bluuebunny/crossref_metadata_2025 huggingface dataset:
Using powerful data from the interRAI MDS to support care and a learning health system: A case study from long-term care
Authors: Dash Darly , Heckman George A. , Boscart Veronique M. , Costa Andrew P. , Killingbeck Jaimie , d’Avernas Josie R.
Published: June 2018

interRAI is a non-profit international consortium of clinicians and scientists who have developed the Minimum Data Set (MDS) 2.0 assessment to systematically identify the health status and care plan of residents in Long-Term Care (LTC). However, LTC staff often fail to realize the clinical utility of this information, viewing it as “data collection for funding purposes” and an administrative task adding to the daily workload. This article reports how one research institute and senior living organization work together to use MDS 2.0 and other information to support better care for residents, plan resource allocation and staffing models, and conduct applied research for older Canadians. A multi-level approach is described on how MDS 2.0 provides a robust infrastructure at the individual, team, organizational, and system levels. Long-term care stakeholders can do much more to unleash the full potential of this powerful tool, and other healthcare sectors can take advantage of this approach.
For Whom the Bell Tolls: A Special Journal Issue on Smoking Control and an Interview With Dr Harry Lando
Authors: Terry Paul E.
Published: June 2018

Opioid addiction has been cast as a “disease of despair.”1 I agree, but I wonder still: If tobacco and opioids were on a spectrum relative to the relief they provide from social, emotional, financial, and other sources of pain in the lives of the disenfranchised, could it be that they are indeed 2 sides of the same coin? For individuals in despair, pain relief is a complicit actor in what will become pleasure seeking and, for smokers, vice versa. Every year, almost as many people are dying by incidentally being near smokers as are dying by accidentally overdosing. Our opioid epidemic has been declared a national public health emergency, though the annual death toll from tobacco is 10 times greater. How should we reconcile this? As is extraordinarily represented in my interview with Dr Harry Lando and as is evident from the range of articles on tobacco control in this special issue, tobacco addiction research draws from every corner of psychology, sociology, philosophy, and other disciplines intent on understanding the human condition.
A pointing error analysis model for large reflector antennas under wind disturbance
Authors: Zhang Jie , Huang Jin , Zhao Pengbing , Liang Wei , Zhang Youran , Wang Congsi
Published: June 2018

Large reflector antennas have been widely used in extensive researches, including satellite communications, detection of gravitational waves, origin of galaxies, and so on. With increasing in the diameter and the working frequency of these antennas, the requirement for pointing accuracy becomes more demanding simultaneously. However, wind disturbance has serious impacts on the pointing accuracy of antennas, which makes it be a severe challenge to the development of large antennas. To reduce the influence of wind disturbances on pointing accuracy, it is important to construct an accurate model for estimating the pointing error caused by wind. The traditional modeling method focuses on treating the wind disturbance as a torque on the motor output, whilst ignoring the oscillations of flexible structures caused by the wind pressure, so the pointing error caused by structural deformation cannot be estimated which lead to a limitation of compensation effect. In this article, based on an entire working condition dynamic model (EWCDM), a pointing error analytical model is proposed to estimate the pointing error caused by deformation of the antenna structure. A series of simulations and tests are carried out on an antenna with a diameter of 7.3 m. The results prove the feasibility of the proposed model.
Dynamic cutting force prediction for micro end milling considering tool vibrations and run-out
Authors: Zhang Xuewei , Yu Tianbiao , Wang Wanshan
Published: June 2018

An accurate prediction of cutting forces in the micro end milling, which is affected by many factors, is the basis for increasing the machining productivity and selecting optimal cutting parameters. This paper develops a dynamic cutting force model in the micro end milling taking into account tool vibrations and run-out. The influence of tool run-out is integrated with the trochoidal trajectory of tooth and the size effect of cutting edge radius into the static undeformed chip thickness. Meanwhile, the real-time tool vibrations are obtained from differential motion equations with the measured modal parameters, in which the process damping effect is superposed as feedback on the undeformed chip thickness. The proposed dynamic cutting force model has been experimentally validated in the micro end milling process of the Al6061 workpiece. The tool run-out parameters and cutting forces coefficients can be identified on the basis of the measured cutting forces. Compared with the traditional model without tool vibrations and run-out, the predicted and measured cutting forces in the micro end milling process show closer agreement when considering tool vibrations and run-out.
Quantification of vertical free moment induced by the human foot–ankle complex during axial loading
Authors: Seki Hiroyuki , Nagura Takeo , Suda Yasunori , Ogihara Naomichi , Ito Kohta , Niki Yasuo , Matsumoto Morio , Nakamura Masaya
Published: June 2018

