bluuebunny/crossref_metadata_2025 huggingface dataset:
Review of Metronidazole Dosing in Preterm Neonates
Authors: Dannelley Jennifer , Martin Erin , Chaaban Hala , Miller Jamie
Published: March 2017

Metronidazole dosing recommendations vary significantly for premature infants in pediatric dosing references and can result in confusion for prescribers. We performed a literature search identifying articles evaluating the pharmacokinetics and dosing of metronidazole in premature infants. The search was limited to English-language articles in MEDLINE (January 1946 to December 2016), EMBASE (January 1974 to December 2016), and International Pharmaceutical Abstracts (January 1970 to December 2016). Reference citations from relevant articles were also reviewed. Six pharmacokinetic studies, representing 152 neonates, were included; however, only three of the well-defined studies were reviewed in depth, and the other three studies were considered foundational. The pharmacokinetic studies included in this review indicate that some published dosing recommendations in pediatric dosing references may result in subtherapeutic metronidazole concentrations. Therefore, postmenstrual age based dosing recommendations were provided by the authors of these pharmacokinetic studies based on a pharmacodynamic target of 6 to 8 mg/L; yet, these dosing recommendations differ from one another. The pharmacokinetic studies included in this review provide some guidance to dosing; however, a major limitation is that outcomes of clinical efficacy and safety were not evaluated. Future studies targeting the optimal dosing and serum concentrations required for clinical efficacy are needed.
Return of target material ions leads to a reduced hysteresis in reactive high power impulse magnetron sputtering: Experiment
Authors: Čapek Jiří , Kadlec Stanislav
Published: March 2017

Titanium and aluminum targets have been reactively sputtered in Ar +O2 or Ar +N2 gas mixtures in order to systematically investigate the effect of reduced hysteresis in reactive high power impulse magnetron sputtering (HiPIMS) as compared to other sputtering techniques utilizing low discharge target power density (e.g., direct current or pulsed direct current mid-frequency magnetron sputtering) operated at the same average discharge power. We found that the negative slope of the flow rate of the reactive gas gettered by the sputtered target material as a function of the reactive gas partial pressure is clearly lower in the case of HiPIMS. This results in a lower critical pumping speed, which implies a reduced hysteresis. We argue that the most important effect explaining the observed behavior is covering of the reacted areas of the target by the returning ionized metal, effectively lowering the target coverage at a given partial pressure. This explanation is supported by a calculation using an analytical model of reactive HiPIMS with time and space averaging (developed by us).
A SONOS device with a separated charge trapping layer for improvement of charge injection
Authors: Ahn Jae-Hyuk , Moon Dong-Il , Ko Seung-Won , Kim Chang-Hoon , Kim Jee-Yeon , Kim Moon-Seok , Seol Myeong-Lok , Moon Joon-Bae , Choi Ji-Min , Oh Jae-Sub , Choi Sung-Jin , Choi Yang-Kyu
Published: March 2017

A charge trapping layer that is separated from the primary gate dielectric is implemented on a FinFET SONOS structure. By virtue of the reduced effective oxide thickness of the primary gate dielectric, a strong gate-to-channel coupling is obtained and thus short-channel effects in the proposed device are effectively suppressed. Moreover, a high program/erase speed and a large shift in the threshold voltage are achieved due to the improved charge injection by the reduced effective oxide thickness. The proposed structure has potential for use in high speed flash memory.
Comparative analysis of modeling and experiments to study spalling process in Si wafers
Authors: Alhomoudi Ibrahim A.
Published: March 2017

A comparative analysis including modeling and experimental evaluation of a spalling process of silicon (Si) substrates was accomplished to define the optimum condition for uniform spalling. The residual stresses in Nickle (Ni) films on Si substrates have been evaluated. Different thicknesses of Ni films electroplated on Si(100) and Si(111) substrates have been used to predict the steady-state spalling depth and crack propagation direction. This study focuses on identifying the key variables; including the Ni film thickness (h) and critical stress needed to peel-off uniform thin layers from a Si substrate. The residual stresses (thermal and epitaxial) in the Ni films have been evaluated through experiment and modeling analysis to distinguish the sources of stress generation. Different thicknesses of spalled films from Si substrates were defined to investigate the influence of the stress intensity factors (KI, KII and KIII) and the energy release rate (J1) on the steady state spalling process. Finally, the critical normal stress (σII) versus h has been determined to predict the spalling depth with uniform thickness.
Decoupling analysis of a novel bearingless flux-switching permanent magnet motor
Authors: Zhao Chenyin , Zhu Huangqiu , Qin Yuemei
Published: March 2017

In this paper, a novel 12/10 stator/rotor pole bearingless flux-switching permanent magnet (BFSPM) motor is proposed to overcome the drawbacks of rotor permanent magnet type bearingless motors. The basic motor configuration, including motor configuration and winding configuration, is introduced firstly. Then, based on the principle of reverse direction magnetization for symmetrical rotor teeth, the radial suspension forces generation principle is analyzed in detail. Finally, decoupling performances between suspension force windings and torque windings are investigated. The results show that the proposed BFSPM not only ensures the merits of high torque output capability compared with conventional 12/10 stator/rotor pole FSPM motor, but also achieves stable radial suspension forces which have little mutual effect with torque. The validity of the proposed structure has been verified by finite element analysis (FEA).
Magnetic hyperthermia performance of magnetite nanoparticle assemblies under different driving fields
Authors: Wu Kai , Wang Jian-Ping
Published: March 2017

