bluuebunny/crossref_metadata_2025 huggingface dataset:
Ignored or Rejected: Retail Exclusion Effects on Construal Levels and Consumer Responses to Compensation
Authors: Sinha Jayati , Lu Fang-Chi
Published: May 2019

Among the top customer complaints regarding retailers are experiences of exclusionary treatment in the form of explicit condescension or implicit disregard. However, little is known about how consumers respond to different instances of exclusion in retail or service settings. This research focuses on how customers respond cognitively and emotionally when frontline staff reject or ignore them and on how retailers can recover from such service failures. Findings from six studies using exclusion as a hypothetical scenario or a real experience demonstrate that direct negative feedback leads customers to feel rejected and to form concrete low-level mental construals, while a lack of attention leads customers to feel ignored and to form abstract high-level construals. Explicit rejection (implicit ignoring) causes consumers to form more (less) vivid mental imagery of the exclusionary experience and to activate a concrete (abstract) mindset, resulting in preferences for tangible (intangible) and visual (textual) compensation options. Retailers are advised to align their compensation with construal levels to increase post-recovery customer satisfaction, customer reviews, intended loyalty, and brand referral behavior.
The Uncertain Self: How Self-Concept Structure Affects Subscription Choice
Authors: Savary Jennifer , Dhar Ravi
Published: May 2019

Whether it is clothing, meals or an exercise regimen, consumers purchase a wide range of goods on a recurring basis using a subscription model. While past research indicates that people continue to subscribe to these services even when they rarely use them, no work to date has examined how identity considerations affect preferences in this domain. Building on research on signaling and self-concept structure, we propose that quitting an ongoing subscription can threaten the stability of the self-concept by signaling a change in identity. Consumers who are uncertain about their self-concept (i.e., low self-concept clarity) and motivated to maintain a stable self-concept are thus more likely to keep unused subscriptions than those who are more certain. In support of the underlying mechanism, we demonstrate that self-concept clarity affects choices only for identity-relevant subscription choices, and that it affects choices for subscriptions, but not one-shot product choices that are a weaker signal of identity. Finally, because signing up for a new subscription also signals an identity change that can threaten the stability of the self, consumers with low self-concept clarity are also less likely to subscribe to a new service compared to those with more certain self-concepts.
Antibiotic Treatment Versus No Treatment for Asymptomatic Bacteriuria in Kidney Transplant Recipients: A Multicenter Randomized Trial
Authors: Sabé Núria , Oriol Isabel , Melilli Edoardo , Manonelles Anna , Bestard Oriol , Polo Carolina , Los Arcos Ibai , Perelló Manel , Garcia Dolors , Riera Lluís , Tebé Cristian , Len Òscar , Moreso Francesc , Cruzado Josep M , Carratalà Jordi
Published: May 2019

Background

Whether antibiotic treatment of asymptomatic bacteriuria (AB) can prevent acute graft pyelonephritis (AGP) in kidney transplant (KT) recipients has not been elucidated.

Methods

In this multicenter, open-label, nonblinded, prospective, noninferiority, randomized controlled trial, we compared antibiotic treatment with no treatment for AB in KT recipients in the first year after transplantation when urinary catheters had been removed. The primary endpoint was the occurrence of AGP. Secondary endpoints included bacteremic AGP, cystitis, susceptibility of urine isolates, graft rejection, graft function, graft loss, opportunistic infections, need for hospitalization, and mortality.

Results

We enrolled 205 KT recipients between 2013 and 2015. AB occurred in 41 (42.3%) and 46 (50.5%) patients in the treatment and no treatment groups, respectively. There were no differences in the primary endpoint in the intention-to-treat population (12.2% [5 of 41] in the treatment group vs 8.7% [4 of 46] in the no treatment group; risk ratio, 1.40; 95% confidence interval, 0.40–4.87) or the per-protocol population (13.8% [4 of 29] in the treatment group vs 6.7% [3 of 45] in the no treatment group; risk ratio, 2.07, 95% confidence interval, 0.50–8.58). No differences were found in secondary endpoints, except for antibiotic susceptibility. Fosfomycin (P = .030), amoxicillin-clavulanic (P < .001) resistance, and extended-spectrum β-lactamase production (P = .044) were more common in KT recipients receiving antibiotic treatment for AB.

Conclusions

Antibiotic treatment of AB was not useful to prevent AGP in KT recipients and may increase antibiotic resistance. However, our findings should be regarded with caution, due to the small sample size analyzed.
Cytokinin Signaling Is Essential for Organ Formation in Marchantia polymorpha
Authors: Aki Shiori S , Mikami Tatsuya , Naramoto Satoshi , Nishihama Ryuichi , Ishizaki Kimitsune , Kojima Mikiko , Takebayashi Yumiko , Sakakibara Hitoshi , Kyozuka Junko , Kohchi Takayuki , Umeda Masaaki
Published: May 2019

