bluuebunny/crossref_metadata_2025 huggingface dataset:
Cecal perforation
Authors: Czajka Gregory , Kreminski Halley
Published: August 2018

Hydrocephalus can be the result of an infection, obstruction, impaired reabsorption of cerebrospinal fluid (CSF), or an abnormal increase in CSF. Ventriculoperitoneal (VP) shunting is the gold standard treatment for hydrocephalus despite its high rate of complications, including catheter obstruction and infection. Spontaneous cecal perforation by a VP shunt is extremely rare. Headache or subtle change in personality may indicate a VP shunt infection. Early recognition of the infection is critical for optimal patient outcomes.
Influence of Postoperative Intraocular Pressure on Graft Detachment After Descemet Membrane Endothelial Keratoplasty
Authors: Heinzelmann Sonja , Böhringer Daniel , Haverkamp Christian , Lapp Thabo , Eberwein Philipp , Reinhard Thomas , Maier Philip
Published: August 2018

Purpose:

Descemet membrane endothelial keratoplasty (DMEK) seems to be the most promising technique for treating endothelium-related disorders of the cornea. However, graft detachment is a frequent complication. It often can be treated by rebubbling procedures. Unfortunately, this increases the risk of subsequent graft failure. It is therefore essential to define risk factors for graft detachment in DMEK. In this study, postoperative intraocular pressure (IOP) is investigated in this regard.

Methods:

In total, 1047 DMEK procedures in patients with Fuchs endothelial dystrophy or bullous keratopathy were reviewed. All rebubbling procedures were recorded as well as postoperative IOP values (first measure 2 hours postoperatively and highest and lowest value within 3 days after surgery), donor factors (donor age, organ culture time, and endothelial cell count), and whether DMEK surgery had been combined with cataract surgery (triple-DMEK). Incidence rates were estimated with the Kaplan–Meier method. Cox regression was used to assess statistical significance.

Results:

The overall rebubbling rate was 24% after 8 weeks. Relative dips in IOP may be associated with a higher risk for graft detachment (hazards ratio = 0.41; P < 0.001). Graft detachment was neither significantly influenced by donor factors, first or maximum IOP, nor by simultaneous cataract surgery (triple-DMEK).

Conclusions:

Avoiding dips in IOP may reduce the risk for graft detachment after DMEK. To prevent lowering of IOP values in the early postsurgical period, it may be advisable to achieve tight surgical wounds at the end of DMEK surgery and optimal filling of the anterior chamber with air and optionally with gas.
Bubble-free Gonioscopy
Authors: Kapetansky Frederick M. , Dusseau Nathaniel B.
Published: August 2018

Purpose:

Accurate gonioscopy is necessary for the diagnosis and the treatment of glaucoma. The “gold standard” for indirect gonioscopy has been the Goldmann 3-mirror lens, requires an optical coupling agent (methylcellulose) between the cornea and under the surface of the goniolens. The design of an ideal lens would not only eliminate the need for gel, but could at the same time solve the problems associated with the trapping of an air bubble under the lens.

Materials and Methods:

This investigation involved a prototype 2-mirror goniolens with a radius of curvature of 8.4 mm and a 16 mm diameter area of corneal contact. A total of, 69 consecutive patients had bilateral keratometer measurements made. The prototype 2-mirror lens was applied to the anesthetized eye. The results of this examination were tabulated by one of the authors (F.M.K.); A=good fit without trapping of air, B=good fit but trapped bubble of air which could be expelled by the patient turning their eye towards the bubble, and C=total failure to expel the trapped bubble of air. Finally, if there were wrinkles in Descemet’s membrane, this was recorded.

Results:

A total of 64 patients were evaluated with a prototype 2-mirror lens. In total, 54/64 (84.38%) of eyes were successfully evaluated without trapping of an air bubble.

Conclusion:

Our stated goal of eliminating the need for gel as a coupling agent without trapping of an air bubble was successful in 54/64 eyes (84.38%). Our findings could spur development of newer bubble-free goniolenses for procedures such as laser trabeculoplasty.
Measuring Disability in Glaucoma
Authors: Sotimehin Ayodeji E. , Ramulu Pradeep Y.
Published: August 2018

Background:

Glaucomatous visual field loss can have far-reaching and debilitating consequences on an individual, affecting one’s ability to perform many important tasks. Although assessment of glaucoma-related disability constitutes an important part of clinical care, there remains a lack of organized, detailed information on the most suitable methods to capture disability in glaucoma.

Purpose:

This review details the available methods to measure glaucoma-related disability and highlights important findings from studies utilizing these various methods.

Methods:

The literature was reviewed to identify papers evaluating disability in glaucoma and findings were summarized by research methodology used and area of impairment.

Results:

Identified methods for capturing glaucoma-related disability included qualitative descriptions, glaucoma-specific quality of life questionnaires, vision-specific questionnaires, general health questionnaires, functional domain-specific questionnaires, evaluation of task performance, event assessment (ie, falls and motor vehicle accidents), and real-world behavior (ie, daily physical activity). Findings using these methods show a strong relationship between glaucoma and/or glaucoma severity and difficulties with reading, driving, mobility, and other tasks such as prehension and facial recognition. In addition, glaucoma has financial and psychological implications on the patient, and can affect caregivers in some cases as well.