The heating performance of magnetic nanoparticles (MNPs) under an alternating magnetic field (AMF) is dependent on several factors. Optimizing these factors improves the heating efficiency for cancer therapy and meanwhile lowers the MNP treatment dosage. AMF is one of the most easily controllable variables to enhance the efficiency of heat generation. This paper investigated the optimal magnetic field strength and frequency for an assembly of magnetite nanoparticles. For hyperthermia treatment in clinical applications, monodispersed NPs are forming nanoclusters in target regions where a strong magnetically interactive environment is anticipated, which leads to a completely different situation than MNPs in ferrofluids. Herein, the energy barrier model is revisited and Néel relaxation time is tailored for high MNP packing densities. AMF strength and frequency are customized for different magnetite NPs to achieve the highest power generation and the best hyperthermia performance.
Doped Ti-pillared clays as effective adsorbents – Application to methylene blue and trimethoprim removal
Authors: González Beatriz , Trujillano Raquel , Vicente Miguel A. , Rives Vicente , de Faria Emerson H. , Ciuffi Katia J. , Korili Sophia A. , Gil Antonio
Published: March 2017

Environmental contextWater is an essential compound for life; however, several factors limit the amount available for human consumption. Every day, thousands of pollutants are discharged into drinking water. Here, new materials that are efficient as adsorbents and photocatalysts for pollutants are reported.
AbstractMontmorillonite was treated with Ti-based solutions doped with various transition metal cations, leading after calcination at 500°C to new doped Ti-pillared montmorillonite solids. These solids were characterised by elemental chemical analysis, powder X-ray diffraction, Fourier-transform (FT)-IR spectroscopy, thermal analyses, nitrogen adsorption, acidity evaluation and electron microscopy. The performance of these solids in the degradation of methylene blue and the adsorption of trimethoprim was evaluated.
Stable isotopes in biota reflect the graduated influence of sewage effluent along a tropical macro-tidal creek
Authors: Warnakulasooriya Kanchana Niwanthi , Butler Edward Charles Villers , Gibb Karen Susanne , Munksgaard Niels Crosley
Published: March 2017

In hydrodynamically complex environments, where conventional water-quality parameters may not adequately quantify sewage influence, stable isotopes in time-integrating biological tissues may provide an alternative monitoring tool. We measured nitrogen and carbon isotope ratios and concentrations in mangrove leaves and muscle tissues of two species of gastropod snails to determine the dispersion and biological assimilation of sewage-derived nutrients in a macro-tidal creek. The values of stable isotope of nitrogen (δ15N) in mangrove leaves and gastropods from the affected creek were significantly higher than those in samples from an unaffected creek, reflecting a graduated influence of sewage-derived N. The δ15N values in mangrove leaves showed high repeatability between sampling rounds and this, coupled with ease of sampling, makes them an effective monitoring tool to trace the influence of sewage effluent in receiving waters. The combined use of values of δ15N and stable isotope of carbon in gastropods showed some promise as a monitoring tool, but intra- and inter-specific variations in isotope values due to spatial differences in available food sources may affect their reliability in tracing sewage influence.
Using telemetry data to develop conceptual models of movement to support the management of riverine fishes
Authors: Koster W. M. , Crook D. A.
Published: March 2017

As human demands for freshwater resources increase, there is growing concern for the long-term viability of native fish populations globally. Understanding the movements of fish, and how these are influenced by or respond to environmental changes, is a critical knowledge requirement for effective management; however, limited information on the ecological requirements of many fish species currently hinders our ability to sustainably manage fish populations. In this paper, we use four native Australian fish species with contrasting life histories as case studies to demonstrate how data derived from acoustic and radiotelemetry studies can be synthesised into conceptual diagrams to help scientists and managers develop targeted and effective conservation management strategies. Commonalities in the observed movement patterns were observed among the species despite their contrasting life histories, but there were also important differences that need to be recognised in the development of species-specific conservation management strategies. We conclude by discussing how such information has been or could be incorporated into conservation management actions, including the implementation of environmental flow releases and the identification of critical habitats.
Rab5-regulated endocytosis plays a crucial role in apical extrusion of transformed cells
Authors: Saitoh Sayaka , Maruyama Takeshi , Yako Yuta , Kajita Mihoko , Fujioka Yoichiro , Ohba Yusuke , Kasai Nobuhiro , Sugama Natsu , Kon Shunsuke , Ishikawa Susumu , Hayashi Takashi , Yamazaki Tomohiro , Tada Masazumi , Fujita Yasuyuki
Published: March 2017

Significance

At the initial stage of carcinogenesis, transformation occurs in a single cell within the epithelium. However, it is not clearly understood what happens at the interface between the newly emerging transformed cells and the surrounding normal epithelial cells. Here, using mammalian cell culture and zebrafish embryo systems, we demonstrate that Rab5, an important regulator of endocytosis, is accumulated and that endocytosis is enhanced in RasV12-transformed cells surrounded by normal cells. The elevation of endocytosis disrupts E-cadherin–based cell–cell adhesions with the surrounding normal cells and modulates signaling pathways, eventually leading to apical elimination of the transformed cells. This report demonstrates that endocytosis plays a crucial role in cell competition between normal and transformed epithelial cells in mammals.
Weyl’s Theorem for pairs of commuting hyponormal operators
Authors: Chavan Sameer , Curto Raúl
Published: March 2017