Cytokinins are known to regulate various physiological events in plants. Cytokinin signaling is mediated by the phosphorelay system, one of the most ancient mechanisms controlling hormonal pathways in plants. The liverwort Marchantia polymorpha possesses all components necessary for cytokinin signaling; however, whether they respond to cytokinins and how the signaling is fine-tuned remain largely unknown. Here, we report cytokinin function in Marchantia development and organ formation. Our measurement of cytokinin species revealed that cis-zeatin is the most abundant cytokinin in Marchantia. We reduced the endogenous cytokinin level by overexpressing the gene for cytokinin oxidase, MpCKX, which inactivates cytokinins, and generated overexpression and knockout lines for type-A (MpRRA) and type-B (MpRRB) response regulators to manipulate the signaling. The overexpression lines of MpCKX and MpRRA, and the knockout lines of MpRRB, shared phenotypes such as inhibition of gemma cup formation, enhanced rhizoid formation and hyponastic thallus growth. Conversely, the knockout lines of MpRRA produced more gemma cups and exhibited epinastic thallus growth. MpRRA expression was elevated by cytokinin treatment and reduced by knocking out MpRRB, suggesting that MpRRA is upregulated by the MpRRB-mediated cytokinin signaling, which is antagonized by MpRRA. Our findings indicate that when plants moved onto land they already deployed the negative feedback loop of cytokinin signaling, which has an indispensable role in organogenesis.
Cost impact of sobering centers on national health care spending in the United States
Authors: Scheuter Claudia , Rochlin Danielle H , Lee Chuan-Mei , Milstein Arnold , Kaplan Robert M
Published: May 2019

Acute alcohol intoxication is responsible for a sizable share of emergency department visits. Intoxicated individuals without other medical needs may not require the high level of care provided by an emergency department. We estimate the impact on U.S. health care spending if individuals with uncomplicated, acute alcohol intoxication were treated in sobering centers instead of the emergency department. We performed a budget impact analysis from the perspective of the U.S. health care system based on published and gray literature reports. Ninety-five percent confidence intervals (CI) were estimated using Monte Carlo modeling with random variation for three variables (cost of an emergency department visit, cost of a sobering center visit, and start-up costs per sobering center visit) and the percentage of cases diverted from emergency departments to sobering centers. Outcomes were expressed in terms of national savings in 2017 U.S. dollars. Assuming a diversion rate of 50% based on previous studies, national savings range from $230 million to $1.0 billion annually. In the Monte Carlo modeling, we found annual national savings of $99.02 million (95% CI: $95.89–$102.19 million), $792.34 million (95% CI: $767.09–$817.58 million), and $1,185.51 million (95% CI: $1,150.64–$1,226.37 million) with diversion rates of 5%, 40%, and 60%, respectively. Implementing sobering centers as a treatment alternative for individuals with uncomplicated acute alcohol intoxication could yield substantial cost savings for the U.S. health care system.
The translation of an evidence-based preschool physical activity intervention from in-person to online delivery of professional development to preschool teachers
Authors: Saunders Ruth P , Schenkelberg Michaela A , Moyer Christina , Howie Erin K , Brown William H , Pate Russell R
Published: May 2019

An intervention shown to be effective in a randomized controlled trial can be translated into an online professional development program and disseminated on a large scale in a timely manner.
5Queer Theory
Authors: Miller Jennifer L
Published: May 2019

This chapter identifies queer theory published in 2018 that engages various aspects of resistance. The review is divided into five sections: 1. Introduction; 2. Models of Resistance, 3. Movement Work and Resistance; 4. The Art of Resistance; 5. Concluding Notes: Critical Optimism.
Maternal Deaths From Hypertensive Disorders: Lessons Learnt
Authors: Nyfløt L.T. , Ellingsen L. , Yli B.M. , Øian P. , Vangen S.
Published: May 2019

(Acta Obstet Gynecol Scand. 2018;97:976–987)

In Norway, hypertensive disorders were the leading cause of maternal death from 1976 to 2011. Recent reductions reported in the maternal mortality ratio for hypertensive disorders in the United Kingdom indicate there is substantial potential for reducing maternal deaths in other countries from this cause, including Norway. The goal of this study was to evaluate maternal deaths from hypertensive disorders of pregnancy in Norway. The investigators hoped to identify aspects of care, such as antihypertensive therapy, anticonvulsant prophylaxis, and timing of delivery, where improvements might have resulted in better outcomes.
Postpartum Hemorrhage Outcomes and Race
Authors: Gyamfi-Bannerman C. , Srinivas S.K. , Wright J.D. , Goffman D. , Siddiq Z. , D’Alton M.E. , Friedman A.M.
Published: May 2019

(Am J Obstet Gynecol. 2018;219:185.e1–185.e10)

Postpartum hemorrhage is a leading contributor to maternal mortality. How race is associated with adverse outcomes in the setting of postpartum hemorrhage is not well characterized. Given that severe morbidity and mortality outcomes in the setting of postpartum hemorrhage may account for an important part of overall maternal disparities, the objective of this study was to determine whether race was associated with an increased risk for mortality and severe morbidity in the setting of obstetrical complications.
Cost-Benefit Analysis of Maintaining a Fully Stocked Malignant Hyperthermia Cart Versus an Initial Dantrolene Treatment Dose for Maternity Units
Authors: Ho P.T. , Carvalho B. , Sun E.C. , Macario A. , Riley E.T.
Published: May 2019

(Anesthesiology. 2018;129:249–259)

Understanding the cost-benefit trade-off of maintaining a malignant hyperthermia (MH) cart has important policy implications. The Malignant Hyperthermia Association of the United States recommends that operating room areas have dantrolene immediately available for administration (within 10 min). One approach to dantrolene availability is an MH cart, stocked with dantrolene, other drugs, and supplies, which is cost-effective in areas with a substantial number of general anesthetics. However, labor and delivery units rarely use MH—triggering drugs. If you consider a hospital with 6000 deliveries in a year with a 30% cesarean delivery rate and a 5% general anesthesia rate, general anesthesia will be used <100 times in 1 year. Such a low incidence prompts the question of whether the standard proposed is necessary for maternity units, because, to meet this standard, many maternity units should have their own MH cart. One may question if the resources used to maintain an MH cart may be better utilized on other initiatives that may have a more significant impact on maternal morbidity or mortality (such as a difficult airway cart).
Postpartum Hemorrhage: New Insights for Definition and Diagnosis
Authors: Borovac-Pinheiro A. , Pacagnella R.C. , Cecatti J.G. , Miller S. , El Ayadi A.M. , Souza J.P. , Durocher J. , Blumenthal P.D. , Winikoff B.
Published: May 2019

