bluuebunny/crossref_metadata_2025 huggingface dataset:
Volatile Profile of Cashew Apple Juice Fibers from Different Production Steps
Authors: Nobre Ana , De Almeida Áfia , Lemos Ana , Magalhães Hilton , Garruti Deborah
Published: May 2015

This study aimed to determine the volatile profile of cashew apple fibers to verify which compounds are still present after successive washings and thus might be responsible for the undesirable remaining cashew-like aroma present in this co-product, which is used to formulate food products like vegetarian burgers and cereal bars. Fibers were obtained from cashew apple juice processing and washed five times in an expeller press. Compounds were analyzed by the headspace solid-phase micro extraction technique (HS-SPME) and gas chromatography-mass spectrometry (GC-MS), using a DB-5 column. Sensory analysis was also performed to compare the intensity of the cashew-like aroma of the fibers with the original juice. Altogether, 80 compounds were detected, being esters and terpenes the major chemical classes. Among the identified substances, 14 were classified as odoriferous in the literature, constituting the matrix used in the Principal Component Analysis (PCA). Odoriferous esters were substantially reduced, but many compounds were extracted by the strength used in the expeller press and remained until the last wash. Among them are the odoriferous compounds ethyl octanoate, γ-dodecalactone, (E)-2-decenal, copaene, and caryophyllene that may contribute for the mild but still perceptible cashew apple aroma in the fibers that have been pressed and washed five times. Development of a deodorization process should include reduction of pressing force and stop at the second wash, to save water and energy, thus reducing operational costs and contributing to process sustainability.
PON1 and Mediterranean Diet
Authors: Lou-Bonafonte José , Gabás-Rivera Clara , Navarro María , Osada Jesús
Published: May 2015

The Mediterranean diet has been proven to be highly effective in the prevention of cardiovascular diseases. Paraoxonase 1 (PON1) has been implicated in the development of those conditions, especially atherosclerosis. The present work describes a systematic review of current evidence supporting the influence of Mediterranean diet and its constituents on this enzyme. Despite the differential response of some genetic polymorphisms, the Mediterranean diet has been shown to exert a protective action on this enzyme. Extra virgin olive oil, the main source of fat, has been particularly effective in increasing PON1 activity, an action that could be due to low saturated fatty acid intake, oleic acid enrichment of phospholipids present in high-density lipoproteins that favor the activity, and increasing hepatic PON1 mRNA and protein expressions induced by minor components present in this oil. Other Mediterranean diet constituents, such as nuts, fruits and vegetables, have been effective in modulating the activity of the enzyme, pomegranate and its compounds being the best characterized items. Ongoing research on compounds isolated from all these natural products, mainly phenolic compounds and carotenoids, indicates that some of them are particularly effective, and this may enhance the use of nutraceuticals and functional foods capable of potentiating PON1 activity.
Patterns of Food Parenting Practices and Children’s Intake of Energy-Dense Snack Foods
Authors: Gevers Dorus , Kremers Stef , De Vries Nanne , Van Assema Patricia
Published: May 2015

Most previous studies of parental influences on children’s diets included just a single or a few types of food parenting practices, while parents actually employ multiple types of practices. Our objective was to investigate the clustering of parents regarding food parenting practices and to characterize the clusters in terms of background characteristics and children’s intake of energy-dense snack foods. A sample of Dutch parents of children aged 4–12 was recruited by a research agency to fill out an online questionnaire. A hierarchical cluster analysis (n = 888) was performed, followed by k-means clustering. ANOVAs, ANCOVAs and chi-square tests were used to investigate associations between cluster membership, parental and child background characteristics, as well as children’s intake of energy-dense snack foods. Four distinct patterns were discovered: “high covert control and rewarding”, “low covert control and non-rewarding”, “high involvement and supportive” and “low involvement and indulgent”. The “high involvement and supportive” cluster was found to be most favorable in terms of children’s intake. Several background factors characterized cluster membership. This study expands the current knowledge about parental influences on children’s diets. Interventions should focus on increasing parental involvement in food parenting.
Blueberries Improve Endothelial Function, but Not Blood Pressure, in Adults with Metabolic Syndrome: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial
Authors: Stull April , Cash Katherine , Champagne Catherine , Gupta Alok , Boston Raymond , Beyl Robbie , Johnson William , Cefalu William
Published: May 2015

Blueberry consumption has been shown to have various health benefits in humans. However, little is known about the effect of blueberry consumption on blood pressure, endothelial function and insulin sensitivity in humans. The present study investigated the role of blueberry consumption on modifying blood pressure in subjects with metabolic syndrome. In addition, endothelial function and insulin sensitivity (secondary measurements) were also assessed. A double-blind and placebo-controlled study was conducted in 44 adults (blueberry, n = 23; and placebo, n = 21). They were randomized to receive a blueberry or placebo smoothie twice daily for six weeks. Twenty-four-hour ambulatory blood pressure, endothelial function and insulin sensitivity were assessed pre- and post-intervention. The blood pressure and insulin sensitivity did not differ between the blueberry and placebo groups. However, the mean change in resting endothelial function, expressed as reactive hyperemia index (RHI), was improved significantly more in the group consuming the blueberries versus the placebo group (p = 0.024). Even after adjusting for confounding factors, i.e., the percent body fat and gender, the blueberry group still had a greater improvement in endothelial function when compared to their counterpart (RHI; 0.32 ± 0.13 versus −0.33 ± 0.14; p = 0.0023). In conclusion, daily dietary consumption of blueberries did not improve blood pressure, but improved (i.e., increased) endothelial function over six weeks in subjects with metabolic syndrome.
Optical Detection of Paraoxon Using Single-Walled Carbon Nanotube Films with Attached Organophosphorus Hydrolase-Expressed Escherichia coli
Authors: Kim Intae , Kim Geon , Kim Chang , Cha Hyung , Lim Geunbae
Published: May 2015

