bluuebunny/crossref_metadata_2025 huggingface dataset:
Setting Performance Standards for a Cost-Effective Human Immunodeficiency Virus Cure Strategy in South Africa
Authors: Paltiel A. David , Zheng Amy , Weinstein Milton C. , Gaynes Melanie R. , Wood Robin , Freedberg Kenneth A. , Sax Paul E. , Walensky Rochelle P.
Published: April 2017

Background

Reports of a single case of human immunodeficiency virus (HIV) eradication suggest that elimination of HIV from individuals is possible. Anticipating both increased research funding and the development of effective, durable cure technologies, we describe the circumstances under which a cure might improve survival and be cost-effective in South Africa.

Methods

We adapted a simulation model comparing a hypothetical cure strategy (“Cure”) to the standard of care, lifetime antiretroviral therapy (“LifetimeART”) among adherent South Africans (58% female; mean age 33.8 years; mean CD4 257/µL; virologic suppression ≥1 year). We portrayed cure as a single intervention, producing sustained viral eradication without ART. We considered both a plausible, more imminently achievable “Baseline Scenario” and a more aspirational “Optimistic Scenario”. Inputs (Baseline/Optimistic) included the following: 50%/75% efficacy; 0.6%/0.0% fatal toxicity; 0.37%/0.085% monthly relapse over 5 years (0.185%/0.0425% per month thereafter); and $2000/$500 cost. These inputs were varied extensively in sensitivity analysis.

Results

At baseline, Cure was “dominated,” yielding lower discounted life expectancy (19.31 life-years [LY] vs 19.37 LY) and greater discounted lifetime costs ($13 800 vs $13 700) than LifetimeART. Under optimistic assumptions, Cure was “cost-saving,” producing greater survival (19.91 LY) and lower lifetime costs ($11 000) than LifetimeART. Findings were highly sensitive to data assumptions, leaving little middle ground where a tradeoff existed between improved survival and higher costs.

Conclusions

Only under the most favorable performance assumptions will an HIV cure strategy prove clinically and economically justifiable in South Africa. The scientific pursuit of a cure should not undermine continued expansions of access to proven, effective, and cost-effective ART.
Clinical Updates in Women’s Health Care Summary: Arrhythmias
Authors: Fuller Brittany S. , Voeltz Michele D.
Published: April 2017

Obstetrician–gynecologists often are the sole providers of health care to female patients. Because cardiovascular disease is the leading cause of death in women in the United States, obstetrician– gynecologists must be aware of the risk factors, symptoms, and signs of cardiovascular disease and arrhythmia. Furthermore, they must be prepared to identify and treat common types of arrhythmia in this population and refer patients to cardiology for specialized care. Understanding the role of pregnancy among women with arrhythmia is critically important to optimize both maternal and fetal outcomes. This monograph discusses the cardiac conduction system and addresses the assessment, diagnosis, and treatment of both pregnant and nonpregnant patients with heart rhythm disorders.
Interprosthetic and Peri-Implant Fractures: Principles of Operative Fixation and Future Directions
Authors: Liporace Frank A. , Yoon Richard S. , Collinge Cory A.
Published: April 2017

Advances in medicine and orthopaedic implant technology have dramatically increased the number of patients sustaining interprosthetic, inter-, or peri-implant fractures. For these complex clinical scenarios, there are currently no available treatment algorithms. In this review, we outline the principles, strategies, and techniques to obtain both successful reconstruction and maximum function.

Level of Evidence:

Therapeutic Level V. See Instructions for Authors for a complete description of levels of evidence.
A Technique for the Management of Concomitant Scaphotrapezoid Arthritis in Patients With Thumb Metacarpotrapezial Arthritis: Interposition Arthroplasty With a Capitate Suture Anchor
Authors: Warganich Tibor , Shin Alexander Y.
Published: April 2017

Scaphotrapezoid (ST) arthritis is a common source of pain and disability that typically presents with concomitant basilar thumb arthritis. ST arthritis is often under recognized and under diagnosed as a source of continued pain after successful basilar thumb arthroplasty. Untreated, symptomatic ST arthritis can cause failure of an otherwise successfully executed thumb carpometacarpal arthroplasty due to persistent pain, which is frustrating to the patient and surgeon. Although multiple surgical treatment options have been described for basilar thumb carpometacarpal joint arthritis, there is no gold standard for the treatment of ST arthritis. We describe a surgical technique with a minimal trapezoid excision and interpositional arthroplasty using an acellular allograft secured with a suture anchor in the capitate.
Both Positive and Negative Fluid Balance May Be Associated With Reduced Long-Term Survival in the Critically Ill
Authors: Balakumar Vikram , Murugan Raghavan , Sileanu Florentina E. , Palevsky Paul , Clermont Gilles , Kellum John A.
Published: April 2017

Objectives:

Among critically ill patients with acute kidney injury, exposure to positive fluid balance, compared with negative fluid balance, has been associated with mortality and impaired renal recovery. However, it is unclear whether positive and negative fluid balances are associated with poor outcome compared to patients with even fluid balance (euvolemia). In this study, we examined the association between exposure to positive or negative fluid balance, compared with even fluid balance, on 1-year mortality and renal recovery.

