bluuebunny/crossref_metadata_2025 huggingface dataset:
Nested Russian Doll-like Genetic Mobility Drives Rapid Dissemination of the Carbapenem Resistance GeneblaKPC
Authors: Sheppard Anna E. , Stoesser Nicole , Wilson Daniel J. , Sebra Robert , Kasarskis Andrew , Anson Luke W. , Giess Adam , Pankhurst Louise J. , Vaughan Alison , Grim Christopher J. , Cox Heather L. , Yeh Anthony J. ,   the Modernising Medical Microbiology (MMM) Informatics Group, Sifri Costi D. , Walker A. Sarah , Peto Tim E. , Crook Derrick W. , Mathers AmyJ.
Published: December 2015

The recent widespread emergence of carbapenem resistance inEnterobacteriaceaeis a major public health concern, as carbapenems are a therapy of last resort in this family of common bacterial pathogens. Resistance genes can mobilize via various mechanisms including conjugation and transposition, however the importance of this mobility in short-term evolution, such as within nosocomial outbreaks, is currently unknown. Using a combination of short- and long-read whole genome sequencing of 281blaKPC-positiveEnterobacteriaceaeisolated from a single hospital over five years, we demonstrate rapid dissemination of this carbapenem resistance gene to multiple species, strains, and plasmids. Mobility ofblaKPCoccurs at multiple nested genetic levels, with transmission ofblaKPCstrains between individuals, frequent transfer ofblaKPCplasmids between strains/species, and frequent transposition of theblaKPCtransposon Tn4401between plasmids. We also identify a common insertion site for Tn4401within various Tn2-like elements, suggesting that homologous recombination between Tn2-like elements has enhanced the spread of Tn4401between different plasmid vectors. Furthermore, while short-read sequencing has known limitations for plasmid assembly, various studies have attempted to overcome this with the use of reference-based methods. We also demonstrate that as a consequence of the genetic mobility observed herein, plasmid structures can be extremely dynamic, and therefore these reference-based methods, as well as traditional partial typing methods, can produce very misleading conclusions. Overall, our findings demonstrate that non-clonal resistance gene dissemination can be extremely rapid, presenting significant challenges for public health surveillance and achieving effective control of antibiotic resistance.

Importance

Increasing antibiotic resistance is a major threat to human health, as highlighted by the recent emergence of multi-drug resistant “superbugs”. Here, we tracked how one important multi-drug resistance gene spread in a single hospital over five years. This revealed high levels of resistance gene mobility to multiple bacterial species, which was facilitated by various different genetic mechanisms. The mobility occurred at multiple nested genetic levels, analogous to a Russian doll set where smaller dolls may be carried along inside larger dolls. Our results challenge traditional views that drug-resistance outbreaks are due to transmission of a single pathogenic strain. Instead, outbreaks can be “gene-based”, and we must therefore focus on tracking specific resistance genes and their context rather than only specific bacteria.
A role for palindromic structures in the cis-region of maize Sirevirus LTRs in transposable element evolution and host epigenetic response
Authors: Bousios Alexandros , Diez Concepcion M. , Takuno Shohei , Bystry Vojtech , Darzentas Nikos , Gaut Brandon S.
Published: December 2015

Transposable elements (TEs) proliferate within the genome of their host, which responds by silencing them epigenetically. Much is known about the mechanisms of silencing in plants, particularly the role of siRNAs in guiding DNA methylation. In contrast, little is known about siRNA targeting patterns along the length of TEs, yet this information may provide crucial insights into the dynamics between hosts and TEs. By focusing on 6456 carefully annotated, full-length Sirevirus LTR retrotransposons in maize, we show that their silencing associates with underlying characteristics of the TE sequence and also uncover three features of the host–TE interaction. First, siRNA mapping varies among families and among elements, but particularly along the length of elements. Within the cis-regulatory portion of the LTRs, a complex palindrome-rich region acts as a hotspot of both siRNA matching and sequence evolution. These patterns are consistent across leaf, tassel, and immature ear libraries, but particularly emphasized for floral tissues and 21- to 22-nt siRNAs. Second, this region has the ability to form hairpins, making it a potential template for the production of miRNA-like, hairpin-derived small RNAs. Third, Sireviruses are targeted by siRNAs as a decreasing function of their age, but the oldest elements remain highly targeted, partially by siRNAs that cross-map to the youngest elements. We show that the targeting of older Sireviruses reflects their conserved palindromes. Altogether, we hypothesize that the palindromes aid the silencing of active elements and influence transposition potential, siRNA targeting levels, and ultimately the fate of an element within the genome.
From noise correlation to resonant ultrasound spectroscopy in rock acoustics
Authors: Barbouteau Sandra , Rasolofosaon Patrick , Dubos‐Sallée Noalwenn , Vassil Virginie , Poitrineau Valérie , Nauroy Jean‐François
Published: December 2015

This article introduces an alternative experimental procedure for measuring the elastic properties of a solid material at laboratory scale, using both the principles of passive seismic interferometry and resonance ultrasound spectroscopy. We generate noise into the studied sample with a pneumatic air blow gun, and we cross‐correlate the signals recorded with two passive piezoelectric sensors put in soft contact with the sample surface. Resonance phenomena are induced in the sample, but in contrast with conventional resonance ultrasound spectroscopy experiments, we have no control over the injected frequencies that are sent all together within the noise spectrum. The spectrum of the correlogram is a good approximation of the resonance spectrum of the vibrating sample and can be inverted in terms of the elastic moduli of the constituent material of the sample.

