bluuebunny/crossref_metadata_2025 huggingface dataset:
Acute Lacunar Infarcts in CLIPPERS: Is the Chronic Infiltrative Lymphocytic Perivascular Disease Process to Blame?
Authors: Saigal Gaurav , Quencer Robert
Published: January 2017

CLIPPERS (chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids) is a recently described chronic inflammatory disorder involving the brainstem with characteristic imaging findings. Since it was originally described in 2002, only a handful of cases have been reported in the literature. We describe two additional cases of CLIPPERS with characteristic clinical and radiological findings. Besides the previously described MR findings, one of the cases also demonstrated multiple basal ganglia lacunar infarcts, a finding which has not been previously reported. We hypothesize that the lacunar infarcts are caused by this chronic infiltrative perivascular disease process.
Arteriovenous Malformation in the Brain: A Theoretical Study Explaining the Behavior of Liquid Embolic Agents during Endovascular Treatment
Authors: Lv Xianli , Wu Zhongxue , Li Youxiang
Published: January 2017

There is no theoretical study on blood flow in brain arteriovenous malformation (AVM). We present a numerical theory on AVM and liquid embolic agent AVM embolization. Darcy's law was used to compute flow relations for brain AVMs. Maag's formula was used to explain the diffuse patterns of N-butyl-2-cyanoacrylate (NBCA) and ethylene-vinyl alcohol copolymer (EVOH) in brain AVMs. According to Darcy's law, the instantaneous blood flow rate through an AVM is directly proportional to the pressure drop between two places in the AVM and indirectly proportional to the distance between them. The greater the pressure gradient (through the AVM), the greater the discharge rate, and the discharge rate of blood will often differ through different AVM (or even through the same AVM, in a different direction) even if the same pressure gradient exists in both cases. Subsequent to Darcy's initial discovery, Maag found that the radius of NBCA or EVOH diffusion is inversely proportional to their viscosity. Darcy's Law and Maag's formula could be used to analyze flow patterns of brain AVM and liquid embolic agent behavior in AVM near ideal.
Systematic review and meta‐analysis of the performance of nurses in small bowel capsule endoscopy reading
Authors: Yung Diana E , Fernandez‐Urien Ignacio , Douglas Sarah , Plevris John N , Sidhu Reena , McAlindon Mark E , Panter Simon , Koulaouzidis Anastasios
Published: January 2017

Introduction

Increasing demands on healthcare systems mean that nurses are taking on more roles as physician extenders. Capsule endoscopy (CE) is a laborious procedure where specialist nurses could reduce physician workload and rationalise resource utilisation. The aim of this review and meta‐analysis is to consolidate data on nurses' performance in small bowel CE (SBCE).

Materials and methods

A comprehensive literature search was conducted for randomised controlled trials and comparative studies on nurses in SBCE reading compared to physicians. We examined the performance of nurses compared to SBCE‐trained physicians.

Results

Sixteen relevant studies were identified, with 820 SBCE examinations involving 20 nurses. 11/16 studies reported the numbers of SBCE findings detected. Overall, the pooled proportion of all findings reported by physicians and nurses was 86%. Studies involving nurses with endoscopic experience showed a summative detection rate of 89%. 7/16 studies reported the number of videos where there was agreement between the nurse and physicians for overall findings/diagnosis. The overall proportion of videos with agreement was 68%. In studies where nurses had endoscopy experience, the proportion of videos with agreement was 71%.

Conclusion

Our meta‐analysis supports a more active role for nurses in SBCE reading. We suggest nurses can function as independent CE readers in general, given adequate training and formal credentialing.
Re‐phrasing the question: A simple tool for evaluation of adherence to therapy in patients with inflammatory bowel disease
Authors: Engel T , Ungar B , Ben‐Haim G , Levhar N , Eliakim R , Ben‐Horin S
Published: January 2017

Background

Non‐adherence to medication in patients with inflammatory bowel disease (IBD) is a challenging problem which is often overlooked or under‐estimated by the physician or denied by the patient. We aimed to examine if re‐phrasing the wording of the question used by the physician could help in revealing more patients who are non‐adherent, and for whom appropriate counseling may be instituted.

Methods

A cross‐sectional questionnaire‐based study of IBD patients treated in a tertiary center was conducted. Patients received a questionnaire detailing their treatments and disease course, as well as their perceptions about disease. Two forms of questions about adherence were deliberately placed in two separate parts of the questionnaire: One was ‘are you taking your medications regularly as prescribed?’ (Standard question), and the second, more emphatic question, was ‘how often does it happen that you miss a drug dosing?’ (Re‐phrased question). The rate of non‐adherence disclosed by each of these questions was compared. Sensitivity, specificity and predicative values were computed for each question against the conventional definition of non‐adherence as taking of less than 80% of prescribed medication doses disclosed by any of the methods. Predictors of non‐compliance and of denying non‐compliance were also explored.

Results

Overall, 165 patients were included (49% female, mean age 33.7 ± 12.7 SD, median age 30 years, 29.6% with ulcerative colitis, 62.4% with Crohn’s disease). Upon questioning, 50 (30.3%) of the patients admitted to non‐adherence in the last month when asked by the emphatic re‐phrased question format, compared with only 10 patients (6%) reporting non‐adherence when asked directly by the standard question (OR 7.4, 95%CI 3.6–15.2, p  < 0.001). Thus, a ‘Do you take your medicine regularly’ question format disclosed only 20% of genuinely non‐compliant patients and had 16% sensitivity and 98.2% specificity for revealing non‐adherence (PPV 80%, NPV 72.9%) compared with the reference re‐phrased question. The leading cause for non‐adherence was skepticism about drug efficacy or safety (20.5%), followed by vacation or weekend (15%), problems with prescription or pharmacy (13.5%) and forgetfulness (10%). No single demographic or clinical factor correlated with non‐adherence. The only factor which correlated with higher probability for non‐adherence was biological and combination treatment.