(Am J Obstet Gynecol. 2018;219(2):162–168)

Prevalence estimates for postpartum hemorrhage (PPH) vary in the literature from 1% to 10% of all deliveries with PPH responsible for >80,000 deaths worldwide in 2015. The most commonly accepted definition of PPH is based on the amount of blood lost after birth. The World Health Organization defined PPH as blood loss of >500 mL from the genital tract after vaginal delivery. This current definition is inadequate. A stronger definition of PPH should include both blood loss and clinical signs of cardiovascular changes after delivery, which would help providers to identify PPH more promptly and accurately.
Obstetric Anesthesiology in the United States: Current and Future Demand for Fellowship-trained Subspecialists
Authors: Gelber K. , Kahwajian H. , Geller A.W. , Zakowski M.I.
Published: May 2019

(Anesth Analg. 2018;127:1445–1447)

Subspeciality training in obstetric anesthesiology is associated with improved patient outcomes (27% reduction in risk of maternal death). Therefore, it is no surprise that the 2015 American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal Fetal Medicine (SMFM) consensus document for improved referral and regionalization of high-risk obstetric services proposed defined levels of high-risk obstetric services with specific requirements. Level II centers require a board-certified anesthesiologist with special training or experience in obstetrics available for consultation, whereas in level III-IV centers, this board-certified anesthesiologist must also be “in charge of obstetric anesthesia services” (level I: birth centers, basic care; II: specialty care; III: subspecialty care; IV: regional perinatal health centers). Considering that the demand for obstetric anesthesia services has increased dramatically in the past few decades, the authors of the present article estimate the workforce demand for fellowship-trained obstetric anesthesiologists (FTOAs).
Obstetrical Providers’ Preferred Mode of Delivery and Attitude Toward Nonmedically Indicated Caesarean Sections: A Cross-Sectional Study
Authors: Rivo J.C. , Amyx M. , Pingray V. , Casale R.A. , Fiorillo A.E. , Krupitzki H.B. , Malamud J.D. , Mendilaharzu M. , Medina M.L. , Del Pino A.B. , Ribola L. , Schvartzman J.A. , Tartalo G.M. , Trasmonte M. , Varela S. , Althabe F. , Belizán J.M.
Published: May 2019

(BJOG. 2018;125:1294–1302)

There has been an international rise in cesarean section (CS) rates, sometimes attributed to an increase in nonmedically indicated CS, including CS on maternal request (CSMR). Some evidence has suggested that women prefer vaginal delivery, however, and provider’s attitudes may have a greater effect on this trend. This study used a sample of Argentine obstetrical providers and described their preferred modes of delivery and attitudes towards CS in the absence of medical indication and CSMR.
Intramuscular Versus Intravenous Oxytocin to Prevent Postpartum Hemorrhage at Vaginal Delivery: Randomized Controlled Trial
Authors: Adnan N. , Conlan-Trant R. , McCormick C. , Boland F. , Murphy D.J.
Published: May 2019

(BMJ. 2018;362:k3546)

Postpartum hemorrhage (PPH) is a leading cause of maternal mortality and has been increasing over the last 15 years in many developed countries. While uterotonic drugs such as oxytocin have been established as useful tools in preventing PPH, the best administration method remains unclear. When given intramuscularly, a uterotonic effect will be obtained in 3 to 7 minutes, with the effect lasting 30 to 60 minutes. Intravenous oxytocin has an effect almost immediately and the plateau concentration is reached at 30 minutes. However, intravenous administration has been associated with hypotension and tachycardia. At these investigators’ medical center, the practice of administering oxytocin 10 international units (IU) intravenously after delivery was changed in 2010 to intramuscular oxytocin, following Royal College of Obstetricians and Gynaecologists guidelines. This randomized, controlled trial, the Labour Oxytocin Route (LabOR) was prompted by concerns from midwives and obstetricians at the study center regarding a perceived rise in PPH after this change in practice was adopted. The LabOR trial aimed to determine whether intravenous oxytocin 10 IU was more effective than intramuscular oxytocin 10 IU at preventing PPH after vaginal delivery.
Is there a Benefit to Continue Magnesium Sulphate Postpartum in Women Receiving Magnesium Sulfate Before Delivery? A Randomized Controlled Study
Authors: Vigil-DeGracia P. , Ludmir J. , Ng J. , Reyes-Tejada O. , Nova C. , Beltré A. , Yuen-Chon V. , Collantes J. , Turcios E. , Lewis R. , Cabrera S.
Published: May 2019

(BJOG. 2018;125:1304–1311)

Magnesium sulfate is proven to prevent eclampsia in women with preeclampsia. Previous studies have not clearly established whether or not the use of magnesium sulfate in the postpartum period contributed to reducing postpartum eclampsia. This study investigated if patients who received a loading dose plus maintenance infusion for 8 or more hours before delivery required an additional maintenance infusion of magnesium sulfate for 24 hours postpartum.
Safety of Eliminating Postpartum Magnesium Sulphate: Intriguing but Not Yet Proven
Authors: Scott J.R.
Published: May 2019

