bluuebunny/crossref_metadata_2025 huggingface dataset:
Neighborhood socioeconomic status at the age of 40 years and ischemic stroke before the age of 50 years: A nationwide cohort study from Sweden
Authors: Carlsson Axel C , Li Xinjun , Holzmann Martin J , Ärnlöv Johan , Wändell Per , Gasevic Danijela , Sundquist Jan , Sundquist Kristina
Published: April 2017

Objective

We aimed to study the association between neighborhood socioeconomic status at the age of 40 years and risk of ischemic stroke before the age of 50 years.

Methods

All individuals in Sweden were included if their 40th birthday occurred between 1998 and 2010. National registers were used to categorize neighborhood socioeconomic status into high, middle, and low and to retrieve information on incident ischemic strokes. Hazard ratios and their 95% confidence intervals were estimated.

Results

A total of 1,153,451 adults (women 48.9%) were followed for a mean of 5.5 years (SD 3.5 years), during which 1777 (0.30%) strokes among men and 1374 (0.24%) strokes among women were recorded. After adjustment for sex, marital status, education level, immigrant status, region of residence, and neighborhood services, there was a lower risk of stroke in residents from high-socioeconomic status neighborhoods (hazard ratio 0.87, 95% confidence interval 0.78–0.96), and an increased risk of stroke in adults from low-socioeconomic status neighborhoods (hazard ratio 1.16, 95% confidence interval 1.06–1.27), compared to their counterparts living in middle-socioeconomic status neighborhoods. After further adjustment for hospital diagnoses of hypertension, diabetes, heart failure, and atrial fibrillation prior to the age of 40, the higher risk in neighborhoods with low socioeconomic status was attenuated, but remained significant (hazard ratio 1.12, 95% confidence interval 1.02–1.23).

Conclusions

In a nationwide study of individuals between 40 and 50 years, we found that the risk of ischemic stroke differed depending on neighborhood socioeconomic status, which calls for increased efforts to prevent cardiovascular diseases in low socioeconomic status neighborhoods.
Reliability of functioning free muscle transfer and vascularized ulnar nerve grafting for elbow flexion in complete brachial plexus palsy
Authors: Potter S. M. , Ferris S. I.
Published: April 2017

We compared outcomes of primary vascularized ulnar nerve grafts from the C5 root neurotizing biceps and brachialis muscles, and gracilis functioning free muscle transfer neurotized by the distal spinal accessory nerve, as a primary or salvage procedure after complete brachial plexus injury. At 45 months, three of eight primary vascularized ulnar nerve graft patients regained grade 4 elbow flexion, while one regained grade 3. All 13 primary gracilis transfer patients regained grade 4 elbow flexion. Four patients with vascularized ulnar nerve grafts failed and subsequently had salvage functioning free muscle transfer procedures resulting in delayed recovery. Although vascularized ulnar nerve graft-based primary reconstructions can provide useful elbow flexion, this was achieved in less than half the cases. We consider primary gracilis functioning free muscle transfer neurotized by the distal spinal accessory nerve as the most reliable reconstruction for the restoration of elbow flexion in complete brachial plexus injury.

Level of evidence: IV
The safety and pharmacokinetics of rapid iloprost aerosol delivery via the BREELIB nebulizer in pulmonary arterial hypertension
Authors: Gessler Tobias , Ghofrani Hossein‐Ardeschir , Held Matthias , Klose Hans , Leuchte Hanno , Olschewski Horst , Rosenkranz Stephan , Fels Lueder , Li Na , Ren Dawn , Kaiser Andreas , Schultze‐Mosgau Marcus‐Hillert , Müllinger Bernhard , Rohde Beate , Seeger Werner
Published: April 2017

The BREELIB nebulizer was developed for iloprost to reduce inhalation times for patients with pulmonary arterial hypertension (PAH). This multicenter, randomized, unblinded, four‐part study compared inhalation time, pharmacokinetics, and acute tolerability of iloprost 5 µg at mouthpiece delivered via BREELIB versus the standard I‐Neb nebulizer in 27 patients with PAH. The primary safety outcome was the proportion of patients with a maximum increase in heart rate (HR) ≥ 25% and/or a maximum decrease in systolic blood pressure ≥ 20% within 30 min after inhalation. Other safety outcomes included systolic, diastolic, and mean blood pressure, HR, oxygen saturation, and adverse events (AEs). Median inhalation times were considerably shorter with BREELIB versus I‐Neb (2.6 versus 10.9 min; n = 24). Maximum iloprost plasma concentration and systemic exposure (area under the plasma concentration–time curve) were 77% and 42% higher, respectively, with BREELIB versus I‐Neb. Five patients experienced a maximum systolic blood pressure decrease ≥ 20%, four with BREELIB (one mildly and transiently symptomatic), and one with I‐Neb; none required medical intervention. AEs reported during the study were consistent with the known safety profile of iloprost. The BREELIB nebulizer offers reduced inhalation time, good tolerability, and may improve iloprost aerosol therapy convenience and thus compliance for patients with PAH.
Barbed suture tissue closure device in urological surgery – a comprehensive review
Authors: Umranikar Salil A , Ubee Sarvpreet S , Selvan Masilamani , Cooke Peter
Published: April 2017