Conclusion

Non‐compliance with treatment is much more common than patients admit. Asking patients how often does it happen that they miss a drug dosing is a simple, practical tool which performs significantly better in disclosing non‐adherence compared with asking patients if they take their medication as they should.
“The Taste of Others”: Divergences in Tastes between Professional Experts and Ordinary Consumers of Movies in France
Authors: Debenedetti Stéphane , Larceneux Fabrice
Published: January 2017

The omnipresence of professional experts in the debates and marketing strategies around movies raises the question of the proximity of their judgments with those of the “ordinary consumer”. Two theoretical perspectives compete on this matter: Divergence or convergence of tastes. Based on a sample of 622 popular films released between 2005 and 2009 in France, this research confirms the divergence of tastes: Professional experts grant no special value to movies that ordinary consumers prefer. However, our results also suggest that publication on the Internet of “hybrid” tastes (those of web users and media critics) builds an artificial form of convergence which can be useful for the market's actors.
Preventing Youth Obesity: The Efficacy of the Social Risk Argument on Eating Intentions and Behaviors
Authors: Werle Carolina Obino Corrêa , Boesen-Mariani Sabine , Gavard-Perret Marie-Laure , Berthaud Stéphanie
Published: January 2017

To evaluate the efficacy of obesity prevention campaigns targeting adolescents, a controlled experiment with 797 underprivileged high and middle school students was conducted. Participants were exposed to different prevention messages and their eating behavior (choice of a snack) and intentions to monitor food intake were measured. Results demonstrate that obesity prevention advertisements using social risks lead to a healthier food choice in comparison with advertisements using the health risk. The efficacy of the message regulatory orientation (prevention vs. promotion) to change intentions to monitor food intake varies according to the type of argument used (social vs. health): The health argument is more effective when it highlights the risks of having an unbalanced diet than when it highlights the benefits of a balanced diet. These results question the efficacy of current prevention campaign strategies.
Emotional and Relational Proximities as Explanatory Factors for Affective Meaning Transfer between Brands and Print Media Brands
Authors: Valette-Florence Rita
Published: January 2017

This paper examines the emotional and relational proximities between print media brands and advertiser brands from the standpoint of theories of meaning transfer and implicit evaluation. To this end, a “hybrid” scale for measuring emotions is created and tested against five successive data sets. Results indicate that this measurement tool can differentiate brands in terms of their respective emotional field. Analysis shows that the emotional proximity between these two types of brand echoes the measure of their affective relational proximity.
Toward a Better Understanding and Measurement of Consumer Hoarding
Authors: Guillard Valérie , Pinson Christian
Published: January 2017

Consumers are often faced with the question of what to do with objects that are still usable but not worth selling and for which they no longer have a use. Our paper shows that some consumers have a tendency to keep them rather than dispose of them. Two qualitative studies and nine quantitative studies were conducted to analyze this recurring behavior and to propose a consumer hoarding scale composed of four dimensions (instrumental, social, economic and sentimental). We show that this hoarding tendency may hinder the product replacement process: Hoarders are likely to postpone the decision to replace a product if they do not know what to do with the one they currently own.
A Contribution to Conceptualizing the Consumption Experience: Emergence of the Dimensions of an Experience through Life Narratives
Authors: Roederer Claire
Published: January 2017

The notion of consumption experience still suffers from a lack of conceptualization. This inductive study, based on the analysis of life narratives, is an attempt to remedy the problem. It identifies four dimensions of a consumption experience. The «praxeological» dimension is action related. The «hedonico-sensorial» dimension concerns a sensorial and thymic evaluation of the context. The «rhetoric» dimension deals with the meaning of an experience. The fourth dimension highlights the relationship with time. These dimensions contribute to a better conceptualization of an experience through remembrance and consequently to closer contact with the client. They can be considered as levers for action to create or strengthen the competitive edge attached to an experience offer.
Towards a Theoretical Clarification of Perceived Value in Marketing
Authors: Rivière Arnaud , Mencarelli Rémi
Published: January 2017

Perceived value by consumers takes on particular importance in the current thinking of managers and marketing researchers. However, the variety of research and the absence of a unified theoretical framework call for further clarification. This paper therefore sets out to identify, on the basis of definitions of and approaches to value, criteria for categorizing and characterizing the notion of perceived value. A comparison with other similar concepts then allows it to be considered within a nomological network. Finally, the managerial implications of perceived value are discussed.
Occupational Health Nursing Education for the 21st Century
Authors: McCullagh Marjorie C.
Published: January 2017

Occupational health nurses are the largest group of occupational health professionals, and are critical to the delivery of quality health care services to the nation's work force. Educational preparation of occupational health nurses has advanced in recent years, and the need for occupational health nurses with advanced degrees is expected to increase. Occupational health nurses use licensure, continuing education, certification, supervisor and peer assessment of job performance, formal education, and practice to maintain their professional competence and protect the public's health. New strategies must be developed to prepare nurses to promote a safe and healthful work force. Funding for programs to prepare occupational health nurses will be essential for meeting this demand. Continuing education programs for occupational health nurses must be developed that demonstrate effectiveness in developing occupational health nurses' skills while minimizing their time away from the workplace.
Snapshot of the AAOHN Membership
Authors: Burgel Barbara J. , Kennerly Susan
Published: January 2017

