bluuebunny/crossref_metadata_2025 huggingface dataset:
Biomarkers of stroke recovery: Consensus-based core recommendations from the Stroke Recovery and Rehabilitation Roundtable
Authors: Boyd Lara A , Hayward Kathryn S , Ward Nick S , Stinear Cathy M , Rosso Charlotte , Fisher Rebecca J , Carter Alexandre R , Leff Alex P , Copland David A , Carey Leeanne M , Cohen Leonardo G , Basso D Michele , Maguire Jane M , Cramer Steven C
Published: November 2017

The most difficult clinical questions in stroke rehabilitation are “What is this patient’s potential for recovery?” and “What is the best rehabilitation strategy for this person, given her/his clinical profile?” Without answers to these questions, clinicians struggle to make decisions regarding the content and focus of therapy, and researchers design studies that inadvertently mix participants who have a high likelihood of responding with those who do not. Developing and implementing biomarkers that distinguish patient subgroups will help address these issues and unravel the factors important to the recovery process. The goal of the present paper is to provide a consensus statement regarding the current state of the evidence for stroke recovery biomarkers. Biomarkers of motor, somatosensory, cognitive and language domains across the recovery timeline post-stroke are considered; with focus on brain structure and function, and exclusion of blood markers and genetics. We provide evidence for biomarkers that are considered ready to be included in clinical trials, as well as others that are promising but not ready and so represent a developmental priority. We conclude with an example that illustrates the utility of biomarkers in recovery and rehabilitation research, demonstrating how the inclusion of a biomarker may enhance future clinical trials. In this way, we propose a way forward for when and where we can include biomarkers to advance the efficacy of the practice of, and research into, rehabilitation and recovery after stroke.
Behind closed doors: The role of debriefing and feedback in a professional rugby team
Authors: Middlemas Simon G , Croft Hayden G , Watson Fiona
Published: November 2017

Despite the popularity of performance analysis with high performance rugby environments, limited attention has been paid to understanding how coaches and practitioners use this information to impact on performance. The aim of this case study was to gain an in-depth understanding of how a professional rugby team – playing in New Zealand’s ITM cup competition – uses the post-match and pre-match meetings to debrief after performance and preview prior to future performance. Multiple ethnographic techniques were employed to generate a comprehensive picture of the phenomena, including participant observation, video recordings, formal and informal interviews, field notes, descriptive statistics and document analysis. Each meeting was transcribed separately and analysed using an inductive content analysis process and themes were identified. The case study explores how four key factors – the role of the coach-facilitator, player engagement, leadership and the balance between reflection and preparation – impact on the debrief/preview process. The findings reveal that while considerable emphasis was placed on the importance of player learning and engagement in team meetings, delivery was often ad hoc, coach-driven and results-focused.
Beliefs about smoking-related lung cancer risk among low socioeconomic individuals: the role of smoking experience and interpersonal communication
Authors: Bekalu Mesfin Awoke , Minsky Sara , Viswanath Kasisomayajula
Published: November 2017

Introduction:

Previous research has documented that smoking prevalence is generally high among low socioeconomic groups and that tobacco industries continue to target these population groups. However, little research has investigated the beliefs of individuals with low socioeconomic position (SEP) about the association between smoking and cancer risks. In this study, we examined beliefs about smoking-related lung cancer risk and the role of smoking experience, mass media exposure and health-related interpersonal communication among a sample of low SEP population.

Methods:

Data were gathered from 324 urban poor recruited from adult education centers in the greater Boston area, Massachusetts, USA as part of a larger project called Click to Connect. While we collected a variety of data at baseline and follow-up, the data for this study come from the baseline survey alone.

Results:

We found that individuals with smoking experience tend to be better than those without in perceiving the lung cancer risks of smoking. Moreover, we found that health-related interpersonal communication with friends and family members is positively associated with beliefs about the link between smoking and lung cancer.

Conclusion:

Our findings suggest that low SEP individuals with smoking experience might be more exposed to anti-tobacco messages than are low SEP individuals without smoking experience. This could suggest that anti-tobacco interventions thus far may have done very little in raising the awareness of low SEP nonsmokers about the dangers of smoking and that they may have little potential to avert the initiation of smoking in this population.
Big data analysis of economic news
Authors: Elshendy Mohammed , Fronzetti Colladon Andrea
Published: November 2017

We propose a novel method to improve the forecast of macroeconomic indicators based on social network and semantic analysis techniques. In particular, we explore variables extracted from the Global Database of Events, Language, and Tone, which monitors the world’s broadcast, print and web news. We investigate the locations and the countries involved in economic events (such as business or economic agreements), as well as the tone and the Goldstein scale of the news where the events are reported. We connect these elements to build three different social networks and to extract new network metrics, which prove their value in extending the predictive power of models only based on the inclusion of other economic or demographic indices. We find that the number of news, their tone, the network constraint of nations and their betweenness centrality oscillations are important predictors of the Gross Domestic Product per Capita and of the Business and Consumer Confidence indices.
Gender-Inclusive Bathrooms Signal Fairness Across Identity Dimensions
Authors: Chaney Kimberly E. , Sanchez Diana T.
Published: November 2017