The experimental procedure is validated on samples made of standard materials (here, aluminium and Plexiglas) by consistently comparing the inverted elastic velocities with the velocities independently measured with the conventional technique of ultrasonic pulse transmission. Moreover, we got similar positive results on dry rock samples, such as Vilhonneur limestone. These encouraging preliminary results open up promising prospects for monitoring fluid substitution in rock samples using the technique described in this paper.
Gout on CT of the feet: A symmetric arthropathy
Authors: Doyle Anthony J , Dalbeth Nicola , McQueen Fiona , Boyer Lucinda , Dong Jing , Rome Keith , Frecklington Mike
Published: December 2015

Introduction

The aim of this study was to assess the distribution of bone erosions in the feet of patients with gout using CT and thereby to test the hypothesis that gout is an asymmetric arthropathy.

Methods

CT scans of both feet were obtained from 25 patients with chronic gout. CT scans were scored for bone erosion using a semi‐quantitative method based on the rheumatoid arthritis MRI scoring system (RAMRIS). CT bone erosion was assessed at 22 bones in each foot (total 1,100 bones) by two independent radiologists. Symmetry was assessed by two methods: (i) comparing right and left foot scores for each patient; and (ii) calculating the proportion of paired joints with or without erosions.

Results

Observer agreement was excellent (intra‐class correlation coefficient 0.92). In the group overall, the difference in scores between the feet was not significant (Student's t‐test P = 0.8). In 17 of 25 patients, the difference in erosion scores between the two feet was less than the inter‐observer difference. In 24 of 25 patients, the proportion of paired joints was greater than 0.5, indicating symmetric disease.

Conclusions

Erosive disease from gout is, in fact, a symmetric process in our patient group. This finding is contrary to the established view of gout as an asymmetric arthritis and lends new insight into the behaviour of this common disease.
Utility of CT‐cisternogram for radiosurgery in trigeminal neuralgia: A not‐to‐be forgotten technique
Authors: Vellayappan Balamurugan , Chakraborty Santanu , Althagafi Saif , MacLean Jillian , Szanto Janos , Sinclair John , Malone Shawn
Published: December 2015

Radiosurgery (RS) is a well‐established ablative therapy for trigeminal neuralgia (TGN). Successful RS requires the delivery of an extremely high dose of radiation to a small cisternal portion of the nerve, which lies amidst critical structures. This study describes the utility of CT‐cisternogram in RS targeting for TGN. We report on patients with TGN who required CT‐cisternogram for target identification for CyberKnife (CK) RS at our institution between September 2010 and April 2015. CT‐cisternogram is a well‐tolerated procedure that adds useful information to RS planning. Illustrative cases with complex anatomy and MRI artifacts related to postoperative changes and Teflon implant are described. CT‐cisternogram is a complementary imaging modality that is useful in some patients, for RS target delineation.
Lounging with robots – social spaces of residents in care: A comparison trial
Authors: Peri Kathryn , Kerse Ngaire , Broadbent Elizabeth , Jayawardena Chandimal , Kuo Tony , Datta Chandan , Stafford Rebecca , MacDonald Bruce
Published: December 2015

Aims

To investigate whether robots could reduce resident sleeping and stimulate activity in the lounges of an older persons' care facility.

Methods

Non‐randomised controlled trial over a 12‐week period. The intervention involved situating robots in low‐level and high‐dependency ward lounges and a comparison with similar lounges without robots. A time sampling observation method was utilised to observe resident behaviour, including sleep and activities over periods of time, to compare interactions in robot and no robot lounges.

Results

The use of robots was modest; overall 13% of residents in robot lounges used the robot. Utilisation was higher in the low‐level care lounges; on average, 23% used the robot, whereas in high‐level care lounges, the television being on was the strongest predictor of sleep.

Conclusion

This study found that having robots in lounges was mostly a positive experience. The amount of time residents slept during the day was significantly less in low‐level care lounges that had a robot.
Electoral Rule Disproportionality and Platform Polarization
Authors: Matakos Konstantinos , Troumpounis Orestis , Xefteris Dimitrios
Published: December 2015

Despite common perception, existing theoretical literature lacks a complete formal argument regarding the relationship between the electoral rule disproportionality and platform polarization. In this article, we build a model that incorporates the disproportionality of the electoral system in a standard Downsian electoral competition setup with mainly, but not necessarily purely, policy‐motivated parties. We first show that in equilibrium, platform polarization is decreasing in the level of the electoral rule disproportionality. We then argue that the number of parties has a positive effect on platform polarization when polarization is measured by the distance between the two most distant platforms. This effect does not hold when polarization is measured by the widely used Dalton index. Constructing a data set covering more than 300 elections, our main theoretical findings are empirically supported, pointing toward the electoral rule disproportionality as a major determinant of polarization.
Integration of trauma and rehabilitation services is the answer to more cost‐effective care
Authors: Wu Jane , Faux Steven G. , Harris Ian , Poulos Christopher J.
Published: December 2015

Background

The pathway from acute trauma care to inpatient rehabilitation has not been previously studied in New South Wales (NSW), Australia. This study aimed to examine the outcomes of patients transferred from a trauma service to its ‘in‐house’ rehabilitation service (Group A) compared with outcomes of patients transferred from a designated trauma centre to an external rehabilitation service (Group B). This is carried out to identify any inefficiencies, delays and opportunities for improvement.