The American Association of Occupational Health Nurses, Inc. (AAOHN) conducted a web-based membership survey of 2,123 members (41% response rate) in May and June 2012. This column presents educational, certification, and selected industry data for registered nurse and advanced practice nurse AAOHN members. Members are highly experienced, with 57% reporting more than 16 years of experience. Sixty-eight percent of AAOHN members are educated at or above the baccalaureate level. An additional 8.4% are currently enrolled in an educational program. Seventy-six percent are nationally certified as occupational health nurses or occupational health nurse specialists (COHN/COHN-S), case managers, safety professionals, ergonomists, or nurse practitioners. The majority (89%) work full-time as employees of their facility (85%), with manufacturing (34%), hospital/health care (26%), and government/military (10%) being the top three industry sectors. Ten percent work for small employers (fewer than 500 employees), whereas 12% work with more than 50,000 employees. Thirteen percent of AAOHN members work globally. Future columns will present additional 2012 AAOHN member survey data.
Occupational Trajectories and Immigrant Worker Health
Authors: Crollard Allison , de Castro A. B. , Tsai Jenny Hsin-Chun
Published: January 2017

During their initial years in the receiving country, many immigrants experience occupational downgrading. Downgrading is a loss of occupational status between one's last job in the home country and first job in the receiving country, often resulting in overeducation or overqualification. Although the extent and determinants of such occupational trajectories have been characterized, the connection to immigrant worker health has not been widely examined. However, an emerging body of knowledge indicates that negative health outcomes are associated with overeducation and overqualification in general worker populations, suggesting similar experiences by immigrant workers. This article provides an overview of the magnitude and conceptualization of occupational downgrading, overeducation, and overqualification and discusses implications for immigrant worker health. Occupational health professionals should spearhead research efforts on occupational downgrading, raise public awareness about the issue, and serve as advocates for immigrant workers' rights.
Nonfatal Occupational Falls among U.S. Health Care Workers, 2008–2010
Authors: Yeoh Han T. , Lockhart Thurmon E. , Wu Xuefang
Published: January 2017

The purpose of this study was to describe antecedents and characteristics of nonfatal fall-related injuries among health care workers in the United States. A special request was made for the Bureau of Labor Statistics to obtain nonfatal fall-related injury data from 2008 to 2010. Overall, workers in the nursing-related profession had the highest percentages of workplace fall-related injuries. Ninety-one percent of these injured workers were female, and more than 50% were between the ages of 45 and 64 years. More than 25% of fall injuries resulted in 31 or more workdays being lost. This study indicated that the most affected body parts were the lower extremities, with most injuries resulting in sprains, strains, and tears. Accordingly, this 3-year study revealed that a high number of fall injuries occurred at night for health care workers compared to other workers in the U.S. private sector.
The Prevalence of Work-Related Neck, Shoulder, and Upper Back Musculoskeletal Disorders among Midwives, Nurses, and Physicians
Authors: Long Maryann H. , Bogossian Fiona E. , Johnston Venerina
Published: January 2017

With the global shortage of health care workers predicted to worsen, attrition from the work force must be minimized. This review examined the incidence or prevalence of neck, shoulder, and upper back musculoskeletal disorders, a possible source of attrition, among midwives, nurses, and physicians. Four electronic databases were systematically searched for publications meeting inclusion criteria. Reference lists of retrieved articles were hand searched for additional articles. After eliminating articles that did not meet inclusion criteria, the remaining articles were assessed for quality and prevalence or incidence data were extracted. Twenty-nine articles published between 1990 and 2012 were included and assessed for quality. Median annual prevalence rates were 45% (neck), 40% (shoulder), and 35% (upper back). Methodological concerns included small sample size, inconsistency of outcome measures, likelihood of non-response bias, and low response rates. Midwives, who have not been well studied, demonstrated prevalence somewhat lower than that of nurses and physicians.
A Longitudinal Study of the Impact of Cumulative Violence Victimization on Comorbid Posttraumatic Stress and Depression among Female Nurses and Nursing Personnel
Authors: Cavanaugh Courtenay , Campbell Jacquelyn , Messing Jill T.
Published: January 2017

This study examined the impact of cumulative violence victimization on health care workers' subsequent posttraumatic stress–depression comorbidity. Female nurses and nursing personnel ( N = 1,044) answered questions about lifetime violence victimization (e.g., childhood abuse, intimate partner violence, and workplace violence) at baseline and completed the Primary Care Posttraumatic Stress (PTS) Disorder screen and Center for Epidemiologic Studies Depression Scale 6 months later. Seven percent screened positive for comorbid posttraumatic stress-depression at 6-month monitoring. Workers who reported one, two, or three or more types of violence victimization at baseline had 2.41 ( p < .10), 2.35 ( p > .05), and 6.44 ( p < .01) greater odds, respectively, of subsequently screening positive for comorbid PTS–depression compared to their counterparts who reported no violence victimization at baseline. These results suggest the need to provide female nurses and nursing personnel with information about (1) the risk cumulative violence victimization poses for poorer mental health and functioning, and (2) evidence-based trauma informed treatment options outside their place of employment for those affected by violence victimization who develop mental health symptoms.
Foot Progression Angle Walking Test
Authors: Ranawat Anil S. , Gaudiani Michael A. , Slullitel Pablo A. , Satalich James , Rebolledo Brian J.
Published: January 2017