The development and implementation of barbed sutures has transformed the technique of tissue closure with increasing application across multiple surgical disciplines. Changes in design and handling such as the introduction of absorbable and non-absorbable bidirectional barbed sutures reflect an increasing applicability in tissues of varying qualities. We undertook a comprehensive review of available literature to provide an evidence-based rationale for the clinical use of barbed suture tissue closure devices. We summarise uses along with advantages and disadvantages reported across a number of surgical specialties such as urology, orthopaedics, gynaecology and plastic surgery. Tangible benefits noted were faster closure speed, maintenance of suture integrity, improved efficiency in closure, avoidance of knots and possibly a cost-benefit effect. In terms of complications, the barbed sutures compared equally with standard sutures with no significant differences. In conclusion, barbed sutures have demonstrated versatility and safety across surgical specialties and compares favourably with standard sutures. There appears to be an increasing popularity in the use of barbed sutures with clear advantages to both surgeon and patient.
An obligation to care for seriously ill children in their homes: A qualitative study of community nurses’ perceptions
Authors: Grimheden Sofia , Lindqvist Gunilla , Bylund-Grenklo Tove , Sandgren Anna
Published: April 2017

When children are seriously ill, being able to be cared for at home with the family is valuable, but community nurses are often not trained to care for children. The aim of this study was therefore to describe community nurses’ perceptions of caring for seriously ill children at home. A content analysis was conducted of 11 semi-structured interviews with nurses. One theme, obligation to care, was found, followed by three categories: making an impact, feeling confident, and emotional processing. In conclusion, we found collaboration with paediatric staff in the hospital is important for community nurses in order to gain confidence, which would optimise care at home for seriously ill children and their families.
Aspects of Swedish ophthalmic nurses’ attitudes towards research
Authors: Martin Lene M
Published: April 2017

The aim of this study was to explore attitudes towards research among a subgroup of Swedish nurses specializing in ophthalmic care and to compare the results with the findings of a similar study from 2001. A cross-sectional survey was conducted with a convenience sample of 250 Swedish nurses. A factor analysis was performed on the responses to a web-based questionnaire to discern the factors underlying the ophthalmic nurses’ attitudes. Responses to open-ended questions were analysed using content analysis. A five-factor solution accounted for 47% of the cumulative variance, with Cronbach’s alpha values ranging from 0.56 to 0.8. The responses to the open-ended questions indicated that among the nurses interested in conducting research, lack of time was the most prominent cause for not doing so, whereas older age and time constraints were the most important factors for those who were not interested in research, largely consistent with previous studies. Furthermore, the nurses mentioned frustration and bad experiences related to conducting research during their education programmes. Overall, however, the participating ophthalmic nurses were more reluctant to engage in research, perhaps because of their significantly older age compared to a previous study cohort. The results reveal new information implying that further qualitative studies would be beneficial to the planning of nursing education and to the integration of nurses in clinical scientific work.
A Retrospective Analysis of Complications Associated With Bone Morphogenetic Protein 2 in Anterior Lumbar Interbody Fusion
Authors: Hindoyan Kevork , Tilan Justin , Buser Zorica , Cohen Jeremiah R. , Brodke Darrel S. , Youssef Jim A. , Park Jong-Beom , Yoon S. Tim , Meisel Hans-Joerg , Wang Jeffrey C.
Published: April 2017

Study Design:

Retrospective review.

Objective:

The aim of our study was to quantify the frequency of complications associated with recombinant human bone morphogenetic protein 2 (rhBMP-2) use in anterior lumbar interbody fusion (ALIF).

Methods:

The orthopedic subset of the Medicare database (PearlDiver) was queried for this retrospective cohort study using International Statistical Classification of Diseases 9 (ICD-9) and Current Procedure Terminology (CPT) codes for ALIF procedures with and without rhBMP-2 between 2005 and 2010. Frequencies of complications and reoperations were then identified within 1 year from the index procedure. Complications included reoperations, pulmonary embolus, deep vein thrombosis, myocardial infarction, nerve-related complications, incision and drainage procedures, wound, sepsis, pneumonia, urinary tract infections, respiratory, heterotopic ossification, retrograde ejaculation, radiculopathy, and other medical complications. Odds ratios (ORs) and 95% confidence intervals (CIs) were used to assess the statistical significance.

Results:

We identified a total of 41 865 patients who had an ALIF procedure. A total of 14 384 patients received rhBMP-2 while 27 481 did not. Overall, 6016 (41.8%) complications within 1 year from surgery were noted within the group who received rhBMP-2 and 12 950 (47.1%) complications within 1 year from surgery were recorded in those who did not receive rhBMP-2 (OR = 0.81, CI = 0.77-0.84). Overall, exposure to rhBMP-2 was associated with significantly decreased odds of complications with exception to reoperation rates (0.9% rhBMP-2 vs 1.0% no rhBMP-2; OR = 0.88, CI = 0.71-1.09) and radiculopathy (4.4% rhBMP-2 vs 4.3% no rhBMP-2; OR = 1.02, CI = 0.93-1.13).

