bluuebunny/crossref_metadata_2025 huggingface dataset:
Examining Variation in Treatment Outcomes among Speakers with Dysarthria
Authors: McAuliffe Megan , Fletcher Annalise
Published: June 2017

Studies investigating the outcomes of behavioral treatments for dysarthria commonly focus on group-level effects. Individual differences in treatment response have received less attention. Currently, we have limited understanding of why some speakers respond favorably to certain intervention programs but others do not. This article advocates for a more individualized approach to assessing the efficacy of speech pathology intervention. A conceptual framework is presented, in which the effects of salient speech features and contextual factors upon treatment outcomes are considered statistically, with a view to informing treatment planning and development of future clinical studies. Preliminary evidence is presented in support of this framework—demonstrating that detailed measurements of the speech signal can predict which individuals respond favorably to certain treatment cues, even among participants with the same dysarthria etiology and subtype. Future directions for the study of individualized assessment and treatment approaches are discussed.
Der Patient mit Thoraxtrauma: chirurgische Versorgung
Authors: Zardo Patrick , Busk Henning , Piatek Stefan , Zinne Norman , Kropivnitskaya Irina , Kutschka Ingo
Published: June 2017

Bei Thoraxtraumata reicht das Spektrum von Verletzungen des Herzens und der großen Gefäße über Parenchymläsionen mit Pneumothorax, Blutungen aus den Interkostalgefäßen, bis hin zu chronischen Hämatothoraces und sekundären Empyemen. Die Anlage einer Thoraxdrainage stellt oft eine suffiziente Therapie dar, in bestimmten Fällen ist aber eine weitergehende chirurgische Therapie in minimalinvasiver Technik (VATS) oder via Thorakotomie erforderlich.
Belastungen im Berufsalltag von Palliativpflegekräften – eine Befragung in Kooperation mit dem KompetenzZentrum Palliative Care Baden-Württemberg (KOMPACT)
Authors: Gencer Deniz , Meffert Cornelia , Herschbach Peter , Hipp Matthias , Becker Gerhild
Published: June 2017

Ziel der Studie Durch den demographischen Wandel wird der Bedarf an spezialisierten Palliativeinrichtungen in Deutschland weiter zunehmen, was bei immer knapperen Ressourcen und steigenden Patientenzahlen möglicherweise zur Überlastung der Pflegekräfte führen kann. Ziel unserer Studie war die Identifikation von Risiken für Überlastungen im Berufsalltag von stationären und ambulanten Palliativpflegekräften.

Methodik Als Projekt des Kompetenzzentrums Palliative Care Baden-Württemberg wurde eine anonyme Befragung der Pflegekräfte aller Palliativstationen und der spezialisierten ambulanten Palliativversorgung (SAPV) innerhalb Baden-Württembergs durchgeführt. Der genutzte Erhebungsbogen erfragte spezifische Belastungen bei der beruflichen Tätigkeit, eine Selbsteinschätzung des eigenen Gesundheitszustandes sowie wichtige Aspekte bezüglich des psychischen Befindens. Insgesamt nahmen 167 Pflegekräfte aus 34 verschiedenen Einrichtungen an der Befragung teil.

Ergebnisse Es zeigte sich ein signifikanter Unterschied zwischen stationär und ambulant tätigen Palliativpflegekräften bezüglich der Art und Intensität der Belastung. Der ermittelte Gesamtbelastungswert war für Pflegekräfte auf Palliativstationen signifikant schlechter im Vergleich zum ambulanten Setting (p<0,001). Eine hohe Wochenarbeitszeit sowie fehlende Berufserfahrung im Bereich Palliative Care führten zu einer schlechteren Vereinbarkeit von Beruf- und Privatleben. Höhere Belastungswerte führten zu einer geringeren Zufriedenheit mit der beruflichen Situation. Je unzufriedener die Pflegenden mit ihrer beruflichen Situation waren, desto weniger gut schätzten sie ihren eigenen Gesundheitszustand ein. Das psychische Befinden der Palliativpflegekräfte war signifikant schlechter im Vergleich mit der Normstichprobe, zahlreiche Pflegekräfte waren „auffällig“ oder sogar „gravierend“ belastet. Durch die Befragung wurde außerdem deutlich, dass die geforderten strukturellen Bedingungen auf den Palliativstationen nur knapp erfüllt werden.

Schlussfolgerung Die Ergebnisse deuten auf schlechtere Arbeitsbedingungen und in der Folge auf eine drohende Überlastung der Pflegekräfte in stationären Palliativeinrichtungen hin. Maßnahmen und Weiterbildungen zur Stressbewältigung und dem Umgang mit berufsbedingten Belastungen scheinen damit bislang nicht ausreichend in den Berufsalltag der Pflegenden implementiert zu sein. In Bezug auf die nicht optimalen strukturellen Bedingungen für Pflegende auf Palliativstationen sollten die seitens der Fachgesellschaften geforderten Standards hinterfragt und re-evaluiert werden.
A Rosa canina – Urtica dioica – Harpagophytum procumbens/zeyheri Combination Significantly Reduces Gonarthritis Symptoms in a Randomized, Placebo-Controlled Double-Blind Study
Authors: Moré Margret , Gruenwald Joerg , Pohl Ute , Uebelhack Ralf
Published: June 2017

The special formulation MA212 (Rosaxan) is composed of rosehip (Rosa canina L.) puree/juice concentrate, nettle (Urtica dioica L.) leaf extract, and devilʼs claw (Harpagophytum procumbens DC. ex Meisn. or Harpagophytum zeyheri Decne.) root extract and also supplies vitamin D. It is a food for special medical purposes ([EU] No 609/2013) for the dietary management of pain in patients with gonarthritis.

