bluuebunny/crossref_metadata_2025 huggingface dataset:
Risk Management
Authors: Lippmann Morton , Schlesinger Richard B.
Published: October 2017

This chapter describes the means that have been and can be used as management tools to limit chemical emissions and exposures to humans and other receptors that result in adverse effects. They include top-down mandates specified in enforceable exposure and/or emission standards (regulatory controls), bottom-up approaches involving control of access or requirements for the use of personal protective equipment (administrative controls), and various technologies that limit the use of chemicals (e.g., materials substitution) and/or capture and treat chemical wastes before their emissions to environmental media (engineering controls).
Our Environmental Future
Authors: Lippmann Morton , Schlesinger Richard B.
Published: October 2017

This chapter describes the rapid growth in human populations, standard of living, chemical pollutant emissions, and ability to protect human health and welfare, while dealing with the growing stresses on aquatic and terrestrial ecosystems during the past century. It also discusses the need to, and means of anticipating the drivers of resource cosumption and usage, the and practical means that can be applied to harness our emerging technological capabilities in order to limit future chemical emissions and their capacity to cause adverse effects on human health and welfare.
Valve disease in critical illness
Authors: Colebourn Claire , Newton Jim
Published: October 2017

This chapter describes the pathophysiology and methods of assessment of valve lesions affecting the aortic and mitral valves. It describes the management of these valve lesions in the critical care setting and guides decision-making about the impact of the valve lesion on the critical illness. The diagnosis and management of infective endocarditis are described in detail.
Field guide to critical care echocardiography
Authors: Colebourn Claire , Newton Jim
Published: October 2017

This chapter is intended as a summary or reference for clinician echocardiographers at the bedside. It gives step-by-step algorithms which address both commonly asked questions and clinical situations which require rapid decision-making using echocardiography in the critically ill. These algorithms cover fluid status and fluid responsiveness, cardiovascular parameters, assessment of the shocked and breathless patient including trauma, assessment of the patient with a clinical diagnosis of pulmonary embolism, and assessment of the unwell obstetric patient and patients who are weaning from mechanical ventilatory support.
Clinical approach
Authors: Forsyth Rob , Newton Richard
Published: October 2017

This chapter addresses consultation management and clinical method. It describes how to put families at ease and enable them to get all they hope from the encounter. It suggests an approach and language to use in difficult situations: the dying child, giving bad news, and bereavement. It offers guidance on clinical examination of central and peripheral nervous systems in newborn and older children. A real-world approach to quick neurological examinations is given. It encourages a synthesis of historical and clinical findings into a differential diagnosis, first siting the lesion, then defining the cause. This promotes the formulation of efficient and effective investigation and treatment plans as the essence of the clinical process.
Emergencies
Authors: Forsyth Rob , Newton Richard
Published: October 2017

This chapter offers practical information on the management of emergencies in paediatric neurology. A step-by-step guide is given to immediate assessment, differential diagnosis, intervention, investigation, and treatment. The common scenarios addressed are acute agitation; coma; convulsive status epilepticus; status dystonicus; sudden onset visual loss, and the child who suddenly stops walking.
The metabolic syndrome in schizophrenia
Authors: Castle David J. , Buckley Peter F. , Gaughran Fiona P.
Published: October 2017

The metabolic syndrome (MS) is a constellation of risk factors including increased waist circumference, high blood pressure, and elevated fasting glucose and triglycerides in conjunction with low levels of high-density lipoprotein. MS is associated with an elevated risk of adverse cardiovascular and other events. The general population rate of MS is increasing, but people with schizophrenia have markedly elevated rates compared to people without a mental illness. Reasons for this excess are complex, but certain antipsychotic agents can exacerbate risk and due care needs to be taken in prescribing such medications, with awareness of longitudinal risk. Treatment needs to be provided following established guidelines, to address aspects of MS should they occur.
A comprehensive monitoring approach to physical healthcare in people with schizophrenia
Authors: Castle David J. , Buckley Peter F. , Gaughran Fiona P.
Published: October 2017

Monitoring of sentinel physical health issues should be part of the routine clinical care of people with schizophrenia and should include everyone involved, not least the patients’ general practitioners and patients themselves. All too often, however, appropriate ongoing monitoring is not part of usual clinical practice, and patients with psychotic disorders continue to have their physical health problems under-recognized and under-treated. There are numerous barriers to effective monitoring, and these operate at a systems level, clinical level, and patient level. Understanding of these barriers and negotiating them is vital and needs to be responsive to individual circumstances. This chapter provides a number of tools that can assist comprehensive longitudinal monitoring and involve the patient in the process. Clinicians and systems need to ensure such procedures and care pathways are delivered upon and continually audited and updated as required.
Interventions for metabolic problems in people with schizophrenia
Authors: Castle David J. , Buckley Peter F. , Gaughran Fiona P.
Published: October 2017

