bluuebunny/crossref_metadata_2025_split huggingface dataset:
Australian Hospital-Based Nurse Educators' Perceptions of Their Role
Authors: Thornton Karleen 
Published: May 2018

This article presents the findings from a phenomenological study that explored the understandings of Australian hospital-based nurse educators' experiences of their role. Purposive sampling resulted in 11 nurse educators from four large metropolitan hospitals within an Australian jurisdiction. The participants were asked how they understand their role and translate that understanding into practice. Thematic analysis identified four themes representative of nurse educators' understanding of their role: Becoming an Educator, Capability Building, Panacea, and Tension. A coherent picture emerged from subthemes highlighting that nurse educators were undervalued and value is added. Being undervalued and value adding are translated into nurse educator practice as resilience, being educationally literate, investing, and having a presence. This article identifies a gap in knowledge related to understanding the nurse educator role and informs recruitment and subsequent retention of nurses into nurse educator roles at a time when the nursing workforce in Australia and internationally is about to experience a major shortfall. Findings are specific to the Australian context and are not necessarily generalizable to other hospital jurisdictions.J Contin Educ Nurs.2018;49(6):274–281.
Inflammatory Bowel Disease Susceptibility Gene C1ORF106 Regulates Intestinal Epithelial Permeability
Authors: Manzanillo Paolo , Mouchess Maria , Ota Naruhisa , Dai Bingbing , Ichikawa Ryan , Wuster Arthur , Haley Benjamin , Alvarado Gabriela , Kwon Youngsu , Caothien Roger , Roose-Girma Meron , Warming Soren , McKenzie Brent S , Keir Mary E , Scherl Alexis , Ouyang Wenjun , Yi Tangsheng 
Published: May 2018

Abstract
Intestinal epithelial cells form a physical barrier that is tightly regulated to control intestinal permeability. Proinflammatory cytokines, such as TNF-α, increase epithelial permeability through disruption of epithelial junctions. The regulation of the epithelial barrier in inflammatory gastrointestinal disease remains to be fully characterized. In this article, we show that the human inflammatory bowel disease genetic susceptibility gene C1ORF106 plays a key role in regulating gut epithelial permeability. C1ORF106 directly interacts with cytohesins to maintain functional epithelial cell junctions. C1orf106-deficient mice are hypersensitive to TNF-α–induced increase in epithelial permeability, and this is associated with increased diarrhea. This study identifies C1ORF106 as an epithelial cell junction protein, and the loss of C1ORF106 augments TNF-α–induced intestinal epithelial leakage and diarrhea that may play a critical role in the development of inflammatory bowel disease.
IL-36γ Protects against Severe Influenza Infection by Promoting Lung Alveolar Macrophage Survival and Limiting Viral Replication
Authors: Wein Alexander N. , Dunbar Paul R. , McMaster Sean R. , Li Zheng-Rong Tiger , Denning Timothy L. , Kohlmeier Jacob E. 
Published: May 2018

Abstract
Although influenza virus infection remains a concerning disease for public health, the roles of individual cytokines during the immune response to influenza infection are not fully understood. We have identified IL-36γ as a key mediator of immune protection during both high- and low-pathogenesis influenza infection. Il36g mRNA is upregulated in the lung following influenza infection, and mice lacking IL-36γ have greatly increased morbidity and mortality upon infection with either H1N1 or H3N2 influenza. The increased severity of influenza infection in IL-36γ–knockout (KO) mice is associated with increased viral titers, higher levels of proinflammatory cytokines early in infection, and more diffuse pathologic conditions late in the disease course. Interestingly, the increased severity of disease in IL-36γ–KO mice correlates with a rapid loss of alveolar macrophages following infection. We find that the alveolar macrophages from naive IL-36γ–KO mice have higher expression of M2-like surface markers compared with wild-type (WT) mice and show increased apoptosis within 24 h of infection. Finally, transfer of WT alveolar macrophages to IL-36γ–KO mice restores protection against lethal influenza challenge to levels observed in WT mice. Together, these data identify a critical role for IL-36γ in immunity against influenza virus and demonstrate the importance of IL-36γ signaling for alveolar macrophage survival during infection.
Emergence of NK Cell Hyporesponsiveness after Two IL-15 Stimulation Cycles
Authors: Frutoso Marie , Morisseau Sébastien , Tamzalit Fella , Quéméner Agnès , Meghnem Dihia , Leray Isabelle , Jacques Yannick , Mortier Erwan 
Published: May 2018