In whole-cell based biosensors, spectrophotometry is one of the most commonly used methods for detecting organophosphates due to its simplicity and reliability. The sensor performance is directly affected by the cell immobilization method because it determines the amount of cells, the mass transfer rate, and the stability. In this study, we demonstrated that our previously-reported microbe immobilization method, a microbe-attached single-walled carbon nanotube film, can be applied to whole-cell-based organophosphate sensors. This method has many advantages over other whole-cell organophosphate sensors, including high specific activity, quick cell immobilization, and excellent stability. A device with circular electrodes was fabricated for an enlarged cell-immobilization area. Escherichia coli expressing organophosphorus hydrolase in the periplasmic space and single-walled carbon nanotubes were attached to the device by our method. Paraoxon was hydrolyzed using this device, and detected by measuring the concentration of the enzymatic reaction product, p-nitrophenol. The specific activity of our device was calculated, and was shown to be over 2.5 times that reported previously for other whole-cell organophosphate sensors. Thus, this method for generation of whole-cell-based OP biosensors might be optimal, as it overcomes many of the caveats that prevent the widespread use of other such devices.
Diamond Nanowires: A Novel Platform for Electrochemistry and Matrix-Free Mass Spectrometry
Authors: Szunerits Sabine , Coffinier Yannick , Boukherroub Rabah
Published: May 2015

Over the last decades, carbon-based nanostructures have generated a huge interest from both fundamental and technological viewpoints owing to their physicochemical characteristics, markedly different from their corresponding bulk states. Among these nanostructured materials, carbon nanotubes (CNTs), and more recently graphene and its derivatives, hold a central position. The large amount of work devoted to these materials is driven not only by their unique mechanical and electrical properties, but also by the advances made in synthetic methods to produce these materials in large quantities with reasonably controllable morphologies. While much less studied than CNTs and graphene, diamond nanowires, the diamond analogue of CNTs, hold promise for several important applications. Diamond nanowires display several advantages such as chemical inertness, high mechanical strength, high thermal and electrical conductivity, together with proven biocompatibility and existence of various strategies to functionalize their surface. The unique physicochemical properties of diamond nanowires have generated wide interest for their use as fillers in nanocomposites, as light detectors and emitters, as substrates for nanoelectronic devices, as tips for scanning probe microscopy as well as for sensing applications. In the past few years, studies on boron-doped diamond nanowires (BDD NWs) focused on increasing their electrochemical active surface area to achieve higher sensitivity and selectivity compared to planar diamond interfaces. The first part of the present review article will cover the promising applications of BDD NWS for label-free sensing. Then, the potential use of diamond nanowires as inorganic substrates for matrix-free laser desorption/ionization mass spectrometry, a powerful label-free approach for quantification and identification of small compounds, will be discussed.
Business Engagement with Sustainable Water Resource Management through Water Footprint Accounting: The Case of the Barilla Company
Authors: Antonelli Marta , Ruini Luca
Published: May 2015

This study investigates business engagement in sustainable water management, focusing on water footprint accounting as a tool to account for water use in food supply chains. An explorative analysis is conducted on the Barilla Company. The study explores two corporate strategies aimed at achieving more sustainable water use: the adoption of environmental products declarations (EPDs), a reporting system that accounts for the environmental footprints of Barilla’s pasta and other products; and the implementation of the Aureo Wheat Programme. The study deployed both primary and secondary data. The study shows that the largest share of the water footprint of pasta relates to the cultivation phase (over 90%), which is almost fully rainfed. EPDs show that the water footprint of the other phases of the supply chain is negligible. It is argued that the use of water footprinting in EPDs can raise awareness about water use in agricultural supply chains to reach a broad spectrum of stakeholders, including consumers. The study also shows that the implementation of the Aureo Wheat Programme, consisting of a shift in cultivation site and in the type of wheat, enabled a reduction in the blue water footprint of pasta, with water savings amounting to 35 million m3 of blue water since 2011.
Improving Water Use in Fodder Production
Authors: Mendoza-Grimón Vanessa , Hernández-Moreno José , Palacios-Díaz María
Published: May 2015

Water deficit in semi-arid regions limits the future of the livestock sector. Also, its high price represents a percentage of the total cost of forage production. Non-conventional water resources applied by subsurface drip irrigation (SDI), in which the safe use lies in the management and not on the level of water treatment, would enhance the ruminant production sustainability. To obtain the optimal benefit, the transformation of water per kilogram of dry matter produced must have a high grade of effectiveness. Under this premise, a maralfalfa crop (Penissetum sp, hybridum) has been established with an SDI system and reclaimed water. Forage yield is analyzed with respect to a 40% irrigation reduction. This study shows that, with the use of these good irrigation management practices, it is possible to harvest an annual production of 90 to 72 t·ha−1 in the warmer regions of the Canary Islands. This implies water consumption between 13,200 and 8100 m3·ha−1. A water consumption of 21,000 m3·ha−1 per year for the same production, at a ratio of 230 L·t−1, can be estimated for the rest of the Canary Islands coastal regions. The use of the water management described in this paper can be profitable in the Canary Islands for fodder production.
An intramolecular C–N cross-coupling of β-enaminones: a simple and efficient way to precursors of some alkaloids of Galipea officinalis
Authors: Doušová Hana , Horák Radim , Růžičková Zdeňka , Šimůnek Petr
Published: May 2015

