bluuebunny/crossref_metadata_2025 huggingface dataset:
Harnessing Teams and Technology to Improve Outcomes in Infants With Single Ventricle
Authors: Shirali Girish , Erickson Lori , Apperson Jonathan , Goggin Kathy , Williams David , Reid Kimberly , Bradley-Ewing Andrea , Tucker Dawn , Bingler Michael , Spertus John , Rabbitt Leslie , Stroup Richard
Published: May 2016

Infants with single ventricle require staged cardiac surgery, with stage I typically performed shortly after birth, stage II at 4 to 6 months of age, and stage III at 3 to 5 years of age. There is a high risk of interstage mortality and morbidity after infants are discharged from the hospital between stages I and II. Traditional home monitoring requires caregivers to record measurements of weight and oxygen saturation into a binder and requires families to assume a surveillance role. We have developed a tablet PC–based solution that provides secure and nearly instantaneous transfer of patient information to a cloud-based server, with the capacity for instant alerts to be sent to the caregiver team. The cloud-based IT infrastructure lends itself well to being able to be scaled to multiple sites while maintaining strict control over the privacy of each site. All transmitted data are transferred to the electronic medical record daily. The system conforms to recently released Food and Drug Administration regulation that pertains to mobile health technologies and devices. Since this platform was developed in March 2014, 30 patients have been monitored. There have been no interstage deaths. The experience of care providers has been unanimously positive. The addition of video has added to the use of the monitoring program. Of 30 families, 23 expressed a preference for the tablet PC over the notebook, 3 had no preference, and 4 preferred the notebook to the tablet PC.
Safety and Use of Anticoagulation After Aortic Valve Replacement With Bioprostheses
Authors: Riaz Haris , Alansari Shehab Ahmad Redha , Khan Muhammad Shahzeb , Riaz Talha , Raza Sajjad , Luni Faraz Khan , Khan Abdur Rahman , Riaz Irbaz Bin , Krasuski Richard A.
Published: May 2016

Background—

The American College of Cardiology guidelines recommend 3 months of anticoagulation after replacement of the aortic valve with a bioprosthesis. However, there remains great variability in the current clinical practice and conflicting results from clinical studies. To assist clinical decision making, we pooled the existing evidence to assess whether anticoagulation in the setting of a new bioprosthesis was associated with improved outcomes or greater risk of bleeding.

Methods and Results—

We searched the PubMed database from the inception of these databases until April 2015 to identify original studies (observational studies or clinical trials) that assessed anticoagulation with warfarin in comparison with either aspirin or no antiplatelet or anticoagulant therapy. We included the studies if their outcomes included thromboembolism or stroke/transient ischemic attacks and bleeding events. Quality assessment was performed in accordance with the Newland Ottawa Scale, and random effects analysis was used to pool the data from the available studies.
I
2
testing was done to assess the heterogeneity of the included studies. After screening through 170 articles, a total of 13 studies (cases=6431; controls=18210) were included in the final analyses. The use of warfarin was associated with a significantly increased risk of overall bleeding (odds ratio, 1.96; 95% confidence interval, 1.25–3.08;
P
<0.0001) or bleeding risk at 3 months (odds ratio, 1.92; 95% confidence interval, 1.10–3.34;
P
<0.0001) compared with aspirin or placebo. With regard to composite primary outcome variables (risk of venous thromboembolism, stroke, or transient ischemic attack) at 3 months, no significant difference was seen with warfarin (odds ratio, 1.13; 95% confidence interval, 0.82–1.56;
P
=0.67). Moreover, anticoagulation was also not shown to improve outcomes at time interval >3 months (odds ratio, 1.12; 95% confidence interval, 0.80–1.58;
P
=0.79).

Conclusions—

Contrary to the current guidelines, a meta-analysis of previous studies suggests that anticoagulation in the setting of an aortic bioprosthesis significantly increases bleeding risk without a favorable effect on thromboembolic events. Larger, randomized controlled studies should be performed to further guide this clinical practice.
Subfractions of High-Density Lipoprotein-Cholesterol and Carotid Intima-Media Thickness
Authors: Tiozzo Eduard , Gardener Hannah , Hudson Barry I. , Dong Chuanhui , Della-Morte David , Crisby Milita , Goldberg Ronald B. , Elkind Mitchell S.V. , Cheung Ying Kuen , Wright Clinton B. , Sacco Ralph L. , Desvarieux Moise , Rundek Tatjana
Published: May 2016

Background and Purpose—

Recent drug trials have challenged the high-density lipoprotein-cholesterol (HDL-C) antiatherosclerotic hypothesis, suggesting that total level of HDL-C may not be the best target for intervention. HDL-C subfractions may be better markers of vascular risk than total levels of HDL-C. The objective of this cross-sectional study was to investigate the relationship between HDL2-C and HDL3-C fractions and carotid intima-media thickness (cIMT) in the population-based Northern Manhattan Study.

Methods—

We evaluated 988 stroke-free participants (mean age, 66±8 years; 60% women; 66% Hispanic, and 34% non-Hispanic) with available data on HDL-C subfractions using precipitation method and cIMT assessed by a high-resolution carotid ultrasound. The associations between HDL-C subfractions and cIMT were analyzed by multiple linear regression models.