Axial loading of the human cadaver lower leg is known to generate eversion of the calcaneus and internal rotation of the tibia if the plantar surface of the foot does not slide on the floor. Such kinematic coupling between calcaneal eversion and internal tibial rotation has been described previously, but no studies have actually quantified the innate ability of the human foot to generate ground reaction moment around the vertical axis of the floor (vertical free moment) due to axial loading of the human cadaver lower leg. This study investigated the vertical free moment generated by eight cadaveric lower leg specimens loaded vertically with traction of the Achilles’ tendon using a six-component force plate. The vertical free moments in all specimens were oriented toward the direction of internal rotation, and the mean magnitude of the vertical free moments was −1.66 N m when an axial load of 450 N was applied. A relatively large ground reaction moment can be applied to the body during walking due to the innate structural mobility of the foot. The structurally embedded capacity of the human foot to generate the vertical free moment may facilitate compensation of the moment generated around the vertical axis of the body during walking due to trunk rotation and leg swing.
Arash: A social robot buddy to support children with cancer in a hospital environment
Authors: Meghdari Ali , Shariati Azadeh , Alemi Minoo , Vossoughi Gholamreza R , Eydi Abdollah , Ahmadi Ehsan , Mozafari Behrad , Amoozandeh Nobaveh Ali , Tahami Reza
Published: June 2018

This article presents the thorough design procedure, specifications, and performance of a mobile social robot friend Arash for educational and therapeutic involvement of children with cancer based on their interests and needs. Our research focuses on employing Arash in a pediatric hospital environment to entertain, assist, and educate children with cancer who suffer from physical pain caused by both the disease and its treatment process. Since cancer treatment causes emotional distress, which can reduce the efficiency of medications, using social robots to interact with children with cancer in a hospital environment could decrease this distress, thereby improving the effectiveness of their treatment. Arash is a 15 degree-of-freedom low-cost humanoid mobile robot buddy, carefully designed with appropriate measures and developed to interact with children ages 5–12 years old. The robot has five physical subsystems: the head, arms, torso, waist, and mobile-platform. The robot’s final appearance is a significant novel concept; since it was selected based on a survey taken from 50 children with chronic diseases at three pediatric hospitals in Tehran, Iran. Founded on these measures and desires, Arash was designed, built, improved, and enhanced to operate successfully in pediatric cancer hospitals. Two experiments were devised to evaluate the children’s level of acceptance and involvement with the robot, assess their feelings about it, and measure how much the robot was similar to the favored conceptual sketch. Both experiments were conducted in the form of storytelling and appearance/performance evaluations. The obtained results confirm high engagement and interest of pediatric cancer patients with the constructed robot.
The application of resilience concepts in palaeoecology
Authors: Davies Althea L , Streeter Richard , Lawson Ian T , Roucoux Katherine H , Hiles William
Published: June 2018

The concept of resilience has become increasingly important in ecological and socio-ecological literature. With its focus on the temporal behaviour of ecosystems, palaeoecology has an important role to play in developing a scientific understanding of ecological resilience. We provide a critical review of the ways in which resilience is being addressed by palaeoecologists. We review ~180 papers, identifying the definitions or conceptualisations of ‘resilience’ that they use, and analysing the ways in which palaeoecology is contributing to our understanding of ecological resilience. We identify three key areas for further development. First, the term ‘resilience’ is frequently defined too broadly to be meaningful without further qualification. In particular, palaeoecologists need to distinguish between ‘press’ vs ‘pulse’ disturbances, and ‘ecological’ vs ‘engineering’ resilience. Palaeoecologists are well placed to critically assess the extent to which these dichotomies apply in real (rather than theoretical) ecosystems, where climate and other environmental parameters are constantly changing. Second, defining a formal ‘response model’ – a statement of the anticipated relationships between proxies, disturbances and resilience properties – can help to clarify arguments, especially inferred causal links, since the difficulty of proving causation is a fundamental limitation of palaeoecology for understanding ecosystem drivers and responses. Third, there is a need for critical analysis of the role of scale in ecosystem resilience. Different palaeoenvironmental proxies are differently able to address the various temporal and spatial scales of ecological change, and these limitations, as well as methodological constraints on inherently noisy proxy data, need to be explored and addressed.
Induced Pluripotent Stem Cells
Authors: Chang Chia-Yu , Ting Hsiao-Chien , Liu Ching-Ann , Su Hong-Lin , Chiou Tzyy-Wen , Harn Horng-Jyh , Lin Shinn-Zong
Published: June 2018

Many neurodegenerative diseases are progressive, complex diseases without clear mechanisms or effective treatments. To study the mechanisms underlying these diseases and to develop treatment strategies, a reliable in vitro modeling system is critical. Induced pluripotent stem cells (iPSCs) have the ability to self-renew and possess the differentiation potential to become any kind of adult cell; thus, they may serve as a powerful material for disease modeling. Indeed, patient cell-derived iPSCs can differentiate into specific cell lineages that display the appropriate disease phenotypes and vulnerabilities. In this review, we highlight neuronal differentiation methods and the current development of iPSC-based neurodegenerative disease modeling tools for mechanism study and drug screening, with a discussion of the challenges and future inspiration for application.
The relationship between musical training and musical empathizing and systemizing traits
Authors: Dahary Hadas , Palma Fernandes Tania , Quintin Eve-Marie
Published: June 2018