Design:

Retrospective cohort study.

Setting:

Eight medical-surgical ICUs at the University of Pittsburgh Medical Center, Pittsburgh, PA.

Patients:

Critically ill patients admitted between July 2000 and October 2008.

Interventions:

None.

Measurements and Main Results:

Among 18,084 patients, fluid balance was categorized as negative (< 0%), even (0% to < 5%), or positive (≥ 5%). Following propensity matching, positive fluid balance, compared with even or negative fluid balance, was associated with increased mortality (30.3% vs 21.1% vs 22%, respectively; p < 0.001). Using Gray’s model, negative fluid balance, compared with even fluid balance, was associated with lower short-term mortality (adjusted hazard ratio range, 0.81; 95% CI, 0.68–0.96) but higher long-term mortality (adjusted hazard ratio range, 1.16–1.22; p = 0.004). Conversely, positive fluid balance was associated with higher mortality throughout 1-year (adjusted hazard ratio range, 1.30–1.92; p < 0.001), which was attenuated in those who received renal replacement therapy (positive fluid balance × renal replacement therapy interaction (adjusted hazard ratio range, 0.43–0.89; p < 0.001). Of patients receiving renal replacement therapy, neither positive (adjusted odds ratio, 0.98; 95% CI, 0.68–1.4) nor negative (adjusted odds ratio, 0.81; 95% CI, 0.43–1.55) fluid balance was associated with renal recovery.

Conclusions:

Among critically ill patients, exposure to positive or negative fluid balance, compared with even fluid balance, was associated with higher 1-year mortality. This mortality risk associated with positive fluid balance, however, was attenuated by use of renal replacement therapy. We found no association between fluid balance and renal recovery.
Brief Report: HPV-17 Infection in Darier Disease With Acrokeratosis Verrucosis of Hopf
Authors: Matsumoto Andrew , Gregory Neal , Rady Peter L. , Tyring Stephen K. , Carlson John A.
Published: April 2017

The co-existence of Darier disease (DD) and acrokeratosis verruciformis of Hopf (AKV) has been noted for decades and the relationship between the 2 entities remains controversial. Although, it has been shown that both diseases are associated with mutations in ATPA2 gene, it is yet to be determined if they are the same disease, or separate but allelic, or interlinked in some other fashion. Herein, the authors report the case of a 13-year-old girl presenting with shiny flat-topped verruca plana–like papules, on the dorsal hands and feet and red–brown crusted papules on her forehead and along the sides of her neck. Histological evaluation of a wart-like lesion shows features of AKV, a verruca plana–like histopathology and focal acantholytic dyskeratosis. Forehead biopsy also demonstrated focal acantholytic dyskeratosis supporting the diagnosis of DD. Polymerase chain reaction for human papillomavirus (HPV) DNA detected HPV-17, a human betapapillomavirus in the verruca plana–like papule. Cytoplasmic expression of the L1 capsid expression was seen in areas of hypergranulosis. The presence of productive betaPV infection in the setting of DD and AKV suggests a susceptibility to HPV infection.
ALK Expression is a Rare Finding in Mycosis Fungoides
Authors: Covington Morgan , Cassarino David , Abdulla Farah
Published: April 2017

Mycosis fungoides (MF) is the most common form of cutaneous T-cell lymphoma. Although indolent in its early stages, MF is more aggressive in advanced stages, particularly if large cell transformation occurs. Histologically, transformed MF is similar to primary cutaneous anaplastic large cell lymphoma (pcALCL) and nodal ALCL (nALCL). MF had not been associated with immunohistochemical expression of anaplastic lymphoma kinase (ALK) until we previously reported a case documenting the presence of ALK by immunohistochemistry in a patient with stage IA MF and concurrent nALCL. This is a unique finding due to the fact that ALK positivity is usually found in nALCL. The goal of this study is to examine the extent to which ALK may be expressed in the different morphologic lesions of MF. One hundred three biopsies from 96 patients, including the patient from the original case, with confirmed MF representing various lesion stages and subtypes, were tested for ALK by immunohistochemical staining. Out of the 103 biopsies, only the original index case of Stage IA MF with concurrent nALCL expressed ALK. From these results, we conclude that ALK is not routinely present in MF in any lesion stage or variant type. Routine staining of ALK is therefore of no additional benefit for the workup of known early stage MF; however, its use may be beneficial in the initial workup of unspecified large cell lymphomas of the skin.
Neutrophilic Figurate Erythema
Authors: Wu Yu-Hung , Hsiao Pa-Fan
Published: April 2017