Conclusions:

A wide variety of research tools have been used to characterize the disability resulting from glaucoma. Together, these tools show that glaucoma affects many abilities which are important for independent living. Strengths and limitations of the various research techniques are discussed so that future studies may use the method(s) most suitable for answering the research question posed.
Residuum Muscle Activation During Gait in Individuals with Traditional and Osteomyoplastic Amputation
Authors: Kotamraju Bhanu Prasad , Commuri Sesh , Mai A. , Dionne Carol P. , Day Jonathan , Ertl William J.J.
Published: August 2018

Introduction

In this case series, distal residuum muscle activation during self-paced, fast-paced, and load-carrying walking gaits was compared by traditional transtibial amputation (TTA) or transtibial osteomyoplastic amputation (TOA) approach.

Method

The activities of the residual muscles (tibialis anterior [TA] and gastrocnemius [GA]) were recorded during the three types of gait that are typically encountered during work-related activities.

Results

The study shows that there was substantial muscle activity in both the TA and the GA muscles of a TOA subject. On the other hand, the TA in TTA subjects did not show any appreciable activity during any of the gaits. Although the GA muscle in the intact lower limb was active in the late stance phase in both TOA and TTA subjects, this muscle was also active in the loading phase and in the early swing phase in both the groups. This GA activation occurs consistently with supporting the body weight during early stance and preparing the limb for the swing phase during the gait cycle.

Conclusions

The results of this study lay the foundation for future studies that investigate the effect of muscle activity on the health of the residual transtibial limb.
Improved 6 Minute Walk Distance and Brain-Type Natriuretic Peptide After Continuous-Flow Ventricular Assist Device Placement in Children
Authors: Goldberg Jason F. , Schlosser Robin S. , Walrath James G. , Morris Shaine A. , Elias Barbara A. , Price Jack F. , Cabrera Antonio G. , Denfield Susan W. , Dreyer Wiliam J. , Wang Yunfei , Adachi Iki , Jeewa Aamir
Published: August 2018

Despite increasing continuous-flow ventricular assist device (CF-VAD) use in children, minimal data exist regarding the functional recovery and rehabilitation potential after device placement. We hypothesized that after CF-VAD implantation, children would demonstrate a time-limited improvement in 6 minute walk distance (6MWD) and brain-type natriuretic peptide (BNP). A retrospective cohort study of 27 patients was conducted, those <18 years of age at a tertiary-care center during the study period. Seventy-four percent were male; median age was 12.7 years. Six minute walk distance and BNP were evaluated within 365 days of implantation. Associations were examined before and after 90 days postimplantation because a plateau in both values was seen after 90 days. Data included 92 6MWD and 341 BNP values. In the first 90 days, 6MWD increased by 12 percent predicted (%P) per 30 days (P < 0.01); with no significant change thereafter, increasing 0.6 %P per 30 days (P = 0.482). In the first 90 days, BNP decreased by 59% per 30 days (P < 0.01); with no significant change thereafter, increasing 1.2% per 30 days (P = 0.561). Six minute walk distance and BNP improved after CF-VAD implantation, with a significant improvement only in the first 90 days. Routine use of 6MWD and BNP can help in assessment of functional recovery in children after CF-VAD placement.
Serum Marker Score Based on Prognostic Nutrition Index, Carcinoembryonic Antigen, and Carbohydrate Antigen 19-9 Is Associated With Recurrence for Patients Undergoing Surgery for Pancreatic Ductal Adenocarcinoma
Authors: Nakagawa Shigeki , Yamashita Yo-ichi , Umezaki Naoki , Yamao Takanobu , Okabe Hirohisa , Imai Katsunori , Nitta Hidetoshi , Hashimoto Daisuke , Chikamoto Akira , Baba Hideo
Published: August 2018

Objectives

The prognostic value of the prognostic nutrition index (PNI) in pancreatic ductal adenocarcinoma (PDAC) is still controversial. This study aimed to assess the correlation between PNI and the outcome for PDAC patients and to generate a new score from PNI and serum markers.

Methods

This study investigated 151 patients who underwent pancreatic resection for PDAC between April 2002 and June 2012. Disease-free survival (DFS), overall survival, and clinicopathological parameters were analyzed according to the PNI value.

Results

The low PNI patients had poorer 5-year DFS rate than high-PNI patients (10.7% and 34.8%, respectively). Multivariate analyses revealed that independent risk factors for poor DFS were high carcinoembryonic antigen (hazard ratio [HR], 1.53; P = 0.038), high carbohydrate antigen 19-9 (HR, 1.67; P = 0.017), positive lymph node metastasis (HR, 1.98; P = 0.017), R1 or 2 resection (HR, 3.50; P < 0.001), and low PNI (HR, 0.37 [high/low]; P = 0.029]. Scoring based on the formula −0.49 × (PNI) + 0.41 × (carcinoembryonic antigen) + 0.67 × (carbohydrate antigen 19-9) was significantly associated with poor DFS (P < 0.001) and overall survival (P = 0.0019).