Conclusions:

The use of rhBMP-2 in patients undergoing ALIF procedure was associated with a significantly decreased rate of complications. Further studies are needed to elucidate a true incidence of complication.
Is Cervical Bracing Necessary After One- and Two-Level Instrumented Anterior Cervical Discectomy and Fusion? A Prospective Randomized Study
Authors: Overley Samuel C. , Merrill Robert K. , Baird Evan O. , Meaike Joshua J. , Cho Samuel K. , Hecht Andrew C. , Qureshi Sheeraz A.
Published: April 2017

Study Design:

Prospective randomized control trial.

Objective:

To investigate the role of cervical collars in postoperative care following 1- and 2-level instrumented anterior cervical discectomy and fusion (ACDF).

Methods:

The Cervical Spine Research Society Resident Fellow Grant funded this project. Fifty consecutive patients undergoing 1- or 2-level ACDF surgery were randomized into groups receiving either no brace or a cervical brace for 6 weeks postoperatively. Neck Disability Index scores were recorded preoperatively and at regular follow-up visits up to 1 year. Computed tomography scans were read 1 year postoperatively to determine fusion rates, and subsidence was measured as change in middle vertebral distance between initial postoperative and 6-month follow-up lateral cervical radiographs.

Results:

Twenty-two patients were in the no-brace group, and 22 patients were in the brace group at final follow-up, with an average age of 50 and 55 years, respectively. The no-brace group had a total of 32 operative levels, whereas the brace group had 38 operative levels. There was no statistically significant difference in 1-year postoperative Neck Disability Index scores between the brace (9.30) and no-brace (6.95) groups ( P = .28), in 6-month subsidence of all operative levels between the brace (0.85 mm) and no-brace (0.79 mm) groups ( P = .72), or in the proportion of fused levels between the brace (89%) and no-brace (97%) groups ( P = .37).

Conclusions:

Our results suggest no advantage in wearing a cervical brace following 1- or 2-level ACDF surgery with respect to 1-year outcome scores, 1-year fusion rates, and 6-month subsidence.
Short Posterior Stabilization in Combination With Cement Augmentation for the Treatment of Thoracolumbar Fractures and the Effects of Implant Removal
Authors: Hoppe Sven , Aghayev Emin , Ahmad Sufian , Keel Marius Johann Baptist , Ecker Timo Michael , Deml Moritz , Benneker Lorin Michael
Published: April 2017

Study Design:

Retrospective case series.

Objective:

Short posterior stabilization with vertebroplasty is one treatment option for thoracolumbar burst fractures (AO A3). Whether it avoids progression in segmental kyphosis, especially after implant removal, is unclear. In a retrospective case-control study, its stability and the effect on intervertebral discs with and without implant removal was studied.

Methods:

Fifty-nine consecutive patients were treated with bisegmental short posterior instrumentation and additional vertebroplasty of the fractured vertebra. Twenty-nine patients (male/female 17/12; age: 41.7 ± 15.4 years) underwent implant removal. Changes of segmental kyphosis and disc heights between both groups (with and without implant removal) were compared on lateral X-rays preoperative, postoperative, after 1 year and after implant removal. Risk factors for loss of reduction were analyzed.

Results:

Kyphosis increased up to 12 months after implant removal. The loss of bisegmental correction was 6.0 ± 4.2 (range 0° to 16°) 12 months after implant removal. Risk factors for loss of reduction are younger patient age, fractures of the thoracolumbar junction (Th12), and degree of traumatic kyphosis. Intervertebral discs traversed by the stabilization lose height and don’t recover within 1 year after implant removal. Without implant removal, disc height of the lower adjacent level is reduced after 24 months.

Conclusions:

Short posterior stabilization in combination with vertebroplasty is a treatment alternative for thoracic and lumbar AO A3 fractures. After implant removal kyphosis increases, predominantly in the segment above the augmented vertebra. Risk factors for loss of reduction include younger age, fractures of the thoracolumbar junction (T12), and higher fracture kyphosis.
Performance and Return to Sport After Sports Hernia Surgery in NFL Players
Authors: Jack Robert A. , Evans David C. , Echo Anthony , McCulloch Patrick C. , Lintner David M. , Varner Kevin E. , Harris Joshua D.
Published: April 2017

Background:

Recognition, diagnosis, and treatment of athletic pubalgia (AP), also known as sports hernia, once underrecognized and undertreated in professional football, are becoming more common. Surgery as the final treatment for sports hernia when nonsurgical treatment fails remains controversial. Given the money involved and popularity of the National Football League (NFL), it is important to understand surgical outcomes in this patient population.

Hypothesis:

After AP surgery, players would: (1) return to sport (RTS) at a greater than 90% rate, (2) play fewer games for fewer years than matched controls, (3) have no difference in performance compared with before AP surgery, and (4) have no difference in performance versus matched controls.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Internet-based injury reports identified players who underwent AP surgery from January 1996 to August 2015. Demographic and performance data were collected for each player. A 1:1 matched control group and an index year analog were identified. Control and case performance scores were calculated using a standardized scoring system. Groups were compared using paired Student t tests.