Neutrophilic figurate erythema (NFE) has been rarely reported. This study aimed to identify the clinical and pathological features of NFE. We retrospectively reviewed the information from diagnostic cases from 2000 to 2013. The diagnosis of NFE includes clinically annular rash, histopathologically predominant neutrophilic perivascular and interstitial infiltrate in the dermis without evidence of vasculitis, and exclusion of other known specific entities. Fifteen cases of NFE were identified, including 11 women and 4 men. The age distribution was 18–66 years (average 41). The major characteristic patterns in NFE were blistering annular erythema (5/15 patients), purpuric annular erythema with vesicles (4/15 patients), and multiple annular rash with central ring-shaped scales (4/15 patients). There was no specific predicted location and no association with a major systemic disease. Papillary dermal edema and mild-to-moderate leukocytoclasis in the upper dermis are the main histopathological features. Ten of the 15 patients had recurrent episodes. Two patients who had single episode were associated with drug reaction. Antineutrophil therapy was required to control the symptoms in 3 patients. NFE has a similar clinical course as erythema annulare centrifugum but has distinct features that can be recognized clinically. The pathologists should be aware of the entity when making the diagnosis of neutrophil-mediated inflammatory disorders. The treatment regimen for neutrophilic dermatoses may be needed to manage the skin lesions.
Clozapine-Associated Agranulocytosis Treatment With Granulocyte Colony-Stimulating Factor/Granulocyte-Macrophage Colony-Stimulating Factor
Authors: Lally John , Malik Steffi , Whiskey Eromona , Taylor David M. , Gaughran Fiona P. , Krivoy Amir , Flanagan Robert J. , Mijovic Aleksandar , MacCabe James H.
Published: April 2017

Purpose/Background

Clozapine is associated with hematological abnormalities, notably neutropenia, which may progress to agranulocytosis. Granulocyte colony-stimulating factor (G-CSF) and granulocyte-macrophage colony-stimulating factor (GM-CSF) have been used to reduce the frequency and duration of clozapine-associated neutropenia. This review aims to explore the use, efficacy, and tolerability of these cytokines in the treatment of clozapine-associated agranulocytosis.

Methods/Procedures

We conducted a systematic review of published interventional and observational studies, case series, and case reports where G-CSF/GM-CSF was used to treat clozapine-associated agranulocytosis.

Findings/Results

We identified 29 reports (40 patients). The median duration of neutrophil recovery time after stopping clozapine and starting cytokine treatment was 7 days (range, 2–13 days) for those with agranulocytosis (absolute neutrophil count < 0.5 × 109 cells/L). Ninety-four percent (n = 29) had no serious adverse reactions, and no deaths occurred.

Implications/Conclusions

Our findings indicate that G-CSF/GM-CSF use is well tolerated and suggest that G-CSF can sometimes be safely used to reduce the duration of neutropenia associated with clozapine use. However, the interpretation of this outcome is difficult, given the likely publication bias for positive outcomes in case reports.
Nitrous Oxide Utility in Labor and Birth
Authors: Collins Michelle
Published: April 2017

The use of nitrous oxide (N2O) for labor and birth has very recently emerged as a viable modality in the United States, despite a long history of use in Canada and Europe. Usually associated with dental procedures, there are significant differences between dental and parturition utility, efficacy, and staff exposure. In addition to using it for pain relief and anxiolysis, those centers utilizing it have noted it to be multipurpose and useful for such situations as: external cephalic version, manual removal of placenta, intravenous starts, during placement of urinary catheters and intracervical Foley bulbs. Nitrous oxide has proven to be especially helpful for repair of lacerations under local anesthesia and is a multiuse modality that should be available to women in all birth settings. This article explores the history of N2O use, provides a comparison of obstetrical use to use in the dental industry, examines the contraindications to, and implications for usage, and discusses logistical points of consideration for clinicians working with women using N2O for labor and birth.
Blood Sampling in Newborns
Authors: Bueno Mariana , Nishi Érika Tihemi , Costa Taine , Freire Laís Machado , Harrison Denise
Published: April 2017

Objective of this study was to conduct a systematic review of YouTube videos showing neonatal blood sampling, and to evaluate pain management and comforting interventions used. Selected videos were consumer- or professional-produced videos showing human newborns undergoing heel lancing or venipuncture for blood sampling, videos showing the entire blood sampling procedure (from the first attempt or puncture to the time of application of a cotton ball or bandage), publication date prior to October 2014, Portuguese titles, available audio. Search terms included “neonate,” “newborn,” “neonatal screening,” and “blood collection.” Two reviewers independently screened the videos and extracted the following data. A total of 13 140 videos were retrieved, of which 1354 were further evaluated, and 68 were included. Videos were mostly consumer produced (97%). Heel lancing was performed in 62 (91%). Forty-nine infants (72%) were held by an adult during the procedure. Median pain score immediately after puncture was 4 (interquartile range [IQR] = 0-5), and median length of cry throughout the procedure was 61 seconds (IQR = 88). Breastfeeding (3%) and swaddling (1.5%) were rarely implemented. Posted YouTube videos in Portuguese of newborns undergoing blood collection demonstrate minimal use of pain treatment, and maximal distress during procedures. Knowledge translation strategies are needed to implement effective measures for neonatal pain relief and comfort.
Sonotubometric Assessment for Severity of Patulous Eustachian Tube
Authors: Takata Iori , Ikeda Ryoukichi , Kawase Tetsuaki , Suzuki Yoko , Sato Takeshi , Katori Yukio , Kobayashi Toshimitsu
Published: April 2017

Objective:

To investigate the relationship between the morphological patency of the eustachian tube (ET) and sound transmission via the ET.

Study Design:

Retrospective chart review and model experiment.

Setting:

Tertiary referral center.

