bluuebunny/crossref_metadata_2025 huggingface dataset:
Confusion, Seduction, Failure: Emotions as Reflexive Knowledge in Conflict Settings
Authors: Hedström Jenny
Published: October 2018

This article highlights the influence of emotions, affective experiences, and rumors on the construction of knowledge within research on conflict and in international politics, as well as within the research process itself. Drawing from fieldwork undertaken in a conflict zone in Myanmar, it suggests that academic knowledge production practices are informed both by the (violent) context in which research is undertaken and by the demands of the discipline to produce a scientifically accepted piece of research. It proposes that attention to emotions may facilitate strong objectivity (Harding 1992) by foregrounding the relationship between research participants, researchers, and the broader research (institutional and immediate) contexts. It introduces the term “rumors-as-affect” as a means to discuss how affective atmospheres or events in the research environments inform research. Three interview situations are presented, in which different emotional reactions are highlighted, focusing on “confusion and guilt”; “seduction”; and finally, “failure and ignorance.” These events illustrate how, in recognizing the role emotions and affective atmospheres play in research on conflict and in international politics (cf. Crawford 2014; Hutchison and Bleiker 2014; Ross 2013), researchers may begin to do justice to our representations of what is encountered in the field and how knowledge is constructed within the discipline.
Integrated Care Models: Optimizing Adult Ambulatory Care in Inflammatory Bowel Disease
Authors: Schoenfeld Roberta , Nguyen Geoffrey C , Bernstein Charles N
Published: October 2018

Background

Inflammatory bowel disease (IBD), including Crohn’s disease and ulcerative colitis, is a chronic, complex and unpredictable disease affecting an increasing number of patients worldwide from a young age. Inflammatory bowel disease is associated with multiple comorbidities and complications, requiring ongoing preventative, acute and chronic care. The purpose of this article is to review the literature on outpatient care models used to treat adults with IBD and to gain insight on how to improve quality of care and reduce costs.

Methods

A comprehensive review of recent literature on PubMed, Scopus and Google Scholar databases about care models used to treat IBD was performed. Key terms included ‘inflammatory bowel disease’, ‘organizational models’, ‘patient care team’ and ‘quality improvement’.

Results

Studies showed that an integrated care model decreases hospital admissions, IBD-related surgeries and comorbidities of IBD, ultimately decreasing direct and indirect costs of IBD compared with a more traditional patient-physician model. A gastroenterologist-led multidisciplinary team (MDT) involving comprehensive care by IBD nurses, a surgeon, psychologist, dietician, pharmacist, and other members as needed is recommended.

Conclusions

A holistic approach to IBD care delivered by a MDT with structured monitoring, active follow-up, patient education and prompt access to care improves outcomes for IBD patients. More research is needed on the cost-effectiveness of integrated care models to demonstrate long-term value and secure funding for implementation. Future research should compare integrated models of care and assess patient and physician satisfaction in these models of delivering IBD care.
Role of Screening History in Clinical Meaning and Optimal Management of Positive Cervical Screening Results
Authors: Castle Philip E , Kinney Walter K , Xue Xiaonan , Cheung Li C , Gage Julia C , Poitras Nancy E , Lorey Thomas S , Katki Hormuzd A , Wentzensen Nicolas , Schiffman Mark
Published: October 2018

Background

Cervical cancer is caused by persistent human papillomavirus (HPV) infection. US consensus management guidelines for a positive cervical screening result typically focus on the current screening result only. A negative testing history may alter risk of the following positive screening results, caused by a new HPV infection, and therefore its optimal management.

Methods

Women ages 30 years and older were screened with triennial HPV and cytology co-testing at Kaiser Permanente Northern California from 2003 to 2014. We estimated the subsequent 5-year risks of cervical intraepithelial neoplasia grade 3 or more severe diagnoses (CIN3+) in a cohort of 1 156 387 women following abnormal (atypical squamous cells of undetermined significance [ASC-US] or worse) cytology and/or positive HPV testing, when the test result followed 0 (n = 990 013), 1 (n = 543 986), 2 (n = 245 974), or 3 (n = 79 946) consecutive negative co-test(s). All statistical tests were two-sided.

Results

Following 0–3 successive negative co-tests, 5-year CIN3+ risks following a positive HPV test decreased progressively from 7.2% (95% CI = 7.0% to 7.4%) to 1.5% (95% CI = 0.7% to 3.4%) (Ptrend < .001). Similarly, risks following an abnormal (ASC-US or worse) cytology result decreased from 6.6% (95% CI = 6.4% to 6.9%) to 1.1% (95% CI = 0.5% to 2.3%) (Ptrend < .001). Risks following low-grade squamous intraepithelial lesion, the risk threshold for referral to colposcopy in the United States, decreased from 5.2% (95% CI = 4.7% to 5.7%) to 0.9% (95% CI = 0.2% to 4.3%). Risks following high-grade squamous intraepithelial lesion or more severe, a specific marker for the presence of precancerous lesions, decreased from 50.0% (95% CI = 47.5% to 52.5%) to 10.0% (95% CI = 2.6% to 34.4%).

