bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence of most common human pathogenicCampylobacterspp. in dogs and cats in Styria, Austria
Authors: Pölzler Thomas , Stüger Hans‐Peter , Lassnig Heimo
Published: January 2018

The aim of this study was to determine the frequency of occurrence of most common human pathogenicCampylobacterspecies,Campylobacter jejuni (C. jejuni)andCampylobacter coli (C. coli), in dogs and cats in Styria, Austria. In the period from April 2010 to April 2012, 842 faecal samples from dogs and cats from Styria, Austria were examined forCampylobacter (C.)species (spp.). All samples were subjected to qualitative microbiological culture testing, and additionally, some of them have been studied using qualitative real‐timePCR. In microbiological culture, 5.9% of all samples investigated wereC. spp. positive. With 3.1% out of positive samples,C. jejuniwas the most common type.Campylobacter upsaliensis (C. upsaliensis)was detected only in 0.5% of the samples. The remaining positive samples (2.4%) were classified asC. species (sp.).C. colicould not be found in any of the samples. A higher prevalence ofC. jejuniwas found in kittens with 14.3% and in diarrhoeic dogs (7.4%) and cats (23.8%). The real‐timePCRrevealed for dogs and cats together, 27% ofC. jejuni‐positive faecal and 8% positive faecal swap samples. The obtainedC. jejunistrains underwent antibiotic resistance testing using three different tests (agar diffusion,MICtesting and E‐test) with different numbers of antibiotics. From the antibiotics used in this study, several showed high test‐dependent resistance rates (cephalexin, cefovecin, kanamycin, sulfamethoxazole/trimethoprim, penicillin G, ciprofloxacin, enrofloxacin, marbofloxacin, nalidixic acid). Overall, the prevalence ofC. spp. in this study was very low compared to others, with the exception ofC. jejuniin kittens and diarrhoeic animals. The results of the real‐timePCRsuggest that the rate of colonization ofC. jejuniwas actually higher than the results of the culture showed. As the resistance rates ofC. jejuniisolates partly were very high, possible transmission of (multi‐) resistantC. jejunistrains to humans especially from kittens and diarrhoeic animals must be expected.
Responses of the photosynthetic apparatus of Abies koreana to drought under different light conditions
Authors: Je Sun Mi , Kim Sun Hee , Woo Soo Young
Published: January 2018

The threat of drought to trees is predicted to increase due to global warming. In a forest stand, the physiological responses of trees can differ depending on the light conditions. We analyzed photosynthetic rate, photopigment, and chlorophyll a fluorescence transient (OJIP test) of Abies koreana E.H. Wilson, under different light (full sunlight and 35 and 75% shading) and water conditions (well‐watering, W; and no‐watering, NW) to examine the combined effect of light and water. After 21 days of no‐watering, we observed decreases in the photosynthetic rate and photopigment contents and quality, impairment of electron transfer from primary to secondary quinone acceptor, inactivation of reaction center, and lower photosynthetic performance index, especially under full sunlight. The time required for recovery after re‐watering was also slower under full sunlight. In conclusion, the adverse effects of drought on light absorption and utility of A. koreana in the photosynthetic process were much greater under high light intensity compared to shading conditions, which alleviated these effects.
Spiritual care training in healthcare: Does it really have an impact?
Authors: Daudt Helena , d'Archangelo Margo , Duquette Dominique
Published: January 2018

Objective

Spiritual care has formed an integral part of palliative care since its inception. People with advanced illnesses, however, frequently report that their spiritual needs are not attended to by their medical care team. The present study examines and describes the impact of a spiritual care training program on practice and cultural change in our Canadian hospice.

Method

A qualitative case study approach was adopted to gather feedback from hospice staff and volunteers using purposive sampling. In-depth interviews were conducted, transcribed, and analyzed using thematic (semantic and latent) analysis.

Result

Our data suggest that the program had a profound personal impact on attendees and contributed to a slight shift in practice patterns in our organization. Using a program not specifically tailored to our local and organizational cultural contexts resulted in some unanticipated challenges such as the range of tensions between personal and cultural boundaries. Although some people criticized parts of the program or questioned the program's value, a general agreement suggests that the program had a positive impact and meaningfully benefited our hospice. “What will happen next?” was the question most frequently voiced by interviewees.

Significance of results

Although the program may not have been a perfect fit for our organization, its use instigated a process of cultural change that unfolds today. The present study suggests that a systematic approach to spiritual care training that includes the concepts of workplace spirituality and sensitive practice offer useful frameworks for the development and implementation of spiritual care training in other institutions.
The dual-inhibitory effect of miR-338-5p on the multidrug resistance and cell growth of hepatocellular carcinoma
Authors: Zhao Yang , Chen Jing , Wei Wenxin , Qi Xinming , Li Chunzhu , Ren Jin
Published: January 2018

