bluuebunny/crossref_metadata_2025 huggingface dataset:
Alogliptin and Gliclazide Similarly Increase Circulating Endothelial Progenitor Cells in Type 2 Diabetes Patients
Authors: Negro Roberto , Greco Eupremio , Greco Giacomo
Published: March 2018

Aim We investigated the effect of alogliptin and gliclazide on endothelial progenitor cells (EPCs) in type 2 diabetes.

Methods Eighty patients with type 2 diabetes and HbA1c between 7.5% and 8.5% were randomized to receive either alogliptin (25 mg/daily) or gliclazide extended-release (30 mg/daily for HbA1c 7.5-8.0% and 60 mg/daily for HbA1c 8.0-8.5%) in combination with metformin for 4 months. At baseline and 4 months, clinical and laboratory parameters of EPCs were determined.

Results After 4 months of treatment, alogliptin and gliclazide resulted in a similar significant reduction in HbA1c (%) (8.0±0.3 vs. 7.1±0.2, and 8.0±0.3 vs. 7.0±0.2, respectively; P<0.05) and a similar and significant increase in EPC count (cells/106 WBC) (CD45−CD133+KDR+ : 2.2±1.2 vs. 3.7±1.6, CD45−CD34+KDR+: 3.3±1.8 vs. 4.9±1.8; P<0.05 for alogliptin; CD45−CD133+KDR+: 2.3±1.3 vs. 3.6±1.5, CD45−CD34+KDR+: 3.1±1.3 vs. 4.6±1.7; P<0.05 for gliclazide).

Conclusions Both alogliptin and gliclazide demonstrated a beneficial effect in increasing EPCs in poorly controlled type 2 diabetes. As alogliptin and gliclazide exhibit different mechanisms of action, the observed increase in EPCs seems to be due to their glucose-lowering effect.
Efficacy and tolerability of a complex homeopathic drug in children suffering from dry cough-A double-blind, placebo-controlled, clinical trial
Authors: Voß Hans , Michalsen Andreas , Brünjes Rainer
Published: March 2018

Background A randomised, placebo-controlled clinical trial in children suffering from acute dry cough was performed to assess the efficacy and tolerability of a complex homeopathic drug (Drosera, Coccus cacti, Cuprum Sulfuricum, Ipecacuanha=Monapax syrup, short: verum).

Methods 89 children received verum and 91 received placebo daily for 7 days (age groups 0.5–3, 4–7 and 8–12 years). The primary efficacy variable was the improvement of the Cough Assessment Score. Tolerability and compliance were also assessed. A confirmatory statistical analysis was performed for the primary efficacy variable and a descriptive analysis for the secondary parameters.

Results The Cough Assessment Score showed an improvement of 5.2±2.6 points for children treated with verum and 3.2±2.6 points in the placebo group (p<0.0001). The difference of the least square means of the improvements was 1.9±0.4. The effect size of Cohen´s d was d=0.77. In all secondary parameters the patients in the verum group showed higher rates of improvement and remission than those in the placebo group. In 15 patients (verum: n=6; placebo: n=9) 18 adverse drug reactions of mild or moderate intensity were observed.

Conclusions Administering verum resulted in a statistically significantly greater improvement of the Cough Assessment Score than the placebo. The tolerability was good and not inferior to that of the placebo.
Defect properties of InGaAsN layers grown as sub-monolayer digital alloys by molecular beam epitaxy
Authors: Baranov Artem I. , Gudovskikh Alexander S. , Kudryashov Dmitry A. , Lazarenko Alexandra A. , Morozov Ivan A. , Mozharov Alexey M. , Nikitina Ekaterina V. , Pirogov Evgeny V. , Sobolev Maxim S. , Zelentsov Kirill S. , Egorov Anton Yu. , Darga Arouna , Le Gall Sylvain , Kleider Jean-Paul
Published: March 2018

The defect properties of InGaAsN dilute nitrides grown as sub-monolayer digital alloys (SDAs) by molecular beam epitaxy for photovoltaic application were studied by space charge capacitance spectroscopy. Alloys of i-InGaAsN (Eg = 1.03 eV) were lattice-matched grown on GaAs wafers as a superlattice of InAs/GaAsN with one monolayer of InAs (<0.5 nm) between wide GaAsN (7–12 nm) layers as active layers in single-junction solar cells. Low p-type background doping was demonstrated at room temperature in samples with InGaAsN layers 900 nm and 1200 nm thick (less 1 × 1015 cm−3). According to admittance spectroscopy and deep-level transient spectroscopy measurements, the SDA approach leads to defect-free growth up to a thickness of 900 nm. An increase in thickness to 1200 nm leads to the formation of non-radiative recombination centers with an activation energy of 0.5 eV (NT = 8.4 × 1014 cm−3) and a shallow defect level at 0.20 eV. The last one leads to the appearance of additional doping, but its concentration is low (NT = 5 × 1014 cm−3) so it does not affect the photoelectric properties. However, further increase in thickness to 1600 nm, leads to significant growth of its concentration to (3–5) × 1015 cm−3, while the concentration of deep levels becomes 1.3 × 1015 cm−3. Therefore, additional free charge carriers appearing due to ionization of the shallow level change the band diagram from p-i-n to p-n junction at room temperature. It leads to a drop of the external quantum efficiency due to the effect of pulling electric field decrease in the p-n junction and an increased number of non-radiative recombination centers that negatively impact lifetimes in InGaAsN.
Electrical gain in interband cascade infrared photodetectors
Authors: Huang Wenxiang , Li Lu , Lei Lin , Massengale Jeremy A. , Yang Rui Q. , Mishima Tetsuya D. , Santos Michael B.
Published: March 2018

