bluuebunny/crossref_metadata_2025 huggingface dataset:
Gouty Tenosynovitis of the Distal Biceps Tendon Insertion Complicated by Partial Rupture
Authors: Fairhurst Rick J. , Schwartz Arnold M. , Rozmaryn Leo M.
Published: May 2016

Background: Given the appreciable prevalence of gout, gout-induced tendon ruptures in the upper extremity are extremely rare. Although these events have been reported only 5 times in the literature, all in patients with a risk factor for or history of gout, they have conspicuously never been diagnosed in the shoulder or elbow. Methods: A 45-year-old, right-hand-dominant man with a history of gout presented with pain in his right anterior elbow and weakness in his forearm after a trivial injury. Results: Here, we report the first case of gouty tenosynovitis of the distal biceps tendon insertion complicated by partial rupture, a composite diagnosis supported by both intraoperative and histological observations. Conclusions: In patients who are clinically diagnosed with biceps tendon rupture and have a history of gout, it is important to consider the possibility of a gout-related pathological manifestation causing or simulating tendon rupture.
Optimized Repopulation of Tendon Hydrogel
Authors: Farnebo Simon , Farnebo Lovisa , Kim Maxwell , Woon Colin , Pham Hung , Chang James
Published: May 2016

Background: Tendon-derived extracellular matrix (ECM) hydrogel has been shown to augment tendon healing in vivo. We hypothesized that reseeding of the gel with adipose-derived stem cells (ASCs) could further assist repopulation of the gel and that combinations of growth factors (GFs) would improve the survival of these cells after reseeding. Methods: A tendon-specific ECM solution was supplemented with varying concentrations of basic fibroblast growth factor (bFGF), insulin-like growth factor–1 (IGF-1), and platelet-derived growth factor–BB (PDGF-BB). Gels were then seeded with ASCs transfected with a green fluorescent protein/luciferin construct. Cell proliferation was determined using the MTT assay and histology, and GF and ASC augmented gels were injected into the back of Sprague Dawley rats. Bioluminescence of seeded gels was continuously followed after reseeding, and cell counts were performed after the gels were explanted at 14 days. Results: Synergistic effects of the GFs were seen, and an optimal combination was determined to be 10 ng/mL bFGF, 100 ng/mL IGF-1, and 100 ng/mL PDGF-BB (2.8-fold increase; P < .05). In vivo bioluminescence showed an improved initial survival of cells in gels supplemented with the optimal concentration of GF compared with the control group (10.6-fold increase at 8 days; P < .05). Cell counts of explants showed a dramatic endogenous repopulation of gels supplemented by GF + ASCs compared with both gels with GF but no ASCs (7.6-fold increase) and gels with ASCs but no GF (1.6-fold increase). Conclusion: Synergistic effects of GFs can be used to improve cellular proliferation of ASCs seeded to a tendon ECM gel. Reseeding with ASCs stimulates endogenous repopulation of the gel in vivo and may be used to further augment tendon healing.
Single Incision Distal Biceps Repair With Hemi-Krackow Suture Technique
Authors: Goljan Peter , Patel Nimit , Stull Justin D. , Donnelly Brandon P. , Culp Randall W.
Published: May 2016

Background: Many surgical methods exist for distal biceps repair. We present the technique and early outcomes of a series of distal biceps repairs completed with a novel suturing technique utilizing a hemi-Krackow locking stitch at the tendon-bone interface. Methods: A retrospective review was performed of patients who underwent primary distal biceps repair using a single anterior incision with 2 suture anchors utilizing a hemi-Krackow stitch. With both anchors, a locking stitch along the tendon edge was complimented by the other strand passing through the central aspect of the distal tendon and advanced to pull the tendon edge down to the bone with appropriate tension. Patients with revision surgery and the use of allograft were excluded. Clinical outcomes included elbow range of motion and grip strength. All patients completed a Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) questionnaire and reported satisfaction level, pain level, and any postoperative complications. Results: Fourteen patients with an average age of 51.3 years (range, 27.8-66.4 years) were included in the study. The dominant arm was injured in 9 cases. At an average of 16.4 months’ follow-up (range, 6.8-34.3 months), all patients had elbow range of motion of 0° to >130°, and grip strength was 101.5% of the uninjured arm (range, 70.6%-121.4%). The Average QuickDASH score was 6.5 (range, 0-36.5). Conclusion: Single incision biceps repair with suture anchor fixation using our hemi-Krackow stitch provided a strong repair allowing easy tensioning of the biceps tendon to bone and showed satisfactory functional outcomes at early follow-up. No patients required revision surgery, and there was only 1 case of transient nerve complaints.
Tethering the Extensor Apparatus Limits PIP Flexion Following K-wire Placement for Pinning Extra-articular Fractures at the Base of the Proximal Phalanx
Authors: Sela Yaron , Peterson Caitlin , Baratz Mark E.
Published: May 2016