Results:

Fifty-six NFL players (57 AP surgeries) were analyzed (mean age, 28.2 ± 3.1 years; mean years in NFL at surgery, 5.4 ± 3.2). Fifty-three players were able to RTS. Controls were in the NFL longer ( P < .05) than players who underwent AP surgery (3.8 ± 2.4 vs 3.2 ± 2.1 years). Controls played more games per season ( P < .05) than post-AP players (14.0 ± 2.3 vs 12.0 ± 3.4 games per season). There was no significant ( P > .05) difference in pre- versus post-AP surgery performance scores and no significant ( P > .05) difference in postoperative performance scores versus controls post-index.

Conclusion:

There was a high RTS rate after AP surgery without a significant difference in postoperative performance, though career length and games per season after AP surgery were significantly less than that of matched controls.
The Implications of Reduced Testing for Teacher Accountability
Authors: Alzen Jessica L. , Fahle Erin M. , Domingue Benjamin W.
Published: April 2017

Every-grade, every-year testing plays a prominent part in U.S. education policy and research, but the rise of standardized testing has been met with frustration and opposition. In response, policymakers have proposed legislation designed to curb the amount of standardized testing. There is little empirical evidence, however, about the potential impact of these alternate approaches on current evaluation systems. Using data from a large, urban school district, we compare value-added (VA) estimates from every-year, every-grade testing to those from two reduced-testing scenarios. We find marginal changes in the value-added estimates in both approaches relative to more traditional VA estimates. Estimates from annual testing in alternating subjects are slightly less precise but have lower associations with prior student achievement than biennial testing in both subjects. Further, there is significant decrease in the number of teachers for whom scores can be estimated in both approaches, exacerbating long-standing concerns with VA methodology.
The relation between block size and building shape
Authors: Taima Masahiro , Asami Yasushi , Hino Kimihiro
Published: April 2017

Block restructuring has been strongly emphasized in Japan for renovating cities. However, little is known about the relation between block size and building shape. Moreover, the shape of buildings designed on a block after restructuring is unclear. In this study, the relation between block size and building shape is analyzed quantitatively, and a three-dimensional building shape is estimated by a model using an urban planning GIS data set of Tokyo. Results show the quantitative relation between block size and building shape, and the building shape image on the blocks. Higher buildings and buildings with a basement tend to be built in larger blocks, leading to efficient use of the maximum volume permitted in the block. In addition, the region composed by larger blocks can be spacious, because the range of building setback will be long in larger blocks. Designation of a high floor area ratio may induce integration and enlargement of blocks. Blocks are less likely to be partitioned in zones when a high floor area ratio is designated.
Most Readmissions Following Ankle Fracture Surgery Are Unrelated to Surgical Site Issues
Authors: Fu Michael C. , Young Kelsey , Cody Elizabeth , Schairer William W. , Demetracopoulos Constantine A. , Ellis Scott J.
Published: April 2017

Background:

Ankle fracture surgeries are generally safe and effective procedures; however, as quality-based reimbursement models are increasingly affected by postoperative readmission, we aimed to determine the causes and risk factors for readmission following ankle fracture surgery.

Methods:

Ankle fracture cases were identified from the prospectively collected American College of Surgeons National Surgical Quality Improvement Program from 2013 to 2014. Demographics, comorbidities, and fracture characteristics were collected. Rates of 30-day adverse events and readmissions were determined as well as the causes for readmission. Multivariable logistic regression analyses were performed to identify risk factors associated with having any adverse events and being readmitted within 30 days of surgery.

Results:

There were 5056 patients included; 167 (3.3%) were open fractures. The rate of any postoperative adverse event was 5.2%. There were 116 unplanned readmissions, with a readmission rate of 2.3%. Of the 116 unplanned readmissions, 49 (42.2%) were for reasons related to the surgery or surgical site, with the most common causes being deep surgical site/hardware infections (12.9%), superficial site infections (11.2%), and wound disruption (6.9%). Most readmissions were for reasons unrelated to the surgical site (51.7%), including cardiac disorders (8.6%), pulmonary disorders (7.8%), and neurological/psychiatric disorders (6.9%). The cause of readmission was unknown for 6% of readmissions. With multivariable logistic regression, the strongest risk factors for readmission were a history of pulmonary disease (odds ratio [OR], 2.29), American Society of Anesthesiologists (ASA) class ≥3 (OR, 2.28), and open fractures (OR, 2.04) (all P < .05).

Conclusion:

In this cohort of 5056 ankle fracture cases, 2.3% of patients were readmitted within 30 days, with at least 51.7% of all unplanned readmissions due to causes unrelated to the surgery or surgical site. Predictors of readmission included a history of pulmonary disease, higher ASA class, and open fractures. Based on these findings, we advocate close medical follow-up with nonorthopaedic providers after discharge for high-risk patients.