While gender-inclusive bathrooms serve a practical function of providing a safe public restroom for transgender individuals, they may also signal identity safety for women and racial minorities who may experience identity threat in organizations. Across three studies, we demonstrated that women (Study 1) and racial minorities (Blacks, Latinos; Studies 2 and 3) report greater procedural fairness and a more positive gender (Study 1) or racial (Studies 2 and 3) climate in organizations with gender-inclusive bathrooms compared to traditional bathrooms. Further, these effects were due to companies with gender-inclusive bathrooms being perceived as lower in gender essentialism (Studies 1–3), signaling more egalitarian social environments (Study 3) and promoting identity safety across stigmatized identity dimensions.
Twitter and Facebook are not representative of the general population: Political attitudes and demographics of British social media users
Authors: Mellon Jonathan , Prosser Christopher
Published: November 2017

A growing social science literature has used Twitter and Facebook to study political and social phenomena including for election forecasting and tracking political conversations. This research note uses a nationally representative probability sample of the British population to examine how Twitter and Facebook users differ from the general population in terms of demographics, political attitudes and political behaviour. We find that Twitter and Facebook users differ substantially from the general population on many politically relevant dimensions including vote choice, turnout, age, gender, and education. On average social media users are younger and better educated than non-users, and they are more liberal and pay more attention to politics. Despite paying more attention to politics, social media users are less likely to vote than non-users, but they are more likely to support the left leaning Labour Party when they do vote. However, we show that these apparent differences mostly arise due to the demographic composition of social media users. After controlling for age, gender, and education, no statistically significant differences arise between social media users and non-users on political attention, values or political behaviour.
Performance of Pediatric Risk of Mortality Score Among Critically Ill Children With Heart Disease
Authors: Russell Rebecca A. , Rettiganti Mallikarjuna , Brundage Nancy , Jeffries Howard E. , Gupta Punkaj
Published: November 2017

Objective:

To evaluate the performance of the Pediatric Risk of Mortality 3 (PRISM-3) score in critically ill children with heart disease.

Methods:

Patients <18 years of age admitted with cardiac diagnoses (cardiac medical and cardiac surgical) to one of the participating pediatric intensive care units in the Virtual Pediatric Systems, LLC, database were included. Performance of PRISM-3 was evaluated with discrimination and calibration measures among both cardiac surgical and cardiac medical patients.

Results:

The study population consisted of 87,993 patients, of which 49% were cardiac medical patients (n = 43,545) and 51% were cardiac surgical patients (n = 44,448). The ability of PRISM-3 to distinguish survivors from nonsurvivors was acceptable for the entire cohort (c-statistic 0.86). However, PRISM-3 did not perform as well when stratified by varied severity of illness categories. Pediatric Risk of Mortality 3 underpredicted mortality among patients with lower severity of illness categories (quintiles 1-4) whereas it overpredicted mortality among patients with greatest severity of illness category (fifth quintile). When stratified by Society of Thoracic Surgeons–European Association for Cardiothoracic Surgery (STS-EACTS) categories, PRISM-3 overpredicted mortality among the STS-EACTS mortality categories 1, 2, and 3 and underpredicted mortality among the STS-EACTS mortality categories 4 and 5. Pediatric Risk of Mortality 3 overpredicted mortality among centers with high cardiac surgery volume whereas it underpredicted mortality among centers with low cardiac surgery volume.

Conclusion:

Data from this large multicenter study do not support the use of PRISM-3 in cardiac surgical or cardiac medical patients. In this study, the ability of PRISM-3 to distinguish survivors from nonsurvivors was fair at best, and the accuracy with which it predicted death was poor.
Identifying the Complex Position of Research Data and Data Sharing Among Researchers in Natural Science
Authors: Kurata Keiko , Matsubayashi Mamiko , Mine Shinji
Published: November 2017

This article aims to provide an overview of researchers’ practices and perceptions on data use and sharing. Semistructured interviews were conducted with 23 Japanese researchers in the natural sciences to identify their research practices and data use, including data sharing. We divided the interview scripts into meaningful phrases as a unit of analysis. Next, we focused on 406 statements on research data and reanalyzed them based on four aspects: stance on research data, practices and perceptions of data use, range of data sharing, and data type. A cluster analysis identified 14 clusters, which were divided into five groups: open access for data, restricted access for data, data interpretation, data processing and preservation, and data infrastructure. Our results reveal the complexity and diversity of the relationship between data and research practices. That is, the practice of research data sharing is heterogeneous, with no “one size fits all” between and among researchers.
Toward Conceptualizing Race and Racial Identity Development Within an Attractor Landscape
Authors: Hill Sean C.
Published: November 2017