Let

T

\mathbf {T}

be a pair of commuting hyponormal operators satisfying the so-called quasitriangular property
\[
<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" alttext="dimension kernel left-parenthesis bold upper T minus bold-italic lamda right-parenthesis greater-than-or-equal-to dimension kernel left-parenthesis bold upper T minus bold-italic lamda right-parenthesis Superscript asterisk Baseline comma">

dim

ker

(

T

−
λ
)
≥

dim

ker

(

T

−

λ

)
∗

,

\textrm {dim} \; \textrm {ker} \; (\mathbf {T}-\boldsymbol \lambda ) \ge \textrm {dim} \; \textrm {ker} \; (\mathbf {T} - {\boldsymbol \lambda })^*,

\]
for every

λ
\boldsymbol \lambda

in the Taylor spectrum

σ
(

T

)

\sigma (\mathbf {T})

of

T

\mathbf {T}

. We prove that the Weyl spectrum of

T

\mathbf {T}

,

ω
(

T

)

\omega (\mathbf {T})

, satisfies the identity
\[

ω
(

T

)
=
σ
(

T

)
∖

π

00

(

T

)
,

\omega (\mathbf {T})=\sigma (\mathbf {T}) \setminus \pi _{00}(\mathbf {T}),

\]
where

π

00

(

T

)

\pi _{00}(\mathbf {T})

denotes the set of isolated eigenvalues of finite multiplicity.

Our method of proof relies on a (strictly

2
2

-variable) fact about the topological boundary of the Taylor spectrum; as a result, our proof does not hold for

d
d

-tuples of commuting hyponormal operators with

d
>
2

d>2

.
HLA-MA: simple yet powerful matching of samples using HLA typing results
Authors: Messerschmidt Clemens , Holtgrewe Manuel , Beule Dieter
Published: March 2017

We propose the simple method HLA-MA for consistency checking in pipelines operating on human HTS data. The method is based on the HLA typing result of the state-of-the-art method OptiType. Provided that there is sufficient coverage of the HLA loci, comparing HLA types allows for simple, fast and robust matching of samples from whole genome, exome and RNA-seq data. Our approach uses information from small but genetically highly variable regions and thus complements approaches that rely on genome or exon-wide variant profiles.

Availability and Implementation

The software is implemented In Python 3 and freely available under the MIT license at https://github.com/bihealth/hlama and via Bioconda.

Supplementary information

Supplementary data are available at Bioinformatics online.
When ecosystems and their services are not co-located: oceans and coasts
Authors: Drakou Evangelia G. , Pendleton Linwood , Effron Micah , Ingram Jane Carter , Teneva Lida
Published: March 2017

Local, regional, and global policies to manage protect and restore our oceans and coasts call for the inclusion of ecosystem services (ES) in policy-relevant research. Marine and coastal ES and the associated benefits to humans are usually assessed, quantified, and mapped at the ecosystem level to inform policy and decision-making. Yet those benefits may reach humans beyond the provisioning ecosystem, at the regional or even global level. Current efforts to map ES generated by a single ecosystem rarely consider the distribution of benefits beyond the ecosystem itself, especially at the regional or global level. In this article, we elaborate on the concept of “extra-local” ES to refer to those ES generating benefits that are enjoyed far from the providing ecosystem, focusing on the marine environment. We emphasize the spatial dimension of the different components of the ES provision framework and apply the proposed conceptual framework to food provision and climate regulation ES provided by marine and coastal ecosystems. We present the different extents of the mapping outputs generated by the ecosystem-based vs. the extra-local mapping approach and discuss practical and conceptual challenges of the approach. Lack of relevant ES mapping methodologies and lack of data appeared to be the most crucial bottlenecks in applying the extra-local approach for marine and coastal ES. We urge for more applications of the proposed framework that can improve marine and coastal ES assessments help fill in data gaps and generate more robust data. Such assessments could better inform marine and coastal policies, especially those linked to equal attribution of benefits, compensation schemes and poverty alleviation.
Keeping It Real in Experimental Research—Understanding When, Where, and How to Enhance Realism and Measure Consumer Behavior
Authors: Morales Andrea C , Amir On , Lee Leonard
Published: March 2017

In this article, we consider why employing realistic experimental designs and measuring actual behavior is important and beneficial for consumer research. More specifically, we discuss when, where, and how researchers might go about doing this in order to increase the veracity and believability of their work. We analyze the choice of independent variables (IVs) along the experimental-realism dimension, ranging from artificial to realistic, and the choice of dependent variables (DVs) along the behavioral-measures dimension ranging from hypothetical intention to actual behavior. Importantly, we also map various goals of consumer research along these two dimensions to highlight when it is most appropriate to enhance the realism and behavioral measures of an experiment. Using a number of illustrative examples from research in the extant literature, we specifically highlight how consumer researchers can increase experimental realism and utilize actual-behavior measures in their experiments in order to improve both the fidelity of the research and the likelihood that the research provides insight into real consumer behavior.
The Endoscopic Endonasal Transmaxillary Approach to Meckel's Cave Through the Inferior Orbital Fissure
Authors: Zhang Xin , Tabani Halima , El-Sayed Ivan , Russell Matthew , Feng Xuequan , Benet Arnau
Published: March 2017

BACKGROUND: Surgical access to Meckel's Cave (MC) is challenging due to its deep location and surrounding important neurovascular structures. Currently existing endoscopic endonasal (EE) approaches require dissecting near the internal carotid artery (ICA) or require transposition of the pterygopalatine neurovascular bundle.