Methods

This is a retrospective cohort study using linked registry data. This study included all patients admitted after a motor vehicle collision to trauma services in NSW over the period of 2009–2012, who required inpatient rehabilitation. Those requiring specialized brain or spinal injury rehabilitation or those who went to private rehabilitation units were excluded.

Results

There were 249 patients in this cohort with majority (59%) in Group A and the remainder in Group B. There was no significant difference between the age of the patients, injury severity or acute length of stay (LOS) between the two groups. Admission and discharge functional independence measure scores were also similar between the two groups. There was a significant difference in the LOS in rehabilitation (30 days for Group A compared with 40 days in Group B, P = 0.02).

Conclusions

Transferring patients to an external rehabilitation service from a designated trauma service is less efficient than providing the same care by the ‘in‐house’ rehabilitation service. There may be opportunities to improve the efficiency of trauma management and reduce costs.
Neoadjuvant chemoradiotherapy for rectal cancer: how important is tumour regression?
Authors: McCoy Melanie J. , Hemmings Chris , Hillery Simon , Penter Cheryl , Bulsara Max K. , Zeps Nik , Platell Cameron F.
Published: December 2015

Background

Pathological complete response following neoadjuvant chemoradiotherapy (CRT) for locally advanced rectal cancer is associated with reduced local recurrence and improved long‐term outcome. However, the prognostic value of a partial response, or of tumour regression in patients with metastatic disease, is less clear.

Methods

We present a single‐centre cohort study of 205 patients with stage II–IV rectal cancer treated with surgery and neoadjuvant CRT between 2006 and 2013. Tumour regression was assessed using the Dworak system.

Results

The probability of 3‐year recurrence‐free survival (RFS) was 95% for Dworak grade 4, 82% for grade 3, 64% for grade 2 and 53% for grade 1 (P = 0.0005). In univariate regression analysis, Dworak grade was associated with RFS (hazard ratio (HR) 0.51, P < 0.0001; trend analysis) and cancer‐specific survival (HR 0.52, P = 0.002). In multivariate analysis, Dworak grade remained an independent predictor of RFS (HR 0.62, P = 0.012), along with clinical metastases stage, resection margin status, the presence or absence of extramural venous invasion and type of surgical procedure.

Conclusions

Tumour regression grade after neoadjuvant CRT was an independent prognostic factor for RFS, highlighting the importance of the degree of local response to CRT.
Too Rich For Diversity: Socioeconomic Status Influences Multifaceted Person Perception of Latino Targets
Authors: Young Danielle M. , Sanchez Diana T. , Wilton Leigh S.
Published: December 2015

Understanding racial categorization processes has implications for how affirmative action policies are implemented. Two studies examined how socioeconomic status (SES) functions to predict support for application of affirmative action and other perceptions of Latino targets. SES emerged as a powerful predictor, over and above the influence of ancestry, on person perception (minority categorization, sociocultural cues) and support for affirmative action among both White (Studies 1 and 2) and minority (Study 2) perceivers. In conjunction with ancestry, SES influenced sociocultural impressions, such as perceptions of discrimination (Study 1 and Study 2) and cultural practices (Study 2), which informed support for implementation of affirmative action policies. Furthermore, the joint influence of SES and ancestry on affirmative action policies persisted even when controlling for general attitudes towards affirmative action (Study 2). Results suggest that SES is an important factor in person perception, and that perceptions of discrimination play a strong role in how “deserving” a target is of affirmative action.
Semiparametric Model of Hedonic Housing Prices in Japan
Authors: Karato Koji , Movshuk Oleksandr , Shimizu Chihiro
Published: December 2015

We propose a semiparametric hedonic model of housing prices with nonlinearity in age and cohort effects. The model avoids the simultaneity problem among age, cohort and year effects, which is a common problem in linear hedonic models. Applying the model to housing prices in Tokyo between 1990 and 2008 revealed significant nonlinearities in both the age and cohort effects, and significant interactions between these effects, with the shape of the age effect differing across housing cohorts. Estimates of the year effect indicated a declining trend in prices that was more pronounced compared with those of conventional linear hedonic models.
Korea's Cash‐for‐Clunkers Program: Household‐Level Evidence
Authors: Min Heechul
Published: December 2015

This paper examines the effects of a vehicle subsidy program introduced in Korea in the wake of the 2008 global recession. I adopt a simple binary choice model to approximate a household's decision to purchase a new car and identify the policy effect using a difference‐in‐difference framework in which non‐eligible households serve as the control group. The estimation results are as follows. First, the subsidy program significantly boosted the overall demand for new vehicles, increasing the average probability of a new purchase by eligible households from 7.1 to 13.9 percent. Second, beneficiaries of the subsidy program were mostly rich households and those owning relatively new cars. Finally, the program effect on aggregate vehicle sales was not quickly reversed in contrast to recent evidence on the comparable US program.
Milk protein profiles in response to Streptococcus agalactiae subclinical mastitis in dairy cows
Authors: Pongthaisong Pongphol , Katawatin Suporn , Thamrongyoswittayakul Chaiyapas , Roytrakul Sittiruk
Published: December 2015