2-Aroylmethylidene-1,2,3,4-tetrahydroquinolines with the appropriate substituents can be suitable precursors for the synthesis of alkaloids from Galipea officinalis (cuspareine, galipeine, galipinine, angustureine). However, only two, rather low-yielding procedures for their synthesis are described in the literature. We have developed a simple and efficient protocol for an intramolecular, palladium or copper-catalysed amination of both chloro- and bromo-substituted 3-amino-1,5-diphenylpent-2-en-1-ones leading to the above-mentioned tetrahydroquinoline moiety. The methodology is superior to the methods published to date.
Safety, Virology and Pharmacokinetics of Oseltamivir in Infants with Laboratory-Confirmed Influenza: A Phase I/II, Prospective, Open-Label, Multicentre Clinical Trial
Authors: Rath Barbara A , Brzostek Jerzy , Guillén Sara , Niranjan Vis , Chappey Colombe , Rayner Craig R , Clinch Barry
Published: May 2015

Background

The influenza antiviral oseltamivir is not licensed for infants aged <1 year in most countries outside the United States. More information is needed on oseltamivir safety at different dosing levels in this vulnerable age group.

Methods

In this prospective, observational, non-randomized study, infants aged <1 year with laboratory-confirmed influenza were treated with oral oseltamivir for 5 days. Cohorts 1, 2 and 3 (aged 91–364, 31–90 and 0–30 days, respectively), received twice-daily dosages of 3, 2.5 and 2 mg/kg, respectively. Assessments included pharmacokinetics, on-treatment adverse events, resistance testing and viral shedding.

Results

A total of 65 patients were enrolled: 40, 20 and 5 in cohorts 1, 2 and 3, respectively. Systemic exposure to oseltamivir carboxylate (active metabolite) reached therapeutic levels in all patients, with an adequate safety margin. On-treatment adverse events ( n=48) were reported by 32 patients (49%). At least one adverse event was reported by 43%, 65% and 40% of infants in cohorts 1, 2 and 3, respectively; most frequently vomiting and diarrhoea. Eight serious adverse events were reported, all of which were considered unrelated to treatment by the investigator. No deaths occurred and no patient had treatment withdrawn. Oseltamivir resistance mutations were detected in eight patients.

Conclusions

Oseltamivir dosages of 2–3 mg/kg were well tolerated in infants aged <1 year and achieved therapeutic exposure levels. The current study supports the adoption of a universal dosing recommendation for infants. Clinicaltrials.gov unique identifier NCT00988325.
La médicalisation de l’accouchement : impacts possibles sur la santé mentale et physique des familles
Authors: Dessureault Anne-Marie
Published: May 2015

L’objet de cet article est de faire le point sur les enjeux éthiques entourant les pratiques périnatales. Celles-ci sont traitées du point de vue de la liberté de choix, des impacts de ces pratiques sur la santé maternelle et infantile, ainsi que du point de vue de leurs effets psychologiques sur la mère, son partenaire et le nouveau-né. Les pratiques actuelles prônant largement l’hospitalisation et la médicalisation de l’accouchement sont donc critiquées et des pistes de solution alternatives sont avancées afin de promouvoir le bien-être des familles vivant une naissance.
Recognizing the Dialectic of Compassionate Care in the Workplace: Feedback From Nurse Educators
Authors: Winch Sarah , Henderson Amanda , Jones Jennifer
Published: May 2015

Compassionate care and compassion fatigue affects managers, clinicians, and patients and is gaining international recognition. Using the café methodology as a structure and nurse educators as participants, a compassion dialectic between the psychological intent of the nurse to be compassionate and a system designed on maximizing throughput, with the least inputs possible is identified. Our findings indicate that the café in itself is not sufficient to enable experienced educators to take responsibility for compassionate care, but the café methodology opens the space for the important steps of naming the problem, recognizing its dialectical nature, deflecting blame for compassion fatigue away from individuals, and balancing the responsibility for compassion across the spectrum of elements that enable care to take place.

J Contin Educ Nurs.
2015;46(5):228–232.
A Game-Based Strategy for the Staff Development of Home Health Care Nurses
Authors: Popil Inna , Dillard-Thompson Darlene
Published: May 2015

This article describes gaming, an interactive teaching strategy that promotes active learning. An evaluation study conducted with home health care nurses tested the use of a game as a teaching tool. The study evaluated learning outcomes and learners’ level of engagement and satisfaction with an educational game as a teaching method.