Conclusions

Following one or more sequential antecedent, documented negative co-tests or HPV tests, women with HPV-positive ASC-US or low-grade squamous intraepithelial lesion might have sufficiently low CIN3+ risk that they do not need colposcopy referral and might instead undergo 6–12-month surveillance for evidence of higher risk before being referred to colposcopy.
Species boundaries in the Trichophyton mentagrophytes / T. interdigitale species complex
Authors: Pchelin Ivan M , Azarov Daniil V , Churina Maria A , Scherbak Sergey G , Apalko Svetlana V , Vasilyeva Natalya V , Taraskina Anastasia E
Published: October 2018

The fungi Trichophyton mentagrophytes and T. interdigitale are closely related species, causing superficial infections in humans and other mammals. The status of these taxa is a field of long-lasting debates. To clarify their phylogenetic relationships within the genus Trichophyton and sharpen the species boundaries, we performed sequencing of four T. mentagrophytes genomes and also evaluated three previously published multilocus data sets. We performed computational species delimitation analysis on all available in GenBank internal transcribed spacer region (ITS) sequences of Trichophyton spp. Phylogenomic data, phylogenetic network, and species delimitation analyses implied that T. mentagrophytes and T. interdigitale belong to the same phylogenetic species. However, we argue that taxonomic status quo should be retained, from the perspective of epidemiological data and the principle of taxonomic stability. Since there is a correlation between ITS genotype and epidemiological source of an isolate, restriction of T. interdigitale to purely anthropophilic ITS genotypes seems to be reasonable.
Physical properties of near-Earth asteroids with a low delta-v: Survey of target candidates for the Hayabusa2 mission
Authors: Hasegawa Sunao , Kuroda Daisuke , Kitazato Kohei , Kasuga Toshihiro , Sekiguchi Tomohiko , Takato Naruhisa , Aoki Kentaro , Arai Akira , Choi Young-Jun , Fuse Tetsuharu , Hanayama Hidekazu , Hattori Takashi , Hsiao Hsiang-Yao , Kashikawa Nobunari , Kawai Nobuyuki , Kawakami Kyoko , Kinoshita Daisuke , Larson Steve , Lin Chi-Sheng , Miyasaka Seidai , Miura Naoya , Nagayama Shogo , Nagumo Yu , Nishihara Setsuko , Ohba Yohei , Ohta Kouji , Ohyama Youichi , Okumura Shin-ichiro , Sarugaku Yuki , Shimizu Yasuhiro , Takagi Yuhei , Takahashi Jun , Toda Hiroyuki , Urakawa Seitaro , Usui Fumihiko , Watanabe Makoto , Weissman Paul , Yanagisawa Kenshi , Yang Hongu , Yoshida Michitoshi , Yoshikawa Makoto , Ishiguro Masateru , Abe Masanao
Published: October 2018

Sample return from the near-Earth asteroid known as 25143 Itokawa was conducted as part of the Hayabusa mission, with a large number of scientific findings being derived from the returned samples. Following the Hayabusa mission, Hayabusa2 was planned, targeting sample return from a primitive asteroid. The primary target body of Hayabusa2 was asteroid 162173 Ryugu; however, it was also necessary to gather physical information for backup target selection. Therefore, we examined five asteroids spectroscopically, 43 asteroids spectrophotometrically, and 41 asteroids through periodic analysis. Hence, the physical properties of 74 near-Earth asteroids were obtained, which helped the Hayabusa2 backup target search, and also furthered understanding of the physical properties of individual asteroids and their origins.
What is the Privatization of Policing?
Authors: White Adam
Published: October 2018

The politics of austerity have deepened market penetration across the UK policing sector, bringing into effect an array of new policing assemblages which cut across the public–private divide like never before and defy simple categorization. However, public discourse has not kept pace with this fast-changing reality, all too often reducing these assemblages into an amorphous singularity–‘privatization’–towards which one is either unambiguously for or against. This article accordingly sets out the analytical tools for developing a more nuanced discourse on the privatization of policing. It first develops a new typology of privatization across five categories: function, formulation of private sphere, trigger of privatization, regulatory influence of the state, and relationship to the ideal-type police monopoly. It then operationalizes this typology using four recent examples of privatization drawn from the UK policing sector. It lastly clarifies how this typology can be used to inform discourse on the privatization of policing.
Towards a Unifying Cognitive, Neurophysiological, and Computational Neuroscience Account of Schizophrenia
Authors: Heinz Andreas , Murray Graham K , Schlagenhauf Florian , Sterzer Philipp , Grace Anthony A , Waltz James A
Published: October 2018

Psychotic experiences may be understood as altered information processing due to aberrant neural computations. A prominent example of such neural computations is the computation of prediction errors (PEs), which signal the difference between expected and experienced events. Among other areas showing PE coding, hippocampal-prefrontal-striatal neurocircuits play a prominent role in information processing. Dysregulation of dopaminergic signaling, often secondary to psychosocial stress, is thought to interfere with the processing of biologically important events (such as reward prediction errors) and result in the aberrant attribution of salience to irrelevant sensory stimuli and internal representations. Bayesian hierarchical predictive coding offers a promising framework for the identification of dysfunctional neurocomputational processes and the development of a mechanistic understanding of psychotic experience. According to this framework, mismatches between prior beliefs encoded at higher levels of the cortical hierarchy and lower-level (sensory) information can also be thought of as PEs, with important consequences for belief updating. Low levels of precision in the representation of prior beliefs relative to sensory data, as well as dysfunctional interactions between prior beliefs and sensory data in an ever-changing environment, have been suggested as a general mechanism underlying psychotic experiences. Translating the promise of the Bayesian hierarchical predictive coding into patient benefit will come from integrating this framework with existing knowledge of the etiology and pathophysiology of psychosis, especially regarding hippocampal-prefrontal-striatal network function and neural mechanisms of information processing and belief updating.
Status Eligibilities: The Eligibility to Exist and Authority to Act in Refugee–Host Relations
Authors: Kyriakides Christopher , McLuhan Arthur , Anderson Karen , Bajjali Lubna
Published: October 2018

