bluuebunny/crossref_metadata_2025 huggingface dataset:
Trends in Mortality Due to Cancer in the United States by Age and County-Level Income, 1999–2015
Authors: Withrow Diana R , Berrington de González Amy , Spillane Susan , Freedman Neal D , Best Ana F , Chen Yingxi , Shiels Meredith S
Published: June 2019

Disparities in cancer mortality by county-level income have increased. It is unclear whether these widening disparities have affected older and younger adults equally. National death certificate data were utilized to ascertain cancer deaths during 1999–2015. Average annual percent changes in mortality rates and mortality rate ratios (RRs) were estimated by county-level income quintile and age (25–64 vs ≥65 years). Among 25- to 64-year-olds, cancer mortality rates were 30% higher (RR = 1.30, 95% confidence interval [CI] = 1.29 to 1.31) in the lowest-vs the highest-income counties in 1999–2001 and 56% higher (RR = 1.56, 95% CI = 1.55 to 1.57) in 2013–2015; the disparities among those 65 years and older were smaller but also widened over time (RR1999–2001 = 1.04, 95% CI = 1.03 to 1.05; RR2013–2015 = 1.14, 95% CI = 1.13 to 1.14). Widening disparities occurred across cancer sites. If all counties had the mortality rates of the highest-income counties, 21.5% of cancer deaths among 25- to 64-year-olds and 7.3% of cancer deaths in those 65 years and older would have been avoided in 2015. These results highlight an ongoing need for equity-focused interventions, particularly among younger adults.
GRB 161219B/SN 2016jca: a powerful stellar collapse
Authors: Ashall C , Mazzali P A , Pian E , Woosley S E , Palazzi E , Prentice S J , Kobayashi S , Holmbo S , Levan A , Perley D , Stritzinger M D , Bufano F , Filippenko A V , Melandri A , Oates S , Rossi A , Selsing J , Zheng W , Castro-Tirado A J , Chincarini G , D’Avanzo P , De Pasquale M , Emery S , Fruchter A S , Hurley K , Moller P , Nomoto K , Tanaka M , Valeev A F
Published: June 2019

We report observations and analysis of the nearby gamma-ray burst GRB 161219B (redshift z = 0.1475) and the associated Type Ic supernova (SN) 2016jca. GRB 161219B had an isotropic gamma-ray energy of ∼1.6 × 1050 erg. Its afterglow is likely refreshed at an epoch preceding the first photometric points (0.6 d), which slows down the decay rates. Combined analysis of the SN light curve and multiwavelength observations of the afterglow suggest that the GRB jet was broad during the afterglow phase (full opening angle ∼42° ± 3°). Our spectral series shows broad absorption lines typical of GRB supernovae (SNe), which testify to the presence of material with velocities up to ∼0.25c. The spectrum at 3.73 d allows for the very early identification of an SN associated with a GRB. Reproducing it requires a large photospheric velocity ($35\, 000 \pm 7000$ km s−1). The kinetic energy of the SN is estimated through models to be Ekin≈4 × 1052 erg in spherical symmetry. The ejected mass in the explosion was Mej≈6.5 ± 1.5 M⊙, much less than that of other GRB-SNe, demonstrating diversity among these events. The total amount of 56Ni in the explosion was 0.27 ± 0.05 M⊙. The observed spectra require the presence of freshly synthesized 56Ni at the highest velocities, at least three times more than a standard GRB-SN. We also find evidence for a decreasing 56Ni abundance as a function of decreasing velocity. This suggests that SN 2016jca was a highly aspherical explosion viewed close to on-axis, powered by a compact remnant. Applying a typical correction for asymmetry, the energy of SN 2016jca was ∼(1–3) × 1052 erg, confirming that most of the energy produced by GRB-SNe goes into the kinetic energy of the SN ejecta.
Atmospheric oscillations provide simultaneous measurement of neutron star mass and radius
Authors: Bollimpalli D A , Wielgus M , Abarca D , Kluźniak W
Published: June 2019

Neutron stars with near-Eddington observable luminosities were shown to harbour levitating atmospheres, suspended above their surfaces. We report a new method to simultaneously measure the mass and radius of a neutron star based on oscillations of such atmospheres. In this paper, we present an analytic derivation of a family of relativistic, oscillatory, spherically symmetric eigenmodes of the optically and geometrically thin levitating atmospheres, including the damping effects induced by the radiation drag. We discover characteristic maxima in the frequencies of the damped oscillations and show that from a measurement of the frequency maximum and of the luminosity one can determine the mass and radius of the neutron star. In addition to the stellar parameters, observation of the variation of the oscillation frequencies with flux would allow us to estimate the stellar luminosity and therefore the distance to the source with an accuracy of a few per cent. We also show that the ratio of any two undamped eigenfrequencies depends only on the adiabatic index of the atmosphere, while for the damped eigenfrequencies, this ratio varies with the luminosity. The damping coefficient is independent of the mode number of the oscillations. Signatures of the dynamics of such atmospheres will be reflected in the source’s X-ray light curves.
ROAD† and K2 photometry of V348 Sgr: probing the pulsation dust connection
Authors: Jeffery C S , Hambsch F-J
Published: June 2019