The objective of this study was to investigate the milk protein profiles of normal milk and those of milk during the course of subclinical mastitis, caused by natural Streptococcus agalactiae infection. Two‐dimensional gel electrophoresis and liquid chromatography mass spectrometry were used to assess protein profiles and to identify the proteins. The results showed that S. agalactiae subclinical mastitis altered the protein profiles of milk. Following Mascot database matching, 11 and 12 protein types were identified in the milk collected from healthy and S. agalactiae subclinical mastitic udders, respectively. The distinct presence of the antibacterial protein cathelicidin‐1 was detected in infected milk samples, which in turn was highly correlated to the severity of subclinical mastitis as represented by the milk somatic cell count (r = 0.616), but not the bacterial count. The protein profile of milk reveals changes in the host response to S. agalactiae intramammary infection; cathelicidin‐1 could therefore serve as a biomarker for the detection of subclinical mastitis in dairy cows.
Self‐expanding metallic stent improves histopathological edema compared with transanal drainage tube for malignant colorectal obstruction
Authors: Takeyama Hiroshi , Kitani Kotaro , Wakasa Tomoko , Tsujie Masanori , Fujiwara Yoshinori , Mizuno Shigeto , Yukawa Masao , Ohta Yoshio , Inoue Masatoshi
Published: December 2015

Background and Aim

To compare the usefulness of the self‐expanding metallic stent (SEMS) with that of the transanal drainage tube (TDT) and emergency surgery after failure of decompression (ESFD) in patients with malignant colonic obstruction (MCO), and to evaluate post‐decompression histopathological changes.

Methods

From January 2010 to June 2015, 39 patients with MCO received SEMS, TDT, and ESFD. We evaluated the outcomes including success rates of placement, clinical outcomes after decompression, and histopathological findings of the resected specimens.

Results

Technical success rates were 100% for SEMS and 78.9% for TDT. Clinical success rates were 100% for SEMS and 80.0% for TDT. Postoperative ileus was significantly less frequent after SEMS than after TDT (P = 0.014). Histopathological edema grade was significantly lower for SEMS than for TDT and ESFD (P < 0.0001). There was no significant difference between edema grade and duration of decompression in the TDT group (P = 0.629), whereas all patients with SEMS were classified in a low edema grade (grade 0–2). Rate of stoma creation was significantly higher in patients with a high edema grade (grade 3) than in those with a low edema grade (grade 0–2) (P = 0.003). There was no microscopic perforation in any group.

Conclusion

Significantly greater resolution of histopathological edema was achieved after placement of SEMS than after placement of TDT. These findings provide an indication of favorable clinical outcomes of SEMS in comparison with TDT and ESFD.
Response of degraded vegetation to introduction of prescribed burning or mowing management in a Mongolian steppe
Authors: Koyama Asuka , Kubo Daisuke , Yoshihara Yu , Jamsran Undarmaa , Okuro Toshiya
Published: December 2015

The understanding of the effectiveness of prescribed burning and mowing as restoration tools of degraded grasslands is important for dryland rangeland management. We examined the effects of spring prescribed burning or seasonal mowing treatments on the degraded vegetation dominated by an unpalatable subshrub, Artemisia adamsii, in grazed Mongolian steppe. Spring burning was conducted in 2013, and three types of mowing treatments (spring, previous summer, and previous summer and autumn) were conducted with varying seasons and frequency, respectively. Soil samples were collected immediately after the spring treatments. Four months after the spring treatments, total plant biomass, the numbers of flowering shoots and florets per shoot of A. adamsii were compared among the treatments. Plant biomass was divided into A. adamsii and herbaceous plants (forbs and graminoids) with different Raunkiaer life forms (chamaephytes, hemicryptophytes and geophytes). Soil properties and total plant biomass were not different among the treatments. For A. adamsii, the biomass and number of flowering shoots were decreased by spring burning and growing‐season mowing, owing to the disappearance of woody‐shoots of A. adamsii. On the other hand, spring mowing had less negative impact on the biomass of A. adamsii due to an increase of the newly‐formed shoots. The biomass of perennial herbaceous‐plants was not affected by spring burning, regardless of the life form, whereas that of the geophytic sedge Carex duriuscula increased in the summer‐and‐autumn mowing. Thus, spring burning and growing‐season mowing have the potential to control undesirable subshrubs due to loss of the woody shoots, while spring mowing may not be recommended as a useful management tool in the Mongolian steppe. Our results emphasize that the introduction of these management tools for degraded‐grassland restoration in dryland rangelands needs more long‐term evaluation considering the relation with external factors such as climate variation and grazing impact.
There is more to risk and safety planning than dramatic risks: Mental health nurses’ risk assessment and safety‐management practice
Authors: Higgins Agnes , Doyle Louise , Downes Carmel , Morrissey Jean , Costello Paul , Brennan Michael , Nash Michael
Published: December 2015

