bluuebunny/crossref_metadata_2025 huggingface dataset:
Ultrastructure of mature spermatozoa of three Bucephalidae (Prosorhynchus longisaccatus, Rhipidocotyle khaliliandBucephalus margaritae) and phylogenetic implications
Authors: Ndiaye Papa Ibnou , Marchand Bernard , Bâ Cheikh Tidiane , Justine Jean-Lou , Bray Rodney A. , Quilichini Yann
Published: December 2018

We describe here the mature spermatozoa of three species of bucephalids, namelyBucephalus margaritae, Rhipidocotyle khaliliandProsorhynchus longisaccatus. This study provides the first ultrastructural data on the generaBucephalusandRhipidocotyleand enabled us to confirm the model of the mature spermatozoon in the Bucephalinae. The spermatozoon exhibits two axonemes with the 9 + “1” pattern of the Trepaxonemata, one of which is very short, lateral expansion, external ornamentation of the plasma membrane located in the anterior extremity of the spermatozoon and associated with cortical microtubules, spine-like bodies, a mitochondrion, and a nucleus. The maximum number of cortical microtubules is located in the anterior part of the spermatozoon. However, more studies are needed to elucidate if spine-like bodies are present in all the Bucephalinae or not. In the Prosorhynchinae, the mature spermatozoon exhibits a similar ultrastructural pattern. Some differences are observed, particularly the axoneme lengths and the arrangement of the spine-like bodies. The posterior extremity of the spermatozoon in the Bucephalinae exhibits only the nucleus, but prosorhynchines have microtubules.
An inertial modified algorithm for solving variational inequalities
Authors: Hieu Dang Van , Quy Pham Kim
Published: December 2018

The paper deals with an inertial-like algorithm for solving a class of variational inequality problems involving Lipschitz continuous and strongly pseudomonotone operators in Hilbert spaces. The presented algorithm can be considered a combination of the modified subgradient extragradient-like algorithm and inertial effects. This is intended to speed up the convergence properties of the algorithm. The main feature of the new algorithm is that it is done without the prior knowledge of the Lipschitz constant and the modulus of strong pseudomonotonicity of the cost operator. Several experiments are performed to illustrate the convergence and computational performance of the new algorithm in comparison with others having similar features. The numerical results have confirmed that the proposed algorithm has a competitive advantage over the existing methods.
Gefährdung beurteilen: Pflicht oder Kür?
Authors: Schön Wolfram
Published: December 2018

Belastungen am Arbeitsplatz können Auslöser für Stress und psychische Erkrankungen sein. Das Arbeitsschutzgesetz verpflichtet seit 2014, eine
Gefährdungsbeurteilung psychischer Belastungen durchzuführen – zum Wohl aller Beteiligten.
Tiefe Hirnstimulation bei Patienten mit Bewegungsstörungen
und Schmerzen
Authors: Nikkhah Guido , Lotze Martin
Published: December 2018

Die Tiefe Hirnstimulation (THS) hat sich bei der Behandlung des idiopathischen
Parkinson-Syndroms als wichtigste Therapieinnovation des letzten Jahrzehnts
herausgestellt. Doch auch andere motorische Störungen sprechen gut auf die THS
an.
Der Blick in die Praxis
Authors: Küppers Axel
Published: December 2018

Das Alexianer Krankenhaus Hedwigshöhe in Berlin setzt auf die Ressourcen
seiner Mitarbeiter und wendet sich mit Verve dem Wohl des Patienten zu.
Das ist Lean Hospital besonderer Ausprägung. Die Fäden laufen in der
Pflegedirektion zusammen. Im Fokus dieses Artikels steht beispielhaft die
Geriatrie.
Evaluación de la función sexual en pacientes con obesidad, antes y después de la cirugía bariátrica
Authors: Silva José Miguel , Puerto Niño Angie , Duarte Andrés , Vargas Isis , Sánchez Basto Catalina
Published: December 2018

Introducción La obesidad afecta diversos aspectos físicos, psicológicos y sociales. Recientemente se ha comenzado a estudiar su relación con la función sexual y el efecto de las intervenciones dirigidas a reducir el peso.

Objetivo Describir los cambios inducidos por la cirugía bariátrica en la función sexual en un grupo de pacientes obesos.

Métodos Estudio observacional prospectivo de pacientes con obesidad mórbida, intervenidos con cirugía bariátrica. Se evaluó la función sexual en hombres con el cuestionario abreviado de función sexual (SHIM) y la encuesta de autoestima y relaciones (SEAR), y en mujeres con el Índice de función sexual femenina (IFSF). La calidad de vida se evaluó con el cuestionario SF-12. Se utilizaron pruebas estadísticas no paramétricas.

Resultados Se incluyeron 19 pacientes, 13 mujeres con un promedio de edad de 45,3 años (22–59) y 6 hombres con un promedio de 41 años (36–54). El seguimiento promedio fue de 19 meses (13,1–25,9). Para el IFSF, todos los dominios demostraron mejoría, aunque la variable deseo fue la única en la que se obtuvo una diferencia estadísticamente significativa (p = 0.027). Los puntajes obtenidos con la escala SHIM, demuestran disminución en la severidad de la disfunción eréctil de 16,8 (8–21) a 22,16 (18–25) (p = 0,059). En calidad de vida, tanto mujeres como hombres reportaron un incremento estadísticamente significativo (p = 0.036 y p = 0.002, respectivamente).