This study of refugee resettlement contributes a novel conceptual framework to the sociology of forced migration. Drawing on interviews with Syrian refugees in their first year of resettlement in Ontario, Canada, we demonstrate how successful sponsorship counters the “non-person” status associated with refugee recognition. During displacement, refugees mobilize their pre-conflict roles to secure self-rescue against forces of conflict. During resettlement, refugees assert their eligibility to exist and authority to act as “persons” in a reception context that challenges the normative authority of their pre-conflict social roles. Refugee–host interactions that affirm pre-conflict social roles provide the basis for shared trust and enhance the experience of resettlement, confirming statuses which counter the structural violence of refugee role confinement.
The Persuasive Power of Protest. How Protest wins Public Support
Authors: Wouters Ruud
Published: October 2018

How do protest actions succeed in winning public support? In this paper, I theorize how features of protest can persuade citizens to support demonstrators. In particular, I argue that broadcasting an attractive collective identity by means of diverse, worthy, united, numerous and committed participants (dWUNC) triggers supportive reactions of observers through increasing identification with protesters. I test this argument by exposing respondents to manipulated television news items of a protest event in two video vignette experiments. Study 1 scrutinizes the effect of dWUNC displays in an asylum seeker demonstration on a sample of Belgian citizens. Study 2 replicates this design in the US for the Black Lives Matter issue of police brutality. Both studies show predispositions of citizens to strongly affect favorability towards protesters. On top of these potent receiver effects, however, also the dWUNC features prove persuasive. In both experiments, a consistent pattern of feature effects is found: demonstrations that mobilized more diverse participants, who behaved worthy and acted in unison, elicited more supportive reactions. Study 2 adds that these protest feature effects are in part mediated by increasing identification with the demonstrators. The heterogeneity of protest feature effects is explored.
Student and Faculty Experiences in the Flipped Learning Environment in Undergraduate Nursing
Authors: Harris Ware Katilya S. , Benson Angela D.
Published: October 2018

AIM

The aim of the study was to describe student and faculty experiences in the flipped learning environment.

BACKGROUND

Studies of flipped instruction in science, technology, engineering, and mathematics reveal improvements in student performance. There is limited research related to student and faculty experiences in the learning environment.

METHOD

This study utilized a multiple-case study research design with two undergraduate nursing courses at two institutions.

RESULTS

Student participants in Case A felt the implementation of flipped learning reflected the pillars of flipped learning more than Case B participants. The strategies used to implement flipped learning in the two cases were different as were student experiences.

CONCLUSION

Three conclusions resulted from the study: flipped learning results in a shift in the student role that requires additional instructor support, instructors would benefit from guidance in the form of best practices, and nurse educators can use flipped learning to better meet the learning needs of their students.
Do Cervical Spine Surgery Patients Recall Their Preoperative Status?
Authors: Aleem Ilyas S. , Currier Bradford L. , Yaszemski Michael J. , Poppendeck Heidi , Huddleston Paul , Eck Jason , Rhee John , Bydon Mohamad , Freedman Brett , Nassr Ahmad
Published: October 2018

Study Design:

This is a prospective cohort study.

Objective:

To characterize the accuracy of patient recollection of preoperative symptoms after cervical spine surgery.

Summary of Background Data:

Recall bias is a well-known source of systematic error. The accuracy of patient recall after cervical spine surgery remains unknown.

Methods:

Consecutive patients undergoing cervical spine surgery for myelopathy or radiculopathy were enrolled. Neck and arm numeric pain scores and Neck Disability Indices were recorded preoperatively. Patients were asked to recall their preoperative status at either short (<1 y) or long-term (≥1 y) follow-up. Actual and recalled scores were compared using paired t tests and relations were quantified using the Pearson correlation coefficients. Multivariable linear regression was used to identify factors impacting recollection.

Results:

In total, 73 patients with a mean age of 58.2 years were included. Compared with their preoperative scores, patients showed significant improvement in neck pain [mean difference (MD)=−2.9; 95% confidence intervals (CIs), −3.5 to −2.3], arm pain (MD, −3.4; 95% CI, −4.0 to −2.8), and disability (MD, −12.4%; 95% CI, −16.9 to −7.9). Patient recollection of preoperative status was significantly more severe than actual for neck pain (MD, +1.5; 95% CI, 0.8–2.2), arm pain (MD, +2.3; 95% CI, 1.6–3.0), and disability (MD, +5.8%; 95% CI, 2.4–9.2). Moderate correlation between actual and recalled scores with regard to neck (r=0.41), arm (r=0.50) pain, and disability (r=0.67) was seen. This was maintained across age, sex, and time between date of surgery and recollection. Over 30% of patients switched their predominant symptom from neck-to-arm pain or vice versa on recall of their preoperative symptoms.

