bluuebunny/crossref_metadata_2025 huggingface dataset:
Operational Code Theory: Beliefs and Foreign Policy Decisions
Authors: Walker Stephen G. , Schafer Mark
Published: January 2018

The process of foreign policy decision making is influenced in large part by beliefs, along with the strategic interaction between actors engendered by their decisions and the resulting political outcomes. In this context, beliefs encompass three kinds of effects: the mirroring effects associated with the decision making situation, the steering effects that arise from this situation, and the learning effects of feedback. These effects are modeled using operational code analysis, although “operational code theory” more accurately describes an alliance of attribution and schema theories from psychology and game theory from economics applied to the domain of politics. This “theory complex” specifies belief-based solutions to the puzzles posed by diagnostic, decision making, and learning processes in world politics. The major social and intellectual dimensions of operational code theory can be traced to Nathan Leites’s seminal research on the Bolshevik operational code, The Operational Code of the Politburo. In the last half of the twentieth century, applications of operational code analysis have emphasized different cognitive, emotional, and motivational mechanisms as intellectual dimensions in explaining foreign policy decisions. The literature on operational code theory may be divided into four general waves of research: idiographic-interpretive studies, nomothetic-typological studies, quantitative-statistical studies, and formal modeling studies. The present trajectory of studies on operational code points to a number of important trends that straddle political psychology and game theory. For example, the psychological processes of mirroring, steering, and learning associated with operational code analysis have the potential to enrich our understanding of game-theoretic models of strategic interaction.
Review of Available Data Sets
Authors: Hensel Paul R.
Published: January 2018

The International Studies Association’s (ISA) Scientific Study of International Processes (SSIP) section is dedicated to the systematic analysis of empirical data covering the entire range of international political questions. Drawing on the canons of scientific inquiry, SSIP seeks to support and promote replicable research in terms of the clarity of a theoretical argument and/or the testing of hypotheses. Journals that have been most likely to publish SSIP-related research include the top three general journals in the field of political science: the American Political Science Review, American Journal of Political Science, and Journal of Politics. A number of more specialized journals frequently publish research of interest to the SSIP community, such as Conflict Management and Peace Science, International Interactions, International Organization, International Studies Quarterly, Journal of Conflict Resolution, and Journal of Peace Research. Together, these journals published a total of 1,024 qualifying articles between 2003 and 2010. These articles cover a wide range of topics, from armed conflict and conflict management to terrorism, international political economy, economic development or growth, monetary policy, foreign aid, sanctions, human rights and repression, international law, international organizations/institutions, and foreign policy attitudes and beliefs. Data users who are interested in conducting their own research must: choose the most appropriate data set(s), become familiar with what the data set includes and how its central concepts are measured, multipurpose data sources, investigate missing data, and assess robustness across multiple data sets.
Feminist Ethics in International Relations
Authors: Ackerly Brooke , Zhang Ying
Published: January 2018

The study of feminist ethics in international relations (IR) is the study of three topics. The first is the feminist contributions to key topics in international ethics and the research agenda that continues to further that enterprise. Feminists have made important contributions to IR thought on central ethical concepts. They rethink these concepts from the perspective of their impact on women, deconstruct the dichotomies of the concepts and their constituent parts, and reconsider how the field should be studied. Next, there is the feminist engagement with the epistemological construction of the discipline of IR itself, by which feminists make the construction of the field itself a normative subject. Finally, there is the feminist methodological contribution of a “meta-methodology”—a research ethic applicable in the research of all questions and able to improve the research practice of all methodologists. The contention here is that ethical IR research must be responsive to the injustices of the world, hence feminists have also explored the connections between scholarship and activism. And this in turn has meant exploring methodologies such as participatory action research that engages one with the political impact of research and methods. Furthermore, contemporary challenges related to climate, globalization, shifts in people, and shifts in global governance are encouraging feminists to work from multiple theoretical perspectives and to triangulate across multiple methods and questions, in order to contribute to our understanding of global problems and the politics of addressing them.
Human Rights and Foreign Policy Analysis
Authors: Blanton Shannon Lindsey , Cingranelli David L.
Published: January 2018

Foreign policy analysis emerged as a subfield ino the late 1950s and early 1960s, when scholars began to focus on substate factors and on the decision making process in evaluating foreign policy. It was during this time that the United States embarked on an effort to establish internationally recognized legal standards aimed at protecting individual human rights. The United Nations Charter and the UN Universal Declaration of Human Rights (UNDHR) made human rights promotion the responsibility of all member nations. But it was only in the late 1970s that human rights became an important component of quantitative foreign policy analysis. Numerous developments, including the Helsinki Accords of 1975 and the International Human Rights Covenants in 1976, helped elevate human rights concerns in the U.S. foreign policy making process. The scholarly literature on the subject revolves around three key issues: whether governments should make the promotion of human rights a goal of their foreign policies; whether the increasing use of human rights language in foreign policy rhetoric has been translated by the United States and other countries into public policies that have been consistent with that rhetoric; and whether the foreign policies of OECD governments actually have led to improved human rights practices in less economically developed countries. While scholars have produced a considerable amount of work that examines the various influences on the policy making process—whether at the individual, institutional, or societal levels of analysis—relatively few of them have focused on human rights perse.
The English Language: A Very Short Introduction
Authors: Horobin Simon
Published: January 2018