Conclusiones La cirugía bariátrica tiene un impacto altamente favorable en la calidad de vida y cambios positivos en todos los dominios de la función sexual de hombres y mujeres. Es posible que esos cambios se vean influidos por variables físicas y psicosociales que deben medirse con investigaciones futuras.
Electrophysiological Responses to Different Follicle-Stimulating Hormone Isoforms on Human Cumulus Oophorus Cells: Preliminary Results
Authors: Loss Eloísa da Silveira , Ayres Laura Silveira , Bos-Mikich Adriana , Frantz Nilo , Arruda Letícia Schmidt
Published: December 2018

Objective The aim of the present study was to provide a better understanding of the specific action of two follicle-stimulating hormone (FSH) isoforms (β-follitropin and sheep FSH) on the membrane potential of human cumulus cells.

Methods Electrophysiological data were associated with the characteristics of the patient, such as age and cause of infertility. The membrane potential of cumulus cells was recorded with borosilicate microelectrodes filled with KCl (3 M) with tip resistance of 15 to 25 MΩ. Sheep FSH and β-follitropin were topically administered onto the cells after stabilization of the resting potential for at least 5 minutes.

Results In cumulus cells, the mean resting membrane potential was - 34.02 ± 2.04 mV (n = 14). The mean membrane resistance was 16.5 ± 1.8 MΩ (n = 14). Sheep FSH (4 mUI/mL) and β-follitropin (4 mUI/mL) produced depolarization in the membrane potential 180 and 120 seconds after the administration of the hormone, respectively.

Conclusion Both FSH isoforms induced similar depolarization patterns, but β-follitropin presented a faster response. A better understanding of the differences of the effects of FSH isoforms on cell membrane potential shall contribute to improve the use of gonadotrophins in fertility treatments.
Bunte neue Arbeitswelt
Authors: Fastenmeier Heribert
Published: December 2018

Flexible Arbeitszeiten liegen voll im Trend. Auch im Krankenhaus halten
sie zunehmend Einzug. Das Klinikum Ingolstadt etwa bietet eine Reihe von
unterschiedlichen Modellen an. Sie bergen enormes Potenzial – für die
Mitarbeiter und das Unternehmen.
PSG II – Alternative Wohnformen auf dem Vormarsch
Authors: Mört Matthias
Published: December 2018

Der Umsetzungszeitpunkt für das Pflegestärkungsgesetz II zum 1. Januar 2017 naht. Es gibt inzwischen erste ambulante Dienste und Verbände, die die großen
Möglichkeiten der Neuausrichtung des Gesetzes prüfen und sich auf deren Umsetzung vorbereiten.
Wie Gefährdungsanzeigen überflüssig werden
Authors: Leydecker Julia , Kutscher Jan
Published: December 2018

Wie die Erfahrung zeigt, bringen Gefährdungsanzeigen meist nicht den erwünschten Effekt – für keinen der Beteiligten. Besser wäre
also, sie entstünden erst gar nicht. Lesen Sie im zweiten Teil mehr über die Vier-Säulen-Strategie unserer Autoren, die
Gefährdungsanzeigen überflüssig machen soll.
Erfolge des Projekts „interprofessionelle Zusammenarbeit“
Authors: Lukuc Sarah
Published: December 2018

Ein oft ungleiches Paar: Ärzte und Pflegende. Wie die Arbeit harmonischer laufen kann und welche Erfolge das mit sich bringt,
berichtet Stationsleitung Sarah Lukuc.
Modeling Pseudomonas aeruginosa inner plasma membrane in planktonic and biofilm modes
Authors: Yu Yalun , Klauda Jeffery B.
Published: December 2018

Pseudomonas aeruginosa changes its growth modes under different conditions. The bacteria in biofilm is more resistant to environmental stress compared to the planktonic mode of growth. The compositions of the inner plasma membrane for the two modes are noticeably different. Major lipid types are chosen from experiment to model the membrane in both modes of growth, and molecular dynamics simulation is used to study the properties of the membrane. The CHARMM36 lipid force field is used and tested against several experimental results. Our models include lipids containing cyclopropane in the middle of the sn-2 tail, namely, 1-palmitoyl-2-cis-11,12-methylene-stearic-acid-sn-glycero-3-phosphoethanolamine and 1-palmitoyl-2-cis-11,12-methylene-stearic-acid-sn-glycero-3-phosphoglycerol. The PE:PG ratio for the two model membranes is close, but the fraction of lipids composed of long-chain and cyclopropane-containing fatty acids changes significantly, causing differences between the two models. Compared to previous model membranes built for Escherichia coli, the inner membrane of P. aeruginosa has a longer averaged lipid tail length and a higher percentage of PG lipids, which are responsible for the changes in membrane properties like membrane thickness and stiffness. Most importantly, the comparison to experiments shows good agreements and encourages the model’s use to study the behavior of proteins from P. aeruginosa associated with the membrane.
Three-dimensional anisotropic thermal conductivity tensor of single crystalline β-Ga2O3
Authors: Jiang Puqing , Qian Xin , Li Xiaobo , Yang Ronggui
Published: December 2018