Level of Evidence:

Level III.
The Minorities Affairs Committee of the American Society for Cell Biology—Fostering the Professional Development of Scientists from Underrepresented Minority Backgrounds
Authors: Segarra Verónica A. , Carrero-Martínez Franklin , Shugart Erika
Published: April 2017

As part of its mission, the American Society for Cell Biology (ASCB) works to increase diversity in the scientific workforce, in part through the work of its Minorities Affairs Committee. It is for this reason that the ASCB was happy to welcome the special September 2016 issue of CBE—Life Sciences Education (LSE) focused on broadening participation. As a response to this special issue, we update our ASCB community and LSE readership on the society’s efforts to broaden participation of underrepresented minorities in the biological sciences.
Ethnological Hermeneutics for an Early Colonial Encounter on the Island of San Juan: The 1532Probanzaof Juan González
Authors: De La Luz-Rodríguez Gabriel
Published: April 2017

This article argues for the importance of an ethnological hermeneutics in the study of the early colonial period in the Caribbean. It does so by applying this methodology to a founding document concerning early colonial encounters on the island of San Juan or present-day Puerto Rico. The 1532 probanza of Juan González is privileged as a text through which crucial information concerning the Spanish colonization of San Juan and its original inhabitants could be obtained. The article thus contextualizes the probanza as part of a genre of colonial writing within the amply known relaciones de méritos y servicios.
Contemporary Diagnostic Imaging of Oral Squamous Cell Carcinoma – A Review of Literature
Authors: Pałasz Paulina , Adamski Łukasz , Górska-Chrząstek Magdalena , Starzyńska Anna , Studniarek Michał
Published: April 2017

Oral squamous cell carcinoma (OSCC) is the most common cancer of the oral cavity and constitutes 95% of all cancers of this area. Men are affected twice as commonly as women, primarily if they are over 50 years of age. Forty percent of the lesions are localized in the tongue and 30% in the floor of the oral cavity. OSCC often affects upper and lower gingiva, buccal mucous membrane, the retromolar triangle and the palate. The prognosis is poor and the five-year survival rate ranges from 20% (OSCC in the floor of the mouth) to 60% (OSCC in the alveolar part of the mandible). Treatment is difficult, because of the localization and the invasiveness of the available methods. The diagnosis is made based on a histopathological examination of a biopsy sample. The low detection rate of early oral SCC is a considerable clinical issue. Although the oral cavity can be easily examined, in the majority of cases oral SCC is diagnosed in its late stages. It is difficult to diagnose metastases in local lymph nodes and distant organs, which is important for planning the scope of resection and further treatment, graft implantation, and differentiation between reactive and metastatic lymph nodes as well as between disease recurrence and scars or adverse reactions after surgery or radiation therapy. Imaging studies are performed as part of the routine work-up in oral SCC. However, it is difficult to interpret the results at the early stages of the disease. The following imaging methods are used – dental radiographs, panoramic radiographs, magnetic resonance imaging with diffusion-weighted and dynamic sequences, perfusion computed tomography, cone beam computed tomography, single-photon emission computed tomography, hybrid methods (PET/CT, PET/MRI, SPECT/CT) and ultrasound. Some important clinical problems can be resolved with the use of novel modalities such as MRI with ADC sequences and PET. The aim of this article is to describe oral squamous cell carcinoma as it appears in different imaging methods considering both their advantages and limitations.
Paraplegia after sclerotherapy of varicose leg veins
Authors: Brenner E. , Prinz N. , Glowacki P. , Moersdorf M. , Maschke M. , Frings N.
Published: April 2017

We would like to present the case of paraplegia due to venous spinal ischaemia, which occurred after sclerotherapy of leg veins and subsequent to previous venous surgery. After exclusion of other pathogenetic causes such as surgery, tumescent local anaesthesia or neurological, infections, cardiological and haemosteaseological causes, this complication must be regarded as a consequence of sclerotherapy. Sources in literature describe shunts (shortened connections) between the leg veins and the venous spinal system, thus enabling minutest particles from sclerotherapy to enter the veins and possibly have a cytotoxic or microembolic effect with spinal ischaemia.
Non-infectious chemotherapy-associated acute toxicities during childhood acute lymphoblastic leukemia therapy
Authors: Schmiegelow Kjeld , Müller Klaus , Mogensen Signe Sloth , Mogensen Pernille Rudebeck , Wolthers Benjamin Ole , Stoltze Ulrik Kristoffer , Tuckuviene Ruta , Frandsen Thomas
Published: April 2017

During chemotherapy for childhood acute lymphoblastic leukemia, all organs can be affected by severe acute side effects, the most common being opportunistic infections, mucositis, central or peripheral neuropathy (or both), bone toxicities (including osteonecrosis), thromboembolism, sinusoidal obstruction syndrome, endocrinopathies (especially steroid-induced adrenal insufficiency and hyperglycemia), high-dose methotrexate-induced nephrotoxicity, asparaginase-associated hypersensitivity, pancreatitis, and hyperlipidemia. Few of the non-infectious acute toxicities are associated with clinically useful risk factors, and across study groups there has been wide diversity in toxicity definitions, capture strategies, and reporting, thus hampering meaningful comparisons of toxicity incidences for different leukemia protocols. Since treatment of acute lymphoblastic leukemia now yields 5-year overall survival rates above 90%, there is a need for strategies for assessing the burden of toxicities in the overall evaluation of anti-leukemic therapy programs.
Last rolls of the yoyo: Assessing the human canonical protein count
Authors: Southan Christopher
Published: April 2017