Chemotherapeutic treatments against hepatocellular carcinoma (HCC) are necessary for both inoperable patients to improve prospects for survival and surgery patients to improve the outcome after surgical resection. However, multidrug resistance (MDR) is a major obstacle to obtaining desirable results. Currently, increasing the chemotherapy sensitivity of tumor cells or discovering novel tumor inhibitors is an effective therapeutic strategy to solve this issue. In the present study, we uncovered the dual-inhibitory effect of miR-338-5p: on the one hand, it could downregulate ABCB1 expression and sensitize HCC cells to doxorubicin and vinblastine by directly targeting the 3′-untranslated region (3′-UTR) of ABCB1, while, on the other hand, it could suppress the proliferation of HCC cells by directly targeting the 3′-UTR of EGFR and reducing EGFR expression. Since EGFR regulates ABCB1 levels, the indirect action of miR-338-5p in ABCB1 modulation was revealed, in which miR-338-5p inhibits ABCB1 expression by targeting the EGFR/ERK1/2 signaling pathway. These data indicate that the miR-338-5p/EGFR/ABCB1 regulatory loop plays a critical role in HCC, and a negative correlation between miR-338-5p and EGFR or ABCB1 was also detected in HCC clinical samples. In conclusion, these findings reveal a critical role for miR-338-5p in the regulation of MDR and proliferation of HCC, suggesting the potential therapeutic implications of miR-338-5p in HCC treatment.
Streamlined ex vivo and in vivo genome editing in mouse embryos using recombinant adeno-associated viruses
Authors: Yoon Yeonsoo , Wang Dan , Tai Phillip W. L. , Riley Joy , Gao Guangping , Rivera-Pérez Jaime A.
Published: January 2018

Recent advances using CRISPR-Cas9 approaches have dramatically enhanced the ease for genetic manipulation in rodents. Notwithstanding, the methods to deliver nucleic acids into pre-implantation embryos have hardly changed since the original description of mouse transgenesis more than 30 years ago. Here we report a novel strategy to generate genetically modified mice by transduction of CRISPR-Cas9 components into pre-implantation mouse embryos via recombinant adeno-associated viruses (rAAVs). Using this approach, we efficiently generated a variety of targeted mutations in explanted embryos, including indel events produced by non-homologous end joining and tailored mutations using homology-directed repair. We also achieved gene modification in vivo by direct delivery of rAAV particles into the oviduct of pregnant females. Our approach greatly simplifies the generation of genetically modified mice and, more importantly, opens the door for streamlined gene editing in other mammalian species.
Whole-genome transcriptomic insights into protective molecular mechanisms in metabolically healthy obese African Americans
Authors: Gaye Amadou , Doumatey Ayo P. , Davis Sharon K. , Rotimi Charles N. , Gibbons Gary H.
Published: January 2018

Several clinical guidelines have been proposed to distinguish metabolically healthy obesity (MHO) from other subgroups of obesity but the molecular mechanisms by which MHO individuals remain metabolically healthy despite having a high fat mass are yet to be elucidated. We conducted the first whole blood transcriptomic study designed to identify specific sets of genes that might shed novel insights into the molecular mechanisms that protect or delay the occurrence of obesity-related co-morbidities in MHO. The study included 29 African-American obese individuals, 8 MHO and 21 metabolically abnormal obese (MAO). Unbiased transcriptome-wide network analysis was carried out to identify molecular modules of co-expressed genes that are collectively associated with MHO. Network analysis identified a group of 23 co-expressed genes, including ribosomal protein genes (RPs), which were significantly downregulated in MHO subjects. The three pathways enriched in the group of co-expressed genes are EIF2 signaling, regulation of eIF4 and p70S6K signaling, and mTOR signaling. The expression of ten of the RPs collectively predicted MHO status with an area under the curve of 0.81. Triglycerides/HDL (TG/HDL) ratio, an index of insulin resistance, was the best predictor of the expression of genes in the MHO group. The higher TG/HDL values observed in the MAO subjects may underlie the activation of endoplasmic reticulum (ER) and related-stress pathways that lead to a chronic inflammatory state. In summary, these findings suggest that controlling ER stress and/or ribosomal stress by downregulating RPs or controlling TG/HDL ratio may represent effective strategies to prevent or delay the occurrence of metabolic disorders in obese individuals.
Cardiac shock wave therapy promotes arteriogenesis of coronary micrangium, and ILK is involved in the biomechanical effects by proteomic analysis
Authors: Yang Wenhui , He Yan , Gan Lulu , Zhang Fan , Hua Baotong , Yang Ping , Liu Juan , Yang Li , Guo Tao
Published: January 2018

Cardiac Shock Wave Therapy (CSWT) improves myocardial perfusion and ameliorates cardiac remodeling after acute myocardial infarction (AMI), but the precise mechanisms remain obscure. Herein, we have applied CSWT to a rat model of AMI to demonstrate the arteriogenesis of coronary micrangium and protein expression changes in ischemic myocardium after CSWT. Four weeks after CSWT, the fraction shortening of rats was improved greatly and the cardiomyocyte apoptosis index was significantly lower than the AMI group (P < 0.05). Besides, the fibrotic area was markedly decreased in the CSWT group. In the infarction border zone, the thickness of smooth muscle layer was expanded apparently after CSWT. Label-free quantitative proteomic analysis and bioinformatics analysis revealed that the differentially expressed proteins were largely enriched in the focal adhesion signaling pathway. And integrin linked kinase (ILK) may be a key factor contributed to arteriogenesis of coronary micrangium during CSWT. In conclusion, non-invasive cardiac shock wave could promote arteriogenesis of coronary micrangium and alleviate myocardial apoptosis and fibrosis after AMI. Furthermore, focal adhesion signaling pathway may have a central role in the related signal network and ILK was closely related to the arteriogenesis of coronary micrangium during CSWT.
Early immune anergy towards recall antigens and mitogens in patients at onset of septic shock
Authors: Feuerecker M. , Sudhoff L. , Crucian B. , Pagel J.-I. , Sams C. , Strewe C. , Guo A. , Schelling G. , Briegel J. , Kaufmann I. , Choukèr A.
Published: January 2018