Subjects:

A total of 56 ears of 28 patients (9 men and 19 women, aged from 12 to 82 yr, mean 40.4 ± 21.5 yr) who underwent sonotubometric measurement using postural change as well as computed tomography (CT) of the ET in the sitting position, including 26 ears with definite patulous ET, 9 ears with possible patulous ET, and 21 ears without patulous ET.

Method:

Commercial equipment for sonotubometry (JK-05A; RION Co., Ltd., Kokubunji, Tokyo, Japan) was used in the following two investigations. Retrospective survey: sound patency of 7 kHz band noise via the ET was assessed by comparison of acoustic transfer function via the ET in the sitting and forward-bending positions. Sound patency via the ET was compared with morphological patency of the ET (cross-sectional area in the narrowest portion) assessed by three-dimensional CT of the ET in the sitting position. Model experiment: effect of the ET caliber on the acoustic transfer function was examined using a simple model constructed with two truncated syringes with silicone barrels and a narrow connecting tube.

Results:

Sound patency assessed by sonotubometry was well correlated with the cross-sectional area at the narrowest portion of the ET in the sitting position (r = 0.786,p < 0.001). Correlation between the sound patency via the narrow tube and the caliber of the tube was also confirmed by the model experiment.

Conclusions:

Sound patency assessed by sonotubometry using 7 kHz band noise could be useful to predict the morphological severity of patulous ET.
Development of a Claims-based Frailty Indicator Anchored to a Well-established Frailty Phenotype
Authors: Segal Jodi B. , Chang Hsien-Yen , Du Yu , Walston Jeremy D. , Carlson Michelle C. , Varadhan Ravi
Published: April 2017

Background:

Fried and colleagues described a frailty phenotype measured in the Cardiovascular Health Study (CHS). This phenotype is manifest when ≥3 of the following are present: low grip strength, low energy, slowed waking speed, low physical activity, or unintentional weight loss. We sought to approximate frailty phenotype using only administrative claims data to enable frailty to be assessed without physical performance measures.

Study Design:

We used the CHS cohort data linked to participants Medicare claims. The reference standard was the frailty phenotype measured at visits 5 and 9. With penalized logistic regression, we developed a parsimonious index for predicting the frailty phenotype using a linear combination of diagnoses, operationalized with claims data. We assessed the predictive validity of frailty index by examining how well it predicted common aging-related outcomes including hospitalization, disability, and death.

Results:

There were 4454 CHS participants from 4 clinical sites. In total, 84% were white, 58% were women and their mean age was 72 years at enrollment. Approximately 11% of the cohort was frail. The model had an area under the receiver operating curve of 0.75 to concurrently predict a frailty phenotype. This Claims-based Frailty Indicator significantly predicted death (odds ratio, 1.84), time to death (hazards ratio, 1.71), number of hospital admissions (incidence rate ratio, 1.74), and nursing home admission (odds ratio, 1.47) in models adjusted for age and sex.

Conclusions:

Claims data alone can be used to classify individuals as frail and nonfrail. The Claims-based Frailty Indicator might be used in research with large datasets for confounding adjustment or risk prediction. The indicator might also be used for emergency preparedness for identification of regions enriched with frail individuals.
Interpreting lipoproteins in nonalcoholic fatty liver disease
Authors: Nemes Katriina , Åberg Fredrik
Published: April 2017

Purpose of review

The pathophysiologies of nonalcoholic fatty liver disease (NAFLD), metabolic syndrome, and cardiovascular disease are closely interlinked and associated with atherogenic dyslipidemia. Liver and cardiovascular disease may silently progress to advanced stages if alarming signs, such as abdominal obesity, elevated fasting and postprandial triglycerides, and low HDL cholesterol are overlooked. We review the metabolic mechanisms in NAFLD at the cellular level in the context of standard clinical lipid measurements.

Recent findings

We discuss the pathogenesis of NAFLD, nonalcoholic steatohepatitis (NASH), and metabolic syndrome, atherogenic dyslipidemia, lipotoxicity, and lipophagy.

Physicians should infer from biomarkers or clinical findings that their abdominally obese patients are at risk of severe cardiovascular, liver fatty disease, or both. Physicians should carry out laboratory tests of plasma cholesterol, triglycerides, LDL and HDL cholesterol, non-HDL cholesterol, apolipoprotein B and platelets, and for diabetes, but importantly, plasma triglycerides also in the nonfasting state. But note, clinical routine plasma lipid and lipoprotein measurements are not necessarily reliable for interpreting severe metabolic changes. Notably, in advanced stages of NAFLD (i.e., late steatohepatitis and cirrhosis), routine lipid profiles do not necessarily show any more abnormalities.
Use of Electronic Consultation System to Improve Access to Care in Pediatric Hematology/Oncology
Authors: Johnston Donna L. , Murto Kimmo , Kurzawa Julia , Liddy Clare , Keely Erin , Lai Lillian
Published: April 2017

Background:

Electronic consultations (eConsult) allow for communication between primary care providers and specialists in an asynchronous manner. This study examined provider satisfaction, topics of interest, and efficiency of eConsult in pediatric hematology/oncology in Ottawa, Canada.

