infection rate. However, to date, the infection rates of these 2 techniques have not been directly compared with large samples at a single institution with fully integrated medical records.

Purpose:

To retrospectively compare postoperative infection rates between arthroscopic and open rotator cuff repair.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

From January 2003 until May 2011, a total of 1556 patients underwent rotator cuff repair at a single institution. These patients were divided into an arthroscopic repair group and an open group. A Pearson chi-square test and Fisher exact test were used, with a subgroup analysis to segment the open repair group into mini-open and open procedures. The odds ratio and 95% CI of developing a postoperative infection was calculated for the 2 groups. A multiple-regressions model was then utilized to identify predictors of the presence of infection. Infection was defined as only those treated with surgical intervention, thus excluding superficial infections treated with antibiotics alone.

Results:

A total of 903 patients had an arthroscopic repair, while 653 had open repairs (600 mini-open, 53 open). There were 4 confirmed infections in the arthroscopic group and 16 in the open group (15 mini-open, 1 open), resulting in postoperative infection rates of 0.44% and 2.45%, respectively. Subgroup analysis of the mini-open and open groups demonstrated a postoperative infection rate of 2.50% and 1.89%, respectively. The open group had an odds ratio of 5.645 (95% CI, 1.9-17.0) to develop a postoperative infection compared with the arthroscopic group.

Conclusion:

Patients undergoing open rotator cuff repair had a significantly higher rate of postoperative infection compared with those undergoing arthroscopic rotator cuff repair.
Upper Extremity Range of Motion and Pitching Profile of Baseball Pitchers in Japan
Authors: Sueyoshi Ted , Nakatani Takuya , Tsuruta Takashi , Emoto Gen
Published: July 2017

Background:

Shoulder range of motion and pitch count in baseball pitchers have been linked to pitching-related upper extremity injury.

Purpose:

To investigate upper extremity range of motion and pitching profiles in baseball pitchers in Japan as well as to make a comparison between injured and noninjured pitchers.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

Forty-one Little League to college-level baseball pitchers were measured for bilateral shoulder and elbow range of motion, including shoulder internal rotation (IR), external rotation (ER), shoulder horizontal adduction (HAD), and elbow extension (EXT). They were also asked to answer a simple questionnaire regarding their past pitching-related medical history and pitching profile. Additionally, 28 participants with baseball-related upper extremity injuries (injury group) were compared with 13 participants without injury (no-injury group) for the same parameters. Collected data were analyzed using analysis of variance.

Results:

Significant limb differences (dominant vs nondominant side) were noted for ER (117.2° vs 109.8°, P = .02), IR (53.5° vs 61.9°, P = .007), HAD (28.3° vs 32.8°, P = .03), and EXT (1.0° vs 4.6°, P = .01). A significant between-group difference (injury vs no-injury group) was observed for IR in both the dominant (55.4° vs 45.6°, P = .03) and nondominant shoulder (65.3° vs 55.0°, P = .01). Participants in the injury group pitched more games in a season and more innings per game started.

Conclusion:

Japanese baseball pitchers displayed adaptive changes in upper extremity range of motion similar to American pitchers when compared bilaterally. Injured pitchers exhibited greater IR range of motion in their pitching arm compared with noninjured pitchers.
Validation of a Cystic Fibrosis Medication Knowledge Questionnaire
Authors: FitzPatrick Beverly , Hawboldt John , Jane Smith Mary , Lee Tiffany
Published: July 2017

Low adherence to cystic fibrosis (CF) treatment is associated with poor health outcomes, while knowledge of the disease and medication regimen can positively influence adherence. This study’s purpose was to develop and validate a questionnaire to help determine CF medication knowledge of pediatric patients and caregivers. Our questionnaire had 37 items: 22 selected-response and 15 open-response questions. We used validation processes from the Standards for Educational and Psychological Testing. CF experts analyzed validity evidence based on content. Then, the questionnaire was field tested with 17 pediatric patients and 18 caregivers. The correlation between age and medication knowledge was medium ( r = .33), but was not significant ( P = .189). Cronbach’s α for the overall test was .84. Participants thought the questionnaire was important and suitable, with a few minor suggestions to improve wording. Strong validity evidence indicates the questionnaire could be used to assess medication knowledge and allow more personalized education to improve adherence.
Creating an Excellent Patient Experience Through Service Education
Authors: Kennedy Denise M
Published: July 2017