The English language is spoken by more than a billion people throughout the world. But where did English come from? And how has it evolved into the language used today? The English Language: A Very Short Introduction investigates how we have arrived at the English we know today, and celebrates the way new speakers and new uses mean that it continues to adapt. Engaging with contemporary concerns about correctness, it considers whether such changes are improvements, or evidence of slipping standards. What is the future for the English language? Will Standard English continue to hold sway, or we are witnessing its replacement by newly emerging Englishes?
The European Union: A Very Short Introduction
Authors: Usherwood Simon , Pinder John
Published: January 2018

The European Union (EU) is a unique political organization. Illustrating how and why it has developed from 1950 to the present day, The European Union: A Very Short Introduction covers a range of topics, including the EU’s early history, the workings of its institutions and what they do, the interplay between ‘eurosceptics’ and federalists, and the role of the EU beyond Europe in international affairs and as a peace-keeper. This new edition covers the migrant crisis, the UK’s decision to leave the EU, and how the EU continues to attract new members. It concludes by considering the future of the EU, and the choices and challenges that may lie ahead.
HPViewer: sensitive and specific genotyping of human papillomavirus in metagenomic DNA
Authors: Hao Yuhan , Yang Liying , Galvao Neto Antonio , Amin Milan R , Kelly Dervla , Brown Stuart M , Branski Ryan C , Pei Zhiheng
Published: January 2018

Motivation

Shotgun DNA sequencing provides sensitive detection of all 182 HPV types in tissue and body fluid. However, existing computational methods either produce false positives misidentifying HPV types due to shared sequences among HPV, human and prokaryotes, or produce false negative since they identify HPV by assembled contigs requiring large abundant of HPV reads.

Results

We designed HPViewer with two custom HPV reference databases masking simple repeats and homology sequences respectively and one homology distance matrix to hybridize these two databases. It directly identified HPV from short DNA reads rather than assembled contigs. Using 100 100 simulated samples, we revealed that HPViewer was robust for samples containing either high or low number of HPV reads. Using 12 shotgun sequencing samples from respiratory papillomatosis, HPViewer was equal to VirusTAP, and Vipie and better than HPVDetector with the respect to specificity and was the most sensitive method in the detection of HPV types 6 and 11. We demonstrated that contigs-based approaches had disadvantages of detection of HPV. In 1573 sets of metagenomic data from 18 human body sites, HPViewer identified 104 types of HPV in a body-site associated pattern and 89 types of HPV co-occurring in one sample with other types of HPV. We demonstrated HPViewer was sensitive and specific for HPV detection in metagenomic data.

Availability and implementation

HPViewer can be accessed at https://github.com/yuhanH/HPViewer/.

Supplementary information

Supplementary data are available at Bioinformatics online.
Pro- versus Antinociceptive Nongenomic Effects of Neuronal Mineralocorticoid versus Glucocorticoid Receptors during Rat Hind Paw Inflammation
Authors: Li Xiongjuan , Shaqura Mohammed , Mohamed Doaa , Beyer Antje , Yamada Shunji , Mousa Shaaban A. , Schäfer Michael
Published: January 2018

Background

In naive rats, corticosteroids activate neuronal membrane–bound glucocorticoid and mineralocorticoid receptors in spinal cord and periphery to modulate nociceptive behavior by nongenomic mechanisms. Here we investigated inflammation-induced changes in neuronal versus glial glucocorticoid and mineralocorticoid receptors and their ligand-mediated nongenomic impact on mechanical nociception in rats.

Methods

In Wistar rats (n = 5 to 7/group) with Freund’s complete adjuvant hind paw inflammation, we examined glucocorticoid and mineralocorticoid receptor expression in spinal cord and peripheral sensory neurons versus glial using quantitative reverse transcription-polymerase chain reaction (qRT-PCR), Western blot, immunohistochemistry, and radioligand binding. Moreover, we explored the expression of mineralocorticoid receptors protecting enzyme 11-betahydroxysteroid dehydrogenase type 2 as well as the nociceptive behavioral changes after glucocorticoid and mineralocorticoid receptors agonist or antagonist application.

Results

Hind paw inflammation resulted in significant upregulation of glucocorticoid receptors in nociceptive neurons of spinal cord (60%) and dorsal root ganglia (15%) as well as mineralocorticoid receptors, while corticosteroid plasma concentrations remained unchanged. Mineralocorticoid (83 ± 16 fmol/mg) but not glucocorticoid (104 ± 20 fmol/mg) membrane binding sites increased twofold in dorsal root ganglia concomitant with upregulated 11-betahydroxysteroid dehydrogenase type 2 (43%). Glucocorticoid and mineralocorticoid receptor expression in spinal microglia and astrocytes was small. Importantly, glucocorticoid receptor agonist dexamethasone or mineralocorticoid receptor antagonist canrenoate-K rapidly and dose-dependently attenuated nociceptive behavior. Isobolographic analysis of the combination of both drugs showed subadditive but not synergistic or additive effects.