Conclusions

Low PNI and serum marker score are significantly associated with poor DFS.
Catastrophic Delayed Hemolytic Transfusion Reaction in a Patient With Sickle Cell Disease Without Alloantibodies: Case Report and Review of Literature
Authors: Jasinski Sylwia , Glasser Chana L.
Published: August 2018

While packed red blood cell (PRBC) transfusion therapy is a mainstay in the treatment of certain patients with sickle cell disease (SCD) and the standard of care for preoperative management, there are associated risks. Delayed hemolytic transfusion reaction (DHTR) is a risk of PRBC transfusion occurring 2 to 20 days from transfusion and typically presents with severe pain characteristic of vaso-occlusive crisis, fever, and hemolytic anemia. DHTRs are uncommon, occurring in only 4% to 11% of transfused patients with SCD, but may be catastrophic in nature with progression to multiorgan failure within hours. Here, we describe a case of a 20-year-old female with sickle cell SS disease who developed a severe DHTR 5 days following an elective preoperative PRBC transfusion, and rapidly progressed to multiorgan failure and death. This is the first reported case of a catastrophic DHTR in a patient with SCD without any detectable known or new alloantibodies.
Bilateral Hypoglossal Nerve Palsy in an Adult Patient With Repaired Tetralogy of Fallot
Authors: Famoso Giorgia , Padroni Marina , Azzini Cristiano , De Vito Alessandro , Saletti Andrea , Casetta Ilaria
Published: August 2018

Introduction:

Spontaneous cervical artery dissection (sCAD) is a major cause of ischemic stroke in young and middle-aged adults, but the occurrence of multiple sCADs could suggest the presence of an underlying arteriopathy. Bilateral hypoglossal nerve palsy caused by extracranial internal carotid artery dissections have been rarely described. We present the case of a 3-vessel sCAD in a patient with repaired tetralogy of Fallot (ToF).

Case Report:

A 50-year-old man was admitted to our stroke unit for a sudden onset of left cervical pain, mild left ptosis, dysarthria, and dysphagia. His medical history was remarkable for surgically repaired ToF. Neurological examination showed left Claude-Bernard-Horner syndrome and bilateral hypoglossal palsy. Diffusion-weighted magnetic resonance imaging excluded parenchymal lesions while magnetic resonance angiography showed a pattern of bilateral extracranial internal carotid and right vertebral dissection.

Conclusions:

This is the first case of multiple-vessel sCAD, and more associated with an unusual clinical presentation, in a patient with surgically repaired ToF, supporting the hypothesis that defective large artery elastogenesis plays a role in this congenital disorder, and suggesting the importance of continuous long-term vascular follow-up.
Triptan-induced Reversible Cerebral Vasoconstriction Syndrome Presenting With Thunderclap Headache and Paraparesis
Authors: Ramineni Kiran K. , Jakkani Ravi K. , Girgani Suresh , Balani Ankit , Satyanarayan Sandeep
Published: August 2018

Reversible cerebral vasoconstriction syndrome is a rare clinical syndrome characterized by sudden thunderclap headache often an under diagnosed neurological emergency. It is often provoked by postpartum state or exposure to provocative drugs. We report a rare case of Rizatriptan-induced reversible cerebral vasoconstriction syndrome presenting with thunderclap headache and paraparesis with complete recovery of neurological and imaging findings.
Investigation of the Video-EEG Findings and Clinical Data in Patients Diagnosed With Epilepsy and Psychosis
Authors: Mehdikhanova Lala , Vanli Yavuz Ebru N. , Çikrikçili Uğur , Baral Kulaksizoğlu Işin , Bebek Nerses , Gürses Candan , Gökyiğit Ayşen , Baykan Betül
Published: August 2018

Background:

Studies on electrophysiological characteristics of patients with epilepsy and concomitant psychosis are limited. We aimed to investigate the clinical and video-electroencephalography (EEG) findings of patients with epilepsy-related psychosis (EP).

Materials and Methods:

Fifteen patients diagnosed with EP, assessed at the video-EEG monitoring unit and were under follow-up at both epilepsy and psychiatry clinics, were included. A total of 67 nonpsychotic epilepsy patients, investigated at the video-EEG monitoring unit were randomly selected as the control group and compared statistically with the EP group.

Results:

In medical history, patients with EP had experienced significantly higher level of status epilepticus (P=0.002) and perinatal cerebral injury (P=0.04), whereas drug-resistant epilepsy was detected at a lower level (P=0.015). With respect to seizure onset zone, the EP group had significantly more seizures of unknown foci, whereas the control group had mostly temporal lobe origin (P=0.0004). EEG findings showed that slow background activity was significantly common among patients with EP (P=0.009). Although only 5 of 15 patients with EP had been operated, 43 of 67 patients had undergone epilepsy surgery (P=0.04) in the control group. However, there was no significant difference between the 2 groups with respect to postoperative seizure control as per Engel classification.

Conclusions:

Although our sample size could be considered small, slowed EEG background activity, and the marked frequency of initial precipitant factors such as status epilepticus, perinatal cerebral injury, and detected neuronal autoantibodies suggested that EP is associated with more extensive involvement. EP is not a contraindication for epilepsy surgery, when appropriately investigated preoperatively.
Feasibility of Using Bluetooth Low Energy Beacon Sensors to Detect Magnifier Usage by Low Vision Patients
Authors: Bittner Ava Katherine , Jacobson Andrew J. , Khan Rakin
Published: August 2018

SIGNIFICANCE

We demonstrated proof of concept for the potential for Bluetooth low energy beacons to reliably collect data to serve as an indicator that low vision patients are using handheld magnifiers for reading, which might be used in the future to prevent the abandonment of magnification or other assistive devices.