V348 Sgr is simultaneously an active hot R Coronae Borealis (RCB) variable, a peculiar extreme helium star, and the hydrogen-deficient central star of a planetary nebula. Explaining the RCB-type variability has been difficult since the star spends much of its time at minimum light. We present new ground-based multicolour photometry covering five observing seasons and 80 d of continuous photometry from space. The latter demonstrate small-amplitude (<0.01 mag) variability at maximum light on time-scales typical for strange-mode pulsation in hot helium supergiants. These could provide a trigger for frequent dust-production episodes; other mechanisms must also be considered. Multicolour photometry probes the reddening properties of extinction events from minimum to maximum light. The latter are comparable with extinction events due to carbonaceous grains seen in cooler RCB stars. Minimal reddening at minimum light is indicative that starlight scattered from circumstellar dust into the line of sight dominates transmitted light.
Searching for fast extragalactic X-ray transients in Chandra surveys
Authors: Yang (杨光) G , Brandt W N , Zhu (朱世甫) S F , Bauer F E , Luo (罗斌) B , Xue (薛永泉) Y Q , Zheng (郑学琛) X C
Published: June 2019

Recent works have discovered two fast (≈10 ks) extragalactic X-ray transients in the Chandra Deep Field-South (CDF-S XT1 and XT2). These findings suggest that a large population of similar extragalactic transients might exist in archival X-ray observations. We develop a method that can effectively detect such transients in a single Chandra exposure, and systematically apply it to Chandra surveys of CDF-S, CDF-N, DEEP2, UDS, COSMOS, and E-CDF-S, totaling 19 Ms of exposure. We find 13 transient candidates, including CDF-S XT1 and XT2. With the aid of available excellent multiwavelength observations, we identify the physical nature of all these candidates. Aside from CDF-S XT1 and XT2, the other 11 sources are all stellar objects, and all of them have z-band magnitudes brighter than 20. We estimate an event rate of ${59^{+77}_{-38}\ \rm {evt\ yr^{-1}\, deg^{-2}}}$ for CDF-S XT-like transients with 0.5–7 keV peak fluxes log Fpeak ≳ −12.6 (erg cm−2 s−1). This event rate translates to ${\approx 15^{+20}_{-10}}$ transients existing among Chandra archival observations at Galactic latitudes |b| > 20°, which can be probed in future work. Future missions such as Athena and the Einstein Probe with large grasps (effective area × field of view) are needed to discover a large sample (∼thousands) of fast extragalactic X-ray transients.
TRAF6 mediates human DNA2 polyubiquitination and nuclear localization to maintain nuclear genome integrity
Authors: Meng Yuan , Liu Changwei , Shen Lei , Zhou Mian , Liu Wenpeng , Kowolik Claudia , Campbell Judith L , Zheng Li , Shen Binghui
Published: June 2019

The multifunctional human DNA2 (hDNA2) nuclease/helicase is required to process DNA ends for homology-directed recombination repair (HDR) and to counteract replication stress. To participate in these processes, hDNA2 must localize to the nucleus and be recruited to the replication or repair sites. However, because hDNA2 lacks the nuclear localization signal that is found in its yeast homolog, it is unclear how its migration into the nucleus is regulated during replication or in response to DNA damage. Here, we report that the E3 ligase TRAF6 binds to and mediates the K63-linked polyubiquitination of hDNA2, increasing the stability of hDNA2 and promoting its nuclear localization. Inhibiting TRAF6-mediated polyubiquitination abolishes the nuclear localization of hDNA2, consequently impairing DNA end resection and HDR. Thus, the current study reveals a mechanism for the regulation of hDNA2 localization and establishes that TRAF6-mediated hDNA2 ubiquitination activates DNA repair pathways to maintain nuclear genome integrity.
Co-SELECT reveals sequence non-specific contribution of DNA shape to transcription factor binding in vitro
Authors: Pal Soumitra , Hoinka Jan , Przytycka Teresa M
Published: June 2019

Understanding the principles of DNA binding by transcription factors (TFs) is of primary importance for studying gene regulation. Recently, several lines of evidence suggested that both DNA sequence and shape contribute to TF binding. However, the following compelling question is yet to be considered: in the absence of any sequence similarity to the binding motif, can DNA shape still increase binding probability? To address this challenge, we developed Co-SELECT, a computational approach to analyze the results of in vitro HT-SELEX experiments for TF–DNA binding. Specifically, Co-SELECT leverages the presence of motif-free sequences in late HT-SELEX rounds and their enrichment in weak binders allows Co-SELECT to detect an evidence for the role of DNA shape features in TF binding. Our approach revealed that, even in the absence of the sequence motif, TFs have propensity to bind to DNA molecules of the shape consistent with the motif specific binding. This provides the first direct evidence that shape features that accompany the preferred sequence motifs also bestow an advantage for weak, sequence non-specific binding.
Associations Between Exposure and Receptivity to Branded Cigarette Advertising and Subsequent Brand Preference Among US Young Adults
Authors: Moran Meghan Bridgid , Soneji Samir , Tan Andy S L , Choi Kelvin
Published: June 2019

Introduction

Exposure and receptivity to cigarette advertising are well-established predictors of cigarette use overall. However, less is known about whether exposure and receptivity to advertising for specific brands of cigarettes (ie, Marlboro, Camel, and Newport) are longitudinally associated with any subsequent cigarette use and subsequent use of those specific brands.