Results—

The mean HDL2-C was 14±8 mg/dL, HDL3-C 32±8 mg/dL, and the mean total HDL-C was 46±14 mg/dL. The mean cIMT was 0.90±0.08 mm. After controlling for demographics and vascular risk factors, HDL2-C and total HDL-C were inversely associated with cIMT (per 2 SDs, β=−0.017,
P
=0.001 and β=−0.012,
P
=0.03, respectively). The same inverse association was more pronounced among those with diabetes mellitus (per 2SDs, HDL2-C: β=−0.043,
P
=0.003 and HDL-C: β=−0.029,
P
=0.02). HDL3-C was not associated with cIMT.

Conclusions—

HDL2-C had greater effect on cIMT than HDL3-C in this large urban population. The effect of HDL2-C was especially pronounced among individuals with diabetes mellitus. More research is needed to determine antiatherosclerotic effects of HDL-C subfractions and their clinical relevance.
The Unity and Diversity of Pentecostal Theology
Authors: Vondey Wolfgang
Published: May 2016

Pentecostal theology is marked by an inherent struggle for self-realization as well as unity and ecumenical integration. A realistic portrayal of worldwide Pentecostalism is confronted with homogeneous and romanticized depictions or false stereotypes. Global Pentecostalism and Pentecostalism in the West are intertwined in a significant theological and ecumenical manner that allows an ecumenical perspective focused on the West to shed light on the unity of Pentecostal theology, the relationship of Pentecostal theology to the ecumenical traditions, and the integration of Pentecostal theology in broader Christian commitments to social justice, peace, and the conservation of the creation. A particular point of convergence exists between Western and worldwide Pentecostal theology in the social activism of the movement. Contemporary Pentecostalism is in transition towards becoming a diversified contributor to the shape of global Christianity and the renewal of the theological agenda.
Music, Poetry, and Lingua Franca in Medieval Iberia
Authors: Reynolds Dwight F.
Published: May 2016

This essay examines three different points of cultural contact between Muslims and Christians in medieval Iberia as documented in three different bodies of texts. In each example, the use of alingua francaresults in the exchange of cultural ideas and the re-presentation of one group in the language of another. The first point of contact is in the court of Córdoba in the early 9th century as recorded in an Arabic biography of a musician, which has survived only as excerpted in a later encyclopedia compiled across the Mediterranean in Syria in the 14th century. The second point of contact takes place only a few decades later, also in Córdoba, and is documented in a Latin epistle composed by a Christian during a period of increasing tension between Muslims and Christians. The third point of contact occurs in Aragon and Catalonia in the late 14th and early 15th century, where ‘Moorish’ and Jewish musicians and dancers were regularly hired to perform at the courts of the royal family and other nobles, the evidence for which is found in financial records composed in Old Catalan. Each of these examples provides evidence of cultural contact that could significantly change our understanding of the relationship between cultural and linguistic groups in this period.
A taxonomic revision of the Neotropical termite genus Rhynchotermes (Isoptera, Termitidae, Syntermitinae)
Authors: CONSTANTINI JOICE P. , CANCELLO ELIANA M.
Published: May 2016

We herein revise the taxonomy of the Neotropical syntermitine genus Rhynchotermes Holmgren. Seven species were recognized and diagnosis given for all available castes. This includes two new species: Rhynchotermes amazonensis Constantini & Cancello sp. nov. and Rhynchotermes matraga Constantini & Cancello sp. nov. Rhynchotermes guarany Cancello is recognized as syn. nov. of Rhynchotermes nasutissimus (Silvestri) and Rhynchotermes nyctobius Mathews syn. nov. of Rhynchotermes diphyes Mathews. The three other formerly described species include Rhynchotermes perarmatus (Snyder), Rhynchotermes piauy Cancello and Rhynchotermes bulbinasus Scheffrahn. We also provide a key to the soldiers of the genus, a distribution map of the species as well as illustrations and biological notes for all species.
A new species of Blaesodactylus (Squamata: Gekkonidae) from Tsingy limestone outcrops in Namoroka National Park, north-western Madagascar
Authors: INEICH IVAN , GLAW FRANK , VENCES MIGUEL
Published: May 2016

We describe a new gekkonid lizard of the genus Blaesodactylus from Tsingy limestone of a deciduous dry forest of Namoroka National Park, north-western Madagascar. Blaesodactylus victori sp. nov., the sixth recognized species of this genus, is distinguished from all other congeners by its large size and a combination of regular small gular granules, spotted venter, lack of dorsal tubercles, enlarged supranasal scales separated ventrally by a much smaller scale in contact with the rostral, and black naris. The new arboreal species is also characterized by its dark dorso-ventral stripes on the head separating infralabial and most supralabial plates and in life by a typical white spotted pattern on a washed grey to dark grey vermiculated dorsum. Molecular phylogenetic data place the species into a clade with B. boivini and B. microtuberculatus, as sister to a subclade containing these two species. The new species shares some morphological characters states with its African sister genus Homopholis, suggesting that its morphology might be rather plesiomorphic. We also identify several previously overlooked morphological traits characterizing the entire B. boivini clade, possibly also being plesiomorphic. Due to its extremely limited presumed extent of occurrence and continuing decline of its habitat we propose an IUCN Red List status of "Critically Endangered" for the new species.
ALEXEY RESHCHIKOV & ILARI EERIKKI SÄÄKSJÄRVI (2015) Seven new species of the genus Physotarsus Townes 1966 (Hymenoptera, Ichneumonidae) from South America. Zootaxa, 3972(1): 026–042.
Authors: RESHCHIKOV ALEXEY , SÄÄKSJÄRVI ILARI EERIKKI
Published: May 2016