Service quality and patient satisfaction affect an organization’s value-based payments. This new value paradigm calls for a new approach to service education and training for front-line staff. Thoughtfully conceived, department-specific content, infused with patient feedback, value creation, and science of service quality principles, was developed to give front-line staff a deeper understanding of the impact of their performance on patient experience, value creation, and value-based revenue. Feedback from nearly 1500 trainees in 60 educational sessions delivered over 7 years indicates good understanding of the content and appreciation of the targeted approach. On a 5-point scale ranging from 1 (least effective) to 5 (most effective), trainees’ ratings of their understanding of service quality concepts and impact on value ranged from 4.7 to 4.9. Verbatim comments showed a positive impact on staff. Employee feedback suggests that value-based service education may be useful in motivating front-line staff, improving service quality, and creating value.
Using Reflective Practice to Support Management Student Learning: Three Brief Assignments
Authors: Reilly Anne H.
Published: July 2017

Reflective practice supports critical thinking and assessment skills through analyzing one’s own life experiences, and the role of reflection in learning has been long recognized. However, drawbacks of many reflective practice assignments are their broad scope and lengthy written requirements. I propose that the reflection process is robust enough to support management student learning through short written tasks as well. Three examples of brief reflective assignments are presented suitable for management educators teaching undergraduate, graduate, or non-credit learners: (1) writing an organizational story, (2) a reflection about learning from adversity, and (3) a goal-oriented personal change. Learning outcomes and student responses have been positive, and the assignments have also been an insightful teaching experience for the instructor.
Venous Air Embolism During Pars Plana Vitrectomy: A Case Report and Review of the Literature
Authors: Kasi Sundeep K. , Grant Scott , Flynn Harry W. , Albini Thomas A. , Relhan Nidhi , Heier Jeffrey S. , Gayer Steven , Garg Sunir J.
Published: July 2017

Purpose:

Presumed venous air embolism (PVAE) is a rare and potentially fatal complication of pars plana vitrectomy that is poorly described and understood but requires improved awareness among ophthalmologists and vitreoretinal surgeons.

Methods:

A case report is presented along with a systematic review of published reports of PVAE during ocular surgery.

Results:

An otherwise healthy adult male undergoing retinal detachment repair under local anesthesia with monitored anesthesia care died from a PVAE. Literature search yielded 2 experimental models, 6 individual case reports, and several editorials. Review of existing reports reveals that PVAE can affect patients of any age or gender with no medical predilection and occurs in cases of trauma, endoresection, or retinal detachment repair. It is typically associated with a drop in end-tidal carbon dioxide during fluid–air exchange and can present similar to a hemorrhagic choroidal detachment. Analysis suggests that venous air embolism can be prevented by ensuring full engagement of the infusion cannula into the vitreous cavity prior to fluid–air exchange.

Conclusion:

Presumed venous air embolism is a potentially fatal complication of ocular surgery and in some cases may be recognized by ophthalmologists as a choroidal detachment during fluid–air exchange in pars plana vitrectomy. It is imperative to immediately stop the air infusion line if venous air embolism is suspected.
Differences in Surgical Performance of Internal Limiting Membrane Peeling for Macular Hole Repair Between Supervised Vitreoretinal Fellows and Vitreoretinal Faculty at a Single Institution
Authors: Gizicki Robert , Chow David , Mak Michael Y.K. , Wong David T. , Muni Rajeev H. , Altomare Filiberto , Berger Alan R. , Giavedoni Louis
Published: July 2017

Purpose:

To investigate the differences in surgical maneuvers between vitreoretinal fellows and experienced vitreoretinal surgeons (attendings) when performing internal limiting membrane (ILM) peel during macular hole (MH) surgery and repair.

Methods:

Prospective case series. Macular hole surgeries performed by fellows and attendings at St Michael’s Hospital (Toronto, Canada) were recorded during a 12-month period. Evaluation of recordings was masked. Total peel time (TPL) in seconds, total movement attempts initiating and extending ILM flaps, intrasurgical complications, and surgical efficiency (ratio of approaches leading to case progression to total approaches) were quantified.

Results:

A total of 145 surgeries were evaluated; 44 met inclusion and exclusion criteria. Of the 44 cases, 25 were performed by fellows and 19 by attendings. Mean TPL was shorter for attendings (336 vs 506 seconds, P = .0032). Attendings had a lower average total movement attempts (32.2 vs 43.2, P = .045) and average flap initiation attempts (16.1 vs 23.3, P = .042). Surgical efficiency was better for attendings (45% vs 37% of approaches led to case progression, P = .038). There was no significant difference between groups in total flap extension attempts or intrasurgical complications.