J Contin Educ Nurs.
2015;46(5):205–207.
Risperidone Use in Children: Gynecomastia, Hyperprolactinemia, and Other Controversies
Authors: Isaac George
Published: May 2015

The use of neuroleptics, especially risperidone, and their common side effect of hyperprolactinemia and the rare but significant adverse effect of gynecomastia has become a contentious issue. Advertisements for class action lawsuits and media reports of gynecomastia cause concern for patients and parents of children prescribed such medicines. The relationship between neuroleptic use, hyperprolactinemia, and gynecomastia is poorly understood, and there is very little guidance for psychiatrists, especially child psychiatrists, who need to prescribe these medicines. Although risperidone ranks high among atypical neuroleptics in producing hyperprolactinemia, unlike what many legal advertisements claim or suggest, no direct connection has been established between hyperprolactinemia and gynecomastia. Prescribers of risperidone and other neuroleptics would benefit from becoming more aware of the issue of neuroleptic-induced hyperprolactinemia and gynecomastia to avoid adverse effects for patients and ethical and legal jeopardy for themselves. This article presents facts and suggests measures that may be helpful for those prescribing risperidone and other neuroleptics, especially for children.

[
Psychiatr Ann
. 2015;45(4):204–206, 208–211.]
Ipsilateral Femoral Neck and Shaft Fractures: Current Diagnostic and Treatment Strategies
Authors: Hak David J. , Mauffrey Cyril , Hake Mark , Hammerberg E. Mark , Stahel Philip F.
Published: May 2015

Associated ipsilateral femoral neck fractures have been reported to occur in 1% to 9% of femoral shaft fractures. The associated femoral neck fracture is often nondisplaced, and the diagnosis is delayed or missed in up to one-third of cases. It is essential to carefully evaluate the femoral neck in all patients sustaining high-energy femoral shaft fractures. Although there are a number of different implant options available for management of this challenging injury, most authors recommend that priority be given to anatomic reduction and optimal stabilization of the femoral neck fracture because nonunion, malunion, or avascular necrosis of this injury is more difficult to successfully treat. [
Orthopedics.
2015; 38(4):247–251.]
Surgical Treatment of Posterior Cruciate Ligament Insufficiency in the United States
Authors: Wang Dean , Berger Neal , Cohen Jeremiah R. , Lord Elizabeth L. , Wang Jeffrey C. , Hame Sharon L.
Published: May 2015

The purpose of this study was to investigate the latest trends and demographics of surgical treatment of posterior cruciate ligament (PCL) insufficiency in the United States. Patients who underwent surgical treatment of PCL insufficiency from 2007 to 2011 were identified by searching the
International Classification of Diseases,
Ninth Revision, Clinical Modification codes and Current Procedural Terminology codes in the PearlDiver Patient Records Database (PearlDiver Technologies, Warsaw, Indiana), a publicly available national database of insurance records. The chronicity of injury, year of procedure, age, sex, region of the United States the surgery was performed, and other concomitant meniscus and ligamentous operations were elicited for each patient. In total, 701 cases of surgical PCL procedures (222 isolated and 479 combined) were identified. More PCL surgeries were completed for acute injuries (74%) than for chronic injuries (26%). Among associated procedures, meniscectomies and meniscus repairs were performed for 293 (41%) and 51 (7%) patients, respectively. Meniscectomies were completed in 77 (35%) isolated reconstructions vs 216 (45%) combined reconstructions (
P
=.01; odds ratio, 0.65). Of the combined PCL surgeries, anterior cruciate ligament (ACL)/PCL was the most common (62%), followed by ACL/PCL/collateral ligament repair (11%) and PCL/other ligamentous reconstruction (9%). No specific trends were observed in the yearly number of PCL procedures performed. The peak number of isolated PCL surgeries was observed in a younger age group (20–29 years) than that of combined PCL surgeries (30–39 years) (
P
<.01). Surgical treatment for PCL insufficiency remains reserved for acute multiligamentous knee injuries, with ACL/PCL operations being the most common combined procedure. [
Orthopedics.
2015; 38(4):e281–e286.].
Accuracy of Patient-Specific Instrumentation Compared With Conventional Instrumentation in Total Knee Arthroplasty
Authors: Jiang Jin , Kang Xin , Lin Qiao , Teng Yuanjun , An Liping , Ma Jingling , Wang Jing , Xia Yayi
Published: May 2015

Patient-specific instrumentation (PSI) has recently been introduced to improve the alignment following total knee arthroplasty (TKA). However, controversy remains between PSI and conventional instrumentation. The aim of this study is to compare the accuracy of PSI with conventional instruments for total knee arthroplasty (TKA). A systematic literature search was performed in databases including PubMed, the Cochrane Library, EMBASE, and Web of Science. All of the available randomized, controlled trials (RCTs) or non-randomized, controlled trials (nRCTs) comparing PSI with conventional instruments for TKA were identified. A statistical analysis was performed of this meta-analysis. Eighteen studies with 2417 patients were included in the authors’ final analysis. The results of the meta-analysis demonstrated that there were no statistical differences in outliers of the mechanical axis (risk ratio [RR], 0.84; 95% confidence interval [CI], 0.61–1.11), the femoral component in the coronal (RR, 0.56; 95% CI, 0.32–1.05) and sagittal (RR, 0.83; 95% CI, 0.60–1.14) plane, the tibial component in the coronal (RR, 0.84; 95% CI, 0.52–1.35) and sagittal (RR, 1.04; 95% CI, 0.69–1.55) plane, and the femoral component rotation (RR, 1.02; 95% CI, 0.57, 1.83) between the 2 groups. In addition, subgroup analysis showed that the study design and imaging used for preoperative scanning did not affect the outcome of the alignment, but a different PSI system might. The authors’ meta-analysis indicated that the accuracy of PSI was not superior to conventional instruments for patients undergoing TKA. Future RCTs should focus on functional outcomes and component survivorship with mid- to long-term follow-up. [
Orthopedics.
2015; 38(4):e305–e313.]
Ceramic-on-Ceramic Versus Ceramic-on-Polyethylene Bearing Surfaces in Total Hip Arthroplasty
Authors: Hu Dongcai , Yang Xiao , Tan Yang , Alaidaros Mohammed , Chen Liaobin
Published: May 2015