OBJECTIVE: To describe a novel approach to access the anterolateral aspect of the MC using a minimally invasive EE route.

METHODS: The EE transmaxillary transinferior orbital fissure approach was simulated in 10 specimens. The approach included an ethmoidectomy followed by an extended medial maxillectomy with transposition of the nasolacrimal duct. The infraorbital fissure was opened, and the infraorbital neurovascular bundle was transposed inferiorly. A quadrilateral space, bound by the maxillary nerve inferomedially, ophthalmic nerve superomedially, infraorbital nerve inferolaterally, and floor of the orbit superolaterally, was exposed. The distances from the foramen rotundum (FR) to the ICA, orbital apex (OA), and infratemporal crest (ITC) and from the OA to the ICA and ITC were measured.

RESULTS: The distances obtained were FR-ICA = 19.42 ± 2.03 mm, FR-ITC = 18.76 ± 1.75 mm, FR-OA = 8.54 ± 1.34 mm, OA-ITC = 19.78 ± 2.63 mm, and OA-ICA = 20.64 ± 142 mm. Two imaginary lines defining safety boundaries were observed between the paraclival ICA and OA, and between the OA and ITC (safety lines 1 and 2).

CONCLUSION: The reported approach provides a less invasive route compared to contemporary approaches, allowing expanded views and manipulation anteromedial and anterolateral to MC. It may be safer than the existing approaches as it does not require transposition of the ICA, infratemporal fossa, and pterygopalatine fossa, and allows access to tumors located anteriorly on the floor of the middle cranial fossa.
Functional Outcome After Resection of Von Hippel-Lindau Disease-Associated Cauda Equina Hemangioblastomas: An Observational Cohort Study
Authors: Mehta Gautam U. , Montgomery Blake K. , Maggio Dominic M. , Chittiboina Prashant , Oldfield Edward H. , Lonser Russell R.
Published: March 2017

BACKGROUND: Cauda equina hemangioblastomas in von Hippel-Lindau (VHL) disease can cause significant neurological signs and symptoms. Despite their associated morbidity, the management of these tumors remains incompletely defined.

OBJECTIVE: To determine optimal management, we analyzed the functional outcomes after resection of these tumors.

METHODS: VHL patients who underwent surgical resection of cauda equina hemangioblastomas at the National Institutes of Health and the University of Virginia were included. Clinical and radiological follow-up was performed at 6- to 12-month intervals after surgery.

RESULTS: Fifteen patients underwent 18 operations for 21 cauda equina hemangioblastomas (median follow-up 5.9 years). Patients often presented with multiple symptoms, including pain (67%), numbness (50%), urinary complaints (33%), and weakness (11%). Median preoperative tumor volume was 1.2 cm3. Four tumors at 3 operations were not resected due to a motor nerve root origin. Gross total resection was achieved in 14 surgeries (93% of operations when resection was attempted). New mild (non-function limiting) neurological symptoms were noted after 11 operations (61%), which most often (64%) resolved within 2 weeks of surgery. At 6-month follow-up, 15 patients (83%) were stable, 2 (11%) were improved, and 1 (6%) was worse. Histological analysis revealed that all tumors originated from within the involved nerve fascicle.

CONCLUSIONS: VHL-associated cauda equina hemangioblastomas have an intrafascicular origin and require interruption of the rootlet of origin for complete resection. Motor nerve root involvement may preclude complete resection but strategies including bony decompression and/or interruption of vascular supply may provide a therapeutic option. Nevertheless, most VHL patients with symptom-producing lesions improve with resection.
Investigating the Phylogenetic Range of Gibberellin Biosynthesis in Bacteria
Authors: Nagel Raimund , Peters Reuben J.
Published: March 2017

Certain plant-associated microbes can produce gibberellin (GA) phytohormones, as first described for the rice fungal pathogen Gibberella fujikuroi and, more recently, for bacteria, including several rhizobia and the rice bacterial pathogen Xanthomonas oryzae pv. oryzicola. The relevant enzymes are encoded by a biosynthetic operon that exhibits both a greater phylogenetic range and scattered distribution among plant-associated bacteria. Here, the phylogenetic distribution of this operon was investigated. To demonstrate conserved functionality, the enzymes encoded by the disparate operon from X. translucens pv. translucens, along with those from the most divergent example, found in Erwinia tracheiphila, were biochemically characterized. In both of these phytopathogens, the operon leads to production of the bioactive GA4. Based on these results, it seems that this operon is widely dedicated to GA biosynthesis. However, there is intriguing variation in the exact product. In particular, although all plant pathogens seem to produce bioactive GA4, rhizobia generally only produce the penultimate hormonal precursor GA9. This is suggested to reflect their distinct interactions with plants, because production of GA4 counteracts the jasmonic-acid-mediated defense response, reflecting the importance of wounds as the entry point for these phytopathogens, whereas such suppression presumably is detrimental in the rhizobial symbiotic relationship.
Sodium-glucose cotransporter-2 inhibitors
Authors: Ashjian Emily , Tingen Jeffrey
Published: March 2017