This 12-week randomized, placebo-controlled double-blind parallel-design study aimed to investigate the efficacy and safety of MA212 versus placebo in patients with gonarthritis.

A 3D-HPLC-fingerprint (3-dimensional high pressure liquid chromatography fingerprint) of MA212 demonstrated the presence of its herbal ingredients. Ninety-two randomized patients consumed 40 mL of MA212 (n = 46) or placebo (n = 44) daily. The Western Ontario and McMaster Universities Arthritis Index (WOMAC), quality-of-life scores at 0, 6, and 12 weeks, and analgesic consumption were documented. Statistically, the initial WOMAC subscores/scores did not differ between groups. During the study, their means significantly improved in both groups. The mean pre-post change of the WOMAC pain score (primary endpoint) was 29.87 in the MA212 group and 10.23 in the placebo group. The group difference demonstrated a significant superiority in favor of MA212 (pU < 0.001; pt < 0.001). Group comparisons of all WOMAC subscores/scores at 6 and 12 weeks reached same significances. Compared to placebo, both physical and mental quality of life significantly improved with MA212. There was a trend towards reduced analgesics consumption with MA212, compared to placebo. In the final efficacy evaluation, physicians (pChi < 0.001) and patients (pChi < 0.001) rated MA212 superior to placebo. MA212 was well tolerated.

This study demonstrates excellent efficacy for MA212 in gonarthritis patients.
Measurement of plasma sheath overlap above a trench
Authors: Sheridan T. E. , Steinberger Thomas E.
Published: June 2017

The plasma sheath above a rectangular trench has been experimentally characterized as the trench width is varied in a radio frequency (rf) plasma discharge for two different rf powers giving two different sets of plasma parameters. Measurements were made using the positions and all six normal mode frequencies of two dust particles floating just inside the sheath edge above the center of the trench. We find that sheath overlap occurs when the trench width ≲3s0 for a trench depth ≈0.7s0, where s0 is the planar sheath width. The electric field gradient inside the sheath edge increases with rf power.
Testing for chlamydial infection: are we meeting clinical guidelines? Evidence from a state-level laboratory data linkage analysis for 15- to 29-year-olds
Authors: Stephens Nicola , Coleman David , Shaw Kelly , Sullivan Maree O' , McGregor Alistair , Cooley Louise , Vally Hassan , Venn Alison
Published: June 2017

Background Clinical guidelines recommend annual chlamydia tests for all sexually active people aged 15–29 years. This study measured adherence to these guidelines and compared testing rates to the projected levels required to reduce chlamydia prevalence. Methods: All chlamydia tests conducted in Tasmania during 2012–13, for residents aged 15–29 years, were linked. Data linkage allowed individuals who had multiple tests across different healthcare settings to be counted only once each year in analyses. Rates of testing and test positivity by age, sex, rebate status and socioeconomic indicators were measured. Results: There were 31 899 eligible tests conducted in 24 830 individuals. Testing coverage was higher in females (21%, 19 404/92 685) than males (6%, 5426/98 123). Positivity was higher in males (16%, 862/5426) than females (10%, 1854/19 404). Most tests (81%, 25 803/31 899) were eligible for a rebate. Positivity was higher in females with non-rebatable tests (12%, 388/3116 compared with those eligible for a rebate (9%, 1466/16 285). More testing occurred in areas of middle disadvantage (10%, 9688/93 678) compared with least (8%, 1680/21 670) and most (10%, 7284/75 460) (both P < 0.001) disadvantaged areas. Higher test positivity was found in areas of most-disadvantage (11%, 822/7284) compared with middle- (10%, 983/9688) and least- (8%, 139/1680) disadvantaged areas. Conclusions: Chlamydia testing rates are lower than recommended levels. Sustaining the current testing rates in females aged 20–24 years may reduce population prevalence within 10 years. This study meets key priorities of national strategies for chlamydia control by providing a method of monitoring testing coverage and evidence to evaluate prevention programs.
Rewriting ‘white’ genres in search of Afro-European identities
Authors: Hauthal Janine
Published: June 2017

Presuming that both travel and crime fiction can be described as traditionally ‘white’ genres, this article investigates how contemporary Black British authors appropriate these genres. Focusing on Mike Phillips’sA Shadow of Myselfand Bernardine Evaristo’sSoul Tourists, the article examines how the two novels redeem and suspend the traditional racial and national coding of travel writing and crime fiction by rehabilitating black mixed-race characters. In both novels, moreover, the rethinking of traditional popular genres coincides with, and is partly enabled by, a transnational shift in focus from Britain to Europe. A closer look at the novels’ respective endings, finally, reveals how each conceptualises the relationship between Britain and Europe differently, and how this difference can be explained by the impact of genre.
The direction giving pointing gestures of the Malay Malaysian speech community
Authors: Mechraoui Amal , Noor Faridah Noor Binti Mohd
Published: June 2017