N/A
Crowdsourcing the El Reno 2013 Tornado: A New Approach for Collation and Display of Storm Chaser Imagery for Scientific Applications
Authors: Seimon Anton , Allen John T. , Seimon Tracie A. , Talbot Skip J. , Hoadley David K.
Published: May 2016

The 31 May 2013 El Reno, Oklahoma, tornado is used to demonstrate how a video imagery database crowdsourced from storm chasers can be time-corrected and georeferenced to inform severe storm research. The tornado’s exceptional magnitude (∼4.3-km diameter and ∼135 m s−1 winds) and the wealth of observational data highlight this storm as a subject for scientific investigation. The storm was documented by mobile research and fixed-base radars, lightning detection networks, and poststorm damage surveys. In addition, more than 250 individuals and groups of storm chasers navigating the tornado captured imagery, constituting a largely untapped resource for scientific investigation.

The El Reno Survey was created to crowdsource imagery from storm chasers and to compile submitted materials in a quality-controlled, open-access research database. Solicitations to storm chasers via social media and e-mail yielded 93 registrants, each contributing still and/or video imagery and metadata. Lightning flash interval is used for precise time calibration of contributed video imagery; when combined with georeferencing from open-source geographical information software, this enables detailed mapping of storm phenomena. A representative set of examples is presented to illustrate how this standardized database and a web-based visualization tool can inform research on tornadoes, lightning, and hail. The project database offers the largest archive of visual material compiled for a single storm event, accessible to the scientific community through a registration process. This approach also offers a new model for poststorm data collection, with instructional materials created to facilitate replication for research into both past and future storm events.
Simulated Response of the Pacific Decadal Oscillation to Climate Change
Authors: Zhang Liping , Delworth Thomas L.
Published: May 2016

The impact of climate change on the Pacific decadal oscillation (PDO) is studied using a fully coupled climate model. The model results show that the PDO has a similar spatial pattern in altered climates, but its amplitude and time scale of variability change in response to global warming or cooling. In response to global warming the PDO amplitude is significantly reduced, with a maximum decrease over the Kuroshio–Oyashio Extension (KOE) region. This reduction appears to be associated with a weakened meridional temperature gradient in the KOE region. In addition, reduced variability of North Pacific wind stress, partially due to reduced air–sea feedback, also helps to weaken the PDO amplitude by reducing the meridional displacements of the subtropical and subpolar gyre boundaries. In contrast, the PDO amplitude increases in response to global cooling.

In the control simulations the model PDO has an approximately bidecadal peak. In a warmer climate the PDO time scale becomes shorter, changing from ~20 to ~12 yr. In a colder climate the time scale of the PDO increases to ~34 yr. Physically, global warming (cooling) enhances (weakens) ocean stratification. The increased (decreased) ocean stratification acts to increase (reduce) the phase speed of internal Rossby waves, thereby altering the time scale of the simulated PDO.
Extreme Noise–Extreme El Niño: How State-Dependent Noise Forcing Creates El Niño–La Niña Asymmetry
Authors: Levine Aaron , Jin Fei Fei , McPhaden Michael J.
Published: May 2016

A major open question about El Niño–Southern Oscillation (ENSO) is what causes ENSO amplitude asymmetry, with strong El Niños generally larger than strong La Niñas. The authors examine a leading hypothesis—that the ENSO state modifies the fetch and/or wind speed of westerly wind bursts (WWBs) that create asymmetric forcing and an asymmetric ENSO response. Further, in El Niño forecasts, the number of WWBs expected increases in the month following a strong WWB when compared with the month preceding it. Using a conceptual model, a relationship is derived between the magnitude of the westerly wind burst state dependence on ENSO and ENSO asymmetry. It is found that this relationship between the magnitude of the state dependence and ENSO asymmetry holds in both the observations and 21 coupled climate models. Finally, it is found that because of state-dependent westerly wind burst forcing, extreme El Niño events tend to be of the eastern Pacific variety.
Comparison of the Tornadic and Nontornadic Supercells Intercepted by VORTEX2 on 10 June 2010
Authors: Klees Alicia M. , Richardson Yvette P. , Markowski Paul M. , Weiss Christopher , Wurman Joshua M. , Kosiba Karen K.
Published: May 2016

On 10 June 2010, the second Verification of the Origins of Rotation in Tornadoes Experiment (VORTEX2) armada collected a rare set of observations of a nontornadic and a tornadic supercell evolving in close proximity to each other. The storms and their environments were analyzed using single- and dual-Doppler radar, mobile mesonet, deployable surface mesonet, and mobile sounding data, with the goal of understanding why one supercell produced no tornadoes while the other produced at least two. Outflow temperature deficits were similar for the two storms, both within the normal range for weakly tornadic supercells but somewhat cold relative to significantly tornadic supercells. The storms formed in a complex environment, with slightly higher storm-relative helicity near the tornadic supercell. The environment evolved significantly in time, with large thermodynamic changes and increases in storm-relative helicity, leading to conditions much more favorable for tornadogenesis. After a few hours, a new storm developed between the supercells, likely leading to the demise of the nontornadic supercell before it was able to experience the enhanced environmental conditions. Two tornadoes developed within the single mesocyclone of the other supercell. After the dissipation of the second tornado, rapid rearward motion of low- to midlevel circulations may have inhibited further tornado production in this storm.
Contrast Volume to Cystatin C-Based Glomerular Filtration Ratio Predicts the Risk of Contrast-Induced Nephropathy After Cardiac Catheterization
Authors: Zhao Jian-bin , Liu Yong , Wu Deng-xuan , Chen Ji-yan , Duan Chong-yang , Chen Shi-qun , Tan Ning
Published: May 2016