Background:

Determining an accurate clinical diagnosis for nonarthritic hip pain may be challenging, as symptoms related to femoroacetabular impingement (FAI) or hip instability can be difficult to elucidate with current testing methods. In addition, commonly utilized physical examination maneuvers are static and do not include a dynamic or weightbearing assessment to reproduce activity-related symptoms. Therefore, implementing a dynamic assessment for FAI and hip instability could help to improve diagnostic accuracy for routine clinical examinations of patients with nonarthritic hip pain.

Purpose:

To assess the efficacy of a novel diagnostic foot progression angle walking (FPAW) test for identifying hip pathology related to FAI or hip instability.

Study Design:

Prospective cohort study; Level of evidence, 3.

Methods:

This prospective study included 199 consecutive patients who were evaluated for unilateral hip pain and who underwent FPAW testing along with standard physical examination testing. Demographic data, including age, sex and hip laterality, were collected from each patient. FPAW testing was performed with directed internal and external foot progression angles from their baseline measurements, with a positive test reproducing pain and/or discomfort. Comparisons were then made with flexion adduction internal rotation (FADIR) and flexion abduction external rotation (FABER) tests as the designated diagnostic standard examinations for FAI and hip instability, respectively. Sensitivity and specificity, along with the McNemar chi-square test for group comparison, were used to generate summary statistics. In addition, areas under the combined receiver operating characteristic curves (AUC) of test performance were calculated for both FPAW and the designated standard examination tests (FADIR, FABER). Radiographic imaging was used subsequently to confirm the diagnosis.

Results:

The average age of the study cohort was 35.4 ± 11.8 years, with 114 patients being female (57%). Positive internal FPAW testing demonstrated 61% sensitivity and 56% specificity for an FAI diagnosis, compared with the 96% sensitivity and 11% specificity seen with FADIR testing. Internal FPAW was less sensitive, yet more specific compared with FADIR ( P < .001). Combined testing had improved accuracy (AUC = 0.58; P < .05) compared with FADIR (AUC = 0.52; P = .21) or FPAW (AUC = 0.57; P = .057) alone. Positive external FPAW revealed 67% sensitivity and 70% specificity for hip instability, while FABER testing was 54% sensitive and 90% specific. External FPAW was significantly more specific but had similar sensitivity to FABER. Combined testing had greater accuracy (AUC = 0.77) compared with FABER (AUC = 0.70) or FPAW (AUC = 0.67) alone ( P < .001).

Conclusion:

The FPAW examination can be used as an adjunct examination to assist and improve the accuracy of the clinical diagnosis for FAI and hip instability.
Exploring Inpatients' Experiences of Healing and Healing Spaces
Authors: MacAllister Lorissa , Bellanti Dawn , Sakallaris Bonnie R.
Published: January 2017

In order to understand a patient’s healing experience it is essential to understand the elements that they, the patient, believes contributed to their healing. Previous research has focused on symptom reducers or contributors through environment such as stress. A person’s experience of healing happens over time not instantaneous. Therefore, in this study, the interviews with patients happened after forty-eight hours of hospitalization. This mixed methods study describes the experiences of seventeen inpatients from two healthcare systems using a phenomenological approach combined with evidence based design evaluation methods to document the setting. The qualitative data was analyzed first for reoccurring themes then further explored and defined through quantitative environmental observations. The seventeen patients defined healing as “getting better/well.” Seventy three statements were recorded about contributors and detractors to healing in the physical environment. Three primary themes emerged from the data as positive influencers of a healing experience: being cared for, being comfortable and experiencing something familiar or like home. These results demonstrate that patients perceive their inpatient healing experience through a supported environment.
Different Combining Process Between Male and Female Patients to Reach Their Overall Satisfaction
Authors: Otani Koichiro , Buchanan Paula R , Desai Samir P , Herrmann Patrick A
Published: January 2017

Patient satisfaction and how it is measured is an important field of study in healthcare. Consequently, there have been many patient satisfaction studies. However, there is a lack of studies that focused on how male and female patients perceive, or weigh, their overall satisfaction. Determining the weights of these attributes by gender is an important outcome to determine overall patient satisfaction and quality of care. Data were collected by applying the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey instrument to record regular patient experience at 70 United States hospitals. The data were collected between July 1, 2011 and June 30, 2012, and there are 43,938 cases in the data set. This study found that all five of the attributes (Nursing Care, Physician Care, Staff Care, Room, and Help) had an association with patient satisfaction. Among them, nursing Care had the largest influence on patient satisfaction of all of the five attributes. This study also showed a statistically significant interaction effect by gender for the interaction between Nursing care x Gender, Physician care x Gender, and Help x Gender. Female patients rated their relationship with their nurses as being more important to their overall satisfaction, while male patients rated their relationship with their doctor as being more important to overall satisfaction. Male patients also rated their relationship with help as being more important to overall satisfaction when compared with the results from female patients. Suggestions to healthcare managers are also discussed.
Developing An Analytic Approach to Understanding the Patient Care Experience
Authors: Springman Mary Kate , Bermeo Yalissa , Limper Heather M , Tothy Alison S
Published: January 2017