When we speak, we do not only produce a chain of words and utterances, but we also perform various body movements that convey information. These movements are usually made with the hands and are what McNeill (1992) terms gestures. Although gesturing is universal, the way we gesture and the meanings we associate with gestures vary cross-culturally. Using a qualitative approach, this paper describes and illustrates the forms and functions of pointing gestures used by Malay speakers. The data discussed is based on 10 video recorded direction-giving interactions. Findings show that pointing among Malay speakers is achieved through the use of various manual pointing gestures and other bodily actions involving gaze, torso and head movements, which communicate distinct functions. This study has indicated that although some gesture forms and functions are shared among Malay speakers and other cultural groups, some direction-giving pointing behaviors are Malay specific.
‘The Memory of the Tree’: A New Theatrical Model of Genogram
Authors: Fiaschini Fabrizio
Published: June 2017

In the context of systemic psychotherapy, the genogram represents a model of graphical representation which the persons involved produce and comment on in order to provide information about their family of origin, from at least a three-generational perspective. This paper proposes a new variant of the genogram, focused on theatrical language: the result of a five-year experiment in the training of dramatherapists, psychologists, psychotherapists and counsellors. Starting from Stanislavski's and Grotowski's research, the paper highlights the potentialities that the theatre perspective may have with the genogram. Thanks to the ‘emotive memory’ and ‘body-memory’, the theatre can enrich the genogram method with a set of operational tools that can increase the introspective potential of the genogram itself, especially through the aid of physical actions. If the act of drawing represents an expressive ‘medium’ in the traditional genogram for stimulating the affective memory of family ties, then the language of performance can even better represent this medium, centred as it is on the activation of the body as a vehicle capable of bringing into contact the individual with his identity and his deep memory, even regarding the family, in order to creatively translate this into a communicative and narrative form.
Effect of addition of elements on two-glass-forming ability of Zr–Ce–Co–Cu immiscible alloys
Authors: Wang Zhong Yuan , He Jie , Yang Bai Jun , Chen Bin , Xi Yao Yao , Zhao Jiu Zhou , Jiang Hong Xiang , Hao Hong Ri , Wang Tong Min
Published: June 2017

The effects of Al element addition and partial substitution of Ce with La, Pr, and Nd on the two-glass-forming ability of the phase-separating Zr–Ce–Co–Cu alloy system have been studied. The distribution of the additions in the two coexistent immiscible liquids was analysed thermodynamically. The results indicate that Al almost equally distributes in the two liquids, whereas the elements La, Pr, and Nd are predominantly found in the Ce–Cu-rich liquid. X-ray diffraction analysis reveals that these additions obviously enhance the two-glass-forming ability of the coexisting liquids. This work presents a strategy for improving the two-glass-forming ability of immiscible alloys to obtain phase-separated bulk metallic glasses.
Associative mechanisms involved in specific Pavlovian-to-instrumental transfer in human learning tasks
Authors: Alarcón Daniel E , Bonardi Charlotte , Delamater Andrew R
Published: June 2017

Four experiments compared the effect of forward and backward conditioning procedures on the ability of conditioned stimuli (CS) to elevate instrumental responding in a Pavlovian-to-instrumental transfer (PIT) task. Two responses were each trained with one distinct outcome (R1->O1, R2->O2), either concurrently (Experiment 1) or separately (Experiments 2, 3 and 4). Then, in Experiments 1 and 2, four CSs were either followed or preceded by one outcome (A->O1, B->O2, O1->C, O2->D). In Experiment 3, each CS was preceded and followed by an outcome: for one group of participants, both outcomes were identical (e.g., O1->A->O1, O2->B->O2), but for the other, they were different (e.g., O1->A->O2, O2->B->O1). In Experiment 4, two CSs were preceded and followed by identical outcomes, and two CSs by different outcomes. In the PIT tests, participants performed R1 and R2 in the presence and absence of the CSs. In Experiments 1 and 2, only the CSs followed by outcomes in Pavlovian training elevated responding. In Experiments 3 and 4, all the CSs elevated responding but based on the outcome that followed them in training. These results support the stimulus-outcome-response (S-O-R) mechanism of specific PIT, according to which CSs elevate responding via activation of its associated outcome representation.
Health-related quality of life measurement in individuals with chronic suppurative otitis media
Authors: Prabhu Prashanth , Ganeshan Aishwarya , C Anusha , Jose Anita , Kiruthika Lavanya
Published: June 2017

The present study attempted to determine health-related quality of life in individuals with chronic suppurative otitis media (CSOM). COMOT-15 and COMQ-12 questionnaires were administered to 100 individuals with CSOM of South India. The study also attempted to determine the possible predictors (demographic and audiological results) of HRQOL based on demographic details (gender, onset and nature of hearing loss) and pure-tone average. The results of study showed that individuals with CSOM in South India exhibit poor health-related quality of life. The ear-related symptoms and emotional difficulties because of CSOM affect their HRQOL. The study also showed that scores were poorer in individuals with higher degree of loss and longer onset of CSOM. It was also found that gender and nature of hearing loss were poor predictors of HRQOL measures. Thus, it is essential to determine HRQOL measures to understand the problems from the patient’s perspective and provide appropriate management.
Differential phosphorylation signals control endocytosis of GPR15
Authors: Okamoto Yukari , Shikano Sojin
Published: June 2017