Conclusions

The enhanced mechanical sensitivity of inflamed hind paws accompanied with corticosteroid receptor upregulation in spinal and peripheral sensory neurons was attenuated immediately after glucocorticoid receptor agonist and mineralocorticoid receptor antagonist administration, suggesting acute nongenomic effects consistent with detected membrane-bound corticosteroid receptors.
What is the optimal target for treat-to-target strategies in rheumatoid arthritis?
Authors: Bergstra Sytske Anne , Allaart Cornelia F.
Published: January 2018

Purpose of review

There has been a trend over time to aim for stricter treatment targets in the treatment of rheumatoid arthritis (RA). We reviewed recent literature to attempt to identify the optimal target in treat-to-target strategies in RA.

Recent findings

Achieving lower disease activity was shown to be beneficial, but few studies directly compared the effect of aiming for different treatment targets. Based on the limited available evidence, aiming for remission seems to result in more patients achieving (drug-free) remission than aiming for low disease activity (LDA), but it does not seem to result in better physical functioning. There are indications that adherence to a remission targeted protocol can be lower. In randomized trials in which LDA or remission were compared with ultrasound remission targets, treatment targeted at ultrasound remission was associated with more intensive treatment, but it did not result in better clinical or imaging outcomes.

There were no benefits of aiming for ultrasound remission in RA-patients. To decide whether remission or LDA is the best target in the treatment of RA-patients, a randomized clinical trial comparing both targets would be needed. On an individual level, cotargets such as functional ability should be considered.
Staged Prone/Supine Fixation of High-Energy Multicolumnar Tibial Plateau Fractures: A Multicenter Analysis
Authors: Row Elliot R. , Komatsu David E. , Watson J. Tracy , Jones Clifford , Kottmeier Stephen
Published: January 2018

Purpose:

We present a surgical strategy to manage multicolumnar tibial plateau fracture variants by addressing the predominant posterior fragment employing a Lobenhoffer approach in the prone position followed by supine patient repositioning for anterolateral column access.

Design:

Multicenter retrospective analysis.

Setting:

Three academic Level 1 trauma centers.

Patients/Methods:

Twenty-eight cases (28 patients/28 knees) met inclusion criteria between 2003 and 2014. Patient demographic information was retrospectively reviewed with a mean follow-up time of 16.6 months (range 12–34 months). Postoperative radiographic analysis, physical examination findings, and patient outcome scores from the Knee Injury and Osteoarthritis Outcome Score questionnaire were recorded.

Results:

The average time to union was 3.6 months (range 3–9 months). Eighty-two percent of patients had satisfactory articular reduction (less than 2 mm articular step off). All patients demonstrated satisfactory coronal (medial proximal tibia angle 87 ± 5 degrees) and sagittal alignment (posterior proximal tibia angle 9 ± 4 degrees). Condylar width averaged 2.2 mm. Twenty percent of cases required posterior lateral columnar plating (in addition to posterior medial columnar plating), with none of these cases requiring an extensile exposure modification (medial gastrocnemius origin detachment) to expose posterior laterally. In 12 cases, the posterior approach was staged to allow for anterior soft tissue recovery before subsequent staged supine positioning and lateral column fixation. The knee range of motion averaged 123 degrees (ranged from 2 degrees of extension to 125 degrees flexion). The average Knee Injury and Osteoarthritis Outcome Score was 78/100 (range 29–95). Eleven percent of the patients in the series developed a surgical site infection (n = 3) with 2 requiring formal irrigation and debridement. The most common aseptic complication was radiographic posttraumatic arthrosis (18%). Clinically, 1 patient eventually required a total knee arthroplasty.

Conclusions:

High-energy multicolumnar tibial plateau fractures with significant posterior articular surface involvement may be predictably addressed with prone positioning, exposure, and fixation followed by supine repositioning and the inclusion of an anterior approach. This study demonstrates excellent postoperative radiographic results and acceptable clinical outcomes resulting from the described staged protocol.

Level of Evidence:

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Opioid Use Disorders Are Associated With Perioperative Morbidity and Mortality in the Hip Fracture Population
Authors: Summers Spencer , Grau Luis , Massel Dustin , Rosas Samuel , Ong Alvin , Hernandez Victor Hugo
Published: January 2018

Objectives:

To determine whether opioid use disorders (OUDs) are associated with adverse perioperative outcomes in patients undergoing surgical fixation for proximal femur fractures.

Methods:

The National Hospital Discharge Survey was queried to identify patients surgically treated for proximal femur fractures between 1990 and 2007. Patients were grouped into those with a diagnosis of OUD, nonopioid drug use disorder, or neither. Demographic information and comorbidities were included in univariable and multivariable analyses to identify independent risk factors for perioperative outcomes.