The pathology of sepsis is typically characterized by an infection and excessive initial inflammation including a cytokine storm, followed by a state of immune suppression or paralysis. This classical view of a two peak kinetic immune response is currently controversially discussed. This study was a sub-study of the randomized clinical Trial SISPCT registered withwww.clinicaltrials.gov(NCT00832039, Registration date: 29/01/2009). Blood samples from 76 patients with severe sepsis and septic shock were incubated for 48 h at 37 °Cin vitrowith bacterial or fungal recall-antigens or specific mitogen antigens within 24 hours of sepsis onset. Recall-antigen stimulation led to a severe dampening of normal cytokine release. This immunologic anergy was similarly observed after mitogen stimulation. Moreover, patients under hydrocortisone therapy or with lowered arterial oxygen tension had further reductions in cytokine levels upon B- and T-cell mitogen stimulation. This investigation reveals an early onset of immunoparalysis during sepsis. This immune incompetence in mounting an adequate response to further infections includes previously sensitized pathogens, as seen with recall-antigens. Also, the immune-suppressive role of hydrocortisone and low PaO2is highlighted. Aside from early broad-spectrum antimicrobial therapy, our findings reinforce the need for maximal immunological support and protection against further infections at the onset of sepsis.
Generalized statistical mechanics of cosmic rays: Application to positron-electron spectral indices
Authors: Yalcin G. Cigdem , Beck Christian
Published: January 2018

Cosmic ray energy spectra exhibit power law distributions over many orders of magnitude that are very well described by the predictions of q-generalized statistical mechanics, based on a q-generalized Hagedorn theory for transverse momentum spectra and hard QCD scattering processes. QCD at largest center of mass energies predicts the entropic index to be $$q=\frac{{\bf{13}}}{{\bf{11}}}$$
q
=

13

11

. Here we show that the escort duality of the nonextensive thermodynamic formalism predicts an energy split of effective temperature given by Δ $${\boldsymbol{k}}{\boldsymbol{T}}{\boldsymbol{=}}{\boldsymbol{\pm }}\frac{{\bf{1}}}{{\bf{10}}}{\boldsymbol{k}}{{\boldsymbol{T}}}_{{\boldsymbol{H}}}{\boldsymbol{\approx }}{\boldsymbol{\pm }}{\bf{18}}$$
k
T
=
±

1

10

k

T

H

≈
±

18
MeV, where T
H
is the Hagedorn temperature. We carefully analyse the measured data of the AMS-02 collaboration and provide evidence that the predicted temperature split is indeed observed, leading to a different energy dependence of the e+ and e− spectral indices. We also observe a distinguished energy scale E* ≈ 50 GeV where the e+ and e− spectral indices differ the most. Linear combinations of the escort and non-escort q-generalized canonical distributions yield excellent agreement with the measured AMS-02 data in the entire energy range.
Design and implementation of multi-signal and time-varying neural reconstructions
Authors: Nanda Sumit , Chen Hanbo , Das Ravi , Bhattacharjee Shatabdi , Cuntz Hermann , Torben-Nielsen Benjamin , Peng Hanchuan , Cox Daniel N. , De Schutter Erik , Ascoli Giorgio A.
Published: January 2018

Several efficient procedures exist to digitally trace neuronal structure from light microscopy, and mature community resources have emerged to store, share, and analyze these datasets. In contrast, the quantification of intracellular distributions and morphological dynamics is not yet standardized. Current widespread descriptions of neuron morphology are static and inadequate for subcellular characterizations. We introduce a new file format to represent multichannel information as well as an open-source Vaa3D plugin to acquire this type of data. Next we define a novel data structure to capture morphological dynamics, and demonstrate its application to different time-lapse experiments. Importantly, we designed both innovations as judicious extensions of the classicSWCformat, thus ensuring full back-compatibility with popular visualization and modeling tools. We then deploy the combined multichannel/time-varying reconstruction system on developing neurons in live Drosophila larvae by digitally tracing fluorescently labeled cytoskeletal components along with overall dendritic morphology as they changed over time. This same design is also suitable for quantifying dendritic calcium dynamics and tracking arbor-wide movement of any subcellular substrate of interest.
Facile synthesis of Bi/BiVO4 composite ellipsoids with high photocatalytic activity
Authors: Jing Qifeng , Feng Xinyan , Pan Jiangling , Chen Limiao , Liu Younian
Published: January 2018

Bi/BiVO4 composites with excellent photocatalytic performance were firstly fabricated via a simple hydrothermal method.
A combined experimental and computational study on the reaction of fluoroarenes with Mg–Mg, Mg–Zn, Mg–Al and Al–Zn bonds
Authors: Bakewell Clare , Ward Bryan J. , White Andrew J. P. , Crimmin Mark R.
Published: January 2018

Through a combined experimental and computational (DFT) approach, the reaction mechanism of the addition of fluoroarenes to Mg–Mg bonds has been determined as a concerted SNAr-like pathway in which one Mg centre acts as a nucleophile and the other an electrophile.
Large area quantum dot luminescent solar concentrators for use with dye-sensitised solar cells
Authors: Brennan Lorcan J. , Purcell-Milton Finn , McKenna Barry , Watson Trystan M. , Gun'ko Yurii K. , Evans Rachel C.
Published: January 2018

Green-emitting quantum dot luminescent solar concentrators are used to sensitise an optically-matched dye-sensitised solar cell.
Carbon transmission of CO2 activated nano-MgO carbon composites enhances phosphate immobilization
Authors: Zhu Xiangdong , Liu Yuchen , Qian Feng , Shang Hua , Wei Xinchao , Zhang Shicheng , Chen Jianmin , Ren Zhiyong Jason
Published: January 2018