The amount of data available to health-care institutions regarding the patient care experience has grown tremendously. Purposeful approaches to condensing, interpreting, and disseminating these data are becoming necessary to further understand how clinical and operational constructs relate to patient satisfaction with their care, identify areas for improvement, and accurately measure the impact of initiatives designed to improve the patient experience. We set out to develop an analytic reporting tool deeply rooted in the patient voice that would compile patient experience data obtained throughout the medical center.
Factors associated with the family migration of farmer-workers in China
Authors: Sun Feng , Xiao Jing Jian
Published: January 2017

The massive migration of laborers from rural areas to urban areas has resulted in many family issues including those related to children’s education and the protection and care of older parents. The purpose of this study was to explore factors associated with the family migration of farmer-workers. Using data from the 2012 China Mobile Population Survey, factors associated with family migration of farmer-workers were identified and policy recommendations for helping migrant-worker families stay together were discussed.
Race/Religion/War
Authors: Feldman Keith P. , Medovoi Leerom
Published: January 2017

This introductory essay points to the long patterns as well as the telling diversity of relationships revealed in genealogies of the race/religion/war triad. Our key observation is that race, religion, and war come together as a meaningful constellation precisely because they together underpin one dominant strategy of the power that we call the political, while at the same time we recognize that the relationships among race, religion, and war are simultaneously too compressed, historically transient, and reversible to take the form of a simple functionalism; indeed, at any particular moment their articulation is historically specific and subject to rearticulation. From the religious crucibles for the formation of race in the conquest of the Americas to the pastoral Christian origins of modern racial governmentality; from the colonial wars of high imperialism and the third-world proxy wars for the purportedly secular rivalry of the Cold War to the contemporary conditions of Muslim migrant and refugee communities—these multiple overlapping genealogies, we argue, are necessary reference points for an adequate analysis of our political present. As one way to think across these genealogies, we highlight the intersection of two ostensibly parallel scholarly trajectories: race as political theology and race as political ontology. Both of these trajectories point toward the condensed relationships among our three terms, illuminating in the process the deep structure of our present.
Militarizing Race
Authors: Goldberg David Theo
Published: January 2017

Against the historical background of the transitions between religion and race, of race as the secularization of the religious, this article traces the ways race operates in the conduct of social struggles, wars, and warring in the making and refashioning of racial conception. This militarizing of society that has constitutively marked modern state formation shapes social disciplining of individuals and the regulation of social structures. The article exemplifies how this has given rise to a discourse of martial races, which in turn shades social practices from the industrial to the financial sector, from political policy to recreation. The article closes with an argument to demilitarize the social and contrast militarizing politics with a politics of irritation.
Effect of Graduated Compression Stockings on Limb Oxygenation and Venous Function during Exercise in Patients with Venous Insufficiency
Authors: Agu Obi , Baker Daryll , Seifalian Alexander M.
Published: January 2017

Despite the established role of compression as the basis for nonoperative treatment of chronic venous insufficiency (CVI), its mechanism of action remains unclear. Near-infrared spectroscopy (NIRS) provides continuous noninvasive monitoring of changes in tissue oxyhemoglobin (HbO2) and deoxyhemoglobin (Hb). We applied NIRS to evaluate the effect of graded stockings on venous function and calf muscle oxygenation during exercise in patients with CVI.

Ten patients (age 56 ± 5 years) with CVI were rested in supine posture for 20 minutes. NIRS optodes were attached to the calf. Venous function was assessed in each patient with and without graded compression stockings (classes I to III) at rest in the supine position, standing, with 10 tiptoe exercises, and on standard walking at 1.6 km/h for 5 minutes. Venous function was assessed by measuring changes in Hb and total hemoglobin (HbT) during the test, and muscle oxygenation was assessed by the oxygenation index (HbD), which is the difference between HbO2 and Hb.

Standing without stockings caused a significant increase in Hb concentration by 10.75 ± 2.24 µmol/L compared with the supine position ( p < .001). This value was reduced when stockings were applied to 6.38 ± 2.75 µmol/L with class III stockings ( p = .005). During tiptoe exercise, the residual Hb concentration value without stockings was 7.62 ± 2.12 µmol/L compared with 5.88 ± 2.87, 3.77 ± 3.37, and 3.46 ± 2.73 ±mol/L for class I, II, and III stockings, respectively. The reduction in Hb concentration reached significance with class II and III stockings compared to without stockings ( p = .04). The HbT concentration was also reduced during tiptoe exercise, with increasing compression from 15.46 ± 5.31 µmol/L without compression to 11.52 ± 4.26 µmol/L with class III stockings ( p = .048). During walking, the Hb concentration was 11.40 ± 3.10 µmol/L without stockings, decreasing significantly ( p < .001) and progressively to 8.49 ± 3.24, 7.71 ± 3.51, and 6.89 ± 3.16 µmol/L with class I, II, and III stockings, respectively. Limb oxygenation (as measured by HbO2 concentration) during walking exercise, however, increased with higher-compression stockings and reached significance with class III stockings only ( p = .03).