Results:

A total of 8154 patients with a diagnosis of drug use disorder and 4704 patients with a diagnosis of OUD were identified from a cohort of 4,732,165 surgically treated proximal femur fractures. Patients with OUD were significantly younger (46 vs. 79), and a significantly smaller proportion of them had medical comorbidities (21.9% vs. 60.2%) when compared with the no drug misuse cohort. Patients with OUD had significantly more medical complications (51.1% vs. 26.8%), mechanical complications (3% vs. 0.3%), and adverse events (55% vs. 39.7%) when compared with the no drug misuse group. OUD had higher odds for leaving against medical advice [odds ratio (OR) 12.868, range 10.7771–15.375], for any adverse event (OR 4.107, range 3.869–4.360), and for mortality (OR 1.744, range 1.250–2.433) when compared with nondrug misusers.

Conclusions:

Despite being younger and with significantly less medical comorbidities, patients with OUD have higher odds for adverse events, leaving against medical advice, and mortality after surgical treatment of a hip fracture.

Level of Evidence:

Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Effect of Blocking Screws on Union of Infraisthmal Femur Fractures Stabilized With a Retrograde Intramedullary Nail
Authors: Van Dyke Bryan , Colley Ryan , Ottomeyer Christina , Palmer Ryan , Pugh Kevin
Published: January 2018

Objective:

To investigate the effect of blocking screws (BS) on the union rate and stability of infraisthmal femur fractures treated with retrograde intramedullary nail (RIMN) insertion.

Design:

Retrospective cohort study.

Setting:

A single level 1 trauma center.

Patients/Participants:

All patients with an infraisthmal femur fracture treated with a RIMN from 2005 to 2012 were included.

Intervention:

All fractures were treated with a RIMN. BS were used at the discretion of the treating surgeon.

Main Outcome Measurements:

(1) Radiographic time to union, (2) initial postoperative sagittal and coronal angulation, and (3) final sagittal and coronal angulation.

Results:

Neither the average time to union (BS 21.1 weeks vs. 21.8 weeks), nor union rates (BS 61% vs. 77%) were statistically different between BS and non-BS constructs. No significant alignment differences existed whether BS were used or not.

Conclusions:

In this study, we were not able to verify our hypothesis. In fact, we did not find any significant advantages when BS were added to a RIMN construct for distal femur fractures with respect to union time, union rate, or improvements in alignment. Additional studies are needed to determine the actual benefit of BS in the treatment of infraisthmal femoral shaft fractures treated with retrograde intramedullary nailing.

Level of Evidence:

Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Rim Plate Augmentation of the Posterolateral Bare Area of the Tibial Plateau Using a 3.5-mm Precontoured Locking Compression Plate: A Cadaveric Study
Authors: Kim Youngwoo , Yoon Yong-Cheol , Cho Jae-Woo , Cho Won-Tae , Jeon Neung-Han , Oh Chang-Wug , Oh Jong-Keon
Published: January 2018

Objective:

To evaluate the effectiveness of an additional rim plate [3.5-mm precontoured locking compression plate (LCP)] for stabilizing the posterolateral fragment in lateral tibial plateau fractures.

Methods:

Standard lateral locking plates [either a proximal tibial plate (PTP) or a proximal tibial locking plate (PTLP)] were applied to 40 matched pair knees from 20 fresh-frozen cadavers followed by the application of a secondary rim plate [variable angle LCP (VALCP)] posterior laterally.

Results:

The mean ratio of supported articular surface in the PTP group was 0.692, whereas that in the PTLP group was 0.569. This difference was statistically significant (P < 0.001). Additional rim plating with a VALCP could only be performed for 27 of 40 knees; 8 of 20 knees in the PTP group and 5 of 20 knees in the PTLP group could not be fitted with a VALCP due to anatomic limitations. For the total standard plating group alone, the mean ratio of supported articular surface was 0.596, whereas the mean ratio of supported articular surface with additional rim plating was 0.798 (P < 0.001). In contrast, additional rim plating was possible for more knees that received a PTLP than a PTP. Ultimately, there was no significant difference in the ratio of supported articular surface after additional rim plating between the 2 different types of standard plates (P = 0.087).

Conclusion:

Our results identified a bare area in the posterolateral corner of the lateral plateau that was unsupported by rafting screws following conventional, 3.5-mm, precontoured LCP plating. Thus, additional rim plating may be useful for treating plateau fractures with a posterolateral fragment.
Tolerance and outcomes of stereotactic radiosurgery combined with anti-programmed cell death-1 (pembrolizumab) for melanoma brain metastases
Authors: Nardin Charlee , Mateus Christine , Texier Mathieu , Lanoy Emilie , Hibat-Allah Salima , Ammari Samy , Robert Caroline , Dhermain Frederic
Published: January 2018