β-Ga2O3 has attracted considerable interest in recent years for high power electronics, where the thermal properties of β-Ga2O3 play a critical role. The thermal conductivity of β-Ga2O3 is expected to be three-dimensionally (3D) anisotropic due to the monoclinic lattice structure. In this work, the 3D anisotropic thermal conductivity tensor of a (010)-oriented β-Ga2O3 single crystal was measured using a recently developed elliptical-beam time-domain thermoreflectance method. Thermal conductivity along any direction in the (010) plane as well as the one perpendicular to the (010) plane can be directly measured, from which the 3D directional distribution of the thermal conductivity can be derived. Our measured results suggest that at room temperature, the highest in-plane thermal conductivity is along a direction between [001] and [102], with a value of 13.3 ± 1.8 W m−1 K−1, and the lowest in-plane thermal conductivity is close to the [100] direction, with a value of 9.5 ± 1.8 W m−1 K−1. The through-plane thermal conductivity, which is along the [010] direction, has the highest value of 22.5 ± 2.5 W m−1 K−1 among all the directions. The temperature-dependent thermal conductivity of β-Ga2O3 was also measured and compared with a theoretical model calculation to understand the temperature dependence and the role of impurity scattering.
Inertial Alfvén solitons in quantum plasma with correction of temperature degeneracy
Authors: Sadiq Nauman , Mushtaq A.
Published: December 2018

Inertial Alfvén solitary waves are investigated in an intermediate β(α≡(β2)/Q<1) quantum plasma, taking into account electron temperature degeneracy correction. We discuss the general coupling parameter Λ to find out the validity of the proposed model in nearly non-degenerate ξ(=eυkBTe)≪1 and nearly degenerate δ(=TeTF)≪1 limiting cases. Employing the reductive perturbation technique, a Korteweg–de Vries (KdV) equation is derived for weakly nonlinear inertial Alfvén solitons in the presence of nearly non-degenerate and nearly degenerate pressure corrections. It is found that in the presence of electron inertia and thermal pressure, the inertial Alfvén solitary waves are accompanied by both hump and dip solitons. Moreover, the effects of the degeneracy parameter G (=Li32(−ξ)Li12(−ξ)) are reflected in the graphical analysis for both limiting cases. The significance of work to astrophysical plasmas is highlighted.
Weakly anisotropic residual contact stress in silicon demonstrated by electron backscatter diffraction and expanding cavity models
Authors: Cook Robert F. , Friedman Lawrence H.
Published: December 2018

The residual stress field surrounding an elastic-plastic spherical indentation contact in Si is determined by electron backscatter diffraction (EBSD)-based experimental measurements and expanding hemispherical cavity-based models. The experiments provide support for indentations as test vehicles for assessment of EBSD as a two-dimensional deformation mapping method but make clear that selection of coordinate axes is critical to determining the correct representation of a stress field. The use of principal stress coordinates rather than the conventional Cartesian coordinates is required in cases in which the direction of the stress field is not aligned with Cartesian axes. In particular, the use of principal coordinates in the analysis of a spherical indentation stress field in Si removed misleading artefacts from the Cartesian-based field and revealed only a weak effect of Si crystalline elastic anisotropy. The experimental results are supported by isotropic and anisotropic finite element analysis models.
Observation of lamellar like fringes and Barkhausen effects in iron-carbon filled vertically aligned carbon nanotubes
Authors: Taallah Ayoub , Willis Maureen , Guo Jian , Xia JiaChen , Lan Mu , Zhang Sijie , Wang Shanling , He Yi , Xiang Gang , Boi Filippo S.
Published: December 2018

Observations of lamellar like fringes in iron-carbon-filled vertically aligned carbon nanotubes (CNTs) produced by pyrolysis of ferrocene and rapid cooling methodologies (controlled quenching) have been investigated. The quantitative phase analysis of encapsulated Fe3C, γ-Fe, and α-Fe by X-ray diffraction reveals that controlling the phase-percentage leads to control of the crystal habit and of magnetic properties. Large coercivities and variable saturation magnetizations were observed. In addition, we reported a thorough study of the hysteresis behavior, the Barkhausen effect which has to be possibly associated with the formation of interfacial-defects in the crystal areas in contact with CNT layers.
Predation of European catfish on anadromous fish species in an anthropised area
Authors: Guillerault Nicolas , Boulêtreau Stéphanie , Santoul Frédéric
Published: December 2018

Increases in both food availability and intraspecific competition downstream of dams have the potential to trigger the emergence of trophic specialisation among fish predators, with considerable implications for prey species populations. The aim of this study was to assess whether the presence of a dam located on the River Garonne (France) affected the dietary preference of the European catfish Silurus glanis towards anadromous prey. Stable isotope analysis showed that the contribution of marine-derived carbon in the diet of the European catfish was substantial (on average 53% of the diet) and was similar between individuals caught downstream of the dam and those caught from the free running part of the river. In contrast with previous studies, a significant relationship between the size of European catfish individuals and their consumption of marine-derived nutrients was found in this study. Anadromous fish populations are in decline; therefore, this significant predation is concerning.
Streptomyces
spp. as biocontrol agents against
Fusarium
species.
Authors: Bubici G.
Published: December 2018