The number of patients with type 2 diabetes mellitus (T2DM) continues to increase in the United States. Glycemic control among patients with diabetes is important to prevent future complications, including microvascular and macrovascular disease. A novel class of medications, sodium-glucose cotransporter-2 inhibitors, presents an additional oral treatment option for patients with T2DM.
Medical Student Perceptions of Feedback and Feedback Behaviors Within the Context of the “Educational Alliance”
Authors: Bowen Lucy , Marshall Michelle , Murdoch-Eaton Deborah
Published: March 2017

Purpose

Using the “educational alliance” as a conceptual framework, the authors explored medical students’ beliefs about feedback and how their feedback behaviors reflect their perceptions.

Method

Five focus groups (four to six medical students each) at one UK medical school in 2015 were used to capture and elucidate learners’ feedback perceptions and behaviors within the context of the learner–educator relationship. A map of key feedback opportunities across the program was used as a tool for exploring student engagement with the feedback process. Qualitative data were analyzed using an approach based on grounded theory principles.

Results

Three learner feedback behaviors emerged: recognizing, using, and seeking feedback. Five core themes influencing these behaviors were generated: learner beliefs, attitudes, and perceptions; relationships; teacher attributes; mode of feedback; and learning culture. Conceptual models illustrating the relationships between the themes and each behavior were developed. Learning culture influenced all three behaviors with a wide context of influences.

Conclusions

Ensuring that feedback leads to improved performance requires more than training educators in best practices. The conceptual models support the educational alliance framework and illustrate the context and complexity of learning culture surrounding the educational relationship, learner, and feedback exchange. The educational alliance approach is underpinned by a mutual understanding of purpose and responsibility. Enhancing learners’ feedback literacy skills seems to be the key aspect of the educational alliance in need of attention. Empowering learners to recognize, seek, and use feedback received within diverse learning cultures is essential.
Age Interactions on Pain Sensitization in Patients With Severe Knee Osteoarthritis and Controls
Authors: Petersen Kristian K. , Arendt-Nielsen Lars , Finocchietti Sara , Hirata Rogerio P. , Simonsen Ole , Laursen Mogens B. , Graven-Nielsen Thomas
Published: March 2017

Objectives:

Widespread pressure hyperalgesia, facilitated temporal summation of pain (TSP), and impaired conditioned pain modulation (CPM) have been found in knee osteoarthritis (KOA) patients compared with controls and these parameters have further been suggested to be altered in the elderly. This study investigated the influence of age on pressure hyperalgesia, TSP, and CPM in patients with KOA and controls.

Materials and Methods:

One hundred thirty-three severe KOA patients and 50 age-matched and sex-matched asymptomatic controls were assessed by cuff algometry and handheld pressure algometry. Pain sensitivity was assessed around the head of the gastrocnemius muscle to identify mild pain detection threshold (MPDT) and pressure tolerance threshold (PTT). TSP was assessed by visual analogue scale scores of the pain evoked by 10 repetitive cuff stimulations. CPM was assessed as the difference in PTT before and during cuff-induced tonic arm pain. Pressure pain thresholds (PPTs) were assessed by handheld algometry at the tibialis anterior muscle. Two subgroups were analyzed in the age range below and above 65 years. Pearson correlations between age and pain parameters were applied.

Results:

Patients demonstrated reduced MPDT, PTT, and PPT (P<0.01), facilitated TSP (P<0.02), and a trend toward impaired CPM (P=0.06) compared with controls. A negative correlation was found between MPDT, PTT, and PPT and age (P<0.05) but no age-related association was found for TSP and CPM.

Discussion:

Pressure hyperalgesia was affected by age whereas dynamic pain mechanisms such as TSP and CPM were unaffected suggesting that these parameters are robust for a larger age range and reliable for long-term follow-up studies.
Sildenafil Citrate Therapy for Oligohydramnios
Authors: Maher Mohammad Ahmed , Sayyed Tarek Mohammad , Elkhouly Nabih
Published: March 2017

OBJECTIVE:

To compare sildenafil plus hydration with hydration alone in improving the amniotic fluid index and neonatal outcomes in pregnancies complicated by idiopathic oligohydramnios ( amniotic fluid index less than 5 cm without underlying maternal or fetal causes and with normal fetal growth).

METHODS:

This was an open-label randomized trial for women carrying singleton pregnancies at 30 weeks of gestation or more with idiopathic oligohydramnios detected during routine ultrasonogram. Women received either oral sildenafil citrate (25 mg every 8 hours) plus intravenous infusion of 2 L isotonic solution or fluids only until delivery. The primary study outcome was the amniotic fluid volume at 6 weeks of follow-up or the final volume before delivery, whichever occurred first. Secondary outcomes were duration of pregnancy prolongation, mode of delivery, and select neonatal outcomes. The study was powered to detect a 45% difference between groups, so, at an α level of 0.05 and 80% power, a sample size of 167 women was required.