To address the risk factors associated with early death in people with schizophrenia, a comprehensive framework is required. This is required to address individuals, systems, and the community. A number of specific frameworks are available to provide better physical health treatments for people with schizophrenia. The most effective of these embrace elements of self-management and self-efficacy. The engagement of patients, carers, and clinicians requires concerted work and effective communication. Peer workers can play a particular role. Various medications can also be used to address specific aspects of the metabolic syndrome in particular, and care should be taken to try to choose (where feasible) antipsychotic medications with the lowest possible risk of metabolic syndrome.
Outcomes Following Endovascular versus Open Repair of Abdominal Aortic Aneurysm
Authors: Kuy SreyRam , Yang Kai J. , Dua Anahita
Published: October 2017

This chapter provides a summary of a landmark study in vascular surgery assessing whether endovascular repair of abdominal aortic aneurysm (AAA) improves short-term outcomes compared to traditional open repair. The OVER trial demonstrated comparable results at 2-year follow-up between the two groups. This chapter describes the basics of the study, including funding, year study began, year study was published, study location, who was studied, who was excluded, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, gives a summary and discusses implications, and concludes with a relevant clinical case.
Endovascular Aneurysm Repair versus Open Repair in Patients with Abdominal Aortic Aneurysm
Authors: Pearce F. Ben , Tan Tze-Woei , Zhang Wayne W.
Published: October 2017

This chapter provides a summary of the landmark EVAR Trial 1, which compared endovascular repair of abdominal aortic aneurysms (AAA) with open repair in patients judged to be fit for both open and endovascular repair. Although endovascular AAA (EVAR) repair was associated with lower perioperative complications and mortality than open surgical repair, after 4 years of follow-up the outcomes of the two approaches were similar. Follow-up at 15 years found EVAR had inferior late survival, necessitating lifelong surveillance of EVAR and reintervention if necessary. The chapter describes the basics of the study, including funding, year study began, year study was published, study location, who was studied, who was excluded, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, gives a summary and discusses implications, and concludes with a relevant clinical case.
Stenting versus Endarterectomy for Treatment of Carotid-Artery Stenosis
Authors: Schoolfield Clint S. , Zhang Wayne W. , Tan Tze-Woei
Published: October 2017

This chapter provides a summary of the landmark CREST study that compared carotid endarterectomy (CEA) and carotid artery stenting (CAS) for patients with symptomatic or asymptomatic carotid artery stenosis. The study found that the combined overall rate of stroke, myocardial infarction (MI) or death between CEA and CAS did not differ significantly in symptomatic or asymptomatic patients. However, during the perioperative period, CAS was associated with an increased risk of stroke and CEA was associated with an increased risk of MI. The chapter describes the basics of the study, including funding, year study began, year study was published, study location, who was studied, who was excluded, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, gives a summary and discusses implications, and concludes with a relevant clinical case.
Improved Survival with Preoperative Radiotherapy in Resectable Rectal Cancer
Authors: Dubose Arielle C. , Lee Benjamin D. , Kuy SreyRam
Published: October 2017

The landmark Swedish Rectal Cancer Trial examined whether preoperative radiation given to patients <80 years of age with resectable rectal cancer impacted rate of local recurrence and survival compared with immediate surgical resection. This trial demonstrated that neoadjuvant radiation therapy decreased rates of local and distant recurrence and improved survival. This chapter describes the basics of the study, including funding, year study began, year study was published, study location, who was studied, who was excluded, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, gives a summary and discusses implications, and concludes with a relevant clinical case.
Hospital Volume and Surgical Mortality in the United States
Authors: Gonzalez Andrew , Kuy SreyRam
Published: October 2017

This landmark study examined whether high-volume hospitals have better outcomes for major cardiovascular and oncologic surgery. The study found that patients undergoing major surgery in high-volume hospitals have significantly lower risk-adjusted mortality compared to other hospitals. However, there is wide variation in the difference in mortality across procedures. The chapter describes the basics of the study, including funding, year study began, year study was published, study location, who was studied, who was excluded, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, gives a summary and discusses implications, and concludes with a relevant clinical case.
Reducing Catheter-Related Bloodstream Infections in the Intensive Care Unit
Authors: Hochman Michael E.
Published: October 2017

This chapter provides a summary of the landmark study known as the Keystone ICU Project. Can rates of catheter-related bloodstream infections be reduced by implementing a safety initiative involving five simple infection-control measures by intensive care unit (ICU) staff? Starting with that question, it describes the basics of the study, including funding, year study began, year study was published, study location, who was studied, who was excluded, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, gives a summary and discusses implications, and concludes with a relevant clinical case on reducing catheter-related bloodstream infections in the ICU.
Sentinel Lymph Node Dissection versus Complete Axillary Dissection in Invasive Breast Cancer
Authors: Kwon Rachel J.
Published: October 2017