Streptomycetes are the largest taxon of antibiotic producers in the microbial world. Nevertheless, they are less studied than other biocontrol agents against Fusarium diseases and, perhaps, plant diseases in general. Plant diseases incited by
Fusarium
species are notably challenging. Four species complexes in the genus are pathogenic:
Fusarium fujikuroi
,
F. graminearum
,
F. solani
and
F. oxysporum
. Being a vascular pathogen,
F. oxysporum
is particularly difficult to control by using microbial antagonists. Most research has remained at early experimental stages, and only few
Streptomyces
spp. strains have been assayed under diverse conditions. Few commercial products consisting of
Streptomyces
spp. have often provided fluctuating results across trials. Five biocontrol trials conducted in the field using streptomycetes report reductions of diverse Fusarium wilts by 0-55%, with one case (cucumber) of yield increase by 1.3-fold. Among 38 articles dealing with pot-experiments, 16 report a disease control level above 50%, seven of which with a level above 70%. The chitinolytic activity of
Streptomyces
spp. strains plays an important role in the biocontrol of Fusarium diseases, and the plant growth promotion trait is a cherished outcome. More attention is being paid to strains endophytic, producing volatile organic compounds, or to the identification of antibiotics and metabolites responsible for the biocontrol. Bioformulation is a critical point in the use of biocontrol agents, but it has been still poorly considered in the experiments. The biocontrol efficacy of well-designed streptomycete consortia or the so-called microbial synthetic communities, possibly in proper bioformulations, and the role of streptomycetes in the reduction of mycotoxins in the grains are aspects that would merit further investigation in the future.
Extracellular protons accelerate hERG channel deactivation by destabilizing voltage sensor relaxation
Authors: Shi Yu Patrick , Thouta Samrat , Cheng Yen May , Claydon Tom W.
Published: December 2018

hERG channels underlie the delayed-rectifier K+ channel current (IKr), which is crucial for membrane repolarization and therefore termination of the cardiac action potential. hERG channels display unusually slow deactivation gating, which contributes to a resurgent current upon repolarization and may protect against post-depolarization–induced arrhythmias. hERG channels also exhibit robust mode shift behavior, which reflects the energetic separation of activation and deactivation pathways due to voltage sensor relaxation into a stable activated state. The mechanism of relaxation is unknown and likely contributes to slow hERG channel deactivation. Here, we use extracellular acidification to probe the structural determinants of voltage sensor relaxation and its influence on the deactivation gating pathway. Using gating current recordings and voltage clamp fluorimetry measurements of voltage sensor domain dynamics, we show that voltage sensor relaxation is destabilized at pH 6.5, causing an ∼20-mV shift in the voltage dependence of deactivation. We show that the pH dependence of the resultant loss of mode shift behavior is similar to that of the deactivation kinetics acceleration, suggesting that voltage sensor relaxation correlates with slower pore gate closure. Neutralization of D509 in S3 also destabilizes the relaxed state of the voltage sensor, mimicking the effect of protons, suggesting that acidic residues on S3, which act as countercharges to S4 basic residues, are involved in stabilizing the relaxed state and slowing deactivation kinetics. Our findings identify the mechanistic determinants of voltage sensor relaxation and define the long-sought mechanism by which protons accelerate hERG deactivation.
Babesiosis-associated Splenic Rupture: Case Series From a Hyperendemic Region
Authors: Patel Kavin M , Johnson Jennie E , Reece Rebecca , Mermel Leonard A
Published: December 2018

Background

Spontaneous splenic rupture is an increasingly reported complication of babesiosis and has been described as a severe complication.

Methods

We performed a retrospective chart review in a high-prevalence area to identify 7 cases of babesiosis-related splenic rupture between 2014 and 2016.

Results

Splenic rupture occurred in approximately 1% of babesiosis cases. Compared to cases without splenic rupture, these patients were younger (by >10 years), healthier (most with ≤1 comorbidity), had a lower degree of parasitemia (<10%), and were less likely to have end-organ dysfunction other than their splenic involvement.

Conclusions

Younger, healthier patients may be more prone to develop splenic rupture, as splenic histiocytes engage in more robust erythrophagocytosis, leading to pathological mechanical strain and rupture.
Mucosal Healing and Bacterial Composition in Response to Enteral Nutrition Vs Steroid-based Induction Therapy—A Randomised Prospective Clinical Trial in Children With Crohn’s Disease
Authors: Pigneur Bénédicte , Lepage Patricia , Mondot Stanislas , Schmitz Jacques , Goulet Olivier , Doré Joël , Ruemmele Frank M
Published: December 2018

Aims

Exclusive enteral nutrition [EEN] is as efficacious as corticosteroids [CS] to induce remission in Crohn’s disease [CD], without their adverse effects. EEN seems to be more efficient than steroids to induce mucosal healing, but the underlying molecular mechanisms are only sparsely understood. We aimed in the present work to study the anti-inflammatory effects of EEN with Modulen IBD® vs CS in active paediatric CD, and to assess its modulatory effects on the intestinal microbiota as compared with steroids.

Materials and Methods

Nineteen patients with new-onset active CD (Harvey-Bradshaw index [HBI] >5), aged from 6 to 17 years, were included in this prospective randomised induction trial with CS [n = 6] or EEN [n = 13]. Patients were assessed at Weeks 0 and 8 using clinical parameters HBI, endoscopic findings (Crohn’s Disease Endoscopic Index of Severity [CDEIS] score) and analysis of faecal microbiota composition.

Results

At 8 weeks, clinical remission [HBI <5] was achieved in 13/13 patients on EEN and 5/6 patients on steroids; the mucosal healing rate was significantly higher in the EEN [89%] compared with steroid group [17%]. There were no significant differences between groups regarding biological markers, but the intestinal microbiota profiles shifted upon EEN-induced remission to a higher proportion of Ruminococcus bacteria compared with steroid-induced remission [p = 0.049], and with higher proportions of bacteria belonging to Clostridium in EEN-treated patients.