GPR15 is an orphan G protein–coupled receptor (GPCR) that serves for an HIV coreceptor and was also recently found as a novel homing receptor for T-cells implicated in colitis. We show that GPR15 undergoes a constitutive endocytosis in the absence of ligand. The endocytosis was clathrin dependent and partially dependent on β-arrestin in HEK293 cells, and nearly half of the internalized GPR15 receptors were recycled to the plasma membrane. An Ala mutation of the distal C-terminal Arg-354 or Ser-357, which forms a consensus phosphorylation site for basophilic kinases, markedly reduced the endocytosis, whereas phosphomimetic mutation of Ser-357 to Asp did not. Ser-357 was phosphorylated in vitro by multiple kinases, including PKA and PKC, and pharmacological activation of these kinases enhanced both phosphorylation of Ser-357 and endocytosis of GPR15. These results suggested that Ser-357 phosphorylation critically controls the ligand-independent endocytosis of GPR15. The functional role of Ser-357 in endocytosis was distinct from that of a conserved Ser/Thr cluster in the more proximal C-terminus, which was responsible for the β-arrestin– and GPCR kinase–dependent endocytosis of GPR15. Thus phosphorylation signals may differentially control cell surface density of GPR15 through endocytosis.
Generic membrane-spanning features endow IRE1α with responsiveness to membrane aberrancy
Authors: Kono Nozomu , Amin-Wetzel Niko , Ron David
Published: June 2017

Altered cellular lipid composition activates the endoplasmic reticulum unfolded protein response (UPR), and UPR signaling effects important changes in lipid metabolism. Secondary effects on protein folding homeostasis likely contribute to UPR activation, but deletion of the unfolded protein stress-sensing luminal domain of the UPR transducers PERK and IRE1α does not abolish their responsiveness to lipid perturbation. This finding suggests that PERK and IRE1α also directly recognize the membrane aberrancy wrought by lipid perturbation. However, beyond the need for a transmembrane domain (TMD), little is known about the features involved. Regulation of the UPR transducers entails changes in their oligomeric state and is easily corrupted by overexpression. We used CRISPR/Cas9-mediated gene editing of the Ern1 locus to study the role of the TMD in the ability of the endogenous IRE1α protein to recognize membrane aberrancy in mammalian cells. Conducted in the background of a point mutation that isolated the response to membrane aberrancy induced by palmitate from unfolded protein stress, our analysis shows that generic membrane-spanning features of the TMD are sufficient for IRE1α’s responsiveness to membrane aberrancy. Our data suggest that IRE1α’s conserved TMD may have been selected for features imparting a relatively muted response to acyl-chain saturation.
Value-added strategy models to provide quality services in senior health business
Authors: Yang Ya-Ting , Lin Neng-Pai , Su Shyi , Chen Ya-Mei , Chang Yao-Mao , Handa Yujiro , Khan Hafsah Arshed Ali , Elsa Hsu Yi-Hsin
Published: June 2017

Objective

The rapid population aging is now a global issue. The increase in the elderly population will impact the health care industry and health enterprises; various senior needs will promote the growth of the senior health industry. Most senior health studies are focused on the demand side and scarcely on supply. Our study selected quality enterprises focused on aging health and analyzed different strategies to provide excellent quality services to senior health enterprises.

Design

We selected 33 quality senior health enterprises in Taiwan and investigated their excellent quality services strategies by face-to-face semi-structured in-depth interviews with CEO and managers of each enterprise in 2013.

Setting

A total of 33 senior health enterprises in Taiwan.

Participants

Overall, 65 CEOs and managers of 33 enterprises were interviewed individually.

Intervention(s)

None.

Main Outcome Measure(s)

Core values and vision, organization structure, quality services provided, strategies for quality services.

Results

This study’s results indicated four type of value-added strategy models adopted by senior enterprises to offer quality services: (i) residential care and co-residence model, (ii) home care and living in place model, (iii) community e-business experience model and (iv) virtual and physical portable device model. The common part in these four strategy models is that the services provided are elderly centered. These models offer virtual and physical integrations, and also offer total solutions for the elderly and their caregivers. Through investigation of successful strategy models for providing quality services to seniors, we identified opportunities to develop innovative service models and successful characteristics, also policy implications were summarized.

Conclusions

The observations from this study will serve as a primary evidenced base for enterprises developing their senior market and, also for promoting the value co-creation possibility through dialogue between customers and those that deliver service.
Substance-Related and Addictive Disorder? The Special Role in HIV Transmission
Authors: Bialer Philip , Ashley Kenneth , Grimaldi John
Published: June 2017

Substance use disorders have been linked to HIV/AIDS since the beginning of the epidemic. Injecting drug use can serve as a mode of viral transmission and in some parts of the world and among certain populations is the primary vector of transmission. Substances of misuse implicated in HIV transmission include alcohol, cocaine, heroin, methamphetamine, and Ecstasy. Use of both non-injecting drugs and alcohol is also associated with increased sexual and other risk-taking behaviors and seroconversion. In addition, substance use disorders and other psychiatric disorders often coexist and can have profound effects on the medical management of HIV/AIDS as well as on a person’s social interaction and quality of life. Many people with HIV/AIDS therefore suffer from triple diagnoses necessitating comprehensive evaluation and treatment and a team approach involving medical, mental health, and substance use caregjvers. Treatment can include detoxification, harm reduction, individual, group, and family therapy, medication, and awareness of potential drug interactions.
Depressive and Bipolar Disorders
Authors: Douaihy Antoine , Conlon Matthew , Ferrara Maria
Published: June 2017