Risk assessment and safety planning are considered a cornerstone of mental health practice, yet limited research exists into how mental health nurses conceptualize ‘risk’ and how they engage with risk assessment and safety planning. The aim of the present study was to explore mental health nurses’ practices and confidence in risk assessment and safety planning. A self‐completed survey was administered to 381 mental health nurses in Ireland. The findings indicate that nurses focus on risk to self and risk to others, with the risk of suicide, self‐harm, substance abuse, and violence being most frequently assessed. Risk from others and ‘iatrogenic’ risk were less frequently considered. Overall, there was limited evidence of recovery‐oriented practice in relation to risk. The results demonstrate a lack of meaningful engagement with respect to collaborative safety planning, the identification and inclusion of protective factors, and the inclusion of positive risk‐taking opportunities. In addition, respondents report a lack of confidence working with positive risk taking and involving family/carers in the risk‐assessment and safety‐planning process. Gaps in knowledge about risk‐assessment and safety‐planning practice, which could be addressed through education, are identified, as are the implications of the findings for practice and research.
Modeling Innovative Methodological Practices in a Dance/Family Studies Transdisciplinary Project
Authors: Sharp Elizabeth A. , Durham DeCesaro Genevieve
Published: December 2015

Using our dance/family studies transdisciplinary project as a site of analysis, we review the existing literature of arts/social science endeavors and share innovative methodological practices from our project. Unlike most arts/social science endeavors, our project is transdisciplinary and is based on a collaboration between a trained choreographer and dancer and a trained family scholar. The transdisciplinary nature of our project is highlighted in the choreographer's kinesthetic analysis of the family scholar's qualitative data, the use of a pilot study, duo‐memoing, and a strong commitment to sharing authorship of all our writing. Throughout the article, we highlight the benefits of our work for the field of family studies.
Person‐Centered Approaches to Understanding Early Family Risk
Authors: Jobe‐Shields Lisa , Andrews Arthur R. , Parra Gilbert R. , Williams Natalie A.
Published: December 2015

Research consistently indicates that exposure to early family adversity is associated with compromised development in early childhood. Consequently, researchers, direct service workers, and policy makers have sought to understand and alleviate the multidimensional stressors faced by families during the prenatal and early childhood periods. Person‐centered approaches are one method of understanding the interplay of risk factors. The present review synthesizes current person‐centered research investigating social and economic risk factors during the prenatal and early childhood periods, and summarizes how person‐centered approaches have advanced the understanding of early family risk and later child adaptive functioning. Results are discussed in the context of the family during early childhood development, with a discussion of clinical and prevention‐based implications.
Advancing Dynamic Family Theories: Applying Optimal Matching Analysis to Family Research
Authors: Martin Todd F.
Published: December 2015

Dynamic theories are centered on explaining the influences of social context and institutional structures on the life course of individuals and families. Life course development theory addresses both normative social patterns and nonnormative deviations. Life course researchers view trajectories as theoretically superior to single time‐point measures because the former look at life‐transition events in the surrounding social context, not in isolation. This article discusses advancing dynamic family theories through the methodological advancement of optimal matching analysis, a form of sequence analysis. Optimal matching analysis is compared to other event‐transition methods and is illustrated by a cohabitation‐based research question that applies optimal matching analysis to the relationship between premarital cohabitation and later marital stability.
Novel functions of platelets in the liver
Authors: Kurokawa Tomohiro , Zheng Yun‐Wen , Ohkohchi Nobuhiro
Published: December 2015

Platelets contain not only proteins needed for hemostasis but also many growth factors that are required for organ development, tissue regeneration, and repair. Thrombocytopenia, which is frequently observed in patients with chronic liver disease (CLD) and cirrhosis, is due to various causes, such as decreased thrombopoietin production and accelerated platelet destruction caused by hypersplenism; however, the relationship between thrombocytopenia and hepatic pathogenesis and the role of platelets in CLD are poorly understood. Thus, in this paper, the experimental evidence for platelets improving liver fibrosis and accelerating liver regeneration is summarized and addressed based on studies conducted in our laboratory and current progress reports from other investigators. Platelets improve liver fibrosis by inactivating hepatic stellate cells to decrease collagen production. The level of intracellular cAMP is increased by adenosine through its receptors on hepatic stellate cells, thereby resulting in inactivation of these cells. Adenosine is produced by degradation of adenine nucleotides, which are stored in abundance within the dense granules of platelets. The regenerative effect of platelets in the liver consists of three mechanisms: a direct effect on hepatocytes, a cooperative effect with liver sinusoidal endothelial cells, and a collaborative effect with Kupffer cells. Based on these experiments, a clinical trial suggested that the increase in platelets induced by platelet transfusion improved liver function in patients with CLD in a clinical setting.We highlight the current knowledge concerning the role of platelets in CLD and expect to open a novel avenue for application of these clinical therapies to treat liver disease.
Active gas aspiration versus simple gas evacuation to reduce shoulder pain after diagnostic laparoscopy: A randomized controlled trial
Authors: Leelasuwattanakul Nujaree , Bunyavehchevin Suvit , Sriprachittichai Pin
Published: December 2015

Aim

To evaluate the effectiveness of active gas aspiration to reduce postoperative shoulder pain in infertile women undergoing day‐case diagnostic laparoscopy.