In order to achieve improved understanding and gain insights into the device operation of interband cascade infrared photodetectors (ICIPs) and ultimately to optimize the design, we present a comparative study of five long-wavelength (LW) ICIPs based on a type-II InAs/GaSb superlattice. This study shows how the device responsivity is affected by the individual absorber thicknesses and the number of cascade stages, through the impact of light attenuation. Additionally, this study further validates that the electrical gain universally exists in non-current-matched ICIPs. With multiple cascade stages to suppress noise, these LW ICIPs achieved superior device performance at high temperatures, in terms of Johnson-noise limited detectivities, compared to commercial MCT detectors. Furthermore, a theory is developed to quantitatively describe the electrical gain in ICIPs and our calculations are in good agreement with the experimental results. Based on the theory, the optimal number of stages for maximizing the device detectivity D* is identified with inclusion of the electrical gain. Our calculation shows that this optimal number of stages is relatively large in the presence of the gain and the maximized D* has a relatively weak dependence on the absorber thickness when it is sufficiently thin.
Heterostructures with diffused interfaces: Luminescent technique for ascertainment of band alignment type
Authors: Abramkin D. S. , Gutakovskii A. K. , Shamirzaev T. S.
Published: March 2018

The experimental ascertainment of band alignment type for semiconductor heterostructures with diffused interfaces is discussed. A method based on the analysis of the spectral shift of photoluminescence (PL) band with excitation density (Pex) that takes into account state filling and band bending effects on the PL band shift is developed. It is shown that the shift of PL band maximum position is proportional to ℏωmax ∼ (Ue + Uh)·ln(Pex) + b·Pex1/3, where Ue (Uh) are electron (hole) Urbach energy tail, and parameter b characterizes the effect of band bending or is equal to zero for heterostructures with type-II or type-I band alignment, respectively. The method was approved with InAs/AlAs, GaAs/AlAs, GaSb/AlAs, and AlSb/AlAs heterostructures containing quantum wells.
Effect of superhydrophobicity on surface damage of silicone rubber under AC voltage
Authors: Li Yufeng , Jin Haiyun , Nie Shichao , Tong Cheng , Gao Naikui
Published: March 2018

In this paper, the influence of superhydrophobicity on the surface damage of silicone rubber is studied. On a common silicone rubber surface, a droplet can become elongated, and arc discharge induced by the droplet can cause tracking on the silicone rubber surface. However, for a superhydrophobic silicone rubber surface, a droplet can leave the silicone rubber due to the low adhesion of the superhydrophobic surface. Accordingly, arc discharge caused by the droplet does not occur, and the surface of the silicone rubber is not affected. Results demonstrate that using a superhydrophobic surface has a significant effect on limiting the surface damage of silicone rubber.
Multiplicative mixing of object identity and image attributes in single inferior temporal neurons
Authors: Ratan Murty N. Apurva , Arun S. P.
Published: March 2018

Significance

Vision is a challenging problem because the same object can produce a variety of images on the retina, mixing signals related to its identity with signals related to its viewing attributes, such as size, position, rotation, etc. Precisely how the brain separates these signals to form an efficient representation is unknown. Here, we show that single neurons in high-level visual cortex encode object identity and attribute multiplicatively and that doing so allows for better decoding of each signal.
Multigenerational memory and adaptive adhesion in early bacterial biofilm communities
Authors: Lee Calvin K. , de Anda Jaime , Baker Amy E. , Bennett Rachel R. , Luo Yun , Lee Ernest Y. , Keefe Joshua A. , Helali Joshua S. , Ma Jie , Zhao Kun , Golestanian Ramin , O’Toole George A. , Wong Gerard C. L.
Published: March 2018

Significance

Bacteria use multigenerational memory based on coupled oscillations of cAMP levels and type IV pili (TFP) activity to adaptively adhere to surfaces. These oscillations create cells with a “surface-sentient” state intermediate between planktonic and sessile, characterized by coordinated surface motility suppression. This intermediate state drastically increases the number of surface nonmotile cells and correlates with a transition in family tree architectures toward exponential surface population growth. Our data support the idea that reversible attachment is vital for irreversible attachment. That is, repeated sensing, division, and detachment cycles create a planktonic population with robust cAMP–TFP-based memory of the surface, allowing cells to return to the surface progressively better adapted for sensing and attachment, ultimately dominating the surface ecology via exponential surface population increase.
Endogenous superoxide is a key effector of the oxygen sensitivity of a model obligate anaerobe
Authors: Lu Zheng , Sethu Ramakrishnan , Imlay James A.
Published: March 2018