This chapter provides a summary of a landmark study in breast surgical oncology: the Z0011 trial. In patients with invasive breast cancer and positive sentinel lymph nodes, does complete axillary lymph node dissection improve survival relative to sentinel node dissection alone? Starting with that question, it describes the basics of the study, including funding, year study began, year study was published, study location, who was studied, who was excluded, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, gives a summary and discusses implications, and concludes with a relevant clinical case involving axillary dissection versus sentinel lymph node biopsy only.
Sentinel Lymph Node Biopsy versus Nodal Observation in Melanoma
Authors: Kwon Rachel J.
Published: October 2017

This chapter provides a summary of a landmark study in surgical oncology. In patients with melanoma who undergo wide excision, does sentinel lymph node biopsy improve survival versus nodal observation (a “wait-and-watch” approach)? Starting with that question, it describes the basics of the study, including funding, year study began, year study was published, study location, who was studied, who was excluded, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, discusses implications, and concludes with a relevant clinical case on sentinel lymph node biopsy versus nodal observation in melanoma.
Perioperative Chemotherapy versus Surgery Alone for Resectable Gastroesophageal Cancer
Authors: Manguso Nicholas , Burch Miguel
Published: October 2017

This chapter provides a summary of a landmark study in the management of gastric cancer (the MAGIC trial). Can the addition of perioperative chemotherapy to surgery improve outcomes in patients with potentially curable gastric cancer? Starting with this question, the chapter describes the basics of the study, including funding, year study began, year study was published, study location, study population, number of patients, study design, intervention, follow-up, endpoints, and criticisms. The chapter briefly reviews other relevant studies and information, gives a summary and discusses the implications and concludes with a clinical vignette to display how the study’s findings can be clinically applied.
Early versus Late Tracheostomy for Intubated Patients
Authors: Kwon Rachel J.
Published: October 2017

This chapter provides a summary of a landmark study in surgical critical care. Does early tracheostomy reduce mortality in ventilated critically ill patients? Starting with that question, it describes the basics of the study, including funding, year study began, year study was published, study location, who was studied, who was excluded, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, gives a summary and discusses implications, and concludes with a relevant clinical case on discussing the option of a tracheostomy with the family of a critically ill patient.
Early Goal-Directed Therapy in Sepsis
Authors: Hochman Michael E.
Published: October 2017

This chapter provides a summary of a landmark study in surgical critical care. Does immediate recognition and management of sepsis improve outcomes? Starting with that question, it describes the basics of the study, including funding, year study began, year study was published, study location, who was studied, who was excluded, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, gives a summary and discusses implications, and concludes with a relevant clinical case about treating a patient who presents to the emergency room with sepsis with early goal-directed therapy.
Laparoscopic versus Open Appendectomy
Authors: Kwon Rachel J.
Published: October 2017

This chapter provides a summary of a landmark study in minimally invasive surgery. Compared with open appendectomy, does laparoscopic appendectomy for acute appendicitis offer any advantage with respect to recovery, complications, or return to normal activities? Starting with that question, it describes the basics of the study, including year study was published, study location, who was studied, who was excluded, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, gives a summary and discusses implications, and concludes with a relevant clinical case involving laparoscopic appendectomy for a patient with acute appendicitis.
Laparoscopic Nissen Fundoplication for GERD
Authors: Kwon Rachel J.
Published: October 2017

This chapter provides a summary of a landmark study in minimally invasive surgery. How does laparoscopic Nissen fundoplication compare to an open surgical procedure in patients with gastroesophageal reflux disease with respect to reflux symptoms and reoperation rates? Starting with that question, it describes the basics of the study, including funding, year study began, year study was published, study location, who was studied, who was excluded, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, discusses implications, and concludes with a relevant clinical case on laparoscopic Nissen fundoplication.
Outcomes After Laparoscopic Splenectomy
Authors: Kwon Rachel J.
Published: October 2017

This chapter provides a summary of a landmark study in minimally invasive surgery. Compared with open splenectomy, what is the benefit of laparoscopic splenectomy? Starting with that question, it describes the basics of the study, including year study began, year study was published, study location, who was studied, who was excluded, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, gives a summary and discusses implications, and concludes with a relevant clinical case involving laparoscopic spleen removal in a patient with immune thrombocytopenia (ITP).
Bariatric Surgery versus Intensive Medical Therapy in Obese Patients with Diabetes
Authors: Choi Michael , Burch Miguel
Published: October 2017