In patients with venous insufficiency, graduated compression stockings may achieve their beneficial effects by reducing venous pooling and improving deeper tissue oxygenation.
Genome-wide characterization of folate transporter proteins of eukaryotic pathogens
Authors: Falade Mofolusho , Otarigho Benson
Published: January 2017

Background:Medically important pathogens are responsible for the death of millions every year. For many of these pathogens, there are limited options for therapy and resistance to commonly used drugs is fast emerging. The availability of genome sequences of many eukaryotic protozoa is providing important data for understanding parasite biology and identifying new drug and vaccine targets. The folate synthesis and salvage pathway are important for eukaryote pathogen survival and organismal biology and may present new targets for drug discovery.

Methods:We applied a combination of bioinformatics methods to examine the genomes of pathogens in the EupathDB for genes encoding homologues of proteins that mediate folate salvage in a bid to identify and assign putative functions. We also performed phylogenetic comparisons of identified proteins. .

Results:We identified 234 proteins to be involve in folate transport in 63 strains, 28 pathogen species and 12 phyla, 60% of which were identified for the first time. Many of the genomes examined contained genes encoding transporters such as folate-binding protein YgfZ, folate/pteridine transporter, folate/biopterin transporter, reduced folate carrier family protein, folate/methotrexate transporter FT1. The mitochondrion is the predicted location of the majority of the proteins, with 15% possessing signal peptides. Phylogeny computation shows the similarity of the proteins identified.

Conclusion:These findings offer new possibilities for potential drug development targeting folate-salvage proteins in eukaryotic pathogens.
Human brain harbors single nucleotide somatic variations in functionally relevant genes possibly mediated by oxidative stress
Authors: Sharma Anchal , Ansari Asgar Hussain , Kumari Renu , Pandey Rajesh , Rehman Rakhshinda , Mehani Bharati , Varma Binuja , Desiraju Bapu K. , Mabalirajan Ulaganathan , Agrawal Anurag , Mukhopadhyay Arijit
Published: January 2017

Somatic variation in DNA can cause cells to deviate from the preordained genomic path in both disease and healthy conditions. Here, using exome sequencing of paired tissue samples, we show that the normal human brain harbors somatic single base variations measuring up to 0.48% of the total variations. Interestingly, about 64% of these somatic variations in the brain are expected to lead to non-synonymous changes, and as much as 87% of these represent G:C>T:A transversion events. Further, the transversion events in the brain were mostly found in the frontal cortex, whereas the corpus callosum from the same individuals harbors the reference genotype. We found a significantly higher amount of 8-OHdG (oxidative stress marker) in the frontal cortex compared to the corpus callosum of the same subjects (p<0.01), correlating with the higher G:C>T:A transversions in the cortex. We found significant enrichment for axon guidance and related pathways for genes harbouring somatic variations. This could represent either a directed selection of genetic variations in these pathways or increased susceptibility of some loci towards oxidative stress. This study highlights that oxidative stress possibly influence single nucleotide somatic variations in normal human brain.
Case Article—Canyon Bicycles: Judgmental Demand Forecasting in Direct Sales
Authors: Diermann Christoph , Huchzermeier Arnd
Published: January 2017

We present a comprehensive introduction to judgmental demand forecasting along with a model that allows for effectively debiasing team forecasts and estimating demand distributions. This case is recommended for classes in operations management, marketing, or retail management; two companion papers are ideal for advanced courses (e.g., master’s or doctorate programs). We confront students with a demand forecasting problem encountered by Canyon Bicycles, the German premium bicycle manufacturer and online retailer. We present both a model and a process for deriving an accurate judgmental demand forecast. In particular, we demonstrate how one can (i) identify the best team composition, (ii) prepare for and run the forecasting meeting, (iii) debias team forecasts, (iv) estimate demand distributions, (v) deal with heterogeneous product collections, and (vi) judge the quality of forecasted demand distributions.
Signaling Virtue: Charitable Behavior Under Consumer Elective Pricing
Authors: Jung Minah H. , Nelson Leif D. , Gneezy Uri , Gneezy Ayelet
Published: January 2017

Two field experiments examined generosity under consumer elective pricing. In shared social responsibility (SSR), consumers choose how much to pay, knowing that a percentage of their payment goes to support a charitable cause. Replicating past research, consumers in our experiments were sensitive to the presence of charitable giving, paying more when a portion of their payment went to charity. Notably, however, they were largely insensitive to the percentage of payment allocated to charity—customers paid little more when 99% of the payment went to charity than when only 1% went to charity. Neither self-selection nor social pressure fully explained higher payments under SSR.

Data and the online appendix are available at https://doi.org/10.1287/mksc.2016.1018 .
Metal-backedversusall-polyethylene unicompartmental knee arthroplasty
Authors: Scott C. E. H. , Eaton M. J. , Nutton R. W. , Wade F. A. , Evans S. L. , Pankaj P.
Published: January 2017

Objectives

Up to 40% of unicompartmental knee arthroplasty (UKA) revisions are performed for unexplained pain which may be caused by elevated proximal tibial bone strain. This study investigates the effect of tibial component metal backing and polyethylene thickness on bone strain in a cemented fixed-bearing medial UKA using a finite element model (FEM) validated experimentally by digital image correlation (DIC) and acoustic emission (AE).

Materials and Methods

A total of ten composite tibias implanted with all-polyethylene (AP) and metal-backed (MB) tibial components were loaded to 2500 N. Cortical strain was measured using DIC and cancellous microdamage using AE. FEMs were created and validated and polyethylene thickness varied from 6 mm to 10 mm. The volume of cancellous bone exposed to < -3000 µε (pathological loading) and < -7000 µε (yield point) minimum principal (compressive) microstrain and > 3000 µε and > 7000 µε maximum principal (tensile) microstrain was computed.