Anti-programmed cell death-1 (anti-PD1) antibodies are currently the first-line treatment for patients with metastatic BRAF wild-type melanoma, alone or combined with the anti-CTLA4 monoclonal antibody, ipilimumab. To date, data on safety and the outcomes of patients treated with the anti-PD1 monoclonal antibodies, pembrolizumab (PB), or nivolumab, combined with stereotactic radiosurgery (SRS), for melanoma brain metastases (MBM) are scarce. We retrospectively reviewed all patients with MBM treated with PB combined with SRS between 2012 and 2015. The primary endpoint was neurotoxicity. The secondary endpoints were local, distant intracranial controls and overall survival (OS). Among 74 patients with MBM treated with SRS, 25 patients with a total of 58 MBM treated with PB combined with SRS within 6 months were included. Radiation necrosis, occurring within a median time of 6.5 months, was observed for four MBM (6.8%) in four patients. No other significant SRS-related adverse event was observed. After a median follow-up of 8.4 months, local control was achieved in 46 (80%) metastases and 17 (68%) patients. Perilesional oedema and intratumour haemorrhage appearing or increasing after SRS were associated with local progression (P<0.001). The median OS was 15.3 months (95% confidence interval: 4.6–26). The timing between SRS and PB administration did not seem to influence the risk of radiation necrosis, intracranial control or OS. SRS combined with PB was well tolerated and achieved local control in 80% of the lesions. Prolonged OS was observed compared with that currently yielded in this population of patients. Prospective studies are required to explore further the optimal ways to combine immunotherapy and SRS.
Success of rechallenging dabrafenib and trametinib combination therapy after trametinib-induced rhabdomyolysis: a case report
Authors: Muto Yusuke , Ng William , Namikawa Kenjiro , Takahashi Akira , Tsutsumida Arata , Nishida Makiko , Yamazaki Naoya
Published: January 2018

The mitogen-activated protein kinase pathway regulates cell growth and differentiation and is activated by BRAF mutations. BRAF mutations are present in about 40–50% of cutaneous melanomas. More than 90% of BRAF mutations are the V600E type. BRAF inhibitor (dabrafenib or vemurafenib) and MEK inhibitor (trametinib or cobimetinib) combination therapies are effective for BRAF-mutant advanced melanomas. A variety of side effects have been observed with combination therapy including pyrexia, fatigue, nausea, and vomiting. Rhabdomyolysis is one of the most severe adverse events, but it is very rare. Only two cases of rhabdomyolysis have been reported in clinical trials. A 41-year-old Japanese woman with cutaneous melanoma was started on a combination of dabrafenib and trametinib therapy after failure of immune checkpoint therapy. One month later, she complained of myalgia and fatigue and was shifted to our hospital. She was diagnosed with trametinib-induced rhabdomyolysis and showed improvement only with a high volume of fluid infusion. We stopped combination therapy, but there were no useful treatment options for her. After resuming dabrafenib, followed by trametinib, she did not have any problems. This is the first case of a patient with metastatic cutaneous melanoma who could recommence combination therapy after trametinib-associated rhabdomyolysis. We assume that not all patients experience recurrence of rhabdomyolysis in trametinib-induced rhabdomyolysis. As few cases have been reported, more information is needed. We have to evaluate safety carefully if rechallenging combination therapy.
Moxifloxacin in Pediatric Patients With Complicated Intra-abdominal Infections
Authors: Wirth Stefan , Emil Sherif G. S. , Engelis Arnis , Digtyar Valeri , Criollo Margarita , DiCasoli Carl , Stass Heino , Willmann Stefan , Nkulikiyinka Richard , Grossmann Ulrike
Published: January 2018

Background:

This study was designed to evaluate primarily the safety and also the efficacy of moxifloxacin (MXF) in children with complicated intra-abdominal infections (cIAIs).

Methods:

In this multicenter, randomized, double-blind, controlled study, 451 pediatric patients aged 3 months to 17 years with cIAIs were treated with intravenous/oral MXF (N = 301) or comparator (COMP, intravenous ertapenem followed by oral amoxicillin/clavulanate; N = 150) for 5 to 14 days. Doses of MXF were selected based on the results of a Phase 1 study in pediatric patients (NCT01049022). The primary endpoint was safety, with particular focus on cardiac and musculoskeletal safety; clinical and bacteriologic efficacy at test of cure was also investigated.

Results:

The proportion of patients with adverse events (AEs) was comparable between the 2 treatment arms (MXF: 58.1% and COMP: 54.7%). The incidence of drug-related AEs was higher in the MXF arm than in the COMP arm (14.3% and 6.7%, respectively). No cases of QTc interval prolongation-related morbidity or mortality were observed. The proportion of patients with musculoskeletal AEs was comparable between treatment arms; no drug-related events were reported. Clinical cure rates were 84.6% and 95.5% in the MXF and COMP arms, respectively, in patients with confirmed pathogen(s) at baseline.

Conclusions:

MXF treatment was well tolerated in children with cIAIs. However, a lower clinical cure rate was observed with MXF treatment compared with COMP. This study does not support a recommendation of MXF for children with cIAIs when alternative more efficacious antibiotics with better safety profile are available.
Chronic Hematic Cyst of the Right Maxillary Sinus and Orbit Presenting as Proptosis
Authors: Ochoa-Escudero Martin , Herrera Diego A. , Dublin Arthur B.
Published: January 2018