RESULTS:

From February 24, 2015, through April 2016, 196 women were screened and 184 were randomized. Follow-up was completed in 166 (90%): 82 in the sildenafil group and 84 in the hydration group. Baseline characteristics were similar between groups. The amniotic fluid volume was higher in the sildenafil group at the final assessment (11.5 compared with 5.4 cm, P=.02). The sildenafil group delivered later (38.3 compared with 36.0 weeks of gestation, P=.001), had a lower rate of cesarean delivery (28% compared with 73%), and their neonates were less likely to be admitted to the neonatal intensive care unit (11% compared with 41%, P=.001).

CONCLUSION:

Sildenafil citrate increases amniotic fluid volume in pregnancies complicated by oligohydramnios.

CLINICAL TRIAL REGISTRATION:

ClinicalTrials.gov, www.clinicaltrials.gov, NCT02372487.
Vaginal Microbiome and Its Relationship to Behavior, Sexual Health, and Sexually Transmitted Diseases
Authors: Lewis Felicia M. T. , Bernstein Kyle T. , Aral Sevgi O.
Published: March 2017

The vaginal microbiota has great significance in maintaining vaginal health and protecting the host from disease. Recent advances in molecular techniques and informatics allow researchers to explore microbial composition in detail and to compare the structure of vaginal microbial communities with behavior and health outcomes, particularly acquisition and transmission of sexually transmitted diseases (STDs) and poor birth outcomes. Vaginal flora have been found to cluster into a limited number of communities, although community structure is dynamic. Certain community types are more associated with poor reproductive outcomes and STDs; communities dominated by Lactobacillus species, particularly Lactobacillus crispatus, are most associated with vaginal health. Modifiable and nonmodifiable factors are strongly associated with community composition, including behavior, race or ethnicity, and hygiene. In this review, we describe the state of the science on the vaginal microbiome and its relationship to behavior, sexual health, and STDs, including determinants of the microbiome that go beyond an individual level.
Empowerment Program for People With Prediabetes: A Randomized Controlled Trial
Authors: Chen Mei-Fang , Hung Shu-Ling , Chen Shu-Lin
Published: March 2017

Background:

Practicing a health-promoting lifestyle is believed to be effective for delaying or preventing the onset of diabetes. However, although empowerment interventions have proven effective for encouraging the adoption of a health-promoting lifestyle in people with diabetes, these interventions are rarely promoted to people with prediabetes.

Purpose:

The aims of this study were to develop an empowerment program for people with prediabetes and to examine its efficacy in terms of the adoption of a health-promoting lifestyle and improvements in blood sugar, body mass index, and self-efficacy.

Methods:

A randomized controlled trial was conducted between May and December 2013. A convenience sample of people with a fasting blood sugar level of 100–125 mg/dl during the previous 3 months was recruited from the health examination center of a hospital in Kaohsiung, Taiwan. Participants were assigned to either the experimental group or the control group using block randomization with a block size of 8. The experimental group (n = 38) participated in a 4-month empowerment program (the ABC empowerment program), which encouraged participants to practice a health-promoting lifestyle in three phases: awareness raising, behavior building, and results checking. The control group (n = 40) received routine clinical care. Statistical analyses included descriptive statistics, independent t test, paired t test, and generalized estimated equations.

Results:

After controlling for the differences at baseline and considering the interaction between group and time from baseline to 1 week and 3 months after completing the intervention, the generalized estimating equation showed significantly larger improvements in a health-promoting lifestyle, blood sugar, and self-efficacy in the experimental group than in the control group (p < .01). Furthermore, the experimental group achieved a larger reduction in body mass index than the control group at 3 months after completing the intervention (p = .001).

Conclusions/Implications for Practice:

The empowerment program was shown to have short-term, positive effects on behavioral, physical, and psychosocial outcomes in a Taiwan population with prediabetes. The results of this study provide a useful reference not only for healthcare personnel when implementing empowerment interventions in people with prediabetes but also for nursing educators and healthcare policymakers.
Best Practices in Management of Postpartum Pain
Authors: Fahey Jenifer O.
Published: March 2017

Pain has been documented as a major concern for women in the postpartum period. Management of postpartum pain, however, is a relatively neglected area of clinical research. As a result, evidence to support interventions to alleviate the discomforts associated with childbirth is sparse. This paucity of research on postpartum pain management is particularly surprising given that in the United States alone nearly 4 million women give birth each year. Inadequate pain relief in the hours to months following childbirth can interfere with maternal-newborn bonding and feeding and, by impeding mobility, can increase the risk of postpartum complications. In addition, pain that is not adequately managed may increase the risk of chronic pain that lasts beyond the postpartum period. In this article, the more common causes of pain following childbirth are reviewed and recommendations for pain management based on available evidence are outlined. Considerations for pain management in lactating women and for hospital discharge are discussed.
Workplace Violence and Perceptions of Safety Among Emergency Department Staff Members: Experiences, Expectations, Tolerance, Reporting, and Recommendations
Authors: Copeland Darcy , Henry Melissa
Published: March 2017