Concepts, theories, and findings of race and racial identity development were reviewed and conceptualized into a single model based on principles of complexity and chaos. This article proposes race can be understood as a complex adaptive system and conceptualized as an attractor landscape. In this model, trajectories represent racial identity development or progression through an attractor landscape comprised of racial categories. Although this works well as a conceptual model, the modeling of racial identity development within an attractor landscape is affected by practical constraints related to data collection and many of the same limitations of existing racial identity development theories. The proposed model also creates additional challenges because of its interdisciplinary nature.
Reverse (Convex) Conchal Bowl: Report of Eight Cases and Its Correction by Modified Conchoplasty Technique
Authors: Shetty Subhash Chandra , Gupta Sanjeev , Hasan Suhel , Cherian Mahil , Joseph Vijay , Guido Norman
Published: November 2017

Many different congenital malformations of the external ear are encountered in otology and plastic surgery practice. However, there has been only one report in the literature of reverse (convex) conchal deformity in otherwise normal ears. Eight such cases were encountered in the combined otology and plastic surgery practice at the authors’ institution. The condition was bilateral in two patients and unilateral in six patients; these patients had no other otological abnormalities. Two patients sought surgical correction. Modified conchoplasty, done by excising and replacing the conchal cartilage in reverse fashion, is presented. Controversies surrounding the embryogenesis of concha are also addressed.
Recurrent Hypothenar Hammer Syndrome: An Unusual Presentation
Authors: Ling Michael C-Y , Brenk Bert Van Md , Howard Jeffrey , Gan Bing Siang
Published: November 2017

Upper extremity ischemia is a relatively rare phenomenon. A case of recurrent, surgically correctable, acute digital ischemia in a worker in the maple syrup industry is presented. The present case illustrates the importance of recognizing occupational exposure to risk factors. A review of the differential diagnosis, clinical work-up and literature surrounding acute vascular occlusion of the hand and upper extremity is presented.
Buttocks lift for tight thighs
Authors: Vazquez-Salisbury Aurelio , Ersek Robert A
Published: November 2017

Existing techniques for tightening loose or excess skin of the lateral thighs have frequently resulted in conspicuous scars on the hips, groin creases or medial thighs. A technique is described by which a wedge of subcutaneous tissue and skin, 10 x 20 cm, can be removed from the inner thigh and central buttocks crease where the scar can be completely hidden. A series of six patients, all seen at different stages after surgery, is presented.
The Use of Carbon Dioxide Laser in Selected Surgical Cases in Patients on Anticoagulant Therapy
Authors: Bell Michael Sg , Ebrahimipour S Shanhrokhi
Published: November 2017

Postoperative bleeding is encountered with much greater frequency in patients with congenital coagulation defects and in patients on warfarin therapy. Anticoagulation management before and after elective surgery is well documented. Cessation of anticoagulation therapy is required before elective surgery, except in the most minor dermatological surgical procedures such as Mohs surgery or simple excisions. This may pose significant economic consequences, especially when hospital admission for several days and substitution of heparin for warfarin under close monitoring is required. Use of a carbon dioxide laser, which considerably reduces intraoperative bleeding and postoperative oozing, is proposed as an alternative approach to selected surgical procedures.
Accuracy of pedicle screw placement based on preoperative computed tomography versus intraoperative data set acquisition for spinal navigation system
Authors: Liu Hao , Chen Weikai , Liu Tao , Meng Bin , Yang Huilin
Published: November 2017

Aim:

To investigate the accuracy of pedicle screw placement based on preoperative computed tomography in comparison with intraoperative data set acquisition for spinal navigation system.

Methods:

The PubMed (MEDLINE), EMBASE, and Web of Science were systematically searched for the literature published up to September 2015. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines. Statistical analysis was performed using the Review Manager 5.3. The dichotomous data for the pedicle violation rate was summarized using relative risk (RR) and 95% confidence intervals (CIs) with the fixed-effects model. The level of significance was set at p < 0.05.

Results:

For this meta-analysis, seven studies used a total of 579 patients and 2981 screws. The results revealed that the accuracy of intraoperative data set acquisition method is significantly higher than preoperative one using 2 mm grading criteria (RR: 1.82, 95% CI: 1.09, 3.04, I2 = 0%, p = 0.02). However, there was no significant difference between two kinds of methods at the 0 mm grading criteria (RR: 1.13, 95% CI: 0.88, 1.46, I2 = 17%, p = 0.34). Using the 2-mm grading criteria, there was a higher accuracy of pedicle screw insertion in O-arm-assisted navigation than CT-based navigation method (RR: 1.96, 95% CI: 1.05, 3.64, I2 = 0%, p = 0.03). The accuracy between CT-based navigation and two-dimensional-based navigation showed no significant difference (RR: 1.02, 95% CI: 0.35-3.03, I2 = 0%, p = 0.97).