Cystatin C is considered to be a better alternative to creatinine for estimating glomerular filtration rate (GFR). The aim of this study was to investigate whether a contrast volume to estimated GFR based on cystatin C (V/eGFRcys) is a better predictor of contrast-induced nephropathy (CIN). We enrolled 1195 consecutive patients undergoing elective cardiac catheterization. Receiver–operating characteristic (ROC) curves were used to identify the optimal cutoff value of V/eGFRcys for detecting CIN. Multivariate regression models were used to evaluate whether V/eGFRcys is an independent risk factor for CIN. A total of 19 (1.6%) patients developed CIN. There was a significant association between a higher V/eGFRcys ratio and CIN risk ( P = .008). A ROC curve analysis indicated that a V/eGFRcys ratio of 2.29 was a fair discriminator for CIN. After adjusting for other known CIN risk factors, V/eGFRcys ratios >2.29 remained significantly associated with CIN (odds ratio = 2.93, 95% confidence interval: 1.02-8.44, P = .047). In conclusion, a V/eGFRcys >2.29 was a significant and independent predictor of CIN after cardiac catheterization.
Perturbation observer based adaptive passive control for damping improvement of multi-terminal voltage source converter-based high voltage direct current systems
Authors: Yang B , Jiang L , Yao Wei , Wu QH
Published: May 2016

This paper proposes a Perturbation Observer-based adaptive passive control (POAPC) for damping improvement of multi-terminal voltage source converter-based high voltage direct current (VSC-MTDC) systems. The POAPC is designed for an N-terminal VSC-MTDC system, and the perturbation is defined as a lumped term including interactions between terminals, unmodelled dynamics and unknown external disturbances, which are estimated online via a perturbation observer. Then an extra system damping is injected for each terminal to improve the transient dynamics via passivation. The POAPC does not require an accurate system model and measurements of full states; only the DC voltage and active and reactive power need to be measured. Case studies are carried out on a four-terminal VSC-MTDC system under four scenarios such as active and reactive power reversal, faults at AC bus, offshore wind farm connection, and fast time-varying parameter uncertainties. Simulation results verify its effectiveness under various operating conditions, compared with that of conventional proportional-integral (PI) control and classical passive control (PC).
Fault tolerant heading control system design for Turac unmanned aerial vehicle
Authors: Yuksek Burak , Ure N Kemal , Caliskan Fikret , Inalhan Gokhan
Published: May 2016

In this study, a fault tolerant heading control system is designed for a one-third scale fixed wing vertical takeoff-and-landing unmanned aerial vehicle, Turac. A nonlinear six degrees-of-freedom (DoF) mathematical model is obtained and linearized at the calculated trim flight condition. A proportional heading control system is designed as a nominal horizontal flight controller. Detection and isolation of the faults that can occur during flight are performed by Kalman filters which are designed individually for each sensor output. After the fault isolation process the obtained fault data is fed to the reconfigurable Kalman filter. Then the feedback signal from the faulty sensor is blocked and the estimated output from the reconfigurable Kalman filter is fed to the control system. So, the closed-loop system could follow the reference signal without updating the controller’s parameters. Simulation studies are performed on the closed-loop system for faulty sensor situations.
The field is ripe: Christian literary scholarship, postcolonial ecocriticism, and environmentalism
Authors: Mabie Joshua
Published: May 2016

Christian literary scholars and ecocritics have generally not engaged each other in sustained and productive conversation. This article therefore updates and extends Timothy J. Burbery’s 2012 call for a Christian ecocriticism by showing that ecocriticism’s recent postcolonial turn has opened new opportunities for Christian literary scholars. Ecocriticism’s heightened attention to ways that environmental problems threaten the lives and livelihoods of the world’s poorest and most vulnerable people provides an opportunity for Christians to become involved in both the scholarly project of ecocriticism and in the work of advancing global environmental justice. The author holds out hope that a rigorous Christian ecocriticism could pave the way for a potent new Christian environmentalism.
The ecology of memory: Augustine, Eliot, and the form of Wendell Berry’s fiction
Authors: Bilbro Jeffrey
Published: May 2016

Berry’s notion of memory has rich theological and literary roots, which reach to Augustine and T. S. Eliot. After a brief tour through Augustine’s theological view of memory and Eliot’s development of this in The Four Quartets, I examine Berry’s short story “Pray without Ceasing” to demonstrate how this theology works out in the form of his story, enabling his characters to understand and love the whole pattern of which they are a part. By understanding how Berry incorporates this ancient Christian view of memory in the structure of his narration, we can see how memory comprises an integral part of his culturally embattled agrarian and ecological vision.
Impact of Middle versus Inferior Total Turbinectomy on Nasal Aerodynamics
Authors: Dayal Anupriya , Rhee John S. , Garcia Guilherme J. M.
Published: May 2016

Objectives

This computational study aims to (1) use virtual surgery to theoretically investigate the maximum possible change in nasal aerodynamics after turbinate surgery, (2) quantify the relative contributions of the middle and inferior turbinates to nasal resistance and air conditioning, and (3) quantify to what extent total turbinectomy impairs the nasal air‐conditioning capacity.