Conclusions:

Relying on patient recollection does not provide an accurate measure of preoperative status after cervical spine surgery. Prospective and not retrospective collection of patient-reported outcomes remain the gold standard to measure and interpret outcomes after cervical spine surgery. Recall bias has the potential to affect patient satisfaction and requires further study.
Vitamin D receptor expression and serum 25(OH)D concentration inversely associates with burden of neurofibromas
Authors: Kluwe Lan , Hagel Christian , Friedrich Reinhard E. , Schnabel Claudia , Schön Gerhard , Mautner Victor
Published: October 2018

Vitamin D and its receptor may play a role in preventing tumor development and progression. As such antineoplastic effects are expected to be weak and to act over long periods, conditions with increased tumor incidence, such as the neurofibromatosis type 1 (NF1), provide suitable study models. We previously found an inverse correlation of serum 25(OH)D concentration with number of neurofibromas in NF1. Here we aim to further explore the role of the vitamin D receptor. A total of 141 adult NF1 patients were included in the study. For 101 of them, serum vitamin 25(OH)D data were available. From 87 patients, blood samples were obtained in PaxGene tubes containing a reagent to stabilize RNA immediately. mRNA of the vitamin D receptor (VDR) gene (coding for the vitamin D receptor) was measured by means of RT-PCR. Correlation of laboratory data with NF1-related tumors was statistically evaluated. Vitamin D receptor in NF1-tumors was examined by means of immunohistochemistry using an antibody against the vitamin D1 receptor. The number of dermal neurofibromas was significantly inversely correlated with VDR mRNA level and with serum 25(OH)D concentration in NF1 patients. In contrast, plexiform neurofibroma and malignant peripheral nerve sheath tumor did not correlate with these two parameters. Immunostaining did not detect vitamin D receptor in NF1-tumors. Both vitamin D and its receptor may play a role in suppressing the development of neurofibromas. Sustaining 25(OH)D at an adequate level may contribute to controlling neurofibromas and possibly also other tumors. This is especially important for individuals with lower expression of VDR.
In-Vivo Quantitative Mapping of the Perforasomes of Deep Inferior Epigastric Artery Perforators
Authors: Leung Rachael , Chae Michael P. , Tobin Vicky , Hunter-Smith David J. , Rozen Warren M.
Published: October 2018

Background:

There is limited understanding of anatomy of perforator angiosomes, or “perforasomes,” of the deep inferior epigastric artery (DIEA). A perforasome is defined as the territory perfused by a single perforator vessel of a named artery, such as the DIEA. Given the clinical significance of this anatomical concept in microsurgical breast reconstruction, this study is a quantitative investigation of DIEA perforasome characteristics and patterns associated with perforasome size, perforator caliber, location and branching, using computed tomographic (CT) angiography.

Methods:

Twenty abdominal arterial-phase CT angiograms were analyzed in 3 dimensions using software (Horos). DIEA perforasomes were mapped, yielding data on 40 medial-row and 40 lateral-row perforasomes. Perforator branch extents and number were measured using 3-dimensional multi-planar reconstruction, and perforator caliber on axial slices.

Results:

Perforasomes exhibited eccentric branching distributions in horizontal and vertical axes, that is, a majority of perforators were not centrally located within their perforasomes. Lateral-row perforasomes displayed greater horizontal eccentricity than medial-row. There was a positive correlation between perforator caliber and perforasome size. Medial-row perforators had more branches and larger caliber than lateral-row.

Conclusions:

This is the first article to quantify relationships between perforators and their territories of supply in vivo, augmenting current understanding of perforasome theory. DIEA perforasomes can be readily visualized and mapped with CT angiography, which may enable effective preoperative flap planning in DIEA perforator flap breast reconstruction. Future investigation may highlight the importance of this information in improving surgical outcomes, including flap survival and fat necrosis reduction, through careful, perforasome-based flap design.
Preserving Orbicularis Branches of the Zygomatic Nerve with the Orbicularis Oculi Muscle—Superficial Musculoaponeurotic System Flap Complex in Facelift Surgery
Authors: Ryu Min-Hee , Kahng David , Khoo Lee Seng , Lao William Wei-Kai
Published: October 2018

The orbicularis oculi muscle (OOM) is sometimes incorporated with the superficial musculoaponeurotic system (SMAS) flap to provide a stronger flap. While elevating the OOM flap, it is important to avoid injury to the orbicularis branches of the zygomatic nerve. When the orbicularis branches of the zygomatic nerve are identified during the OOM-SMAS flap elevation, a transverse OOM flap was created to preserve the nerve. Postoperative follow-up was 12 months. There was no functional impairment of the OOM in the follow-up period. There are anatomical variations of the orbicularis branches of the zygomatic nerve. When it is identified, a transverse OOM flap incorporating it can be raised to avoid inadvertent injury. Using this method, good results were achieved with virtually no complications.
Facial Malformation in Crouzon’s Syndrome Is Consistent with Cranial Base Development in Time and Space
Authors: Lu Xiaona , Forte Antonio Jorge , Sawh-Martinez Rajendra , Madari Sarika , Wu Robin , Cabrejo Raysa , Steinbacher Derek M. , Alperovich Michael , Alonso Nivaldo , Persing John A.
Published: October 2018

Background:

In Crouzon’s syndrome, cranial base deformities begin sequentially in the anterior cranial fossa initially, and later to the posterior cranial base. Facial characteristics are likely related to cranial base development. The temporal correlation between cranial base development and facial features is in need of clarification in Crouzon’s patients, to clarify initial sites of deformity, which may impact surgical decision making.