Workplace violence (WPV) is a widely recognized problem in emergency departments (EDs). The majority of WPV studies do not include nonclinical staff and do not address expectations of violence, tolerance to violence, or perceptions of safety. Among a multidisciplinary sample of ED staff members, specific study aims were to (a) describe exposure to WPV; (b) describe perceptions of safety, tolerance to violence, and expectation of violence; (c) describe reporting behaviors and perceived barriers to reporting violence; (d) examine relationships between demographic variables, experiences of violence, tolerance to violence, perceptions of safety, and reporting behaviors; and (e) identify perceptions of viable interventions to improve workplace safety. A cross-sectional design was used to survey ED staff members in a Level 1 Shock Trauma center. Eleven disciplines were represented in 147 completed surveys; 88% of respondents reported exposure to WPV in the previous 6 months. Members of every discipline reported exposure to WPV; 98% of the sample felt safe at work and 64% felt violence was an expected part of the job. Most violence was not reported, primarily because “nobody was hurt.” Emergency department staff members expected and experienced violence; nevertheless, there was a widespread perception of safety. Perceptions of safety and reasons for not reporting did not mirror previous findings. The WPV exposure is not isolated to clinical staff members and occurs even when prevention strategies are in place. The definition of WPV and the individual's interpretation of the event might preclude reporting.
Incidence, Intensity, and Impact of Pain in Recently Discharged Adult Trauma Patients: An Exploratory Study
Authors: Goldsmith Helen , Curtis Kate , McCloughen Andrea
Published: March 2017

The long-term implications of pain following injury are well known; however, the immediate posthospitalization incidence and impact of pain is less understood. Inadequate pain relief during this time can delay return to work, leading to psychological stress and chronic pain. This exploratory study aimed to identify the incidence, intensity, and impact of injury-related pain in recently discharged adult trauma patients. During July to December 2014, 82 recently discharged adult trauma patients completed a questionnaire about their injury-related pain experience approximately 2 weeks posthospital discharge from a Level 1 trauma center. The questionnaire was developed using the Brief Pain Inventory, assessing severity, and impact of pain through a score from 0 to 10. The average age of participants was 52 years, the median Injury Severity Score was 6, and almost all (n = 80, 98%) experienced a blunt injury. The majority of participants reported pain since discharge (n = 80, 98%), with 65 (81%) still experiencing pain on the day of data collection. Normal work was most affected by pain, with an average score of 6.6 of 10, closely followed by effect on general activity (6.1 of 10) and enjoyment of life (5.7 of 10). The highest pain severity was reported by those with injuries from road trauma, with low Injury Severity Scores, who were female, and did not speak English at home. Pain in the recently discharged adult trauma patient is common, intense and interferes with quality of life. Identification of barriers to effective pain management and interventions to address these barriers are required.
Life Interrupted: The Trauma Caregiver Experience
Authors: Newcomb Anna B. , Hymes Robert A.
Published: March 2017

Traumatic injury frequently leads to an abrupt change in physical and psychological functioning; informal caregivers play a significant role in the recovery process in the hospital and at home. The purpose of this study was to describe the range of stressors and burdens experienced by orthopedic trauma family caregivers in the acute care setting, as well as responses and strategies employed. Qualitative, in-depth interviews were conducted in the hospital with 12 family caregivers of severely injured orthopedic trauma patients. Interviews were audiotaped, transcribed, and analyzed to identify the range of experiences and common themes. Data were organized into 4 categories: stressors and needs; barriers; resources; and response. Stressors and barriers included the confusion and turmoil of life in the hospital, exposure to tragedy, difficulty obtaining and understanding information, and a sense that the family was not considered an integral part of the care plan. Factors influencing caregiver coping included access to the patient, provider communication, caregiver internal and external resources, and the presence of staff assisting in negotiation of the complex and unfamiliar hospital system. Understanding the caregiver experience enables nursing providers to build trust and offer effective support and guidance; caregiver-centered systems of information from admission to discharge may facilitate adaptation and improved caregiving.
Pediatric-type Follicular Lymphoma and Pediatric Nodal Marginal Zone Lymphoma: Recent Clinical, Morphologic, Immunophenotypic, and Genetic Insights
Authors: Koo Matthew , Ohgami Robert S.
Published: March 2017

Pediatric-type follicular lymphoma and pediatric nodal marginal zone lymphoma are 2 of the rarest B-cell lymphomas. Although they are both predominantly seen in children, they can manifest in the adult population as well. Our understanding of these lymphomas has advanced rapidly in recent years such that we not only have a firm grasp of the morphologic and immunophenotypic findings, but also have a deeper insight into critical genetic and molecular pathways of these diseases. This review will cover the clinical and pathologic characteristics, treatment, prognosis, and important differential diagnoses of these entities.
The Association Between Temperament and Microbiota in Healthy Individuals: A Pilot Study
Authors: Kim Hojun , Park Young-Jae
Published: March 2017

Objective

The purpose of this study was to examine whether enterotypes in the gut microbiome could be determined by clustering validity indexes and whether these enterotypes were associated with individual differences in temperament traits.

Methods

Sixty healthy Korean participants (21 men; 27.5 [8.1] years, 39 women; 34.5 [14.3] years) were asked to answer 60 temperament questions (novelty seeking, harm avoidance, reward dependence, and persistence) from the Korean version of the Temperament and Character Inventory-125. The participants' stool samples were submitted, and relative operational taxonomic units were calculated using 16S rRNA gene-based microarrays. Differences between sexes and age-related effects on the temperament and operational taxonomic unit abundances were determined, and optimal clustering numbers related to enterotypes were examined using connectivity and silhouette width (SW) indexes. Finally, the differences in temperament between enterotypes were examined.