Methods

We analyzed data from a US sample of 7325 young adults aged 18–24 years who completed both Wave 1 and Wave 2 of the Population Assessment of Tobacco and Health study. Weighted logistic regression models were used to examine (1) among Wave 1 never-smokers, associations between Wave 1 exposure and receptivity to advertising for Marlboro, Camel, and Newport and subsequent overall and brand-specific smoking initiation at Wave 2, and (2) among Wave 1 ever-smokers, associations between Wave 1 exposure and receptivity to advertising for Marlboro, Camel, and Newport and subsequent preference of those brands at Wave 2.

Results

Among Wave 1 young-adult never-smokers, exposure to Camel advertising, but not Marlboro or Newport, was associated with smoking initiation with any brand of cigarettes at Wave 2. Among Wave 1 young-adult ever-smokers, receptivity to Marlboro, Camel, and Newport advertising was associated with subsequent preference for each brand, respectively, at Wave 2.

Conclusions

This study found evidence for the association between receptivity to branded cigarette marketing and subsequent use of that brand. These findings provide evidence regarding the pathways through which cigarette marketing attracts young adults to use cigarettes and can inform tobacco prevention and counter-marketing efforts.

Implications

This study extends prior work on the effects of cigarette advertising exposure and receptivity by illustrating the brand specificity of this advertising. These findings provide evidence that receptivity to branded cigarette advertising is longitudinally associated with preference for those specific cigarette brands.
Workers’ recovery from concussions presenting to the emergency department
Authors: Gaudet L A , Eliyahu L , Beach J , Mrazik M , Cummings G , Voaklander D C , Rowe B H
Published: June 2019

Background

The emergency department (ED) is the first point of care for many patients with concussion, and post-concussion syndrome can impact vocational outcomes like successful return to work. Evaluation of concussion in general adult populations is needed.

Aims

To document the occurrence and outcomes of work-related concussion presenting to the ED for treatment.

Methods

This study enrolled adults presenting with concussion to three urban Canadian EDs. Baseline ED interviews, physician questionnaires and patient phone interviews at 30 and 90 days documented work-related events, ED management, discharge advice, patient adherence and symptom severity. Work-related injury and return to work were modelled using logistic or linear regression, as appropriate.

Results

Overall, 172 enrolled workers completed at least one follow-up. Work-related concussions were uncommon (n = 28). Most employees (80%) missed at least 1 day of work (median = 7; interquartile range: 3–14). Most (91%) employees returned to work within 90 days, while 41% reported persistent symptoms. Manual labour and self-reported history of attention deficit hyperactivity disorder were associated with work-related concussion, while days of missed work increased with marital status (divorced), history of sleep disorder and physician’s advice to avoid work.

Conclusion

Work-related concussions are infrequent; however, most workers who sustain a concussion will miss work, and many return while still experiencing symptoms. Work-related concussion and days of missed work are mainly affected by non-modifiable factors. Workers, employers and the workers’ compensation system should take necessary precautions to ensure that workers return to work safely and successfully following a concussion.
Excessive daytime sleepiness and alcohol consumption among commercial drivers
Authors: Filomeno R , Ikeda A , Maruyama K , Wada H , Tanigawa T
Published: June 2019

Background

Commercial drivers suffering from excessive daytime sleepiness (EDS) have been identified as a major cause of road traffic accidents. Alcohol usage directly affects sleep, adversely affecting next-day alertness and performance.

Aims

To examine the relationship between alcohol consumption and EDS among commercial truck drivers in Japan and the implications of this on public health.

Methods

All participants in this cross-sectional study were commercial motor vehicle drivers from Tokyo and Niigata Prefecture. Participants completed a self-administered questionnaire with details of their age, body mass index, alcohol consumption, Epworth Sleepiness Scale (ESS) score and tobacco usage. Participants’ oxygen desaturation index was determined by a pulse oximetry device that participants took home.

Results

A total of 1422 males registered with the Japan Trucking Association and aged 20–69 years participated. The multivariate-adjusted odds ratio (OR) of EDS among participants aged <43 years was 0.81 (95% confidence interval (CI) 0.47–1.40) for light drinkers, 0.93 (95% CI 0.51–1.70) for moderate drinkers and 0.61 (95% CI 0.21–1.79) for heavy drinkers, compared to non-drinkers. The multivariate-adjusted OR among participants aged ≥43 years was 1.42 (95% CI 0.59–3.45) for light drinkers, 1.53 (95% CI 0.63–3.75) for moderate drinkers and 3.37 (95% CI 1.14–9.96) for heavy drinkers (P for interaction = 0.05).

Conclusion

We found that the association between ESS and alcohol intake was more evident among those aged ≥43 years, who reported higher levels of EDS with increased alcohol consumption.
Occipital to Angular Artery Bypass for Post-irradiation Ischemia: 3-Dimensional Operative Video
Authors: Zenonos Georgios A , Morcos Jacques J
Published: June 2019

The authors present a 3D surgical video of a direct occipital to angular artery bypass for cerebral revascularization in the setting of Post-irradiation middle cerebral artery stenosis and symptomatic hypoperfusion. The case refers to a 50-yr-old woman with a history of an unresectable residual skull base meningioma, previously approached through a left frontotemporal craniotomy, and treated with radiation 5 yr prior to presentation. She now presented with right-sided limb shaking transient ischemic attacks and aphasia, along with evidence of left middle cerebral artery territory ischemia. Her symptoms were progressive, despite extensive external carotid collateral blood supply through the prior craniotomy.