Depressive disorders are highly prevalent among persons living with HIV/AIDS. Depressive disorders significantly negatively affects adherence to antiretroviral therapy and HIV viral suppression and is associated with poor quality of life and major impairment in overall functioning. This chapter reviews the prevalence, risk factors, assessment and diagnosis of depressive and bipolar disorders. It also examines the impact of depression on sexual behaviors, adherence to antiretroviral therapy, quality of life, and mortality. This chapter also includes a comprehensive discussion of treatment approaches and considerations for HIV-infected individuals with depressive disorders. Furthermore, it reviews the bipolar disorder spectrum in HIV/AIDS as well as other psychiatric disorders co-occurring with depressive disorders.
HIV-Associated Neurocognitive Disorders
Authors: Letendre Scott , Iudicello Jennifer , Ances Beau , Marcotte Thomas D. , Spudich Serena , Cohen Mary Ann
Published: June 2017

The human immunodeficiency virus (HIV) enters the central nervous system soon after infection; can infect glia and tissue macrophages in the brain; and can injure neurons, resulting in loss of dendrites. These and other processes underpin a syndrome of cognitive and motor impairment termed HIV-associated neurocognitive disorder (HAND). This chapter principally focuses on HAND, although delirium and other neurocognitive disorders are also discussed and should remain in the differential diagnosis of cognitive impairment in persons with HIV. A differential diagnosis of cognitive impairment in HIV also includes multimorbid conditions that can influence neurocognitive performance, such as metabolic syndrome, vascular disease, medication toxicity, and substance use disorders. When developing treatment recommendations for HAND, initiation of ART and treatment of multimorbid conditions and other neurocognitive disorders should be prioritized. It is important for clinicians to regularly monitor HIV patients for HAND and other neurocognitive disorders since cognitive impairment can affect activities of daily living; quality of life; adherence to risk reduction, medical care, and medication; and survival.
Fatigue and HIV
Authors: Breitbart William , Dickerman Anna L.
Published: June 2017

Fatigue is commonly reported by persons with HIV and AIDS and is associated with impaired physical function, reduced quality of life, and suboptimal treatment adherence. Patients regard fatigue as an important condition to be addressed because it is disabling and distressing. In the past, fatigue was overlooked and undertreated by physicians, but clinicians caring for persons with HIV and AIDS have been giving more attention to symptom management and patients’ quality of life. Increased attention to symptom management in HIV and AIDS warrants familiarity with major issues in evaluation and treatment of fatigue. This chapter reviews the definition and assessment of fatigue, prevalence of fatigue in HIV/AIDS and its impact on patients, medical and psychological causes of fatigue, and evidence-based treatment strategies.
The Role of Psychiatric Disorders in HIV Transmission and Prevention
Authors: Hobkirk Andréa L. , Kalichman Seth C. , Stoff David M. , Meade Christina S.
Published: June 2017

Adults with severe mental illness (SMI) have been disproportionately affected by the HIV/AIDS epidemic, with prevalence estimates ranging from 1% to 8% in the United States and up to 27% internationally. Compared to the general population, adults with SMI tend to engage in higher rates of sexual and drug use behaviors associated with HIV transmission. In addition, psychiatric illness can develop secondary to HIV infection and contribute to further transmission on HIV to others. HIV risk behavior is driven by several direct and indirect factors, including psychiatric symptoms, substance use, traumatic experience, socioeconomic status, and HIV infection itself. This chapter addresses the complex multidimensional relationship between psychiatric disorders and transmission of HIV as well as its prevention. This chapter also presents several HIV risk reduction interventions designed for vulnerable men and women in outpatient mental health clinics and the community.
Stellar envelopes of globular clusters embedded in dark mini-haloes
Authors: Peñarrubia Jorge , Varri Anna Lisa , Breen Philip G. , Ferguson Annette M. N. , Sánchez-Janssen Rubén
Published: June 2017

We show that hard encounters in the central regions of globular clusters (GCs) embedded in dark matter (DM) haloes necessarily lead to the formation of gravitationally bound stellar envelopes that extend far beyond the nominal tidal radius of the system. Using statistical arguments and numerical techniques, we derive the equilibrium distribution function of stars ejected from the centre of a non-divergent spherical potential. Independently of the velocity distribution with which stars are ejected, GC envelopes have density profiles that approach asymptotically ρ ∼ r−4 at large distances and become isothermal towards the centre. Adding a DM halo component leaves two clear-cut observational signatures: (i) a flattening, or slightly increase of the projected velocity dispersion profile at large distances, and (ii) an outer surface density profile that is systematically shallower than in models with no DM.
Privatization with ‘Vested Interests’ in China
Authors: Zheng Yu
Published: June 2017

Vested interests have been blamed for resisting the reform of state-owned enterprises (SOEs) in China. Yet, various interest groups have heterogeneous interests in privatization. Using both firm- and provincial-level data, we find that SOE managers and local bureaucrats—two key players of privatization—have contingent, rather than vested, interests in privatization, depending partly on their political connections with the central government. On the one hand, political connections motivate SOE managers to privatize more state ownership while retaining managerial control. On the other hand, central connections discourage provincial leaders from using privatization to boost their economic performance. These results shed light on the conditions under which China implements its economic reforms. With the increasing embeddedness and declining autonomy for policymakers, the once well-performing developmental state models now face serious challenges as politically powerful interest groups can manipulate economic reforms for their own purposes rather than for structural transformation.
BioBrick-based ‘Quick Gene Assembly’ in vitro
Authors: Yamazaki Ken-ichi , de Mora Kim , Saitoh Kensuke
Published: June 2017