Methods:

We conducted a cross-sectional assessment of all eConsult cases directed to pediatric hematology/oncology specialists using the Champlain BASE (Building Access to Specialists through eConsultation) eConsult service from June 1, 2014 to May 31, 2016.

Results:

There were 1064 eConsults to pediatrics during the study timeperiod and pediatric hematology/oncology consults accounted for 8% (85). During the same study timeperiod, 524 consults were seen in the pediatric hematology/oncology clinic. The majority of the eConsults were for hematology (90.5%) in contrast to oncology topics (9.5%). The most common topics were anemia, hemoglobinopathy, bleeding disorder, and thrombotic state. Primary care providers rated the eConsult service very highly, and their comments were very positive. The eConsult service resulted in deferral of 40% of consults originally contemplated to require a face-to-face specialist visit.

Conclusions:

This study showed successful implementation and use of the eConsult service for pediatric hematology/oncology and resulted in avoidance of a large number of face-to-face consultation. The common topics identified areas for continuing medical education.
Mean Levels and Variability in Affect, Diabetes Self-Care Behaviors, and Continuously Monitored Glucose: A Daily Study of Latinos With Type 2 Diabetes
Authors: Wagner Julie , Armeli Stephen , Tennen Howard , Bermudez-Millan Angela , Wolpert Howard , Pérez-Escamilla Rafael
Published: April 2017

Objective

This study investigated between- and within-person associations among mean levels and variability in affect, diabetes self-care behaviors, and continuously monitored glucose in Latinos with type 2 diabetes.

Methods

Fifty participants (M [SD] age = 57.8 [11.7] years, 74% women, mean [SD] glycosylated hemoglobin A1c = 8.3% [1.5%]) wore a “blinded” continuous glucose monitor for 7 days, and they responded to twice daily automated phone surveys regarding positive affect, negative affect, and self-care behaviors.

Results

Higher mean levels of NA were associated with higher mean glucose (r = .30), greater percent hyperglycemia (r = .34) and greater percentage of out-of-range glucose (r = .34). Higher NA variability was also related to higher mean glucose (r = .34), greater percent of hyperglycemia (r = .44) and greater percentage of out-of-range glucose (r = .43). Higher positive affect variability was related to lower percentage of hypoglycemia (r = −.33). Higher mean levels of self-care behaviors were related to lower glucose variability (r = −.35). Finally, higher self-care behavior variability was related to greater percentage of hyperglycemia (r = .31) and greater percentage of out-of-range glucose (r = −.28). In multilevel regression models, within-person increases from mean levels of self-care were associated with lower mean levels of glucose (b = −7.4, 95% confidence interval [CI] = −12.8 to −1.9), lower percentage of hyperglycemia (b = −0.04, 95% CI = −0.07 to −0.01), and higher percentage of hypoglycemia (b = 0.02, 95% CI = 0.01 to 0.03) in the subsequent 10-hour period.

Conclusions

Near-to-real time sampling documented associations of glucose with affect and diabetes self-care that are not detectable with traditional measures.
Unilateral Blindness After Septoplasty
Authors: Kilavuz Ahmet Erdem , Yildirim Duzgun , Serin Gediz Murat , Kaytaz Asim
Published: April 2017

Septoplasty is a frequently performed procedure with mostly minor complications. Nevertheless, it may lead to serious complications.

The authors present a 29-year-old patient admitted to their hospital 10 days after septoplasty in another institution. He suffered a total loss of vision immediately after the surgery.

High-resolution computed tomography and magnetic resonance imaging revealed a direct trauma of the optic canal and an inflamed and edematous optic nerve. Even though a successful endoscopic optic nerve was performed, the patient's loss of vision did not improve after the surgery.

Blindness after septoplasty is an extremely rare but a devastating complication. There are only few patients that indicates the optic nerve injury caused by a direct trauma.
Outcome for Patients With Pathological Esophageal Acid Exposure After Laparoscopic Fundoplication
Authors: Oor Jelmer E. , Nieuwenhuijs Vincent B. , Devitt Peter G. , Hazebroek Eric J. , Watson David I.
Published: April 2017

Objective:

The aim of the current study was to assess symptomatic outcome and need for surgical reintervention for patients identified with pathological esophageal acid exposure by routine postoperative 24-hour pH-monitoring.

Background:

Although laparoscopic fundoplication is associated with excellent short- and midterm results, recurrent symptoms pose an important challenge. Postoperative pH-monitoring is considered the “gold standard” for diagnosing recurrent GERD and frequently used for routine postoperative follow up.

Methods:

Analysis of prospectively collected data from patients who underwent laparoscopic fundoplication between April 1994 and June 2015 and underwent routine postoperative 24-hour pH-monitoring was performed. Symptomatic outcome and need for surgical reintervention up to 5 years was compared between patients with pathological and physiological postoperative esophageal acid exposure. Primary endpoints were heartburn score and need for surgical reintervention for recurrent reflux.

Results:

A total of 309 patients in whom routine postoperative 24-hour pH-monitoring was performed were included. Pathological acid exposure was present in 33 patients (11%) compared with 276 patients (89%) with physiological acid exposure. During 5-year follow up, there were no differences in heartburn, dysphagia, or satisfaction scores. Eighteen percent of all patients with abnormal postoperative pH-studies underwent redo fundoplication during 5-year follow up.