Conclusions:

Compared to fellows, attendings peel ILM in MH surgery faster, more efficiently with a lower number of flap initiation attempts and total movements.
Management of anticoagulant and antiplatelet therapy in patients undergoing interventional pulmonary procedures
Authors: Pathak Vikas , Allender J. Erin , Grant Mollie W.
Published: July 2017

There has been great progress in antithrombotic therapy over the past several years. Its use has increased with the advent of novel anticoagulants, as these medications do not require frequent blood tests for monitoring. Antithrombotic therapy is aimed at reducing the risk of thromboembolic events in patients with atrial fibrillation, coronary artery disease, deep vein thrombosis, valvular heart disease and pulmonary embolism. These patients are often critically ill and frequently undergo urgent interventions requiring discontinuation of anticoagulant or antiplatelet therapy which can increase the risk of thrombosis; however, continuing these agents can lead to increased risk of haemorrhage.

The purpose of this article is to summarise the literature surrounding the safety of using antiplatelet and anticoagulant therapies in patients undergoing interventional pulmonary procedures.
Integrative analysis of the Pekin duck (Anas anas) MicroRNAome during feather follicle development
Authors: Chen Xingyong , Ge Kai , Wang Min , Zhang Cheng , Geng Zhaoyu
Published: July 2017

Background

The quality and yield of duck feathers are very important economic traits that might be controlled by miRNA regulation. The aim of the present study was to investigate the mechanism underlying the crosstalk between individual miRNAs and the activity of signaling pathways that control the growth of duck feathers during different periods. We therefore conducted a comprehensive investigation using Solexa sequencing technology on the Pekin duck microRNAome over six stages of feather development at days 11, 15, and 20 of embryonic development (during the hatching period), and at 1 day and 4 and 10 weeks posthatch.

Results

There were a total of 354 known miRNAs and 129 novel candidate miRNAs found based on comparisons with known miRNAs in the Gallus gallus miRBase. The series of miRNAs related to feather follicle formation as summarized in the present study showed two expression patterns, with primary follicle developed during embryonic stage and secondary follicle developed mainly at early post hatch stage. Analysis of miRNA expression profiles identified 18 highly expressed miRNAs, which might be directly responsible for regulation of feather development. The Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis suggested that in addition to Wnt and transforming growth factor (TGFβ) signaling pathways, which were widely reported in response to follicle formation, another group of signaling pathways that regulate lipid synthesis and metabolism, such as the phosphatidylinositol signaling system and glycerolipid metabolism and signaling, are also responsible for follicle formation.

Conclusion

The highly expressed miRNAs provide a valuable reference for further investigation into the functional miRNAs important for feather development. Lipid synthesis and metabolism related signaling pathways might be responsible for lipid formation on the surface of feather, and should be paid much more attention for their relation to feather quality.
Adaptive multinary inversion of gravity and gravity gradiometry data
Authors: Zhdanov Michael S. , Lin Wei
Published: July 2017

We have developed a novel approach for inversion of gravity and gravity gradiometry data based on multinary transformation of the model parameters. This concept is a generalization of binary density inversion to the models described by any number of discrete model parameters. The multinary inversion makes it possible to explicitly exploit the sharp contrasts of the density between the host media and anomalous targets in the inversion of gravity and gravity gradiometry data. In the framework of the multinary inversion method, we use the given values of density and error functions to transform the density distribution into the desired step-function distribution. To accommodate a possible deviation of the densities from the fixed discrete values, we develop an adaptive technique for selecting the corresponding standard deviations, guided by the inversion process. The novel adaptive multinary inversion algorithm is demonstrated to be effective in determining the shape, location, and densities of the anomalous targets. We find that this method can be effectively applied for the inversion of the full tensor gravity gradiometry (FTG) data computer simulated for the SEG salt density model and for the field FTG data collected in the Nordkapp Basin, Barents Sea.
m6aViewer: software for the detection, analysis, and visualization ofN6-methyladenosine peaks from m6A-seq/ME-RIP sequencing data
Authors: Antanaviciute Agne , Baquero-Perez Belinda , Watson Christopher M. , Harrison Sally M. , Lascelles Carolina , Crinnion Laura , Markham Alexander F. , Bonthron David T. , Whitehouse Adrian , Carr Ian M.
Published: July 2017