A 28-year-old man presented to the emergency room complaining of right proptosis. He also manifested eye pain and facial fullness and redness in this side. Seven years ago, he had right hemifacial gunshot trauma treated with surgical reconstruction. The CT scan showed expansion of the right maxillary sinus due to a hypodense nonenhancing lesion extending to the nasal cavity, masticatory space, and extraconal space of the orbit. MRI was performed showing high signal intensity of the lesion on T2-weighted images indicating a cystic nature. T1-weighted images also demonstrated high signal intensity of the lesion suggesting hemorrhage. At endoscopic maxillary antrostomy, the diagnosis of a chronic hematic cyst was confirmed. Chronic hematic cysts of the orbit should be included in the differential diagnosis of proptosis, especially if there is clinical history of past trauma. Due to the fact that physical examination is nonspecific, radiologic evaluation is useful to confirm the diagnosis and for presurgical planning.
Key Factors Leading to Program Selection: A Survey of Physician Assistant Program Interviewees
Authors: Sierra Talia , Forbes Jennifer , Mirly Alan , Domenech Rodríguez Melanie M.
Published: January 2018

Purpose

The purpose of this study was to determine which factors had the greatest influence on physician assistant (PA) interviewees' decision to choose a PA program to attend. The information in this article may assist PA programs in making their program more attractive to potential applicants and also may help applicants identify programs that will best fit their needs.

Methods

Applicants who interviewed with a PA program were asked to rate 33 different influential factors when choosing a program to attend.

Results

Respondents most highly endorsed quality of faculty and staff, first-time Physician Assistant National Certifying Examination pass rates, and morale of faculty and staff. Results varied by demographics, including marital status, age, and sex of respondent. Results also varied from pre-PA students.

Conclusions

Although there are numerous factors involved in program selection, PA programs may want to focus on the quality and morale of their faculty and staff to help improve the likelihood of attracting and retaining the highest quality applicants.
Factors Influencing Physician Assistant Students' Attitudes Toward Deservingness of Care for Undocumented Mexicans
Authors: Bowen Denise J. , Mickus Maureen , Rosales Alma N.
Published: January 2018

Purpose

Attitudes regarding health-related deservingness of care for vulnerable patient populations can impact the quality of services provided. This study was aimed at identifying the influences that shape these attitudes among physician assistant (PA) students.

Methods

The study focused on PA students' perspectives toward care for a particularly vulnerable population, undocumented Mexican immigrants. An in-person survey was administered to first- and second-year PA students (n = 75). Multiple regression was used to assess whether familiarity, stereotyping, language skills, cultural preparedness, societal views, and background characteristics of PA students influenced attitudes toward deservingness of care.

Results

Results suggested that cultural preparedness among PA students was associated with positive views toward deservingness of both emergency services (β = 0.38,p< .001) and primary care (β = −0.211,p= .05) for undocumented Mexicans. Negative societal views toward this population predicted an unwillingness to endorse emergency care (β = −0.43,p< .001) and primary care (β = −0.45,p< .001).

Conclusions

Demographic projections indicate continued trends toward increasingly diverse patient populations, with dramatic growth among Hispanics. The findings of this study suggest that greater cultural preparedness is needed for future PAs. Furthermore, strategies for increasing PA students' self-awareness of how their broader societal views shape service delivery are warranted to ensure equitable care.
Bacterial Biofilms on Extracorporeal Membrane Oxygenation Catheters
Authors: Yeo Hye Ju , Yoon Seong Hoon , Lee Seung Eun , Cho Woo Hyun , Kim Dohyung , Jeon Doosoo , Shin Kyung-Hwa , Kim Yun Seong
Published: January 2018

Despite the advantages of extracorporeal membrane oxygenation (ECMO), secondary catheter infection remains a major concern during ECMO support. In this study, to clarify the mechanism of ECMO catheter-related infection, we evaluated the impact of infection on biofilm formation on the surfaces of ECMO catheters, and we investigated clinical factors associated with biofilm formation. Catheters used for ECMO were prospectively collected aseptically from the femoral vein, internal jugular vein, and femoral artery of 81 patients with acute cardiorespiratory failure between January 2015 and October 2016. Prepared catheter sections were investigated by fluorescence microscopy, confocal scanning laser microscopy, transmission electron microscopy, and using semiquantitative culture methods. Of the 81 patients, 51 were assigned to the infection group and 30 to a control group. Biofilms were identified in 43.1% patients in the infection group, and in 20% controls (p = 0.034). Extracorporeal membrane oxygenation flow, systemic infection, and carbapenem-resistant Acinetobacter baumannii (CRAB) infection were associated with biofilm formation in a univariate analysis (odds ratio [OR]: 1.00, 95% confidence interval [CI]: 1.00–1.00, p = 0.007; OR: 3.03, 95% CI: 1.06–8.69, p = 0.039; OR: 9.60, 95% CI: 2.94–31.30, p < 0.001, respectively). However, of these factors, only CRAB infection was found to independently predict the presence of a biofilm by a multivariate logistic regression analysis (OR: 9.60, 95% CI: 2.94–31.30; p < 0.001). Biofilms were more prevalent in patients with an infection than in uninfected controls. Carbapenem-resistant A. baumannii infection was identified as an independent risk factor for biofilm formation on ECMO catheters.
Diabetes pathogenic mechanisms and potential new therapies based upon a novel target called TXNIP
Authors: Thielen Lance , Shalev Anath
Published: January 2018

Purpose of review

Thioredoxin-interacting protein has emerged as a major factor regulating pancreatic β-cell dysfunction and death, key processes in the pathogenesis of type 1 and type 2 diabetes. Accumulating evidence based on basic, preclinical, and retrospective epidemiological research suggests that TXNIP represents a promising therapeutic target for diabetes. The present review is aimed at providing an update regarding these developments.