PURPOSE

Bluetooth low energy beacons are an emerging novel technology involving tiny sensors that collect real-time, continuous, objective data, which might help to ascertain the abandonment of low vision devices in a timely manner, thus prompting a follow-up evaluation to attempt to resolve issues. We evaluated whether Bluetooth beacon data could indicate when low vision patients used handheld optical magnifiers for reading.

METHODS

We recorded temperature and/or relative humidity data from Estimote sticker and BlueMaestro Tempo Disc beacons attached to handles of optical magnifiers used for reading by low vision patients in clinic (n = 16) and at home (n = 3).

RESULTS

In the clinic, patients whose hand/fingers made direct versus indirect contact with Estimote beacons had greater temperature increases on average from baseline after 30 seconds (0.73°C vs. 0.28°C), 60 seconds (1.04°C vs. 0.40°C), 90 seconds (1.39°C vs. 0.60°C), 105 to 120 seconds (1.59°C vs. 0.62°C), and 135 to 150 seconds (2.07°C vs. 0.97°C). During magnifier usage at home, BlueMaestro beacons measured rapidly increased temperature (5.6°C per minute on average; range 2.7 to 7.3°C) and relative humidity (19.4% per minute on average; range 8.7 to 34%). Humidity tended to reach its maximum increase and return back to baseline significantly more quickly than temperature (P = .007). All increases during magnifier usage were much greater than the maximum room fluctuations without use (clinic, 0.2°C over 120 seconds; home, 0.6°C and 2.4% over 1 minute). The beacons were nonintrusive and acceptable by patients.

CONCLUSIONS

Estimote and BlueMaestro beacons can reliably detect temperature and/or humidity increases when held by low vision patients while reading with a magnifier.
Recommendations on the Indications for RBC Transfusion for the Critically Ill Child Receiving Support From Extracorporeal Membrane Oxygenation, Ventricular Assist, and Renal Replacement Therapy Devices From the Pediatric Critical Care Transfusion and Anemia Expertise Initiative
Authors: Bembea Melania M. , Cheifetz Ira M. , Fortenberry James D. , Bunchman Timothy E. , Valentine Stacey L. , Bateman Scot T. , Steiner Marie E.
Published: August 2018

Objectives:

To present recommendations and supporting literature for RBC transfusions in critically ill children supported with extracorporeal membrane oxygenation, ventricular assist devices, or renal replacement therapy.

Design:

Consensus conference series of international, multidisciplinary experts in RBC transfusion management of critically ill children.

Methods:

The panel of 38 experts developed evidence-based, and when evidence was lacking, expert-based clinical recommendations as well as research priorities for RBC transfusions in critically ill children. The extracorporeal membrane oxygenation/ventricular assist device/renal replacement therapy subgroup included six experts. We conducted electronic searches of the PubMed, EMBASE, and Cochrane Library databases from 1980 to May 2017, using medical subject heading terms and text words to define concepts of RBC transfusion, extracorporeal membrane oxygenation, ventricular assist device, and renal replacement therapy. We used a standardized data extraction form to construct evidence tables and graded the evidence using the Grading of Recommendations Assessment, Development, and Evaluation system. Recommendations developed and supporting literature were reviewed and scored by all panel members. Agreement was obtained using the Research and Development/UCLA Appropriateness Method.

Results:

For inpatients requiring extracorporeal membrane oxygenation, ventricular assist device, or renal replacement therapy support, there was expert agreement (> 80%) on five good practice statements aimed to improve accuracy and uniform reporting of RBC transfusion data in pediatric extracorporeal membrane oxygenation, ventricular assist device, and renal replacement therapy studies and quality improvement projects; four clinical recommendations of physiologic metrics and biomarkers of oxygen delivery, in addition to hemoglobin concentration, to guide RBC transfusion, acknowledging insufficient evidence to recommend specific RBC transfusion strategies; and eight research recommendations.

Conclusions:

Further research surrounding indications, risks, benefits, and alternatives to RBC transfusion in children on extracorporeal devices is clearly needed. Using a structured literature review and grading process, the Transfusion and Anemia Expertise Initiative panel concluded that there is currently insufficient evidence to recommend specific RBC transfusion variables in children requiring extracorporeal membrane oxygenation, ventricular assist device, or renal replacement therapy support.
Examining the Appropriateness and Motivations Behind Low-Acuity Pediatric Emergency Department Visits
Authors: Haasz Maya , Ostro Daniel , Scolnik Dennis
Published: August 2018

Objectives

High patient volumes have a deleterious effect on care in the pediatric emergency department (PED). Our study assessed the motivation for PED visits that could have been assessed by a primary care physician.

Methods

We identified a convenience sample of patients presenting to the SickKids Hospital PED in June and July 2011 with a Paediatric Canadian Triage and Acuity Score 4 or 5. Patients completed a forced answer yes/no survey describing potential motivators for visiting the PED. Visit appropriateness was determined by a modified version of the DeAngelis tool, an explicit criteria-based tool frequently used for this purpose.

Results

Of the included 635 patients with Paediatric Canadian Triage and Acuity Score 4 and 5, 25% were truly inappropriate as per DeAngelis criteria. Of these, perceived expertise at the tertiary care hospital (93.1%) and ease of getting tests (80.8%) were the most common reasons behind PED presentation.