In 2004, when the protein estimate from the finished human genome was only 24,000, the surprise was compounded as reviewed estimates fell to 19,000 by 2014. However, variability in the total canonical protein counts (i.e. excluding alternative splice forms) of open reading frames (ORFs) in different annotation portals persists. This work assesses these differences and possible causes. A 16-year analysis of Ensembl and UniProtKB/Swiss-Prot shows convergence to a protein number of ~20,000. The former had shown some yo-yoing, but both have now plateaued. Nine major annotation portals, reviewed at the beginning of 2017, gave a spread of counts from 21,819 down to 18,891. The 4-way cross-reference concordance (within UniProt) between Ensembl, Swiss-Prot, Entrez Gene and the Human Gene Nomenclature Committee (HGNC) drops to 18,690, indicating methodological differences in protein definitions and experimental existence support between sources. The Swiss-Prot and neXtProt evidence criteria include mass spectrometry peptide verification and also cross-references for antibody detection from the Human Protein Atlas. Notwithstanding, hundreds of Swiss-Prot entries are classified as non-coding biotypes by HGNC. The only inference that protein numbers might still rise comes from numerous reports of small ORF (smORF) discovery. However, while there have been recent cases of protein verifications from previous miss-annotation of non-coding RNA, very few have passed the Swiss-Prot curation and genome annotation thresholds. The post-genomic era has seen both advances in data generation and improvements in the human reference assembly. Notwithstanding, current numbers, while persistently discordant, show that the earlier yo-yoing has largely ceased. Given the importance to biology and biomedicine of defining the canonical human proteome, the task will need more collaborative inter-source curation combined with broader and deeper experimental confirmation in vivo and in vitro of proteins predicted in silico. The eventual closure could be well be below ~19,000.
Evaluation of hearing level in patients on long term aspirin therapy
Authors: Pokharel Apar , Bhandary Sangita
Published: April 2017

Introduction: Aspirin is a routinely prescribed drug, most notably for cardiovascular diseases, such as myocardial ischemia. This cross sectional, comparative study study aims to explore differences in hearing status between the cardiovascular disease patients on aspirin therapy and age matched healthy controls.

Methods: The study population consisted of 182 patients with heart disease taking long term aspirin (i.e., for more than one year). The control population consisted of 221 age matched healthy controls who were not taking aspirin.

Results: Not aspirin, but the age of the patient was found to be the important risk factor for hearing loss. 

Conclusions: When confounding factors like age of the patient, hypertension and diabetes were taken into account, aspirin in its antiplatelet dose was not found to be the cause of any audiological problems like tinnitus and hearing loss.
Neopeptide Analyser: A software tool for neopeptide discovery in proteomics data
Authors: Peffers Mandy J. , Jones Andrew R. , McCabe Antony , Anderson James
Published: April 2017

Experiments involving mass spectrometry (MS)-based proteomics are widely used for analyses of connective tissues. Common examples include the use of relative quantification to identify differentially expressed peptides and proteins in cartilage and tendon. We are working on characterising so-called ‘neopeptides’, i.e. peptides formed due to native cleavage of proteins, for example under pathological conditions. Unlike peptides typically quantified in MS workflows due to the in vitro use of an enzyme such as trypsin, a neopeptide has at least one terminus that was not due to the use of trypsin in the workflow. The identification of neopeptides within these datasets is important in understanding disease pathology, and the development of antibodies that could be utilised as diagnostic biomarkers for diseases, such as osteoarthritis, and targets for novel treatments. Our previously described neopeptide data analysis workflow was laborious and was not amenable to robust statistical analysis, which reduced confidence in the neopeptides identified. To overcome this, we developed ‘Neopeptide Analyser’, a user friendly neopeptide analysis tool used in conjunction with label-free MS quantification tool Progenesis QIP for proteomics. Neopeptide Analyser filters data sourced from Progenesis QIP output to identify neopeptide sequences, as well as give the residues that are adjacent to the peptide in its corresponding protein sequence. It also produces normalised values for the neopeptide quantification values and uses these to perform statistical tests, which are also included in the output. Neopeptide Analyser is available as a Java application for Mac, Windows and Linux. The analysis features and ease of use encourages data exploration, which could aid the discovery of novel pathways in extracellular matrix degradation, the identification of potential biomarkers and as a tool to investigate matrix turnover. Neopeptide Analyser is available from https://github.com/PGB-LIV/neo-pep-tool/releases/.
Nudges y decisiones inconscientes: sesgo de statu quo y políticas públicas en Colombia
Authors: Monroy Cely Daniel Alejandro
Published: April 2017

El artículo presenta una síntesis de una anomalía cognitiva denominada comúnmente como “sesgo de statu quo” y muestra cómo esta puede influir en la toma de decisiones individuales y por tanto, en la efectividad de las políticas públicas en algunos contextos relevantes, entre ellos: (i) los malos hábitos alimenticios de las personas; y (ii) el problema de la calidad del ahorro para pensiones de jubilación. Además, el artículo sugiere algunas estrategias (nudges) acerca de cómo la prevalencia del “sesgo de statu quo” podría servir a los diseñadores de políticas como una herramienta para el mejor diseño y la efectividad de las políticas en los mismos contextos mencionados. El artículo finaliza con una breve reflexión acerca de la ética y el uso de nudges por parte de los mencionados diseñadores.
La Alianza del Pacífico como actor regional: factores de éxito para la cohesión regional hacía la proyección internacional
Authors: Ortiz Morales Jenny Catherine
Published: April 2017