(BJOG. 2018;125(10):1312)

The development of eclampsia in women with preeclampsia significantly increases maternal morbidity and mortality. While the prophylactic use of magnesium sulfate has been used to prevent eclampsia in patients with preeclampsia, there is a lack of consensus regarding the optimum dosage, timing and administration schedule. In the United States, a magnesium sulfate infusion is commonly administered through labor and for 12 to 24 hours postpartum, after an initial 4 to 6 g loading dose.
Effect of Individual Dietetic Intervention on Gestational Weight Gain and Associated Complications in Obese Pregnant Women
Authors: Robertson N. , Ladlow B.
Published: May 2019

(Aust N Z J Obstet Gynaecol. 2018;58:274–277)

Obesity in pregnancy is increasingly prevalent and associated with many complications. Dietetic intervention may be useful in optimizing gestational weight gain (GWG) in obese pregnant women and improving maternal and fetal outcomes. A GWG target of 5 to 9 kg is recommended for obese women by the Institute of Medicine (IOM), but lower GWG may be safe for individuals in obesity classes 2 and 3 if guided by a clinician. This study aimed to review the effect of individual nutritional counseling by a dietitian on GWG and obstetric outcomes.
Neonatal Outcomes of Elective Early-term Births After Demonstrated Fetal Lung Maturity
Authors: Tita A.T.N. , Jablonski K.A. , Bailit J.L. , Grobman W.A. , Wapner R.J. , Reddy U.M. , Varner M.W. , Thorp J.M. , Leveno K.J. , Caritis S.N. , Iams J.D. , Saade G. , Sorokin Y. , Rouse D.J. , Blackwell S.C. , Tolosa J.E.
Published: May 2019

(Am J Obstet Gynecol. 2018;219:296.e1–296.e8)

Positive fetal lung maturity testing is associated with a decrease in the risk of respiratory neonatal morbidity in preterm and early-term neonates, compared with neonates who do not undergo testing. However, several studies suggest that respiratory outcomes, among others, are worse even after fetal lung maturity has been demonstrated in early-term neonates, compared with full-term neonates. This has led to a decline in fetal lung maturity testing. This study aimed to estimate the frequency and risks of adverse neonatal outcomes with early-term birth after positive fetal lung maturity testing compared with full-term birth in the absence of indications for early delivery.
Use of Nonsteroidal Antiinflammatory Drugs During Pregnancy and the Risk of Miscarriage
Authors: Li D.K. , Ferber J.R. , Odouli R. , Quesenberry C.
Published: May 2019

(Am J Obstet Gynecol. 2018;219:275.e1–275.e8)

While nonsteroidal antiinflammatory drugs (NSAIDs) are commonly used among pregnant women, there is concern that exposure to NSAIDs during early pregnancy may have an adverse impact on implantation and increase the risk of miscarriage. For successful embryonic implantation, a sufficient amount of prostaglandin is required, but NSAIDs inhibit the biosynthesis of prostaglandin. Previous studies have yielded conflicting results. This study aimed to determine whether the use of NSAIDs during pregnancy is associated with the risk of miscarriage by using a natural indication-control cohort of pregnant women using acetaminophen rather than NSAIDs.
Opioid Detoxification in Pregnancy: Systematic Review and Meta-Analysis of Perinatal Outcomes
Authors: Wang M.J. , Kuper S.G. , Sims B. , Paddock C.S. , Dantzler J. , Muir S. , Harper L.M.
Published: May 2019

(Am J Perinatol. 2018. Doi:10.1055/s-0038-1670680)

Opioid replacement therapy (ORT) is the recommended treatment for opioid use disorder during pregnancy, as it is associated with more positive maternal and neonatal outcomes and reduction in risky behavior. However, as ORT uses methadone or buprenorphine, neonatal abstinence syndrome (NAS) remains an issue, and the long-term neurodevelopmental impact of ORT exposure during pregnancy and NAS on neonates is unclear. The authors of the present study thereby reviewed the literature to determine neonatal effects of prenatal opioid maintenance therapy versus detoxification in opioid-dependent women and assessed the efficacy and safety of available treatment options.
Role of Epigenetic Mechanisms in Transmitting the Effects of Neonatal Sevoflurane Exposure to the Next Generation of Male, but not Female, Rats
Authors: Ju L.S. , Yang J.J. , Morey T.E. , Gravenstein N. , Seubert C.N. , Resnick J.L. , Zhang J.Q. , Martynyuk A.E.
Published: May 2019

(Br J Anaesth. 2018;121:406–416)

Neonatal anesthesia-induced abnormalities and their mechanisms are poorly understood, even in exposed animals. Some studies have shown that rats, especially male rats, develop behavioral deficiencies and exacerbated hypothalamic-pituitary adrenal responses to stress when exposed as neonates to anesthetic. Furthermore, recent studies suggest that these deleterious effects could be carried into the next generation via epigenetic mechanisms (noncoding RNAs, DNA methylation). There is a pressing need for further research, in order to establish safety guidelines for anesthesia in children, The authors of the present study exposed neonatal rats to sevoflurane and evaluated their progeny for inherited behavioral and molecular alterations.
Risk Factors for Cesarean Delivery and Adverse Neonatal Outcome in Twin Pregnancies Attempting Vaginal Delivery
Authors: Schachter-Safrai N. , Karavani G. , Haj-Yahya R. , Shlomai N.O. , Porat S.
Published: May 2019