This chapter provides a summary of a landmark study in bariatric surgery. In obese patients with uncontrolled type 2 diabetes, does bariatric surgery plus intensive medical therapy achieve improved glycemic control in significantly more patients than medical therapy alone? Starting with that question, this chapter describes the basics of the study, including funding, study location, who was studied, who was excluded, how many patients, study design, study intervention, follow-up, endpoints, results, criticisms, and limitations. The chapter also briefly reviews other relevant studies and information, discusses implications and concludes with a relevant clinical case about bariatric surgery for a morbidly obese female patient with a BMI of 37 and type 2 diabetes.
Internal Mammary Artery Ligation versus Sham Sternotomy for Angina Pectoris
Authors: Catanzaro Michael P.
Published: October 2017

This chapter provides a summary of a landmark historical study in cardiac surgery related to internal mammary artery ligation versus sham sternotomy for angina pectoris. It describes the history of the procedure and a summary of the study including study design and results, and relates the study to a modern-day principle of evidence-based medicine: blinding and sham surgery. Whether or not sham surgery is ethical remains under debate. Proponents for sham surgery agree that it should be used only when a question cannot be answered adequately by other methods. Cobb and his colleagues were among the first to demonstrate the value of sham studies in addressing important clinical questions.
Antibiotics
Authors: Török M. Estée , Cooke Fiona J. , Moran Ed
Published: October 2017

This chapter provides a systematic summary of antibiotics, primarily those used in bacterial infections, grouped by class and mechanism of action. Each summary provides information on the mode of action, mechanisms of resistance, pharmacology, and clinical use.
Viruses
Authors: Török M. Estée , Cooke Fiona J. , Moran Ed
Published: October 2017

This chapter provides an overview of viruses, starting with the basics of virology, before moving on to a systematic overview of each virus, covering important aspects of epidemiology, pathogenesis, clinical features of infection, diagnosis, and treatment and prevention. This chapter also includes prion disease, even if the causative agent is not a virus.
Helminths
Authors: Török M. Estée , Cooke Fiona J. , Moran Ed
Published: October 2017

This chapter provides an overview of helminths, together with a systematic overview of each species, covering important aspects of epidemiology, pathogenesis, clinical features of infection, diagnosis, and treatment and prevention.
Sexually transmitted infections
Authors: Török M. Estée , Cooke Fiona J. , Moran Ed
Published: October 2017

This chapter covers the diagnosis and management of sexually transmitted infections, including bacterial vaginosis, with causes including vaginal discharge, vulvovaginal candidiasis, and trichomoniasis. The chapter also covers vulvovaginal candidiasis, genital warts or anogenital warts caused by human papillomavirus, tropical genital ulceration (which is commoner in patients presenting with sexually transmitted infections in the developing world and is an important factor in the spread of HIV), genital herpes, pelvic inflammatory disease, toxic shock syndrome, gonorrhoea, chlamydia, trichomoniasis, and syphilis.
Pregnancy and childhood
Authors: Török M. Estée , Cooke Fiona J. , Moran Ed
Published: October 2017

This chapter covers congenital infections, maternal infections associated with neonatal morbidity, management of rash contact in pregnancy, rash illnesses in pregnancy, prevention of congenital and perinatal infections, chorioamnionitis, puerperal sepsis, neonatal sepsis, viral causes of childhood illness, enteroviral infections, and bacterial causes of childhood illness.
A History of Borderline Personality Disorder
Authors: New Antonia S. , Triebwasser Joseph
Published: October 2017

Borderline personality disorder (BPD) is complex and its phenomenology is hard to define, contributing to the view that it is not a “real” disorder. Yet increasingly powerful research suggests that it is both “real” and disabling, with high morbidity and even mortality. A review of the disorder’s history helps to shed light on the possible confusion surrounding the diagnosis and also provide insight into what has been consistently observed through different iterations of the disorder. The term “borderline personality disorder” has its origins in decades-old responses to a then bewildering, previously unrecognized patient population. This chapter presents the history of the name “borderline personality disorder” as well as historical case descriptions of individuals with symptoms that currently would be classified as BPD. It also considers the implications of the reclassification of “personality disorders” in DSM-5 into “Section 2” alongside disorders that have to date been placed on Axis I.
Clinical Phenomenology of Borderline Personality Disorder
Authors: Siever Larry
Published: October 2017