Conclusions:

Pathological acid exposure demonstrated by routine postoperative pH-monitoring was not associated with worse symptomatic outcome in terms of reflux control and satisfaction. A possible explanation for this finding is that laparoscopic fundoplication reduces the patients’ ability to perceive reflux. This underlines the importance of assessing the association between symptomatic outcome and esophageal function tests in determining outcome of antireflux surgery.
Insular Cortex Mediates Approach and Avoidance Responses to Social Affective Stimuli
Authors: Rogers-Carter Morgan M. , Varela Juan A. , Gribbons Katherine B. , Pierce Anne F. , McGoey Morgan T. , Ritchey Maureen , Christianson John P.
Published: April 2017

Social animals detect the affective states of others and utilize this information to orchestrate appropriate social interactions. Social affective behaviors include cooperation, reproductive acts and avoiding sick individuals. In a social affective behavioral test in which experimental adult male rats were given the choice to interact with either naive or stressed conspecifics, the experimental rats demonstrated both approach and avoidant behaviors towards the conspecific, depending upon the age of the conspecific; experimental adult rats approached the stressed juvenile but avoided the stressed adult. Optogenetic inhibition of the insular cortex, a region anatomically positioned to contribute to social cognition, disrupted these behaviors. Receptors for the social nonapeptide oxytocin (OT) are found in high density within the insular cortex and here oxytocin increased intrinsic excitability and synaptic efficacy in acute insular cortex slices. Blockade of oxytocin receptors (OTRs) in the insula eliminated the effect of conspecific stress on approach behavior, while insular administration of OT recapitulated the behaviors typically observed in response to stressed conspecifics. Network analysis using Fos immunoreactivity identified functional connectivity between the insular cortex and the network of regions involved in social decision making. These results implicate insular cortex as a novel target of OT and suggest that insula is a key component in the circuit underlying age-dependent social responses to stressed conspecifics.
An embryonic system to assess Wnt transcriptional targets
Authors: Suresh Jahnavi , Harmston Nathan , Lim Ka Keat , Kaur Prameet , Jin Helen Jingshu , Lusk Jay B. , Petretto Enrico , Tolwinski Nicholas S.
Published: April 2017

During animal development, complex signals determine and organize a vast number of tissues using a very small number of signal transduction pathways. These developmental signaling pathways determine cell fates through a coordinated transcriptional response that remains poorly understood. The Wnt pathway is involved in a variety of these cellular functions, and its signals are transmitted in part through a β-catenin/TCF transcriptional complex. Here we report anin vivo Drosophilaassay that can be used to distinguish between activation, de-repression and repression of transcriptional responses, separating upstream and downstream pathway activation and canonical/non-canonical Wnt signals in embryos. We find specific sets of genes downstream of both β-catenin and TCF with an additional group of genes regulated by Wnt, while the non-canonical Wnt4 regulates a separate cohort of genes. We correlate transcriptional changes with phenotypic outcomes of cell differentiation and embryo size, showing our model can be used to characterize developmental signaling compartmentalizationin vivo.
CRISPR-Cas9 screens in human cells and primary neurons identify modifiers ofC9orf72dipeptide repeat protein toxicity
Authors: Haney Michael S. , Kramer Nicholas J. , Morgens David W. , Jovičić Ana , Couthouis Julien , Li Amy , Ousey James , Ma Rosanna , Bieri Gregor , Bassik Michael C. , Gitler Aaron D.
Published: April 2017

Hexanucleotide repeat expansions in theC9orf72gene are the most common cause of amyotrophic lateral sclerosis and frontotemporal dementia (c9FTD/ALS). The nucleotide repeat expansions are translated into dipeptide repeat (DPR) proteins, which are aggregation-prone and may contribute to neurodegeneration. Studies in model organisms, including yeast and flies have converged upon nucleocytoplasmic transport as one underlying pathogenic mechanism, but a comprehensive understanding of the molecular and cellular underpinnings of DPR toxicity in human cells is still lacking. We used the bacteria-derived clustered regularly interspaced short palindromic repeats (CRISPR)-Cas9 system to perform genome-wide gene knockout screens for suppressors and enhancers ofC9orf72DPR toxicity in human cells. We validated hits by performing secondary CRISPR-Cas9 screens in primary mouse neurons. Our screens revealed genes involved in nucleocytoplasmic transport, reinforcing the previous findings from model systems. We also uncovered new potent modifiers of DPR toxicity whose gene products function in the endoplasmic reticulum (ER), proteasome, RNA processing pathways, and in chromatin modification. Since regulators of ER stress emerged prominently from the screens, we further investigated one such modifier,TMX2, which we identified as a modulator of the ER-stress signature elicited byC9orf72DPRs in neurons. Together, this work identifies novel suppressors of DPR toxicity that represent potential therapeutic targets and demonstrates the promise of CRISPR-Cas9 screens to define mechanisms of neurodegenerative diseases.