(Acta Obstet Gynecol Scand. 2018;97:845–851)

Concerns regarding the safety of vaginal delivery for twins has persisted due to some patients’ and obstetricians’ perception that it may lead to increased morbidity and mortality for the second twin. The Twin Birth Study, though, demonstrated the safety of planned vaginal delivery as neither maternal risk or neonatal morbidity and mortality was decreased with planned cesarean delivery. Because of these study results, the American College of Obstetricians and Gynecologists and the Society of Maternal-Fetal Medicine have recommended that women with twin gestations where the first twin is in the cephalic presentation be counseled to plan a vaginal delivery. However, that study did not assess risk factors that could lead to an unplanned cesarean delivery and also did not report on outcomes for those pregnancies that did require an unplanned cesarean delivery. The goal of this study was to identify risk factors for both cesarean delivery and delivery-related neonatal morbidity and mortality among women who were attempting vaginal delivery of twins.
Intravenous Remifentanil Patient-controlled Analgesia Versus Intramuscular Pethidine for Pain Relief in Labour (RESPITE): An Open-label, Multicenter, Randomized Controlled Trial
Authors: Wilson M.J.A. , MacArthur C. , Hewitt C.A. , Handley K. , Gao F. , Beeson L. , Daniels J.
Published: May 2019

(Lancet. 2018;392:662–672)

While pethidine (meperidine) is widely used for pain relief during labor, there are unfavorable side effects, such as nausea/vomiting, maternal sedation, and possible neonatal depression. In addition, more than a third of women receiving pethidine ultimately request epidural labor analgesia. Remifentanil is a potential alternative to pethidine for labor pain relief. Its rapid onset and short duration of action provide some benefits although its short duration requires administration via intravenous (IV) patient controlled analgesia (PCA). It is not commonly used in maternity units in the United Kingdom, however, as previous trials evaluating remifentanil versus pethidine yielded low-quality evidence. Stronger evidence was required to evaluate the efficacy and safety of remifentanil as compared with pethidine for labor pain management. The RESPITE trial primary outcome compared IV remifentanil PCA with intramuscular pethidine looking at the need to convert to epidural analgesia with secondary outcomes evaluating visual analog scale (VAS) pain scores, mode of delivery and adverse maternal or neonatal outcomes.
The Effect of Spinal Hyperbaric Bupivacaine-Fentanyl or Hyperbaric Bupivacaine on Uterine Tone and Fetal Heart Rate in Laboring Women: A Randomized Controlled Study
Authors: Kuberan A. , Jain K. , Bagga R. , Makkar J.K.
Published: May 2019

(Anaesthesia. 2018;73:832–838)

Combined spinal-epidural (CSE) analgesia is a rapid and effective analgesic technique during labor, with minimal motor impairment and high maternal satisfaction. Despite these advantages, high incidences of fetal heart rate (FHR) abnormalities and uterine hyperactivity have been reported with its use. This study assessed the difference between spinal bupivacaine-fentanyl or bupivacaine on baseline uterine tone and FHR abnormalities; the hypothesis was that the use of fentanyl would be associated with higher uterine tone.
Management of Anesthesia and Delivery in Women With Chiari I Malformations
Authors: Waters J.F.R. , OʼNeal M.A. , Pilato M. , Waters S. , Larkin J.C. , Waters J.H.
Published: May 2019

(Obstet Gynecol. 2018;132:1180–1184)

A type I Chiari malformation, which is the most common type of Chiari malformation (0.6% prevalence), is defined as descent of the cerebellar tonsils below the foramen magnum by >5 mm. While most patients with this congenital malformation are asymptomatic, 30% can experience symptoms, ranging from headaches exacerbated by cough to more severe effects, such as confusion, deconjugate gaze, and papilledema as a result of increased intracranial pressure. Subsequently, there are concerns that pregnant women with Chiari I malformations may experience tonsillar herniation and neurological deterioration during vaginal delivery. In this case series, the authors assessed whether vaginal delivery or neuraxial anesthesia increased the risk of neurological deterioration in women with uncorrected Chiari I malformation.
Randomized Double-blind Comparison of Bolus Phenylephrine or Ephedrine for Treatment of Hypotension in Women With Preeclampsia Undergoing Caesarean Section
Authors: Mohta M. , Duggal S. , Chilkoti G.T.
Published: May 2019

(Anaesthesia. 2018;73:839–846)

Preeclampsia is a common complication of pregnancy. In the past, anesthesiologists had sometimes avoided the use of spinal anesthesia in parturients with preeclampsis due to concerns about spinal-induced hypotension leading to inadequate uteroplacental perfusion. However, more recent studies have shown spinal anesthesia to be a safe technique in preeclamptic women as the hypotension associated with it is less severe than that experienced by normotensive parturients and is easily treated. However, effective treatment of postspinal hypotension remains an important component of anesthetic management. While phenylephrine has become the vasopressor of choice for treatment of hypotension in healthy women undergoing cesarean section due to the lower risk of fetal acidosis, the preferred vasopressor for preeclamptic women remains unclear. This randomized, double blind study was performed to compare the effects of phenylephrine versus ephedrine for the treatment of spinal-induced hypotension in preeclamptic women undergoing cesarean section.
Hypnotic Agents for Induction of General Anesthesia in Caesarean Section Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Authors: Houthoff Khemlani K. , Weibel S. , Kranke P. , Schreiber J.U.
Published: May 2019

(J Clin Anesth. 2018;48:73–80)