Material and Methods

Seventy four infertile women undergoing diagnostic laparoscopy during July 2013 to February 2014 were randomized to an active gas aspiration or simple gas evacuation (control) group at the end of the surgery. Postoperative shoulder and wound pain were assessed using a visual analog scale at 6, 12 and 24 h after surgery. Consumption of rescue analgesics and adverse events were recorded.

Results

There were 37 patients in each group. The shoulder pain scores of the active gas aspiration group showed lower pain intensity than the simple gas evacuation group, with statistically significant results at at all time points. There was no significant difference in surgical wound pain. The proportion of patients who required postoperative rescue analgesics was lower in the study than in control group (43.2% vs 67.6%, P = 0.035). There was no significant difference in adverse events until 24 h after surgery.

Conclusions

Active gas aspiration provided a significantly superior effect on postoperative shoulder pain relief after diagnostic laparoscopy when compared to simple gas evacuation, without any adverse events.
Quality Evaluation of Zirconium Dioxide Frameworks Produced in Five Dental Laboratories from Different Countries
Authors: Schneebeli Esther , Brägger Urs , Scherrer Susanne S. , Keller Andrea , Wittneben Julia G. , Hicklin Stefan P.
Published: December 2015

Purpose

The aim of this study was to assess and compare quality as well as economic aspects of CAD/CAM high strength ceramic three‐unit FDP frameworks ordered from dental laboratories located in emerging countries and Switzerland.

Material and Methods

The master casts of six cases were sent to five dental laboratories located in Thailand (Bangkok), China (Peking and Shenzhen), Turkey (Izmir), and Switzerland (Bern). Each laboratory was using a different CAD/CAM system. The clinical fit of the frameworks was qualitatively assessed, and the thickness of the framework material, the connector height, the width, and the diameter were evaluated using a measuring sensor. The analysis of the internal fit of the frameworks was performed by means of a replica technique, whereas the inner and outer surfaces of the frameworks were evaluated for traces of postprocessing and damage to the intaglio surface with light and electronic microscopes. Groups (dental laboratories and cases) were compared for statistically significant differences using Mann‐Whitney U‐tests after Bonferroni correction.

Results

An acceptable clinical fit was found at 97.9% of the margins produced in laboratory E, 87.5% in B, 93.7% in C, 79.2% in A, and 62.5% in D. The mean framework thicknesses were not statistically significantly different for the premolar regions; however, for the molar area 4/8 of the evaluated sites were statistically significantly different. Circumference, surface, and width of the connectors produced in the different laboratories were statistically significantly different but not the height. There were great differences in the designs for the pontic and connector regions, and some of the frameworks would not be recommended for clinical use. Traces of heavy postprocessing were found in frameworks from some of the laboratories. The prices per framework ranged from US$177 to US$896.

Conclusions

By ordering laboratory work in developing countries, a considerable price reduction was obtained compared to the price level in Switzerland. Despite the use of the standardized CAD/CAM chains of production in all laboratories, a large variability in the quality aspects, such as clinical marginal fit, connector and pontic design, as well as postprocessing traces was noted. Recommended sound handling of postprocessing was not applied in all laboratories. Dentists should be aware of the true and factitious advantages of CAD/CAM production chains and not lose control over the process.
Infant born with a linear and whorled papulovesicular rash with eosinophilia
Authors: Bandyopadhyay Debabrata
Published: December 2015

See Answer
Characteristics of Farm Equipment‐Related Crashes Associated With Injury in Children and Adolescents on Farm Equipment
Authors: Toussaint Maisha , Faust Kayla , Peek‐Asa Corinne , Ramirez Marizen
Published: December 2015

Purpose

Operating or riding on farm equipment is one of the leading causes of farm‐related injuries and fatalities among children and adolescents. The aim of this study is to examine environment, crash, vehicle, and occupant characteristics and the probability of injury, given a crash, in youth under age 18 on farm equipment.

Method

Data from the Departments of Transportation on farm equipment‐related crashes across 9 Midwestern states from 2005‐2010 were used. Odds ratios were calculated using logistic regression to assess the relationship between environment, crash, vehicle, and occupant characteristics and the probability of injury, given a crash.

Findings

A total of 434 farm equipment‐related crashes involved 505 child or adolescent occupants on farm equipment: 198 passengers and 307 operators. Passengers of farm equipment had 4.1 higher odds of injury than operators. Occupants who used restraints had significantly lower odds of injury than those who did not. Furthermore, occupants on farm equipment that was rear‐ended or sideswiped had significantly lower odds of injury compared to occupants on farm equipment involved in noncollision crashes. Likewise, occupants on farm equipment that was impacted while turning had significantly lower odds of injury compared to those on equipment that was impacted while moving straight.

Conclusion

Precautions should be taken to limit or restrict youth from riding on or operating farm equipment. These findings reiterate the need to enforce policies that improve safety measures for youth involved in or exposed to agricultural tasks.
Geographic Variation in Treatment and Outcomes Among Patients With AMI: Investigating Urban‐Rural Differences Among Hospitalized Patients
Authors: Bechtold Daniel , Salvatierra G.G. , Bulley Emily , Cypro Alex , Daratha Kenn B.
Published: December 2015

Background

The value of early invasive revascularization for patients suffering acute myocardial infarction (AMI) is well known. However, access to revascularization services varies geographically and demographically. Previous studies have not examined the influence of rural residence on revascularization rates and outcomes among patients hospitalized with AMI.