Significance

Microbes display profound differences in their tolerance for oxygen, and this trait organizes the structure of many microbial communities. However, the molecular basis of oxygen sensitivity is not well understood. In this study we determined that
Bacteroides thetaiotaomicron
, an abundant member of the human intestinal flora, is incapacitated by superoxide stress when it enters a fully oxic environment. The key difference from oxygen-tolerant bacteria lies not in its defensive systems, nor in the nature of the affected enzymes, but in the rate of endogenous oxidant formation. Anaerobes thrive in oxygen-poor environments because they deploy low-potential electron-transfer pathways; these results suggest that an ancillary effect is the reactivity of these pathways with oxygen, thereby generating enough reactive oxygen species to preclude oxic growth.
The search forBrachyspiraouter membrane proteins that interact with the host
Authors: Trott Darren J. , Alt David P. , Zuerner Richard L. , Wannemuehler Michael J. , Stanton Thaddeus B.
Published: March 2018

Little is known about the outer membrane structure ofBrachyspira hyodysenteriae and Brachyspira pilosicolior the role of outer membrane proteins (OMPs) in host colonization and the development of disease. The isolation of outer membrane vesicles fromB. hyodysenteriaehas confirmed that cholesterol is a significant outer membrane constituent and that it may impart unique characteristics to the lipid bilayer structure, including a reduced density. Unique proteins that have been identified in theB. hyodysenteriaeouter membrane include the variable surface proteins (Vsp) and lipoproteins such as SmpA and BmpB. While the function of these proteins remains to be determined, there is indirect evidence to suggest that they may be involved in immune evasion. These data may explain the ability of the organism to initiate chronic infection. OMPs may be responsible for the unique attachment ofB. pilosicolito colonic epithelial cells; however, the onlyB. pilosicoliOMPs that have been identified to date are involved in metabolism. In order to identify furtherB. pilosicoliOMPs we have isolated membrane vesicle fractions from porcine strain 95–1000 by osmotic lysis and isopycnic centrifugation. The fractions were free of contamination by cytoplasm and fla-gella and contained outer membrane. Inner membrane contamination was minimal but could not be completely excluded. An abundant 45-kDa, heat-modifiable protein was shown to have significant homology withB. hyodysenteriaeVsp, and monoclonal antibodies were produced that reacted with fiveB. pilosicoli-specificmembrane protein epitopes. The first of these proteins to be characterized is a unique surface-exposed lipoprotein.
Human intestinal spirochetosis diagnosed with colonoscopy and analysis of partial 16S rDNA sequences of involved spirochetes
Authors: Kraatz Wolfgang , Thunberg Ulf , Pettersson Bertil , Fellström Claes
Published: March 2018

DNA was extracted from colonic biopsies of 33 patients with and three without evidence of intestinal spirochetosis (IS) in the large bowel. The biopsies were subjected to PCR. A pair of primers, generating a 207 bp fragment, were designed to detect specifically the 16S rDNA gene ofBrachyspira. PCR products of the expected size were obtained from 33 samples with histologic evidence of IS. The PCR amplicons were used for sequencing. The sequences obtained were aligned to the corresponding 16S rRNA sequences of five type strains ofBrachyspira. The sequences of 23 PCR products were 99–100% identical with the correspond-ingB.aalborgitype strain sequence. Two cases showed 99–100% sequence similarity with the type strain ofB.pilosicoliP43/6/78. Six cases could not be referred to any of the known species ofBrachyspira. Two PCR products gave incomplete sequences.
Austenite reversion in low-carbon martensitic stainless steels – a CALPHAD-assisted review
Authors: Niessen Frank
Published: March 2018

Low-carbon martensitic stainless steels with 11.5–16 wt-% Cr and < 0.07 wt-% C are characterised by high corrosion resistance, strength, ductility and impact toughness, obtained by formation of fine-grained reverted austenite from lath martensite upon inter-critical annealing. The review treats the mechanisms governing the formation and stabilisation of reverted austenite and is assisted by the computation of phase equilibria. Literature data on Cr and Ni concentrations of the reverted austenite/martensite dual-phase microstructure are assessed with respect to predicted concentrations. Reasonable agreement was found for concentrations in martensite. Systematic excess of Cr in austenite of approx. 2 wt-% relative to calculations was suspected to originate from the growth of M23C6 with a coherent interface to austenite. Within large scatter, measured values of Ni in austenite were on average 2 wt-% below predictions. Complex equilibration of the microstructure and experimental error are discussed as possible origins of the discrepancies.
High-temperature oxidation behaviour of AlTiSiN and AlCrSiN coatings
Authors: Liu Yan , Liu Hui dong , Wan Qiang , Cai Yao , Chen Hao , Chen Yan ming , Guo Jia lin , Yang Bing
Published: March 2018

This study was aimed to explore the high-temperature oxidation behaviour of AlTiSiN and AlCrSiN coatings. The coatings were deposited using arc ion plating and annealed in air at a temperature range of 600–1000°C for 2 h. The results showed that the oxidation of AlTiSiN coatings started at 900°C and failed at 1000°C. However, the oxidation of AlCrSiN was different from AlTiSiN coatings, which commenced at 800°C and kept stable till 1000°C. The hardness of the as-deposited AlTiSiN coatings dropped from 25.2 to 16.5 GPa after 1000°C annealing, while AlCrSiN coatings decreased from 24.2 to 20.5 GPa. The AlCrSiN coating exhibits a better high-temperature oxidation resistance than AlTiSiN coating.
Photocatalytic behaviour of anodised titanium using different cathodes
Authors: González Morán Irene , Fernández Martínez Francisco , del Río Merino Mercedes , Diamanti Maria Vittoria , Pedeferri MariaPia , Chen Xiaobo
Published: March 2018