Thiopentone is a well-known general anesthesia induction agent for cesarean section (CS). Alternative agents include benzodiazepines, ketamine, and propofol. However, all these agents are lipid soluble and have rapid maternal-fetal equilibration. There is no reliable evidence available to support the use of any one of these specific drugs as a dedicated hypnotic agent in the setting of general anesthesia in CS patients. Therefore, to identify an “evidence-supported” practice, the authors of the present study conducted a meta-analysis as per PRISMA guidelines to compare the efficacy and safety profiles of benzodiazepines, ketamine, and propofol to that of thiopentone.
A Randomized Trial Comparing Surgeon-administered Intraoperative Transversus Abdominis Plane Block With Anesthesiologist-administered Transcutaneous Block
Authors: Narasimhulu D.M. , Scharfman L. , Minkoff H. , George B. , Homel P. , Tyagaraj K.
Published: May 2019

(Int J Obstet Anesth. 2018;35:26–32)

Traditionally, transversus abdominis plane (TAP) blocks are performed percutaneously by anesthesiologists using ultrasound guidance to prevent damage to intra-abdominal structures or injection into the incorrect plane. However, ultrasound-guided blocks pose potential problems, particularly in obese patients or patients with poor muscular tone, where visualization may be difficult. There have been reports of puncturing intraperitoneal structures during the performance of these blocks. In addition, ultrasound-guided blocks may be time consuming. An alternative to this method is surgeon-administered intraoperative TAP blocks, which eliminate the risk of intraperitoneal injury since they are performed under direct visualization. This study aimed to compare surgical TAP blocks with conventional TAP blocks in patients undergoing cesarean delivery.
Preoperative Caesarean Delivery Intravenous Acetaminophen Treatment for Postoperative Pain Control: A Randomized Double-blinded Placebo Control Trial
Authors: Towers C.V. , Shelton S. , van Nes J. , Gregory E. , Liske E. , Smalley A. , Mobley E. , Faircloth B. , Fortner K.B.
Published: May 2019

(Am J Obstet Gynecol. 2018;218:353.e1–353.e4)

Acetaminophen is thought to inhibit central pain receptor sites, which may lead to an overall reduction in perception of pain. Thus, it is possible that the use of preoperative intravenous (IV) acetaminophen could decrease the use of opioids after cesarean delivery. In the present study, the authors evaluated the effects of a preoperative IV dose of acetaminophen on maternal opioid use after cesarean delivery, postdelivery length of stay, pain scores on postoperative days 1 and 2, and acetaminophen levels in cord blood.
The promise and perils of ‘Big Data’: focus on spondyloarthritis
Authors: Curtis Jeffrey R.
Published: May 2019

Purpose of review

This review will describe the available large-scale data sources to study spondyloarthritis (SpA), enumerate approaches to identify SpA and its disease-related manifestations and outcomes, and will outline existing and future methods to collect novel data types [e.g. patient-reported outcomes (PRO), passive data from wearables and biosensors].

Recent findings

In addition to traditional clinic visit-based SpA registries, newer data sources, such as health plan claims data, single and multispecialty electronic health record (EHR) based registries, patient registries and linkages between data sources, have catalyzed the breadth and depth of SpA research. Health activity tracker devices and PRO collected via PROMIS instruments have been shown to have good validity when assessed in SpA patients as compared to legacy disease-specific instruments. In certain cases, machine learning outperforms traditional methods to identify SpA and its associated manifestations in EHR and claims data, and may predict disease flare.

Although caution remains in the application of newer data sources and methods including the important need for replication, the availability of new data sources, health tracker devices and analytic methods holds great promise to catalyze SpA research.
Supine Test: A New Test for Detecting Lacrimal Gland Prolapse Before Upper Blepharoplasty
Authors: Kashkouli Mohsen Bahmani , Tabrizi Amir , Ghazizadeh Mahya , Khademi Behzad , Karimi Nasser
Published: May 2019

Purpose:

To introduce a new (Supine) test and assess the values of lateral eyelid bulging for diagnosis of lacrimal gland (LG) prolapse before upper blepharoplasty.

Methods:

In a prospective case series (2011–2017), lateral eyelid bulging and Supine Test were recorded, preoperatively. Lacrimal gland prolapse was graded as mild (<4 mm), moderate (4–7 mm), and severe (>7 mm). A few spots of cautery on LG capsule was performed in patients with bilateral mild and suture repositioning in unilateral or bilateral moderate and severe LG prolapse. Patients with asymmetric LG prolapse were treated based on more severe grade, bilaterally.

Results:

Included were 1,207 patients. Frequency of positive Supine Test (11.8%, 142/1,207) increased from almost 10% in patients less than 41 years of age to 15% in more than 60 years of age. Their mean age was significantly older, and 53.2% showed asymmetric LG prolapse. Septum was just opened in patients with positive Supine Test, and all had LG prolapse of ≥3 mm (mean: 5.6 mm, range: 3–14 mm). Mild LG prolapse, moderate LG prolapse, and severe LG prolapse were observed in 22.5%, 62.6%, and 14.7% of the patients, respectively. Mean follow-up time was 22 months (12–60 months). Recurrence was observed in 1 patient (bilateral) after suture repositioning. Lateral eyelid bulging had a high negative (96.2%) and low positive (30.6%) predictive value when compared with the Supine Test.