Study Design

Virtual surgery and computational fluid dynamics.

Setting

Academic tertiary medical center.

Subjects and Methods

Ten patients with inferior turbinate hypertrophy were studied. Three‐dimensional models of their nasal anatomies were built according to presurgery computed tomography scans. Virtual surgery was applied to create models representing either total inferior turbinectomy (TIT) or total middle turbinectomy (TMT). Airflow, heat transfer, and humidity transport were simulated at a steady‐state inhalation rate of 15 L/min. The surface area stimulated by mucosal cooling was defined as the area where heat fluxes exceed 50 W/m2.

Results

In both virtual total turbinectomy models, nasal resistance decreased and airflow increased. However, the surface area where heat fluxes exceed 50 W/m2 either decreased (TIT) or did not change significantly (TMT), suggesting that total turbinectomy may reduce the stimulation of cold receptors by inspired air. Nasal heating and humidification efficiencies decreased significantly after both TIT and TMT. All changes were greater in the TIT models than in the TMT models.

Conclusion

TIT yields greater increases in nasal airflow but also impairs the nasal air‐conditioning capacity to a greater extent than TMT. Radical resection of the turbinates may decrease the surface area stimulated by mucosal cooling.
MERS versus Standard Surgical Approaches for Porcine Vocal Fold Scarring with Adipose Stem Cell Constructs
Authors: Woo Joo Hyun , King Suzanne N. , Hoffman Henry , Dailey Seth , Wang Sarah , Christensen Michael B. , Thibeault Susan L.
Published: May 2016

Objective

Cells, scaffold, and surgical approaches are important for regeneration of the lamina propria of the scarred vocal fold (VF). Microendoscopy of Reinke’s space (MERS) is a surgical approach used to access the lamina propria. The present study evaluated MERS in the treatment of VF scarring as compared with standardized approaches for the treatment of VF scarring with adipose stem cell constructs.

Study Design

Animal study.

Setting

Academic center.

Subjects and Methods

VF injury was performed bilaterally to induce scarring in 20 pigs. Eight weeks after injury, pigs were classified into no treatment, minithyrotomy, VF injection, VF incision/dissection, and MERS. All groups (except control) were implanted with adipose stem cell and hyaluronan. Four weeks after treatment, histology for collagen, hyaluronan, and fibronectin; mRNA expression for α‐smooth muscle actin, tumor growth factor β1, collagen 1α1, collagen 3α1, matrix metalloproteinase 2, basic fibroblast growth factor, and hepatocyte growth factor; and tissue rheology were evaluated.

Results

Differences were measured among surgical approaches for protein levels of collagen, hyaluronan, and fibronectin (P =. 0133, P <. 0001, and P =. 0025, respectively). Fibroblast growth factor, collagen 1α1, and matrix metalloproteinase 2 transcript levels were different among treatment groups (P =. 003, P =. 0086, and P =. 014, respectively), while no differences were measured for α‐smooth muscle actin, tumor growth factor β1, hepatocyte growth factor, and collagen 3α1. Rheologically, significant differences were not measured between groups.

Conclusion

MERS is a promising surgical approach for the treatment of VF scarring, optimizing the placement of implanted biomaterials.
Spatial Mapping in the Rat Olfactory Bulb by Odor and Direct Electrical Stimulation
Authors: Coelho Daniel H. , Costanzo Richard M.
Published: May 2016

Objectives

To directly measure the spatial mapping in the olfactory bulb by odor presentation and by direct electrical stimulation.

Study Design

Experimental (animal).

Setting

University research laboratory.

Subjects and Methods

Odor (n = 8) and electrical stimulation (n = 4) of the olfactory bulb in rats were used to demonstrate the spatial mapping of neural responses in the olfactory bulb. Both multiunit responses to odor stimulation and evoked potential responses to localized electrical stimulation were measured in different regions of the olfactory bulb.

Results

Responses that were recorded simultaneously from an array of 32 electrodes positioned at different locations within the olfactory bulb were mapped. Results show different spatial patterns of neural activity for different odors (odor maps). Direct stimulation of the olfactory bulb with electrical current pulses from electrodes positioned at different locations was also effective in generating spatial patterns of neural activity.

Conclusion

These data suggest that by programming an array of stimulating electrodes, it should be possible to selectively activate different regions of the olfactory bulb, generating unique patterns of neural activity as seen in normal smell.
Pretreatment Hematologic Findings as Novel Predictive Markers for Facial Palsy Prognosis
Authors: Wasano Koichiro , Kawasaki Taiji , Yamamoto Sayuri , Tomisato Shuta , Shinden Seiichi , Ishikawa Toru , Minami Shujiro , Wakabayashi Takeshi , Ogawa Kaoru
Published: May 2016

Objective

To examine the relationship between prognosis of 2 different facial palsies and pretreatment hematologic laboratory values.

Study Design

Multicenter case series with chart review.

Setting

Three tertiary care hospitals.