Conclusions

Both steroid and EEN induced clinical remission. However, patients with EEN-induced remission showed a higher rate of mucosal healing and this was associated with a different gut microbiota compositional shift in these children.
Critical success factors of public health sponsorship in Australia
Authors: Sung Billy , Phau Ian , Cheah Isaac , Teah Kevin
Published: December 2018

Public health sponsorship is a unique phenomenon in Australia. The current research examines the critical success factors of Western Australian Health Promotion Foundation’s (Healthway) sponsorship program, Australia’s largest public health sponsorship program. Using stakeholder interviews and expert observational studies, two studies present five key success factors: (i) effective segmentation and targeting of health messages; (ii) collaboration between Healthway and partnering organization to leverage sponsored events; (iii) displacement of unhealth sponsorship; (iv) use of leveraging strategies to raise awareness of health messages; and (v) environmental changes that facilitate behavioural change. The current research provides insights into how and why sponsorship is an effective public health promotion tool.
Performance of bleeding risk scores in dialysis patients
Authors: Ocak Gurbey , Ramspek Chava , Rookmaaker Maarten B , Blankestijn Peter J , Verhaar Marianne C , Bos Willem Jan W , Dekker Friedo W , van Diepen Merel
Published: December 2018

Background

Bleeding risk scores have been created to identify patients with an increased bleeding risk, which could also be useful in dialysis patients. However, the predictive performances of these bleeding risk scores in dialysis patients are unknown. Therefore, the aim of this study was to validate existing bleeding risk scores in dialysis patients.

Methods

A cohort of 1745 incident dialysis patients was prospectively followed for 3 years during which bleeding events were registered. We evaluated the discriminative performance of the Hypertension, Abnormal kidney and liver function, Stroke, Bleeding, Labile INR, Elderly and Drugs or alcohol (HASBLED), the AnTicoagulation and Risk factors In Atrial fibrillation (ATRIA), the Hepatic or kidney disease, Ethanol abuse, Malignancy, Older age, Reduced platelet count or Reduced platelet function, Hypertension, Anaemia, Genetic factors, Excessive fall risk and Stroke (HEMORR2HAGES) and the Outcomes Registry for Better Informed Treatment (ORBIT) bleeding risk scores by calculating C-statistics with 95% confidence intervals (CI). In addition, calibration was evaluated by comparing predicted and observed risks.

Results

Of the 1745 dialysis patients, 183 patients had a bleeding event, corresponding to an incidence rate of 5.23/100 person-years. The HASBLED [C-statistic of 0.58 (95% CI 0.54–0.62)], ATRIA [C-statistic of 0.55 (95% CI 0.51–0.60)], HEMORR2HAGES [C-statistic of 0.56 (95% CI 0.52–0.61)] and ORBIT [C-statistic of 0.56 (95% CI 0.52–0.61)] risk scores had poor discriminative performances in dialysis patients. Furthermore, the calibration analyses showed that patients with a low risk of bleeding according to the HASBLED, ATRIA, HEMORR2HAGES and ORBIT bleeding risk scores had higher incidence rates for bleeding in our cohort than predicted.

Conclusions

The HASBLED, ATRIA, HEMORR2HAGES and ORBIT bleeding risk scores had poor predictive abilities in dialysis patients. Therefore, these bleeding risk scores may not be useful in this population.
Complete Decongestive Therapy Is an Option for the Treatment of Rosacea Lymphedema (Morbihan Disease): Two Cases
Authors: Kutlay Sehim , Ozdemir Elif Can , Pala Zahide , Ozen Selin , Sanli Hatice
Published: December 2018

Background and Purpose

Morbihan disease, also known as rosacea lymphedema, is a rare persistent form of lymphedema that is associated with the disease rosacea. Even though acne rosacea responds well to standard medical treatment, the lymphedema component of the disease is resistant to both medical and surgical therapy. Complete decongestive therapy (CDT) can be considered as a conservative alternative option for treatment of rosacea lymphedema. To date, there is no report on the use of CDT in treating facial lymphedema secondary to acne rosacea.

Case Description

We present 2 cases of women with a diagnosis of Morbihan disease and chronic facial lymphedema that remained resistant to drug treatment for many years before CDT was offered. The treatment program included 4 components: manual lymphatic drainage, compression bandaging, exercises to enhance lymphatic drainage, and patient education.

Outcomes

Following 10 to 15 sessions of CDT, the first patient's facial edema had almost completely resolved. The second patient's response to treatment was assessed as moderate.

Discussion

To the best of our knowledge, these 2 cases of Morbihan disease treated with CDT are the first of their kind to be presented in the literature. As the treatment options for Morbihan disease remain inadequate, we believe that CDT should be considered as a treatment option in those patients who do not benefit from or refuse drug treatment, before moving on to more invasive procedures. Prospective studies should be designed to demonstrate the efficacy of CDT and provide management details.
Consumption Taxes and Corporate Investment
Authors: Jacob Martin , Michaely Roni , Müller Maximilian A
Published: December 2018

Consumers nominally pay the consumption tax, but theoretical and empirical evidence is mixed on whether corporations partly shoulder this burden, thereby affecting corporate investment. Using a quasi-natural experiment, we show that consumption taxes decrease investment. Firms facing more elastic demand decrease investment more strongly, because they bear more of the consumption tax. We corroborate the validity of our findings using 86 consumption tax changes in a cross-country panel. We document two mechanisms underlying the investment response: reduced firms’ profitability and lower aggregate consumption. Importantly, the magnitude of the investment response to consumption taxes is similar to that of corporate taxes.