Conclusions:

The intraoperative data set acquisition method may decrease the incidence of perforated screws over 2 mm but not increase the number of screws fully contained within the pedicle compared to preoperative CT-based navigation system. A significantly higher accuracy of intraoperative (O-arm) than preoperative CT-based navigation was revealed using 2 mm grading criteria.
Cut-off values of the Japanese Orthopaedic Association score corresponding to Constant scores for evaluating outcomes in rotator cuff tear
Authors: Kawakami Junichi , Gotoh Masafumi , Matsuura Koumei , Shin Kunichika , Fujito Ikuhisa , Tanaka Aya , Matsunaga Saho , Imai Takaki , Nagamatsu Takashi , Madokoro Kazuya , Shiba Naoto
Published: November 2017

Purpose:

To clarify the cut-off value of the Japanese Orthopaedic Association (JOA) score corresponding to rotator cuff tear outcome as evaluated by the Constant score.

Methods:

The subjects were 230 patients with rotator cuff tear. The Constant and JOA scores on the first examination in our hospital were evaluated. After investigation of the correlation between the Constant and JOA scores, the cut-off JOA score was calculated, corresponding to excellent, good and fair outcomes as evaluated by the Constant score.

Results:

The Constant and JOA scores on the first examination were 49.64 ± 12.84 and 72.52 ± 12.84, respectively, with a strong correlation ( r = 0.87, p < 0.01). Receiver operating characteristic analysis revealed that the cut-off JOA score was 87.0 for excellent outcome (area under the curve, AUC: 0.93; sensitivity: 100%; specificity: 88.6%; p < 0.01), 84.0 for good outcome (AUC: 0.94; sensitivity: 100%; specificity: 83.4%; p < 0.01) and 78.0 for fair outcome (AUC: 0.88; sensitivity: 100%; specificity: 71.3%; p < 0.01).

Conclusions:

In patients with rotator cuff tear, good outcome as judged by a Constant score of ≥80 corresponds to a JOA score cut-off of 84.0. Judgement of the treatment outcomes and evaluation of the surgical method may be more accurate when using clear cut-off values for the scoring system employed, such as those determined in our study.
A Case of Escherichia coli Hemolytic Uremic Syndrome in a 10-Year-Old Male With Severe Neurologic Involvement Successfully Treated With Eculizumab
Authors: Rasa Malia , Musgrave James , Abe Keith , Tanaka Len , Xoinis Konstantine , Shiramizu Bruce , Foskett Gretchen , Lau Rhiana
Published: November 2017

Hemolytic uremic syndrome (HUS) can be classified as typical and atypical, and the treatment recommendations currently differ between the 2 types. Eculizumab is recommended as first-line treatment for atypical HUS; however, its use in typical HUS has been controversial. We report a case of a 10-year-old male with severe neurologic impairment who was successfully treated with eculizumab, which was started 4 days after onset of neurologic symptoms. Our case supports the use of eculizumab in typical HUS with neurologic involvement, even when given later in the course, as the pathophysiology of typical HUS has been shown to involve activation of the complement pathway, similar to atypical HUS. Further studies are required to establish the efficacy and duration of eculizumab use in this patient population.
Seeing the park for the trees: New York’s “Million Trees” campaign vs. the deep roots of environmental inequality
Authors: Garrison Jessica Debats
Published: November 2017

Trees provide many environmental benefits, but low-income communities of color tend to have fewer of them. New York City attempted to correct this disparity by planting a million trees via public–private partnership between 2007 and 2015. This paper examines MillionTreesNYC’s environmental justice goals and planting strategies via program documents and interviews with program partners, and assesses equity outcomes via regression analysis of new trees planted, existing tree canopy, park space, and sociodemographic characteristics measured at the level of the census block group. Ultimately, MillionTreesNYC did not prioritize low-income communities of color to a measurable degree, and planted more trees in areas with greater existing tree canopy. Despite public–private partnerships’ reputation for prioritizing profit over equity, the problem was not a lack of commitment to environmental justice. Instead, MillionTreesNYC’s focus on parks, which are themselves inequitably distributed, frustrated the city’s efforts to equalize the urban forest. This paper therefore exposes the deep historical roots of environmental injustice, which are difficult to eradicate without careful attention to both past and present socio-spatial inequities.
Discharge Disposition Costs Following Total Shoulder Arthroplasty: A Comprehensive National Analysis
Authors: Rosas Samuel , Kurowicki Jennifer , Triplet Jacob J , Berglund Derek D , Horn Brandon , Levy Jonathan C
Published: November 2017

Background

Total shoulder arthroplasty (TSA) is the fastest growing sector of arthroplasty in the United States. One of the greatest drivers of costs following joint replacement surgery has been shown to be discharge disposition. This study examines the costs associated in the first 90 days of care following shoulder arthroplasty with a specific focus on the effects of discharge disposition.

Methods

We conducted a retrospective, case–control study of the entire Medicare population from 2011 to 2014 identifying TSA patients based on International Classification of Disease ninth revision codes. Only patients with demographic and discharge information were included. Costs were analyzed based on mean reimbursements. Patients were stratified according to 4 disposition groups: home, skilled nursing facility (SNF), intermediate care facility (ICF), and inpatient rehabilitation (InR). The correlation of the Charlson Comorbidity Index (CCI) to discharge disposition was also examined.