Background: Closed reduction with percutaneous Kirschner wires (K-wires) is the most minimally invasive surgical option for stabilizing phalanx fractures. This study examines the effect of K-wire placement on proximal interphalangeal (PIP) joint motion. Methods: PIP joint flexion was measured in the digits of 4 fresh-frozen cadaver hands after placing a suture loop through the flexor tendons and placing tension on the flexors via a mechanical scale. The load necessary to flex the PIP joint to 90° or to maximum flexion was recorded. The load was removed and K-wires were inserted in 3 locations about the metacarpophalangeal joint (MPJ): through the extensor tendon and across the MPJ, adjacent to the extensor tendon insertion site and across the MPJ, and through the sagittal band and into the base of the proximal phalanx (P1). The load on the tendons was reapplied, and angles of PIP joint flexion were recorded for each of the 3 conditions. Results: The mean angle of PIP joint flexion prior to K-wire insertion was 87°, and the mean load applied was 241 g. The angles of flexion were 53° when the K-wire was placed through the extensor tendon, 70° when the K-wire was placed adjacent to the tendon, and 75° when the K-wire was placed into the base of P1 by going through the sagittal band, midway between the volar plate and the extensor tendon. Conclusions: K-wires placed remote from the extensor tendon create less of an immediate tether to PIP joint flexion than those placed through or adjacent to the extensor tendon.
Hand and Wrist Injuries in Elite Boxing
Authors: Loosemore Michael , Lightfoot Joseph , Gatt Ian , Hayton Mike , Beardsley Chris
Published: May 2016

Background: The purpose of this investigation was to explore prospectively the nature and duration of hand and wrist injuries in training and competition in the Great Britain (GB) amateur boxing squad between 2005 and 2012. Methods: Longitudinal prospective injury surveillance of the GB boxing squad was performed from 2005 to 2012. The location, region affected, description, and the duration of each injury were recorded by the team doctor and team physiotherapist. We recorded whether the injury occurred during competition or training and also whether it was a new or a recurrent injury. The injury rate during competition was calculated as the number of injuries per 1000 hours. Results: Finger carpometacarpal instability and finger metacarpophalangeal joint extensor hood and capsule sprain also known as “boxer’s knuckle” injuries were significantly more common than other injury diagnoses. The number of injuries during training or competition was similar, which is remarkable given the far greater number of training hours than competition hours performed. Injury rate for hand and wrist injuries in competition was 347 injuries per 1000 hours, while the estimated injury rate in training was <0.5 injuries per 1000 hours. Conclusion: Carpometacarpal instability and boxer’s knuckle were more common than any other kind of hand and wrist injury in this cohort of elite amateur boxers. The rate of hand and wrist injuries was higher in competition than in training. Our study highlights the importance of hand and wrist injury prevention in the competition environment.
Atypical Mycobacterial Infections of the Upper Extremity
Authors: Lopez Mariela , Croley Julie , Murphy Kevin D.
Published: May 2016

Background: Atypical mycobacterial infections are uncommon and characterized by a chronic, indolent course before diagnosis. Historically, these infections are associated with marine-related injury and/or immune dysfunction. Our institution has successfully diagnosed and treated an increasing number of these infections. The objective of this study is to review our experience with these rare infections and verify the developing trends encountered. Methods: A retrospective review was performed for patients with positive nontuberculous mycobacterial cultures of the upper extremity from 2000 to 2013. Patient demographics, source of transmission, symptom duration, mycobacterial species, operative and antibiotic treatments, and outcomes were recorded. Results: Thirty-four patients were identified. The mean symptomatic period before diagnosis was 9 months (range, 1-60 months). Fourteen patients had identifiable causes of immune dysfunction while the rest appeared immune competent. Patients were infected by Mycobacterium marinum (n = 14), Mycobacterium abscessus (n = 8), Mycobacterium fortuitum (n = 7), and other less common species (n = 5). Although most patients had unidentifiable causes of infection (n = 15), some could correlate infection to marine injury, lacerations, insect bites, animal bites, and tattoos. All patients received operative intervention including debridement. Antibiotics were given for a mean duration of 5 months. Ninety-seven percent had complete resolution of disease. Conclusions: Although M. marinum infections make up the majority of infections at our institution, we report a higher total incidence of nonmarinum infections. These infections are occurring in seemingly healthy individuals with no history of exposure with marine water. Successful treatment relies on having a heightened clinical awareness and adequate diagnosis.
Reverse Radial Forearm Flap to Provide Arterial Inflow to a Toe Transfer
Authors: Kim Joohak , Yoon Alfred P. , Jones Neil F.
Published: May 2016

Background: Toe-to-thumb transfer has become the gold standard for thumb reconstruction, but in badly mutilated hands, additional soft tissue coverage may be required or a suitable recipient artery may not be available. There are only 3 case reports describing the successful use of a reverse radial forearm flap for coverage of a soft tissue defect around the thumb as well as providing arterial inflow for a toe transfer, performed either simultaneously or secondarily. Methods: A single surgeon’s experience of all toe-to-hand transfers performed in conjunction with a reverse radial forearm flap between 1995 and 2014 was reviewed, including patient demographics, type of toe transfer and vascular pedicle, whether immediate or secondary, follow-up, and complications. Results: Eight toe-to-hand transfers were performed in 7 patients—3 children (age range, 3-15 years) and 4 adults (age range, 19-39 years). Three patients underwent primary toe-to-thumb transfer simultaneously with a reverse radial forearm flap, and 5 patients underwent secondary toe-to-hand transfer between 4 months and 2½ years after an initial reverse radial forearm flap. All toe transfers survived completely. Average follow-up was 5.1 years. All patients were satisfied with the function and appearance of their reconstructed thumb. Conclusion: The reverse radial forearm flap is a very reliable procedure as a “Sister” or “Siamese” flap to provide immediate arterial inflow to a simultaneous toe-to-thumb transfer, or to provide primary soft tissue coverage on the radial aspect of the hand and subsequently provide a recipient arterial inflow for a secondary toe transfer.
Delayed Repair of Ulnar Artery at the Distal Forearm
Authors: Boretto Jorge G. , Zaidenberg Ezequiel , Gallucci Gerardo L. , Alfie Verónica , De Carli Pablo
Published: May 2016