Methods

Our retrospective cohort study included patients hospitalized in Washington State with a primary diagnosis of AMI from 2009 to 2012. Urban or rural residence was determined using rural‐urban commuting area (RUCA) codes. Multivariable models were used to evaluate geographic variation in rates of invasive versus medical management, in‐hospital mortality, rehospitalization, and subsequent revascularization procedures.

Results

Our study included 25,156 urban dwellers and 2,770 rural residents. Adjusted models found rural patients to be at increased odds of undergoing invasive revascularization during the initial episode of AMI care (OR = 1.11; 95% CI: 1.01‐1.21; P = .02) compared to urban dwelling patients. Rural patients were more likely to be transferred for care (OR = 4.28; 95% CI: 3.93‐4.66; P < .001) and more likely to undergo coronary artery bypass grafting (CABG) (OR = 1.55; 95% CI: 1.35‐1.78; P < .001) compared to the urban cohort. We found no significant geographic cohort differences in in‐hospital mortality or subsequent revascularization rates.

Conclusion

Our findings suggest that despite limited access to cardiac care facilities, rural patients are accessing revascularization services. However, rural residents are more likely to undergo CABG during their index admission. High transfer rates suggest that rural regions rely on effective transfer networks to access invasive cardiac services.
Linking Law andNewGovernance: Examining Gaps, Hybrids, and Integration in Water Policy
Authors: Holley Cameron
Published: December 2015

Since the 1980s there have been significant shifts from traditional environmental enforcement toward networks, cooperation, and more pluralized forms of governance. The most recent iterations of these new approaches are increasingly characterized asNewEnvironmentalGovernance (NEG). A range of common characteristics that include collaboration, participation, adaptation, and nonbinding guidelines and agreements defineNEGapproaches. Despite a growingNEGliterature, it is unclear whether and howNEGcan be effectively implemented in the same policy domain as traditional hard law. This article empirically explores and theorizes the dynamics ofNEG's interaction with conventional law. It proposes a spectrum of eight possible interactions between traditional law andNEGapproaches, before evaluating three distinct perspectives, namely, gaps,NEGin the shadow of the law, and integration. It studies these relationships by empirically evaluating three case studies fromAustralia,NewZealand, and the United States that correspond to these interactions. The article explores the strengths and weaknesses of the three relationships. It finds that a significant barrier to achieving productive cohesion between law andNEGis the worldview of regulators, who eschewNEGcollaboration as ineffectual or incompatible with hard law. Recommendations are offered on how to better achieve cohesive implementation between law andNEG.
Using a Computational Model to Understand Possible Sources of Skews in Distributions of Job Performance
Authors: Vancouver Jeffrey B. , Li Xiaofei , Weinhardt Justin M. , Steel Piers , Purl Justin D.
Published: December 2015

The typical assumption that performance is distributed normally has come under question in recent years (e.g., O'Boyle & Aguinis, 2012). This paper uses a dynamic, computational model of performance‐as‐results to examine possible sources of such distributions. That is, building off the classic model of job performance (Campbell & Pritchard, 1976), components of a dynamic model are examined in 4 separate experiments using Monte Carlo simulations. The experiments indicate that positively skewed distributions can arise from pure luck, multiplicative combinations of factors where 1 of those factors has a zero origin, Matthew effects associated with learning, and feedback effects of performance on resource allocation policies by external agents. The results are discussed in terms of explanations for positively skewed performance distributions and the use and expansion of the computational model for examining dynamic performance more generally.
Reproducibility and responsiveness of a Danish Pedi‐IKDC subjective knee form for children with knee disorders
Authors: Jacobsen J. S. , Knudsen P. , Fynbo C. , Rolving N. , Warming S.
Published: December 2015

The modified International Knee Documentation Committee Subjective Knee Form (Pedi‐IKDC) is a widely used patient‐reported tool ranging on a scale from 0 to 100. We aimed to translate Pedi‐IKDC into Danish and assess its reproducibility and responsiveness in children with knee disorders. The translation complied with the international guidelines. Reproducibility was assessed in 53 children (15 years) responding Pedi‐IKDC at baseline and after 3–14 days. For analysis of responsiveness, 94 children (15 years) responded Pedi‐IKDC again after 3 months. Test–retest reliability was excellent. Intraclass correlation coefficient was 0.9, standard error of measurement was 4.1 points, and smallest detectable change (SDC) was 11.3 points. Evaluating responsiveness as a large effect was found in children reporting improvement compared with children reporting deterioration. The change score was correlated to the external anchor Global Rating Scale consisting of 15 answers from −7 “A very great deal worse” to +7 “A very great deal better,” with a Spearmen's rho of 0.45 (P > 0.001). The minimal clinically important changes was 12.0. In conclusion, excellent test–retest reproducibility was found at group level, but at individual level the SDC was high. The Pedi‐IKDC showed adequate responsiveness and is suitable for assessing improvement or deterioration in children with knee disorders.
Unilateral elbow flexion fatigue modulates corticospinal responsiveness in non‐fatigued contralateral biceps brachii
Authors: Aboodarda S. J. , Šambaher N. , Behm D. G.
Published: December 2015