Conclusions

Patients presenting to our PED typically have primary care physicians; however, access to their physicians during off-hours and availability of off-site testing is limited. Public policy aimed at decreasing overcrowding in the PED should address these themes.
Retrospective Analysis of Contrast-enhanced Ultrasonography Effectiveness in Reducing Time to Diagnosis and Imaging-related Expenditures at a Single Large United States County Hospital
Authors: Streb Jeffrey W. , Tchelepi Hisham , Malhi Harshawn , Deurdulian Corinne , Grant Edward G.
Published: August 2018

Hepatic and renal lesions detected during ultrasound examinations frequently require subsequent contrast-enhanced computed tomography (CT) or magnetic resonance imaging (MRI) for characterization, delaying time to imaging diagnosis and increasing overall health care expenditures. Contrast-enhanced ultrasonography (CEUS) is a comparatively low-cost diagnostic tool that is underutilized in the evaluation of such indeterminate or suspicious hepatic and renal lesions. A retrospective chart review of CEUS examinations performed in our department demonstrated significantly shorter time to imaging diagnosis with CEUS compared to CT or MRI, largely due to the ability to perform the CEUS examination at the time of initial examination. For example mean time to completion for outpatient examinations was 5.2, 52.3, and 123.5 days for CEUS, CT, and MRI, respectively. The majority (78.4%) of CEUS examinations were completed the same day as the initial examination. Additionally, 66.7% of CEUS examinations were deemed diagnostic, abrogating further workup with CT or MRI in most cases. Annual imaging cost reduction of up to US $117,000 is anticipated in our institution based on projected reductions in follow-up CT and MRI examinations. These results indicate when CEUS was used as a first step to characterize both incidental lesions in patients without known risk factors for malignancy as well as suspicious lesions in patients with risk factors it can greatly reduce time to diagnosis and health care expenditures.
Positioning Techniques to Improve the Ultrasound Evaluation of the Elbow
Authors: Mezian Kamal , Machač Stanislav , Zavareh Ali , Majerníková Lucia , Vacek Jan , Navrátil Leoš , Schmitz Marc
Published: August 2018

We introduce an ergonomic positioning for sonographic scanning of elbow joint where the patient is lying semisupine on the examination bed. This is in contrast with the conventional positioning where the patient is sitting on the edge of the bed or across the table on a chair. Our proposed positioning is more comfortable for both the patient and ultrasound practitioner. It also allows immediate ultrasound-guided injections with lesser risk regarding a vasovagal syncope of the patient.
Biogeography and Edaphic Factors Structure Coastal Sediment Microbial Communities More than Vegetation Removal by Sudden Vegetation Dieback
Authors: Gorham Courtney , Barry Aidan , Lawrence Beth A. , Stevena Blaire
Published: August 2018

Development of sudden vegetation dieback (SVD), a phenomenon that causes the rapid mortality of salt marsh plants, specifically Spartina alterniflora, has affected large-scale alterations in Atlantic coastal systems, through the often-complete removal of vegetation. In this study, two wetlands that differ in the time since development of SVD were compared in order to study biogeographic and temporal patterns that structure coastal wetland microbial communities and their response to disturbance.

Biogeographic and edaphic factors that distinguished the two wetlands, such as differing salinity, water content, and soil carbon and nitrogen between the sites were more strongly associated with sediment microbial community structure than either sampling date or SVD development. In fact, no OTUs differed in abundance due to the season samples were collected, or vegetation loss due to SVD. This is not to say that SVD did not alter the composition of the microbial communities. The taxonomic composition of sediment communities in SVD-affected sediments was more heterogeneous between samples and a small number of OTUs were enriched in the vegetated sediments. Yet, these data suggest that coastal wetland sediment communities are predominantly shaped by environmental conditions and are generally resilient to temporal cycles or ecosystem disturbances.

Importance

One of the challenges of microbial ecology is predicting how microbial communities will respond to ecosystem change. Yet, few studies have addressed whether microbial responses to disturbance are consistent over space or time. In this study we employ SVD as a natural vegetation removal experiment and compare the sediment microbial communities between two geographically separated wetlands (ca 125 km). In this manner, we uncover a hierarchical structuring of the microbial communities, being predominantly governed by biogeography, with lesser effects due to disturbance, or temporal dynamics.
Why pro‐life arguments still are not convincing: A reply to my critics
Authors: Räsänen Joona
Published: August 2018

I argued in ‘Pro‐life arguments against infanticide and why they are not convincing’ that arguments presented by pro‐life philosophers are mistaken and cannot show infanticide to be immoral. Several scholars have offered responses to my arguments. In this paper, I reply to my critics: Daniel Rodger, Bruce P. Blackshaw and Clinton Wilcox. I also reply to Christopher Kaczor. I argue that pro‐life arguments still are not convincing.
The Long Arm of Trauma During Childhood: Associations with Resources in Couple Relationships
Authors: Banford Witting Alyssa , Busby Dean
Published: August 2018

Traumatic experiences within and outside the family of origin in childhood may disrupt couple functioning later in life. Using a sample of 3,958 couples assessed through the Relationship Evaluation Questionnaire (RELATE), an actor–partner independence model was fit to test direct and indirect associations between negative impact from one's family of origin (accounting for physical violence and sexual abuse) and resources in couple relationships. Resources were defined using intervention principles derived from the Conservation of Resources (COR) theory. Actor and partner effects suggested negative family impact associates with relationship instability and is mediated through negative couple communication. Actor effects suggested negative family impact associates with less calmness in one's self and is also mediated through negative couple communication.
THE ROLE OF PATENTS IN INFORMATION AND COMMUNICATION TECHNOLOGIES: A SURVEY OF THE LITERATURE
Authors: Comino Stefano , Manenti Fabio M. , Thumm Nikolaus
Published: August 2018