Although individual differences in engagement with and response to music are well documented, little is known about variations in musical empathizing and systemizing (E-S) traits and their relation to musical sophistication, including musical training. The current study examines the relationship between musical and general (non-musical) E-S traits and how musical sophistication and specific aspects of musical training are related to musical E-S traits. A total of 81 respondents reported on their level of musical sophistication and training (e.g., musical abilities, formal training, and engagement in musical activities) and endorsement of musical and general E-S traits. Participants were asked to complete the Goldsmiths Musical Sophistication Index (musical sophistication and training), the Empathizing and Systemizing quotients (general, non-musical E-S traits), and the Musical Empathizing and Systemizing inventory (musical E-S traits). Results suggest that general E-S traits are related to musical E-S traits and that musical sophistication, including but not limited to formal training, is positively associated with musical E-S traits. Furthermore, greater music training, as measured by the number of instruments played and years of formal instrumental and theory training, is related to greater endorsement of E-S traits. This study provides grounds for assessing the link between musical sophistication and training and musical E-S traits within clinical populations that have atypicalities in empathizing (e.g., autism spectrum disorder).
Individual training and employees’ cooperative behavior: Evidence from a contextualized laboratory experiment
Authors: van Gerwen Nikki , Buskens Vincent , van der Lippe Tanja
Published: June 2018

Employers are constantly seeking to improve employee performance by means of investing in employee training. The results of training are to a large extent dependent on employees’ willingness to behave productively in a cooperative manner. Yet, systematic evidence investigating the causal relation between training and employees’ cooperative behavior is rare. Here, we present results from a contextualized laboratory experiment in which subjects, who differ in terms of training participation, were asked to contribute resources to a team effort. We conclude that training promotes cooperative behavior, that is, voluntary contributions made to the team effort, in teams of employees working together for short periods of time. Training enhances cooperative behavior the most when provided to the higher skilled subjects. We also find that members in more stable teams act very cooperatively under all conditions, but their contributions do not increase further with training.
An effective cell-based smoothed finite element model for the transient responses of magneto-electro-elastic structures
Authors: Zhou Liming , Li Ming , Meng Guangwei , Zhao Hongwei
Published: June 2018

To overcome the over-stiffness and the imprecise magneto-electro-elastic coupling effects of finite element model, we presented a cell-based smoothed finite element model to more accurately simulate the transient responses of magneto-electro-elastic structures. In the cell-based smoothed finite element model, the gradient smoothing technique was introduced into a magneto-electro-elastic multi-physical-field finite element model. The cell-based smoothed finite element model can achieve a close-to-exact stiffness of the continuum structures which could automatically discrete elements for complicated regions more readily and thus remarkably reduced the numerical errors. In addition, the modified Wilson- θ method was presented for solving the motion equation of magneto-electro-elastic structures. Several numerical examples were investigated and exhibited that the cell-based smoothed finite element model could receive more accurate and reliable simulation results than the standard finite element model. Besides, the cell-based smoothed finite element model was employed to calculate transient responses of magneto-electro-elastic sensor and typical micro-electro-mechanical systems–based magneto-electro-elastic energy harvester. Therefore, the cell-based smoothed finite element model can be adopted to tackle the practical magneto-electro-elastic problems such as smart vibration transducers, magnetic field sensors, and energy harvester devices in intelligent magneto-electro-elastic structures systems.
Listening to Patients’ Voices: Workarounds Patients Use to Construct Pain Intensity Ratings
Authors: Dannecker Erin A. , Warne-Griggs Melissa D. , Royse Lisa A. , Hoffman Kimberly G.
Published: June 2018

This study analyzed patients’ perspectives about a measure of current, usual, and extreme pain and a measure of activity-related pain. Thirty-one patients with osteoarthritis participated in focus groups. Researchers completed thematic analysis of transcripts using coding software and an inductive approach. Three emerging themes were that many factors affected patients’ perceptions and ratings of pain intensity, patients used different approaches to construct pain ratings, and patients interpreted maximal response anchors differently. Particularly, novel findings were that patients evaluated pain fluctuation, location, duration, and quality when constructing pain intensity ratings. Also, activity items helped patients to remember pain and provided a valued context for communicating pain experiences. However, the activities needed to be sufficiently described and personally relevant. These findings further clarify the challenges patients face and the workarounds they use when rating pain intensity. The patients’ suggestions for improved administration methods and items warrant future investigation.
Online Communication Settings and the Qualitative Research Process: Acclimating Students and Novice Researchers
Authors: Gregory Katherine
Published: June 2018

In the last 20 years, qualitative research scholars have begun to interrogate methodological and analytic issues concerning online research settings as both data sources and instruments for digital methods. This article examines the adaptation of parts of a qualitative research curriculum for understanding online communication settings. I propose methodological best practices for researchers and educators that I developed while teaching research methods to undergraduate and graduate students across disciplinary departments and discuss obstacles faced during my own research while gathering data from online sources. This article confronts issues concerning the disembodied aspects of applying what in practice should be rooted in a humanistic inquiry. Furthermore, as some approaches to online qualitative research as a digital method grow increasingly problematic with the development of new data mining technologies, I will also briefly touch upon borderline ethical practices involving data-scraping-based qualitative research.
When Clock Time Governs Interaction: How Time Influences Health Professionals’ Intersectoral Collaboration
Authors: Bendix Andersen Anne , Beedholm Kirsten , Kolbæk Raymond , Frederiksen Kirsten
Published: June 2018