Recent methods for transcriptome-wideN6-methyladenosine (m6A) profiling have facilitated investigations into the RNA methylome and established m6A as a dynamic modification that has critical regulatory roles in gene expression and may play a role in human disease. However, bioinformatics resources available for the analysis of m6A sequencing data are still limited. Here, we describe m6aViewer—a cross-platform application for analysis and visualization of m6A peaks from sequencing data. m6aViewer implements a novel m6A peak-calling algorithm that identifies high-confidence methylated residues with more precision than previously described approaches. The application enables data analysis through a graphical user interface, and thus, in contrast to other currently available tools, does not require the user to be skilled in computer programming. m6aViewer and test data can be downloaded here: http://dna2.leeds.ac.uk/m6a.
Priming in a permissive type I-C CRISPR–Cas system reveals distinct dynamics of spacer acquisition and loss
Authors: Rao Chitong , Chin Denny , Ensminger Alexander W.
Published: July 2017

CRISPR–Cas is a bacterial and archaeal adaptive immune system that uses short, invader-derived sequences termed spacers to target invasive nucleic acids. Upon recognition of previously encountered invaders, the system can stimulate secondary spacer acquisitions, a process known as primed adaptation. Previous studies of primed adaptation have been complicated by intrinsically high interference efficiency of most systems against bona fide targets. As such, most primed adaptation to date has been studied within the context of imperfect sequence complementarity between spacers and targets. Here, we take advantage of a native type I-C CRISPR–Cas system in Legionella pneumophila that displays robust primed adaptation even within the context of a perfectly matched target. Using next-generation sequencing to survey acquired spacers, we observe strand bias and positional preference that are consistent with a 3′–5′ translocation of the adaptation machinery. We show that spacer acquisition happens in a wide range of frequencies across the plasmid, including a remarkable hotspot that predominates irrespective of the priming strand. We systematically characterize protospacer sequence constraints in both adaptation and interference and reveal extensive flexibilities regarding the protospacer adjacent motif in both processes. Lastly, in a strain with a genetically truncated CRISPR array, we observe increased interference efficiency, which, when coupled with forced maintenance of a targeted plasmid, provides a useful experimental system to study spacer loss. Based on these observations, we propose that the Legionella pneumophila type I-C system represents a powerful model to study primed adaptation and the interplay between CRISPR interference and adaptation.
A case of an 81-year-old woman with ‘broken-heart syndrome’ after a house fire
Authors: Perkins Teryn , Iwuji Kenneth , Chariyawong Phumpattra , Jenkins Leigh Ann
Published: July 2017

Takotsubo cardiomyopathy is a transient cardiomyopathy predominantly characterized byleft ventricular hypokinesis and wall motion abnormalities, usually apical ballooning during thesystolic phase of heart contraction. The clinical presentation may closely mimic acute coronarysyndrome. The majority of the cases are diagnosed in post-menopausal Caucasian women.The exact mechanism of takotsubo cardiomyopathy is unknown. To avoid complications andmortality, early diagnosis and treatment are important.
Sugammadex: A neuromuscular blockade agent encapsulator
Authors: Yepes Hurtado Victoria
Published: July 2017

Sugammadex sodium, a modified γ-cyclodextrin, represents a new class of drugs effectiveat reversing non-depolarizing muscle relaxants rocuronium and vecuronium. The cylindrical,basket-like structure encapsulates neuromuscular blocking agents which results in rapidreversal of paralysis within three minutes. The current literature was reviewed to analyze theclinical implications and considerations with its administration.
Sleep quality, sleep habits, and chronotypes of medical interns at the beginning of their training
Authors: Limsuwat Chok , Aswanetmanee Pantaree , Awili Mustafa , Raziuddin Ahmed , Thammasitboon Supat
Published: July 2017

