bluuebunny/crossref_metadata_2025 huggingface dataset:
ALMA and RATIR observations of GRB 131030A
Authors: Huang Kuiyun , Urata Yuji , Takahashi Satoko , Im Myungshin , Yu Po-Chieh , Choi Changsu , Butler Nathaniel , Watson Alan M. , Kutyrev Alexander , Lee William H. , Klein Chris , Fox Ori D. , Littlejohns Owen , Cucchiara Nino , Troja Eleonora , González Jesús , Richer Michael G. , Román-Zúñiga Carlos , Bloom Josh , Prochaska J. Xavier , Gehrels Neil , Moseley Harvey , Georgiev Leonid , de Diego José A. , Ramirez-Ruiz Enrico
Published: December 2016

We report on the first open-use based Atacama Large Millimeter/submm Array (ALMA) 345 GHz observation for the late afterglow phase of GRB 131030A. The ALMA observation constrained a deep limit at 17.1 d for the afterglow and host galaxy. We also identified a faint submillimeter source (ALMA J2300−0522) near the GRB 131030A position. The deep limit at 345 GHz and multifrequency observations obtained using Swift and RATIR yielded forward-shock modeling with a two-dimensional relativistic hydrodynamic jet simulation and described X-ray excess in the afterglow. The excess was inconsistent with the synchrotron self-inverse Compton radiation from the forward shock. The host galaxy of GRB 131030A and optical counterpart of ALMA J2300−0522 were also identified in the Subaru image. Based on the deep ALMA limit for the host galaxy, the 3σ upper limits of IR luminosity and the star formation rate (SFR) are estimated as LIR < 1.11 × 1011 L⊙ and SFR <18.7 (M⊙ yr−1), respectively. Although the separation angle from the burst location (3${^{\prime\prime}_{.}}$5) was rather large, ALMA J2300−0522 may be one component of the GRB 131030A host galaxy, according to previous host galaxy cases.
Comparison of cardiovascular risk algorithms in patients with vs without rheumatoid arthritis and the role of C-reactive protein in predicting cardiovascular outcomes in rheumatoid arthritis
Authors: Alemao Evo , Cawston Hélène , Bourhis François , Al Maiwenn , Rutten-van Molken Maureen , Liao Katherine P. , Solomon Daniel H.
Published: December 2016

Objectives. The aims were to compare the performance of cardiovascular risk calculators, Framingham Risk Score (FRS) and QRISK2, in RA and matched non-RA patients and to evaluate whether their performance could be enhanced by the addition of CRP.

Methods. We conducted a retrospective analysis, using a clinical practice data set linked to Hospital Episode Statistics (HES) data from the UK. Patients presenting with at least one RA diagnosis code and no prior cardiovascular events were matched to non-RA patients using disease risk scores. The overall performance of the FRS and QRISK2 was compared between cohorts, and assessed with and without CRP in the RA cohort using C-Index, Akaike Information Criterion (AIC) and the net reclassification index (NRI).

Results. Four thousand seven hundred and eighty RA patients met the inclusion criteria and were followed for a mean of 3.8 years. The C-Index for the FRS in the non-RA and RA cohort was 0.783 and 0.754 (P < 0.001) and that of the QRISK2 was 0.770 and 0.744 (P < 0.001), respectively. Log[CRP] was positively associated with cardiovascular events, but improvements in the FRS and QRISK2 C-Indices as a result of inclusion of CRP were small, from 0.764 to 0.767 (P = 0.026) for FRS and from 0.764 to 0.765 (P = 0.250) for QRISK2. The NRI was 3.2% (95% CI: −2.8, 5.7%) for FRS and −2.0% (95% CI: −5.8, 4.5%) for QRISK2.

Conclusion. The C-Index for the FRS and QRISK2 was significantly better in the non-RA compared with RA patients. The addition of CRP in both equations was not associated with a significant improvement in reclassification based on NRI.
Pain Catastrophizing is Not Associated With Spinal Nociceptive Processing in People With Chronic Widespread Pain
Authors: Rice David A. , Parker Rosalind S. , Lewis Gwyn N. , Kluger Michal T. , McNair Peter J.
Published: December 2016

Objectives:

Pain catastrophizing has been associated with higher pain intensity, increased risk of developing chronic pain and poorer outcomes after treatment. Despite this, the mechanisms by which pain catastrophizing influences pain remain poorly understood. It has been hypothesized that pain catastrophizing may impair descending inhibition of spinal level nociception. The aims of this study were to compare spinal nociceptive processing in people with chronic widespread pain and pain-free controls and examine potential relationships between measures of pain catastrophizing and spinal nociception.

Materials and Methods:

Twenty-six patients with chronic widespread pain and 22 pain-free individuals participated in this study. Spinal nociception was measured using the nociceptive flexion reflex (NFR) threshold and NFR inhibition, measured as the change in NFR area during exposure to a second, painful conditioning stimulus (cold water immersion). Pain catastrophizing was assessed using the Pain Catastrophizing Scale and a situational pain catastrophizing scale.

Results:

Compared with pain-free controls, patients with chronic widespread pain had higher pain catastrophizing scores and lower NFR thresholds. Although NFR area was reduced by a painful conditioning stimulus in controls, this was not apparent in individuals with chronic widespread pain. No significant correlations were observed between measures of pain catastrophizing and spinal nociception.