Subjects and Methods

We examined the clinical records of 468 facial palsy patients who were treated with an antiviral drug in combination with either oral or intravenous corticosteroids in participating hospitals between 2010 and 2014. Patients were divided into a Bell’s palsy group or a Hunt’s palsy group. We used the Yanagihara facial nerve grading system to grade the severity of facial palsy. “Recovery” from facial palsy was defined as achieving a Yanagihara score ≥36 points within 6 months of onset and having no accompanying facial contracture or synkinesis. We collected information about pretreatment hematologic findings, demographic data, and electrophysiologic test results of the Bell and Hunt group patients who recovered and those who did not. We then compared these data across the 2 palsy groups.

Results

In the Bell’s palsy group, recovered and unrecovered patients differed significantly in age, sex, electroneuronography score, stapedial muscle reflex, neutrophil rate, lymphocyte rate, neutrophil‐to‐lymphocyte ratio, and initial Yanagihara score. In the Hunt’s palsy group, recovered and unrecovered patients differed in age, electroneuronography score, stapedial muscle reflex, monocyte rate, platelet count, mean corpuscular volume, and initial Yanagihara score.

Conclusions

Pretreatment hematologic findings, which reflect the severity of inflammation and bone marrow dysfunction caused by a virus infection, are useful for predicting the prognosis of facial palsy.
Functional Outcomes after Salvage Transoral Laser Microsurgery for Laryngeal Squamous Cell Carcinoma
Authors: Fink Daniel S. , Sibley Haley , Kunduk Melda , Schexnaildre Mell , Sutton Collin , Kakade‐Pawar Anagha , McWhorter Andrew J.
Published: May 2016

Objectives

Transoral laser microsurgery (TLM) has been increasingly used in lieu of total laryngectomy to treat malignancy after definitive radiation. There are few data in the literature regarding functional outcomes. We retrospectively reviewed voice and swallowing outcomes in patients who underwent TLM for recurrent laryngeal carcinoma.

Study Design

Case series with chart review.

Setting

Tertiary care center.

Subjects and Methods

Forty‐two patients were identified with recurrent squamous cell carcinoma of the larynx after definitive radiation therapy from 2001 to 2013: 28 patients with glottic recurrence and 14 with supraglottic recurrence. Swallowing outcomes were evaluated by gastrostomy tube dependence, the MD Anderson Dysphagia Inventory, and the Functional Oral Intake Scale. Voice outcomes were evaluated by the Voice Handicap Index and observer‐rated perceptual analysis.

Results

No significant difference was noted between mean pre‐ and postoperative MD Anderson Dysphagia Inventory scores: 78.25 and 74.9, respectively (P =. 118, t = 1.6955). Mean Functional Oral Intake Scale scores after TLM for supraglottic and glottic recurrences were 6.4 and 6.6, respectively. Of 42 patients, 17 (40.5%) required a gastrostomy tube either during radiation or in conjunction with the salvage procedure. Of 17 patients, 15 resumed sufficient oral diet for tube removal. Patients’ mean Voice Handicap Index score did increase from 34.3 to 51.5 (P =. 047), and their mean perceptual score did decrease from 60.0 to 45.3 (P =. 005). However, at 1‐year follow‐up, there was no significant difference in perceptual score: 61.1 to 57.1 (P =. 722).

Conclusions

TLM is a successful surgical option for recurrent laryngeal cancer with acceptable functional outcomes.
Digital Storytelling as a Narrative Health Promotion Process
Authors: DiFulvio Gloria T. , Gubrium Aline C. , Fiddian-Green Alice , Lowe Sarah E. , Del Toro-Mejias Lizbeth Marie
Published: May 2016

Digital storytelling (DST) engages participants in a group-based process to create and share narrative accounts of life events. The process of individuals telling their own stories has not been well assessed as a mechanism of health behavior change. This study looks at outcomes associated with engaging in the DST process for vulnerable youth. The project focused on the experiences of Puerto Rican Latinas between the ages of 15 to 21. A total of 30 participants enrolled in a 4-day DST workshops, with 29 completing a 1 to 3-minute digital story. Self-reported data on several scales (self-esteem, social support, empowerment, and sexual attitudes and behaviors) were collected and analyzed. Participants showed an increase in positive social interactions from baseline to 3-month post workshop. Participants also demonstrated increases in optimism and control over the future immediately after the workshop, but this change was not sustained at 3 months. Analysis of qualitative results and implications are discussed.
Hospital Malnutrition Related to Fasting and Underfeeding
Authors: Arenas Moya Diego , Plascencia Gaitán Alejandra , Ornelas Camacho Denisse , Arenas Márquez Humberto
Published: May 2016

Hospital malnutrition is a relevant clinical issue present in about 50% of patients that is associated with increased morbidity, mortality, and cost of care. Because of the relation of malnutrition with chronic and acute inflammatory processes secondary to disease, nutrition therapy is considered an important medical treatment. However, there is little discussion about the impact of another critical issue related to hospital malnutrition, that is, lack of appropriate food or nutrition therapy given to the patients. Unnecessary fasting practices and the use of inappropriate nutrition prescriptions result in underfeeding that can be a related or direct cause of hospital malnutrition, independent of disease or inflammatory state. Suboptimal prescription of oral, enteral, and parenteral nutrition should be analyzed and discussed from an ethical perspective since this practice has the potential to harm patients. In addition, absence or inadequate provision of nutrition may present barriers for improved patient outcomes and could be prevented by simply recognizing lack of knowledge, skills, or experience in nutrition and entrusting nutrition prescription to interdisciplinary teams with clinicians well prepared in nutrition sciences. This article reviews potential barriers to the prevention or treatment of hospital malnutrition and proposes specific actions that can help clinicians to overcome and implement optimal nutrition not just as medical therapy but also as a basic comfort care that may help patients nutritionally, clinically, physically, and emotionally.
Performance-Based Impairment Measures as Predictors of Early-Stage Activity Limitations in Community-Dwelling Older Adults
Authors: Terhorst Lauren , Holm Margo B. , Toto Pamela E. , Rogers Joan C.
Published: May 2016