Results

A total of 50 979 patients met the inclusion criteria. The mean 90-day costs for patients discharged home were $12 691 (standard deviation [SD]: $471.9), for those who went to an SNF was $15 093 (SD: $622.4), for ICF $15 473 (SD: $2366) and for those who went to InR $24 731 (SD: $1922; P < .001). Over the 4-year period, trends in discharge to home significantly increased ( P = .037), while trends in discharge to InR significantly decreased ( P = .015). The CCI correlated significantly with discharge disposition setting ( P < .001).

Conclusion

The 90-day reimbursements of TSA are significantly affected by discharge disposition. Although discharge to home continues to increase, patients with a greater comorbidity burden are discharged more often to an inpatient facility.
Assessment in Music: A Practitioner Introduction to Assessing Students
Authors: Denis John M.
Published: November 2017

There has been an increased interest in documenting the growth and learning outcomes of students in all subjects in the past 20 years, and music education has not been immune to the accountability movement. Yet, in spite of the increased sociopolitical pressures put on educators, music has remained a difficult discipline to assess, which in turn has created tension between music educators and policymakers. This review of literature examines the basic nature of assessment in music education and discusses possible concepts and methods to improve practitioner understanding of student growth and learning. Topics include (a) What is assessment? (b) Why does assessment matter? (c) How do we assess in music? and (d) What challenges occur in music assessment?
Chronic disease burden and frailty in survivors of childhood HSCT: a report from the St. Jude Lifetime Cohort Study
Authors: Eissa Hesham M. , Lu Lu , Baassiri Malek , Bhakta Nickhill , Ehrhardt Matthew J. , Triplett Brandon M. , Green Daniel M. , Mulrooney Daniel A. , Robison Leslie L. , Hudson Melissa M. , Ness Kirsten K.
Published: November 2017

Key Points

Childhood HSCT survivors suffer from a higher burden of severe/life-threatening conditions compared to conventional therapy survivors. Seven percent of HSCT survivors exhibit frailty phenotype at early age, placing them at higher risk for early mortality.
The Japanese version of the questionnaire about the process of recovery: development and validity and reliability testing
Authors: Kanehara Akiko , Kotake Risa , Miyamoto Yuki , Kumakura Yousuke , Morita Kentaro , Ishiura Tomoko , Shimizu Kimiko , Fujieda Yumiko , Ando Shuntaro , Kondo Shinsuke , Kasai Kiyoto
Published: November 2017

Background

Personal recovery is increasingly recognised as an important outcome measure in mental health services. This study aimed to develop a Japanese version of the Questionnaire about the Process of Recovery (QPR-J) and test its validity and reliability.

Methods

The study comprised two stages that employed the cross-sectional and prospective cohort designs, respectively. We translated the questionnaire using a standard translation/back-translation method. Convergent validity was examined by calculating Pearson’s correlation coefficients with scores on the Recovery Assessment Scale (RAS) and the Short-Form-8 Health Survey (SF-8). An exploratory factor analysis (EFA) was conducted to examine factorial validity. We used intraclass correlation and Cronbach’s alpha to examine the test-retest and internal consistency reliability of the QPR-J’s 22-item full scale, 17-item intrapersonal and 5-item interpersonal subscales. We conducted an EFA along with a confirmatory factor analysis (CFA).

Results

Data were obtained from 197 users of mental health services (mean age: 42.0 years; 61.9% female; 49.2% diagnosed with schizophrenia). The QPR-J showed adequate convergent validity, exhibiting significant, positive correlations with the RAS and SF-8 scores. The QPR-J’s full version, subscales, showed excellent test-retest and internal consistency reliability, with the exception of acceptable but relatively low internal consistency reliability for the interpersonal subscale. Based on the results of the CFA and EFA, we adopted the factor structure extracted from the original 2-factor model based on the present CFA.

Conclusion

The QPR-J is an adequately valid and reliable measure of the process of recovery among Japanese users with mental health services.
Compatibility of Family History Cancer Guidelines With Meaningful Use Standards
Authors: Aziz Ayesha , Pflieger Lance , O’Connell Nathaniel , Schiffman Joshua , Welch Brandon M.
Published: November 2017

Purpose

To evaluate the potential of implementing established family cancer guidelines as clinical decision support within meaningful use (MU)–compliant health information technology systems.

Methods

We conducted a systematic analysis of cancer guidelines involving family health history (FHx) published before 2015. By comparing existing cancer guideline statements to current MU FHx standard requirements, we determined whether the cancer guideline statements could be implemented as clinical decision support. For guidelines that could not implemented, we determined the primary reasons for incompatibility.

Results

A total of 531 statements from 55 guidelines published by 11 different organizations were reviewed and analyzed. Overall, 18% to 66% of guideline statements could or could not be implemented in MU-compliant health information technology systems, depending on which MU standard was used. Health Level Seven (HL7) models performed better than SNOMED models. Implementability of guideline statements varied by cancer type and guideline organizations. The greatest deficiencies in implementability of statements were largely a result of the fact that MU standards required only first-degree relatives and that FHx terms used in guidelines statements were ambiguous.