Background:The purpose of this study was to evaluate the rate of patency after delayed repair of the ulnar artery following primary ligation. Methods: Adult patients with primary ligation of the injured ulnar artery at the forearm who had a delayed repair of the artery were included. Postoperative arterial patency was determined by either physical examination or color Doppler ultrasonographic imaging. Postoperative complications and Disabilities of the Arm, Shoulder and Hand score were recorded. Results: Eight consecutive patients during a 3-year period were included. The mean age was 35 years. Four cases were women. The surgery was performed at a mean of 5 days after the injury and ligation. At a mean follow-up of 22 months, 7 patients had a patent artery. One patient suffered a hematoma. Conclusions: A high rate of patency can be obtained after delayed repair of the ulnar artery at the forearm.
Intraneural Median Nerve Anatomy and Implications for Treating Mixed Median Nerve Injury in the Hand
Authors: Franco Michael J. , Nguyen Dennis C. , Phillips Benjamin Z. , Mackinnon Susan E.
Published: May 2016

Background: Nerve transfers have resulted in increased interest in the microanatomy of peripheral nerves. Herein, we expand our understanding of the internal anatomy of the digital nerve to the ulnar index and long fingers, the radial long and ring fingers, and the nerves to the second and third web spaces. Methods: The median nerve was dissected from the digital nerves to the antecubital fossa in 14 fresh upper extremities. The distance of proximal internal neurolysis of the fascicles to the second and third web space and proper digital nerves was measured relative to the radial styloid. Plexi encountered during proximal lysis were noted. Results: Digital nerves to the ulnar index and radial long fingers were lysed 2.4 ± 0.5 cm (mean ± SD), and digital nerves to the ulnar long and the radial ring fingers were lysed 3.0 ± 0.6 cm distal to the radial styloid. Fascicles to the third web space were lysed to the takeoff of the anterior interosseous nerve, 21.1 ± 1.4 cm. Plexus groupings were encountered at 4.5 ± 1.6 cm, 8.3 ± 1.2, cm and 16.1 ± 1.9 cm proximal to radial styloid. The fascicles to the second web space were lysed to 5.0 ± 1.2 cm proximal to radial styloid where a plexus grouping was encountered. Another plexus group was found at 3.3 ± 1.3 cm. Conclusions: We demonstrate that extended internal neurolysis of second web space, along with the digital nerves, is technically and clinically feasible. This technique can be used to treat mixed median nerve injury in the hand and wrist.
MRI Correlation of Radial Head Fractures and Forearm Injuries
Authors: Awan Hisham , Goitz Robert
Published: May 2016

Background: Radial head fractures can be associated with soft tissue injuries of the forearm and wrist. The Essex-Lopresti injury can lead to significant morbidity, especially if the diagnosis is not made acutely. Better identification of such injuries is needed to allow optimal surgical treatment and prevent long-term sequelae. We used magnetic resonance imaging (MRI) to correlate the degree of soft tissue injuries with radial head fractures. Methods: Sixteen pairs of forearms with an associated radial head fracture in 15 patients prospectively underwent an MRI within 2 weeks of their injury. MRI findings were correlated with fracture type, associated soft tissue injury, and presence of symptomatic wrist pain. Results: According to the modified Mason classification, there were 8 type I, 5 type II, and 3 type III radial head fractures. Wrist pain was reported in 8 of 16 extremities, and 2 had associated wrist pathology, including an acute scaphoid fracture in 1 patient and a preexisting stage II scapholunate advanced collapse (SLAC) wrist in another patient. The MRI findings included an elbow effusion in all 16 patients, edema in the proximal third of the radius in 15 extremities, which extended to the middle third in 3 extremities, edema of the interosseous membrane (IOM) in 5 extremities, and edema of the soft tissues including the supinator and/or pronator quadratus in 13 extremities. Conclusions: Eighty percent of patients with edema of the IOM had associated wrist pain. Soft tissue injuries of the forearm did not correlate with the severity of the radial head fracture.
Biceps to Triceps Transfer in Tetraplegic Patients
Authors: Medina José , Marcos-García Alberto , Jiménez Isidro , Muratore Gustavo , Méndez-Suárez José Luis
Published: May 2016