Results

Experimental AE data and the FEM volume of cancellous bone with compressive strain < -3000 µε correlated strongly: R = 0.947, R2= 0.847, percentage error 12.5% (p < 0.001). DIC and FEM data correlated: R = 0.838, R2= 0.702, percentage error 4.5% (p < 0.001). FEM strain patterns included MB lateral edge concentrations; AP concentrations at keel, peg and at the region of load application. Cancellous strains were higher in AP implants at all loads: 2.2- (10 mm) to 3.2-times (6 mm) the volume of cancellous bone compressively strained < -7000 µε.

Conclusion

AP tibial components display greater volumes of pathologically overstrained cancellous bone than MB implants of the same geometry. Increasing AP thickness does not overcome these pathological forces and comes at the cost of greater bone resection. Cite this article: C. E. H. Scott, M. J. Eaton, R. W. Nutton, F. A. Wade, S. L. Evans, P. Pankaj. Metal-backed versus all-polyethylene unicompartmental knee arthroplasty: Proximal tibial strain in an experimentally validated finite element model. Bone Joint Res 2017;6:22–30. DOI:10.1302/2046-3758.61.BJR-2016-0142.R1
La adaptación climática mediante la innovación en materiales como un proceso de supervivencia: The Revenant a través del análisis de Dersu Uzala
Authors: Jorge Camacho Cristina
Published: January 2017

Las situaciones de emergencia causadas por catástrofes naturales o conflictos aceleran los procesos de adaptación a situaciones climáticas difíciles y de innovación constructiva mediante materiales compuestos y prototipos estructurales más ligeros. Cuatro actores intervienen desde diferentes puntos de vista alrededor de un mismo tema: la supervivencia. Un primer actor comienza la fase de proyecto con unos mapas de un territorio que va modificando al incorporar los datos geográficos y los acontecimientos meteorológicos en sus expediciones sobre el territorio en diferentes épocas del año. Un segundo actor recoge materiales de cada localización, los agrupa y construye recintos para habitar que son capaces de convivir con las duras condiciones climáticas de la zona. A continuación, un tercer actor construye atmósferas fílmicas desde tres puntos de vista como si fueran vistas 3D que le permiten captar la importancia de los fenómenos atmosféricos que afectan al proyecto común. Finalmente, un cuarto actor narra la intervención y comprueba cómo las condiciones del lugar determinan la conexión entre las ideas iniciales y la obra final. Estos cuatro actores están presentes en el análisis de la película Dersu Uzala que el director japonés Akira Kurosawa rodó en la taiga de Usuri en 1976. Actualmente, los actores realizan ensayos de nuevos materiales que pueden ser aplicados desde la macroescala territorial con movimientos topográficos en situaciones climatológicas ad-versas hasta la nanotecnología en materiales compuestos que usan elementos de refuerzo como la fibra de carbono o el grafeno mediante un sistema cosido en vez de pegado; los cuales se utilizan en plataformas marinas o en construcciones de emergencia favoreciendo la regeneración ambiental del lugar donde se implantan. Desde Dersu Uzala (1976) de Akira Kurosawa hasta The Revenant (2015) de Alejandro González Iñárritu podemos ver una aproximación a una arquitectura de supervivencia a través del comportamiento de sus personajes: “mientras todavía tengas aliento para respirar, lucha”.
Faktor Risiko Diare Persisten pada Pasien yang Dirawat di Departemen Ilmu Kesehatan Anak RS Dr. Cipto Mangunkusumo Jakarta
Authors: Putra IGN Sanjaya , Firmansyah Agus , Hegar Badriul , Boediarso Aswitha D , Kadim Muzal , Alatas Fatima Safira
Published: January 2017

Latar belakang. Program pengobatan rehidrasi oral telah berhasil mengontrol kematian akibat diare akut.Sekitar 3%-20% kasus diare akut pada anak akan berkembang menjadi diare persisten. Kematian akibatdiare persisten cukup tinggi ± 65% dari seluruh kematian akibat diare.Tujuan. Menentukan faktor risiko terjadinya diare persisten dan mengukur besar pengaruh tiap faktorrisiko tersebut terhadap terjadinya diare persisten pada anak yang dirawat di ruang rawat inap bagian anakRS Dr. Cipto Mangukusumo Jakarta.Metode. Rancang penelitian retrospektif, kasus-kontrol. Data penelitian diperoleh dari catatan medikpasien, semua pasien (54 pasien) diare persisten yang dirawat mulai 1 Januari 2004-30 Juni 2007 yangmemenuhi kriteria inklusi dipilih sebagai kasus dan 108 pasien diare akut dipilih secara consecutive samplingsebagai kontrol.Hasil. Pada analisis univariat didapatkan perbedaan bermakna antara 54 pasien dengan diare persisten(kasus) dan 108 pasien dengan diare akut (kontrol) dalam hubungan melanjutnya diare akut menjadi diarepersisten pada faktor risiko: pemberian antibiotik (p=0,042, RO :1,984, IK : 0,021-3,854), anemia (p=0,005,RO :2,568, IK : 1,313-5,024 ) dan malnutrisi (p= 0,001, RO : 10,974, IK :3,442-34,814). Pada regresilogistik multivariat, dua faktor risiko memperlihatkan hubungan yang bermakna yaitu anemia (p=0,025,RO :2,374, IK : 1,117-5,047) dan malnutrisi (p= 0,001, RO : 12,621, IK :3,580-44,814).Kesimpulan. Anemia dan malnutrisi pada diare akut merupakan faktor risiko untuk melanjutnya diare akutmenjadi diare persisten.
Perbedaan Respon Hematologi dan Perkembangan Kognitif pada Anak Anemia Defisiensi Besi Usia Sekolah Dasar yang Mendapat Terapi Besi Satu Kali dan Tiga kali Sehari
Authors: Lubis Bidasari , Saragih Rina AC , Gunadi Dedi , Rosdiana Nelly , Andriani Elvi
Published: January 2017