When setting up patient pathways that cross health care sectors, professionals in emergency units strive to fulfill system requirements by creating efficient patient pathways that comply with standards for length of stay. We conducted an ethnographic field study, focusing on health professionals’ collaboration, of 10 elderly patients with chronic illnesses, following them from discharge to their home or other places where they received health care services. We found that clock time not only governed the professionals’ ways of collaborating, but acceleration of patient pathways also became an overall goal in health care delivery. Professionals’ efforts to save time came to represent a “monetary value,” leading to speedier planning of patient pathways and consequent risks of disregarding important issues when treating and caring for elderly patients. We suggest that such issues are significant to the future planning and improvement of patient pathways that involve elderly citizens who are in need of intersectoral health care delivery.
Deaf Qualitative Health Research: Leveraging Technology to Conduct Linguistically and Sociopolitically Appropriate Methods of Inquiry
Authors: Anderson Melissa L. , Riker Timothy , Gagne Kurt , Hakulin Stephanie , Higgins Todd , Meehan Jonah , Stout Elizabeth , Pici-D’Ottavio Emma , Cappetta Kelsey , Wolf Craig Kelly S.
Published: June 2018

One of the most understudied health disparity populations in the United States is the Deaf community—a sociolinguistic minority group of at least 500,000 individuals who communicate using American Sign Language. Research within this population is lacking, in part, due to researchers’ use of methodologies that are inaccessible to Deaf sign language users. Traditional qualitative methods were developed to collect and analyze participants’ spoken language. There is, therefore, a paradigm shift that must occur to move from an auditory data schema to one that prioritizes the collection and analysis of visual data. To effectively navigate this shift when working with Deaf sign language users, there are unique linguistic and sociopolitical considerations that should be taken into account. The current article explores these considerations and outlines an emerging method of conducting qualitative analysis that, we argue, has the potential to enhance qualitative researchers’ work regardless of the population of focus.
Varieties of Hope Among Family Caregivers of Patients With Lymphoma
Authors: Fu Fang , Chen Yan-Yan , Li Quanyu , Zhu Fuzhong
Published: June 2018

In this study, 16 family caregivers of patients with lymphoma were interviewed on their changing perceptions of hope. The changing process starts from diagnosis to the present treatment state. We found that the changing perception of hope can be divided into three stages: the stage of generalized hope focusing merely on treatment and passive hope focusing on harm-avoidance, the stage of specified hope and active hope aiming at comfort-seeking, and the stage of multifaceted hope. Family caregivers’ understanding of the past experience of and new information on the disease are the foundation of the perception of hope. The perception of hope in cancer patients’ family caregivers develops from “therapeutic hope” to “psychosocial hope,” shifting from “consequential hope” to “procedural hope.”
Embodied Cognitive Robotics and the learning of sensorimotor schemes
Authors: Lara Bruno , Astorga Dadai , Mendoza-Bock Emmanuel , Pardo Manuel , Escobar Esaú , Ciria Alejandra
Published: June 2018

Embodied Cognitive Robotics focuses its attention on the design of artificial agents capable of performing cognitive tasks autonomously. A central issue in this consists in studying process by which agents learn through interaction with their environment. Embodied Cognitive Robotics aims to implement models of cognitive processes coming from Cognitive Sciences. The guidelines in this research area are a direct response to the shortcomings of Classical Artificial Intelligence, where high-level tasks and behaviors were studied. This article describes the work carried out in the Cognitive Robotics Laboratory at the Universidad Autónoma del Estado de Morelos (UAEM). Our work is based on the concept of low-level sensorimotor schemes coded by Internal Models, thus falling as a matter of course within the tenets of Embodied Cognition, particularly with the idea that cognition must be understood as occurring in agents that have a body with which they interact in a specific environment. It is through this interaction that learning emerges laying the ground for cognitive processes. Our research includes theoretical work laying the foundations of Embodied Cognitive Robotics, as well as work with artificial and with natural agents.
Inhaled Epoprostenol Through Noninvasive Routes of Ventilator Support Systems
Authors: Ammar Mahmoud A. , Sasidhar Madhu , Lam Simon W.
Published: June 2018