The choice between ceramic-on-ceramic (COC) and ceramic-on-polyethylene (COP) in primary total hip arthroplasty (THA) remains controversial. The purpose of this study was to evaluate the reliability and durability of COC vs COP bearing surfaces in THA. Based on published randomized, controlled trials (RCTs) identified in PubMed, Embase, and the Cochrane Central Register of Controlled Trials, the authors performed a meta-analysis comparing the clinical and radiographic outcomes of COC with those of COP. Two investigators independently selected the studies and extracted the data. The methodological quality of each RCT was assessed using the Physiotherapy Evidence Database (PEDro) scale. Relative risks and 95% confidence intervals from each trial were pooled using random-effects or fixed-effects models depending on the heterogeneity of the included studies. Nine RCTs involving 1575 patients (1747 hips) met the predetermined inclusion criteria. Eight of 9 included RCTs had high methodological quality. The heterogeneity was not significant, and all the results were pooled using a fixed-effects model. The results demonstrated that COC significantly increased the risks of squeaking and total implant fracture compared with COP. No significant differences with respect to revision, osteolysis and radiolucent lines, loosening, dislocation, and deep infection were observed between the COC and COP bearing surfaces. This meta-analysis resulted in no sufficient evidence to identify any clinical or radiographic advantage of COC vs COP bearing surfaces in the short- to mid-term follow-up period. Long-term follow-up is required for further evaluation. [
Orthopedics
. 2015; 38(4):e331–e338.]
L5 Pedicle Subtraction Osteotomy for High-Grade Isthmic Spondylolisthesis
Authors: Radcliff Kristen E. , Jakoi Andre M.
Published: May 2015

To the authors’ knowledge, this is the first article to present a pedicle subtraction osteotomy in the lumbar spine to correct and stabilize a high-grade isthmic spondylolisthesis, which poses many challenges with regard to treatment options and outcomes. The optimal surgical treatment for high-grade spondylolisthesis is controversial, but the goals of treatment are to stabilize the affected spinal levels and to decompress the neural elements. A pedicle subtraction osteotomy is a reconstructive procedure that addresses fixed sagittal imbalance by increasing lumbar lordosis through posterior spinal column shortening. The authors report a 46-year-old patient with chronic, progressively worsening back and leg radiculopathy accompanied by sagittal plane malalignment and for which a pedicle subtraction osteotomy was performed. The procedure yielded stabilization of the patient’s lumbar spondylolisthesis and sagittal plane alignment was restoration. At 3 months postoperatively, the patient’s pain had fully resolved and her motor and neurologic examination exhibited no deficits. At 24 months postoperatively, she was still symptom-free and ambulating without assistance. This report is the first documented successful pedicle subtraction osteotomy in the treatment of high-grade spondylolisthesis. This report indicates that certain patient populations may be amenable to pedicle subtraction osteotomy as a treatment option for pathology involving high-grade isthmic spondylolisthesis [
Orthopedics
. 2015; 38(4):e347–e351.]
Tuberculosis of the Cervical Spine
Authors: Macke Jeremy J. , Engel Adam J. , Sawin Paul D. , Bancroft Laura W.
Published: May 2015

A 25-year-old male state-prisoner presented with altered mental status, right neck pain, and uncontrolled hypertension.
Elective Hand Surgery After Axillary Lymph Node Dissection for Cancer
Authors: Lee R. Jay , LaPorte Dawn M. , Brooks Jaysson T. , Schubert Cornelius D. , Deune E. Gene
Published: May 2015

After axillary lymph node dissection (ALND), patients are cautioned against ipsilateral interventional procedures to avoid the theoretical increased risk of postoperative complications, particularly lymphedema. The authors’ goal was to evaluate the complications of elective hand surgery after ALND. The authors reviewed patients presenting to their hand clinic from 1998 to 2011, selecting those with a diagnosis of breast cancer or melanoma and a history of previous ALND; the authors excluded those treated nonoperatively and those treated with elective surgery in the contralateral hand. Average age of the 22 patients meeting the criteria (20 with a history of breast cancer, 6 with preexisting lymphedema) was 53.9 years (range, 26.7 to 73.6 years) at the time of ALND and 63.1 years (range, 31.7 to 83.5 years) at the time of hand surgery. Average interval between surgeries was 9.2 years (range, 8 days to 37.3 years). Follow-up averaged 9.2 months (range, 8 days to 41.7 months). Fifteen patients were surveyed for long-term postoperative results (average surgery-to-survey interval, 4.3 years [range, 1 to 11.9 years]). Fifteen patients had uneventful postoperative recoveries, 4 had peri-incisional erythema requiring oral antibiotics, 1 had incisional pain and scarring, 1 had chronic wound-healing issues, and 1 had a dehiscence requiring a return to the operating room. In the 15 patients who completed the follow-up survey, there was no disease exacerbation in the 3 patients with preexisting lymphedema, and there were no new cases of lymphedema. Routine minor hand surgery did not result in lymphedema and did not increase existing lymphedema in these patients with previous ipsilateral ALND, but almost one-third of them had short-term complications in the postoperative recovery period. [
Orthopedics.
2015; 38(5):e367–e373.]
Unicortical Versus Bicortical Locked Plate Fixation in Midshaft Clavicle Fractures
Authors: Bravman Jonathan T. , Taylor Michal L. , Baldini Todd , Vidal Armando F.
Published: May 2015