Conclusion

FHx cancer guidelines and MU-based systems vary widely and are mostly incompatible. We identified sources of incompatibility and made recommendations that could improve the implementability of FHx cancer guidelines. Our findings and recommendations can enhance the use of established FHx cancer risk guidelines in routine clinical workflows.
An ultraprocessive, accurate reverse transcriptase encoded by a metazoan group II intron
Authors: Zhao Chen , Liu Fei , Pyle Anna Marie
Published: November 2017

Group II introns and non-LTR retrotransposons encode a phylogenetically related family of highly processive reverse transcriptases (RTs) that are essential for mobility and persistence of these retroelements. Recent crystallographic studies on members of this RT family have revealed that they are structurally distinct from the retroviral RTs that are typically used in biotechnology. However, quantitative, structure-guided analysis of processivity, efficiency, and accuracy of this alternate RT family has been lacking. Here, we characterize the processivity of a group II intron maturase RT from Eubacterium rectale (E.r.), for which high-resolution structural information is available. We find that the E.r. maturase RT (MarathonRT) efficiently copies transcripts at least 10 kb in length and displays superior intrinsic RT processivity compared to commercial enzymes such as Superscript IV (SSIV). The elevated processivity of MarathonRT is at least partly mediated by a loop structure in the finger subdomain that acts as a steric guard (the α-loop). Additionally, we find that a positively charged secondary RNA binding site on the surface of the RT diminishes the primer utilization efficiency of the enzyme, and that reengineering of this surface enhances capabilities of the MarathonRT. Finally, using single-molecule sequencing, we show that the error frequency of MarathonRT is comparable to that of other high-performance RTs, such as SSIV, which were tested in parallel. Our results provide a structural framework for understanding the enhanced processivity of retroelement RTs, and they demonstrate the potential for engineering a powerful new generation of RT tools for application in biotechnology and research.
Suspected mitral valve disease: clinical assessment
Authors: Hall Angela
Published: November 2017

Echocardiography remains the diagnostic tool of choice when assessing valve disease. It is important that the patient is assessed appropriately, using physical assessment and history-taking during consultation. It is necessary for practitioners to understand the diagnostic tools, so the most appropriate investigations are carried out. Clinicians rely upon comprehensive history-taking and physical examination for accurate diagnoses, but assessing the severity of valvular heart disease relies upon quantitative measurements and data. The blurring of professional boundaries between health workers has resulted in nurses acquiring new skills and roles, enabling them to carry out consultation and diagnose patients. Advances in technology have resulted in a plethora of invasive and non-invasive diagnostic tools. Echocardiography is a form of ultrasound used routinely in modern health care and is widely accepted as an invaluable tool in the diagnosis and interpretation of the findings in structural heart disease. Mitral valve disease is increasing in prevalence in the context of the ageing population and optimal management, diagnosis and surveillance are crucial. A combination of subjective and objective data provide information for the clinician to formulate a differential, followed by a confirmed, diagnosis. The role of the specialist nurse has developed—they are often in charge of their own caseload of patients, and making autonomous decisions.
Stroke: the key risk factors
Authors: Sibson Lynda , Khadjooi Kayvan
Published: November 2017

This is the first in a series of two articles focusing on stroke and transient ischaemic attacks (TIAs) in adults. The current article will identify and discuss the key risk factors in stroke. Stroke risk factors have great similarity to other cardiovascular events. Identifying and addressing the more preventable lifestyle risk factors could positively impact upon the reduction and prevention of strokes and TIAs. Improved understanding of these key risk factors is vital among the public and health professionals. Arguably, this is an important part of the role of all health professionals, whether in a primary/community, secondary or tertiary health-care setting. Individuals are often only diagnosed with hypertension and/or diabetes, for example, on acute admission for suspected stroke, or during outline assessment such as when registering with a GP practice. The next article in this series will concentrate on acute stroke and TIA assessment and treatment.
Perioperative risk
Authors: Lacey JRN , Khan N , Oliver CM
Published: November 2017

The high-risk surgical patient is a growing challenge to modern health care. This cohort, although comprising only 10–15% of surgical procedures, accounts for approximately 80% of postoperative deaths and suffers a high rate of postoperative morbidity. Developing robust systems to help identify and better manage this patient group should be a priority.

Risk stratification has become a valuable clinical tool for shared decision-making and the development of individualized care plans. Methods for stratifying individual risk include assessment tools, measures of functional capacity and plasma biomarker assays. Routine evaluation of perioperative risk is central to the delivery of high quality, appropriate surgical care.
Quality improvement in perioperative medicine: driving the revolution
Authors: Wilson Matthew , Walker David
Published: November 2017

Perioperative medicine and quality improvement are both emerging fields with the potential to contribute to safer and more reliable care for surgical patients. One key component has been the evolution of the national audit project programme. This article describes the current state of quality improvement within perioperative medicine, the evolution of the national audit project programme and the effects it has produced on the quality of patient care. The article also highlights opportunities for health-care professionals to engage with this innovative area of medicine.
Early adopters of perioperative medicine: who are they and what motivates them?
Authors: Groves C , Whiteman A , Kumar G , Stephens R , Walker D
Published: November 2017

Perioperative medicine is an emerging specialty aimed at improving outcomes in the high-risk surgical population. The authors set out to characterize the demographics and determine the motivation of ‘early adopters’ of this specialty by retrospectively reviewing the application forms of students enrolled on the UCL Perioperative Medicine Masters Programme.