This chapter takes an in-depth look at the clinical phenomenology of borderline personality disorder (BPD); the core, essential dimensions that are widely recognized as part of this personality disorder; and will essentially examine what an individual with BPD looks like. Although research on mental illness is moving toward a more neurobiological approach to understanding illness, as we learn more about the brain and the ways in which it affects us, clinicians must maintain awareness of clinical phenomenology. The importance of learning the biological components of mental illness cannot be underscored enough, but as we learn what parts of the brain are activated during various mental activities, we need to be able to understand patients’ clinical manifestations of a disorder and the ways in which it directly affects their lives and the lives of those around them.
Genetic Influences on Borderline Personality Disorder
Authors: Distel Marijn A. , de Moor Marleen H. M.
Published: October 2017

Borderline personality disorder (BPD) tends to “run in families.” Twin and twin family studies show that BPD is moderately heritable, with some evidence for nonadditive gene action. BPD co-occurs with Axis I and other Axis II disorders, as well as with a certain profile of normal personality traits. Multivariate twin (family) studies have shown that these phenotypic associations are partly due to genetic associations, and this is observed most strongly for BPD and neuroticism. Candidate gene-finding studies for BPD suggest the possible role of genes in the serotonergic and dopaminergic system, but this needs to be confirmed in larger genome-wide studies. Future studies will complement the knowledge described in this chapter to enable us to move toward a comprehensive model of the development of BPD in which biological and environmental influences on BPD are integrated.
Substance Use Disorder in Borderline Personality Disorder
Authors: Brodsky Beth S. , Dimeff Linda
Published: October 2017

This chapter presents what is currently known about the comorbidity of substance use disorders (SUDs) and borderline personality disorder (BPD), outlines the ways in which substance use and SUDs have a unique clinical presentation within the context of BPD, and describes how the distinct features of SUDs in BPD inform conceptualization and the treatment approach. The high comorbidity of SUD in individuals diagnosed with BPD adds to the complexity of clinical presentation, symptom severity, and obstacles to treatment engagement and effectiveness. Dialectical behavior therapy (DBT), when modified for individuals with BPD, can be effective. This chapter reviews the increased risks, challenges, and obstacles to treatment presented by SUD-BPD comorbidity and describes efforts to adapt DBT to this population that have resulted in new interventions for treatment engagement, behavioral goal setting, and expansion of the standard frame of conducting psychotherapy that more directly target the specific challenges of treating SUD-BPD.
Borderline Personality Disorder and Mood Disorders
Authors: Fertuck Eric A. , Chesin Megan S. , Johnston Brian
Published: October 2017

Borderline personality disorder (BPD) and mood disorder (MD) can be difficult to differentiate from each other due to several overlapping clinical features. Among BPD symptoms, chronic dysphoria can be mistaken for major depression, while affective instability may be confused with the depressed and elevated mood episodes of bipolar disorder (BD). Conversely, in those with BPD, co-occurring MDs can be difficult to rigorously assess and treat. Even though there is moderate to high co-occurrence between these conditions, BPD and MDs have distinct facets of impulsivity, affective instability, and mood symptoms. Furthermore, BPD, MD, and their co-occurrence predict courses of illness, prognosis, treatment outcomes, and suicide risk. Consequently, thorough assessment and differential diagnosis of these conditions should inform treatment planning and clinical management in both BPD and MD.
Family Psychoeducation Approaches for Borderline Personality Disorder
Authors: Porr Valerie
Published: October 2017

This chapter provides a rationale for training family members of individuals with borderline personality disorder (BPD) to help them develop into therapeutic allies and treatment adjuncts. It also describes the experiences of family members in finding help for their loved ones with BPD and the family psychoeducation programs currently available for BPD and other disorders. By default, families often are the only alternative available to handle crisis situations since some individuals with BPD refuse to participate in therapy, have dropped out of therapy, or appropriate BPD services are not available in their communities. With an understanding of BPD, social support, and appropriate training, families can potentially develop as adjuncts and that can help improve treatment outcome
Assessing, Managing, and Resolving Suicide Risk in Borderline Personality Disorder
Authors: Carmel Adam , Sung Jeffrey , Comtois Katherine Anne
Published: October 2017

The aim of this chapter is to aid the clinician in managing and resolving suicidality by providing an overview of different theoretical approaches to conceptualizing, assessing, managing, and treating suicidal behaviors in borderline personality disorder (BPD). After a brief introduction to the evidence base for these treatments, the suicide risk management and treatment strategies are examined for five evidence-based psychotherapies designed for BPD. Psychotherapies for suicidal patients in general (not specific to BPD) are also considered. Finally, conclusions drawn from comparing and contrasting these psychotherapies focus on key themes to improve clinicians’ approach to patients with BPD at their most difficult time.
Cultural and Social Aspects of Emotion Regulation
Authors: Koydemir Selda , Essau Cecilia A.
Published: October 2017