The video analyzes the surgical steps of the procedure, emphasizing multiple surgical pearls. After positioning, an incision is designed to expose the full course of the occipital artery. After dissection of the donor vessel, a craniotomy is performed to expose the distal sylvian fissure. The donor and recipient vessels are prepared, and the anastomosis is performed with interrupted sutures given the sub-millimeter diameter of the recipient vessel (suture used: 10-0 Ethilon BV75-3 Taper, Ethicon, Johnson & Johnson). Every step of the closure is modified to avoid any constriction of the donor vessel. The patient tolerated the procedure well, and multiple modalities, both intra- and post operatively confirmed patency of, and robust flow within the bypass.

No identifying patient information is included. However, the patient's consent was obtained for this publication.
Transdiscal C7 Pedicle Subtraction Osteotomy With a Strut Graft and the Correction of Sagittal and Coronal Imbalance of the Cervical Spine
Authors: Park Jong-Hyeok , Lee Jong Beom , Kim Il Sup , Hong Jae Taek
Published: June 2019

BACKGROUND

Cervical spine deformity negatively affects patients’ quality of life. Pedicle subtraction osteotomy (PSO) has reported to correct cervical deformity but it is challenging and carries a significant risk of morbidity.

OBJECTIVE

To report transdiscal C7 PSO with a strut graft for the correction of sagittal and coronal imbalance in patients with fixed cervical deformity.

METHODS

After standard exposure, the spine was instrumented from C2 to T3. T1 subtotal laminectomy, and C6 to C7 total laminectomies were necessary for C7 PSO. Osteotomy was initiated with removal of C6–7 and C7–T1 facet joints to isolate C7 pedicles and identify bilateral C7/C8 roots. Bilateral C7 pediculectomies and transdiscal PSO were performed. A rectangular strut allograft was then inserted into the PSO site. The location of the strut graft was used as a fulcrum of sagittal and coronal correction. The head fixator was released and the head was extended under intraoperative neuromonitoring, and then detailed sagittal and coronal balances were controlled by compressing or distracting between the pedicle screws above and below the osteotomy.

RESULTS

This technique was applied in 2 patients with fixed subaxial cervical deformities. Transdiscal PSO could add more amount of correction and provide the additional fusion surface. The strut graft prevented sagittal translation, foraminal narrowing, and excessive focal cord kinking during PSO. Both patients showed radiologic and clinical improvements after surgery, and no neurovascular complication occurred after the surgery.

CONCLUSION

Transdiscal C7 PSO with a strut graft placement provided a safe way of correcting sagittal and coronal imbalance simultaneously and reduced neurological complication by preventing sagittal translation, foraminal narrowing and spinal cord kinking.
Injectable Amniotic Membrane/Umbilical Cord Particulate for Knee Osteoarthritis: A Prospective, Single-Center Pilot Study
Authors: Castellanos Ramon , Tighe Sean
Published: June 2019

Objective

To evaluate the short-term safety and effectiveness of amniotic membrane/umbilical cord particulate (AMUC) in managing pain in patients with various severities of knee osteoarthritis (OA).

Design

Single-center, prospective, investigator-initiated pilot study.

Setting

Private practice.

Subjects

A total of 20 knee OA patients aged ≥18 years were enrolled with pain >40 mm, as determined by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)–A.

Methods

Patients received an ultrasound-guided, intra-articular injection of 50 mg of AMUC particulate reconstituted in 2 mL of preservative-free saline. All patients were then monitored at six weeks, 12 weeks, and 24 weeks postinjection. Patients who did not show >30% reduction in pain received a second injection of AMUC at six weeks. WOMAC, Patient Global Assessment, medication usage, and magnetic resonance imaging (MRI) were assessed.

Results

Knee OA pain significantly decreased from 74.3 ± 17.2 at baseline to 45.0 ± 25.4 at six weeks (P < 0.01), 35.4 ± 26.6 at 12 weeks (P < 0.001), and 37.4 ± 26.7 at 24 weeks (P < 0.001). This pain reduction was associated with a significant improvement in physical function (WOMAC-C) at all time points (P < 0.05) and stiffness (WOMAC-B) at 12 weeks (P = 0.01). Eleven patients received a second injection, which was significantly correlated with body mass index >30 kg/m2 (P = 0.025). MRI evaluation of the overall population revealed an improvement in the severity of bone marrow lesions in seven patients. No adverse events were observed.

Conclusions

AMUC particulate injection relieved pain and improved physical function in patients with symptomatic knee OA.
Malignant Hyperthermia During Translabyrinthine Acoustic Neuroma Surgery After Previous Uneventful Surgery
Authors: Erbele Isaac , Chapman Eric , Wilson Meghan N. , Arriaga Moises A.
Published: June 2019

Objective:

Review current literature and guidelines for malignant hyperthermia in the context of neurotologic surgery.

Patient:

A case of malignant hyperthermia during vestibular schwannoma surgery, in a patient previously exposed to anesthesia.

Interventions:

Excision of vestibular schwannoma, acute management of malignant hyperthermia.

Main Outcome Measures:

Knowledge of the basic pathophysiology, clinical manifestations, and treatment protocols for malignant hyperthermia.

Results:

Rapid termination of the procedure and appropriate modifications in surgical technique permitted expeditious treatment of malignant hyperthermia and prevented its lethality.