Objective: The objective of the current investigation was to explore performance-based predictors of decline in the performance quality of everyday tasks as a first step for early identification, screening, and referral to minimize disability in community-dwelling older adults. Method: This was a secondary analysis of data from 256 community-based older women. Mobility, activities of daily living (ADLs), and instrumental activities of daily living (IADLs) were measured using the Performance Assessment of Self-Care Skills (PASS). Logistic regression models explored cognitive and motor predictors of performance quality while controlling for demographics and diagnoses. Results: Functional reach ( p = .049) and cognition ( p = .012) were predictive of mobility quality, whereas balance ( p = .007) and the Keitel Function ( p = .005) were predictive of ADL quality. Manipulation and cognitive measures were predictive of cognitive and physical IADL quality. Discussion: Cognitive and physical screens are both important to identify older adults at risk for disability.
Parenteral 5-Fluorocytosine for Candidiasis
Authors: MacLeod S. M. , Ti T. Y. , Williams R. B. , Sellers E. M.
Published: May 2016

5-Fluorocytosine (5-FC), a systemic antifungal drug, has recently been approved for oral use in North America; however, the parenteral preparation remains an investigational drug. This report describes the use of parenteral 5-FC in nine patients with candidiasis. Six patients had invasive fungal infection and three patients had colonization. Eight patients received 5-FC intravenously and one received an intraperitoneal infusion. Of the six patients with invasive candidiasis, four received concurrent amphotericin B therapy. Candidiasis was cleared in eight of the nine patients. One patient died during therapy with combined 5-FC and amphotericin B. No clinically significant adverse effects of parenteral 5-FC were observed; however, two patients showed a transient increase in SGOT.
Erythrocyte Lithium and the Erythrocyte: Plasma Lithium Ratio as Indicators of Mood Changes: Preliminary Report
Authors: Berg Mary J. , Lantz Robert K. , Francis Paul , Kelly William N. , Kostenbauder Harry B. , Hughes Mary , Latta Robert
Published: May 2016

Fifteen patients diagnosed as bipolar I, bipolar II, unipolar, or bipolar I/schizophrenic, and each receiving prophylactic lithium carbonate, were studied for nine months in an outpatient clinic. Every four to six weeks, plasma and erythrocyte (RBC) lithium concentrations and RBC: plasma lithium ratios were monitored and mood scales were recorded. In those patients who showed a change in mood, a positive association was found between decreased RBC lithium concentration and depression ( p = 0.0156), and also between RBC: plasma lithium ratio and depression ( p = 0.0156). No relationship between plasma lithium concentration changes and depression could be determined.
A Critical Review of the Safety and Antiemetic Efficacy of Delta-9-Tetrahydrocannabinol
Authors: Cocchetto David M. , Cook Linda F. , Cato Allen E.
Published: May 2016

Over the past six years, both governmental institutions and private enterprise have expressed great interest and activity in the isolation of chemical constituents from the Cannabis sativa plant and synthesis of novel cannabinoid compounds with potential medicinal uses. Evaluation of the safety and antiemetic efficacy of delta-9-tetrahydrocannabinol, the primary psychoactive cannabinoid component of marijuana, comprises one of several very active areas of cannabinoid clinical research. The results of clinical studies of the safety and antiemetic efficacy of delta-9-tetrahydrocannabinol in patients receiving cancer chemotherapy are critically evaluated. Deficiencies in current knowledge of the clinical pharmacology of delta-9-tetrahydrocannabinol are discussed in the context of antiemetic drug evaluation.
Cyproheptadine-Induced Remission of Cushing's Disease Due to Pituitary Basophil Adenoma
Authors: Jimenez-Alonso J. , Munoz-Avila J. , Jaimez L. , Pérez-Jimenez F. , Bellido C. , Jiménez-Perepérez J.A.
Published: May 2016

Serotonin is involved in the control of ACTH secretion, possibly by stimulating corticotropin releasing factor secretion from the hypothalamus. Cushing's disease seems to be due to defective hypothalamic regulation of ACTH release from the pituitary gland. Cyproheptadine is a potent antagonist of serotonin and has been used successfully in some patients with Cushing's disease, although, generally, in women without radiological evidence of pituitary tumors. We report the successful use of cyproheptadine in a 54-year-old man with Cushing's disease due to pituitary basophil adenoma. Significant clinical and biochemical improvement was noted 45 days after treatment began. The results in this patient support our findings that cyproheptadine can be effective in patients with Cushing's disease due to pituitary tumors, as well as in preparing very ill patients for surgery or managing such patients until radiotherapy takes effect.
The Effectiveness of Auxiliary Prescription Labels: A Pilot Study
Authors: Wiederholt Joseph B. , Kotzan Jeffrey A. , Cooper James W.
Published: May 2016

Affixed auxiliary prescription labels are widely used in the practice of pharmacy because they supposedly provide the patient with pertinent information that is not contained within the prescription signature. Yet, whether the labels are effective is not known, nor is it known whether the label's elements, such as color, form, and logo, affect perception of the written text. Sound scientific analyses of these questions are limited. Therefore, a pilot study involving a series of experiments was designed to determine whether individual perception of pertinent information is affected by the use of affixed auxiliary prescription labels. The second objective of this study was to evaluate how color and logo differences affected perception of the label's written text.