Methods:

Thirty-six computed tomography scans of unoperated Crouzon’s syndrome patients and 54 controls were included and divided into 5 age-subgroups. All the planes used for analysis were set as perpendicular to a defined “midplane” to offset the confounding factor caused by potential asymmetry.

Results:

The angle between Sella-Nasion plane and Frankfort horizontal plane was significantly increased before 6 months of age (P= 0.014), with an average 70% (P< 0.001) increase ultimately into adulthood. The angle between SN and maxillary plane and the angle between Sella-Nasion and occlusal planes increased consistently through infancy to adulthood (124% and 42%, respectively, bothP< 0.001). The relative angle of mandibular plane to Frankfort horizontal plane increased before 6 months (28%,P= 0.007) with a peak timeframe from 2 to 18 years. Facial lateral curvature related measurements indicate the whole face is inclined posteriorly and inferiorly direction in relation to the anterior cranial base.

Conclusion:

Crouzon’s facial malformation development is synchronous and positionally correlational with cranial base deformity. It transmitted from orbit to mandible, with the most evident morphologic changes are in the orbit and midface.
Comparisons of Health Promoting Behavior, Depression, and Life Satisfaction Between Older Adults in Rural Areas in South Korea Living in Group Homes and at Home
Authors: SOK Sohyune R. , CHEON Bo Kyeong , GU Min Kyung , KIM Ok Sun
Published: October 2018

Background:

In South Korea, population aging is advancing at a more rapid rate in rural areas than urban areas, leading to a particularly high percentage of rural-dwelling older adults.

Purpose:

The aim of this study was to examine and compare health promoting behaviors, depression, and life satisfaction between rural-dwelling older adults who live, respectively, in group homes and at home.

Methods:

A cross-sectional descriptive study design was employed. Study participants included 160 older adults aged 65 years and older who were living in group homes (n = 80) and at home (n = 80) in Gyeonggi province, South Korea. The Health Promotion Lifestyle Profile-II was used to examine health promoting behaviors, the Korean Geriatric Depression Screening Scale was used to examine depression, and the Life Satisfaction Index was used to examine life satisfaction. Data were analyzed using SPSS Version 21.0.

Results:

The data showed significant differences between the two groups in terms of health promoting behaviors (t = −9.035, p < .001), depression (t = 20.861, p < .001), and life satisfaction (t = −12.153, p < .001).

Conclusions/Implications for Practice:

The mean scores for health promotion behaviors and life satisfaction were higher, and the mean score for depression was lower in the group-home group than the at-home group. The findings from this study may be employed as basic data for establishing residence-appropriate nursing intervention protocols for older adults living in rural areas.
What Effect Does Smoking Have on the Surgical Closure of Tympanic Membrane Perforations? A Review
Authors: Visvanathan Vikranth , Vallamkondu Vamsidhar , Bhimrao Sanjiv K.
Published: October 2018

Objectives:

The link between cigarette smoking and outcome following surgical repair of tympanic membrane perforation is unclear. The objective of this study was to conduct a systematic review on the link between smoking and success rate following surgical repair of tympanic membrane perforations.

Materials and Methods:

Systematic review performed using the following data sources: 1) Cochrane central register of controlled trials (1997 to April 30, 2018), 2) Medline (February 1948 to April 30, 2018), and 3) Embase (1975 to April 30, 2018). Inclusion criteria for this study was: 1) studies reporting surgical closure of tympanic membrane perforations in smokers, 2)primary and revision cases, 3) English language literature, 4) minimum follow-up period of 6 months, and 5) pre and postoperative audiogram. The exclusion criteria were: 1) no identifiable data on smokers in reported outcomes, 2) less than 6 months follow-up, 3) no audiometric outcomes, and 4) non-English language articles.

Results:

A total of 75 studies were identified on initial search and 8 were eligible for the study. All studies were of level 4 evidence. In these eight studies, overall surgical closure of tympanic membrane perforation was successful in 512/577 (88.7%) of nonsmokers and 151/197 (76.6%) in smokers. This difference was statistically significant.

Conclusions:

Smokers may have a lower success rate compared against nonsmokers for surgical repair of tympanic membrane perforations. Our review has limitations and more prospective high-quality controlled trials are required to further study this association.
Prevalence of Radiographic Cochlear–Facial Nerve Dehiscence
Authors: Song Yohan , Alyono Jennifer C. , Bartholomew Ryan A. , Vaisbuch Yona , Corrales Carleton Eduardo , Blevins Nikolas H.
Published: October 2018

Objective:

To determine the prevalence of radiographic cochlear–facial nerve dehiscence (CFD).

Study Design:

Retrospective radiological study.

Setting:

Two tertiary-referral centers.

Patients:

Two hundred six temporal-bone computed tomography (CT) scans (405 total ears) of otology/neurotology patients from two academic institutions between the years 2014 and 2017.

Intervention:

Diagnostic.