Received September 25, 2017; editorial decision August 26, 2018 by Editor Wei Jiang. Authors have furnished an Internet Appendix, which is available on the Oxford University Press Web site next to the link to the final published paper online.
Comparative effectiveness of abatacept, rituximab, tocilizumab and TNFi biologics in RA: results from the nationwide Swedish register
Authors: Frisell Thomas , Dehlin Mats , Di Giuseppe Daniela , Feltelius Nils , Turesson Carl , Askling Johan ,   ARTIS Study Group, Ernestam Sofia , Klareskog Lars , Nisell Ralph , Baecklund Eva , Kastbom Alf , Jacobsson Lennart , Lindqvist Elisabet , d’Elia Helena Forsblad , Rantapää-Dahlqvist Solbritt
Published: December 2018

Objectives

Current guidelines rank abatacept, rituximab, tocilizumab and TNF-inhibitors (TNFi) as having equal effectiveness for the treatment of RA, at least as second line therapies. These recommendations are mainly based on meta-analysis of randomized controlled trials, with few direct drug–drug comparisons. Our objective was to compare the real-world absolute and relative effectiveness among RA patients starting any of the available biologic DMARDs (bDMARDs).

Methods

We used the Swedish Rheumatology Register to identify patients with RA initiating TNFi, rituximab, abatacept or tocilizumab in 2010–2016 as first bDMARD (n = 9333), or after switch from TNFi as first bDMARD (n = 3941). National Swedish registers provided additional covariates and censoring events. Effectiveness was assessed 3 and 12 months after treatment start, as the proportion remaining on therapy and with EULAR Good Response, HAQ improvement >0.2, zero swollen/tender joints and CDAI remission. Adjusted differences were estimated with multivariable linear regression.

Results

Patients starting non-TNFi (vs TNFi) as first bDMARD had a higher proportion remaining on drug and reaching most response outcomes as first bDMARD (1-year EULAR Good Response/HAQ improvement: TNFi 24.9/25.4%, rituximab 28.6/37.2%, abatacept 31.9/33.7%, tocilizumab 50.9/43.1%). After switch from a first TNFi, rituximab and tocilizumab, but not abatacept, were associated with significantly better response measures than TNFi (1-year EULAR Good Response/HAQ improvement: TNFi 11.6/16.1%, rituximab 24.8/33.2%, abatacept 13.1/17.5%, tocilizumab 34.1/29.4%). Differences remained significant after adjusting for potential confounders.

Conclusion

Treatment outcomes among RA patients treated in Swedish clinical practice are in line with a superior effectiveness of non-TNFi bDMARDs, in particular tocilizumab and rituximab, compared with TNFi.
BAYESIAN SPECTRUM DECONVOLUTION INCLUDING UNCERTAINTIES AND MODEL SELECTION: APPLICATION TO X-RAY EMISSION DATA USING WINBUGS
Authors: Behrens R , Reginatto M
Published: December 2018

Spectrum deconvolution is an important task in ionizing radiation measurements, as the pulse height spectra, or, in general, the measured data from spectrometers or other measuring instruments are usually determined by the convolution of the response function with the fluence spectra. The method presented here for obtaining fluence spectra from the measurements is an application of Bayesian parameter estimation to the deconvolution of X-ray emission data. The problem of choosing the optimal model among several possible models is also considered, as well as an approach to include contributions from various sources of uncertainty, both correlated and uncorrelated. The application is carried out using the Bayesian software WinBUGS.
Social Class, Gender, and Contemporary Parenting Standards in the United States: Evidence from a National Survey Experiment
Authors: Ishizuka Patrick
Published: December 2018

Social scientists have documented a substantial increase in both mothers’ and fathers’ time spent with children since the 1960s in the United States. Yet parenting behaviors remain deeply divided by social class and gender, with important implications for the reproduction of inequality. To understand rising parental investments in children and persistent class and gender differences in parenting, popular accounts and academic studies have pointed to an apparent cultural shift toward norms of time-intensive, child-centered parenting, particularly for mothers and among middle-class parents. However, prior research has produced inconclusive evidence relating to social class, gender, and contemporary parenting norms. Using data from an original vignette survey experiment conducted with a nationally representative sample of more than 3,600 parents, this study examines cultural norms related to parenting elementary school-aged children, considering how both social class and gender shape views about good parenting. Results indicate that parents of different social classes express remarkably similar support for intensive mothering and fathering across a range of situations, whether sons or daughters are involved. These findings suggest that cultural norms of child-centered, time-intensive mothering and fathering are now pervasive, pointing to high contemporary standards for parental investments in children.
Duration of Scar Maturation: Retrospective Analyses of 361 Hypertrophic Scars Over 5 Years
Authors: Kant Sander , van den Kerckhove Eric , Colla Carlo , van der Hulst René , Piatkowski de Grzymala Andrzej
Published: December 2018

OBJECTIVE:

Maturation remains the least understood phase of wound healing; estimates of maturation time are broad and inaccurate. A more precise estimation of maturation time could influence scar therapy and give insight to the wound healing cascade. The objective of this study was to assess the mean time between onset and complete maturation of hypertrophic scars.

METHODS:

This retrospective study was performed in an outpatient clinic of the Maastricht University Medical Center exclusively focused on scar treatment; 361 patients with a hypertrophic scar were included between September 2010 and December 2015.

MAIN OUTCOME MEASURES:

Date of onset and date of complete maturation were documented in patients’ medical files. Patients were divided into three patient groups: <30 years, 30–55 years, and >55 years. Different scar causes and scar therapies were analyzed in relation to maturation time.

MAIN RESULTS:

These results reveal statistically significant differences (P < .05) in mean maturation time between the <30 (35.76 months) and >55 patients (22.53 months) and between >55 and 30–55 year old patients (34.64 months). Significant differences in mean maturation time were also found between scars treated with pressure therapy (23.20 months) and combination therapy (30.59 months), silicone therapy (35.51 months), injection therapy (46.43 months), and other therapies (41.31 months). No significant differences in maturation time were found relative to scar cause.