Este artículo analiza la cohesión regional de la Alianza del Pacífico para su consolidación como actor regional. A partir de su creación con la firma del Acuerdo Marco (2012), inicia el proceso de objeto pasivo a sujeto activo, de acuerdo con los niveles de regionalidad, siendo la Alianza del Pacífico un proyecto embrionario que busca responder a los retos de la globalización para una proyección mancomunada de sus países miembros y servir de plataforma de inserción internacional. Sin embargo, su consolidación como actor regional dentro del orden latinoamericano enfrenta grandes desafíos dadas sus debilidades y fortalezas en materia de liderazgo, interdependencia, convergencia, identidad e institucionalidad como factores de éxito para la cohesión regional que catapulte potencialidades frente a las oportunidades y amenazas del sistema internacional.
La visión del desarrollo dentro del contexto global y regional. El regionalismo a través de la Alianza del Pacífico y la Asociación Latinoamericana de Integración 2005-2014.
Authors: Maldonado Bodart Marcela , López Leyva Santos
Published: April 2017

Históricamente han existido distintos debates para alcanzar el desarrollo, desde diferentes ámbitos y espacios. La visión del desarrollo desde el espacio global, ha tenido una importante evolución hasta nuestros días, principalmente después de la II Guerra Mundial, a través de la Cooperación Internacional para el Desarrollo (CID). Desde el espacio regional, los mecanismos de cooperación económica han reflejado ser dinámicos y positivos para el desarrollo. Por ello, el presente trabajo pretende en primera instancia, realizar una revisión de la evolución sobre la visión de desarrollo desde un contexto global y regional. En una segunda fase, busca analizar las aportaciones comerciales, desde una visión del desarrollo regional, por medio de un análisis comparativo de la Alianza del Pacífico (AP) con respecto a la región y a la Asociación Latinoamericana de Integración (ALADI) para el periodo 2005-2014, como mecanismos de cooperación económica en América Latina y el Caribe (ALyC) que buscan un desarrollo dentro de la misma región.
The Impacts of a National Internship Program on Interns’ Perceived Leadership, Critical Thinking, and Communication Skills
Authors: Duncan Dennis W. , Birdsong Victoria , Fuhrman Nicholas , Borron Abigail
Published: April 2017

At perhaps all levels of education, strong leadership skills are often equated with the ability to engage in critical thinking, and effective oral and written communication. The purpose of this study was to identify the self-perceived expansion of animal health interns’ leadership, critical thinking and communication competencies using the University of Florida – Engagement, Cognitive Maturity, and Innovativeness (UF-EMI) and Leadership Skills Inventory (LSI) assessments. For the UF-EMI, the total mean score of the pre-critical thinking disposition of all interns was 104.73; post-critical thinking disposition was 114.46, an increase of 9.73. Results of the LSI indicate just 70% accept who they are and don’t see themselves as good listeners.
Teaching Leadership in Technical Programs at Community Colleges
Authors: DeBlauw Amanda L. , Daugherty Jenny L.
Published: April 2017

This descriptive study explored how community colleges are teaching leadership in technical programs. Leadership education curricular offerings were identified via a survey and selected programs reviewed. 68 Deans, Directors, or Chairpersons of a Business, Management, or Technology program completed the survey, representing 61 community colleges. A review of four programs was conducted through web searches and interviews of leaders representing two of these programs were conducted. Leadership education is an emerging area for community colleges; one that is narrowly defined as workplace readiness, communication, and confidence building activities. There appears to be a need for technical programs to teach students leadership skills, as well as technical skills. Further research is needed to determine which leadership skills are needed for technologists at the community college level.
Effects of Participation in Formal Leadership Training in International Students Compared to Domestic Students: A National Study
Authors: Collier Daniel A. , Rosch David M. , Houston Derek A.
Published: April 2017

International student enrollment has experienced dramatic increases on U.S. campuses. Using a national dataset, the study explores and compares international and domestic students’ incoming and post-training levels of motivation to lead, leadership self- efficacy, and leadership skill using inverse-probability weighting of propensity scores to explore differences between the two samples. Unweighted findings suggest that international and domestic students enter programs similarly across in many ways, and leave the immersion program with similar gains. However, a matched-sample comparison suggests that international students’ growth was statistically different in ethical leadership skills, affective- identity motivation to lead, and leadership self-efficacy. Discussion focuses on the benefits of leadership development to international students why campuses could build partnerships between units that serve international students and leadership educators to facilitate a more inclusive campus.
ECG of the month
Authors: Regan Martin
Published: April 2017

Martin Regan presents an ECG for you to analyse
Research Roundup
Authors: Cowan Helen
Published: April 2017

Helen Cowan presents a selection of recently published articles of interest to nurses working in cardiovascular nursing. The aim of this roundup is to provide a brief overview of the research papers selected. A full reference is provided for those who wish to take a look at the research in further detail
On normalising anxiety: a royal perspective and expert advice
Authors: Cowan Helen
Published: April 2017

On 6th February 2017, our columnist, Helen Cowan, was honoured to meet the Duke and Duchess of Cambridge at an event hosted by the Guild of Health Writers in London. The evening was entitled ‘The Anxiety Epidemic’; its aim was to encourage health writers to make mental health a mainstream subject. The Duke spoke of ‘bringing mental health onto a par with physical health’ in terms of the openness with which sufferers speak about their condition
Examining the emotional and psychological experiences of people with heart failure
Authors: Mahoney-Davies Gerwyn , Davis Cara , Glen Catriona , Clifton Catherine , Salkovskis Paul M
Published: April 2017

Aims and objectives:

The aims of this study were to understand the emotional and psychological experiences of patients with heart failure in a busy NHS service and make recommendations for how best to support this population.