Higher rates of poor outcomes in displaced midshaft clavicle fractures treated nonoperatively have recently been reported. Along with expanding indications for operative fixation and increasing application of locked plate constructs, it is unknown whether complications related to bicortical penetration of the clavicle can be avoided using unicortical fixation. The purpose of this study is to compare the biomechanical properties of unicortical and bicortical fixation in precontoured vs manually contoured locking clavicle plates. Forty-eight Sawbone composite human clavicle specimens (item #3408; Pacific Research Laboratories, Vashon, Washington) with a midshaft clavicle osteotomy were reduced and plated in 8 specimens each using a bicortical and unicortical fixation for each of 3 locked plate constructs (3.5-mm LCP Reconstruction Plate; 3.5-mm LCP Superior Clavicle Plate; 3.5-mm LCP Superior Anterior Clavicle Plate; Synthes, Inc, West Chester, Pennsylvania). Specimens were tested for stiffness in axial torsion and cantilever bending and then loaded to failure in 3-point bending. Data were analyzed using 2-way analysis of variance and Tukey’s test (
P
<.05). No significant differences were found between unicortical and bicortical fixation in failure load, cantilever bending, and cross body stiffness. Bicortical fixation was significantly stiffer than unicortical fixation in torsion only for the same plates. Significant differences also existed between plates in torsion. Unicortical locked plate fixation may be a reasonable option in the treatment of displaced midshaft clavicle fracture fixation to avoid complications associated with posteroinferior hardware penetration following clavicle fracture fixation based on the biomechanical performance of these constructs. However, it remains unclear whether these differences will be clinically significant. [
Orthopedics.
2015; 38(5):e411–e416.]
Bilateral Arthroscopic Rotator Cuff Repair Using a Single-Stage Procedure
Authors: Pak Chi Hyoung , Moon Young Lae , Sim Sung Woo , Elsayed Moustafa Ismail
Published: May 2015

Bilateral rotator cuff tears requiring repair are not uncommon. Typically, these tears have been treated with staged surgeries. However, in appropriately selected cases, single-stage repair is preferable because it reduces costs, the number of admissions, total hospitalization, and rehabilitation time. It can also reduce patient suffering by providing relief with a single procedure. The authors compared 10 patients with a mean age of 55 years who had bilateral symptomatic rotator cuff tear and underwent single-stage bilateral arthroscopic cuff repair (group A) with 17 patients with a mean age of 55 years who had unilateral symptomatic rotator cuff tear and underwent unilateral arthroscopic cuff repair (group B). Clinical assessment was performed preoperatively and at 3, 6, and 12 months postoperatively with the visual analog scale, the University of California Los Angeles (UCLA) score, and the Korean shoulder score. Overall function, pain, and strength were improved significantly in both groups. Although the difference in visual analog scale score between both groups decreased during follow-up, this score was significantly lower in group B (
P
=.026). At initial follow-up, the UCLA score was higher in group A. However, at the last follow-up, this score was significantly higher in group B (
P
<.001). The Korean shoulder score was significantly higher in group A at all follow-up times (
P
<.001). The study findings showed that single-stage bilateral rotator cuff repair is a preferable option in appropriately selected patients. It can provide satisfactory results without additional complications, and it does not lead to longer hospitalization or rehabilitation than unilateral repair. [
Orthopedics.
2015; 38(5):e423–e427.]
Greater Trochanteric Fragmentation After Failed Metal-on-Metal Hip Arthroplasty
Authors: Panichkul Phonthakorn , Fricka Kevin B. , Hopper Robert H. , Engh C. Anderson
Published: May 2015

Adverse reaction to metal debris (ARMD) involving the hip joint has emerged as an important reason for failure and revision among patients with metal-on-metal (MOM) hip arthroplasty. To the authors’ knowledge, there are no reports of adverse radiographic sequelae in the greater trochanter subsequent to revision for ARMD. The authors describe clinical and radiographic findings in 2 patients who developed greater trochanteric fragmentation 1 to 2 years after conversion of their failed MOM hips to polyethylene bearings. Both patients had solid pseudotumors with tissue necrosis. Several reports describe various clinical features of ARMD. Although poor outcomes have been demonstrated after some MOM revisions, to the authors’ knowledge, no reports document greater trochanter fragmentation in ARMD. The current patients highlight the fact that tissue damage occurring with MOM bearing hips can involve bone in addition to soft tissue even after a pseudotumor has been removed and serum metal levels have decreased to normal levels after revision. Unlike the greater trochanteric fractures historically associated with polyethylene wear and osteolysis, no evidence of bone cysts or lesions was found prior to the fractures and neither fracture healed with conservative treatment. For these 2 patients, the authors believe the tissue necrosis included both soft tissue and bone. The necrotic bone resorbed gradually after removal of the MOM bearing, resulting in bone fragmentation with ongoing symptoms. These patients emphasize and remind us that damage is not only limited to soft tissues, but also includes bone. Surgeons should be aware of this radiographic finding and the associated clinical symptoms. [
Orthopedics.
2015; 38(5):e447–e451.]
Does Prior RN Clinical Experience Predict Academic Success in Graduate Nurse Practitioner Programs?
Authors: El-Banna Majeda M. , Briggs Linda A. , Leslie Mayri Sagady , Athey Erin K. , Pericak Arlene , Falk Nancy L. , Greene Jessica
Published: May 2015

Background:

There is limited evidence on whether prior RN clinical experience is predictive of academic success in graduate nurse practitioner (NP) programs. The purpose of this study was to explore whether the frequently held assumption that more prior clinical experience is associated with better academic success in The George Washington University online NP programs.