Main Outcome Measures:

The cochlear–facial nerve partition width (CFPW) was measured on coronal CT sections and defined as the shortest distance between the cochlear basal turn and facial nerve (FN) labyrinthine segment. We used logistics regression analyses to determine positive predictors for radiographic evidence of CFD.

Results:

The overall prevalence of radiographic CFD was 5.4% (22/406 ears). 9.2% of patients (19/206) had CFD. Of these 19 patients, only one patient had mixed hearing loss that could not be explained by any other vestibular or auditory etiology. Three out of 206 patients had dehiscence in both ears (1.4%). The average CFPW was 0.6 ± 0.2 mm, and fallopian canal width was 1.1 ± 0.02 mm (n = 405). Older age, use of traditional CT scans, and thinner CT slice thickness were significant predictors for radiographic CFD.

Conclusions:

The radiographic prevalence of CFD is higher than what is reported in histologic studies, and may over-estimate the true prevalence of CFD. The clinician should keep this in mind when considering this as potential cause for third-window symptoms.
In vivo Assessment of an Endolymphatic Hydrops Gradient Along the Cochlea in Patients With Menière's Disease by Magnetic Resonance Imaging—A Pilot Study
Authors: Bier Georg , Bongers Malte Niklas , Schabel Christoph , Heindel Walter , Ernemann Ulrike , Hempel Johann-Martin
Published: October 2018

Objective:

To assess three strategies for evaluation and description of potential endolymphatic hydrops (EH) gradients along the cochlea in patients with Menière's disease.

Study Design:

Prospective observational study.

Methods:

Ten patients with definite Menière's disease revealed by magnetic resonance imaging were included in this prospectively conducted pilot study. The presence of cochlear endolymphatic hydrops as well as a potential hydrops gradient along the cochlea were subjectively evaluated by two readers. Furthermore, both readers performed planimetric measurements of the relative extent of endolymphatic hydrops in the cochlear turns for calculation of an apico-basal-index (ABI) and an average gradient slope of the endolymphatic hydrops. These models were correlated with the available pure tone audiometry (PTA).

Results:

Qualitatively, 13 of 16 inner ears presented an apical EH distribution. The median ABI was 1.69 for patients with low-tone hearing loss and 1.17 for patients with a flat PTA curve (p = 0.03). The median EH slope was 7.44 and correlated with the steepness of the PTA (ρ = 0.583; p = 0.018). The subjective analysis and the slope model were best fit for prediction of a low-tone hearing loss type with sensitivities of 100% (specificity, 42.86%) and 88.9% (specificity, 71.4%), respectively. The inter-reader agreement in all three approaches was considered substantial to perfect.

Conclusion:

The presented qualitative approach and the slope model represent reliable methods for the description of a potential EH gradient along the cochlea. Furthermore, the average EH steepness along the cochlea correlates with the type of hearing loss.
Understanding Pancreatic Diseases Using Animated Pancreas Patient
Authors: Munigala Satish , Gardner Timothy B. , O'Reilly Eileen M. , Castillo Carlos Fernández-del , Ko Andrew H. , Pleskow Douglas , Mills Jeannine B. , Vollmer Charles M. , Searle Nicholas A. , Alsante Matthew , Holt Jane M. , Gelrud Andres
Published: October 2018

Objectives

The aim of this study was to evaluate the impact of Animated Pancreas Patient (APP) educational modules (APP website and YouTube) on pancreas education, awareness, and health outcomes.

Methods

This was a retrospective study of APP metrics data from September 2013 to October 2017. We evaluated audience reach (number of visit sessions, unique visitors, page views) and calculated top views by media type (animation, expert video, patient video, and slide show) and top retention videos from the modules. We also assessed the educational impact through learner feedback survey.

Results

The APP had 1,475,252 views (547,693 unique visitors, 63.1% in United States) during the study period. Most popular topic viewed among the animations was “Role and Anatomy of the Pancreas” (n = 361,116), and most common expert video viewed was “Chronic Pancreatitis: What Foods and Beverages Should I Avoid?” (n = 31,667). Participants who completed the online feedback survey reported knowledge gains and commitments to change.

Conclusions

Pancreas education in visual formats of learning provided by APP demonstrated wide reach and has substantial potential to inform and impact behaviors of patients and caregivers. Continued efforts should be made to provide patient resources that address health literacy and patient education and respond to patient needs for better quality of life and improved health outcomes in pancreatic diseases.
Not All Pediatric Bladder Masses are Rhabdomyosarcoma: Report of a Rare Case With Review of the Literature
Authors: Mitra Suvradeep , Joshi Rashmi , Gupta Kirti , Mahajan Jai Kumar
Published: October 2018

Leiomyoma of the urinary bladder in the pediatric age group is one of the rarest tumors with only 2 case reports in the English literature. Rhabdomyosarcoma is the commonest tumor at this site in this age group. It needs to be distinguished from rhabdomyosarcoma by histomorphology for appropriate treatment and management. We report the third case of urinary bladder leiomyoma arising in a 6-year-old boy with a short review of the literature.
Burkitt Lymphoma Presenting With Intracardiac Mass and Tumor Thrombosis in the Anterior Mediastinum With Literature Review
Authors: Koca Yozgat Ayça , Ozyoruk Derya , Kacar Dilek , Cetin Ibrahim İ. , Yaman Bajin Inci , Inan Kubilay , Oguz Ayse S.
Published: October 2018