Conclusions:

Malignant hyperthermia is a rare and lethal condition that may arise in neurotologic surgery, even in patients who have previously received general anesthesia. The neurotologic surgeon has a role in early recognition and expeditious termination of surgery to help reduce its mortality.
Benefit of Gemcitabine/Nab-Paclitaxel Rescue of Patients With Borderline Resectable or Locally Advanced Pancreatic Adenocarcinoma After Early Failure of FOLFIRINOX
Authors: Vreeland Timothy J. , McAllister Florencia , Javadi Sanaz , Prakash Laura R. , Fogelman David R. , Ho Linus , Varadhachary Gauri , Aloia Thomas A. , Vauthey Jean-Nicolas , Lee Jeffrey E. , Kim Michael P. , Katz Matthew H. G. , Tzeng Ching-Wei D.
Published: June 2019

Objectives

Neoadjuvant therapy (NT) is used for advanced pancreatic ductal adenocarcinoma (PDAC). No clear guidelines exist for switching therapies when patients do not respond to initial NT. We sought to characterize patients who underwent early switch from FOLFIRINOX to gemcitabine/nab-paclitaxel (GA) as NT for PDAC.

Methods

We identified patients at a single institution switched from FOLFIRINOX to GA within the first 4 months of NT for PDAC during 2012–2017. We compared clinicopathologic data and oncologic outcomes.

Results

Of 25 patients who met the criteria, 21 showed a serologic or radiographic response to GA; 11 (52%) reached resection. Responders had decreased carbohydrate antigen (CA) 19-9 levels from pretreatment to post-GA (P = 0.036). Resected responders had significantly decreased CA 19-9 comparing preswitch to post-GA (P = 0.048). The only predictor of GA response was prechemotherapy CA 19-9 of less than1000 U/mL (P = 0.021). Predictors of reaching resection were head/uncinate tumor (P = 0.010) and presenting stage lower than locally advanced (P = 0.041).

Conclusions

When patients do not respond to neoadjuvant FOLFIRINOX, early switch to GA should be considered. Future efforts should be directed toward identifying markers that will allow correct choice of initial therapy rather than attempting to rescue patients who respond poorly to first-line therapy.
Symptom Experience of Older Adults With Type 2 Diabetes and Diabetes-Related Distress
Authors: Hernandez Lenore , Leutwyler Heather , Cataldo Janine , Kanaya Alka , Swislocki Arthur , Chesla Catherine
Published: June 2019

Background

An older, more diverse population and longer life spans are major contributors to the anticipated tripling of Type 2 diabetes prevalence by 2050. Diabetes-related distress affects up to 40% of people diagnosed with Type 2 diabetes and may be a greater risk for older adults due to greater prevalence of comorbidities.

Objective

The objective of this phenomenological study was to describe how diabetes-related distress in older adults (≥65 years) with Type 2 diabetes might be uniquely experienced.

Methods

Participants were recruited using convenience sampling and snowball sampling. Interpretive phenomenology guided the research design and analysis. With interpretive interviews, we investigated the everyday health, symptoms, and life experiences of living with Type 2 diabetes and elevated diabetes distress.

Results

Among the older adults in this study, the most prevalent symptoms were fatigue, hypoglycemia, diarrhea, pain, loss of balance, and falling. These diabetes-related symptoms led to substantial loss of independence, decreased quality of life, and constrained social lives due to restricted activities.

Discussion

Diabetes-related distress presents with some unique symptoms and responses in older adults. Improving knowledge regarding the symptom experience of older adults with diabetes-related distress may allow healthcare providers to tailor treatment and thus improve outcomes for older adults struggling with diabetes.
Early Intervention Therapy Services for Infants With or at Risk for Cerebral Palsy
Authors: Gmmash Afnan S. , Effgen Susan K.
Published: June 2019

Objective:

The purpose of this study was to explore the practices physical therapists and occupational therapists use in early intervention (EI) for infants with or at risk for cerebral palsy (CP).

Methods:

A survey was disseminated nationally to EI providers using an online anonymous link.

Results:

Two hundred sixty-nine therapists completed at least 50% of the survey. Four percent of therapists use the General Movement Assessment to predict CP, 57% reported infants at risk for CP receive therapy once a week, 89% identified parents' goals as the most important factor in customizing the EI program, and 75% provide parents with home programs. However, 73% never or rarely use outcome measures to prioritize parents' goals; 31% provide parents with individualized home program and more than 60% never assess environmental enrichment.

Conclusion:

Therapists do not incorporate sufficient strategies for goal-oriented interventions, comprehensive parent education, and optimum environmental enrichment.
LAG-3 and GAL-3 in Endometrial Carcinoma: Emerging Candidates for Immunotherapy
Authors: Friedman Lisa A. , Ring Kari L. , Mills Anne M.
Published: June 2019