Conclusions:

Positive Supine Test means LG prolapse of ≥3 mm (100% positive predictive value). Negative lateral eyelid bulging was highly predictive of no LG prolapse.
Intent of health care providers to adopt a clinical decision support tool in the management of minor pediatric head injuries
Authors: Zarchi Tova B.
Published: May 2019

Background:

Radiographic neuroimaging in minor pediatric head injuries contains risks of radiation-induced malignancy. The Pediatric Emergency Care Applied Research Network (PECARN) head injury protocol identifies head-injured children who are at very low risk of clinically important traumatic brain injuries and can safely not receive a head computed tomography (CT) scan.

Local problem:

The identified urgent care facility had no facility-wide protocol to manage head injuries.

Methods:

The purpose of the evidence-based practice project was to educate health care providers on the risks of indiscriminate head CT prescription and the utility of the PECARN head injury protocol in the management of minor pediatric head injuries.

Interventions:

A knowledge assessment was conducted using pre- and posttests and the likelihood to adopt the PECARN head injury protocol in clinical practice was evaluated using the Evidence-Based Practice Attitude Scale. Additionally, rates of head CT scans ordered that were inappropriate according to the PECARN head injury protocol were calculated postproject and compared with preproject rates.

Results:

Data analysis was performed using descriptive statistics. Findings included increase in provider knowledge on the use of the PECARN head injury protocol and high likelihood of intent to adopt the PECARN head injury protocol in clinical practice. In addition, rates of head CT prescription postproject were lower than preproject rates, and 82.61% of CT scans ordered postproject were appropriate according to the PECARN head injury protocol.

Conclusions:

Using the PECARN head injury protocol was associated with consistency of care, reduced unnecessary health care resource utilization, and health care costs.
Contemporary management of frontal sinus fractures
Authors: Dedhia Raj D. , Morisada Megan V. , Tollefson Travis T. , Strong E. Bradley
Published: May 2019

Purpose of review

Frontal sinus fracture management is evolving. This article will highlight recent literature and provide an evidence-based algorithm in the contemporary management of frontal sinus fractures.

Recent findings

The role of transnasal endoscopic treatment of frontal sinus fractures has expanded to include fracture reduction and posterior table reconstruction. Evidence continues to support the safety of nonoperative management in select frontal sinus outflow tract fractures.

The management of frontal sinus fractures with frontal sinus outflow tract injury continues to evolve with a trend toward observation and minimally invasive approaches. Restoration of the frontal sinus outflow tracts with transnasal endoscopic techniques is being used increasingly in the acute and delayed setting. For severe fractures, the role of conservative treatment paradigms requires further research.
The effect of Tai Chi and Qigong on health-related quality of life in Parkinson’s disease: a systematic review and meta-analysis of systematic reviews
Authors: Fidan Oznur , Seyyar Gulce Kallem , Aras Bahar , Colak Ertugrul , Aras Ozgen
Published: May 2019

The overall aim of the treatment in Parkinson’s disease is to optimize functional independence, safety, well-being and thereby health-related quality of life. Tai Chi and Qigong are widely used exercises in Parkinson’s disease, but there is insufficient evidence to support or refute the efficacy of Tai Chi and Qigong, especially on health-related quality of life in patients with Parkinson’s disease. The aim of this study was to conduct a systematic review and a meta-analysis from the systematic reviews that evaluate the effectiveness of Tai Chi and Qigong on health-related quality of life in Parkinson’s disease. A comprehensive literature search was conducted to identify the systematic reviews and meta-analyses by using Cochrane Library, MEDLINE, PubMed, etc., databases up to the end of November 2018. From 1504 articles, seven fulfilled the inclusion criteria and were included in our study. Five of the included systematic reviews were about Tai Chi, and two of them were about both Tai Chi and Qigong. According to our meta-analysis, there was no significant effect of Tai Chi and Qigong on health-related quality of life in patients with Parkinson’s disease, when compared to the control group (standardized mean difference −0.166, 95% confidence interval −0.676 to 0.344; P = 0.523). In conclusion, our systematic review and meta-analysis showed no significant effect of Tai Chi and Qigong statistically on health-related quality of life in patients with Parkinson’s disease, but the small effect size in our study favoured the potential benefit of Tai Chi and Qigong on health-related quality of life in Parkinson’s disease.
Trunk and Head Control During Walking in Patients With Unilateral Vestibular Hypofunction
Authors: Zhang Fang , Liu Peng , Ou Yongkang , Huang Qiuhong , Song Rong , Dou Zulin , Zheng Yiqing
Published: May 2019

Objectives

The aim of the study was to investigate (a) postural control, especially trunk and head control, in patients with unilateral vestibular hypofunction and healthy controls during walking on firm and foam surface and (b) the difference between the impact of left and right unilateral vestibular hypofunction, and correlation between trunk/head control and vestibular function in the patients.

Design

Thirteen patients and 13 healthy controls were recruited. Vestibular function was examined based on the canal paresis value. Participants walked on a treadmill on firm and foam surface. Peak-to-peak trunk (T
roll and T
pitch) and head roll and pitch angle (H
roll and H
pitch) were calculated as primary outcome measures.

Results

In the unilateral vestibular hypofunction group but not healthy controls, T
roll was significantly higher on foam than firm surface (P = 0.03). T
pitch was significantly higher on foam than firm surface in both groups (P = 0.02). Patients had significantly lower H
roll (P = 0.03) and H
pitch (P = 0.02) and lower head-trunk correlation in both medio-lateral (P = 0.05) and anteroposterior direction (P = 0.03) than those in the healthy control group.