In the last decades, titanium dioxide (TiO2) has been widely researched because of its applications in photocatalytic environmental pollution removal and in hydrogen generation. Hence, this work deals with the synthesis of titanium dioxide by anodising titanium sheets, however using different cathodes, which may induce differences in the composition and structure of the obtained oxide layers so that these suspected differences can be observed. All specimens were equally thermally treated after anodising to enhance their photocatalytic activity, since this step allows the titanium dioxide to crystallise. Their morphology and crystal structure were characterised by X-ray diffraction and Fourier transform infrared, and optical properties were characterised by ultraviolet–visible absorption spectroscopy. Furthermore, tests of their photocatalytic properties in the degradation of organic dyes were performed in order to have a first evaluation. Indeed, differences in the photocatalytic behaviour of the anodised specimens using different cathodes were found and evaluated.
Amount of Naloxone Used to Reverse Opioid Overdoses outside of Medical Practice in a City with Increasing Illicitly Manufactured Fentanyl in Illicit Drug Supply
Authors: Bell Alice , Bennett Alex S. , Jones T. Stephen , Doe-Simkins Maya , Williams Leslie D.
Published: March 2018

Background: Illicitly manufactured fentanyl (IMF) prevalence has increased. However, there is uncertainty about naloxone dose(s) used by nonmedical bystanders to reverse opioid overdoses in the context of increasing IMF. Methods: We used community naloxone distribution program data about naloxone doses and fatal opioid overdoses from the Allegheny County Medical Examiner. From January 2013 to December 2016, staff interviewed participants who administered naloxone in response to 1072 overdoses. We calculated frequencies, percentages, and conducted a 1-way analysis of variance (ANOVA). Results: Despite increases in fentanyl-contributed deaths, there were no statistically significant differences between any of the 4 years (2013–2016) on average number of naloxone doses used by participants to reverse an overdose ( F = 0.88; P = .449). Conclusion: Even though IMF is more potent than heroin and is a rapidly increasing contributor to drug overdose deaths in Allegheny County, the average dose of naloxone administered has not changed. Our findings differ from studies in different areas also experiencing increasing IMF prevalence. Additional investigations are needed to clarify the amount of naloxone needed to reverse opioid overdoses in the community caused by new synthetic opioids.
Pyloroplasty may reduce weight loss 1 year after esophagectomy
Authors: Harada K , Yoshida N , Baba Y , Nakamura K , Kosumi K , Ishimoto T , Iwatsuki M , Miyamoto Y , Sakamoto Y , Ajani J A , Watanabe M , Baba H
Published: March 2018

Weight loss after esophagectomy is common and is associated with unfavorable prognosis. However, the clinical features and surgical methods that influence postesophagectomy weight loss are not well characterized. This study aims to determine those features (especially the surgical methods) that may affect postoperative weight loss. We reviewed 221 esophageal cancer patients who had undergone esophagectomy at Kumamoto University Hospital (Kumamoto, Japan) between November 2012 and June 2015. Among these, we recruited 106 patients who had undergone transthoracic esophagectomy with gastric conduit reconstruction, had no cancer recurrence within 1 year, and no missing follow-up data. We tabulated the body weight changes and risk factors associated with weight loss exceeding 10% at 1-year postesophagectomy. The mean body weights at baseline and 1-year postsurgery were 60.3 kg (standard error (SE): 0.91) and 52.6 (SE: 0.91), respectively. One year postsurgery, the body weights had changed as follows: mean: −12.2%; median: −12.9%; standard deviation: 9.06; range: −36.1–18.56%; interquartile range: −10.5 to −14.0%. In the multivariate logistic regression analysis, the absence of pyloroplasty was the sole risk factor for more than 10% weight loss (OR: 3.22; 95% CI: 1.08–11.9; P = 0.036). Our data suggest that pyloroplasty with esophagectomy can overcome the post-surgical weight loss.
The VIX, the Variance Premium, and Expected Returns*
Authors: Osterrieder Daniela , Ventosa-Santaulària Daniel , Vera-Valdés J Eduardo
Published: March 2018

Existing studies find conflicting estimates of the risk–return relation. We show that the trade-off parameter is inconsistently estimated when observed or estimated conditional variances measure risk. The inconsistency arises from misspecified, unbalanced, and endogenous return regressions. These problems are eliminated if risk is captured by the variance premium (VP) instead; it is unobservable, however. We propose a 2SLS estimator that produces consistent estimates without observing the VP. Using this method, we find a positive risk–return trade-off and long-run return predictability. Our approach outperforms commonly used risk–return estimation methods, and reveals a significant link between the VP and economic uncertainty.
Deciphering chest pain in women
Authors: Briggs Linda A.
Published: March 2018

The causes of chest pain range from benign sources such as muscle strain to life-threatening diagnoses such as aortic dissection and myocardial infarction. The likelihood and presentations of disorders causing chest pain are different between women and men. This article highlights important features in determining a correct diagnosis.
Three-dimensional Printed Surgical Simulator for Kirschner Wire Placement in Hand Fractures
Authors: Brichacek Michal , Diaz-Abele Julian , Shiga Sarah , Petropolis Christian
Published: March 2018