LAG-3 is an immunosuppressive checkpoint molecule expressed on T cells. One of its ligands, GAL-3, can promote the progression of malignancy and has been identified on tumor cells. Both LAG-3 and GAL-3 are the targets of emerging immunotherapies, but have not been well-studied in endometrial carcinomas. LAG-3, CD3, and GAL-3 immunohistochemistry was performed on 75 endometrial cancers (25 nonmethylated mismatch repair-deficient, 25 MLH1-hypermethylated mismatch repair-deficient, and 25 mismatch repair-intact). LAG-3+ and CD3+ lymphocytes were averaged per high-power field. Tumoral GAL-3 expression was semiquantitatively scored. Tumor-infiltrating lymphocyte expression of LAG-3 and CD3 were positively correlated (Spearman ρ=0.521, P<0.001) and greater in mismatch repair–deficient compared with mismatch repair–intact tumors (LAG-3: P<0.001; CD3: P<0.001). The majority (64%) of endometrial carcinomas demonstrated ≥1% tumoral GAL-3 expression, with higher rates in mismatch repair-deficient versus intact tumors at the ≥1% (80% vs. 32%, P<0.001) and the ≥5% thresholds (52% vs. 16%, P=0.003). At the ≥5% threshold, nonmethylated mismatch repair-deficient cancers were more likely than intact tumors carcinomas to express GAL-3 (60% vs. 4/25 16%, P=0.003). LAG-3+ lymphocytes were positively correlated with GAL-3 expression in nonmethylated mismatch repair-deficient endometrial carcinomas only (Spearman ρ=0.461, P=0.020). LAG-3+ tumor-associated lymphocytes and GAL-3+ neoplastic cells are common in endometrial carcinomas, particularly in nonmethylated mismatch repair-deficient cancers. This supports a role for immunotherapies targeting LAG-3 and/or GAL-3 in a subset of endometrial carcinomas, potentially in concert with other checkpoint inhibitors.
Toxic Shock Syndrome Caused by Staphylococcal Infection After Breast Implant Surgery
Authors: Hisanaga Kana , Kadota Hideki , Fukushima Seita , Inatomi Yusuke , Shimamoto Ryo , Kamizono Kenichi , Hanada Masuo , Yoshida Sei
Published: June 2019

Toxic shock syndrome is a rare but life-threatening complication after breast implant surgery. We describe a 77-year-old woman who developed toxic shock syndrome caused by methicillin-resistant Staphylococcus aureus after breast implant reconstruction. Despite a high fever and markedly increased white blood cell count, suggesting severe infection, she initially had no symptoms of local findings, such as wound swelling and redness of the breast. Soon after diagnosis of toxic shock syndrome and removal of her breast implant, she was recovered from the shock state. To date, 16 cases of toxic shock syndrome have been reported, including this case, and they were related to breast implants or tissue expander surgery. The common and noteworthy characteristic of these cases was the lack of local findings, such as swelling or redness, which suggests infection. Therefore, early diagnosis is generally difficult, and the initiation of proper treatment can be delayed without knowledge of this characteristic. Toxic shock syndrome requires early diagnosis and treatment. If the patient has a deteriorated vital sign after breast implant surgery or tissue expander breast reconstruction, toxic shock syndrome should be suspected, even if there are no local signs of infection, and removal of the artifact should be considered as soon as possible.
Chaperone Use in Plastic and Reconstructive Surgery Outpatient Clinics
Authors: Vakayil Victor , Kim Nicholas , Barta Jo , Choudry Umar
Published: June 2019

Introduction

Patient perspectives on chaperone use during examinations, especially in surgical subspecialties, are understudied. We aimed to identify specific patient cohorts that desire the presence of chaperones and compare patient and surgeon perspectives, all in an effort to improve quality of care.

Methods and Materials

We prospectively administered a 15-question survey to all patients visiting 2 plastic surgery outpatient clinics between January 2015 and April 2016. Data on demographics, types of procedures (cosmetic or reconstructive), area of examination (sensitive or nonsensitive), views on chaperone use, type of chaperone, and instances of inappropriate behavior by surgeons were collected. Univariate analysis was performed after stratifying patients on their individual desire to have a chaperone. Subsequently, multivariate regression models were constructed to identify individual patient cohorts independently more likely to require a chaperone.

Results

A total of 398 participants were surveyed. There were 58.3% female and 41.7% male respondents; of whom 41.8% were 55 years or older and 8.1% were younger than 24 years. Ninety percent of all patients were receiving care for a reconstructive procedure. Most (77%) were being examined over a nonsensitive area. Overall, 82.1% preferred not to have a chaperone present during examinations. Most (72.6%) felt the sex of the examining physician was inconsequential to their need for a chaperone. Most (54.8%) preferred either a family member or a friend to be the chaperone. Only 1.8% (n = 7) experienced inappropriate behavior, of whom 77% (n = 5) noted the absence of a chaperone while being examined. On multivariate analysis, younger patients and examination over a sensitive area were independently associated with a higher odd of requiring a chaperone (odds ratios, 3.4 [95% confidence interval, 1.3–8.9; P = 0.016] and 3.9 [95% confidence interval, 1.9–6.7; P < 0.001], respectively).

Conclusions

Most patients did not want a chaperone during examinations. Younger patients and those having a sensitive area examined were independently more likely to desire a chaperone. Patients preferred having their family member or friend as their chaperone. Given the major differences in perceptions, plastic surgeons should consider selectively using chaperones rather than the carte blanche use of chaperones with every patient.
Effects of Dressing Materials on Donor Site Morbidity
Authors: Macharia Mwea , Nangole Ferdinand Wanjala
Published: June 2019

Skin graft donor wounds should heal with rapid epithelialization resulting in good aesthetic and minimal donor site morbidity. Several dressing materials are now available for the dressing of the donor sites. Few studies have, however, been done to compare the efficacy of these dressing materials.

This study compared the effectiveness of paraffin gauze, hydrocolloid, antimicrobial biguanide foam, and silver hydrofiber dressings on donor site wounds at a tertiary hospital in Kenya.

Patients who underwent split-thickness skin graft were recruited and randomized into 4 arms. The donor site wound was dressed with either of the 4 dressing material mentioned earlier. The patient and observers were blinded. Outcome variables that were assessed were donor site pain on days 1, 3, and 10, and infection and percentage epithelialization on day 10.