Chapter 4 investigates how emotion regulation is a socially constructed, culturally influenced phenomenon. Investigating emotion regulation through a cultural lens provides a viable framework to differentiate social norms according to a larger social context. In Western cultures fostering autonomy and cultivating a positive personal self-concept is important for emotion regulation. In contrast, in non-Western cultures achieving harmony among relationships is the primary goal of emotion regulation. Cross-cultural research has determined both similarities and differences. Accordingly, empirical findings suggest emotion expression is common in Western cultures, whereas, suppression is common among Asian cultures. Relatedly, the same regulatory strategies have divergent effects in different cultures. Research has demonstrated the association between suppression and psychopathology in Western cultures; however, emotional suppression has been associated with positive health outcomes in East Asian cultures. Yet, cultures are often heterogeneous in nature, supporting both autonomy and harmony; thus, future research should consider intra-cultural differences more closely.
Quantifying the impact of mergers on the angular momentum of simulated galaxies
Authors: Lagos Claudia del P. , Stevens Adam R. H. , Bower Richard G. , Davis Timothy A. , Contreras Sergio , Padilla Nelson D. , Obreschkow Danail , Croton Darren , Trayford James W. , Welker Charlotte , Theuns Tom
Published: October 2017

We use eagle to quantify the effect galaxy mergers have on the stellar specific angular momentum of galaxies, jstars. We split mergers into dry (gas-poor)/wet (gas-rich), major/minor and different spin alignments and orbital parameters. Wet (dry) mergers have an average neutral gas-to-stellar mass ratio of 1.1 (0.02), while major (minor) mergers are those with stellar mass ratios ≥0.3 (0.1–0.3). We correlate the positions of galaxies in the jstars–stellar mass plane at z = 0 with their merger history, and find that galaxies of low spins suffered dry mergers, while galaxies of normal/high spins suffered predominantly wet mergers, if any. The radial jstars profiles of galaxies that went through dry mergers are deficient by ≈0.3 dex at r ≲ 10 r50 (with r50 being the half-stellar mass radius), compared to galaxies that went through wet mergers. Studying the merger remnants reveals that dry mergers reduce jstars by ≈30 per cent, while wet mergers increase it by ≈10 per cent, on average. The latter is connected to the build-up of the bulge by newly formed stars of high rotational speed. Moving from minor to major mergers accentuates these effects. When the spin vectors of the galaxies prior to the dry merger are misaligned, jstars decreases by a greater magnitude, while in wet mergers corotation and high orbital angular momentum efficiently spun-up galaxies. We predict what would be the observational signatures in the jstars profiles driven by dry mergers: (i) shallow radial profiles and (ii) profiles that rise beyond ≈10 r50, both of which are significantly different from spiral galaxies.
Caring for Cows in a Time of Rinderpest: Non-academic Veterinary Practitioners in the County of Flanders, 1769–1785
Authors: Van Roosbroeck Filip
Published: October 2017

Non-academically trained practitioners of early modern veterinary medicine are still commonly described in decidedly unflattering terms; their practices often conceived of as folkloristic or otherwise static and unchanging. This article examines a group of such veterinary practitioners in the county of Flanders, known as cow masters. It argues that the medicine they practised was theoretically sophisticated and in line with contemporary mainstream medicine, while they made use of a variety of newly available chemical and exotic remedies. It is postulated that these newer remedies augmented the market for specialised practitioners, which has important implications for the history of medicine as a whole.
Geographic Variance of Cost Associated With Hysterectomy
Authors: Sheyn David , Mahajan Sangeeta , Billow Megan , Fleary Alexandra , Hayashi Emi , El-Nashar Sherif A.
Published: October 2017

(Abstracted from Obstet Gynecol 2017;129:844–853)

With recent changes in access to health care services and the aging populations in the United States, increasing attention is being given to understanding factors contributing to the cost of health care. A recent study conducted by the National Academy of Medicine assessed Medicare costs across the country and found significant geographic variation in cost in the United States.
Anesthetic Cream Use During Office Pessary Removal and Replacement: A Randomized Controlled Trial
Authors: Taege Susanne K. , Adams William , Mueller Elizabeth R. , Brubaker Linda , Fitzgerald Colleen M. , Brincat Cynthia
Published: October 2017

(Abstracted from Obstet Gynecol 2017;130:190–197)

An inexpensive, nonsurgical treatment option for pelvic organ prolapse and stress urinary incontinence is the vaginal pessary; these are especially for women with severe medical comorbidities that make them poor surgical candidates. Although attempts at pessary fitting are successful in nearly 90% of patients, approximately half discontinue use within 24 months after fitting.
Effect of an Internet-Based Program on Weight Loss for Low-Income Postpartum Women: A Randomized Clinical Trial
Authors: Phelan Suzanne , Hagobian Todd , Brannen Anna , Hatley Karen E. , Schaffner Andrew , Muñoz-Christian Karen , Tate Deborah F.
Published: October 2017