Closed reduction and percutaneous pinning (CRPP) of hand fractures can be a deceptively challenging procedure that requires significant hands-on time to teach and learn. We created a realistic three-dimensional simulator that can be used for teaching junior residents the CRPP. Computer-aided design and computer-aided manufacturing (CAD/CAM) software was used to create a three-dimensional hand model incorporating several common hand fractures: Bennett’s fracture, transverse fifth metacarpal neck, and transverse second proximal phalanx. Three-dimensional printing was used to create molds in which the bones and soft tissue were poured. A polyurethane foam was utilized for the bones with iron incorporated to render them radiopaque, whereas silicone of varying viscosities was used for the soft tissues. Five plastic surgery residents and 5 consultants evaluated the model. Individuals then completed an anonymous 12-question survey evaluating the model based on realism, educational utility, and overall usefulness. Survey responses obtained from both residents and consultants were strongly in favor of the simulator. Average realism was graded as 4.48/5 by residents and 4.68/5 by consultants. Average educational utility was graded as 5/5 by residents and 4.95/5 by consultants. Average overall usefulness was graded as 5/5 by both groups. We created an anatomically accurate and realistic simulator for CRPP of hand fractures that was low cost and easily reproducible. Initial feedback was encouraging in regard to realism, educational utility, and overall usefulness.
Prevalence of Ocular Hypertension and Glaucoma as Well as Associated Factors in Graves' Orbitopathy
Authors: Kim Ji Won , Ko JaeSang , Woo Young Jun , Bae Hyoung Won , Yoon Jin Sook
Published: March 2018

Purpose:

The purpose of this study was to determine the prevalence of ocular hypertension (OHT) and open-angle glaucoma (OAG) in patients with Graves' orbitopathy (GO) and to investigate the associations between clinical features of the disease and the prevalence of OHT and OAG.

Methods:

A cross-sectional analytic study was conducted among a total of 1128 patients with GO. A complete ophthalmic examination was performed, including intraocular pressure, optic disc photography, visual field testing using a Humphrey visual field analyzer, and retinal nerve fiber layer thickness measured by optical coherence tomography. The results were analyzed by univariate and multivariate logistic regression.

Results:

A 6.8% prevalence of OHT (77/1128) and a 1.6% prevalence of OAG (18/1128) were observed. When considering only patients older than 40 years, the prevalence of OHT and OAG was 9.5% and 3.4%, respectively. Twenty-nine of the 1128 patients (2.6%) developed compressive optic neuropathy. Of the factors evaluated, male sex [odds ratio (OR), 1.83; 95% confidence interval (CI), 1.08-3.10], duration of GO (6 to 24 mo; OR, 2.08; 95% CI, 1.17-3.71; 24 to 60 mo; OR, 3.45; 95% CI, 1.66-7.18), clinical activity score ≥3 (OR, 1.76; 95% CI, 1.03-3.01), extraocular muscle involvement (OR, 4.65; 95% CI, 2.54-8.50), and lid retraction (OR, 2.17; 95% CI, 1.19-3.96) were associated with the prevalence of OHT in GO. The prevalence of OAG was associated with male sex (OR, 4.29; 95% CI, 1.60-11.51) and duration of GO (≥60 mo; OR, 4.28; 95% CI, 1.11-16.47).

Conclusions:

The prevalence of OHT in patients with GO was higher and the prevalence of OAG was similar to that in the general population.
Glaucoma With Crouzon Syndrome
Authors: Alshamrani Abdulaziz A. , Al-Shahwan Sami
Published: March 2018

Background:

Crouzon syndrome is the most common form of craniosynostosis, and mutations in the fibroblast growth factor receptor 2 and 3 (FGFR2andFGFR3) genes are implicated in its pathogenesis.

Observation:

A 10-year-old female patient with Crouzon syndrome and congenital glaucoma treated with trabeculectomy and ocular hypotensive medications was examined. The patient had proptosis, exposure keratopathy, megalocornea, thin central corneal thickness, a shallow anterior chamber, mild anterior subcapsular cataract, and a cup-to-disc ratio of 0.9. Ultrasound biomicroscopy revealed a shallow anterior chamber, posterior synechiae, and closed angle in the right eye, as well as a narrow angle in the left eye, despite an axial length of 28.9 mm in the right eye and 30.0 mm in the left eye, measured by A-scan ultrasound biometry. The crystalline lens thickness measured by ultrasound biomicroscopy was 4.18 mm in the right eye and 4.12 mm in the left eye.