Background: The administration of inhaled epoprostenol (iEPO) through noninvasive routes of ventilator support systems has never been previously evaluated. Objective: Describe the use of iEPO when administered through noninvasive routes of ventilator support systems. Methods: Critically ill patients admitted to the intensive care unit who received iEPO through noninvasive routes were analyzed. Improvements in respiratory status and hemodynamic parameters were evaluated. Safety end points assessed included hypotension, rebound hypoxemia, significant bleeding, and thrombocytopenia. Results: A total of 36 patients received iEPO through noninvasive routes: high-flow oxygen therapy through nasal cannula, n = 29 (81%) and noninvasive positive-pressure ventilation, n = 7 (19%). Sixteen patients had improvement in their respiratory status: mean decrease in fraction of inspired oxygen (FiO2), 20% ± 13%; mean increase in partial pressure of arterial oxygen to FiO2 (PaO2/FiO2) ratio, 60 ± 50 mm Hg; and mean decrease in HFNC oxygen flow rate, 6 ± 3 liters per minute (LPM). Eight patients had declines in their respiratory status (mean increase in FiO2, 30% ± 20%; mean decrease in PaO2/FiO2 ratio, 38 ± 20 mm Hg; and mean increase in HFNC oxygen flow rate, 15 ± 10 LPM), and 12 patients had no change in their respiratory status. Conclusion and Relevance: This represents the first evaluation of the administration of iEPO through noninvasive routes of ventilator support systems and demonstrates that in critically ill patients, iEPO could be administered through a noninvasive route. Further evaluation is needed to determine the extent of benefit with this route of administration.
Calcifying Odontogenic Cyst Associated With Dentigerous Cyst in a 15-Year-Old Girl
Authors: Aristizabal Arboleda Paola , Sánchez-Romero Celeste , de Almeida Oslei Paes , Flores Alvarado Sergio A. , Martínez Pedraza Ricardo
Published: June 2018

Calcifying odontogenic cyst (COC) is a rare odontogenic cyst with ameloblastic epithelial lining containing clusters of ghost cells. COCs have been described in association with several odontogenic tumors, more commonly odontomas and rarely with dentigerous cyst (DC). In this article, we describe a case of COC associated with DC in a 15-year-old girl, who presented with a swelling on the right middle third of the face, producing facial asymmetry. Panoramic radiography showed a well-circumscribed, corticated, and unilocular radiolucency at the level of the right maxillary sinus, involving 2 unerupted premolars. The lesion was enucleated and histologically revealed a COC associated with DC, which presented mucous metaplasia. Immunohistochemical reactions were performed to better illustrate this rare synchronous occurrence of COC and DC, showing positivity for CK5, CK14, CK19, and p63 in both lesions. CK18 was negative in COC, and Bcl-2 was negative in DC. Periodic acid Schiff highlighted the mucous cells in the DC lining.
“Everybody’s Really Close-Knit”: Disconnections Between Helping Victims of Intimate Partner Violence and More General Helping in Rural Communities
Authors: Banyard Victoria L. , Edwards Katie M. , Moschella Elizabeth A. , Seavey Katherine M.
Published: June 2018

Social support is key to well-being for victims of intimate partner violence (IPV), and bystanders have an important role to play in preventing IPV by taking action when there is risk for violence. The current study used qualitative interviews to explore young adults’ perspectives on helping in situations of IPV, and more general helping, in the rural communities in which they resided. Participants were 74 individuals between the ages of 18 and 24 years from 16 rural counties across the eastern United States. Participants generally described their communities as close-knit and helpful, especially around daily hassles (e.g., broken down car) and unusual circumstances (e.g., house fire). Although participants generated ways in which community members help IPV victims, these mostly focused on providing support or taking action in the aftermath of IPV as opposed to more preventive actions. Lack of financial resources were uniquely cited as a barrier to more general helping, whereas concerns about privacy and lack of deservingness of help were barriers to both general helping and helping in IPV situations, although these were more pronounced in IPV situations than general helping situations. Taken together, these results suggest that although people generally see their communities as helpful and close-knit, these perceptions and scripts did not necessarily translate to helping in situations of IPV. Bystander intervention programs are needed that provide more specific helping scripts for IPV.
Granulocyte colony-stimulating factor utilization postautologous hematopoietic stem cell transplant in multiple myeloma patients: Does one size fit all?
Authors: Jackson Emily R , Jared Jason R , Piccolo Jennifer K , Woo Kaitlin M , Mably Mary S , Reed Michael P , Callander Natalie S
Published: June 2018

Purpose

To evaluate a single institution’s experience with granulocyte colony-stimulating factor after autologous hematopoietic stem cell transplant in myeloma patients to identify populations that benefit most from granulocyte colony-stimulating factor administration.

Methods

Retrospective chart reviews were conducted on patients 18+ years with multiple myeloma that underwent autologous hematopoietic stem cell transplant at UW Health from January 2012 to May 2016. Data collection included demographics, length of stay, time to engraftment, Eastern Cooperative Oncology Group performance status score, and hematopoietic cell transplantation-comorbidity index. The primary outcome was days from transplant to engraftment, defined as absolute neutrophil count  > 500/mm3 for two consecutive days or absolute neutrophil count > 1000/mm3 once. A subset analysis was performed on patients whose date of engraftment was known.

Results

In total, 216 individual patients were included in the full cohort and 122 patients included in the subset analysis. Median time to engraftment between patients administered granulocyte colony-stimulating factor and the nongranulocyte colony-stimulating factor group was 12 versus 19 days (P < 0.001) in the full cohort and 12 versus 14 days (P < 0.001) in the subset analysis. The average length of stay posthematopoietic stem cell transplant in the granulocyte colony-stimulating factor group was 15 days versus 17 days in the nongranulocyte colony-stimulating factor group (P = 0.026) in the subset analysis. Additionally, no difference in time to engraftment was seen when stratified by age, Eastern Cooperative Oncology Group performance status score, or hematopoietic cell transplantation-comorbidity index.