Background: Management and indications for surgery in the tetraplegic patient are highly complex because of the substantial functional deficits that they present and their effect on their daily activity. Our purpose was to evaluate the functional outcome in tetraplegic patients who underwent biceps-to-triceps transfer surgery according to Zancolli’s modified technique. Methods: This is a retrospective study of 6 biceps-to-triceps transfers using Zancolli’s modified technique in 4 patients. Mean follow-up was 45 months. We evaluated each patient’s DASH (Disabilities of the Arm, Shoulder and Hand) score before surgery and 12 months later. Results: In the 6 arms that underwent surgery, full and active elbow extension against gravity at 12 months after surgery was achieved. The mean DASH score was 73.2 preoperatively and 20.8 twelve months postoperatively. One complication occurred. One patient reported loss of elbow flexion preventing thigh lift for transfers. This was resolved with a program of rehabilitation and specific muscle strengthening Conclusions: Zancolli’s modified technique is simple and effective, with few complications, whereby we can provide more autonomy for the tetraplegic patient.
Prospective Evaluation of Opioid Consumption Following Carpal Tunnel Release Surgery
Authors: Chapman Talia , Kim Nayoung , Maltenfort Mitchell , Ilyas Asif M.
Published: May 2016

Background: Postoperative pain management and opioid consumption following carpal tunnel release (CTR) surgery may be influenced by many variables. To understand factors affecting opioid consumption, a prospective study was undertaken with the hypothesis that CTR performed under local anesthesia (wide awake local anesthesia with no tourniquet [WALANT]) would result in increased opioid consumption postoperatively compared with cases performed under sedation. Methods: All patients undergoing open CTR surgery were consecutively enrolled over a 6-month period. Information collected included patient demographics, surgical technique, amount and type of narcotic prescribed, number of pills taken, and type of anesthesia. Results: 277 patients were enrolled (56% women, 44% men). On average, 21 pills were prescribed, and 4.3 pills (median = 2) were consumed. There was no difference in consumption between patients who received WALANT (78 cases) versus (198 cases) sedation (4.9 vs 3.9 pills, respectively) ( P = .22). There was no difference in opioid consumption based on insurance type ( P = .47) or type of narcotic ( P = .85). However, more men consumed no opioids (47%) compared with women (36%) ( P < .05) and older patients consumed less than younger patients ( P < .05). Conclusions: Opioid consumption following CTR is more influenced by age and gender, and less influenced by anesthesia type, insurance type, or the type of opioid prescribed. Many more opioids were prescribed than needed, on an average of 5:1. Many patients, particularly older patients, do not require any opioid analgesia after CTR.
A Survey of the Use of Ultrasound by Upper Extremity Surgeons
Authors: Wang William L. , Kruse Kevin , Fowler John R.
Published: May 2016

Background: Ultrasound is a versatile imaging modality that can be used by upper extremity surgeons for diagnostic purposes and guided injections. The perceptions of ultrasound for diagnosis and treatment among upper extremity surgeons and its barriers for adoption have not been formally surveyed. The purpose of this study is to determine the current usage of musculoskeletal ultrasound for diagnostic purposes and guided injections by upper extremity surgeons and their reasons for using it or not using it in practice. Methods: A 22-question survey was distributed to the American Society for Surgery of the Hand (ASSH). The survey questions consisted of respondent characteristic questions and questions pertaining to the use of ultrasound. Chi-square analysis was performed to assess for a difference in ultrasound usage across respondent characteristics. Results: Three hundred four (43%) answered that they have an ultrasound machine in their office; Fifty-one percent (362) of the respondents use ultrasound for diagnostic purposes. Fifty-five (8%) of the survey respondents use ultrasound to diagnose carpal tunnel syndrome; 168 (23.5%) respondents reported that they use ultrasound for guided injections. There was a statistically significant difference between access to an ultrasound machine in the office by practice setting and use of ultrasound for diagnostic purposes by practice setting. Conclusions: The use of ultrasound by upper extremity surgeons is split for diagnostic purposes, with fewer surgeons using ultrasound to diagnose carpal tunnel syndrome and guided injections. Ultrasound machine availability and the use of ultrasound for diagnosis appear to be influenced by practice setting.
Global Historical Sociology: Theoretical and Methodological Issues – an Introduction
Authors: Ascione Gennaro , Chambers Iain
Published: May 2016

The ongoing collective effort to turn historical sociology into a globally oriented research programme implies a profound reconsideration of its conceptual and terminological premises, as well as a constant critical gaze over the colonial geopolitics of knowledge sociological thinking draws legitimation from. Three strategies are here discussed canonization, re-signification and re-conceptualization.
A case for stopping the early withdrawal of life sustaining therapies in patients with devastating brain injuries
Authors: Manara Alex R , Thomas Ian , Harding Richard
Published: May 2016

Early prognostication in patients with a devastating brain injury is not always accurate and can lead to inappropriate decisions. We present case histories to support the recent recommendations of the Neurocritical Care Society that treatment withdrawal decisions should be delayed by up to 72 h in these patients. Development of pathways incorporating these recommendations can improve prognostication, enhance end of life care given to these patients and their families, and increase the opportunities to explore the donation wishes of more patients. They may also standardise the approach to decision making in the same way as the recommendations for management of patients after out of hospital cardiac arrest have done.
Evolution of CCL11: genetic characterization in lagomorphs and evidence of positive and purifying selection in mammals
Authors: Neves Fabiana , Abrantes Joana , Esteves Pedro J
Published: May 2016