Recent findings

TXNIP has been shown to be induced by glucose and increased in diabetes and to promote β-cell apoptosis, whereas TXNIP deletion protected against diabetes. More recently, TXNIP inhibition has also been found to promote insulin production and glucagon-like peptide 1 signaling via regulation of a microRNA. β-Cell TXNIP expression itself was found to be regulated by hypoglycemic agents, carbohydrate-response-element-binding protein, and cytosolic calcium or the calcium channel blocker, verapamil. Retrospective studies now further suggest that verapamil use might be associated with a lower incidence of type 2 diabetes in humans.

TXNIP has emerged as a key factor in the regulation of functional β-cell mass and TXNIP inhibition has shown beneficial effects in a variety of studies. Thus, the inhibition of TXNIP may provide a novel approach to the treatment of diabetes.
The impact of myeloperoxidase on HDL function in myocardial infarction
Authors: Tietge Uwe J.F.
Published: January 2018

Purpose of review

The focus in cardiovascular research is shifting from determining mass HDL cholesterol levels toward investigating HDL functionalities as biomarker for cardiovascular disease. Myeloperoxidase (MPO), a main effector enzyme of the innate immune system, is increasingly implicated to negatively impact HDL function by various chemical modifications of HDL-associated proteins. This review summarizes recent insights how MPO affects HDL function in the setting of acute myocardial infarction (MI), mainly focusing on human data.

Recent findings

First the mechanisms how MPO renders HDL particles dysfunctional and the usefulness of MPO as prospective biomarker for MI incidence and outcomes are described. Then the evidence for MPO causing specific HDL function impairments in MI and the clinical value of these observations is discussed in the context of the different HDL function assays employed.

MPO modification of HDL in acute MI generates dysfunctional HDL. Features of HDL dysfunction can be used to stratify MI patients and seem associated with outcomes. More prospective studies are warranted to explore, if MPO-modified HDL is causally linked to severity and outcomes of MI. If this could be established, MPO would represent an attractive target to improve HDL dysfunction in MI and provide clinical benefit for patients.
Familial hypercholesterolemia: experience from the French-Canadian population
Authors: Paquette Martine , Genest Jacques , Baass Alexis
Published: January 2018

Purpose of review

There has recently been renewed interest in the study of the various facets of familial hypercholesterolemia, a severe monogenic disease associated with elevated LDL-cholesterol and premature cardiovascular disease (CVD). In the present review, novel data presenting the frequency of familial hypercholesterolemia as well as factors modulating the cardiovascular risk in familial hypercholesterolemia will be discussed.

Recent findings

Recent studies have showed that familial hypercholesterolemia is much more prevalent than initially thought. Classically, it was estimated that familial hypercholesterolemia affected one in 500 people worldwide, but a recent large-scale meta-analysis has shown a prevalence closer to one in 250. In the French-Canadian population, this disease is even more frequent reaching one in 81 in certain regions of the Province of Quebec. Several novel studies in the French-Canadian population have shown that the clinical outcomes in familial hypercholesterolemia seem to be greatly influenced by risk factors other than LDL-cholesterol. Also, scores to predict CVD in familial hypercholesterolemia have been recently proposed.

Familial hypercholesterolemia is more frequent than initially thought and the phenotype of this disease can be variable. Indeed, both clinical and genetic variables can modulate the CVD risk in this population.
Genetics of familial hypercholesterolemia: a tool for development of novel lipid lowering pharmaceuticals?
Authors: Volta Andrea , Hovingh G. Kees , Grefhorst Aldo
Published: January 2018

Purpose of review

Familial hypercholesterolemia is characterized by high LDL cholesterol and an elevated risk to develop coronary heart disease. Mutations in LDL receptor-mediated cholesterol uptake are the main cause of familial hypercholesterolemia. However, multiple mutations in various other genes are also associated with high LDL cholesterol and even familial hypercholesterolemia. Thus, pharmaceuticals that target these genes and proteins might be attractive treatment options to reduce LDL cholesterol. This review provides an overview of the recent developments and clinical testing of such pharmaceuticals.

Recent findings

About 80 genes are associated with hypercholesterolemia but only pharmaceuticals that inhibit cholesteryl ester transfer protein (CETP), angiopoietin-related protein 3 (ANGPTL3), and apolipoprotein C-III (apoC-III) have recently been tested in clinical trials. Inhibition of CETP and ANGPTL3 lowered LDL cholesterol. ANGPTL3 inhibition had the largest effect and was even effective in familial hypercholesterolemia patients. The effect of apoC-III inhibition on LDL cholesterol is not conclusive.