Results

There was no significant effect of sex or age on gut microbiota and temperament scores. The hierarchical dendrogram, connectivity, and SW analysis indicated bimodal enterotypes. Bacteroidaceae were more abundant in enterotype 1 (46.24%, N = 45), whereas Prevotellaceae were more abundant in enterotype 2 (43.83%, n = 15). Among the four temperament dimensions, novelty seeking and reward dependence scores were higher in enterotype 1 (10.82 [2.99] and 8.07 [2.51] points) than in enterotype 2 (8.87 [2.42] and 5.73 [1.03] points).

Conclusions

The results suggest an association between temperament and enterotypes in healthy Korean adults. It is conceivable that this association may develop early in life as a result of biological processes catalyzed by the gut microbiota during infancy.
Novel opsin gene variation in large-bodied, diurnal lemurs
Authors: Jacobs Rachel L. , MacFie Tammie S. , Spriggs Amanda N. , Baden Andrea L. , Morelli Toni Lyn , Irwin Mitchell T. , Lawler Richard R. , Pastorini Jennifer , Mayor Mireya , Lei Runhua , Culligan Ryan , Hawkins Melissa T. R. , Kappeler Peter M. , Wright Patricia C. , Louis Edward E. , Mundy Nicholas I. , Bradley Brenda J.
Published: March 2017

Some primate populations include both trichromatic and dichromatic (red–green colour blind) individuals due to allelic variation at the X-linked opsin locus. This polymorphic trichromacy is well described in day-active New World monkeys. Less is known about colour vision in Malagasy lemurs, but, unlike New World monkeys, only some day-active lemurs are polymorphic, while others are dichromatic. The evolutionary pressures underlying these differences in lemurs are unknown, but aspects of species ecology, including variation in activity pattern, are hypothesized to play a role. Limited data on X-linked opsin variation in lemurs make such hypotheses difficult to evaluate. We provide the first detailed examination of X-linked opsin variation across a lemur clade (Indriidae). We sequenced the X-linked opsin in the most strictly diurnal and largest extant lemur,Indri indri, and nine species of smaller, generally diurnal indriids (Propithecus). Although nocturnalAvahi(sister taxon toPropithecus) lacks a polymorphism, at least eight species of diurnal indriids have two or more X-linked opsin alleles. Four rainforest-living taxa—I. indriand the three largestPropithecusspecies—have alleles not previously documented in lemurs. Moreover, we identified at least three opsin alleles inIndriwith peak spectral sensitivities similar to some New World monkeys.
Lung anatomy and histology of the extant coelacanth shed light on the loss of air-breathing during deep-water adaptation in actinistians
Authors: Cupello Camila , Meunier François J. , Herbin Marc , Clément Gaël , Brito Paulo M.
Published: March 2017

Lungs are specialized organs originated from the posterior pharyngeal cavity and considered as plesiomorphic for osteichthyans, as they are found in extant basal actinopterygians (i.e.Polypterus) and in all major groups of extant sarcopterygians. The presence of a vestigial lung in adult stages of the extant coelacanthLatimeria chalumnaeis the result of allometric growth during ontogeny, in relation with long-time adaptation to deep water. Here, we present the first detailed histological and anatomical description of the lung ofLatimeria chalumnae, providing new insights into its arrested differentiation in an air-breathing complex, mainly represented by the absence of pneumocytes and of compartmentalization in the latest ontogenetic stages.
The elastic theory of shells using geometric algebra
Authors: Gregory A. L. , Lasenby J. , Agarwal A.
Published: March 2017

We present a novel derivation of the elastic theory of shells. We use the language of geometric algebra, which allows us to express the fundamental laws in component-free form, thus aiding physical interpretation. It also provides the tools to express equations in an arbitrary coordinate system, which enhances their usefulness. The role of moments and angular velocity, and the apparent use by previous authors of an unphysical angular velocity, has been clarified through the use of a bivector representation. In the linearized theory, clarification of previous coordinate conventions which have been the cause of confusion is provided, and the introduction of prior strain into the linearized theory of shells is made possible.
Heterogeneous resource allocation can change social hierarchy in public goods games
Authors: Meloni Sandro , Xia Cheng-Yi , Moreno Yamir
Published: March 2017

Public goods games (PGGs) represent one of the most useful tools to study group interactions. However, even if they could provide an explanation for the emergence and stability of cooperation in modern societies, they are not able to reproduce some key features observed in social and economical interactions. The typical shape of wealth distribution—known as Pareto Law—and the microscopic organization of wealth production are two of them. Here, we introduce a modification to the classical formulation of PGGs that allows for the emergence of both of these features from first principles. Unlike traditional PGGs, where players contribute equally to all the games in which they participate, we allow individuals to redistribute their contribution according to what they earned in previous rounds. Results from numerical simulations show that not only a Pareto distribution for the pay-offs naturally emerges but also that if players do not invest enough in one round they can act as defectors even if they are formally cooperators. Our results not only give an explanation for wealth heterogeneity observed in real data but also point to a conceptual change on cooperation in collective dilemmas.