Background:

People with heart failure often experience depression, anxiety and other emotional and psychological difficulties. Their quality of life is reduced. Qualitative studies attempting to understand this have reported conflicting findings.

Design:

A qualitative approach was taken, with some supporting quantitative data.

Methods:

Ten participants were asked to complete the PHQ–9 and GAD–7, and rate their level of concern about their mood, anxiety, quality of life and social functioning. They completed a semi-structured interview about their experience of living with heart failure and the emotional and psychological impact of this. The interview was analysed thematically.

Results:

Participants scored in the moderate range on both depression and anxiety measures. They were more concerned about their mood, anxiety, quality of life and social functioning now than before the onset of heart failure. The themes present in the interview data were: changes to self and others; emotional reactions; thoughts about death; expectations for the future; and hospital experiences.

Conclusions:

Some people with heart failure report moderate levels of depression and anxiety, and significant changes in their lives; they display varying emotional reactions to these. People have clear expectations for the future and impose limits on their life. Services can make changes to support this population. Suggestions for doing this are made.
Atrial fibrillation: catheter ablation
Authors: Palmer Sarah Jane
Published: April 2017

This section presents a variety of conditions, treatments, clinical procedures and developments in the field of cardiovascular care. It aims to update and refresh nurses' knowledge on correct theory and practice, as well as introduce students and junior nurses to aspects of practice
Francis Gibson's cardiac journey: yesterday and today
Authors: Gibson Francis
Published: April 2017

In last year's March issue of the British Journal of Cardiac Nursing, Francis (Frank) Gibson shared his plight with Wolff-Parkinson White syndrome. In his article, he mentioned that he also recently suffered from atrial fibrillation. Here, Francis Gibson reflects upon the care he received for this arrhythmia, and some of the challenges he faced along the way
Midwifery in Shetland and Orkney
Authors: Page Lesley , Ross–Davie Mary
Published: April 2017

Giving the best start and offering holistic health care in women's health and reproductive services in Shetland and Orkney
Prevention of neonatal whooping cough in England: The essential role of the midwife
Authors: Green David , Labriola Giuseppe , Smeaton Laura , Falconer Michelle
Published: April 2017

Following an increase in the incidence of whooping cough (pertussis) in the general population from 2011, coupled with neonatal pertussis mortality seen in 2012, a programme of maternal pertussis immunisation was introduced to the UK in the same year. The programme aims to provide passive immunity from birth, until active immunity can be provided through the routine immunisation programme from 8 weeks of age. Since its introduction, evaluation of the vaccine given in pregnancy has demonstrated its safety, efficacy and patient acceptability. Uptake of the vaccine has reached 70% and its continued use is an opportunity to protect newborn babies from a serious and sometimes fatal vaccine-preventable infection. Midwives should discuss pertussis immunisation with pregnant women and either signpost them to their GP to receive it or, if commissioned to do so, administer the vaccine themselves.
Labour and beyond: The roles of synthetic and endogenous oxytocin in transition to motherhood
Authors: Khajehei Marjan
Published: April 2017

During spontaneous labour, endogenous oxytocin is released from the pituitary gland and initiates uterine contractions. In some women, it is necessary to induce or augment labour contractions. Induction or augmentation of labour using synthetic oxytocin (Syntocinon) is one of the most common interventions to facilitate the progress of labour and birth. Both Syntocinon and endogenous oxytocin affect the body through oxytocin receptors. Although the use of Syntocinon is regarded as a relatively safe intervention during labour, it works in a different way from endogenous oxytocin and has different effects on the mother and child. Syntocinon may negatively affect birth outcomes for mother and baby, interfere with the success of lactation and breastfeeding, impair the mother-child attachment and may affect the child's development. We review the effect of endogenous oxytocin and Syntocinon on the health and wellbeing of women during labour and after birth, discuss the benefits of endogenous oxytocin and highlight some adverse effects of Syntocinon.
Management of shoulder dystocia using the HELPERR mnemonic
Authors: Huntley Mary , Smith Janice Dickson
Published: April 2017

Shoulder dystocia is a rare obstetric emergency which can be managed using the HELPERR mnemonic. Midwives should recognise the signs and understand the principles of managing shoulder dystocia. Step-by-step images to illustrate the HELPERR mnemonic can enhance knowledge and understanding of this logical sequence of actions.
Assessing Gillick competence
Authors: Griffith Richard
Published: April 2017

Recently released figures from the Office for National Statistics (2016) show that some 4160 girls under 16 became pregnant in England and Wales in 2014. To manage teenage pregnancies effectively, midwives must be able to assess the child's competence to consent to their maternity care.