Conclusions and Importance:

Despite long axial lengths, shallow anterior chambers with occluded angles are possible in Crouzon syndrome and are most likely caused byFGFR2-related anterior segment dysgenesis. To the best of our knowledge, this is the first report that describes closed angles and anterior segment dysgenesis as a secondary cause of congenital glaucoma in Crouzon syndrome.
Aerobic Exercise During Early Murine Doxorubicin Exposure Mitigates Cardiac Toxicity
Authors: Wang Fei , Iskra Brian , Kleinerman Eugenie , Alvarez-Florez Claudia , Andrews Thomas , Shaw Angela , Chandra Joya , Schadler Keri , Aune Gregory J.
Published: March 2018

We report the cardioprotective effects of moderate aerobic exercise from parallel pediatric murine models of doxorubicin (Doxo) exposure in non–tumor-bearing immune competent (NTB-IC) mice and tumor-bearing nude mice (TB-NM). In both models, animals at 4 weeks of age underwent Doxo treatment with or without 2 weeks of simultaneous exercise. In sedentary NTB-IC or TB-NM mice, Doxo treatment resulted in a statistically significant decrease in ejection fraction and fractional shortening compared with control animals. Interestingly, moderate aerobic exercise during Doxo treatment significantly mitigated decreases in ejection fraction and fractional shortening. In contrast, these protective effects of exercise were not observed when exercise was started after completion of Doxo treatments. Moreover, in the TB-NM model, Doxo caused a decrease in heart mass: tibia length and in body weight that was prevented by exercise, whereas NTB-IC mice exhibited no change in these measurements. Doxo delivery to the hearts of TB-NM was decreased by consistent moderate aerobic exercise before Doxo injection. These findings demonstrate the important but subtle differences in cardiotoxicity observed in different mouse models. Collectively, these results also strongly suggest that aerobic exercise during early-life Doxo exposure mitigates cardiotoxicity, possibly through altered delivery of Doxo to myocardial tissue.
Shame and Defectiveness Beliefs in Treatment Seeking Patients With Body Dysmorphic Disorder
Authors: Weingarden Hilary , Shaw Ashley M. , Phillips Katharine A. , Wilhelm Sabine
Published: March 2018

Shame is a distressing emotion experienced when individuals judge themselves in a broadly negative and critical manner. Clinical descriptions of body dysmorphic disorder (BDD) emphasize the centrality of shame, yet research on shame in BDD remains scarce. This study is the largest investigation of shame in clinically diagnosed individuals with BDD, and it is the first to examine whether shame changes with treatment. Eighty-three adults with BDD were treated with 14 weeks of open-label escitalopram. Shame was measured using the Young Schema Questionnaire–Short Form. Shame was significantly higher in individuals with BDD than in previously reported healthy control and psychiatric outpatient samples. Shame was significantly, moderately correlated with greater suicidal thoughts and hopelessness and marginally significantly correlated with greater BDD severity. Shame decreased significantly with treatment. Reductions in shame with escitalopram were significantly associated with reductions in suicidal thoughts and hopelessness, even when accounting for reductions in BDD and depression severity.
Perspectives on Patient Safety and Medical Malpractice: A Comparison of Medical and Legal Systems in Italy and the United States
Authors: di Luca Alessandro , Vetrugno Giuseppe , Pascali Vincenzo Lorenzo , Oliva Antonio , Ozonoff Al
Published: March 2018

Objectives

Italy is experiencing a crisis of malpractice litigation with important repercussions on the insurance industry (e.g., lower profits), physicians (e.g., defensive medicine), and the courts (e.g., work backlog, lengthy proceedings). We searched for common ground between legal systems in Italy and the United States and considered the implications for international collaborations in patient safety.

Methods

We examined the judicial frameworks of medical malpractice litigation in two countries with different legal foundations: the United States (a public-private system governed by common law) and Italy (a publicly financed healthcare system governed by civil law).

Results

We found important differences and similarities across the two systems that suggest a high compatibility for future comparisons and collaborations. Although many Italian hospitals maintain risk management programs, the U.S. emphasis on patient safety and quality has not yet been integrated into Italian healthcare systems.

Conclusions

Based on our findings, we propose that the Italian system might benefit from assertively adopting some concepts from the U.S. system. In particular, we consider the role of the law and Italian medicolegal experts as key facilitators for the integration of patient safety and risk management units within Italian healthcare facilities.
Association Between Hospital Staffing Models and Failure to Rescue
Authors: Ward Sarah T. , Dimick Justin B. , Zhang Wenying , Campbell Darrell A. , Ghaferi Amir A.
Published: March 2018

Objective:

To identify hospital staffing models associated with failure to rescue (FTR) rates at low- and high-performing hospitals.

Background:

FTR is an important quality measure in surgical safety and is a metric that hospitals are seeking to improve. Specific unit-level determinants of FTR, however, remain unknown.

Methods:

Retrospective, observational study using data from the Michigan Quality Surgical Collaborative, which is a prospectively collected and clinically audited database in the state of Michigan. We identified 44,567 patients undergoing major general or vascular surgery from 2008 to 2012. Our main outcome measures were mortality, complications, and FTR rates.

Results:

Hospital rates of FTR across low, middle, and high tertiles were 8.9%, 16.5%, and 19.9%, respectively (P < 0.001). Low FTR hospitals tended to have a closed intensive care unit staffing model (56% vs 20%, P < 0.001) and a higher proportion of board-certified intensivists (88% vs 60%, P < 0.001) when compared to high FTR hospitals. There was also significantly more staffing of low FTR hospitals by hospitalists (85% vs 20%, P < 0.001) and residents (62% vs 40%, P < 0.01). Low FTR hospitals were noted to have more overnight coverage (75% vs 45%, P < 0.001) as well as a dedicated rapid response team (90% vs 60%, P < 0.001).