Burkitt lymphoma manifesting as an intracardiac mass is a rare entity. This report describes the case of a 10-year-old boy who presented with an intracardiac mass and tumor thrombosis in the anterior mediastinum that proved to be Burkitt lymphoma. The LMB-96 chemotherapy protocol was given and at the end of the treatment there was still residual mass. A biopsy was performed and the pathology revealed thymus tissue. The patient has been in complete remission for 3 months. Burkitt lymphoma has a short doubling time and an intracardiac lesion can become life threatening. Early recognition and prompt treatment are crucial in achieving optimal outcomes.
Improving Functional Assessment in Older Adults Transitioning From Hospital to Home
Authors: Liebzeit Daniel , King Barbara , Bratzke Lisa , Boltz Marie
Published: October 2018

Purpose/Objectives:

The purpose of this article is to highlight how scientists have assessed all components of functional status in older adults transitioning from hospital to home to date, discuss ways of improving assessment of functional status, and discuss implications for case management research and practice.

Primary Practice Setting(s):

This article focuses on case management of older adults transitioning from hospital to home.

Findings/Conclusions:

There any many ways to assess functional status, including basic activities of daily living (BADL), instrumental activities of daily living (IADL), and other nonphysical domains of function such as leisure, social, and productive activities. However, assessment of function in older adults transitioning from hospital to home is primarily limited to BADL. Nonphysical domains of functional status have been linked to important outcomes in community-dwelling older adults and could give clinicians and researchers a better understanding of how older adults are functioning, as well as allow for earlier recognition of those who are beginning to experience functional decline.

Implications for Case Management Practice:

In case management, it is important to ask older adults about goals regarding their functional status and how they think about their functioning in the hospital and at home. Early identification of older adults' functional goals while in the hospital is the first step toward regaining their ideal or premorbid function after discharge to home. To best determine baseline functional status, we may need to consider assessments that can measure multiple domains of functioning in older adults, such as the Sickness Impact Profile. Gaining a more comprehensive understanding and assessment of functional status for hospitalized older adults would help inform discharge destinations and improve transitions in care.
Clinical Nurse Specialists’ Perceptions of a Mental Health Patient Portal
Authors: Mayhew Cari , Strudwick Gillian , Waddell Janice
Published: October 2018

Purpose:

The purposes of this study were to explore clinical nurse specialists’ views of the potential influence of a mental health portal on nursing practice and to identify portal implementation strategies.

Methods:

A qualitative descriptive approach was used. Semistructured interviews were conducted with 5 clinical nurse specialists. Two independent coders conducted an inductive content analysis of the transcribed interviews to generate codes describing patterns in the data to identify originating themes.

Results:

The content analysis uncovered the following 4 themes: (1) implementation strategies, (2) nurse likelihood to recommend, (3) impact on nursing practice, and (4) perceived influence on patients.

Conclusion:

Direct care nurses may benefit from education and coaching on how to document in the record using patient-centered language that is understandable to patients who may be reading it. In addition, the use of patient portals should be designed to fit into nurses’ existing clinical workflows. Finally, more research is needed to identify the benefits and unintended consequences of patient portals within a mental health context.
A Best Practice Initiative to Optimize Transfer of Young Adults With Osteogenesis Imperfecta From Child to Adult Healthcare Services
Authors: Isabel Carrier Jaimie , Siedlikowski Maia , Chougui Khadidja , Plourde Sylvie-Anne , Mercier Corinne , Thevasagayam Gloria , Lafrance Marie-Élaine , Wong Trudy , Bilodeau Claudette , Michalovic Alisha , Thorstad Kelly , Rauch Frank , Tsimicalis Argerie
Published: October 2018

Purpose

The aims of this study were (1) to review the current body of knowledge on the transition experiences of adolescents with osteogenesis imperfecta (OI) and appraise the evidence available on transfer summary tools, (2) to develop guidelines for the successful transition of adolescents with OI from child to adult healthcare services, and (3) to create a transfer tool tailored to adolescents with OI.

Design and Methods

This knowledge synthesis study was overseen by an interprofessional expert task force at Shriners Hospitals for Children–Canada and entailed (1) review of the literature, (2) development of guidelines, and (3) creation of a tool.

Results

The tool was created from evidence compiled from case reports, clinical examples, and nonexperimental studies.

Conclusion

The transfer tool proposes guidelines designed to facilitate a smooth transition from child to adult healthcare services. It also offers creation of a clinically meaningful, person-focused, OI transfer tool that may in turn help improve the transition experience for adolescents. This study significantly contributes to the dearth of literature on transition experiences in OI and on transfer tools in general. Future research is needed to evaluate the implementation and evaluation of the OI transfer tool in practice.
Assessing the Feasibility of Providing a Real-Time Response to Seizures Detected With Continuous Long-Term Neonatal Electroencephalography Monitoring
Authors: Sharpe Cynthia , Davis Suzanne L , Reiner Gail E. , Lee Lilly I , Gold Jeff J , Nespeca Mark , Wang Sonya G , Joe Priscilla , Kuperman Rachel , Gardner Marissa , Honold Jose , Lane Brian , Knodel Ellen , Rowe Deborah , Battin Malcolm R. , Bridge Renee , Goodmar Jim , Castro Ben , Rasmussen Maynard , Arnell Kathy , Harbert MaryJane , Haas Richard
Published: October 2018

Purpose:

Continuous video electroencephalography (cEEG) monitoring is the recommended gold standard of care for at-risk neonates but is not available in many Neonatal Intensive Care Units (NICUs). To conduct a randomized treatment trial of levetiracetam for the first-line treatment of neonatal seizures (the NEOLEV2 trial), we developed a monitoring infrastructure at five NICUs, implementing recent technological advancements to provide continuous video EEG monitoring and real-time response to seizure detection. Here, we report on the feasibility of providing this level of care.