During the last few decades, the number of patents in information and communication technologies has increased considerably. An increasing number of patents and the associated fragmentation of IP rights have generated a series of potentially problematic consequences. Patent thickets, royalty stacking, the emergence of patent assertion entities, increased patent litigation – particularly around standard essential patents – and the difficulties with defining fair, reasonable, and nondiscriminatory licensing terms are some of the most debated issues in the literature that we review in this paper. We devote a specific section of our survey to patent quality, currently one of the most debated issues surrounding the patent system. In our analysis, we mix theoretical and empirical arguments with a more policy‐oriented reasoning. This allows us to better position the different issues in the relevant political and economic context.
IMPLICIT BANK DEBT GUARANTEES: COSTS, BENEFITS AND RISKS
Authors: Schich Sebastian
Published: August 2018

The expectation by market participants that public authorities might bailout the creditors of banks that are considered too important for financial system stability or another reason to be allowed to fail, is commonly referred to as an implicit guarantee. Public authorities do not have any explicit commitment to intervene; they may even honestly state that they not want to do so ex ante, but may feel compelled to do so ex post. A declared policy aim is to limit the value of implicit guarantees by making banks stronger, more easily resolvable in case of distress, as well as by imposing extra charges that rise as banks become more systemically important. As part of the latter approach, globally systemically important banks are identified and subjected to more costly and intrusive regulation. There is little evidence that specific approach has been successful so far. There is some evidence that the introduction of new resolution frameworks has been helpful, while the use of newly available resolution tools and the involvement of bank creditors in the burden sharing associated with bank failure resolution has significantly reduced the value of implicit bank debt guarantees, where it occurred. In that sense, actions speak louder than words.
CRYPTO‐CURRENCIES – AN INTRODUCTION TO NOT‐SO‐FUNNY MONEYS
Authors: Smith Christie , Kumar Aaron
Published: August 2018

We introduce the distributed ledger (blockchain) technology of crypto‐currencies. We examine the ‘monetary’ attributes of crypto‐currencies, and describe some of the reasons they have been adopted. The paper discusses the mechanics of Bitcoin – the original crypto‐currency – to illustrate the fundamental elements of decentralized crypto‐currencies. We then provide a high‐level summary of the implications of crypto‐currencies for consumers, financial systems, and for monetary and regulatory authorities. We argue that crypto‐currencies are unlikely to supplant traditional fiat currencies and we anticipate an enduring role for financial intermediaries in facilitating credit.
The Resilience of Separation of Powers? Congress and the Russia Investigation
Authors: Kriner Douglas , Schickler Eric
Published: August 2018

The return of unified government following President Trump's election in 2016 triggered fears that separation of powers could fail to rein in executive misconduct. However, Congress' handling of the Russia probe largely accords with lessons derived from analysis of more than a century of investigative activity. Unified government greatly blunted the force of the probe in the House; however, the Senate investigation has been more productive and comprehensive. The investigation directly led to sanctions legislation and contributed to the pressure to appoint a special counsel. More generally, it has significantly weakened President Trump's political position by eroding his support among the public.
Reviewer Acknowledgements
Authors: Gibbs Nikki
Published: August 2018

Reviewer AcknowledgementsApplied Economics and Finance (AEF) would like to acknowledge the following reviewers for their assistance with peer review of manuscripts for this issue. Many authors, regardless of whether AEF publishes their work, appreciate the helpful feedback provided by the reviewers. Their comments and suggestions were of great help to the authors in improving the quality of their papers. Each of the reviewers listed below returned at least one review for this issue.Reviewers for Volume 5, Number 5Mahmoud Mohammed Sabra, Al Azhar University-Gaza, PalestineGeorge Theocharides, Cyprus International Institute of Management, CyprusOltiana Muharremi Pelari, University of Vlora, AlbaniaRamona Orastean, Lucian Blaga University of Sibiu, RomaniaIgor Matyushenko, School of Foreign Economic Relations and Touristic Business, UkraineMurad Harasheh, University of Milan-Bicocca, ItalySteven V. Cates, Kaplan University, USAMagdalena Zioło, University of Szczecin, PolandPatrycja Kowalczyk-Rolczynska, Wroclaw University of Economics, PolandGetamesay Bekele Meshesha, Debre Berhan University, EthiopiaSajid Mohy Ul Din, Universiti Utara Malaysia, MalaysiaMarco Muscettola, Independent Researcher-Credit Risk Manager, ItalyY. Saidi, M’sila University, AlgeriaRichard Nguyen, Alliant International University, USASzabolcs Blazsek, Universidad Francisco Marroquín, GuatemalaFarhat Iqbal, University of Balochistan, Quetta – Pakistan. , PakistanLuca Giordano, CONSOB, ItalyRuhet Genc, Turkish-German University, TurkeyErdal Gumus, Eskisehir Osmangazi University, TurkeyRomeo Victor Ionescu, Dunarea de Jos University, RomaniaNuno Crespo, ISCTE-IUL, PortugalSherry Jensen, Florida Institute of Technology, USAMojeed Idowu John Odumeso-Jimoh, Noble Integrated Resources & Management, NigeriaAndrey Kudryavtsev, The Max Stern Yezreel Valley Academic College, IsraelZi-Yi Guo, Wells Fargo Bank, N.A., USADilshodjon Rakhmonov, Tashkent State University of Economics, UzbekistanPayal Chadha, University of Wales Prifysgol Cymru, KuwaitMagdalena Radulescu, University of Pitesti, RomaniaHe Nie, Jinan University, ChinaTaro Abe, Nagoya Gakuin University, JapanIbrahim Baghdadi, Lebanese University, LebanonMamdouh Abdelmoula M. Abdelsalam, Minufiya University, EgyptNikki GibbsEditorial AssistantOn behalf of,The Editorial Board of Applied Economics and FinanceRedfame Publishing9450 SW Gemini Dr. #99416Beaverton, OR 97008, USAURL: http://aef.redfame.com
Pleural effusion in a geriatric cat
Authors: Hele Elizabeth
Published: August 2018