Conclusions:

Low FTR hospitals had significantly more staffing resources than high FTR hospitals. Although hiring additional staff may be beneficial, there remain significant financial limitations for many hospitals to implement robust staffing models. Thus, our ongoing work seeks to improve rescue and implement effective staffing strategies within these constraints.
CoboChild: a blended mobile game-based learning service for children in museum contexts
Authors: Hsu Tien-Yu , Liang HsinYi , Chiou Chuang-Kai , Tseng Judy C.R.
Published: March 2018

Purpose

The purpose of this paper is to develop a blended mobile game-based learning service called CoboChild Mobile Exploration Service (hereinafter CoboChild) to support children’s learning in an environment blending virtual game worlds and a museum’s physical space. The contextual model of learning (CML) was applied to consider the related influential factors affecting museum learning and to promote children’s continuous learning and revisit motivations.

Design/methodology/approach

CoboChild provides a thematic game-based learning environment to facilitate children’s interactions with exhibits and other visitors. A practical system has been implemented in the National Museum of Natural Science (NMNS), Taiwan. A questionnaire was used to examine whether CoboChild can effectively fulfill the CML and to evaluate the impacts on museum learning.

Findings

CoboChild effectively fulfilled the CML to facilitate children’s interactive experiences and re-visit motivations in the blended mobile game-based learning environment. Most children described the system as providing fruitful playfulness while improving their interpretations of exhibitions and learning experiences.

Practical implications

CoboChild considers the related contextual influences on the effective support of children’s learning in a museum, and builds a child-centered museum learning environment with highly integrated blended learning resources for children. CoboChild has been successfully operating in the NMNS since 2011.

Originality/value

This study developed a blended mobile game-based learning service to effectively support children’s learning in museum contexts. The related issues are shown to improve the design of blended museum learning services. This innovative approach can be applied to the design of other child-centered services for engaging children’s interactive experiences in museums.
Cleaning up the paper trail – our clinical notes in open view
Authors: Lambe Gerard , Linnane Niall , Callanan Ian , Butler Marcus W.
Published: March 2018

Purpose

Ireland’s physicians have a legal and an ethical duty to protect confidential patient information. Most healthcare records in Ireland remain paper based, so the purpose of this paper is to: assess the protection afforded to paper records; log highest risk records; note the variations that occurred during the working week; and observe the varying protection that occurred when staff, students and public members were present.

Design/methodology/approach

A customised audit tool was created using Sphinx software. Data were collected for three months. All wards included in the study were visited once during four discrete time periods across the working week. The medical records trolley’s location was noted and total unattended medical records, total unattended nursing records, total unattended patient lists and when nursing personnel, medical students, public and a ward secretary were visibly present were recorded.

Findings

During 84 occasions when the authors visited wards, unattended medical records were identified on 33 per cent of occasions, 49 per cent were found during weekend visiting hours and just 4 per cent were found during morning rounds. The unattended medical records belonged to patients admitted to a medical specialty in 73 per cent of cases and a surgical specialty in 27 per cent. Medical records were found unattended in the nurses’ station with much greater frequency when the ward secretary was off duty. Unattended nursing records were identified on 67 per cent of occasions the authors visited the ward and were most commonly found unattended in groups of six or more.

Practical implications

This study is a timely reminder that confidential patient information is at risk from inappropriate disclosure in the hospital. There are few context-specific standards for data protection to guide healthcare professionals, particularly paper records. Nursing records are left unattended with twice the frequency of medical records and are found unattended in greater numbers than medical records. Protection is strongest when ward secretaries are on duty. Over-reliance on vigilant ward secretaries could represent a threat to confidential patient information.

Originality/value

While other studies identified data protection as an issue, this study assesses how data security varies inside and outside conventional working hours. It provides a rationale and an impetus for specific changes across the whole working week. By identifying the on-duty ward secretary’s favourable effect on medical record security, it highlights the need for alternative arrangements when the ward secretary is off duty. Data were collected prospectively in real time, giving a more accurate healthcare record security snapshot in each data collection point.
Barriers to empathy-based care: oncology nurses’ perceptions
Authors: Taleghani Fariba , Ashouri Elaheh , Memarzadeh Mehrdad , Saburi Mortaza
Published: March 2018

Purpose

The purpose of this paper is to explore oncology nurses’ barriers to empathy-based care perceptions.

Design/methodology/approach

The authors used a descriptive qualitative method. In total, 18 oncology nurses were selected via purposive sampling. Data were collected through in-depth interviews and qualitative content analysis using an inductive approach.

Findings

Three main categories emerged from the data analysis: barriers related to nursing including: lacking compassion; disinterest in oncology nursing and self-criticism; psychological distress; barriers related to healthcare: job strain; task-centeredness; no formal training; poor manager support; nurse-patient gender imbalance; and barriers related to cancer care including: difficulty maintaining empathy with cancer patients; and inappropriate cancer patient

Practical implications

Oncology nurses provided insights into barriers to empathy-based care and the challenges they encountered while caring for cancer patients. Understanding these barriers is the first step to overcoming obstacles and creating an open and caring environment to provide an empathic care culture.