Because of the technological limitations of de novo DNA synthesis in (i) making constructs containing tandemly repeated DNA sequence units, (ii) making an unbiased DNA library containing DNA fragments with sequence multiplicity in a specific region of target genes, and (iii) replacing DNA fragments, development of efficient and reliable biochemical gene assembly methods is still anticipated. We succeeded in developing a biological standardized genetic parts that are flanked between a common upstream and downstream nucleotide sequences in an appropriate plasmid DNA vector (BioBrick)-based novel assembly method that can be used to assemble genes composed of 25 tandemly repeated BioBricks in the correct format in vitro. We named our new DNA part assembly system: ‘Quick Gene Assembly (QGA)’. The time required for finishing a sequential fusion of five BioBricks is less than 24 h. We believe that the QGA method could be one of the best methods for ‘gene construction based on engineering principles’ at the present time, and is also a method suitable for automation in the near future.
A Novel Phylogroup ofPseudomonas cichoriiIdentified Following an Unusual Disease Outbreak on Tomato
Authors: Timilsina Sujan , Adkison Heather , Testen Anna L. , Newberry Eric A. , Miller Sally A. , Paret Matthews L. , Minsavage Gerald V. , Goss Erica M. , Jones Jeffrey B. , Vallad Gary E.
Published: June 2017

Recently, in Central Florida tomato production fields, tomato foliage and fruit were observed with symptoms similar to bacterial speck. Fluorescent pseudomonads were consistently isolated and the strains were characterized by standard LOPAT tests, pathogenicity tests, and genetic characterization using 16S ribosomal RNA (rRNA) sequences and multilocus sequence analysis (MLSA) of conserved housekeeping genes. LOPAT test results indicated that the strains were likely Pseudomonas cichorii. These strains were pathogenic on tomato and were also pathogenic on lettuce, the host for the type strain of P. cichorii. Likewise, strains of P. cichorii isolated in Florida since the early 1980s from hosts other than tomato, along with the type strain, were also pathogenic on tomato. Genetic characterization using 16S rRNA and MLSA confirmed that the strains were most closely related to P. cichorii but varied significantly from the type strain. The Florida P. cichorii strains formed a separate phylogenetic group along with P. cichorii strains isolated from tomato in Tanzania. These strains were different from the previously described morphotypes and genomovars of P. cichorii. Our results indicate the presence of a genetically distinct group of multihost pathogenic P. cichorii strains that have been present in Florida since at least the early 1980s.
Skin and Wound Care in Lymphedema Patients: A Taxonomy, Primer, and Literature Review
Authors: Fife Caroline E. , Farrow Wade , Hebert Adelaide A. , Armer Nathan C. , Stewart Bob R. , Cormier Janice N. , Armer Jane M.
Published: June 2017

BACKGROUND:

Lymphedema is a condition of localized protein-rich swelling from damaged or malfunctioning lymphatics. Because the immune system is compromised, there is a high risk of infection. Infection in patients with lymphedema may present in a variety of ways.

OBJECTIVE:

The goals of this review were to standardize the terminology of skin breakdown in the context of lymphedema, synthesize the available information to create best practice recommendations in support of the American Lymphedema Framework Project update to its Best Practices document, and create recommendations for further research.

DATA SOURCES:

Publications on skin care and wounds were retrieved, summarized, and evaluated by a team of investigators and clinical experts.

STUDY SELECTION AND DATA EXTRACTION:

Terms for lymphedema-associated skin breakdown were compiled and paired with photographs of commonly noted skin changes among patients with lymphedema. A list of standard dermatological terms was created. A more extensive literature search was then conducted by all authors.

DATA SYNTHESIS:

Skin disorders associated with lymphedema have been classified into 5 categories. Descriptions, photographs, and recommendations for treatment are presented.

CONCLUSIONS:

Skin care is an important defense against infection. Because of the lack of research, a consensus of thought and content leaders’ opinion should guide the best practices for wound care in lymphedema.
Genocide Rape Trauma Management
Authors: Mukamana Donatilla , Brysiewicz Petra , Collins Anthony , Rosa William
Published: June 2017

During the 1994 Rwandan genocide, rape was widely used as a strategic weapon against Tutsi women. More than 20 years later, many of these women are still suffering devastating psychological, social, and physical effects of these experiences and remain in need of effective interventions that address their complex trauma. This article develops the theory of genocide rape trauma management as a conceptual framework for promoting the holistic health and recovery of female genocide rape survivors. A qualitative study using grounded theory explored the lived experiences of genocide rape survivors and led to the development of this model. The need for a contextually appropriate model is highlighted, with historical and current data regarding the Rwandan context and the experiences of genocide rape survivors. The research details the complex dynamics of emotional, physical, existential, and psychosocial sequelae related to genocide rape trauma, and how these interact with both local community and broader political attitudes toward survivors, as well as the serious interrelated economic challenges and limitations in current public health and welfare services. The research demonstrates the necessary elements of a holistic approach encompassing a synergistic combination of skilled psychological care, self-help strategies, collaborative support groups, community education, social reintegration, advocacy, accessible medical care, and economic empowerment. These interacting elements form the basis of the theory of genocide rape trauma management, offering an encompassing integrated framework that can be adapted to, and evaluated in, other similar contexts.
NK Cell–derived Exosomes From NK Cells Previously Exposed to Neuroblastoma Cells Augment the Antitumor Activity of Cytokine-activated NK Cells
Authors: Shoae-Hassani Alireza , Hamidieh Amir Ali , Behfar Maryam , Mohseni Rashin , Mortazavi-Tabatabaei Seyed A. , Asgharzadeh Shahab
Published: June 2017