THIS series gives readers the opportunity to consider and contribute to discussion of some of the ethical dilemmas that can arise in veterinary practice. Each month, a case scenario is presented, followed by discussion of some of the issues involved.

In addition, a possible way forward is suggested; however, there is rarely a cut‐and‐dried answer in such cases, and readers may wish to suggest an alternative approach. This month's dilemma, ‘Pleural effusion in a geriatric cat’, was submitted and is discussed by Elizabeth Hele. Readers with comments to contribute are invited to send them as soon as possible, so that they can be considered for publication in the next issue.

The series is being coordinated by Dr Steven McCulloch, acting director of the Centre for Animal Welfare, University of Winchester. It aims to provide a framework that will help practising veterinarians find solutions when facing similar dilemmas.
Spectrum ofELANEmutations in congenital neutropenia: a single-centre study in patients of Indian origin
Authors: Arun A Kumar , Senthamizhselvi Anandan , Hemamalini Suresh , Edison Eunice S , Korula Anu , Fouzia N A , George Biju , Mathews Vikram , Balasubramanian Poonkuzhali
Published: August 2018

Aims

Congenital and cyclical neutropenia are rare inherited diseases that result in recurrent life-threatening bacterial infections due to a deficiency of mature neutrophils. Cyclical neutropenia is usually caused by heterozygousELANEmutations while congenital neutropenia is genetically heterogeneous with mutations in genes likeELANE, HAX-1, G6PC3andGFI1.The presence ofELANEmutation aids in the establishment of diagnosis and rules out other secondary causes of neutropenia such as autoimmune cytopenia and evolving aplasia. Further, patients withELANEmutations are also at a high risk of developing myelodysplasia or acute myeloid leukaemia. Hence it is important to screen for these mutations in patients presenting with neutropenia early in life.

Methods

The study included 52 patients who were evaluated for inherited neutropenia. Genomic DNA was extracted from peripheral blood leucocytes and mutation analysis was done by bidirectional Sanger sequencing.

Results

Ten different missense, frameshift or splice site variants inELANEgene were identified in 11 patients: c.125C>T (p.Pro42Leu), c.164G>A (p.Cys55Tyr), c.169G>A (p.Ala57Thr), c.179T>C (p.Ile60Thr), c.770C>T (p.Pro257Leu), c.367–8C>A, c.597+1G>A along with three novel mutations c.302T>A (p.Val101Glu), c.468G>T (p.Try156Cys) and c.596delT (Phe199Ser fs*13). Family studies were available for three patients and, in all three instances, the mutation had a de novo origin.

Conclusion

The widespread distribution of mutations suggests the need to screen all the exons inELANEgene for proper characterisation of the genotype.
Foster care, syndemic health disparities and associations with HIV/STI diagnoses among young adult substance users
Authors: Buttram Mance E , Pagano Maria E , Kurtz Steven P
Published: August 2018

Objectives

Foster care history is associated with many health and social problems, including sexual risk behaviours, HIV and other sexually transmitted infections (STIs). This cross-sectional study compares sexual risk behaviours among a sample of young adult substance users in Miami (N=602) with and without foster care histories.

Methods

Participants completed a comprehensive assessment which included sections on foster care, sexual risk behaviours and related health and social problems. Logistic regression was used to examine the relationship between foster care history, associated syndemic vulnerabilities and increased likelihood of having a prior HIV/STI diagnosis.

Results

Bivariate analyses indicated that foster care alumni were more likely to report a prior HIV/STI diagnosis, higher condomless sex frequencies, being high on alcohol or drugs during sex, sexual victimisation and a history of homelessness compared with other participants in the sample (p<0.05). Multivariate analyses revealed that foster care history, sexual victimisation and group sex participation are associated with a prior HIV/STI diagnosis (p<0.05). Group sex participation doubled the odds of a prior HIV/STI diagnosis for foster care alumni, compared with other participants (p<0.5).