(Abstracted from JAMA 2017;317(23):2381–2391)

Postpartum weight retention increases the lifetime risk of obesity, and this risk seems to be highest among low-income women. The current clinical trial aimed to test if an Internet-based weight loss program in addition to a special supplemental nutrition program for women, infants, and children (WIC program) could aid low-income postpartum women in greater weight loss than the WIC program alone.
Buprenorphine for the Treatment of the Neonatal Abstinence Syndrome
Authors: Kraft Walter K. , Adeniyi-Jones Susan C. , Chervoneva Inna , Greenspan Jay S. , Abatemarco Diane , Kaltenbach Karol , Ehrlich Michelle E.
Published: October 2017

(Abstracted from N Engl J Med 2017;376:2341–2348)

Neonates born to women who are addicted to opioids are at high risk of developing neonatal abstinence syndrome (NAS). Traditional treatment commonly includes the use of morphine, but this treatment often leads to a prolonged hospitalization.
Estimated Perinatal HIV Infection Among Infants Born in the United States, 2002–2013
Authors: Taylor Allan W. , Nesheim Steven R. , Zhang Xinjian , Song Ruiguang , FitzHarris Lauren F. , Lampe Margaret A. , Weidle Paul J. , Sweeney Patricia
Published: October 2017

(Abstracted from JAMA Pediatr 2017;171(5):435–442)

Robust interventions to prevent perinatal human immunodeficiency virus (HIV) transmission are well understood and have been available for a number of years. Reduction of maternal HIV viral load using antiretroviral (ARV) therapeutics has become accepted practice in pregnant women similarly to how it is used in nonpregnant women.
Etiology and Clinical Presentation of Birth Defects: Population Based Study
Authors: Feldkamp Marcia L. , Carey John C. , Byrne Janice L. B. , Krikov Sergey , Botto Lorenzo D.
Published: October 2017

(Abstracted from BMJ 2017;357:j2249)

Major birth defects occur in 1 in 33 births and are the leading cause of infant mortality in the United States. Birth defects are an increasing public health challenge because of their worldwide societal impact and relatively static occurrence rates despite widespread medical advancements.
Operative versus nonoperative management of pediatric type 1 open forearm fractures: a retrospective review
Authors: Goss David A. , Mundy Andrew , Beebe Allan C. , Klingele Kevin E. , Balch Samora Julie , Samora Walter P.
Published: October 2017

Background:

Considerable debate exists regarding the management of type 1 open forearm fractures in the pediatric population. The purpose of this study was to compare outcomes of nonoperative with operative treatment, and specifically to determine if there are differences in infection rates and complications.

Methods:

We retrospectively reviewed 155 consecutive type 1 open fractures treated at a single large pediatric hospital from 1995-2013. Inclusion criteria were patients younger than 18 yr of age with type 1 open forearm fractures with a minimum of 6 mo follow-up. Exclusion criteria were patients with type 2 or 3 injuries, inadequate documentation, and less than 6 mo follow-up.

Results:

From 1995-2013, 19,455 fractures of the forearm were treated. We identified 185 type 1 open fractures, 30 of which were excluded for inadequate follow-up or documentation. One hundred and nineteen patients were managed nonoperatively, and 36 patients were managed operatively with a mean age of 8.8 and 11.2 yr, respectively. There was a 0% infection rate in the nonoperative group. One patient in the operative group developed an infected nonunion. Initial sagittal deformity for the operative and nonoperative groups was 18.8 and 24.7 degrees. Residual deformity at final follow-up was significantly higher in the nonoperative group in both sagittal (P=0.031) and coronal (P=0.017) planes, although all patients fell within accepted parameters. Other than infection rate, there were no differences in complications between the two groups. The overall infection rate was 0.65%, with a 0% infection rate in the nonoperative group. Operations were performed more frequently in older children.

Conclusions:

Our results indicate that nonoperative management of type 1 open fractures in the pediatric population can be safe and effective.
Limb salvage in the upper limb: a review
Authors: White Thomas Christopher Haydon , MacInnes Scott J. , Sita-Lumsden Ailsa Roberg , Carey Smith Richard
Published: October 2017