CO2 activated nano-MgO carbon composites exhibit high phosphate immobilization ability through surface precipitation (Mg(H2PO4)2 precipitate) with carbon transmission.
Co3O4-doped Co/CoFe nanoparticles encapsulated in carbon shells as bifunctional electrocatalysts for rechargeable Zn–Air batteries
Authors: Li Tongtong , Lu Yongxin , Zhao Shuaishuai , Gao Zhi-Da , Song Yan-Yan
Published: January 2018

Carbon-encapsulated Co3O4-doped Co/CoFe bifunctional catalysts prepared by annealing LDHs act as a highly efficient air cathode in rechargeable Zn–air batteries.
6-(7-nitro-2,1,3-benzoxadiazol-4-ylthio) hexanol: a promising new anticancer compound
Authors: Sha Huan-huan , Wang Zhen , Dong Shu-chen , Hu Tian-mu , Liu Si-wen , Zhang Jun-ying , Wu Yang , Ma Rong , Wu Jian-zhong , Chen Dan , Feng Ji-feng
Published: January 2018

The 7-nitro-2,1,3-nitrobenzoxadiazole (NBD) derivatives are a series of compounds containing the NBD scaffold that are not glutathione (GSH) peptidomimetics, and result in a strong inhibition of glutathione S-transferases (GSTs). Growing evidences highlight their pivotal roles and outstanding anticancer activity in different tumor models. In particular, 6-(7-nitro-2,1,3-benzoxadiazol-4-ylthio) hexanol (NBDHEX) is extensively studied, which is a very efficient inhibitor of GSTP1-1. It triggers apoptosis in several tumor cell lines and this cytotoxic activity is observed at micro and submicromolar concentrations. Importantly, studies have shown that NBDHEX acts as an anticancer drug by inhibiting GSTs catalytic activity, avoiding inconvenience of the inhibitor extrusion from the cell by specific pumps and disrupting the interaction between the GSTP1-1 and key signaling effectors. Additionally, some researchers also have discovered that NBDHEX can act as late-phase autophagy inhibitor, which opens new opportunities to fully exploit its therapeutic potential. In this review, we summarize the advantages, anticancer mechanisms, and analogs of this compound, which will establish the basis on the usage of NBDHEX in clinical applications in future.
Changing the Subject: The Place of Revisions in Grammatical Development
Authors: Rispoli Matthew
Published: January 2018

Purpose

This article focuses on toddlers' revisions of the sentence subject and tests the hypothesis that subject diversity (i.e., the number of different subjects produced) increases the probability of subject revision.

Method

One-hour language samples were collected from 61 children (32 girls) at 27 months. Spontaneously produced, active declarative sentences (ADSs) were analyzed for subject diversity and the presence of subject revision and repetition. The number of different words produced, mean length of utterance, tense/agreement productivity score, and the number of ADSs were also measured.

Results

Regression analyses were performed with revision and repetition as the dependent variables. Subject diversity significantly predicted the probability of revision, whereas the number of ADSs predicted the probability of repetition.

Conclusion

The results support the hypothesis that subject diversity increases the probability of subject revision. It is proposed that lexical diversity within specific syntactic positions is the primary mechanism whereby revision rates increase with grammatical development. The results underscore the need to differentiate repetition from revision in the classification of disfluencies.
Vehicle deformation depth based injury risk function for safety benefit evaluation of crash avoidance and mitigation systems
Authors: Chen Long , Luo Yugong , Napolitano Fabrizio Stefano , Zobel Robert , Li Keqiang
Published: January 2018

As the delta‐v‐based injury models used to evaluate intelligent driving systems are always fitted with European or American crash database, they cannot achieve wide application in those countries where limited in‐depth analysed crash data are recorded. An injury model which is based on easily accessible information, is urgently needed. In this study, a deformation depth based injury risk model is proposed to overcome the limitation of delta‐v. First, a correlation between the vehicle deformation depth and occupant injury risk is verified from the aspects of retrospective safety assessment and stiffness cluster analysis using German in‐depth accident study and national automotive sampling system–crashworthiness data system. Furthermore, injury risk‐deformation functions are regressed for different stiffness clusters using the crash data. The fitting accuracy reaches 97%, higher than the existing literature. A novel safety benefit assessment simulation platform is built with the regressed injury risk model. Based on this platform, an autonomous emergency braking system is evaluated. Only 1% error of the safety benefit exists between the proposed model and the delta‐v based one.
Synthesis of Heterobenzylic Fluorides
Authors: Britton Robert , Meanwell Michael
Published: January 2018

Fluorination at heterobenzylic positions can have a significant impact on basicity, lipophilicity, and metabolism of drug leads. As a consequence, the development of new methods to access heterobenzylic fluorides has particular relevance to medicinal chemistry. This short review provides a survey of common methods used to synthesize heterobenzylic fluorides and includes fluoride displacement reactions of previously functionalized molecules (e.g., deoxyfluorination and halide exchange) and electrophilic fluorination of resonance-stabilized heterobenzylic anions. In addition, recent advances in the direct fluorination of heterobenzylic C(sp3)–H bonds and monofluoromethylation of heterocyclic C(sp2)–H bonds are presented.