Discussion:

Despite increased excitability and decreased inhibition of spinal nociception in patients with chronic widespread pain, we could find no evidence of a significant relationship between pain catastrophizing and measures of spinal nociceptive processing.
Complications Rates of Recertification Applicants to Those Seeking Initial Orthopedic Board Certification
Authors: Hunter Joshua G. , Baumhauer Judith F.
Published: December 2016

The American Board of Orthopaedic Surgeons (ABOS) has integrated Maintenance of Certification process to ensure continued physician education and improved clinical performance. The purpose of this study was to evaluate overall change in complication rates for foot and ankle (FA) procedures by surgeons seeking board recertification (BRC) to initial board certifiers (IBC) using ABOS case lists. The ABOS database and case list was reviewed from January, 2006 to December, 2010 for the most commonly performed FA procedures as indicated by current procedural terminology codes (27600-28899; 29893-29907) by 2 distinct groups: (1) those seeking their IBC, and (2) those seeking their BRC. The 15 most common FA procedural codes were identified and complications reported from these codes were tallied and recorded. The 15 most commonly reported procedures comprised 8 traumatic and 7 elective procedures. There was a statistically significant difference of cases reporting at least 1 complication from IBC compared with BRC (14.5% vs. 9.9%, P<0.001). All rates were significantly less (P<0.001) in BRC versus IBC for infection (2.3% vs. 3.8%), wound dehiscence (1.6% vs. 3.0%), skin ulcer/blister (0.9% vs. 1.8%), implant fracture (0.2% vs. 1.0%), pulmonary embolus/deep vein thrombosis (0.4% vs. 0.8%), nerve injury (0.3% vs. 0.8%), iatrogenic bone fracture (0.01% vs. 0.3%). There was a significant overall reduction in the complication rates, both collectively and individually for BRC compared with IBC. Continued efforts to collect and analyze cross-sectional data could be useful in designing customized risk-reduction programs and monitoring surgeon practice performance.

Level of Evidence: Diagnostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Measuring Moral Distress Among Critical Care Clinicians: Validation and Psychometric Properties of the Italian Moral Distress Scale-Revised*
Authors: Lamiani Giulia , Setti Ilaria , Barlascini Luca , Vegni Elena , Argentero Piergiorgio
Published: December 2016

Objectives:

Moral distress is a common experience among critical care professionals, leading to frustration, withdrawal from patient care, and job abandonment. Most of the studies on moral distress have used the Moral Distress Scale or its revised version (Moral Distress Scale-Revised). However, these scales have never been validated through factor analysis. This article aims to explore the factorial structure of the Moral Distress Scale-Revised and develop a valid and reliable scale through factor analysis.

Design:

Validation study using a survey design.

Setting:

Eight medical-surgical ICUs in the north of Italy.

Subjects:

A total of 184 clinicians (64 physicians, 94 nurses, and 14 residents).

Interventions:

The Moral Distress Scale-Revised was translated into Italian and administered along with a measure of depression (Beck Depression Inventory-Second Edition) to establish convergent validity. Exploratory factor analysis was conducted to explore the Moral Distress Scale-Revised factorial structure. Items with low (less than or equal to 0.350) or multiple saturations were removed. The resulting model was tested through confirmatory factor analysis.

Measurements and Main Results:

The Italian Moral Distress Scale-Revised is composed of 14 items referring to four factors: futile care, poor teamwork, deceptive communication, and ethical misconduct. This model accounts for 59% of the total variance and presents a good fit with the data (root mean square error of approximation = 0.06; comparative fit index = 0.95; Tucker-Lewis index = 0.94; weighted root mean square residual = 0.65). The Italian Moral Distress Scale-Revised evinces good reliability (α = 0.81) and moderately correlates with Beck Depression Inventory-Second Edition (r = 0.293; p < 0.001). No significant differences were found in the moral distress total score between physicians and nurses. However, nurses scored higher on futile care than physicians (t = 2.051; p = 0.042), whereas physicians scored higher on deceptive communication than nurses (t = 3.617; p < 0.001). Moral distress was higher for those clinicians considering to give up their position (t = 2.778; p = 0.006).

Conclusions:

The Italian Moral Distress Scale-Revised is a valid and reliable instrument to assess moral distress among critical care clinicians and develop tailored interventions addressing its different components. Further research could test the generalizability of its factorial structure in other cultures.
End-of-Life Nursing Care and Education
Authors: D'Antonio Jocelyn
Published: December 2016

The dying experience is forever carried in the life story of those for whom the nurse cares. A goal of end-of-life nursing education is to produce nurses who are comfortable with death and dying and who have had the opportunity to reflect on their thoughts and feelings about end-of-life care. This article reviews the history, development, and teaching methods of end-of-life care, offering recommendations for future education.
End of Life in a Haitian American, Faith-Based Community
Authors: Ladd Susan Charlotte , Gordon Shirley C.
Published: December 2016

This article presents two models resulting from a grounded theory study of the end-of-life decision-making process for Haitian Americans. Successful access to this vulnerable population was achieved through the faith-based community. The first model describes this faith-based community of Haitian Americans. The second model describes the process used by families in this community who must make end-of-life healthcare decisions. Implications for nursing practice and caring science include a need to improve the congruence between the nursing care provided at this vulnerable time and the cultural values of a population.
Chronic Localized Fibrosing Leukocytoclastic Vasculitis Associated With Lymphedema, Intralymphatic and Intravascular Lymphocytosis, and Chronic Myelogenous Leukemia: A Case Report of Unilateral Erythema Elevatum Diutinum
Authors: Atallah Juliana , Garces Juan C. , Loayza Enrique , Carlson John A.
Published: December 2016