Originality/value

Given that oncology nurses experience several emotions, positive coping strategies for these distresses should be adopted. Healthcare systems should change cancer-caring culture from task-centered to patient-centered care. Compassion and empathy should become patient care values.
Brexit associated sharp depreciation and implications for UK’s inflation and balance of payments
Authors: Nasir Muhammad Ali , Simpson Justine
Published: March 2018

Purpose

The purpose of this paper is to analyse the implications of exchange rate depreciation for inflation targeting and trade balance of UK in the context of the Brexit epoch.

Design/methodology/approach

The study employed a time-varying structural vector auto-regression (TVSVAR) model framework in which the sources of time variation were both the coefficients and variance-covariance matrix of the innovations on the data from January 1989 to September 2016.

Findings

The findings suggest that the depreciation of the Stirling has significant effects on inflation and trade balance in UK in context of Brexit epoch. It also showed that such a depreciation can be helpful in the improvement of external balance as well as steering the inflation to its statutory target. Despite, the inflation targeting, there is strong evidence of a pass-through.

Research limitations/implications

Research has profound implications in terms of the sharp depreciation of GBP associated with the Brexit outcome. The study is very topical and could be very interesting to the readership of JES as well as wider audience. The study has limitations in a context that the significance of the results and association of the under analysis entities is contingent on the future trade relationships and Channel between UK and EU. Therefore, although there is a lot of uncertainty about the future of Britain trade relationships, this study provides guidance on the importance of exchange rate channel if the similar trade arrangements prevails in the post-Brexit era.

Practical implications

The research has profound practical implications, using a TVSVAR model in which the relationship among the entities varies over time; it has shown the importance of exchange rate in terms of external balance and inflation targeting. Hence, it has appeal for the practitioners as well as academics.

Social implications

The research has great social implications. The Brexit is the biggest political and economic event of this era for UK and EU. There are big questions about the relationship between UK and EU in the post-Brexit epoch as well as questions about the future of the European integration. In this context, this study has shown that how the exchange rate could play an important role for the UK economy when its contemporary trade channels prevail. Concomitantly, it has social implications particularly for the European society.

Originality/value

The research is an original piece of work. It has contributed to the debate on the exchange rate deprecation, external balance and inflation targeting in context of the Brexit associated sharp depreciation of Stirling. It has used a framework, i.e. TVSVAR, which also have unique features in terms of testing the associations among under analysis entities against time.
Shared experiences and awareness from learning in a student multicultural environment
Authors: Sanchez Bengoa Dolores , Ganassali Stephane , Kaufmann Hans Ruediger , Rajala Arto , Trevisan Italo , Berkel Johan van , Zulauf Katrin , Wagner Ralf
Published: March 2018

Purpose

This paper aims to analyze the skills and attitudes development of multicultural teams. In todays’ environment, business interconnectivity and multicultural societies are becoming the normal way of living. Although students are increasingly facing multicultural learning environments, their awareness and willingness or harmonious and productive learning in these environments need to be prepared for in a systematic manner. Therefore, it is necessary that the students are conscious of their commonalities and differences with other students to gain cultural competence. Students’ progress in developing their cultural intelligence is determined by co-operative social skills and the amount of interactions in a multicultural environment.

Design/methodology/approach

The research was conducted using a quantitative methodology. The questionnaire development roots in a students’ self-assessment scheme proposed by Armstrong (Wharton School, University of Pennsylvania) covering the progress made during the participation in an intercultural project.

Findings

The research findings relate to attitudes toward developing and sharing knowledge, stress, learning and task orientation, intercultural communication and cultural awareness skills related to the impacts of culture on the different ways of learning when working in multicultural teams. The study confirmed that knowledge gains and competence progress are higher in international teams compared to national teams.

Research limitations/implications

To provide for better differentiation as to the student profile, e.g., nationality, cultural categories, a larger sample size is suggested.

Practical implications

The study might be seen as a road map for universities and international companies alike for imparting cognitive, affective and behavioral competencies.

Originality/value

This study complements previous studies investigating the phenomenon of stress with multi-cultural complexity in more long-term durations. It implies stress factors to appear also in short-term multi-cultural exposures.
Strategic internationalization through curriculum innovations and stakeholder engagement
Authors: Guillotin Bertrand
Published: March 2018

Purpose

Anti-globalization and protectionism movements have transformed strategic internationalization, international business (IB) student engagement and enrollment growth into very complex endeavors. Whereas the literature is rather scarce on solutions, this paper aims to offer some best practices at a highly ranked IB program that can be very useful to business school leaders.

Design/methodology/approach

Descriptive case study of the Fox IB program (Temple University, USA) is based on an inductive approach and the Quality Function Deployment framework to design and internationalize the curriculum.

Findings

Listening to the voice of the customers through student and employer testimonials, the author found the elements that make an IB program and curriculum successful. Even senior students who are “between opportunities” feel that the new IB curriculum have prepared them well for their career.

Research limitations/implications

While the case study methodology is well-suited to understand strategies and processes, this research has natural limitations in terms of generalizability.

Practical implications

Academic Directors and business school leaders can use these best practices to innovate, engage their stakeholders and grow enrollments. By increasing job placement opportunities and enrollments, they create a virtuous cycle of success and can obtain additional resources for their program.

Social implications

The value of management education to society is almost incalculable. IB is an integrative management discipline that is instrumental to the success of the global economy and society.

Originality/value

The best practices of the highly ranked Fox IB program and the 21 student and employer testimonials in this case study have never been shared before.