Wounds dressed with hydrocolloids were the least painful on all the 3 postoperative days assessed. Those dressed with paraffin gauze were the most painful on day 1, whereas those with antimicrobial foam were the most painful on the 10th day. The mean (SD) percentage epithelialization of the wounds on the 10th day were as follows; hydrocolloids, 92.2% (20.9%); silver hydrofiber, 91.4% (18.8%); paraffin gauze, 73.4% (24.9%); and antimicrobial biguanide foam, 11.0% (10.3%). Paraffin gauze dressed wounds were the most infected at 22%.

In conclusion, all the 4 dressing materials had different scores among the factors assessed. Hydrocolloids dressings and silver hydrofiber dressing would, however, be the preferred dressing materials for the donor site based on these study findings as reflected by the high epithelialization low infection rates and less pain.
Detection and quantification of Erysipelothrix rhusiopathiae in blood from infected chickens – addressing challenges with detection of DNA from infectious agents in host species with nucleated red blood cells
Authors: Wattrang Eva , Jäderblom Victoria , Jinnerot Tomas , Eriksson Helena , Bagge Elisabeth , Persson Maria , Dalgaard Tina Sørensen , Söderlund Robert
Published: June 2019

Purpose. The present study aimed to establish pretreatment protocols as well as real-time and droplet digital polymerase chain reaction (PCR) methodologies to detect and quantify

Erysipelothrix rhusiopathiae

(ER) DNA in blood samples from infected chickens, as tools for routine diagnostics and monitoring of experimental infections. Chicken blood is a problematic matrix for PCR analysis because nucleated erythrocytes contribute large amounts of host DNA that inhibit amplification.

Methodology. Using artificially spiked samples of fresh chicken blood, as well as blood samples from three experimental infection studies, the performance of pretreatment protocols, including choice of blood stabilization agent, centrifugation speeds and Ficoll gradient separation, was evaluated. The results were compared with those from traditional culture-based protocols combined with matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS).

Results/Key findings. Simple preparations producing cell-free samples performed well on artificial spike-in samples, providing high sensitivity. However, performance was poor in clinical samples or artificial samples where the bacteria were incubated for 4 h or more in fresh blood prior to DNA extraction. In these samples, a Ficoll separation protocol that creates samples rich in lymphocytes, monocytes and thrombocytes prior to DNA extraction was far more effective.

Conclusions. Our results indicate that ER bacteria undergo rapid phagocytosis in chicken blood and that analysis of a blood fraction enriched for phagocytic cells is necessary for reliable detection and quantification. The presented results explain the poor performance of PCR detection reported in previously published experimental ER infection studies, and the proposed solutions are likely to have broader implications for PCR-based veterinary diagnostics in non-mammalian host species such as poultry and fish.
Real-time monitoring of mechanical cues in the regenerative niche reveal dynamic strain magnitudes that enhance bone repair
Authors: Klosterhoff Brett S. , Kaiser Jarred , Nelson Bradley D. , Karipott Salil S. , Ruehle Marissa A. , Hollister Scott J. , Weiss Jeffrey A. , Ong Keat Ghee , Willett Nick J. , Guldberg Robert E.
Published: June 2019

Mechanical loads exerted on the skeleton during activities such as walking are important regulators of bone repair, but dynamic biomechanical signals are difficult to measure inside the body. The inability to measure the mechanical environment in injured tissues is a significant barrier to developing integrative regenerative and rehabilitative strategies that can accelerate recovery from fracture, segmental bone loss, and spinal fusion. Here we engineered an implantable strain sensor platform and measured strain across a bone defect in real-time throughout rehabilitation. We used the sensor to longitudinally quantify mechanical cues imparted by a load-sharing fixation plate that significantly enhanced bone regeneration in rats. We found that sensor readings correlated with the status of healing, suggesting a potential role for strain sensing as an X-ray-free healing assessment platform. This study demonstrates a promising approach to quantitatively develop and exploit mechanical rehabilitation strategies that enhance bone repair.
Kinetics of Xist-induced gene silencing can be predicted from combinations of epigenetic and genomic features
Authors: Barros de Andrade e Sousa Lisa , Jonkers Iris , Syx Laurène , Dunkel Ilona , Chaumeil Julie , Picard Christel , Foret Benjamin , Chen Chong-Jian , Lis John T. , Heard Edith , Schulz Edda G. , Marsico Annalisa
Published: June 2019

To initiate X-Chromosome inactivation (XCI), the long noncoding RNA Xist mediates chromosome-wide gene silencing of one X Chromosome in female mammals to equalize gene dosage between the sexes. The efficiency of gene silencing is highly variable across genes, with some genes even escaping XCI in somatic cells. A gene's susceptibility to Xist-mediated silencing appears to be determined by a complex interplay of epigenetic and genomic features; however, the underlying rules remain poorly understood. We have quantified chromosome-wide gene silencing kinetics at the level of the nascent transcriptome using allele-specific Precision nuclear Run-On sequencing (PRO-seq). We have developed a Random Forest machine-learning model that can predict the measured silencing dynamics based on a large set of epigenetic and genomic features and tested its predictive power experimentally. The genomic distance to the Xist locus, followed by gene density and distance to LINE elements, are the prime determinants of the speed of gene silencing. Moreover, we find two distinct gene classes associated with different silencing pathways: a class that requires Xist-repeat A for silencing, which is known to activate the SPEN pathway, and a second class in which genes are premarked by Polycomb complexes and tend to rely on the B repeat in Xist for silencing, known to recruit Polycomb complexes during XCI. Moreover, a series of features associated with active transcriptional elongation and chromatin 3D structure are enriched at rapidly silenced genes. Our machine-learning approach can thus uncover the complex combinatorial rules underlying gene silencing during X inactivation.
Can ethical leadership hinder sales performance? A limited resource perspective of job embeddedness
Authors: Lee Chih-Jen , Huang Stanley Y.B.
Published: June 2019