One of the pathogenic causes of cutaneous inflammatory pseudotumors is chronic localized fibrosing leukocytoclastic vasculitis (CLFLCV), a vasculitic reaction pattern seen in granuloma faciale (GF), a localized vasculitis, and erythema elevatum diutinum (EED), a generalized vasculitis. Patients with myelodysplastic syndromes (MDSs) are at risk for a diverse spectrum of cutaneous neutrophilic dermatoses such as EED. Herein, we report a 74-year-old man who presented with a large ulcerative, fungating tumor affecting the right flexor ankle caused by CLFLCV. During his workup and management, MDS and Philadelphia chromosome-negative chronic myeloid leukemia was diagnosed. Surgical excision of the inflammatory mass promptly triggered tumor recurrence, whereas antineutrophil therapy (dapsone coupled with hydroxyurea, and prednisone) lead to tumor regression. Histopathologic examination revealed an eosinophilic-rich small-vessel neutrophilic vasculitis associated with storiform and angiocentric fibrosis (GF-like). In the regions of fibrosis, dilated lymphatic and vascular spaces were numerous, some of which were congested with small CD3+-positive lymphocytes (intralymphatic and intravascular lymphocytosis). These findings indicate coexisting localized lymphedema. By direct immunofluorescence, IgM and C4d vessel deposits were detected. The pathogenesis of the fibrotic nodules and plaques of CLFLCV is suspected to be due to recurring bouts of immune-complex vasculitis, creating a cycle of vessel damage followed by reparative granulation tissue. Poor lymphatic drainage may be the underlying factor initiating and maintaining recurrent, localized episodes of immune-complex vasculitis and progressive fibrosis. Although his tumor histopathology resembled GF—eosinophilic rich CLFLCV—the clinical context points to a solitary and paraneoplastic case of EED.
Azathioprine Therapy in a Pediatric TPMT-Deficient Patient—Still an Option
Authors: van Moorsel S. A. W. , Bevers N. , Meurs M. , van Rossum L. K. , Hooymans P. M. , Wong D. R.
Published: December 2016

We describe the case of a pediatric patient on azathioprine therapy with previously undiagnosed homozygote thiopurine S-methyltransferase (TPMT) deficiency, resulting in myelotoxic thiopurine metabolite levels. The patient was successfully treated with a very low azathioprine dose of 50 mg once a week (4% of standard dose), guided by frequent thiopurine metabolite measurement and a close clinical surveillance. We demonstrate that azathioprine therapy still might be an effective and safe therapeutic option in pediatric thiopurine S-methyltransferase–deficient IBD patients.
Technique to Improve Tracheostomy Speaking Valve Tolerance after Head and Neck Free Flap Reconstruction
Authors: Stranix John T. , Danziger Keri M. , Dumbrava Veturia L. , Mars Ginger , Hirsch David L. , Levine Jamie P.
Published: December 2016

Increased upper airway resistance from postoperative changes after major head and neck surgery may cause elevated transtracheal pressures and result in tracheostomy speaking valve intolerance. This may be particularly true among patients with baseline pulmonary disease. We describe a patient recovering from oral cancer resection and flap reconstruction who demonstrated prolonged ventilator dependence and tracheostomy speaking valve intolerance with abnormal tracheal manometry. We attempted to improve speaking valve tolerance through the adaptation of a valve modification intended to reduce transtracheal pressures. Drilling holes into the 1-way speaking valve allowed for excess air egress and resulted in normalization of transtracheal pressures with improved speaking valve tolerance. This 1-way speaking valve modification may serve as a simple method to allow for earlier restoration of voicing and potentially reduce the number of ventilator- dependent days in this patient population.
Two Cases of Adverse Reactions of Hyaluronic Acid–based Filler Injections
Authors: Fan Xing , Dong Ming , Li Tong , Ma Qiaoxin , Yin Yue
Published: December 2016

Hyaluronic acid (HA) is one of the natural components of the human body with high biocompatibility, biodegradability, and nonimmunogenicity, which makes it the ideal biomedical filling agent currently available. However, for many medical practitioners, HA filler injections remain a relatively new item to carry out. Learning while practicing, it is inevitable to encounter some difficulties and adverse reactions in its application. Here we report two cases of adverse reactions to HA-based filler injections, including anaphylactic reaction on the face and vascular thrombosis after augmentation rhinoplasty with HA filler. In this report, we highlight the management and prevention of the adverse reactions, especially in case 2, because vascular thrombosis is one of the severe complications and injectors should know how to avoid it and how to deal with it, thereby increasing the safety of HA-based procedures.
EFFECTS OF A MODIFIED VITRECTOMY PROBE IN SMALL-GAUGE VITRECTOMY
Authors: Rizzo Stanislao , Fantoni Gualtiero , de Santis Giovanni , Lue Jaw-Chyng Lormen , Ciampi Jonathan , Palla Michele , Genovesi Ebert Federica , Savastano Alfonso , De Maria Carmelo , Vozzi Giovanni , Brant Fernandes Rodrigo A. , Faraldi Francesco , Criscenti Giuseppe
Published: December 2016

Purpose:

Thorough this experimental study, the physic features of a modified 23-gauge vitrectomy probe were evaluated in vitro.