Methods:

Twenty-five key informant interviews were conducted with study neurologists, neonatologists, coordinators, and EEG technicians from the commercial EEG monitoring company Corticare. A general inductive approach was used to analyze these qualitative data.

Results:

A robust infrastructure for continuous video EEG monitoring, remote review, and real-time seizure detection was established at all sites. At the time of this survey, 260 babies had been recruited and monitored for 2 to 6 days. The EEG technician review by the commercial EEG monitoring company was reassuring to families and neonatologists and led to earlier detection of seizures but did not reduce work load for neurologists. Neurologists found the automated neonatal seizure detector algorithm provided by the EEG software company Persyst useful, but the accuracy of the algorithm was not such that it could be used without review by human expert. Placement of EEG electrodes to initiate monitoring, especially after hours, remains problematic.

Conclusions:

Technological advancements have made it possible to provide at-risk neonates with continuous video EEG monitoring, real-time detection of and response to seizures. However, this standard of care remains unfeasible in usual clinical practice. Chief obstacles remain starting a recording and resourcing the real-time specialist review of suspect seizures.
Homologous expression and characterization of gassericin T and gassericin S, a novel class IIb bacteriocin produced byLactobacillus gasseriLA327
Authors: Kasuga Genki , Tanaka Masaru , Harada Yuki , Nagashima Hiroshi , Yamato Taisei , Wakimoto Ayaka , Ito Yoshiyuki , Kawai Yasushi , Kok Jan , Masuda Testuya
Published: October 2018

Lactobacillus gasseriLA327 isolated from the large intestine tissue in humans is a bacteriocinogenic strain and is predicted to produce two kinds of class IIb bacteriocins, i.e. gassericin T (GT) and acidocin LF221A (Acd LF221A). In this study, DNA sequencing of the genes for GT and Acd LF221A onLb. gasseriLA327 revealed that the amino acid sequences for GT completely corresponded with those ofgatexcept for GatK (histidine kinase). However, those for the Acd LF221A had analogues which differed in at least one amino acid residue to be a putative class IIb bacteriocin designated as gassericin S (GS). By deletion test of GT structural genes (gatAX), the LA327 strain retained the bacteriocin activity, and the LA327 mutant strain lacking the ABC-type transporter gene (gatT) completely lost the bacteriocin activity. This indicates that LA327 strain is a GS producer, and GS production is performed viagatwith the inclusion ofgatT. Homologous expression using deletion mutants for GS and GT containing each single peptide elucidated that GS (GasAX) and GT (GatAX) showed synergistic activity as class IIb bacteriocins, respectively, and no synergistic activity was observed between each peptide of GS and GT. The molecular mass of GS was estimated to be theoretical ca. 5,400 Da byin situactivity assay after SDS-PAGE, clarifying that GS was actually expressed as an active class IIb bacteriocin. Furthermore, stability of GS expressed against pH, heat and protease was determined.

Importance

We determined the complete DNA sequence for GS, a novel class IIb bacteriocin ofLb. gasseri, and succeeded to express GS as active bacteriocins. Our results clarified the interaction of each class IIb component peptide for GT in addition to GS via construction of homologous mutants which were not dependent on the purification. These data may demonstrate the characteristics of class IIb bacteriocins forLb. gasseri.
Ligand Geometry Controls Adhesion formation via Integrin Clustering
Authors: Changede Rishita , Cai Haogang , Wind Shalom , Sheetz Michael P.
Published: October 2018

Integrin-mediated cell matrix adhesions are key to sensing the geometry and rigidity of the extracellular environment to regulate vital cellular processes.In vivo, the extracellular matrix (ECM) is composed of a fibrous mesh. To understand the geometry that supports adhesion formation on fibrous substrates, we patterned 10 nm gold-palladium single lines or pairs of lines (total width within 100 nm), mimicking thin single ECM fibers or a minimal mesh geometry, respectively and functionalized it with integrin binding ligand Arg-Gly-Asp (RGD). Single lines showed reduced focal adhesion kinase (FAK) recruitment and did not support cell spreading or formation of focal adhesions, despite the presence of a high density of integrin-binding ligands. Using super resolution microscopy, we observed transient integrin clusters on single lines, whereas stable 110 nm integrin clusters formed on pairs of lines similar to those on continuous substrates. This indicated that two-dimensional ligand geometry is required for adhesion formation on rigid substrates. A mechanism to form modular 100nm integrin clusters bridging the minimal fiber mesh would require unliganded integrins. We observed that integrin mutants unable to bind ligand co-clustered with ligand-bound integrins when present in an active extended conformation. Thus, these results indicate that functional integrin clusters are required to form focal adhesions and unliganded integrins can co-cluster to bridge between thin matrix fibers and can form stable integrin adhesions on dense fibrous networks.