Immune cell–derived exosomes can increase immunity against tumors. In contrast, tumor-derived exosomes can reduce the immunity and can change the tumor microenvironment to further develop and provide metastasis. These effects take place by an alteration in the innate and adaptive immune cell functions. In this experiment, we studied the natural killer (NK) cells’ effectiveness on tumor cells after expansion and thereafter incubated it with exosomes. The exosomes were derived from 2 populations of NK cells: (1) naive NK cells and, (2) NK cells previously exposed to neuroblastoma (NB) cells. Moreover, we have studied the NB-derived exosomes on NK cell function. The molecular load of the characterized exosomes (by means of nanoparticle-tracking analysis, flow cytometry, scanning electron microscopy, and western blot) from NK cells exposed to the NB cell revealed their expression of natural killer cell receptors in addition to CD56, NKG2D, and KIR2DL2 receptors. These exosomes were used to treat NK cells and thereafter administered to NB tumor cells both in vitro and in vivo. Our results showed some kind of NK cells’ education by the exosomes. This education from NK cells previously exposed to NB cell–derived exosomes caused efficient and greater cytotoxicity against NB tumors, but NB-derived exosomes act as tumor promoters by providing a tumor supporting niche. Hence, this method of preparing the exosomes has a dramatic effect on activation of anti-NK cells against NB cells.
SWEPT-SOURCE OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY IN RICKETTSIAL RETINITIS
Authors: Kahloun Rim , Jelliti Bechir , Ksiaa Imen , Ben Amor Hager , Zaouali Sonia , Lupidi Marco , Ben Yahia Salim , Khairallah Moncef
Published: June 2017

Purpose:

To report optical coherence tomography angiography findings in a patient with rickettsial retinitis.

Methods:

A 29-year-old man complaining of acute blurring vision in the right eye associated with Rickettsia conorii infection underwent a comprehensive ocular examination, fluorescein angiography, spectral-domain optical coherence tomography, and swept-source optical coherence tomography angiography.

Results:

Funduscopy showed two large areas of retinitis in the inferior macula along the distribution of the inferotemporal artery with associated retinal hemorrhages, retinal edema, and serous retinal detachment. Fluorescein angiography showed early hypofluorescence and late staining of white retinal lesions and associated adjacent retinal vascular leakage and optic disc hyperfluorescence. Optical coherence tomography angiography showed hypointense dark areas in the superficial capillary plexus and larger hypointense areas in the deep capillary plexus, outer retina, and choriocapillaris layer. The patient was treated with doxycycline and prednisone. Six weeks after presentation, retinal changes seen at the acute phase had resolved, leading to mild residual retinal pigment epithelial changes. Fluorescein angiography showed retinal capillary nonperfusion within areas of resolved retinitis. Spectral-domain optical coherence tomography findings included inner retinal atrophy, intraretinal cysts, and disruption of ellipsoid zone and interdigitation zone. Swept-source optical coherence tomography angiography showed well-delineated hypointense greyish areas of retinal capillary nonperfusion in both the superficial and deep capillary plexuses. Visual field testing revealed the presence of a corresponding paracentral defect.

Conclusion:

Optical coherence tomography angiography may be a valuable noninvasive imaging technique for detecting and analyzing occlusive complications associated with rickettsial retinitis.
How to succeed at medical interviews
Authors: Koshy Kiron , Whitehurst Katharine , Liu Alison , Gundogan Buket , Fowler Alexander , Agha Riaz
Published: June 2017

Few people truly relish being interviewed. But as a professional, you will go through a number of interviews in your life that will affect your career progression. In this article, we provide some tips on how best to prepare for a medical interview, both in terms of your portfolio and interview practice. Advice is also given on how to maximize performance during the interview and gain the most from reflection afterwards.
Analysis of a Physician-led, Team-based Care Model for the Treatment of Glaucoma
Authors: Winkler Nelson S. , Damento Gena M. , Khanna Sunil S. , Hodge David O. , Khanna Cheryl L.
Published: June 2017

Purpose:

To determine the effect of a protocol for a new physician-led, team-based glaucoma care model implemented in 2008 at Mayo Clinic’s campus in Rochester, Minnesota (MCR), to increase conformance with the American Academy of Ophthalmology (AAO) Preferred Practice Pattern guidelines for treatment of primary open-angle glaucoma.

Methods:

Records of 591 patients with newly diagnosed glaucoma were assessed retrospectively for the completion of 9 AAO Preferred Practice Pattern recommended metrics including measured corneal thickness, intraocular pressure (IOP), cup to disk ratio, visual acuity, recorded IOP target, gonioscopy, fundus photos, ocular coherence tomography, and visual field in the 3 years before and 3 years after protocol implementation. Treatment by the glaucoma care team at MCR was compared with treatment at a community-based general ophthalmology practice and with a group of comprehensive ophthalmologists at MCR without team care, which served as controls.