Of the many potential pharmaceutical targets involved in LDL cholesterol, only a few have been studied so far. Of these, pharmaceuticals that inhibit CETP or ANGPTL3 are promising novel treatment options to reduce LDL cholesterol but the effect of apoC-III inhibition requires more research.
The Evolving Science of Patient and Family Engagement
Authors: Reid-Ponte Patricia
Published: January 2018

Patient- and family-centered care is a central tenet of nursing practice. This concept has evolved to include patient partnerships, patient engagement, and patient activation. This column differentiates these concepts and describes the core principles embedded in the overriding intention of ensuring that patients (and their families or significant others) are orchestrators of their health and their care plans. In this interview, Karen Drenkard, PhD, RN, FAAN, NEA-BC, CNO, of the GetWellNetwork, discusses work by the O’Neil Center as a leader in this area.
Technological Complexity and Emergence of the Entanglement
Authors: Clancy Thomas R.
Published: January 2018

As systems evolve over time, their natural tendency is to become increasingly more complex. Studies in the field of complex systems have generated new perspectives on the application of management strategies in health systems. Much of this research appears as a natural extension of the cross-disciplinary field of systems theory. This article is the 3rd in a series of articles that focus on why technological complexity is increasing and strategies nurse administrators can use to successfully implement change in the face of it.
Using Time-Referenced Data to Assess Medication Administration Performance and Quality
Authors: Welton John M. , Kleiner Catherine , Valdez Carolyn , Richardson Sara , Boyle Kathy , Lucas Eric
Published: January 2018

OBJECTIVE

This study tests the feasibility of using a large (big) clinical data set to test the ability to extract time-referenced data related to medication administration to identify late doses and as-needed (PRN) administration patterns by RNs in an inpatient setting.

METHODS

The study is a secondary analysis of a set of data using bar-code medication administration time stamps (n = 3043812) for 50883 patients admitted to a single, urban, 525-bed hospital in 11 inpatient units by 714 nurses between April 1, 2013, and March 31, 2015.

RESULTS

The large majority of scheduled medications (43.3%) were administered between 9 to 10 AM and 9 to 10 pm accounting for the most amount of delayed doses. On average, patients received 8.9 medications per day, and nurses administered 19.7 medications per shift. The average full-time nurse administered 3414 medications per year.

CONCLUSIONS

The findings support use of time-referenced data to identify clinical processes and performance in administering scheduled and PRN medications.
Creating and Sustaining a Healthy Food Environment in Hospitals Contracting With a Food Service Management Company
Authors: Kolasa Kathryn M.
Published: January 2018

This article updates an article published in Nutrition Today in 2010, “Moving Toward Healthier Eating Environments in Hospitals” (2010;45(2):54–65). It seeks to provide advocates for healthy food environments who are employed by a hospital with a contract food service, with suggestions of the roles they can play in initiating and/or maintaining a healthy food environment. These suggestions come from the literature as well as interviews with professionals engaged in creating and sustaining an environment where the healthy choice is an easy choice—in the face of competing priorities and realities
More Foot, Less Fork
Authors: Grasso Alessandra C. , McDermott Ann Yelmokas
Published: January 2018

Physical inactivity and sedentary behavior are modifiable risk factors to numerous chronic diseases and conditions such as obesity, depression, heart failure, and lower back pain. Integrating physical activity (PA) and exercise strategies into patient consultations for the prevention and treatment of chronic diseases is the epitome of the global health initiative, Exercise Is Medicine. Nutrition and health professionals can play an important role in this growing movement of increasing PA by documenting PA assessment, incorporating PA in patient counseling, prescribing tailored exercise prescriptions, and including resource referrals at each clinical visit. This article presents a brief background of PA, exercise, and sedentary behavior research and application strategies targeting health outcomes and illustrates why and how nutrition and health professionals play a role in Exercise Is Medicine to support increased PA in patient populations.
Muscular Strength Is Associated with Higher Intraocular Pressure in Physically Active Males
Authors: Vera Jesús , Jiménez Raimundo , García-Ramos Amador , Cárdenas David
Published: January 2018

SIGNIFICANCE

The positive association between intraocular pressure (IOP) and relative maximum force may have relevance for exercise recommendations when IOP is a concern.

PURPOSE

The relationship between exercise and IOP has been approached in several studies. However, the influence of muscle function on IOP remains underexplored. This study aimed to determine the relationship between the maximal mechanical capabilities of muscles to generate force, velocity, and power with IOP.

METHODS

Sixty-five physically active males participated in this cross-sectional study. Baseline IOP measures were obtained by rebound tonometry, and participants performed an incremental loading test in the ballistic bench press.

RESULTS

Baseline IOP showed a strong positive correlation with relative maximum force (r
65 = 0.85, P < .001) relative maximum power (r
65 = 0.85, P < .001), and relative one-repetition maximum (r
65 = 0.91, P < .001). Also, a moderate positive association was obtained between baseline IOP and maximum force (r
65 = 0.74, P < .001), maximum power (r
65 = 0.72, P < .001), and maximum dynamic strength (r
65 = 0.80, P < .001). No significant correlations between IOP and maximal velocity were obtained (all P > .05).

CONCLUSIONS

There is a positive association between greater upper-body power and strength with higher baseline IOP, which might have important implications in the management of ocular health and especially in individuals constantly involved in resistance training programs (e.g., military personnel, weightlifters). The possible protective effect of high fitness level on the acute IOP response to strength exercise needs to be addressed in future studies.