Introduction: Despite the implementation of resident work hour regulations, studieshave not consistently shown beneficial changes in residents’ sleep quality or duration. Wehypothesized that inter-individual sleep-related differences may exist prior to training and thepre-existing sleep health and habits may impact training.Objective: To determine interns’ baseline sleep quality, sleep hygiene, chronotypes, andtheir correlates at the beginning of their residency training program.Methods: A cross-sectional study using an anonymous “Resident Sleep Survey” includedbaseline demographic information and questionnaires, including the Epworth SleepinessScale (ESS), the Pittsburgh’s Sleep Quality Index (PSQI), the Morningness-EveningnessQuestionnaire (MEQ), and the Sleep Hygiene Index (SHI).Results: One hundred and twenty-nine subjects participated the study; 45.7 % (n=59)were male and 18.6 % (n=24) were married. Twenty percent of interns had an ESS >10. ThePSQI revealed that 28% of interns had poor sleep hygiene. The mean sleep efficiency was91.2 ±7.4% estimated from the PSQI. Non-married interns had a lower prevalence of morningchronotypes (22.3% vs. 45.8%, p=0.02). Morning chronotype interns had a lower ESS score(6.1 ±3.1 vs. 7.6 ±3.6, p=0.03) and a lower SHI (29 ±7.0 vs. 34.3 ±7.1, p=0.003).Conclusion: About a quarter of interns had poor sleep quality and excessive daytimesleepiness prior to their training. Non-morning chronotype interns appeared to have moredaytime sleepiness and poorer sleep quality. Since pre-existing sleep problems may adverselyaffect learning, we suggest that strategies to improve sleep hygiene and quality in this specificpopulation should be emphasized early in their training.
Integrated Anesthesiologist and Room Scheduling for Surgeries: Methodology and Application
Authors: Rath Sandeep , Rajaram Kumar , Mahajan Aman
Published: July 2017

We consider the problem of minimizing daily expected resource usage and overtime costs across multiple parallel resources such as anesthesiologists and operating rooms, which are used to conduct a variety of surgical procedures at large multispecialty hospitals. To address this problem, we develop a two-stage, mixed-integer stochastic dynamic programming model with recourse. The first stage allocates these resources across multiple surgeries with uncertain durations and prescribes the sequence of surgeries to these resources. The second stage determines actual start times to surgeries based on realized durations of preceding surgeries and assigns overtime to resources to ensure all surgeries are completed using the allocation and sequence determined in the first stage. We develop a data-driven robust optimization method that solves large-scale real-sized versions of this model close to optimality. We validate and implement this model as a decision support system at the UCLA Ronald Reagan Medical Center. This system effectively incorporates the flexibility in the resources and uncertainty in surgical durations, and explicitly trades off resource usage and overtime costs. This has increased the average daily utilization of the anesthesiologists by 3.5% and of the operating rooms by 3.8%. This has led to an average daily cost savings of around 7% or estimated to be $2.2 million on an annual basis. In addition, the insights based on this model have significantly influenced decision making at the operating services department at this hospital.

The e-companion is available at https://doi.org/10.1287/opre.2017.1634 .
Recognising the signs of slapped cheek syndrome
Authors: Lepkowska Dorothy
Published: July 2017

There have been recent outbreaks of slapped cheek syndrome or fifth disease in the UK. Dorothy Lepkowska looks at some of the signs and what parents should know.
‘I had a lump in my stomach’: Swedish gay and lesbian students' experiences of their time in school
Authors: Hammarlund Kina , Sjunnesson Sara , Tettenborn Nina , Jomeen Julie , Thorstensson Stina
Published: July 2017

Objectives:

Gay and lesbian youth can experience ignorance and a lack of acknowledgement surrounding their sexual orientation during their time in school. This qualitative interview study describes how Swedish gay and lesbian students experience their secondary school years on the basis that society has heteronormative values.

Methods:

The data is based on eight telephone interviews with gay and lesbian young adults, aged 18–25 and was analysed using a qualitative narrative approach.

Findings:

The findings presented four themes: not fitting into the norm of heterosexuality, lacking confirmation of their own homosexuality, finding courage, seeing the school as a supportive or a non-supportive environment.

Conclusions:

A way to normalise homosexuality can be to discuss sexual development and attraction from a health-promoting perspective. Professionals working in school need to feel comfortable with issues such as sexuality in order to create a situation of confidence for the student.
Reducing impulsiveness in young people
Authors: Thornton Stephanie
Published: July 2017

Impulsiveness can affect academic performance and can lead to risky behaviours. Stephanie Thornton looks at strategies to help young people control it.
Addressing aggressive behaviour in school-aged children
Authors: Thornton Stephanie
Published: July 2017

Aggressive behaviour in school age children is a serious and pervasive issue. Stephanie Thornton looks at some of the potential causes and strategies to address this issue.
Spectral transmissions: All-night television’s role in the formation of first-wave punk aesthetics
Authors: McMahon Tony
Published: July 2017