Results:

Adherence to AAO recommendations increased for the documentation of target IOP (+24%, 42.6% to 66.7%; P=0.007), gonioscopy (+27%, 66.7% to 93.3%; P≤0.001), fundus photos (+29%, 44.4% to 73.3%; P≤0.001), and ocular coherence tomography (+20%, 48.1% to 68.0%; P=0.02) after protocol initiation. No change in pattern of testing occurred in the control groups without team care during the same time period. Type and severity of glaucoma were similar between MCR and community practice.

Conclusions:

An increase in compliance with AAO guidelines was found after implementation of our protocol for a physician-led, team-based care model to standardize glaucoma care among providers.
Prevalence of Pseudoexfoliation Syndrome in an Isolated Island Population of Korea: The Woodo Study
Authors: Lee Sang-Yoon , Kim Seondo , Kim Jeong Hong , Hong Sung-Chul , Lee Keun Hwa , Lee Hye-Sook , Shin Aesun , Jeong Jinho
Published: June 2017

Purpose:

To determine the prevalence and clinical characteristics of pseudoexfoliation syndrome (PXS) within Korean population living in Woodo Island.

Methods:

Among the 625 residents aged 50 years or older, 305 residents (197 women and 108 men) participated in the study; a response rate of 48.8%. Participants filled out questionnaires on life style. Intraocular pressure and corneal endothelial cell function was measured. Both pupils were dilated. Fundus photographs and stereo disc photographs were taken. Vertical cup-to-disc ratio was determined. Pure tone audiometry threshold was measured at 0.5, 1, 2, 4, and 6 kHz of frequencies for each ear.

Results:

The prevalence rate of PXS among Woodo Island residents older than 50 years significantly increased with age, from 1.0% [95% confidence interval (CI), 0%-2.8%] in participants aged 50 to 59 years to 23.3% (95% CI, 8.2%-38.5%) in those aged over 80 years (P<0.001). The prevalence of PXS showed no significant difference between men and women in all age groups. The age-standardized prevalence rate of PXS was 10.4% (95% CI, 8.0%-12.8%), with a rate of 9.4% (95% CI, 5.8%-13.1%) in men and 14.9% (95% CI, 11.3%-18.4%) in women. PXS did not show significant association with smoking, outdoor activity, and occupation, except alcohol consumption. PXS showed significant decrease in endothelial cell density. Pure tone audiometry test of PXS group revealed statistically significant decrease in 1, 2 kHz.

Conclusions:

The prevalence of PXS was 10.4% in the 50 years and older age group, and tended to increase with age. Decrease in corneal endothelial function and selective hearing loss was correlated in PXE patients, supporting impairment of systemic endothelial function in PXE syndrome.
Oral Serum-Derived Bovine Immunoglobulin for Management of Infectious Diarrhea due to Norovirus and Cryptosporidiosis in Solid Organ Transplant Patients
Authors: Gelfand Michael S. , Cleveland Kerry O.
Published: June 2017

Diarrhea and its sequelae are commonly seen in renal transplant recipients. Current effective options to treat many causes of infectious diarrhea in this population are limited. Oral serum-derived bovine immunoglobulin was recently successfully used to manage 2 renal transplant patients with diarrhea due to cryptosporidiosis and norovirus infection, respectively.
Concomitant Primary Labial and Genital Herpes Simplex I Infections
Authors: Dylewski Joe
Published: June 2017

There has been a decrease in the prevalence of herpes simplex type I (HSV I) infection in adolescents in the United States while the relative number of genital infections caused by HSV I has increased. Although transmission is more likely to occur during active skin lesions, asymptomatic shedding of herpes simplex virus from oral or genital sources can lead to infection in susceptible hosts. I wish to report the acquisition of concomitant primary labial and genital HSV I infection in a man and woman from an asymptomatic woman with a history of labial HSV I infection.
Human Immunodeficiency Virus as Progressive Primary Myopathy
Authors: Shashidhara Sowmya , Trivedi Sangita , Shah Pinkal , Jha Bharati
Published: June 2017

Human immunodeficiency virus infection in children has a different way of presentation. The involvement of muscular system is most commonly described as pyomyositis because of opportunistic infections or myopathy secondary to highly active antiretroviral therapy in both children and adults. Primary myopathy presenting as a progressive weakness is usually seen in adults and rarely observed in children with only a few cases described in the literature. In this case, we report a 7-year-old Indian girl with perinatal HIV infection presenting with progressive weakness and otherwise asymptomatic. An improvement was observed after antiretroviral and rehabilitative therapy.
Pasteurella Multocida Cardiovascular Implantable Electronic Device Infection With Recurrent Bacteremia
Authors: Boctor Noelle , Nguyen David , Williams Brett
Published: June 2017

The annual rate of placement of cardiovascular implantable electronic devices (CIEDs), which includes pacemakers and implantable cardiac defibrillators, has steadily increased over the last several decades. With an increasing number of implantations has been an increasing incidence of CIED infections. It is generally recommended that patients with infections of CIEDs complete a course of antibiotics and have the device removed if possible. However, gram-negative organisms are uncommon in CIED infection, and it has been suggested that cases of suspected gram-negative CIED infection may not necessitate the same management approach. Here, we report a case of presumed Pasteurella multocida CIED infection and share our experience with its several management challenges.