The interactions between chemokines and their receptors are crucial for differentiation and activation of inflammatory cells. CC chemokine ligand 11 (CCL11) binds to CCR3 and to CCR5 that in leporids underwent gene conversion with CCR2. Here, we genetically characterized CCL11 in lagomorphs (leporids and pikas). All lagomorphs have a potentially functional CCL11, and the Pygmy rabbit has a mutation in the stop codon that leads to a longer protein. Other mammals also have mutations at the stop codon that result in proteins with different lengths. By employing maximum likelihood methods, we observed that, in mammals, CCL11 exhibits both signatures of purifying and positive selection. Signatures of purifying selection were detected in sites important for receptor binding and activation. Of the three sites detected as under positive selection, two were located close to the stop codon. Our results suggest that CCL11 is functional in all lagomorphs, and that the signatures of purifying and positive selection in mammalian CCL11 probably reflect the protein’s biological roles.
Cytomegalovirus may mimic the presentation of intrahepatic cholestasis and hemolysis, elevated liver enzymes and low platelets in immunosuppressed pregnant women
Authors: Wander Gurleen , Neuberger Francesa , Dhanjal Mandish K , Nelson-Piercy Catherine , Soh May Ching
Published: May 2016

Most published cases of cytomegalovirus infection in pregnancy relate to congenital abnormalities in neonates infected in early pregnancy, while the mother remains asymptomatic. We describe a diagnostically challenging case of an immunosuppressed woman with scleroderma who developed deranged liver function tests attributed to intrahepatic cholestasis of pregnancy and haemolysis, elevated liver enzymes and low platelets syndrome but was ultimately found to have disseminated cytomegalovirus. Cytomegalovirus can present in a myriad of ways. Clinicians caring for immunocompromised pregnant women should consider cytomegalovirus as a possible differential diagnosis when reviewing abnormal liver function tests.
Must smart objects look human? Study of the impact of anthropomorphism on the acceptance of companion robots
Authors: Goudey Alain , Bonnin Gaël
Published: May 2016

Smart products will play a central role in consumer living in years to come. Close to humans because of their “intelligence,” should they also look like humans? The aim of this research is to test the impact of anatomical anthropomorphism on the acceptance of an autonomous product, the companion robot, measured by its perceived usefulness, ease of use, and use intentions. Our results show that, unlike previous marketing research on traditional product anthropomorphism, the human appearance of a companion robot does not increase its acceptance by consumers. However, we show that a partially anthropomorphic appearance improves acceptance by people with practical experience of similar technology (the smartphone), while it reduces acceptance by other people. Our results also emphasize the difficulty of extending research on the impact of anthropomorphism on consumers. They also highlight the need to integrate appearance in acceptance models, and they show how experience with products similar to the new one influences the impact of appearance. Finally, we show the role of the categorization process in the impact of appearance.
Salespeople’s unethical behavior during a sales contest: The mediation effect of the perceived ethical climate of the game
Authors: Poujol Fanny-Juliet , Harfouche Antoine , Pezet Eric
Published: May 2016

This article aims to improve Murphy’s explanation of the consequences of sales contests by underlying the relationships that exist between the psychographic variables of salespeople (competitiveness and status aspiration), the perceived ethical climate of the contest, and unethical behaviors observed during the contest. Data were gathered via a survey questionnaire that targeted salespersons selling financial products in four different French banks. A total of 747 completed questionnaires were collected and their data analyzed using Partial Least Squares techniques. Results show that sales contests can create a specific ethical climate that mediates the relation between salespeople’s status aspiration and competitiveness and their unethical behavior during a sales contest.
The embodied rhetoric of consumerist activism through the lens of conceptual metaphor theory: An exploratory study and research perspectives
Authors: Bouillé Julien , Basso Frédéric , Robert-Demontrond Philippe
Published: May 2016

This article provides an analysis of the militant rhetoric used by consumer activist movements through the lens of conceptual metaphor theory (CMT). This theory, developed in the field of cognitive linguistics, highlights the fact that our metaphorical language is not only literal. It also orders our thoughts and actions. We begin by demonstrating the extent to which this theory is useful in developing a detailed understanding of consumer activist movements when compared to other conceptual approaches. Specifically, CMT makes it possible to better identify how actors experience their militant activities. We then conduct a virtual ethnographic study to examine the content of verbal and non-verbal communication produced and published online by activists. Various cases of real consumerist activism are studied through the metaphorical language used by these activists. The results of our observations enable us to identify those aspects of activism that are emphasised to consumers with a view to informing and persuading them. Finally, we discuss the conceptual and methodological perspectives stemming from this research.
Image of Luxury Brands
Authors: Díaz-Bustamante Mónica , Carcelén Sonia , Puelles María
Published: May 2016

The luxury market has experienced considerable growth over recent years, being one of the sectors that have been the most resistant to the current economic recession. Selective fragrances make up one of the primary categories of the so-called accessible luxury consumed by a middle class that is seeking to approach the upper classes by copying their lifestyle. Despite the importance of this market, there is relatively little literature existing in regard to the study of the image of luxury brands due to the complexity of the luxury phenomenon. This article presents the results of an initial qualitative study conducted on focus groups of luxury fragrance consumers, making it possible to identify the types of attributes to be considered when studying the brand image of said luxury products. Subsequently, a quantitative study was conducted to determine the perceived image of the main luxury fragrances brands by consumers. Thanks to this study, it has been possible to determine the typical profile of each of the analyzed brands, to define the underlying dimensions of the image of luxury fragrances brands, and to analyze the correlations and dependency relations existing between the luxury brand dimension and the other attributes of image for the studied brands and between all the image attributes themselves.
Jeff Foxworthy’s Redneck Humor and the Boundaries of Middle-Class American Whiteness
Authors: Thomas J. David
Published: May 2016