In this article, I examine all-night television’s role in the formation of first wave punk aesthetics in Melbourne, Australia. I argue that the confluence of two events – the commencement of all night television transmissions and the emergence of punk – contributed to a Bourdieuian habitas that exerted a hitherto unexamined influence on the music of the time. Drawing on personal experiences, Greil Marcus’ examination of unknown connections between ‘punk’ practitioners, and the work of Pierre Bourdieu, I conclude that all-night television transmissions played an important and as yet unacknowledged role in shaping the Melbourne music scene of today. In addition to this, I suggest that all night television is a lens through which further examination of punk in other areas – both geographically and philosophically – can usefully be explored.
Gig Reviews
Authors: Cross Rich , Evans Gerard
Published: July 2017

Vi Day, Another Winter of Discontent Festival, The Dome, The Boston Arms, London, 19 February 2017

Grow Your Own Records Mini Festival, Dublin Castle, London, 26 November 2016
Exhibition Review
Authors: Trowell Ian
Published: July 2017

COUM Transmissions Exhibition, Humber Street Gallery, Hull, UK, 3 February–22 March 2017
Digging up the dead cities: Abandoned streets and past ruins of the future in the glossy punk magazine
Authors: Trowell Ian
Published: July 2017

This article excavates, examines and celebrates the short run of the magazines Punk’s Not Dead! (a single issue printed in 1981), Punk! Lives (eleven issues printed between 1982 and 1983) and Noise! (sixteen issues in 1982) as a small corpus of overlooked dedicated punk literature – coincident with the UK82 incarnation of punk − that takes the form of a pop-style poster magazine. This revisiting is undertaken with three key aims: to re-assert these resources back into both the punk historical canon and the general history of pop music literature, to provoke a critical discussion of what their existence might imply, and to take a more detailed look at the iconographic construction of the images in what are essentially photograph-driven poster magazines within a wider music-media climate of carefully crafted images. In examining the images it identifies three predominant themes: the street, the apocalypse and the graveyard, respectively mapped across from the genres of Oi!, street-punk/UK82 and positive-punk/goth that are covered in the magazines.
Ethics and practices in American DIY spaces
Authors: Woods Peter J.
Published: July 2017

The history of punk and its subgenres is, in part, a history of DIY spaces and the influences these spaces have on punk and the DIY scene at large. A better understanding of the ethical guidelines of DIY venue organizers would provide insight into the practices of these venues by providing a glimpse into the motivating factors behind these actions. To approach these issues, this article utilizes existing research to examine current DIY practices and their relation to punk culture, as well as defining the primary ethical guidelines in the DIY scene, followed by new research into these issues. In this study, I spoke with eleven different organizers of long running DIY spaces around the United States. These interviews revealed an overwhelming drive to construct DIY venues as inclusive spaces that provide resources for a variety of communities. In practice, however, the heightened sense of alignment between organizations and artists reported by the participants alludes to a lack of diversity amongst the viewpoints of those within these communities.
Discriminate me: Racial exclusivity and neoliberalism’s subcultural influence on New York hardcore
Authors: Parkes Alan
Published: July 2017

While research on neo-liberal policy exposes its influence across economic, political and social lines, scholars often fall short of examining policy implications for minority groups and youth cultures. In the 1970s and 1980s, New York City officials and elites challenged years of Keynesianism that represented prevailing post-World War II economic ideology, prompting underfunded municipal programmes and rising unemployment that subsequently ensured racial segregation. New York City’s condition weighed heavy on youth cultures that arose from urban declension in a city recognized as an international tastemaker. While punk, in the 1970s, in part symbolized the city’s cultural influence, by the early 1980s, hardcore, punk’s more aggressive successor, became a reaction to New York’s waning state. Hardcore represented youth culture navigating economic and social conditions in an era of postwar de-industrialization and rising conservativism. Nonetheless, hardcore bands’ pleas for unity in defiance of neo-liberal policy fell short of offering an escape to the pervasiveness of economic conservativism that purportedly ensured New York’s rise from economic crisis. Like business in Lower Manhattan, whiteness defined hardcore. Highlighting the shortcomings of New York hardcore through examination of its whiteness in spite of calls for inclusivity reveals a deep-seated relationship between youth culture and prevailing economic and political policy. Pleas for inclusiveness met a scene that limited participation through maintaining racial exclusion. Ultimately, hardcore’s inclusive ethos failed to materialize into the physical space the subculture occupied, exposing a subcultural representation of the segregation that marred New York beyond the scene’s walls.