Conclusions

Patients with unilateral vestibular hypofunction seemed to rely more on lower limb somatosensory input for trunk control especially in the medio-lateral direction compared with healthy controls. Lower head sway and head-trunk correlation may suggest a more independent and successful head control strategy in patients.
X-Linked Dystonia-Parkinsonism: recent advances
Authors: Bragg D. Cristopher , Sharma Nutan , Ozelius Laurie J.
Published: May 2019

Purpose of review

Our understanding of X-Linked Dystonia-Parkinsonism (XDP) has advanced considerably in recent years because of a wealth of new data describing its genetic basis, cellular phenotypes, neuroimaging features, and response to deep brain stimulation (DBS). This review provides a concise summary of these studies.

Recent findings

XDP is associated with a SINE-VNTR-Alu (SVA)-type retrotransposon insertion within the TAF1 gene. This element includes a hexameric DNA repeat expansion, (CCCTCT)
n
, the length of which varies among patients and is inversely correlated to age of disease onset. In cell models, the SVA alters TAF1 splicing and reduces levels of full-length transcript. Neuroimaging data have confirmed previous neuropathology studies that XDP involves a progressive striatal atrophy, while further detecting functional alterations in additional brain regions. In patients exhibiting features of both dystonia and parkinsonism, pallidal DBS has resulted in rapid improvement of hyperkinetic movements, but effects on hypokinetic features have been inconsistent.

The discovery that XDP is linked to a polymorphic hexameric sequence suggests that it could share mechanisms with other DNA repeat disorders, whereas the transcriptional defect in cell models raises the possibility that strategies to correct TAF1 splicing could provide therapeutic benefit.
Differences in stress reactivity between zebrafish with alternative stress coping styles
Authors: Wong Ryan Y. , French Jeffrey , Russ Jacalyn B.
Published: May 2019

Animals experience stress in a variety of contexts and the behavioural and neuroendocrine responses to stress can vary among conspecifics. The responses across stressors often covary within an individual and are consistently different between individuals, which represent distinct stress coping styles (e.g. proactive and reactive). While studies have identified differences in peak glucocorticoid levels, less is known about how cortisol levels differ between stress coping styles at other time points of the glucocorticoid stress response. Here we quantified whole-body cortisol levels and stress-related behaviours (e.g. depth preference, movement) at time points representing the rise and recovery periods of the stress response in zebrafish lines selectively bred to display the proactive and reactive coping style. We found that cortisol levels and stress behaviours are significantly different between the lines, sexes and time points. Further, individuals from the reactive line showed significantly higher cortisol levels during the rising phase of the stress response compared with those from the proactive line. We also observed a significant correlation between individual variation of cortisol levels and depth preference but only in the reactive line. Our results show that differences in cortisol levels between the alternative stress coping styles extend to the rising phase of the endocrine stress response and that cortisol levels may explain variation in depth preferences in the reactive line. Differences in the timing and duration of cortisol levels may influence immediate behavioural displays and longer lasting neuromolecular mechanisms that modulate future responses.
Suction-induced habitat selection in sand bubbler crabs
Authors: Sassa Shinji , Yang Soonbo
Published: May 2019

We show that a decapod crustacean, the sand bubbler crab (SBC)
Scopimera globosa
, uses suction, which is the tension of moisture in the sediment, to select habitats at normal times and at the time of disaster events, through a range of controlled laboratory experiments and field observations at various sandflats in Japan. When SBCs are released on fields with no spatial suction gradient, their direction of movement is random. However, the situation clearly changes with increasing suction gradients, in which case the SBCs move to suitable zones for burrowing. Predictions based on suction–burrowing relationships coupled with the knowledge of geophysical state changes induced by suction dynamics are consistent with the observed formation of habitats throughout the seasons. Such suction-induced habitat selection in SBCs manifests itself in a robust way even following sudden events such as typhoons, where erosion and deposition processes distinctly alter the geomorphological profiles, as well as the states of suction, yet consistently yielding habitats at the newly formed, suitable suction environments. Repeated battles were observed in a suitable suction environment over burrows, with the competition rate more than seven times as high as that in a critical suction environment for burrowing.
Leishmaniasis in Eurasia and Africa: geographical distribution of vector species and pathogens
Authors: Cunze Sarah , Kochmann Judith , Koch Lisa K. , Hasselmann Korbinian J. Q. , Klimpel Sven
Published: May 2019

Leishmaniasis is a vector-borne disease with a broad global occurrence and an increasing number of recorded cases; however, it is still one of the world's most neglected diseases. We here provide climatic suitability maps generated by means of an ecological niche modelling approach for 32
Phlebotomus
vector species with proven or suspected vector competence for five
Leishmania
pathogens occurring in Eurasia and Africa. A GIS-based spatial overlay analysis was then used to compare the distributional patterns of vectors and pathogens to help evaluate the vector species–pathogen relationship currently found in the literature. Based on this single factor of vector incrimination, that is, co-occurrence of both vector and pathogen, most of the pathogens occurred with at least one of the associated vector species. In the case of
L. donovani
, only a not yet confirmed vector species,
P. rodhaini,
could explain the occurrence of the pathogen in regions of Africa.
Phlebotomus alexandri
and
P. longiductus
on the other hand, proven vector species of
L. donovani,
do not seem to qualify as vectors for the pathogen. Their distribution is restricted to northern latitudes and does not match the pathogen's distribution, which lies in southern latitudes. Other more locally confined mismatches were discussed for each pathogen species. The comparative geographical GIS-overlay of vector species and pathogens functions as a first indication that testing and re-evaluation of some pathogen–vector relationships might be worthwhile to improve risk assessments of leishmaniasis.