Recent studies examine the use of rhetorical boundaries to produce intra-racial othering within whiteness. I expand this project by exploring the textual and social codes in Jeff Foxworthy humor that demarcate the boundaries between the redneck and the non-redneck. Such boundaries are complex, porous fault-lines that use symbolic pollution embedded in humor to stigmatize White outsiders. Social codes referencing symbolic pollution establish boundaries to define and insulate a normative, mainstream White identity from the intra-racial threat of redneck identity. This project provides a novel addition to whiteness studies by taking redneck humor analytically seriously and concludes by drawing comparisons between codes found in Foxworthy humor and those levied against rural Whites during the eugenics era.
A Case of Transfusion Error in a Trauma Patient With Subsequent Root Cause Analysis Leading to Institutional Change
Authors: Clifford Sean Patrick , Mick Paul Brian , Derhake Brian Matthew
Published: May 2016

A 28-year-old man presented emergently to the operating room following a gun-shot injury to his right groin. Our hospital’s Massive Transfusion Protocol was initiated as the patient entered the operating room actively hemorrhaging and severely hypotensive. During the aggressive resuscitation efforts, the patient was inadvertently transfused 2 units of packed red blood cells intended for another patient due to a series of errors. Fortunately, the incorrect product was compatible, and the patient recovered from his near-fatal injuries. Root cause analysis was used to review the transfusion error and develop an action plan to help prevent future occurrences.
Exploring the Experiences of Living With Stroke Through Narrative
Authors: Nasr Nasrin , Mawson Susan , Wright Peter , Parker Jack , Mountain Gail
Published: May 2016

Chronic illness models are normally used to explain and predict the experience of living with a long-term condition. The aim of this study was to present the findings of narrative interviews with stroke survivors and their family carers to understand their experiences of stroke. We interviewed five people with stroke and three family carers from the United Kingdom. We used thematic analysis to generate themes from their narrative accounts and then linked them to broader theoretical perspectives while influenced by the concept of reinterpretation of life. The narrative accounts of participants are mainly structured based on how their changed bodies poststroke changed their identities and roles and consequently their relationships with others. In this study, we underline the need for using methods like narrative to explain strategies that people use to make sense of their experiences of living with a long-term condition such as stroke.
Pathophysiological significance and therapeutic targeting of germinal center kinase in diffuse large B-cell lymphoma
Authors: Matthews Julie Marie , Bhatt Shruti , Patricelli Matthew P. , Nomanbhoy Tyzoon K. , Jiang Xiaoyu , Natkunam Yasodha , Gentles Andrew J. , Martinez Ezequiel , Zhu Daxing , Chapman Jennifer Rose , Cortizas Elena , Shyam Ragini , Chinichian Shideh , Advani Ranjana , Tan Li , Zhang Jianming , Choi Hwan Geun , Tibshirani Robert , Buhrlage Sara J. , Gratzinger Dita , Verdun Ramiro , Gray Nathanael S. , Lossos Izidore S.
Published: May 2016

Key Points

GCK signaling is activated in DLBCL, and this signaling is important to DLBCL proliferation and survival. Therapeutic targeting of GCK is feasible and may advance efforts to cure DLBCL patients.
Parallel computation of genome-scale RNA secondary structure to detect structural constraints on human genome
Authors: Kawaguchi Risa , Kiryu Hisanori
Published: May 2016

Background

RNA secondary structure around splice sites is known to assist normal splicing by promoting spliceosome recognition. However, analyzing the structural properties of entire intronic regions or pre-mRNA sequences has been difficult hitherto, owing to serious experimental and computational limitations, such as low read coverage and numerical problems.

Results

Our novel software, “ParasoR”, is designed to run on a computer cluster and enables the exact computation of various structural features of long RNA sequences under the constraint of maximal base-pairing distance. ParasoR divides dynamic programming (DP) matrices into smaller pieces, such that each piece can be computed by a separate computer node without losing the connectivity information between the pieces. ParasoR directly computes the ratios of DP variables to avoid the reduction of numerical precision caused by the cancellation of a large number of Boltzmann factors. The structural preferences of mRNAs computed by ParasoR shows a high concordance with those determined by high-throughput sequencing analyses.

Using ParasoR, we investigated the global structural preferences of transcribed regions in the human genome. A genome-wide folding simulation indicated that transcribed regions are significantly more structural than intergenic regions after removing repeat sequences and k-mer frequency bias. In particular, we observed a highly significant preference for base pairing over entire intronic regions as compared to their antisense sequences, as well as to intergenic regions. A comparison between pre-mRNAs and mRNAs showed that coding regions become more accessible after splicing, indicating constraints for translational efficiency. Such changes are correlated with gene expression levels, as well as GC content, and are enriched among genes associated with cytoskeleton and kinase functions.