Conclusion

Our study supports use of granulocyte colony-stimulating factor posthematopoietic stem cell transplant in myeloma patients to decrease time to engraftment and length of stay. Consideration should be given to utilization in all patients in this population posthematopoietic stem cell transplant. Further research is needed to identify the populations that benefit most from granulocyte colony-stimulating factor administration.
Clinical pharmacists’ contributions to hematopoietic stem cell transplantation: A systematic review
Authors: Barboza-Zanetti Maria Olívia , Barboza-Zanetti Ariane Cristina , Rodrigues-Abjaude Samir Antonio , Pinto-Simões Belinda , Leira-Pereira Leonardo Régis
Published: June 2018

Aims

The goal of the present review was to identify studies that assess how pharmaceutical services contribute to hematopoietic stem cell transplantation (HSCT).

Methods

We conducted a systematic literature review of published studies describing results from clinical services provided by pharmacists working with HSCT, conducted according to PRISMA guidelines ( PROSPERO registration number CRD42017062391). A search strategy was applied within PubMed, CENTRAL, EMBASE, SCOPUS, and LILACS databases in April 2017. Inclusion criteria were observational or experimental studies that addressed the following research question: “What are a clinical pharmacist’s main contributions to HSCT?” The quality of selected studies was evaluated using the Downs and Black checklist.

Results

We identified 1838 studies, and seven were included in the systematic review. The results indicated that clinical pharmacy is useful during HSCT treatment within both inpatient and outpatient settings. Pharmaceutical contributions identified included management of pharmacotherapy-related problems, participation in discussions with clinical teams, drug reconciliation, patient and team education regarding pharmacotherapy, preparation of guidelines and educational materials, and evaluation of medication adherence. These activities favored the control and prevention of pharmacotherapy-related problems, the maintenance of immunosuppressive serum levels, improvement in patients’ clinical and nutritional status, facilitated medication adherence, and provided economic and humanistic gains.

Conclusions

Despite the small number of articles discussing the topic under analysis, the results were unanimous in confirming the positive impact of pharmacists’ contributions to clinical practice for HSCT.
Comparative Assessment on Mechanism Underlying Renal Toxicity of Commercial Formulation of Roundup Herbicide and Glyphosate Alone in Male Albino Rat
Authors: Dedeke Gabriel A. , Owagboriaye Folarin O. , Ademolu Kehinde O. , Olujimi Olanrewaju O. , Aladesida Adeyinka A.
Published: June 2018

There have been major concerns that the nephrotoxicity of commercial formulations of Roundup herbicide is due to the active ingredient glyphosate. We therefore investigated and compared the mechanisms underlining the nephrotoxicity of Roundup herbicide and glyphosate alone in rat. Fifty-six adult male rats randomized into 7 groups of 8 rats per group were exposed to Roundup formulation and glyphosate alone daily by gavage at 3.6, 50.4, and 248.4 mg/kg body weight (bw) of glyphosate concentrations for 12 weeks with distilled water administered to the control group. Kidney biomarker (serum urea and creatinine, plasma cystatin-C, and neutrophil gelatinase-associated lipocalin), oxidative stress indices in the kidney tissue, activities of kidney membrane-bound enzymes (Mg-adenosine triphosphatase [ATPase], Ca-ATPase, Na/K-ATPase, and total ATPase), and histopathological changes in the kidney were monitored. Glyphosate concentration in the kidney was quantified by high-performance liquid chromatography with ultraviolet detection. Significant ( P < 0.05) alterations in the levels of the kidney biomarker, oxidative stress markers, and membrane-bound enzymes were observed in the rats exposed to Roundup compared to the rats exposed to glyphosate alone. Rats exposed to Roundup accumulated more glyphosate residue in their kidney tissue. Severe histopathological lesions were only seen in the kidneys of rats exposed to Roundup. The nephrotoxicity observed cannot be due to the active ingredient in the Roundup formulation, as glyphosate alone has virtually no effect on the renal function of the exposed animals. Therefore, the general claim attributing nephrotoxicity of a glyphosate-based herbicide to its active ingredient should be discouraged.
Gastrointestinal Diaphragm Disease With Retained Capsule Endoscope, Associated With Crohn’s Disease: A Case Report
Authors: Cubero Rego David , Qualia Cary M , Chismark A David , Strait Lauren , Lee Hwajeong
Published: June 2018

Gastrointestinal diaphragm disease is a rare entity characterized by the formation of thin membranous circumferential mucosal septa, resulting in marked narrowing of the intestinal lumen. The most frequent etiology is the chronic use of nonsteroidal anti-inflammatory drugs (NSAIDs). Idiopathic cases and other possible etiologies have been reported. We present a rare association of diaphragm disease with Crohn’s disease in a boy without a history of significant NSAID usage.
The predictive value of magnetic resonance imaging of retinoblastoma for the likelihood of high-risk pathologic features
Authors: Hiasat Jamila G , Saleh Alaa , Al-Hussaini Maysa , Al Nawaiseh Ibrahim , Mehyar Mustafa , Qandeel Monther , Mohammad Mona , Deebajah Rasha , Sultan Iyad , Jaradat Imad , Mansour Asem , Yousef Yacoub A
Published: June 2018

Purpose:

To evaluate the predictive value of magnetic resonance imaging in retinoblastoma for the likelihood of high-risk pathologic features.