Conclusions

This exploratory study identifies characteristics that distinguish foster care alumni from non-alumni and signals the need to better serve the sexual and related health needs of individuals with foster care histories. Clinicians and healthcare providers should provide foster care alumni with detailed HIV/STI risk reduction information and resources and services to address related syndemic vulnerabilities (eg, victimisation and homelessness).
Inroads through the bacterial cell envelope: seeing is believing
Authors: Khursigara Cezar M. , Koval Susan F. , Moyles Dianne M. , Harris Robert J.
Published: August 2018

A singular feature of all prokaryotic cells is the presence of a cell envelope composed of a cytoplasmic membrane and a cell wall. The introduction of bacterial cell fractionation techniques in the 1950s and 1960s along with developments in procedures for electron microscopy opened the window towards an understanding of the chemical composition and architecture of the cell envelope. This review traces the contribution of Terry Beveridge in these endeavours, beginning with his doctoral studies in the 1970s on the structure of paracrystalline surface arrays (S-layers), followed by an exploration of cryogenic methods for preserving bacteria for ultrastructural analyses. His insights are reflected in a current example of the contribution of cryo-electron microscopy to S-layer studies — the structure and assembly of the surface array of Caulobacter crescentus. The review then focuses on Terry’s contributions to imaging the ultrastructure of bacterial cell envelopes and to the development of cryo-electron microscopy techniques, including the use of CEMOVIS (Cryo-electron Microscopy of Vitreous Sections) to “see” the ultrastructure of the Gram-positive cell envelope — his last scientific endeavour.
A review of X-ray spectrometry and particle accelerator in Mongolia
Authors: Bolortuya D. , Zuzaan P. , Baatarkhuu D.
Published: August 2018

Applications of X-ray fluorescence (XRF) spectrometer and electron accelerator are reviewed with regard to the historical development in Mongolia. The first XRF spectrometer was installed at Nuclear Research Laboratory, National University of Mongolia (NUM) in 1975. Since that time, XRF has developed into a suitable multi-elemental analysis technique with many fields of practical applications. In 1996, electron cycle accelerator (facility called Microtron MT22) was established at the Mongolian Academy of Science (MAS). The maximum energy is set to 22 MeV, suitable for routine activation analysis. The photo and neutron induced nuclear reactions and analysis of chemical elements in various samples and structure analysis of semi-precious stones were studied using the accelerator. Nevertheless, the MT22 is not used for particle induced X-ray emission (PIXE) analysis since it is difficult to obtain calibration parameters. In case of Mongolia, collected research samples are sent to Japan and New Zealand for PIXE analysis because this analysis method has higher sensitivity compared to conventional XRF method. In order to develop the X-ray research field in Mongolia, an international conference on X-ray analysis has been held every three years since 2006. Nowadays, there are above 20 laboratories in Mongolia which use the XRF methods and techniques, among them about 80 percent of them are utilized for fields of geology, mining and their industrial control processing and others are used for environment, monitoring control and research studies.
Torus classical conformal blocks
Authors: Menotti Pietro
Published: August 2018

After deriving the classical Ward identity for the variation of the action under a change of the modulus of the torus, we map the problem of the sphere with four sources to the torus. We extend the method previously developed for computing the classical conformal blocks for the sphere topology to the tours topology. We give the explicit results for the classical blocks up to the third-order in the nome included and compare them with the classical limit of the quantum conformal blocks. The extension to higher orders is straightforward.
Knowledge-Based Model of Expert Systems Using Rela-Model
Authors: Do Nhon V. , Nguyen Hien D. , Selamat Ali
Published: August 2018

Knowledge about relations plays a crucial role in human’s knowledge. Different methods for representing this type of knowledge have been proposed. However, due to the lack of theoretical foundations, these methods cannot guarantee criteria in knowledge representation such as formality, universality, usability and practicality. They are not adequate to represent the knowledge domains in practice which have many components. Based on formal ontology approach, a knowledge model about relations, called Rela-model, is presented in this paper. It has the components such as concepts, relations between concepts, and rules. The concepts in this model consist of attributes, facts and rules of itself. Each object in a concept has also equipped its behavior to solve problems on it. The methods for solving problems based on Rela-model are also studied. The general problems on this model are the following: Given some objects and facts on them, determine the closure of set of attributes and facts on the objects or determine an object or consider a relation between the objects. The algorithms to solve problems are designed and their properties, such as finiteness, effectiveness, have also been proved. Besides the solid mathematical foundation, Rela-model also has a simple specification language which can effectively represent the knowledge, thus it can be used in many real situations. Our approach is also applied to build two systems: the intelligent problem solver about solid geometry in high school mathematics, and the expert system to diagnose diseases in diabetic microvascular complication.
Testing Multi-Threaded Applications Using Answer Set Programming
Authors: Xue Xiaozhen , Siami-Namini Sima , Namin Akbar Siami
Published: August 2018

We introduce a technique to formally represent and specify race conditions in multithreaded applications. Answer set programming (ASP) is a logic-based knowledge representation paradigm to formally express belief acquired through reasoning in an application domain. The transparent and expressiveness representation of problems along with powerful non-monotonic reasoning power enable ASP to abstractly represent and solve some certain classes of NP hard problems in polynomial times. We use ASP to formally express race conditions and thus represent potential data races often occurred in multithreaded applications with shared memory models. We then use ASP to generate all possible test inputs and thread interleaving, i.e. scheduling, whose executions would result in deterministically exposing thread interleaving failures. We evaluated the proposed technique with some moderate sized Java programs, and our experimental results confirm that the proposed technique can practically expose common data races in multithreaded programs with low false positive rates. We conjecture that, in addition to generating threads scheduling whose execution order leads to the exposition of data races, ASP has several other applications in constraint-based software testing research and can be utilized to express and solve similar test case generation problems where constraints play a key role in determining the complexity of searches.