CONCLUSIONS:

This study shows that hypertrophic scars take significantly more time to completely maturate than previously believed, and older patients show the fastest healing. Further, scars treated with pressure therapy maturate fastest.
Outcomes Research in Vulnerable Pediatric Populations
Authors: Lee Ka-Eun M. , Diacovo Thomas G. , Calderon Johanna , Byrne Mary W. , Ing Caleb
Published: December 2018

The Pediatric Anesthesia and Neurodevelopment Assessment (PANDA) study team held its biennial symposium in April 2018 to discuss issues on anesthetic neurotoxicity in the developing brain. One of the sessions invited speakers with different areas of expertise to discuss “Outcomes Research in Vulnerable Pediatric Populations.” The vulnerable populations included neonates, children with congenital heart disease, children from low socioeconomic status, and children with incarcerated parents. Each speaker presented some of the ongoing research efforts in these groups as well as the challenges encountered in studying them.
A Systematic Review of Development Programs Designed to Address Leadership in Academic Health Center Faculty
Authors: Moore Simas Tiffany A. , Cain Joanna M. , Milner Robert J. , Meacham Martha E. , Bannon Annika L. , Levin Leonard L. , Amir Nili , Leung Katherine , Ockene Judith K. , Thorndyke Luanne E.
Published: December 2018

Introduction:

To describe Academic Health Center (AHC) faculty leadership development program characteristics and categorize leadership topics into thematic areas suggesting competency domains to guide programmatic curricular development.

Methods:

A systematic literature review was conducted (PubMed/MEDLINE, Scopus, Cumulative Index of Nursing and Allied Health Literature [CINAHL], and Journal Storage [JSTOR databases]). Eligible studies described programs with leadership development intent for faculty in AHCs. Information was extracted using a structured data form and process.

Results:

Six hundred ninety citations were screened; 25 publications describing 22 unique programs were eligible. The majority (73%) were institutionally based; mean class size was 18.5 (SD ± 10.2, range 4.5–48); and mean in-person time commitment was 110 hours (SD ± 101.2, range 16–416), commonly occurring in regular intervals over months to years (n = 10, 45%). Six programs provided per participant costs (mean $7,400, range $1000–$21,000). Didactic teaching was the primary instructional method (99.5%); a majority (68%) included project work. Fourteen thematic content areas were derived from 264 abstracted topics. The majority or near majority incorporated content regarding leadership skills, organizational strategy and alignment, management, self-assessment, and finance/budget.

Discussion:

Institutions and faculty invest significantly in leadership development programs, addressing perceived needs and with perceived benefit for both. The prevalence of common curricular content indicates that AHCs deem important faculty development in leadership, business, and self-assessment skills.
Mild Hypothermia Is Ineffective to Protect Against Myocardial Injury Induced by Chemical Anoxia or Forced Calcium Overload
Authors: Kawada Toru , Yamazaki Toji , Akiyama Tsuyoshi , Hayama Yohsuke , Sugimachi Masaru
Published: December 2018

Although hypothermia suppresses myocardial ischemia/reperfusion injury, whether it also protects the myocardium against cellular stresses such as chemical anoxia and calcium overload remains unknown. We examined the effect of mild hypothermia (33°C) on myocardial injury during ischemia/reperfusion, local administration of sodium cyanide (chemical anoxia), or local administration of maitotoxin (forced Ca2+ overload) using cardiac microdialysis applied to the feline left ventricle. Baseline myoglobin levels (in ng/mL) were 237 ± 57 and 150 ± 46 under normothermia and hypothermia, respectively (mean ± SE, n = 6 probes each). Coronary artery occlusion increased the myoglobin level to 2600 ± 424 under normothermia, which was suppressed to 1160 ± 149 under hypothermia (P < 0.05). Reperfusion further increased the myoglobin level to 6790 ± 1550 under normothermia, which was also suppressed to 2060 ± 343 under hypothermia (P < 0.05). By contrast, hypothermia did not affect the cyanide-induced myoglobin release (930 ± 130 vs. 912 ± 62, n = 6 probes each) or the maitotoxin-induced myoglobin release (2070 ± 511 vs. 2110 ± 567, n = 6 probes each). In conclusion, mild hypothermia does not make the myocardium resistant to cellular stresses such as chemical anoxia and forced Ca2+ overload.
SEROUS MACULAR DETACHMENT ASSOCIATED WITH WALDENSTROM MACROGLOBULINEMIA MANAGED WITH IBRUTINIB: A CASE REPORT AND NEW INSIGHTS INTO PATHOGENESIS
Authors: Leskov Ilya , Knezevic Alexander , Gill Manjot K.
Published: December 2018

Purpose:

To report a case of serous macular detachment in a patient with Waldenstrom macroglobulinemia treated with ibrutinib.

Methods:

The patient underwent a complete ophthalmic examination and imaging at presentation and at follow-up visits up to 13 months.

Results:

At presentation, there were serous macular detachments bilaterally with no dye leakage on fluorescein angiography or vasculature abnormalities on optical coherence tomography angiography. After treatment with ibrutinib, there was near resolution of the patient's retinopathy with an improvement in vision at 13 months' follow-up.