Methods:

A modified vitrectomy probe to increase vitreous outflow rate with a small-diameter probe, that also minimized tractional forces on the retina, was created and tested. The “new” probe was created by drilling an opening into the inner duct of a traditional 23-gauge probe with electrochemical or electrodischarge micromachining. Both vitreous outflow and tractional forces on the retina were examined using experimental models of vitreous surgery.

Results:

The additional opening allowed the modified probe to have a cutting rate of 5,000 cuts per minute, while sustaining an outflow approximately 45% higher than in conventional 23-gauge probes. The modified probe performed two cutting actions per cycle, not one, as in standard probes. Because tractional force is influenced by cutting rate, retinal forces were 2.2 times lower than those observed with traditional cutters.

Conclusion:

The modified probe could be useful in vitreoretinal surgery. It allows for faster vitreous removal while minimizing tractional forces on the retina. Moreover, any available probe can be modified by creating a hole in the inner duct.
VISUAL FUNCTION CORRELATES OF FOVEAL SLOPE CHANGES ON OPTICAL COHERENCE TOMOGRAPHY IN MACULAR TELANGIECTASIA TYPE 2
Authors: Jaisankar Durgasri , Raman Rajiv , Gondhale Harshal , Chhablani Jay , Agarwal Manisha
Published: December 2016

Purpose:

To evaluate changes in foveal and parafoveal thickness measured using optical coherence tomography across five stages of macular telangiectasia 2 (MacTel 2) and to correlate the foveal slope angle with best-corrected visual acuity (BCVA).

Methods:

A multicentered, cross-sectional study of 90 patients with bilateral MacTel 2 was carried out. We reviewed medical records of patients who had undergone optical coherence tomography. Mean retinal thickness foveal and subfoveal were noted from ETDRS (Early Treatment Diabetic Retinopathy Study) mapping and later used for calculating foveal slope angle. The change in retinal thickness and foveal angle across five stages of MacTel 2 was assessed. Central foveal thickness and foveal slope angle were correlated with BCVA.

Results:

The foveal slope angles were calculated quadrantwise and stagewise. The mean slope angle was minimum in temporal quadrant (6.29°) followed by inferior (7.13°), superior (7.54°), and nasal (7.93°). The slope angles were 9.27°, 7.95°, 6.70°, 6.10°, and 6.31° in Stages 1, 2, 3, 4, and 5, respectively. Statistically significant correlation noted between the temporal, superior, inferior slope angles and BCVA (in logarithm of the minimum angle of resolution) with r = −0.18, −0.19, and −0.25, respectively (P < 0.05). No statistically significant correlation was noted between central retinal thickness and BCVA.

Conclusion:

The BCVA correlates better with slope angles than central retinal thickness. This implies that, change in both foveal and parafoveal regions accounts for vision change. Greater the foveal slope angle, the better the vision.
POLYPOIDAL CHOROIDAL VASCULOPATHY: A CLINICOPATHOLOGIC STUDY
Authors: Moussa Kareem , Bloomer Michele M. , Schwartz Daniel M. , Pan Carolyn K. , Toy Brian C. , Crawford Joseph B. , Afshar Armin R.
Published: December 2016

Purpose:

To present a unique case of polypoidal choroidal vasculopathy presenting as a blind, painful eye with a suspected intraocular mass, and to correlate clinical findings with histopathologic studies.

Methods:

Clinical case report and literature review.

Results:

A 58-year-old Vietnamese man presented with a blind, painful eye with concern for an intraocular mass. B-scan ultrasonography showed massive intraocular hemorrhage and could not rule out a tumor. The patient underwent enucleation and the histopathologic findings were consistent with polypoidal choroidal vasculopathy.

Conclusion:

Polypoidal choroidal vasculopathy can present with dense vitreous hemorrhage and may masquerade as an intraocular mass. It can progress rapidly and lead to profound, irreversible vision loss. A diagnosis of polypoidal choroidal vasculopathy should be considered in patients of African or East Asian origin presenting with vitreous hemorrhage.
The COMT Val158Met Polymorphism Is Associated With Response to Add-on Dextromethorphan Treatment in Bipolar Disorder
Authors: Lee Sheng-Yu , Chen Shiou-Lan , Wang Tzu-Yun , Chang Yun-Hsuan , Chen Po See , Huang San-Yuan , Tzeng Nian-Sheng , Wang Liang-Jen , Lee I Hui , Chen Kao Ching , Yang Yen Kuang , Lu Ru-Band
Published: December 2016

Purpose/Background

We previously conducted a randomized, double-blind, controlled, 12-week study evaluating the effect of add-on dextromethorphan (DM), a noncompetitive N-methyl-d-aspartate receptor antagonist, on patients with bipolar disorder (BD) treated using valproate (VPA), which showed negative clinical differences. The genetic variation between each individual may be responsible for interindividual differences. The catechol-O-methyltransferase (COMT) gene has been a candidate gene for BD. In the current study, we investigated whether the COMT Val158Met polymorphism predicts treatment response to VPA + add-on DM and to VPA + placebo.