1 Introduction

2 Heterobenzylic Fluorides

2.1 Deoxyfluorination

2.2 Halide Exchange

2.3 Electrophilic Fluorination of Heterobenzylic Anions

2.4 Late Stage C–H Bond Fluorination

2.5 Monofluoromethylation of C(sp2)–H Bonds

3 Conclusions
Fascia Suture Technique and Suture-mediated Closure Devices: Systematic Review
Authors: Kostakis Ioannis , Moris Demetrios , Palla Viktoria-Varvara , Moulakakis Konstantinos , Karaolanis Georgios
Published: January 2018

Background The aim of the present study is to review the available data on suture-mediated closure devices (SMCDs) and fascia suture technique (FST), which are alternatives for minimizing the invasiveness of percutaneous endovascular aortic aneurysm repair (p-EVAR) and reduce the complications related to groin dissections.

Methods The Medline, ClinicalTrials.gov, and Cochrane library – Cochrane Central Register of Controlled Trials (CENTRAL) databases were searched for publications regarding SMCD and FST between January 1999 and December 2016.

Results We review 37 original articles, 30 referring to SMCDs (Prostar XL and Proglide), which included 3,992 patients, and 6 articles referring to FST, which include 426 patients. The two techniques are compared only in one article (100 patients). The two types of SMCDs were Prostar and Proglide. In most studies on SMCDs, the reported technical success rates were between 89 and 100%, but the complication rates varied greatly between 0 and 25%. Concerning FST, the technical success rates were also high, ranging between 87 and 99%. However, intraoperative complication rates ranged between 1.2 and 13%, whereas postoperative complication rates varied from 0.9 to 6.2% for the short-term and from 1.9 to 13.6% for the long-term.

Conclusions SMCDs and FST seem to be effective and simple methods for closing common femoral artery (CFA) punctures after p-EVAR. FST can reduce the access closure time and the procedural costs with a quite short learning curve, whereas it can work as a bailout procedure for failed SMCDs suture. The few failures of the SMCDs and FST that may occur due to bleeding or occlusion can easily be managed.
Anti-N-Methyl-D-Aspartate Receptor Encephalitis in a 3-Year-Old Toddler with the Involvement of Severe Autonomic Dysfunctions in Gastrointestinal System: A Case Report
Authors: Liu Li-Ying , Wang Yang-Yang , Pang Ling-Yu , Zhang Gui-Xia , Zou Li-Ping
Published: January 2018

Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is under-recognized in children and adults. It is characterized by prominent neurologic and psychiatric features at first onset. Autonomic manifestations are rarer in children than in adults. We report a 3-year-old male patient with rare manifestation of severe autonomic dysfunctions of the gastrointestinal system and atypical prodromal symptoms. The serum and CSF of the patient were positive for anti-NMDA receptor antibodies, and his electroencephalogram results showed an “extreme delta brush” pattern. The patient had completely recovered by the sixth-month assessment after receiving first-line immunomodulatory treatment. Thus, anti-NMDAR encephalitis should be considered in the differential diagnosis of children with mental status changes and widespread autonomic dysfunction, particularly if symptoms are accompanied by gastrointestinal dysmotility and anhidrosis.
Comparison of Four Methods of Treating Ectopic Pregnancy: A Retrospective Cohort Study
Authors: Inal Zeynep , Inal Hasan
Published: January 2018

Objective To compare the results of expectant management, single and multidose methotrexate (MTX) and surgical management of ectopic pregnancy (EP).

Materials and Methods In this retrospective cohort study, the original files of 233 patients who were treated for EP between May 2009 and December 2016 were analyzed. The patients were assigned to the following groups based on the applied treatment methods: Group 1, expectant management (n = 24), Group 2, single-dose MTX (n = 144), Group 3, multiple-dose MTX (n = 25), and Group 4, surgical intervention (n = 40). The following parameters were recorded and assessed: sociodemographic characteristics, pelvic ultrasonography findings (gestational sac, ectopic mass appearance, positive fetal cardiac activity), serum beta-human chorionic gonadotropin (β-hCG) levels on Day 0, Day 4, and Day 7, and surgical procedures in women that underwent surgical interventions.

Results The sociodemographic characteristics were similar in all four groups. The percentage of ectopic mass and positive fetal cardiac activity was greater and the diameter of the mass was larger in Group 4 than in the other groups. The β-hCG values on Day 0, Day 4, and Day 7 were statistically different between the groups (p < 0.001). The cutoff value for the β-hCG change for EP resolution was 18% between Day 0 and Day 4 (AUC = 0.726, p < 0.001) and 15% between Day 4 and Day 7 (AUC = 0.874, p < 0.001). The probability of the requirement for an additional dose of MTX was 0.78 (95% CI 0.71 – 0.87; p < 0.001) times lower in patients who had a > 18% decrease in β-hCG levels from Day 0 to Day 4 in comparison to those who had a decrease < 18% from Day 0 to Day 4. The probability of the requirement for an additional dose of MTX was 1.64 (95% CI 1.25 – 2.16; p < 0.001) times greater in patients whose reduction in β-hCG levels from Day 4 to Day 7 was < 15% in comparison to those who had > 15% reduction from Day 4 to Day 7.