Methods:

A retrospective study of 64 eyes enucleated from 60 retinoblastoma patients. Contrast-enhanced magnetic resonance imaging was performed before enucleation. Main outcome measures included demographics, laterality, accuracy, sensitivity, and specificity of magnetic resonance imaging in detecting high-risk pathologic features.

Results:

Optic nerve invasion and choroidal invasion were seen microscopically in 34 (53%) and 28 (44%) eyes, respectively, while they were detected in magnetic resonance imaging in 22 (34%) and 15 (23%) eyes, respectively. The accuracy of magnetic resonance imaging in detecting prelaminar invasion was 77% (sensitivity 89%, specificity 98%), 56% for laminar invasion (sensitivity 27%, specificity 94%), 84% for postlaminar invasion (sensitivity 42%, specificity 98%), and 100% for optic cut edge invasion (sensitivity100%, specificity 100%). The accuracy of magnetic resonance imaging in detecting focal choroidal invasion was 48% (sensitivity 33%, specificity 97%), and 84% for massive choroidal invasion (sensitivity 53%, specificity 98%), and the accuracy in detecting extrascleral extension was 96% (sensitivity 67%, specificity 98%).

Conclusions and relevance:

Magnetic resonance imaging should not be the only method to stratify patients at high risk from those who are not, eventhough it can predict with high accuracy extensive postlaminar optic nerve invasion, massive choroidal invasion, and extrascleral tumor extension.
Risk factors for conversion surgery to total hip arthroplasty of a hemiarthroplasty performed for a femoral neck fracture
Authors: Grosso Matthew J. , Danoff Jonathan R. , Thacher Ryan , Murtaugh Taylor S. , Hickernell Thomas R. , Shah Roshan P. , Macaulay William
Published: June 2018

Introduction:

The purpose of this study was to determine risk factors for conversion to total hip arthroplasty (THA) in patients originally treated with hemiarthroplasty (HA) for displaced femoral neck fractures.

Methods:

In this case-controlled study, we identified 54 patients who were treated with HA for femoral neck fracture (FNF) who subsequently underwent conversion to THA at our institution between 2003 and 2013. We randomly selected 142 control patients who underwent HA for a displaced FNF without conversion surgery during the same time period. We compared demographic data, implant parameters, and radiographic data between the groups to identify risk factors for conversion surgery.

Results:

In the univariate analysis, younger age at index surgery (mean 75 vs. 80 years, p = 0.006), higher body mass index (26.1 vs. 23.7, p = 0.031), bipolar prosthesis (20% vs. 36%, p = 0.024), absence of dementia (6% vs. 23%, p = 0.01), increased leg length compared to contralateral limb (6.5 mm vs. 0.2 mm, p<0.001), and increased HA femoral head size compared to the contralateral femoral head (2.7 mm vs. 1.5 mm, p = 0.02) were associated with a significantly increased risk of conversion surgery. In the multivariate logistic regression, decreased age at index surgery, no dementia, use of a bipolar head, and increased leg length discrepancy (LLD) were associated with risk of conversion.

Conclusions:

Patient characteristics, including younger age, increased BMI, and absence of dementia can lead to increased risk for conversion of HA to THA. Intraoperative considerations of head size and increase in ipsilateral LLD may increase the risk of conversion surgery. These factors should be considered by surgeons who employ HA for displaced FNFs.
Outcomes and mortality after hip fractures treated in Kazakhstan
Authors: Amrayev Sultan , AbuJazar Ussama , Stucinskas Justinas , Smailys Alfredas , Tarasevicius Sarunas
Published: June 2018

Introduction:

Patients with hip fractures are usually treated operatively in Western Europe. However, in Mid-Asia different indications are used to decide whether this patient is suitable for operative treatment and those are related to specific traditions and rules in hospital. Thus, traditions and surgeon/patient fears seem to affect treatment choices in hip fractures and subsequent outcomes. The aim of our study was to investigate patients with hip fractures and compare outcome at 1-year follow-up in the operated and nonoperated patient groups.

Methods:

All patients over 50 years old who sustained a hip fracture, between January 2014 and December 2014, were included. Patients were assessed preoperatively and at 1-year follow-up, using questionnaires from National Swedish Hip Fracture Register and quality of life (Euroqol EQ-5D).

Results:

Out of 398 included patients, 299 were operated on and 99 were not. 344 patients remained for our analysis before the end of 1-year follow-up. 51 patients (65%) deceased in the nonoperated group as compared to 55 (21%) in the operated group, p<0.001. Out of 27 patients in the nonoperated group hip function was evaluated at 1-year follow-up, 11 (41%) were walking independently or using 1 stick, as compared to 192 (91%) in the operated group.