Methods/Procedures

Patients with BD (n = 309) undergoing regular VPA treatments were randomly assigned to groups given either add-on DM (30 mg/d) (n = 102), DM (60 mg/d) (n = 101), or placebo (n = 106) for 12 weeks. The Hamilton Depression Rating Scale and Young Mania Rating Scale were used to evaluate clinical response during weeks 0, 1, 2, 4, 8, and 12. The genotypes of the COMT Val158Met polymorphism were determined using polymerase chain reaction plus restriction fragment length polymorphism analysis. To adjust for within-subject dependence over repeated assessments, multiple linear regression with generalized estimating equation methods was used.

Findings/Results

When stratified by the COMT Val158Met genotypes, significantly greater decreases in Hamilton Depression Rating Scale scores were found in the VPA + DM (30 mg/d) group in patients with the Val/Met genotype (P = 0.008).

Conclusions

We conclude that the COMT Val158Met polymorphism may influence responses to DM (30 mg/d) by decreasing depressive symptoms in BD patients.
Agitation in Patients Recovering From Traumatic Brain Injury: Nursing Management
Authors: Mortimer Diane Schretzman , Berg Wesley
Published: December 2016

This article reviews clinical and research literature regarding the nursing management of agitation after severe traumatic brain injury. Neuroscience nurses in acute rehabilitation settings use an evidence-based approach to perform multifaceted assessments and implement effective individualized plans of care. These essential efforts minimize the effects of agitation and help patients achieve optimal outcomes.
A Mysterious Role of Arginine Vasopressin Levels in Ménière's Disease—Meta-analysis of Clinical Studies
Authors: Wu Jing , Zhou Jie , Dong Lu , Fan Wenjing , Zhang Jinyu , Wu Caiqin
Published: December 2016

Objective:

There are contradicting claims that patients with Ménière's disease (MD) have elevated levels of arginine vasopressin (AVP). The results of published studies regarding the difference of AVP level between MD patients and non-MD control subjects are inconsistent. We propose that the discrepancy of AVP levels during different MD phases may be a potential reason. Thus, we conducted a meta-analysis to analyze the precise estimate of this hypothesis.

Data Sources:

PubMed, Medline, and Cochrane databases from the earliest publication, up until September 2016; references from meta-analyses and related review articles.

Study Selection and Data Extraction:

Clinical studies that reported AVP level in MD patients and non-MD controls were independently reviewed according to the inclusion criteria. The Newcastle–Ottawa Scale was used to assess quality of studies.

Data Synthesis:

Random effects model was used to calculate the weighted mean difference.

Conclusion:

Eight studies met the inclusion criteria. AVP levels of MD patients in acute phase (WMD = 2.29, 95% CI = 0.84–3.74, Z = 3.10, p = 0.002) were significantly higher than non-MD subjects. For MD patients in remission phase the difference of AVP levels between the MD patients and the non-MD controls was found (WMD = 0.54, 95% CI = −0.06 to 1.02, Z = 2.20, p = 0.03). However, AVP level was not an ideal biomarker of MD patients. Regardless of MD phase, there were no significant differences in the AVP level of MD patients (WMD = 0.27, 95% CI = −0.10 to 0.64, Z = 1.43, p = 0.15). Future investigations with larger sample sizes are needed to verify the results.
Pathophysiology of IgA Nephropathy
Authors: Al Hussain Turki , Hussein Maged H. , Al Mana Hadeel , Akhtar Mohammed
Published: December 2016

Immunoglobulin (Ig)A nephropathy is the most prevalent primary chronic glomerular disease in the world. Studies of molecular and cellular interactions involved in the pathogenesis of IgA nephropathy have revealed several inherent abnormalities in the production and subsequent handling of IgA1. In patients with this disease, altered glycan structures in the unique hinge region of the heavy chains of IgA1 molecules lead to the exposure of antigenic determinants, which are recognized by naturally occurring antiglycan antibodies of the IgG and/or IgA1 isotype. In addition, due to a homing abnormality there is a gradual shift of mucosal IgA1 producing lymphoplasma cells from mucosal lymphoid tissue to bone marrow resulting in excess production of mucosal-type IgA1 in the systemic circulation. As a result, nephritogenic immune complexes form in the circulation and deposit in the glomerular mesangium. Deposited immune complexes induce proliferation of resident mesangial cells with increased production of extracellular matrix proteins. A number of inflammatory cytokines produced by the mesangial cells damage the filtration barrier resulting in hematuria and proteinuria ultimately leading to progressive renal damage.
Brief Report: Increased Frequency of CD39+ CD56bright Natural Killer Cells in HIV-1 Infection Correlates With Immune Activation and Disease Progression
Authors: Dierks Patrick , Wroblewski Raluca , Eberhard Johanna M. , Martrus Gloria , Degen Olaf , Hertling Sandra , Schmiedel Stefan , Lunemann Sebastian , Hüfner Anja , Lohse Ansgar W. , Altfeld Marcus , van Lunzen Jan , Schulze zur Wiesch Julian
Published: December 2016