Conclusions Additional dose requirements for patients with EP may be predicted early in the changes in β-hCG levels between Day 0 and Day 4. Further prospective studies are required to elucidate this issue.
Outcome of Low-Invasive Local Split-Thickness Lengthening for Iliotibial Band Friction Syndrome
Authors: Inoue Hiroaki , Hara Kunio , Arai Yuji , Nakagawa Shuji , Kan Hiroyuki , Hino Manabu , Fujiwara Hiroyoshi , Kubo Toshikazu
Published: January 2018

Conventional surgical methods for iliotibial band friction syndrome (ITBFS) may affect the iliotibial band (ITB), delaying return to sports activities or impeding performance. We have developed a minimally invasive method. This study retrospectively analyzed the outcomes of this procedure in individuals with ITBFS. This study included 34 knees of 31 individuals. Surgery involved lengthening the central part of the ITB by splitting it into a superficial and a deep layer, maintaining the anterior and posterior fibers immediately above the lateral epicondyle. Outcomes included time to resume sports activity, personal best times to run a 5000-m race before and after surgery, and 2-month post-surgery muscle strengths. The mean postoperative time to return to competition was 5.8 weeks. Personal best times of 5000-m race improved in 13 of 17 runners. Two months post-surgery, the mean extensor muscle strengths on the healthy and affected sides did not significantly differ nor did the flexor muscle strengths. In ITBFS, the ITB itself is normal. Lengthening the limited region of the ITB immediately above the lateral femoral epicondyle removes the cause of ITBFS, with a reduction in inflammation. This technique resulted in early return to competition without degrading performance.
Is Breast Surgery Necessary for Breast Carcinoma in Complete Remission Following Neoadjuvant Chemotherapy?
Authors: Richter Hannah , Hennigs André , Schaefgen Benedikt , Hahn Markus , Blohmer Jens , Kümmel Sherko , Kühn Thorsten , Thill Marc , Friedrichs Kay , Sohn Christof , Golatta Michael , Heil Jörg
Published: January 2018

The likelihood of pathological complete remission (pCR) of breast cancer following neoadjuvant chemotherapy (NACT) is increasing; most of all in the triple negative and HER2 positive tumour subgroups. The question thus arises whether or not breast surgery is necessary when there is complete remission after NACT, and whether it provides any improvement of the oncological treatment result when tumour is no longer detectable. Avoiding surgery and possibly even radiotherapy would only be conceivable on the basis of a reliable diagnosis of pCR without operating. Current imaging does not achieve the necessary sensitivity and specificity to assure the diagnosis of pathological complete remission. Further studies are therefore required to determine which methods are best able to evaluate tumour response to NACT. Studies on image-guided, minimally invasive biopsies after NACT have delivered first promising results towards diagnosing pCR before surgery and could provide the basis for further studies on the possibility of avoiding surgery in this specific patient collective.
Die Mehrebenenanalyse als Verfahren zur Analyse rehabilitationswissenschaftlicher Forschungsfragen
Authors: Wirtz Markus Antonius
Published: January 2018

In rehabilitationswissenschaftlichen Studien liegen oft Daten vor, die Informationen auf unterschiedlichen hierarchischen Ebenen repräsentieren. Hierarchische Stichprobenstrukturen sind dadurch gekennzeichnet, dass Stichprobenmitglieder (z. B. Rehabilitanden) als gruppiert oder als Mitglieder natürlicher Teileinheiten (Cluster; z. B. Teams, Gruppen, Einrichtungen) betrachtet werden müssen. Werden bspw. Daten von Rehabilitanden aus verschiedenen Einrichtungen analysiert, so muss davon ausgegangen werden, dass die Zugehörigkeit zu der jeweiligen Einrichtung (Ebene 2; Cluster-Einheiten) mit der Ausprägung der Merkmale der Rehabilitanden (Ebene 1; Individualeinheiten) in Zusammenhang steht. Nehmen Rehabilitanden an verschiedenen Schulungsgruppen teil, so ist zu erwarten, dass die Ausprägung des Behandlungserfolgs der Rehabilitanden (Ebene 1) durch die Zugehörigkeit zu einer spezifischen Schulungsgruppe (Ebene 2) mit beeinflusst wird. Die Mehrebenenanalyse bzw. hierarchische lineare Modelle ermöglichen die simultane und integrierte Analyse von Daten unterschiedlicher Hierarchieebenen. In diesem Beitrag wird gezeigt, worauf bei der Erhebung hierarchisch strukturierter Stichproben, der Datenaufbereitung, der Hypothesenformulierung, der statistischen Datenanalyse und der Ergebnisinterpretation zu achten ist, damit Effekten der Clusterzugehörigkeit angemessen Rechnung getragen werden kann.
Der Umgang mit Angehörigen der Opfer der Aktion „T4“ durch die NS-Behörden und die Anstalten in Württemberg
Authors: Schmidt-Michel Paul-Otto , Müller Thomas
Published: January 2018

Die Rolle der Angehörigen im Rahmen der „Euthanasie“-Aktion „T4“ ist in den letzten Jahren kontrovers diskutiert worden. Anhand von Dokumenten der NS-Bürokratie, Stellungnahmen der Anstaltspsychiater aus dem Jahr 1945 an die französische Besatzungsmacht und Briefen von Angehörigen an die Heilanstalt Weissenau/Württemberg werden diese Quellen unter dem Aspekt der Reaktionen der Angehörigen auf die Aktion „T4“ ausgewertet. Die Ergebnisse bezeugen ein breites Spektrum der Reaktionen der Angehörigen, die überwiegend durch Angst, Ohnmacht und Protest gekennzeichnet sind.
Reconstruction of a Circumferential Upper Extremity Soft Tissue Defect With a Dermal Regeneration Template and Skin Grafting
Authors: Son Ji H. , Bafus Blaine , Khandelwal Anjay , Chepla Kyle J.
Published: January 2018