One Sentence Summary

Genome-wide CRISPR-Cas9 screens in human cells reveal mechanisms and targets for ALS-associatedC9orf72dipeptide repeat protein toxicity.
Horizontal Gene Transfer Constrains the Timing of Methanogen Evolution
Authors: Wolfe Joanna M. , Fournier Gregory P.
Published: April 2017

Microbial methanogenesis may have been a major component of Earth’s carbon cycle during the Archaean Eon, generating a methane greenhouse that increased global temperatures enough for a liquid hydrosphere, despite the sun’s lower luminosity at the time. Evaluation of potential solutions to the “faint young sun” hypothesis by determining the age of microbial methanogenesis was limited by ambiguous geochemical evidence, and the absence of a diagnostic fossil record. To overcome these challenges, we utilize a temporal constraint: a horizontal gene transfer (HGT) event from within archaeal methanogens to the ancestor of Cyanobacteria, one of the few microbial clades with recognized crown group fossils. Results of molecular clock analyses calibrated by this HGT-propagated constraint show methanogens diverging within Euryarchaeota no later than 3.51 Ga, with methanogenesis itself likely evolving earlier. This timing provides independent support for scenarios wherein microbial methane production was important in maintaining temperatures on the early Earth.
Ubiquitin- and ATP-dependent unfoldase activity of P97/VCP•NPLOC4•UFD1L1 is enhanced by a mutation that causes multisystem proteinopathy
Authors: Blythe Emily E. , Olson Kristine C. , Chau Vincent , Deshaies Raymond J.
Published: April 2017

p97 is a ‘segregase’ that plays a key role in numerous ubiquitin-dependent pathways, such as ER-associated degradation (ERAD). It has been hypothesized that p97 extracts proteins from membranes or macromolecular complexes to enable their proteasomal degradation; however, the complex nature of p97 substrates has made it difficult to directly observe the fundamental basis for this activity. To address this issue, we developed a soluble p97 substrate—Ub-GFP modified with K48-linked ubiquitin chains—for in vitro p97 activity assays. We demonstrate for the first time that wild type p97 can unfold proteins and that this activity is dependent on the p97 adaptor NPLOC4-UFD1L, ATP hydrolysis, and substrate ubiquitination, with branched chains providing maximal stimulation. Furthermore, we show that a p97 mutant that causes inclusion body myopathy, Paget’s Disease of bone, and frontotemporal dementia (IBMPFD) in humans unfolds substrate faster, suggesting that excess activity may underlie pathogenesis. This work overcomes a significant barrier in the study of p97 and will allow the future dissection of p97 mechanism at a level of detail previously unattainable.
Special section: advancing customer experience and big data impact via academic–practitioner collaboration
Authors: Burton Jamie , Nasr Linda , Gruber Thorsten , Bruce Helen L.
Published: April 2017

Purpose

This paper aims to outline the purpose, planning, development and delivery of the “1st Academic-Practitioner Research with Impact workshop: Customer Experience Management (CEM) and Big Data” held at Alliance Manchester Business School on 18th and 19th January 2016, at which four subsequent papers were initially developed.

Design/methodology/approach

The paper sets out a summary of the importance and significance of the four papers developed at the workshop and how the co-creative dialogue between managerial practitioners, presenting key problems and issues that they face, and carefully selected teams of academics was facilitated.

Findings

To develop richer and more impactful understanding of current problems challenging customer-focused managers, there is a need for more dialogue and engagement between academics and practitioners.

Practical implications

The paper serves as a guideline for developing future workshops that aim at strengthening the links between academia and the business world.

Originality/value

This paper highlights the value of academic–practitioner workshops for focusing academic research on areas of importance for practitioners to generate impact. The innovative format of the workshop and the resulting impactful papers should serve as a call and motivation for future academic–practitioner workshop development.
Alternative measures of satisfaction and word of mouth
Authors: Sivadas Eugene , Jindal Rupinder Paul
Published: April 2017

Purpose

Scholars have conceptualized and measured customer satisfaction in several different ways such as overall satisfaction and relative satisfaction. This paper aims to study if how one conceptualizes customer satisfaction matters. The authors study if key attributes of customer satisfaction differ in their impact based on how satisfaction is conceptualized. Furthermore, they examine the effects of these alternative measures of satisfaction on word of mouth (WOM).

Design/methodology/approach

The authors conduct three survey studies: at a single independently owned restaurant (n = 248); across restaurants using a national sample of respondents (n = 208); and across apparel retailers using a local sample of respondents (n = 214). The authors analyzed data using iterative seemingly unrelated regression and recursive system of equations with correlated errors.

Findings

The core offering (food quality or merchandise quality) and service influence overall satisfaction about equally; however, influence of the core offering on relative satisfaction is more than that of service. Furthermore, while overall satisfaction influences WOM, relative satisfaction does not. Thus, focusing solely on the core offering to improve relative satisfaction may not be enough. Positive WOM is generated when customers are overall satisfied with the brand which demands both a superior core offering as well as high service. Firms should aim for overall best performance rather than merely better relative performance.