Exercise‐induced fatigue can change motor performance in non‐exercised muscles. The objective was to investigate unilateral elbow flexion (EF) fatigue effects on the maximal voluntary force (MVC) and corticospinal excitability of contralateral non‐exercised biceps brachii (BB). Transcranial magnetic, transmastoid electrical, and brachial plexus electrical stimulation were used to elicit motor evoked potentials (MEP), cervicomedullary motor evoked potentials (CMEP), and compound muscle action potentials in the contralateral non‐exercised BB of 12 participants before and after (i) two bouts of 100‐s unilateral EF (fatigue) or (ii) control. Three stimuli were evoked every 1.5 s during a series of 6‐s isometric EF at 100%, 50%, and 5% of MVC. The non‐exercised EF MVC force, electromyographic activity, and voluntary activation were not significantly different between fatigue and control. Non‐exercised BB MEP and CMEP amplitudes during 100% MVCs demonstrated significantly higher (P = 0.03) and lower values (P = 0.01), respectively, after fatigue compared with control. There was no difference between the two conditions for MEP and CMEP amplitudes during 50% and 5% MVCs. Unilateral exercise‐induced EF fatigue did not lead to cross‐over central fatigue to the contralateral homologous muscle but enhanced the supraspinal responsiveness (MEP/CMEP) of the neural circuitries supplying central commands to non‐exercised muscles at higher contraction intensity.
What is the Role of Culture in the Association of Relationships with Health?
Authors: Campos Belinda
Published: December 2015

There is now widespread recognition that relationships have important implications for health. To better understand this linkage, scholars have called for greater bridging between relationship science and the study of health. The goal of this paper is to raise awareness of another factor that needs to be incorporated into this area of study: culture. I recommend three steps that researchers can take to systematically incorporate culture into the study of relationships and health. First, I suggest four possible culture patterns to study: similarity, moderation, mediation, and novel constructs. Second, I suggest that theoretically meaningful cultural variation and multiple cultures be concurrently studied. The value of this strategy is highlighted via examples from three contexts that emphasize distinct approaches to self and emotion in relationships. Third, I suggest that key relationship processes in families and couples, two relationships with extensive implications for health, be studied. Selected studies of four relationship processes known to be relevant for health – expectations, formation and maintenance, emotions, and social support – are briefly reviewed to highlight the value of this focus. The theoretical and applied benefit of incorporating culture into the study of the association of relationships with health is discussed.
Asociación entre calidad del servicio deportivo, valor y satisfacción de usuarios en España
Authors: Nuviala Alberto , Grao-Cruces Alberto , Fernández-Ozcorta Eduardo , Nuviala Román
Published: December 2015

Los modelos conceptuales facilitan la gestión de los servicios deportivos que explican, pero los desarrollados en otros países no ofrecen garantías para ser reproducidos correctamente en España. El objetivo del estudio fue comprobar la reproducibilidad del modelo de evaluación de los servicios deportivos propuesto por Murray y Howat (2002), en el contexto de las organizaciones deportivas en España. En una muestra de 2667 usuarios de servicios deportivos españoles, se relacionaron los conceptos calidad, valor percibido y satisfacción, utilizando modelos de ecuaciones estructurales. Los resultados indicaron el papel de la calidad como antecedente del valor percibido y de la satisfacción de los usuarios. No se encontró relación entre el valor y la satisfacción. Este estudio supone un paso hacia el desarrollo de modelos más integrales, para ayudar a los administradores de los servicios deportivos españoles a establecer estrategias que incrementen la satisfacción y fidelidad del usuario.
Adaptación al castellano de la Centrality of Event Scale (CES)
Authors: Fernández Alcántara Manuel , De los Santos-Roig Macarena , Pérez-Marfil Mª Nieves , Catena-Martínez Andrés , Pérez-García Miguel , Martí-García Celia , Cruz-Quintana Francisco
Published: December 2015

La “Centrality of Event Scale” (CES) es un instrumento utilizado para evaluar la centralidad que tiene una determinada experiencia en la persona. Estudios previos muestran que la centralidad es un constructo altamente relacionado con el estrés post-traumático, la depresión o el duelo complicado. El objetivo de este estudio fue realizar su adaptación al castellano y caracterizar su fiabilidad y validez. Participaron dos muestras compuestas por 208 y 320 estudiantes universitarios que completaron la CES y medidas de depresión (BDI), ansiedad (STAI) y sintomatología de estrés post-traumático (PSS). Los resultados coinciden con los obtenidos con la versión original de la CES, tanto en consistencia interna (alfa de Cronbach de 0.92 y 0.94, para cada muestra), como en test-retest a los dos meses (r=0.803, p<0.01). El análisis de componentes principales muestra un único factor explicativo que daba cuenta del 45% de la varianza. Finalmente las puntuaciones de la CES muestran relaciones con diversos índices de psicopatología, siendo además un predictor, junto con las medidas de ansiedad y depresión, del 32% de la sintomatología de estrés post-traumático. La adaptación al castellano de la escala CES parece ser una medida válida y fiable sobre centralidad del evento.