Purpose

The purpose of this study is to borrow from a limited resource view of job embeddedness to argue that ethical leadership can hurt salespeople’s growth of sales performance by a latent growth model.

Design/methodology/approach

This work surveyed 825 salespeople in Greater China at three points over six months to test the latent growth model.

Findings

The findings reveal that as salespeople perceive more ethical leadership at the initial point, they may show more increases in job embeddedness behavior development that lead to decreases in social capital and human capital behavior development, which consequently decreases sales performance over time.

Originality/value

These findings unearth a novel idea that ethical leadership may erode growth of sales performance over time.
Knowledge sharing of inpatriates
Authors: Schuster Tassilo , Holtbrügge Dirk , Engelhard Franziska
Published: June 2019

Purpose

The purpose of this study is to analyze the effects of inpatriates’ abilities, motivation and opportunities on knowledge sharing and the moderating role of boundary spanning in this context.

Design/methodology/approach

By integrating the ability–motivation–opportunity framework with the concept of boundary spanning four hypotheses are developed, which are tested against the data of 187 inpatriates working in Germany.

Findings

The study reveals that inpatriates’ motivation and certain opportunities are positively related to knowledge sharing, whereas inpatriates’ abilities do not show a positive effect. Moreover, it is shown that inpatriate boundary spanning has a moderating effect on this relationship.

Originality/value

Based on the results, the study enhances the current literature by introducing the concept of reputation asymmetry. Moreover, requirements of how inpatriates’ assignments should be designed and implications for further research are outlined.
Introduce a novel configurationof microchannel andhigh-conductivity insertsfor cooling of disc-shaped electronic components
Authors: Dadsetani Reza , Sheikhzadeh Ghanbar Ali , Hajmohammadi Mohammad Reza , Safaei Mohammad Reza
Published: June 2019

Purpose

Electronic components’ efficiency is the cornerstone of technology progress. The cooling process used for electronic components plays a main role in their performance. Embedded high-conductivity material and provided microchannel heat sink are two common cooling methods. The former is expensive to implement while the latter needs micro-pump, which consumes energy to circulate the flow. The aim of this study is providing a new configuration and method for improving the performance of electronic components.

Design/methodology/approach

To manage these challenges and improve the cooling efficiency, a novel method named Hybrid is presented here. Each method's performance has been investigated, and the results are widely compared with others. Considering the micro-pump power, the supply of the microchannel flow and the thermal conductivity ratio (thermal conductivity ratio is defined as the ratio of thermal conductivity of high thermal conductivity material to the thermal conductivity of base solid), the maximum disk temperature of each method was evaluated and compared to others.

Findings

The results indicated that the Hybrid method can reduce the maximum disk temperature up to 90 per cent compared to the embedded high thermal conductivity at the same thermal conductivity ratio. Moreover, the Hybrid method further reduces the maximum disk temperature up to 75 per cent compared to the microchannel, at equivalent power consumption.

Originality/value

The information in this research is presented in such a way that designers can choose the desired composition, the limited amount of consumed energy and the high temperature of the component. According to the study of radial-hybrid configuration, the different ratio of microchannel and materials with a high thermal conductivity coefficient in the constant cooling volume was investigated. The goal of the investigation was to decrease the maximum temperature of a plate on constant energy consumption. This aim has been obtained in the radial-hybrid configuration.
Peer-to-peer accommodation services in the sharing economy
Authors: So Kevin Kam Fung , Xie Karen L. , Wu Jiang
Published: June 2019

Purpose

This study aims to focus on peer-to-peer accommodation services in the sharing economy. Adopting construal level theory as the theoretical foundation, this study investigates the main and interaction effects of social and spatial distances on guest loyalty toward peer-to-peer accommodation.

Design/methodology/approach

This study uses a secondary source of online observational data archived on Xiaozhu, a leading peer-to-peer accommodation sharing platform in China. It consists of 2,612 observations of 1,304 unique travelers who stayed at 559 listings managed by 281 hosts in four major metropolitan areas of China over four years from August 2012 to August 2016. Non-linear binary choice panel models of probability regressions were used to estimate the effects of psychological distances (social and spatial) between hosts and guests on the likelihood of repeat purchase. The software used for the econometric analyses is STATA 14.

Findings

The results indicate that social distance negatively affects guest loyalty toward the listing hosts, while spatial distance has a positive influence on guest loyalty. The results also show significant interactions between the two psychological distance dimensions in influencing loyalty. The findings provide important insight into the influences of psychological distances on travelers’ repeat purchase behavior toward peer-to-peer accommodation providers.

Originality/value

This study contributes to the literature by providing empirical evidence that supports the importance of psychological distances in forming a loyal relationship between hosts and guests in the peer-to-peer accommodation sector of the sharing economy.