A total of 139 applications were reviewed. The median age of applicants was 35 years; 81% were UK based, with the remainder from a worldwide distribution. Seventeen per cent were consultant anaesthetists and 64% anaesthetic trainees, with the remainder including doctors from other specialties (17%) and nurses (2%). Qualitative analysis using grounded theory methodology revealed common motivational themes: the belief that perioperative medicine would lead to better patient care, that it represents the future working practice for anaesthetists, a desire to be able to better lead local developments, and personal fulfilment and benefit.

The responses provided insight into the motivation of an international cohort of professionals. Perioperative medicine was perceived as a developing multidisciplinary specialty that will lead to better patient care. Applicants understood the importance of perioperative care extending beyond the operating theatre which may explain the growing demand for training in perioperative medicine.
Evolution of laser lipolysis in non-invasive fat reduction and body sculpting
Authors: Balaratnam Sherina
Published: November 2017

Laser–assisted lipolysis is a commonly used and accepted modality for the removal of unwanted fatty tissue. The evolution of lasers to selectively target fat will be covered in this paper, together with a review of the author's 12 months' clinical experience with an innovative US Food and Drug Administration approved non-invasive technology for selective photothermolysis.
Whole system change needed in gender identity services
Authors: Quaile Alistair
Published: November 2017

Many aesthetic practitioners treat patients who identify as transgender who are looking to feminise or masculinise their facial features. Those who are experiencing concerns with their gender identity often attend private practices, as waiting times for NHS specialist services are too long. Alistair Quaile outlines the problems affecting this patient group and explains proposals being put forward for the future
Social media: understanding its impact on body image in adolescents
Authors: Treneman-Evans Georgia
Published: November 2017

Social networking sites (SNS) are used more often than any other type of website. However, the emergence and popularity of these platforms is said to be increasingly associated with body image concerns and dissatisfaction. Georgia Treneman-Evans discusses the impact of social media on body image, with reference to some of the most commonly used SNS and the practice of taking selfies
Chasing payments from individuals: how the Debt Claims Protocol has changed
Authors: Bernstein Adam
Published: November 2017

Rules that took effect on 1 October 2017 will make it much more difficult for businesses to chase individuals for outstanding payments, whether as private citizens or in business as sole traders. A failure to follow the new regimen will automatically put the creditor on the back foot. Adam Bernstein explains the Debt Claims Protocol and outlines the requirements for letters before claim
Standing out online: how using the ABCDE model can work for your clinic
Authors: Shaviv Miriam , Bermant Danny
Published: November 2017

Competition for patients online is intense. So how do you attract leads who are not price-shoppers, and persuade them to seek treatment with you rather than the clinic down the road? Miriam Shaviv and Danny Bermant outline the key principles behind the ABCDE model—a repeatable, scalable online marketing system you can use to bring in new patients and build your practice
Knowing your competitors: how you can work together for mutual success
Authors: Smith Victoria , Wiggins Nancy
Published: November 2017

There is nothing to be feared from a little competition. For the most part, it prevents you from becoming complacent, keeps you on your toes, and encourages you to focus on building a strong brand and providing excellent customer service. Victoria Smith and Nancy Wiggins look at why competition is healthy and how embracing it has the potential to present unexpected opportunities and increase patient
Tutorial 1
Authors: Magnoni Dee
Published: November 2017

This first tutorial provides an overview of the OSI2016 landscape.
Culture of Communication Workgroup Report
Authors: DeFelice Barbara , Haigh Susan , Matthews Barrett , Morgan Dan , Olson Eric L. , Reynolds Leslie J. , Samberg Rachel G. , Steinhauer Jason , Yess Mary
Published: November 2017

Following a common thread from throughout OSI2016, this workgroup will develop partnership proposals for this community to work together to improve the culture of communication inside academia, particularly inside research. As part of this effort, it may be important to clarify messaging surrounding the benefits and impacts of open access (OA) inside academia, particularly inside research. It may also be important to determine what resources and information are needed before this messaging can be effective, including showing the benefits of OA to a skeptical research community; addressing the many concerns of stakeholders; clearly explaining its pros and cons; and demonstrating the case for why the transition to OA is worth the trouble.
Global Flip & Other Studies Workgroup Report
Authors: Archambault Eric , Campbell Colleen , Dempsey Lorcan , Kaufman Roy , Naim Kamran , Schimmer Ralf , Van der Stelt Wim , Sutton Caroline , Wacha Megan
Published: November 2017