The expression pattern of the ectonucleotidases CD39 and CD73 on natural killer (NK) cells was examined in peripheral blood mononuclear cell of 61 HIV-1–infected patients. Increased frequencies of CD39+CD56bright NK cells were detectable in untreated HIV patients, which was associated with high viral load, low CD4+ T-cell count, and CD8+ T-cell activation. Additionally, levels of CD39 on NK cells were inducible by in vitro stimulation of NK cells, correlating with aryl hydrocarbon receptor and interleukin 10 expression. Here, we provide the first evidence of increased CD39+CD56bright NK cell frequencies during HIV infection, which might have consequences for NK cell function and HIV pathogenesis.
First-Person Point-of-View–Augmented Reality for Central Line Insertion Training
Authors: Rochlen Lauryn R. , Levine Robert , Tait Alan R.
Published: December 2016

Introduction

The value of simulation in medical education and procedural skills training is well recognized. Despite this, many mannequin-based trainers are limited by the inability of the trainee to view the internal anatomical structures. This study evaluates the usability and feasibility of a first-person point-of-view–augmented reality (AR) trainer on needle insertion as a component of central venous catheter placement.

Methods

Forty subjects, including medical students and anesthesiology residents and faculty, participated. Augmented reality glasses were provided through which the relevant internal anatomical landmarks were projected. After a practice period, participants were asked to place the needle in the mannequin without the benefit of the AR-projected internal anatomy. The ability of the trainees to correctly place the needle was documented. Participants also completed a short survey describing their perceptions of the AR technology.

Results

Participants reported that the AR technology was realistic (77.5%) and that the ability to view the internal anatomy was helpful (92.5%). Furthermore, 85% and 82.1%, respectively, believed that the AR technology promoted learning and should be incorporated into medical training. The ability to successfully place the needle was similar between experienced and nonexperienced participants; however, less experienced participants were more likely to inadvertently puncture the carotid artery.

Conclusions

Results of this pilot study demonstrated the usability and feasibility of AR technology as a potentially important adjunct to simulated medical skills training. Further development and evaluation of this innovative technology under a variety of simulated medical training settings would be an important next step.
Repetitive Facial Nerve Stimulation Using Occipitalis Muscle
Authors: Adatepe Turgut , Gündüz Ayşegül , Yildirim Ahmet , Uzun Nurten
Published: December 2016

Purpose:

We aimed to evaluate the reliability and reproducibility of repetitive nerve stimulation recorded on occipitalis muscle by comparing recordings on nasalis muscle in healthy subjects.

Methods:

A total of 23 healthy subjects (mean age: 44.7 ± 13.8 years) underwent detailed neurological examination and repetitive nerve stimulation using nasalis and occipitalis muscles. Amplitude and area percentage changes of compound muscle action potentials (CMAPs) after repetitive nerve stimulation with different frequency were compared between right and left sides and between recordings on nasalis and occipitalis muscles.

Results:

Comparisons of percentage amplitude changes of nasalis and occipitalis CMAPs showed no differences (+0.1% ± 3.8% vs. +1.4% ± 3.9%, P = 0.129). Average area percentage change of nasalis CMAPs was 0.3% ± 19.0%, whereas the value of occipitalis CMAP was +2.8% ± 15.2% (P = 0.851). Comparisons of nasalis and occipitalis CMAPs values showed no differences.

Conclusions:

The repetitive nerve stimulation recorded on occipitalis muscle is simple, easy to apply, noninvasive, consistent, and reproducible.
Subjective Memory Immediately Following Electroconvulsive Therapy
Authors: Brus Ole , Nordanskog Pia , Båve Ullvi , Cao Yang , Hammar Åsa , Landén Mikael , Lundberg Johan , Nordenskjöld Axel
Published: December 2016

Objectives

The aims of the present study were to describe the short-term rate of subjective memory worsening (SMW) and identify factors of importance for SMW in a large clinical sample treated for depression with electroconvulsive therapy (ECT).

Methods

This register-based study included 1212 patients from the Swedish National Quality Register for ECT. Subjective memory worsening was defined as a 2-point worsening on the memory item of the Comprehensive Psychopathological Rating Scale from before to within 1 week after treatment. Associations between patient characteristics and treatment factors were examined using logistic regression.

Results

Subjective memory worsening was experienced in 26%. It was more common in women than in men (31% vs 18%; P < 0.001) and more common in patients aged 18 to 39 years than in patients 65 years or older (32% vs 22%; P = 0.008). Patients with less subjective memory disturbances before ECT had a greater risk of SMW. Patients in remission after ECT had a lower risk of SMW. A brief pulse width stimulus gave higher risk of SMW compared with ultrabrief pulse (odds ratio, 1.61; 95% confidence interval, 1.05–2.47).

Conclusions

Subjective memory worsening is reported by a minority of patients. However, young women are at risk of experiencing SMW. Ultrabrief pulse width stimulus could be considered for patients treated with unilateral electrode placement who experience SMW. Each patient should be monitored with regard to symptoms and adverse effects, and treatment should be adjusted on an individual basis to maximize the clinical effect and with efforts to minimize the cognitive adverse effects.
Disruption of MiaA provides insights into the regulation of phenazine biosynthesis under suboptimal growth conditions in Pseudomonas chlororaphis 30-84
Authors: Yu Jun Myoung , Wang Dongping , Pierson Leland S. , Pierson Elizabeth A.
Published: December 2016