Conclusions

We have shown that ParasoR is very useful for analyzing the structural properties of long RNA sequences such as mRNAs, pre-mRNAs, and long non-coding RNAs whose lengths can be more than a million bases in the human genome. In our analyses, transcribed regions including introns are indicated to be subject to various types of structural constraints that cannot be explained from simple sequence composition biases. ParasoR is freely available at https://github.com/carushi/ParasoR.
Perceptions of Pediatric Nephrologists regarding Timing of Dialysis Initiation in Children in Canada
Authors: Saban Jeremy A. , Zappitelli Michael , Samuel Susan M. , Sood Manish M. , Alexander R. Todd , Arora Steven , Erickson Robin L. , Kroeker Kristine , Manns Braden J. , Dart Allison B.
Published: May 2016

Background:

Significant practice variation exists in Canada with respect to timing of dialysis initiation in children. In the absence of evidence to guide practice, physicians' perceptions may significantly influence decision-making.

Objective:

The objectives of this study are to (1) evaluate Canadian pediatric nephrologists' perceptions regarding dialysis initiation in children with chronic kidney disease (CKD) and (2) determine the factors guiding practice that may contribute to practice variation across Canada.

Design:

This study was a cross-sectional online survey.

Setting:

This study was done in academic pediatric nephrology centers in Canada.

Participants:

The participants of this study are pediatric nephrologists.

Measurements and methods:

An anonymous web-based survey was administered to pediatric nephrologists in Canada to evaluate perspectives and practice patterns regarding timing of dialysis initiation. We also explored the importance of estimated glomerular filtration rate (eGFR) vs. symptoms and the role of patient and provider factors influencing decisions.

Results:

Thirty-five nephrologists (59 %) completed the survey. Most respondents care for advanced CKD patients in a multidisciplinary clinic (86 %) and no centers have a formal policy on timing of dialysis initiation. Seventy-five percent of centers follow <20 stage 4–5 CKD patients, and 9 % follow >30 patients. Discussions about dialysis initiation are generally informal (75 %) and the decision to start is made by the nephrologist (37 %) or a team (57 %). Fifty percent agreed GFR was important when deciding when to initiate dialysis, 41 % were neutral, and 9 % disagreed. Variability exists in the threshold that nephrologists considered early (vs. late) dialysis initiation: >20 (21 %), >15 (38 %), >12 (26 %), and >10 ml/min/1.73 m2 (12 %). Practitioners however typically start dialysis in asymptomatic patients at eGFRs of 7–9 (9 %), 10–11 (41 %), 12–14 (38 %), and 15–19 (6 %) ml/min/1.73 m2. Patient factors important in the decision to start dialysis for >90 % of nephrologists were fatigue, >10 % weight loss, nausea, increasing missed school, and awaiting a pre-emptive transplant. Age was only a factor for 56 %.

Limitations:

This study has a 59 % response rate.

Conclusions:

Variability exists in Canada regarding the importance and threshold of eGFR guiding the decision as to when to start dialysis in children, whereas patient symptoms are almost universally important to pediatric nephrologists' decision-making. Additional studies evaluating outcomes of children starting dialysis earlier vs. later are needed to standardize decision-making and care for children with kidney failure.
A cross-sectional study of problem gambling and its correlates among college students in South India
Authors: George Sanju , Jaisoorya TS , Nair Sivasankaran , Rani Anjana , Menon Priya , Madhavan Revamma , Rajan Jeevan Chakkandan , Radhakrishnan Komath Sankaran , Jose Vineeta , Benegal Vivek , Thennarassu K. , Petry Nancy M.
Published: May 2016

Background

In the Western world, a significant portion of college students have gambled. College gamblers have one of the highest rates of problem gambling. To date, there have been no studies on gambling participation or the rates of problem gambling in India.

Aims

This study evaluated the prevalence of gambling participation and problem gambling in college students in India. It also evaluated demographic and psychosocial correlates of gambling in that population.

Method

We surveyed 5784 college students from 58 colleges in the district of Ernakulam, Kerala, India, using cluster random sampling. Students completed questionnaires that addressed gambling, substance use, psychological distress, suicidality and attention-deficit hyperactivity disorder (ADHD).

Results

A total of 5580 completed questionnaires were returned, and while only 1090 (19.5%) college students reported having ever gambled, 415 (7.4%) reported problem gambling. Lotteries were the most popular form of gambling. Problem gamblers in comparison with non-gamblers were significantly more likely to be male, have a part-time job, greater academic failures, higher substance use, higher psychological distress scores, higher suicidality and higher ADHD symptom scores. In comparison with non-problem gamblers, problem gamblers were significantly more likely to have greater academic failures, higher psychological distress scores, higher suicidality and higher ADHD symptom scores.

Conclusions

This study, the first to look at the prevalence of gambling in India, found relatively low rates of gambling participation in college students but high rates of problem gambling among those who did gamble. Correlates of gambling were generally similar to those noted in other countries. Since 38% of college students who had gambled had a gambling problem, there is a need for immediate public health measures to raise awareness about gambling, and to prevent and treat problem gambling in this population.
Quantitative imaging of lipids in live mouse oocytes and early embryos using CARS microscopy
Authors: Bradley Josephine , Pope Iestyn , Masia Francesco , Sanusi Randa , Langbein Wolfgang , Swann Karl , Borri Paola
Published: May 2016