Conclusions:

We conclude that nonoperative treatment of hip fracture patients is associated with higher mortality and worse functional outcome as compared to those who were treated operatively. We therefore advocate operative treatment of the hip fracture in the vast majority of cases.
Effect of periarticular morphine injection for total hip arthroplasty: a randomised, double-blind trial
Authors: Iwakiri Kentaro , Ohta Yoichi , Minoda Yukihide , Kobayashi Akio , Nakamura Hiroaki
Published: June 2018

Background:

The periarticular multimodal cocktail injection is currently commonly used to treat postoperative pain after total hip arthroplasty (THA). Despite its analgesic effect, it is frequently reported to cause nausea and vomiting, which are adverse effects of opioids. This study aimed to assess the efficacy of morphine as a component of a multimodal cocktail injection for providing postoperative analgesia and alleviating swelling in patients who underwent THA.

Materials and methods:

This was a prospective, single-centre, randomised controlled trial involving 100 patients scheduled for unilateral THA. A mixture of steroids, local anaesthetics, NSAIDs, and epinephrine with or without morphine (0.1 mg/kg), was injected into randomly assigned patients. Postoperative assessment was performed with all attending personnel and patients blind to group assignment. Visual analogue scale (VAS) of pain, range of motion (ROM), nausea numerical rating scale (NRS), the total dose of antiemetic drugs used and thigh swelling were compared between groups on postoperative days.

Results:

Pain VAS scores both at rest and on motion did not differ between the 2 groups at any postoperative time-point. The nausea NRS scores during the postoperative period from 0 minutes to 1 hour and the total dose of antiemetic drugs administered were significantly higher in the morphine group. The thigh girth showed no difference between groups on any of the postoperative days.

Conclusions:

The results of this study suggested that addition of morphine to the multimodal cocktail injection after THA is not effective for relieving postoperative pain, alleviating swelling, or improving ROM, and results in nausea and vomiting. Randomised controlled trial registration number UMIN000022668.
Narcotic use and total hip arthroplasty
Authors: Bolarinwa Surajudeen A , Casp Aaron A , Cancienne Jourdan M , Werner Brian C , Browne James A
Published: June 2018

Background:

The purpose of this study is to: (1) characterise risk factors for prolonged narcotic use following total hip arthroplasty (THA); (2) examine preoperative and prolonged postoperative narcotic use as independent risk factors for complications following THA.

Methods:

A national database identified primary THA patients from 2007–2015. Preoperative (POU) and prolonged postoperative narcotics users (PPU) were identified. A multivariable logistic regression analysis was utilised to identify any patient-related risk factors for prolonged use, and examined POU and PPU as risk factors for complications following THA.

Results:

55,354 THA patients were included, 18,740 (33.8%) POU and 14,996 (27.1%) PPU. Preoperative narcotics use was the most significant factor associated with prolonged postoperative narcotic use. Preoperative and prolonged postoperative use were associated with significantly higher complications postoperatively.

Conclusions:

Preoperative narcotic use is the most significant patient specific risk factor for prolonged postoperative narcotic use. POUs and PPUs are at a significantly higher risk of postoperative infection and revision surgery.
Efficacy of urokinase lock to treat thrombotic dysfunction of tunneled hemodialysis catheters: A retrospective cohort study
Authors: Van Hulle Freya , Bonkain Florence , De Clerck Dieter , Aerden Dimitri , Vanwijn Isabelle , Tielemans Christian , Wissing Karl Martin
Published: June 2018

Background:

There are few data to inform decisions about the optimal management of occluded tunneled cuffed hemodialysis catheters with thrombolytic locking solutions. The effect of dose, dwell-time, and number of administrations remains controversial.

Methods:

In this retrospective single-center review of tunneled cuffed catheters used between 2010 and 2014, restoration of blood flow as well as pre- and post-pump pressures after either short (30 min) or prolonged (48–72 h) administration of 100,000 IU of urokinase locking solution was evaluated in all thrombotic dysfunctions. We also assessed if multiple urokinase locks for the same thrombotic dysfunction event were more efficient to restore catheter performance than single administration.

Results:

Data on 773 thrombotic events in 148 patients (236 catheters) were collected during observation period. After urokinase treatment, blood flow and pre-pump pressure improved (median of 50 mL/min and 20 mmHg) whereas post-pump pressure decreased (median of 15 mmHg) (all P < 0.0001). The short thrombolytic procedure, used in more severely dysfunctional catheters, resulted in significantly larger improvements in catheter function than the long procedure. Multiple administrations for the same thrombotic event further improved access function in case of persisting dysfunction after first lock but had no added beneficial effect if blood flow and/or pump pressures were normalized after first urokinase lock.

Conclusion:

Both short and prolonged administration of urokinase locks were efficient in restoring blood flow and pre- and post-pump pressures in dialysis catheters with thrombotic dysfunction. Multiple urokinase locks provide added benefit on these outcomes only in case of persisting dysfunction after the first lock.