Originality/value

To the best of the authors’ knowledge, this is the first paper to simultaneously study these two alternative measures of customer satisfaction along with their antecedents and influence on WOM.
Emotional intelligence in front-line/back-office employee relationships
Authors: Kearney Treasa , Walsh Gianfranco , Barnett Willy , Gong Taeshik , Schwabe Maria , Ifie Kemefasu
Published: April 2017

Purpose

This paper aims to undertake a simultaneous assessment of interdependence in the behaviours of front-line and back-office employees and their joint effect on customer-related organisational performance. It also tests for a moderating influence of the emotional intelligence of front-line salespeople and back-office employees.

Design/methodology/approach

The sample comprises 105 front-line sales employees and 77 back-office employees. The customer-related organisational performance data come from a UK business-to-business (B2B) electronics company. With these triadic data, this study uses partial least squares to estimate the measurement and structural models.

Findings

Salespeople’s customer orientation directly affects customer-related organisational performance; the relationship is moderated by salespeople’s emotional intelligence. The emotional intelligence of salespeople also directly affects the customer-directed citizenship behaviour of back-office employees. Furthermore, the emotional intelligence of back-office staff moderates the link between the emotional intelligence of salespeople and back-office staff citizenship behaviour. Back-office staff citizenship behaviour, in turn, affects customer-related organisational performance.

Originality/value

The emotions deployed by employees in interactions with customers clearly shape customers’ perceptions of service quality, as well as employee-level performance outcomes. However, prior literature lacks insights into the simultaneous effects of front-line and back-office employee behaviour, especially in B2B settings. This paper addresses these research gaps by investigating triadic relationships – among back-office employees, front-line employees and customer outcomes – in a B2B setting, where they are of particular managerial interest.
Does corporate social responsibility matter to financial service representatives in faith-expressive firms?
Authors: Al-Wugayan Adel A.A.
Published: April 2017

Purpose

This paper aims to investigate the conceptual and empirical effects of corporate social responsibility (CSR) on affective and behavioral inclinations of financial service representatives (FSRs) in faith-expressive (FE) banks and financial institutions in non-Western markets.

Design/methodology/approach

Drawing upon recent CSR research findings, this study proposed a conceptual model of the association between FSRs’ perceptions of the firm’s CSR toward stakeholders with FSRs’ affective attachment, work engagement and proactive work inclinations using survey data (n= 175). Pre-analysis procedures were applied followed by structural equation modeling to test the hypotheses.

Findings

FSRs were more emotionally attached to the firm when CSR initiatives were directed at them or toward social organizations, but were generally ambivalent to CSR directed to suppliers or competition. As firm attachment becomes stronger, propensity to engage in work and proactive work behaviors increases.

Research limitations/implications

This paper improves management understanding and sensitivity to managing the service salesforce in FE firms as emerging organizations. Future research can focus on actual measures of job performance and on comparative results when applied to traditional financial firms.

Practical implications

Marketing managers relying on CSR to motivate FSRs should realize its limitations when applied to FE firms. Qualitative approaches to solicit stakeholders’ input are encouraged to improve CSR performance.

Originality/value

In non-Western FE firms, strategizing CSR initiative spending should include its potential impact on service employees dealing with customers with particular attention to firm attachment, and inclination to excel in service providing.
Can We Help?: Kids Volunteering to Help Their Communities
Authors: Swain Holly Hilboldt , Chapman Meagan Roberts
Published: April 2017

Purpose

The purpose of this paper is to allow students to explore the role of volunteerism in their communities as they become community helpers through a service learning project to engage in action within their local areas. This lesson introduces various social studies concepts of civic responsibility while allowing students to think critically and examine their own feelings of empathy and ways to enact these feelings to help others.

Design/methodology/approach

Students create a class service project after they explore the content of the trade book and related resources and teach and learn with one another about helping their communities. Students will expand their learning and apply critical thinking as they note similarities and differences in community helpers’ abilities and their own abilities while they identify themselves as citizens of a community.

Findings

Findings include actively engaged students independently and cooperatively participating in meaningful and relevant learning. The lessons are designed so that they may be differentiated for differing needs of early childhood students and for students with special needs. Further, the lessons encourage an interdisciplinary approach to teaching social studies in the early grades.

Originality/value

The value of this lesson is apparent in the way it allows early childhood students and students with special needs to recognize their own roles as volunteers and agents of change in their communities. This lesson provides ample support for teachers working with early childhood students and students with special needs who may have few experiences with service learning prior to these lessons.
Social justice through citizenship education: a collective responsibility
Authors: Fry Sara Winstead , O’Brien Jason
Published: April 2017

Purpose

Existing research suggests that preservice elementary teachers tend to believe “good” citizens are people who follow laws and help others rather than people who embrace a more active model of citizenship that includes working to improve society. The purpose of this paper is to propose that this trend results from a self-perpetuating cycle of passive citizenship that develops in part due to state curriculum standards and school experiences which focus on transmitting knowledge rather than preparing students to be active agents of change.

Design/methodology/approach

The paper presents the results of action research conducted in a teacher preparation course; the research was designed to investigate the impact of a systematic effort to see if preservice teachers’ perspectives could be broadened to include a social justice perspective.

Findings

As a result of the findings, the authors argue that to counteract the cycle of passive citizenship, education to create a more socially just world must be a collective responsibility shared by teachers at all levels, K-16.

Originality/value

This is original research that examines an approach to end a cycle of passive citizenship by promoting social justice.