Extensive degloving injuries of the upper extremity are rare and pose unique reconstructive challenges. Circumferential loss of soft tissue coverage over the elbow treated by skin grafting is often complicated by elbow contracture and decreased range of motion, requiring secondary contracture release and free-flap reconstruction to restore function. As an alternative approach, we report a good outcome after the use of a dermal regenerative template and subsequent split-thickness skin grafting. A 38-year-old right hand dominant man presented with circumferential degloving injury of the entire right upper extremity to the level of the chest wall after an industrial accident. An immediate right transradial amputation was performed and serial debridement was required to remove all devitalized tissue. A dermal regenerative template with subsequent split-thickness skin grafting was used to cover the circumferential elbow soft tissue defect. Occupational therapy and splinting were used preoperatively and postoperatively to prevent contracture. However, axillary scar contracture release was required 4 months after injury. Six months after skin grafting, the patient had stable soft tissue coverage of the upper extremity. Shoulder motion measured 120-degree abduction and 140-degree forward flexion and elbow range of motion was 15 to 150 degrees. In this case, an excellent clinical outcome was obtained with a dermal regenerative template, aggressive wound care, and a multidisciplinary team approach.
Relationship Between Race, Insurance Coverage, and Visual Acuity at the Time of Cataract Surgery
Authors: Stone Jordan S. , Fukuoka Hideki , Weinreb Robert N. , Afshari Natalie A.
Published: January 2018

Objective:

To assess the relationship between sociodemographic variables (including race, age, and insurance coverage) and preoperative best-corrected visual acuity (BCVA) at the time of first-eye cataract surgery.

Methods:

Single-center retrospective chart review study at Shiley Eye Institute, University of California, San Diego (UCSD). Medical record data from 600 patients were collected from the appointment immediately preceding cataract surgery, including BCVA in the operated eye converted to the logarithmic minimal angle of resolution (logMAR), insurance coverage, race, sex, age, body mass index, smoking status (including pack years), systemic and ocular comorbidities, and ocular surgical history. Preoperative BCVA in the operated eye was the main outcome measure.

Results:

Univariate analysis revealed significant differences in BCVA between groups by insurance type (public, private, and uninsured), race (Asian, black, Hispanic, white, and other), and sex (male and female) (P<0.001, P<0.001, and P=0.019, respectively). Further multivariate analysis revealed significant pairwise differences, with better BCVA associated with white race (0.85, logMAR [Snellen 20/140]) than Hispanic race (1.06, [20/230], P=0.017), and better BCVA associated with private insurance (0.79, [20/125]) versus public insurance (0.96, [20/180], P=0.0002).

Conclusion:

Hispanic race and public insurance coverage were each associated with worse preoperative BCVA compared with white race and private insurance, respectively. This suggests that Hispanic race and public insurance may predispose patients to decreased access to cataract surgery. Additional large, prospective studies are required to rigorously test and elaborate on this finding.
Global Practice Patterns in the Management of Infantile Cataracts
Authors: Koo Euna B. , VanderVeen Deborah K. , Lambert Scott R.
Published: January 2018

Objectives:

Surveys are an important tool to assess the impact of research on physicians' approach to patient care. This survey was conducted to assess current practice patterns in the management of infantile cataracts in light of the findings of the Infant Aphakia Treatment Study.

Methods:

Pediatric ophthalmologists were emailed a link to the survey using newsletters from American Association of Pediatric Ophthalmology and Strabismus, World Society of Pediatric Ophthalmology and Strabismus, and the Pediatric Listserv. The 17-question survey was anonymous and active during July to August 2016.

Results:

One hundred twenty-five respondents (North America, 65%; Asia, 12%; Europe, 9%; and other, 14%) reported operating on pediatric cataracts. Most practice in a university setting (55%). There was a strong consensus that unilateral cataract surgery should be performed between ages 4 to 6 weeks and aphakic contact lenses should be used to optically correct their eyes, particularly in children ≤6 months of age. For bilateral cataracts, there was a trend for surgeons to perform cataract surgery at an older age than unilateral cataract surgery. Surgeons who performed less than 5 versus greater than 20 pediatric cataract surgeries/year were more likely to use aphakic contact lenses in children undergoing cataract surgery more than 6 months of age (62% vs. 35%, P=0.04). Most respondents (73%) indicated that the Infant Aphakia Treatment Study had changed how they manage unilateral congenital cataracts.

Conclusion:

Most pediatric cataract surgeons perform congenital cataract surgery between ages 4 to 6 weeks and use aphakic contact lenses for initial optical correction in infants less than 6 months. Surgeons have equal preference for intraocular lenses and contact lenses in infants more than 6 months of age.
Medically unexplained physical symptoms in patients visiting the emergency department: an international multicentre retrospective study
Authors: Alsma Jelmer , Wouw Jens van de , Jellema Korné , Coffeng Sophie M. , Tobback Els , Delesie Liesbeth , Brand Crispijn L. van den , Vogelaers Dirk , Mariman An , Paepe Peter de , van Saase Jan L. , Weiland Anne
Published: January 2018

Objective

The objective of this study was to assess the incidence and characteristics of patients presenting with physical symptoms that remain medically unexplained at the emergency department (ED).

Patients and methods

A retrospective chart study was carried out in three hospitals in The Netherlands and Belgium. All patients (age > 18 years) visiting the ED in 4 selected weeks in 2013 at the Erasmus University Medical Center (Erasmus MC) in Rotterdam, The Netherlands, and 1 selected week in 2013 at the Haaglanden Medical Center, Westeinde HMC in The Hague, The Netherlands, and the University Hospital Ghent (UZG), Belgium, were included. Descriptive statistics were used for data analysis.