Many products of secondary metabolism are activated by quorum sensing (QS), yet even at cell densities sufficient for QS, their production may be repressed under suboptimal growth conditions via mechanisms that still require elucidation. For many beneficial plant-associated bacteria, secondary metabolites such as phenazines are important for their competitive survival and plant-protective activities. Previous work established that phenazine biosynthesis in Pseudomonas chlororaphis 30-84 is regulated by the PhzR/PhzI QS system, which in turn is regulated by transcriptional regulator Pip, two-component system RpeA/RpeB and stationary phase/stress sigma factor RpoS. Disruption of MiaA, a tRNA modification enzyme, altered primary metabolism and growth leading to widespread effects on secondary metabolism, including reduced phenazine production and oxidative stress tolerance. Thus, the miaA mutant provided the opportunity to examine the regulation of phenazine production in response to altered metabolism and growth or stress tolerance. Despite the importance of MiaA for translation efficiency, the most significant effect of miaA disruption on phenazine production was the reduction in the transcription of phzR, phzI and pip, whereas neither the transcription nor translation of RpeB, a transcriptional regulator of pip, was affected. Constitutive expression of rpeB or pip in the miaA mutant completely restored phenazine production, but it resulted in further growth impairment. Constitutive expression of RpoS alleviated sensitivity to oxidative stress resulting from RpoS translation inefficiency in the miaA mutant, but it did not restore phenazine production. Our results support the model that cells curtail phenazine biosynthesis under suboptimal growth conditions via RpeB/Pip-mediated regulation of QS.
Chromatin environment, transcriptional regulation, and splicing distinguish lincRNAs and mRNAs
Authors: Melé Marta , Mattioli Kaia , Mallard William , Shechner David M. , Gerhardinger Chiara , Rinn John L.
Published: December 2016

While long intergenic noncoding RNAs (lincRNAs) and mRNAs share similar biogenesis pathways, these transcript classes differ in many regards. LincRNAs are less evolutionarily conserved, less abundant, and more tissue-specific, suggesting that their pre- and post-transcriptional regulation is different from that of mRNAs. Here, we perform an in-depth characterization of the features that contribute to lincRNA regulation in multiple human cell lines. We find that lincRNA promoters are depleted of transcription factor (TF) binding sites, yet enriched for some specific factors such as GATA and FOS relative to mRNA promoters. Surprisingly, we find that H3K9me3—a histone modification typically associated with transcriptional repression—is more enriched at the promoters of active lincRNA loci than at those of active mRNAs. Moreover, H3K9me3-marked lincRNA genes are more tissue-specific. The most discriminant differences between lincRNAs and mRNAs involve splicing. LincRNAs are less efficiently spliced, which cannot be explained by differences in U1 binding or the density of exonic splicing enhancers but may be partially attributed to lower U2AF65 binding and weaker splicing-related motifs. Conversely, the stability of lincRNAs and mRNAs is similar, differing only with regard to the location of stabilizing protein binding sites. Finally, we find that certain transcriptional properties are correlated with higher evolutionary conservation in both DNA and RNA motifs and are enriched in lincRNAs that have been functionally characterized.
BOS Brands: challenges of internationalisation
Authors: Human Christopher James , Bick Geoff
Published: December 2016

Subject area

This teaching case focuses on the field of marketing, particularly, the situation of building a global brand as small and medium-sized enterprises (SME) internationalizing from an emerging market.

Study level/applicability

It is recommended for postgraduate and post-experience students, for example, in MBA programmes and executive education courses.

Case overview

This teaching case focuses on the field of marketing, particularly, the situation of building a global brand as SME internationalizing from an emerging market. It is recommended for postgraduate and post-experience students, for example, in MBA programmes and executive education courses. BOS Brands provides an interesting case on the internationalisation experience of a Born Global firm, particularly from an emerging market context. This medium-sized South African business develops, distributes and markets Rooibos-based beverages in Southern Africa and Europe, with eyes on a broader global presence. The case provides insights into the strategic decisions required to successfully take a medium-sized business into competitive foreign markets without the capital and support enjoyed by many larger multinational corporations. Among other issues, BOS Brands provides fertile ground to explore the selection of target country and entry mode, overcoming cultural and physical distance, opportunity recognition and the roles of networks and innovation.

Expected learning outcomes

The expected learning outcomes are to: analyse the decision-making process of the internationalising SME in terms of internationalisation factors, timing and phases and evaluation of potential target countries and entry mode options and launch marketing approach; understand the complexities of marketing in a foreign cultural and business context (including cultural and physical distance); and develop alternative marketing strategies for an entrepreneurial SME to grow internationally given limited resources.

Supplementary materials

Teaching notes are available for educators only. Please contact your library to gain login details or email support@emeraldinsight.com to request teaching notes.

Subject code

CSS 8: Marketing.
Determinants of restaurant internationalization: an upper echelons theory perspective
Authors: Lee Won Seok , Kim Insin , Moon Joonho
Published: December 2016

Purpose

The purpose of this research is to account for the internationalization of restaurants. The conceptual framework of upper echelons theory is applied to identify the demographic determinants of internationalization among chief executive officers (CEOs).

Design/methodology/approach

Data from 30 restaurant firms for the period 1999-2013 were collected from a variety of sources, primarily Compustat and Execucomp, based on Standard Industrial Classification (SIC) code 5812, the annual 10-K and public information. A panel feasible generalized least squares model was used as the main instrument of analysis.