Latar belakang. Anemia defisiensi besi (ADB) dapat menyebabkan gangguan belajar dan mental dalam jangka panjang, bahkan dapat menetap. Tingkat kepatuhan pengobatan yang diberikan tiga kali sehari masih rendah. Hal ini dapat ditingkatkan dengan pemberian satu kali sehari sehingga diharapkan pengobatan akan berhasil.Tujuan. Membandingkan respon pengobatan pada pemberian sulfas frosus satu kali sehari dengan 3 kali sehari pada anak usia sekolah yang menderita anemia defisiensi besi.Metode. Penelitian dilakukan di Kecamatan Bilah Hulu, Kabupaten Rantau Prapat terhadap murid sekolah dasar. Anak dengan Hb <12, hipokrom mikrositer, Mentzer Index >13 dan RDW index >220 diikutsertakan dalam penelitian. Fungsi kognitif dinilai dengan Weschler Intelligence Scale for Children. Sampel secara random dibagi menjadi 2 kelompok yang mendapat sulfas ferosus 3 kali sehari dan satu kali sehari dengan dosis yang sama (besi elemental 5 mg/kgBB/hari).Hasil. Lima puluh anak dinilai dengan WISC, didapati rerata Full IQ 83,80 (SD=13,14), Performance IQ 81,08 (SD=14,58) dan Verbal IQ 88,10 (SD=14,20). Didapatkan skor aritmatika yang rendah (7+3,23). Tingkat IQ didapati average 36%, dull normal 28%, borderline 24%, dan mental defective 10%. Konsentrasi yang rendah dijumpai pada 44% dan sangat rendah 10%. Terdapat peningkatan bermakna kadar hemoglobin pada kedua kelompok setelah pemberian terapi besi (p<0,05), namun tidak dijumpai perbedaan bermakna peningkatan Hb antar kedua kelompok (p=0,29).Kesimpulan. Full IQ anak sekolah dasar yang menderita anemia defisiensi besi tidak melebihi tingkat average, didapati gangguan konsentrasi dan fungsi kognitif, terutama dalam matematika. Tidak didapati perbedaan bermakna antara kelompok terapi besi tiga kali sehari dibandingkan satu kali sehari dalam peningkatan Hb.
Profil Asidosis Tubulus Renalis pada Anak di RS Cipto Mangunkusumo Jakarta
Authors: Hendrata Erwin Lukas , Tambunan Taralan , Sjarif Damayanti Rusli , Chair Imral
Published: January 2017

Latar belakang. Asidosis tubulus renalis (ATR) adalah suatu sindrom klinis yang disebabkan oleh gangguanreabsorpsi bikarbonat (HCO3-) di tubulus proksimal renal atau gangguan pengasaman urin (sekresi ion H+)di tubulus distal. Ditandai oleh asidosis metabolik hiperkloremik, senjang anion plasma normal, dan fungsiglomerulus normal.Sampai saat ini diagnosis ATR masih sulit ditegakkan terutama karena gejala klinis yangtidak spesifik. Tanpa pengobatan dini, adekuat, dan berkesinambungan maka anak dengan ATR berpotensimengalami gangguan pertumbuhan, nefrokalsinosis, nefrolitiasis, osteomalasia, gagal ginjal, hiperkalemia,atau bahkan kematian.Tujuan.Menilai profil anak dengan asidosis tubulus renalis sehingga diagnosis dan pengobatan ATR dapatdilakukan lebih dini.Metode. Penelitian serial kasus dengan sumber data diperoleh dari rekam medis pasien ATR yang berobatdi Departemen Ilmu Kesehatan Anak Fakultas Kedokteran Universitas Indonesia-Rumah Sakit CiptoMangunkusumo (IKA FKUI-RSCM) sejak Januari 1998 hingga Desember 2008.Hasil. Didapatkan 54 pasien ATR baru yang berarti terjadi peningkatan lebih dari 9 kali lipat dibandingpenelitian terdahulu yang dilakukan pada tahun 1975-1995. Peningkatan tersebut mungkin disebabkanmeningkatnya kewaspadaan petugas kesehatan terhadap gejala gagal tumbuh dan ATR diduga sebagai salahsatu etiologinya. Gejala tersering yang ditemukan adalah gagal tumbuh, perawakan pendek, dan anoreksia.Nefrokalsinosis didapatkan pada 6 (21%) dari 28 subjek penelitian. Setelah pemberian terapi alkali, denganrerata lama pengamatan 20 bulan, peningkatan BB/TB terjadi pada 27/34 subjek. Peningkatan BB/TBterjadi terutama dalam 6 bulan pertama pengobatan.Kesimpulan. Gagal tumbuh, terutama bila disertai perawakan pendek, anoreksia, dan muntah pada seoranganak dapat dipakai sebagai petunjuk untuk kemungkinan diagnosis ATR.