Results

A total of 2869 patients (Erasmus MC 1674, HMC 691, UZG 504) were included. Medically unexplained physical symptoms in the emergency department (EDMUPS) were present in 13.4% of all ED visits (Erasmus MC 12.5%, HMC 18.7%, UZG 9.1%). No EDMUPS were identified in trauma patients. When excluding trauma patients, EDMUPS were present in 18.5% (Erasmus MC 16.8%, HMC 26.5%, UZG 13.3%) of the visits. The characteristics of patients with and without EDMUPS differed significantly; patients with EDMUPS were more often younger, female, self-referred, frequent visitors, were prescribed less medication and more often had a psychiatric disease. Dutch and Belgian Hospital differed in the distribution of patients in triage categories and in the incidence of psychiatric illnesses.

Conclusion

Physical symptoms remain unexplained in a significant number of patients at the time of ED assessment.
A sleep-regulatory circuit integrating circadian, homeostatic and environmental information in Drosophila
Authors: Lamaze Angélique , Krätschmer Patrick , Jepson James E. C.
Published: January 2018

In the wild, when to go to sleep is a critical decision. Sleep onset is controlled by two processes: the circadian clock, and a homeostat measuring sleep drive [1, 2]. Environmental stimuli must also clearly intersect with the circadian clock and/or homeostat so that sleep is initiated only when appropriate. Yet how circadian, homeostatic and environmental cues are integrated at the circuit level is unclear. Recently, we found that DN1p clock neurons in Drosophila act to prolong morning wakefulness at elevated ambient temperatures [3]. Here we show that a subset of DN1p neurons exhibit temperature-sensitive increases in excitability, and define an output pathway linking DN1p neurons to downstream sleep-regulatory circuits. We show that DN1p neurons project axons to a subdomain of the Anterior Optic Tubercle (AOTU), and here make inhibitory synaptic connections with sleep-promoting tubercular-bulbar (TuBu) neurons. Using unbiased trans-synaptic labeling, we show that these TuBu neurons form synaptic connections with R-neurons innervating the ellipsoid body, subsets of which control homeostatic sleep drive [4]. DN1p excitability is clock-dependent, peaking in the late night and early morning [5]. Thus, integration of circadian and thermo-sensory information by DN1p neurons and subsequent inhibition of sleep-promoting TuBu neurons provides a mechanism by which an environmental stimulus can regulate sleep onset during a specific compartment of the day-night cycle. Furthermore, our results suggest that the AOTU functionally links circadian and sleep homeostat circuits in Drosophila.
Audit committee effectiveness and financial reporting timeliness
Authors: Oussii Ahmed Atef , Boulila Taktak Neila
Published: January 2018

Purpose

The purpose of this paper is to investigate whether there is any relationship between the effectiveness of an audit committee and the financial reporting timeliness of Tunisian listed companies as proxied by external audit delay (AD). Analysis focuses on five audit committee characteristics: authority, financial expertise, independence, size and diligence.

Design/methodology/approach

Empirical tests address 162 firm-year observations drawn from Tunisian listed companies during 2011-2013.

Findings

Multivariate analyses indicate that audit committees with members who have financial expertise are significantly associated with shorter AD. Thus, the results suggest that audit committee financial expertise contributes to the improvement of financial statements’ timeliness.

Research limitations/implications

The audit committee attributes examined in this study were based on DeZoortet al.(2002) framework. There could be other aspects of audit committee effectiveness such as audit committee tenure and audit committee chair characteristics, which were not addressed in the present study. Thus, future research may consider and examine these other components of audit committee effectiveness.

Practical implications

Findings have managerial implications. Companies can re-look into how to further improve audit committee composition in order to enhance the timeliness of financial reporting. The issues of audit committee effectiveness and timely reporting also affect regulators and policy makers since they need to play a role in the establishment of effective audit committees and the improvement of financial reporting timeliness.

Originality/value

This study is one of few that have examined the impact of audit committee effectiveness on ADs in an emerging market country. Findings lend credence to the belief that audit committee members’ financial expertise enhances the quality of financial reporting by firms in a North African market criticized for the lack of maturity of its corporate governance system (Klibi, 2015; Fitch Ratings, 2009).
Heat and mass transfer characteristics of MHD three-dimensional flow over a stretching sheet filled with water-based alumina nanofluid
Authors: A. Reddy P. Sudarsan , Chamkha A.
Published: January 2018

Purpose

This paper aims to understand the influence of velocity slip, nanoparticle volume fraction, chemical reaction and non-linear thermal radiation on MHD three-dimensional heat and mass transfer boundary layer flow over a stretching sheet filled with water-based alumina nanofluid. To get more meaningful results, the authors have taken nonlinear thermal radiation in the heat transfer process.

Design/methodology/approach

Suitable similarity variables are introduced to convert governing partial differential equations into the set of ordinary differential equations, and are solved numerically using a versatile, extensively validated finite element method with Galerkin’s weighted residual simulation. The velocity, temperature and concentration profiles of nanoparticles as well as skin friction coefficient, Nusselt number and Sherwood number for different non-dimensional parameters such as volume fraction, magnetic, radiation and velocity slip parameters as well as the Prandtl number are examined in detail, and are presented through plots and tables.

Findings

It is noticed that the rate of heat transfer enhances with higher values of nanoparticle volume fraction parameter. It is worth mentioning that the heat transfer rates improve as the values of increase. Increasing values of M, R, θw and β decelerates the thickness of the thermal boundary layer in the fluid regime. The heat transfer rates decelerate as the values of suction parameter increase.

Originality/value

The authors have written this paper based on the best of their knowledge on heat and mass transfer analysis of nanofluids. The information in this paper is new and not copied from any other sources.