Findings

The findings indicate that the CEO gender and share ownership negatively affect the internationalization of restaurant companies, whereas size, the extent of franchising, the type of restaurant and stock options positively affect the degree of internationalization. Additionally, an inverted U-shaped relation exists between CEO tenure and the degree of internationalization.

Practical implications

The presented information may provide shareholders and boards of directors with valuable guidelines regarding the assignment of appropriate managers depending on the extent to which their companies are pursuing internationalization strategies.

Originality/value

Most studies in hospitality sectors have focused only on accounting-based measures to explain strategic decision-making, although proponents of upper echelons theory have argued that CEO attributes influence strategic decisions/changes. This study contributes to the literature on hospitality by identifying the effects of CEO characteristics on internationalization decisions.
Adult vocational decision, career satisfaction and future intention
Authors: Zopiatis Anastasios , Theocharous Antonis L. , Constanti Panayiotis
Published: December 2016

Purpose

This study aims to examine the association between the elements which influence the career decision-making process of tenured hospitality employees and their existing level of career satisfaction (CSat) and future intention.

Design/methodology/approach

Adopting a quantitative approach, a questionnaire survey collected data from 564 individuals working as full-time employees at all levels of the hierarchy in four- and five-star hotel establishments in Cyprus. Structural equation modeling analysis, preceded by exploratory factor analysis, was utilized to assess the constructs’ relationships and address the postulated hypotheses.

Findings

The results suggest that accurate job-person fit, reflective career awareness and the individuals’ pragmatic occupational perceptions, positively influence their CSat and, subsequently, strengthen their intention to remain and progress within the industry.

Research limitations/implications

The study’s setting, the Cyprus hospitality industry, a Mediterranean seasonal destination with unique operational characteristics, may limit the generalizability of the findings to business environments in other regions.

Practical implications

Insights are of interest and value to stakeholders, including academic scholars wishing to build on this investigation, industry professionals striving to revitalize interest toward relevant professions, career counselors’ vocational decision guidance tactics and strategies and individuals envisioning a prosperous hospitality career.

Originality/value

The paper enhances and enriches our conceptual knowledge of a relatively barren landscape, investigating the behavior of mature employees’ choice of a hospitality career.
Workplace incivility and its effect upon restaurant frontline service employee emotions and service performance
Authors: Cho Meehee , Bonn Mark A. , Han Su Jin , Lee Kyung Hee
Published: December 2016

Purpose

This study aims to acquire a better understanding about consequences of workplace incivility upon restaurant frontline service employees caused by customers, supervisors and coworkers. The moderating roles of perceived organizational support (POS) and emotion regulation ability (ERA) were also tested to determine the possibility for reducing the negative effect of workplace incivility upon the emotional exhaustion of restaurant frontline service employees.

Design/methodology/approach

Using data obtained from 239 restaurant frontline service employees, a 35-item instrument was used to assess workplace incivility and its effects upon emotional exhaustion, perceived service performance, POS and ERA. A structural equation model was used to test hypotheses. The multi-group approach was used to investigate the moderating effects POS and ERA have upon the relationships between workplace incivility, emotional exhaustion and perceived service performance.

Findings

Results documented that workplace incivility significantly increases emotional exhaustion and further leads to low levels of job service performance. Customer incivility was especially found to have the strongest power for increasing emotional exhaustion, followed by supervisor incivility. Also, results confirmed that POS and ERA play significant roles in moderating the relationships between workplace incivility, emotional exhaustion and perceived service performance. Based upon this study’s findings, theoretical and practical implications are offered for developing successful employee management strategies.

Practical implications

Results suggest specific practical management implications pertaining to restaurant frontline service employees. This study’s research findings recommend the development of more efficient support programs designed to diffuse potential situations involving workplace incivility. Findings further highlight the important role employee ERA has upon the effects of incivility and frontline service performance. Implications are provided with respect to specific strategic direction management should consider to recruit and select the most appropriate employees for restaurant frontline service positions.

Originality/value

The current study’s conceptual research was developed in an attempt to simultaneously address all three dimensions of workplace incivility to examine how they affect employee emotions and their job performance.
“The wound is still open”: the Nakba experience among internally displaced Palestinians in Israel
Authors: Ghnadre-Naser Sfaa , Somer Eli
Published: December 2016

Purpose

While the 1948 Nakba represents the most significant crisis in the history of the Palestinian people, its psychological effects on its survivors in Israel have yet to be explored. The purpose of this paper is to examine the subjective experience and the psychological implications of the Nakba ordeals and the ensuing uprooting among the internally displaced Palestinians living in Israel.

Design/methodology/approach

Qualitative semi-structured in-depth interviews were conducted with ten internally displaced Palestinians who experienced the Nakba as youngsters. The interview transcripts were analyzed thematically in line with accepted practice in phenomenological research in psychology.

Findings

Participants had experienced a wide range of traumatic events intertwined with protracted daily struggles and accumulated losses. These experiences resulted in pronounced psychological distress and immense inner pain that was perpetuated throughout their lives, rendering the Nakba an unresolved traumatic experience.

Research limitations/implications

This paper describes the psychological outcome of the Nakba among a small sample of elderly survivors. Further urgent research is needed to collect valuable untapped information from this aging and dwindling community.

Originality/value

Although more than six decades have elapsed since the tragic events, the current research paper constitutes a pioneering effort to document the subjective experience of the Nakba. The current research findings counterbalance 60 years of public and academic disregard of this tragic period.