Method:

Applications (
n
= 106) for clinical NP students entering from 2008–2010 were examined along with data on academic performance.

Results:

No relationship was found between years of prior RN clinical experience and three educational outcome variables (cumulative grade point average [GPA], clinical course GPA, and having failed any courses or been put on probation). However, students with the most prior RN clinical experience were less likely to graduate in 4 years, compared with those with the least experience.

Conclusion:

These findings serve as a building block of empirical evidence for admissions committees as they consider entry requirements for NP programs. [
J Nurs Educ.
2015;54(5):276–280.]
Introduction of Unresponsive Patient Simulation Scenarios Into an Undergraduate Nursing Health Assessment Course
Authors: Luctkar-Flude Marian , Tyerman Jane , Wilson-Keates Barbara , Pulling Cheryl , Larocque Monica , Yorke Jessica
Published: May 2015

Background:

Despite certification in basic life support, nursing students may not be proficient in performing critical assessments and interventions for unresponsive patients. Thus, a new simulation module comprising four unresponsive patient scenarios was introduced into a second-year nursing health assessment course.

Method:

This cross-sectional study describes nursing student experience, knowledge, confidence, and performance of assessments and interventions for the unresponsive patient across 3 years of an undergraduate nursing program.

Results:

Overall knowledge, confidence, and performance scores were similar between second-, third-, and fourth-year students (
N
= 239); however, performance times for many critical assessments and interventions were poor. Second-year nursing students’ knowledge increased significantly following the new simulation module (
p
= 0.002).

Conclusion:

Findings suggest a need for more repetition of basic unresponsive patient scenarios to provide mastery. It is anticipated that addition of unresponsive patient scenarios into the second year will enhance performance by the final year of the program. [
J Nurs Educ
. 2015;54(5):281–285.]
ECRG4 expression in normal rat tissues: expression study and literature review
Authors: Porzionato A. , Rucinski M. , Macchi V. , Sarasin G. , Malendowicz L.K. , De Caro R.
Published: May 2015

The Esophageal Cancer Related Gene 4 (ECRG4) is a highly conserved tumour suppressor gene encoding various peptides (augurin, CÎ”16 augurin, ecilin, argilin, CÎ”16 argilin) which can be processed and secreted. In the present work, we examined ECRG4 expression and location in a wide range of rat organs and reviewed the available literature. ECRG4 mRNA was identified in all examined tissues by quantitative PCR (qPCR). ECRG4 immunoreaction was mainly cytoplasmic, and was detected in heart and skeletal muscles, smooth muscle cells showing only weak reactions. In the digestive system, ECRG4 immunostaining was stronger in the esophageal epithelium, bases of gastric glands, hepatocytes and pancreatic acinar epithelium. In the lymphatic system, immunoreactive cells were detectable in the thymus cortex, lymph node medulla and splenic red pulp. In the central and peripheral nervous systems, different neuronal groups showed different reaction intensities. In the endocrine system, ECRG4 immunoreaction was detected in the hypothalamic paraventricular and supraoptic nuclei, hypophysis, thyroid and parathyroid glands, adrenal zona glomerularis and medulla and Leydig cells, as well as in follicular and luteal cells of the ovary. In the literature, ECRG4 has been reported to inhibit cell proliferation and increase apoptosis in various cell types. It is down-regulated, frequently due to hypermethylation, in esophageal, prostate, breast and colon cancers, together with glioma (oncosuppressor function), although it is up-regulated in papillary thyroid cancer (oncogenic role). ECRG4 expression is also higher in non-proliferating cells of the lymphatic system. In conclusion, our identification of ECRG4 in many structures suggests the involvement of ECRG4 in the tumorigenesis of other organs and also the need for further research. In addition, on the basis of the location of ECRG4 in neurons and endocrine cells and the fact that it can be secreted, its role as a neurotransmitter/neuromodulator and endocrine factor must be examined in depth in the future.
An Eocene post-kimberlite maar lake: lacustrine oil-shale crater-fill deposits, Lac de Gras area, Northwest Territories, Canada
Authors: Hamblin A P
Published: May 2015