Conclusion:

Serous macular detachments in Waldenstrom macroglobulinemia–associated retinopathy may be due to the disruption of the retinal pigment epithelium pump mechanism by hyperglobulinemia. The favorable course of this patient, treated with the novel tyrosine kinase inhibitor ibrutinib, suggests this may be the preferred treatment for Waldenstrom macroglobulinemia patients with associated retinopathy.
Targeted Minimally Invasive Parathyroidectomy for Ectopic Aortopulmonary Adenoma under Gamma Probe Guidance
Authors: Ergi Defne Güneş , Bayram Ilknur Kepenekci , Baran Cagdas , Özkan Elgin , Inan Mustafa Bahadir , Akar Ahmet Ruchan
Published: December 2018

We report a case of 53-year-old woman with the parathyroid adenoma (PA) located in the aortopulmonary window with an aberrant right subclavian artery. Her preoperative calcium level was 11.3 mg/dL (reference range = 8.8–10.6 mg/dL). The parathyroid hormone level was significantly elevated at 127.4 pg/mL (reference range = 12–88 pg/mL) as measured on immunoradiometric assay. Dual-phase technetium-99m–labeled sestamibi parathyroid scintigraphy and fluorine-18 18F-fluorocholine positron emission tomography/computed tomography revealed a mediastinal tumor measuring 3 × 5 × 6 mm located anterolateral to the aortopulmonary window. Minimally invasive removal of PA was performed through 3.5-cm reverse J-shaped partial upper sternotomy to the third intercostal space. Postoperative recovery was uneventful, and serum calcium and parathyroid hormone levels normalized within 24 hours of surgery. Our case represents the rare occurrence of a mediastinal PA associated with aberrant right subclavian artery treated with targeted minimally invasive approach using different imaging modalities including technetium-99m–sestamibi scintigraphy and fluorine-18 18F-fluorocholine positron emission tomography/computed tomography, and intraoperative use of gamma probe for precise localization PA.
QTc Prolongation Associated With Psychiatric Medications
Authors: Shao Wanda , Ayub Shehzad , Drutel Robert , Heise William C. , Gerkin Richard
Published: December 2018

Objective

The aim of our study was to assess the impact of psychiatric medications and concomitant risk factors on the prevalence of QTc prolongation and torsades de pointes (TdP) in hospitalized subjects. We examined the association between individual risk scores and QTc prolongation and proposed an evidence-based protocol for electrocardiogram monitoring on psychotropic medications.

Method

Electrocardiograms (ECGs) of subjects hospitalized over a 1-year period were analyzed for QTc prolongation, associated risk factors, and use of medications. Analysis was performed using logistic regression to identify independent predictors of QTc prolongation, and the Pearson χ2 test was used for risk score assessment.

Results

A total of 1249 ECGs of 517 subjects were included in this study. Eighty-seven subjects had QTcB intervals greater than 470 milliseconds for females and greater than 450 milliseconds for males. Twelve (2.3%) subjects had QTcB of 500 milliseconds or greater, or greater than 60 milliseconds of change from baseline. Of these subjects, only 1 case of QTc interval change was related to routine use of psychiatric medications. There were no incidents of TdP. Age, diabetes, hypokalemia, overdose, diphenhydramine, and haloperidol were significant independent predictors of QTc prolongation. Risk scores were significantly correlated with QTc prolongation (P = 0.001).

Conclusion

Our retrospective review study found that the occurrence of TdP and QTc prolongation was low in this subject population. QT abnormalities were associated with known risk factors, and risk scores correlated well with QTc prolongation. Providers can use the protocol proposed in this study, which incorporates risk scores and the CredibleMeds classification system to determine the need for ECG monitoring and to guide treatment.
Rupture of the Patellar Tendon After Platelet-Rich Plasma Treatment: A Case Report
Authors: Redler Andrea , Proietti Lorenzo , Mazza Daniele , Koverech Guido , Vadala Antonio , De Carli Angelo , Ferretti Andrea
Published: December 2018

Introduction:

Rupture of the patellar tendon is becoming more and more frequent, even in sports activities overloading the extensor mechanism of the knee. Platelet-rich plasma (PRP) treatment has been recently introduced in treatment for several knee- and sport-related injuries including muscle strain cartilage defect and tendinopathies. The aim of this case report is to present a case of rupture of the patellar tendon occurred after injections of PRP.

Case Report:

A case of a 40-year-old male soccer player sustaining a patellar tendon rupture after a series of 4 PRP injections. At surgery, a complete rupture in the middle of the patellar tendon was found, with severe degenerative changes of the tendon tissue. This case questions the actual efficacy and safety of PRP in severe degenerative tendinopathies.
New stimulant formulations for pediatric attention-deficit/hyperactivity disorder: a case-based approach for the primary care provider
Authors: Partain Paige I. , White Jacob , Hammerness Paul
Published: December 2018

Purpose of review

To provide an up-to-date clinical review of U.S. Food and Drug Administration (FDA)-approved stimulant medications for attention-deficit/hyperactivity disorder (ADHD), including a framework for individualized treatment by primary care pediatric providers.

Recent findings

Stimulant medications are first-line agents for pediatric ADHD. Since 2012, 11 novel stimulant medications have been approved by the FDA for the treatment of ADHD. Because of an expanded formulary of available methylphenidate-based and amphetamine-based stimulants, primary care providers may be unfamiliar with some novel medications outside a select formulary.

The current broad formulary of methylphenidate-based and amphetamine-based stimulants provides primary care clinicians with a greater opportunity for personalized medicine within the patient-centered medical home. Through a systematic review of prior relevant medication trials, a consideration of daily symptom burden and thoughtful pragmatics, primary care providers can offer a more precise, customized stimulant treatment.