In their report, delegates of the Who Decides? workgroup of the OSI2016 conference put forth three proposals in which key stakeholders might convene to enact an economically viable and sustainable transformation of the current scholarly communications system to one of open access. The “Global Flip” workgroup of OSI2017 discussed the previous year’s “Proposal 3: Transformation: a “global flip” of research journals to open access” in which “libraries, publishers, and funders, convened by an organization with global standing, come together to redirect subscription funding toward transforming existing journals to open access publication.”  Tasked with creating broad action plans for further research into the feasibility and impact of such a transformation, we identify a number of driving forces in the envisioned transformation, which could be further developed to assure its ultimate success as well as possible barriers to its desired fruition and suggested actions to remove them.
PREFACIANDO
Authors: Lomanto Marília
Published: November 2017

Não por apego a surto de fé, mas por respeito à espiritualidade ancestral que marca o povo que desfila pela cidade de Feira de Santana, quando a fé se movimenta e canta a cidade e, com ela, sua identidade territorial, sua cultura, seus riscos, sua diversidade, a generosidade com que se deixa atravessar por milhares de pés que vão e voltam por suas ruas, vindos de todos os cantos, porque cidade grande, porque cidade onde flutuam desejos de todas as cores e formas e, sobretudo, porque cidade que mobiliza e constrói saberes que dialogam com outros saberes, no espaço socialmente referenciado da Universidade Estadual de Feira de Santana - UEFS
The ‘hollowing out’ of smaller third sector organisations?
Authors: Aiken Mike , Harris Margaret
Published: November 2017

This paper explores whether small and medium-sized third sector organisations (SMTSOs) are being ‘hollowed out’ due to multiple interacting pressures from their policy environment. We draw together and synthesise recent research and consider the extent to which cumulative policy pressures are eroding some core features of SMTSOs. We conclude by considering the extent to which the pressures faced by SMTSOs may limit their capacity to meet governmental expectations about their contribution to a ‘shared society’.
Trajectories of transition: Economies and geographies of theatre in contemporary Athens
Authors: Hager Philip
Published: November 2017

In this article, I trace institutional transitions that have framed, produced and hosted theatre in Athens during the last four decades. In doing so, I seek to devise a methodology that examines the city’s changing theatrical landscapes against the backdrop of Metapolitefsi’s trajectories of transition and the post-2010 in-crisis permutations. Subsequently, I pursue a twofold argument: first, I observe the ways in which state subsidies forged theatrical economies that contributed to the shaping of Athens’ geographies; and by focusing on the example of the Onassis Cultural Centre, I propose that a key marker of change is a move towards an ethic of hospitality, concurrent with the systematization of the economies of debt in Greek society.
Cartographies of gender in contemporary Greek theatre: A work in progress?
Authors: Rosi Lina
Published: November 2017

The article explores some ways in which Greek theatre production during the last 30 years has engaged with gender politics. Most theatre historians and critics agree that the impact of second-wave feminism was rather insubstantial in the context of Greek theatre, and despite the presence of women in fields such as acting, playwriting, set and costume design and directing, there is no trace of a collective effort to develop a tradition of feminist playwriting and theatre practice. Discussing selected works by women playwrights in the light of the reception of feminist thought in Greece from the early years of Metapolitefsi until today, my intention is to trace the different trends of feminist dramaturgies and their genealogies. The first trend refers to plays that expose and discuss issues related with the everyday experience of women and that, in their majority, adopt a realist aesthetic; the second includes women-centred works that adopt a more experimental dramatic style and use intertextuality in order to turn to history, myth or popular legends; and the third refers to the form of the monologue as a distinctive genre carrying a strong feminist dimension.
Bronquiolitis
Authors: Estrada Nicolás , Vesga Paula Andrea , Restrepo Julio César
Published: November 2017

La bronquiolitis es una enfermedad que involucra las vías respiratorias inferiores y afecta a un gran número de lactantes en el mundo. Se estima que a causa de esta enfermedad hay, anualmente, 3.4 millones de admisiones hospitalarias y 199,000 muertes en los países en vía de desarrollo. La enfermedad es más frecuente en las temporadas de lluvia y existen múltiples factores de riesgo que pueden aumentar su gravedad. El agente causal más importante de la bronquiolitis es el virus sincitial respiratorio, el cual se transmite por medio de fómites nasales. El cuadro clínico inicia con síntomas de la vía aérea superior que progresan a las vías aéreas inferiores, llegando a causar insuficiencia respiratoria como consecuencia de una alta liberación de mediadores proinflamatorios. El diagnóstico es clínico, sin embargo, se utilizan otros métodos diagnósticos cuando hay sospecha de otra patología. Diferentes terapias han sido propuestas para su manejo clínico, que se basan en medidas de sostén para el paciente, el uso de oxígeno, nebulizaciones de solución salina hipertónica, corticosteroides, antivirales, profilaxis con palivizumab y, más recientemente, el uso de sulfato de zinc. Todavía existe un considerable desconocimiento acerca de algunos aspectos relacionados con el manejo de esta enfermedad. Sin embargo, se han descubierto nuevos mecanismos fisiopatológicos que en un futuro podrían llegar a ser un blanco terapéutico.