Limb salvage has replaced amputation as the mainstay of treatment for upper limb primary sarcomas, metastases, complex limb reconstruction in arthroplasty, and as salvage after trauma. There is currently no consensus as to the optimal reconstructive technique. Regardless of the technique used, however, there may be functional impairment. Limb salvage options after significant tissue loss include allograft, allograft and prosthesis hybrid, and endoprostheses. Allografts provide good soft-tissue reconstruction options but have been associated with higher complication rates than allograft and prosthesis hybrids and endoprosthesis. The optimal method of proximal humeral reconstruction remains controversial. Reconstruction while preserving abductor and rotator cuff function provides the best functional stability. In the absence of a rotator cuff with preservation of the axillary nerve and deltoid, reverse shoulder arthroplasty provides good results. When wider resection is required, tendon transfers have not been shown to improve stability or function, and in this setting a constrained prosthesis should be considered.
The role of expandable prostheses
Authors: Benevenia Joseph , Steadman Peter , Ippolito Joseph
Published: October 2017

In skeletally immature individuals who require wide tumor resection with removal of an active physis, an expandable prosthesis can be used for limb salvage. These prostheses first became available in the early 1980s for patients with primary oncologic disease; however, the early designs were plagued with mechanical failure. Later designs employed ball-bearing mechanisms and a C-collar mechanism for an interposition spacer. By the mid 1990s a minimally invasive expandable prosthesis became available in which expansion was achieved through a small incision. With each new innovation, a decrease in the complication rate was noted; however, problems still occurred with the surgical procedure that was required for each lengthening. By the early 2000s, noninvasive lengthening was innovated by the application of an external electromagnetic field, with the advantages being more frequent expansions in smaller increments, minimal patient discomfort, and no operations necessary. Although the complication rate for lengthening decreased, these designs reported a high mechanical failure rate. Nevertheless, these designs were improved upon, with mean MSTS scores of 82% to 85% and satisfactory functional outcomes. One of the notable problems with expandable prostheses has been infection, with the risk of infection increasing by 5% per lengthening. The utility of specific coatings, such as silver, has been investigated. Because expandable implants are designed for pediatric patients, their longevity is still a concern.
What did we learn from ‘omics’ studies in osteoarthritis
Authors: Ruiz-Romero Cristina , Rego-Perez Ignacio , Blanco Francisco J.
Published: October 2017

Purpose of review

‘Omics’ technologies developed for the massive analysis of the major biologically relevant molecules (genes, proteins, metabolites) have been applied to the study of osteoarthritis (OA) for more than a decade.

Recent findings

‘Omics’ studies have undoubtedly contributed to increase the knowledge on pathogenic processes related with OA and have provided hundreds to thousands of molecules that might have a putative biomarker utility for this disease.

This review describes the most recent ‘omics’ studies in OA research, their conclusions, and discuss those remaining challenges. Still many validation studies must be performed in large and well-characterized cohorts for the translation of the findings from ‘omics’ strategies to clinical applications. The development of tools for the intelligent integration of ‘omics’ data with clinical and imaging information is also mandatory to take full profit of the work that has been already performed.
Magnetic Resonance Neurography of the Lumbosacral Plexus in Failed Back Surgery Syndrome
Authors: Dessouky Riham , Khaleel Mohammed , Khalifa Dalia N. , Tantawy Hazim I. , Chhabra Avneesh
Published: October 2017

Study Design.

Retrospective clinical case series.

Objective.

To study the role of magnetic resonance neurography (MRN) of the lumbosacral plexus in management of patients with failed back surgery syndrome (FBSS).

Summary of Background Data.

FBSS is one of the major problems in health care, affecting up to 40% of patients after spine surgery. To date, no imaging modality has been used to effectively classify nerve compression, because nerve injuries are challenging to detect on conventional lumbar spine magnetic resonance imaging (MRI). To our knowledge, no previous studies have addressed the use of MRN in FBSS or compared it to lumbar spine MRI.

Methods.

From 203 consecutive 3 T MRN studies of lumbosacral plexus in 1 year, 12% (25/203) presented as FBSS. Demographic data, number of previous lumbar MRIs and their findings, MRN findings, interval between MRI and MRN, pre-and post-MRN diagnosis, pain levels, and treatments were recorded. Changes in diagnosis, treatment, and outcomes after MRN were determined.

Results.

The final sample of 25 patients had a mean age 62 ± 15 and male to female ratio 1:1.08. Approximately 88% (22/25) had previous lumbar MRI, of which 27% had 3 or more. Most common imaging findings were neuroforaminal stenosis 22.6% (7/31) on MRI and neuropathy 22.9% (19/83) on MRN. Mean interval between MRI and MRN was 13.9 ± 28.3 months. Lumbar MRIs were inconclusive in 36% (8/22). MRN detected 63% (52/83) more findings and changed the diagnosis and treatment in 12% and 48% of FBSS cases, respectively. Favorable outcomes were recorded in 40% to 67% of patients following MRN-guided treatments.

Conclusion.

FBSS is a complex problem and MRN of lumbosacral plexus impacts its management by better directing source of symptoms.

Level of Evidence: 4