Mammalian oocytes contain lipid droplets that are a store of fatty acids, whose metabolism plays a significant role in pre-implantation development. Fluorescent staining has previously been used to image lipid droplets in mammalian oocytes and embryos, but this method is not quantitative and often incompatible with live cell imaging and subsequent development. Here we have applied chemically-specific, label-free coherent anti-Stokes Raman scattering (CARS) microscopy to mouse oocytes and pre-implantation embryos. We show that CARS imaging can quantify the size, number and spatial distribution of lipid droplets in living mouse oocytes and embryos up to the blastocyst stage. Notably, it can be used in a way that does not compromise oocyte maturation or embryo development. We have also correlated CARS with two-photon fluorescence microscopy simultaneously acquired using fluorescent lipid probes on fixed samples, and found only a partial degree of correlation, depending on the lipid probe, clearly exemplifying the limitation of lipid labelling. In addition, we show that differences in the chemical composition of lipid droplets in living oocytes matured in media supplemented with different saturated and unsaturated fatty acids can be detected using CARS hyperspectral imaging. These results demonstrate that CARS microscopy provides a novel non-invasive method of quantifying lipid content, type and spatial distribution with sub-micron resolution in living mammalian oocytes and embryos.
Notch maintains Drosophila type II neuroblasts by suppressing the expression of the Fez transcription factor Earmuff
Authors: Li Xiaosu , Xie Yonggang , Zhu Sijun
Published: May 2016

Notch signaling is critical for maintaining neural stem cell (NSC) self-renewal and heterogeneity, however the underlying mechanism is not well understood. In Drosophila, loss of Notch prematurely terminates the self-renewal of larval type II neuroblasts (NBs, the Drosophila NSCs) and transforms type II NBs into type I NBs. Here we demonstrate that Notch maintains type II NBs by suppressing the activation of earmuff (erm) by Pointed P1 (PntP1). We show that loss of Notch or components of its canonical pathway leads to PntP1-dependent ectopic Erm expression in type II NBs. Knockdown of Erm significantly rescues the loss of Notch phenotypes and misexpression of Erm phenocopies the loss of Notch. Ectopically expressed Erm promotes the transformation of type II NBs into type I NBs by inhibiting PntP1's function and expression in type II NBs. Our work not only elucidates a critical mechanism of Notch-mediated maintenance of type II NB self-renewal and identity, but also reveals a novel function of Erm.
A toolbox to study epidermal cell types in zebrafish
Authors: Eisenhoffer George T. , Slattum Gloria , Ruiz Oscar E. , Otsuna Hideo , Bryan Chase D. , Lopez Justin , Wagner Daniel S. , Bonkowsky Joshua L. , Chien Chi-Bin , Dorsky Richard I. , Rosenblatt Jody
Published: May 2016

Epithelia provide a critical protective barrier for our organs and are also the sites where most carcinomas form. Most studies on epithelia and carcinomas use cell culture or organisms where high-resolution live imaging is inaccessible without invasive techniques. Here, we introduce the developing zebrafish epidermis as an excellent in vivo model system for studying a living epithelium. We developed tools to fluorescently tag specific epithelial cell types and express genes in a mosaic fashion using five GAL4 lines identified from an enhancer trap screen. When crossed to a variety of UAS effector lines, we can now track, ablate or monitor single cells at sub-cellular resolution. Using photo-cleavable morpholino oligonucleotides that target GAL4, we can also express genes in a mosaic fashion at specific times during development. Together, this system provides an excellent in vivo alternative to tissue culture cells, without the intrinsic concerns of culture conditions or transformation, and enables the investigation of distinct cell types within living epithelial tissues.
Optimal Recharging Policies for Electric Vehicles
Authors: Sweda Timothy M. , Dolinskaya Irina S. , Klabjan Diego
Published: May 2016

Recharging decisions for electric vehicles require many special considerations because of battery dynamics. Battery longevity is prolonged by recharging less frequently and at slower rates, and also by not charging the battery too close to its maximum capacity. In this paper, we address the problem of finding an optimal recharging policy for an electric vehicle along a given path. The path consists of a sequence of nodes, each representing a charging station, and the driver must decide where to stop and how much to recharge at each stop. We present efficient algorithms for finding an optimal policy in general instances with deterministic travel costs and homogeneous charging stations, and also for two specialized cases—one where the vehicle can stop anywhere along the path to recharge and another with equidistant charging stations along the path. In addition, we develop two heuristic procedures that we characterize analytically and explore empirically. We further analyze and test our solution methods on model variations that include stochastic travel costs and nonhomogeneous charging stations.
What to do if you are concerned that a child or young person is at risk of, or has suffered FGM
Authors: Hayward Melanie
Published: May 2016

The ‘What to do if’ series aims to provide school nursing practitioners with practical safeguarding information on a variety of issues. This first article focusses on female genital mutilation (FGM).
Supporting students with bipolar disorder
Authors: Thornton Stephanie
Published: May 2016

Bipolar disorder is a serious mental illness, which can have a destructive impact on individuals with the condition. Stephanie Thornton looks at the causes, incidence and management of the condition.
Nine hours a week marking – but no evidence of what works
Authors: Henshaw Pete
Published: May 2016

Research fund set-up after report warns that marking practices are driving high workload, but with no ‘solid evidence to justify them’
Supporting staff mental health
Authors: Gallagher Mandy
Published: May 2016

Can schools do more to tackle the rise of stress-related illnesses among their staff? Mandy Gallagher suggests some strategies that could help