Participants were selected for the experiments after being screened for color blindness, corrected vision, and, in some cases, previous pharmacy employment. Subjects viewed labels affixed to prescription vials via a two-channel tachistoscope. The tachistoscopic methodology measured perception, and its accuracy was verified through a forced-choice instrument.

Results from the pilot study were threefold: (1) a sound scientific analysis found affixed auxiliary labels to be effective, (2) significant variance could be attributed to both individual and subject differences, and (3) the unique effects of color and logo could not be determined.
Decrease in Theophylline Clearance after the Administration of Erythromycin to a Patient with Obstructive Lung Disease
Authors: Green J.A. , Clementi W.A.
Published: May 2016

It has been demonstrated previously that erythromycin can inhibit the total body clearance of theophylline, resulting in elevated serum theophylline concentrations. The overall incidence of this interaction and the population at risk have not been elucidated fully. Recent investigations have suggested that such an interaction is doubtful and that patients in whom this occurrence was suspect developed alterations in theophylline disposition secondary to worsening pulmonary function, not from erythromycin therapy alone. This case report shows that the interaction between theophylline and erythromycin can be clinically significant, producing as much as a 50-percent reduction in the total body clearance of the bronchodilator. The magnitude and time course of this interaction in patients with congestive heart failure and chronic obstructive pulmonary disease may differ considerably from that reported in healthy volunteers.
Procainamide Disposition in Obesity
Authors: Christoff Patricia B. , Conti David R. , Naylor Cartha , Jusko William J.
Published: May 2016

The pharmacokinetics of intravenous procainamide (PA) were studied in seven obese and seven normal subjects. Serum concentrations and urinary excretion rates of PA and its active metabolite, NAPA, were measured by high performance liquid chromatography. Pharmacokinetic parameters were related to ideal body weight (IBW) and total body weight (TBW). The volume of distribution at steady state (Vssd) was similar for both groups when based per unit of IBW. Plasma clearance of PA, corrected for body surface area, was greater in obese subjects when adjusted for IBW, but similar on the basis of TBW. For its components, metabolic and renal clearance, the obese subjects showed similar metabolic clearances, but a significant increase was found in renal clearance per unit of body surface area based on both IBW (normal mean, 11.9 L/h/m2; obese, 19.0 L/h/m2) and TBW (normal mean, 11.7 L/h/m2; obese, 15.7 L/h/m2). This appears to be due to increased tubular secretion of PA in the obese group. In contrast, these subjects had lower renal clearances of NAPA. Variability in disposition of PA may, thus, be affected by patient physiology and method of parameter normalization.
Hypoprothrombinemia in Naproxen Overdose
Authors: Waugh Phyllis K. , Keatinge Daniel W.
Published: May 2016

Transient prolongation of the prothrombin time was observed in the setting of a 10-g overdose of naproxen. The patient reported was previously healthy, without chronic liver disease, bleeding disorders, or malnutrition. The most likely mechanism for this effect is direct inhibition of the synthesis of vitamin-K-dependent clotting factors, possibly via production of “abnormal” prothrombin.
Hypoglycemia in Patients Receiving Disopyramide Phosphate
Authors: Strathman Irvin , Schubert Elliot N. , Cohen Albert , Nitzberg David M.
Published: May 2016

Postmarketing drug surveillance revealed the occurrence of hypoglycemia associated with the use of disopyramide phosphate (Norpace) for the control of ventricular arrhythmias. The data obtained suggest that elderly patients or those with impaired hepatic or renal function may be more at risk of developing hypoglycemia while taking disopyramide. In a clinical study, nine healthy male volunteers were dosed with disopyramide to steady-state concentration. Comparison of the glucose levels during periods of fast, when the presence of food did not present a confounding factor, suggested that disopyramide may have a glucoregulatory effect in humans. A placebo-controlled clinical study, conducted in 11 healthy, male subjects, demonstrated that disopyramide evoked a small, but statistically significant, decrease in glucose levels during both the fed and fasted state. None of the classical signs or symptoms associated with hypoglycemia were noted during either of these clinical studies.
The Shape of the Rho Chi Key
Authors: Tyler Varro E.
Published: May 2016

Lack of curricular balance long has been a problem in pharmacy education. Presently, excessive emphasis on individualized instruction and a failure to develop and implement innovative instructional methodologies in clinical pharmacy have resulted in programs that are severely distorted in terms of resource utilization. A proposal is made to restore a proper balance to the curriculum, to encourage elimination of outmoded instructional areas, and to promote the utilization of novel teaching techniques. If properly constructed, such a program should allow conferral of the Doctor of Pharmacy degree and examination for licensure after a period of 5½ academic years. It is suggested that the Rho Chi Society use its vast human resources to assist in the development of such a program.