Sedimentology and organic petrology-geochemistry from a 160-metre core have been integrated to study the characteristics of an isolated pocket of fine-grained, siliciclastic Eocene sediments deposited within a small kimberlite crater basin, Lac de Gras, Northwest
Territories, Canada. These sediments overlie the "Giraffe Pipe", a kimberlite occurrence located at about 65°N/110°W, 25 km northeast of the Ekati Diamond Mine. The strata recovered in the studied core represent an overall shallowing-upward succession of lacustrine-peat mire basin-fill,
interpreted to portray the deposits of a maar lake, one of the first identified in Canada (and one of the few maars anywhere to be associated with a kimberlitic pipe). Previously-published palynological data suggest a late Early Eocene to early Middle Eocene age, approximately congruent with a
previous radiometric date of 47.4 +/- 0>5 Ma. These deposits include three stratal units: a) a Lower Lacustrine Zone dominated by dark, freshwater, organic-rich mudstone and thick occurrences of oil shale (% total organic carbon: TOC = 15-50 %), interpreted as recording low
energy, shallow sub-lacustrine deposition within the crater basin; b) a thin Middle Transitional Zone with evidence of very shallow subaqueous deposition and subaerial exposure (TOC = 2-12 %); and c) an Upper Mire Zone characterized by thick subaerial peat deposits (TOC = 39-55 %), with
minor sublacustrine mudstones, interpreted to represent accumulation in a primarily continental setting filling the crater basin. Both lower and upper portions of the succession are characterized by shallowing-upward, higher order sequences whose boundaries correspond with marked changes in TOC, and
Rock Eval hydrogen and oxygen indices. These are interpreted to represent either cyclic climatic wet/dry phases or episodic kimberlite/diatreme collapse (downward stoping) subsidence/fill phases. The distribution and type of microscopic organic matter reflects the sedimentological observations: the
lower, lacustrinedominated zone includes abundant freshwater diatoms, chrysophytes and liptinites (e.g. sporinite, alginite), whereas the upper, peat mire zone consists predominantly of woody/peat macerals with wellpreserved plant macrofossils. Huminites through the section have reflectance values
averaging 0.23 %Ro, indicating that the thermal maturity of these ~47 M.Y.-old sediments, remarkably, is only slightly greater than modern peats, and that post-kimberlite burial and thermal alteration have been insignificant, with temperatures no greater than ~ 30°C. An abrupt
cooling and the presence of bentonites during the rapid transitional conversion from lacustrine to mire facies, may indicate a previously-unrecognized regional, post-eruptive, uplift phase, which is recorded in both geochemical and sedimentological indicators.
Minkowski content and fractal Euler characteristic for conformal graph directed systems
Authors: Kesseböhmer Marc , Kombrink Sabrina
Published: May 2015

We study the (local) Minkowski content and the (local) fractal Euler characteristic of limit sets

F \subset \mathbb R

of conformal graph directed systems (cGDS)

\Phi

. For the local quantities we prove that the logarithmic Cesàro averages always exist and are constant multiples of the

\delta

-conformal measure. If

\Phi

is non-lattice, then also the non-average local quantities exist and coincide with their respective average versions. When the conformal contractions of

\Phi

are analytic, the local versions exist if and only if

\Phi

is non-lattice. For the non-local quantities the above results in particular imply that limit sets of Fuchsian groups of Schottky type are Minkowski measurable, proving a conjecture of Lapidus from 1993. Further, when the contractions of the cGDS are similarities, we obtain that the Minkowski content and the fractal Euler characteristic of

F

exist if and only if

\Phi

is non-lattice, generalising earlier results by Falconer, Gatzouras, Lapidus and van Frankenhuijsen for non-degenerate self-similar subsets of

\mathbb R

that satisfy the open set condition.
Review of Mass Drug Administration for Malaria and Its Operational Challenges
Authors: Newby Gretchen , Hwang Jimee , Koita Kadiatou , Chen Ingrid , Greenwood Brian , von Seidlein Lorenz , Shanks G. Dennis , Slutsker Laurence , Kachur S. Patrick , Wegbreit Jennifer , Ippolito Matthew M. , Poirot Eugenie , Gosling Roly
Published: May 2015

Mass drug administration (MDA) was a component of many malaria programs during the eradication era, but later was seldomly deployed due to concerns regarding efficacy and feasibility and fear of accelerating drug resistance. Recently, however, there has been renewed interest in the role of MDA as an elimination tool. Following a 2013 Cochrane Review that focused on the quantitative effects of malaria MDA, we have conducted a systematic, qualitative review of published, unpublished, and gray literature documenting past MDA experiences. We have also consulted with field experts, using their historical experience to provide an informed, contextual perspective on the role of MDA in malaria elimination. Substantial knowledge gaps remain and more research is necessary, particularly on optimal target population size, methods to improve coverage, and primaquine safety. Despite these gaps, MDA has been used successfully to control and eliminate Plasmodium falciparum and P. vivax malaria in the past, and should be considered as part of a comprehensive malaria elimination strategy in specific settings.
Matrix Metalloproteinase-9 Polymorphism 1562 C > T (rs3918242) Associated with Protection Against Placental Malaria
Authors: Apoorv Thittayil Suresh , Babu Phanithi Prakash , Meese Stefanie , Gai Prabhanjan P. , Bedu-Addo George , Mockenhaupt Frank P.
Published: May 2015

Phagocytosis of malaria pigment (hemozoin) induces increased activity of matrix metalloproteinase (MMP)-9, an endopeptidase involved in cytokine regulation. In this study, we examined whether a common functional MMP-9 promoter polymorphism (rs3918242) affects Plasmodium falciparum infection in pregnancy. Eighteen percent of Ghanaian primiparae carried the minor T allele. It was associated with reduced odds of placental hemozoin and of placental as well as peripheral blood parasitemia. The results indicate that a common MMP-9 polymorphism protects against placental malaria indicating that this endopeptidase is involved in susceptibility to P. falciparum.