Abstract
IL-15 is a cytokine playing a crucial role in the function of immune cells, including NK and CD8 T cells. In this study, we demonstrated that in vivo, in mice, IL-15–prestimulated NK cells were no longer able to respond to a second cycle of IL-15 stimulation. This was illustrated by defects in cell maturation, proliferation, and activation, seemingly linked to the environment surrounding NK cells but not related to the presence of CD4 regulatory T cells, TGF-β, or IL-10. Moreover, NK cells from immunodeficient mice could respond to two cycles of IL-15 stimulation, whereas an adoptive transfer of CD44+CD8+ cells impaired their responsiveness to the second cycle. Conversely, in immunocompetent mice, NK cell responsiveness to a second IL-15 stimulation was restored by the depletion of CD8+ cells. These biological findings refine our understanding of the complex mode of action of NK cells in vivo, and they should be taken into consideration for IL-15–based therapy.
Tumor Suppressor p14ARF Enhances IFN-γ–Activated Immune Response by Inhibiting PIAS1 via SUMOylation
Authors: Alagu Jennifer , Itahana Yoko , Sim Faizal , Chao Sheng-Hao , Bi Xuezhi , Itahana Koji 
Published: May 2018

Abstract
The ability of cells to induce the appropriate transcriptional response to inflammatory stimuli is crucial for the timely induction of host defense mechanisms. Although a role for tumor suppressor p14ARF (ARF) in the innate immune response was previously demonstrated, the underlying mechanism is still unclear. ARF is a potent upregulator of protein SUMOylation; however, no association of this function with the immune system has been made. In this study, we show the unique role of ARF in IFN-γ–induced immune response using human cell lines. Through a systematic search of proteins SUMOylated by ARF, we identified PIAS1, an inhibitor of IFN-activated transcription factor STAT1, as a novel ARF-binding partner and SUMOylation target. In response to IFN-γ treatment, ARF promoted PIAS1 SUMOylation to inhibit the ability of PIAS1 to attenuate IFN-γ response. Wild-type, but not ARF mutants unable to enhance PIAS1 SUMOylation, prevented the PIAS1-mediated inhibition of IFN-γ response. Conversely, the SUMO-deconjugase SENP1 deSUMOylated PIAS1 to reactivate PIAS1 that was inhibited by ARF. These findings suggest that PIAS1 function is negatively modulated by SUMO modification and that SUMOylation by ARF is required to inhibit PIAS1 activity and restore IFN-γ–induced transcription. In the presence of ARF, in which case PIAS1 is inhibited, depletion of PIAS1 did not have an additive effect on IFN-γ response, suggesting that ARF-mediated enhancement of IFN-γ response is mainly due to PIAS1 inhibition. Our findings reveal a novel function of ARF to inhibit PIAS1 by enhancing SUMOylation to promote the robust induction of IFN-γ response.
Clinical Outcome Measures and Return-to-Sport Timing in Adolescent Athletes After Anterior Cruciate Ligament Reconstruction
Authors: Burland Julie P. , Kostyun Regina O. , Kostyun Kyle J. , Solomito Matthew , Nissen Carl , Milewski Matthew D. 
Published: May 2018

Context: Multiple factors are likely associated with an adolescent athlete's ability to return to play after anterior cruciate ligament (ACL) reconstruction (ACLR).Objective: To investigate the relationship between self-reported and functional outcome measures on return-to-play timing in an adolescent population, in athletes who returned and those who did not return to sport, and to identify a cutoff value for isometric quadriceps strength that could serve as a clinical target for maximizing the odds of returning to play after ACLR.Design: Cross-sectional study.Setting: Outpatient clinic.Patients or Other Participants: Adolescent athletes who underwent ACLR and completed clinical measures at their 3- and 6-month follow-up appointments were included.Main Outcome Measure(s): Clinical measures included functional outcomes of isometric and isokinetic strength tests and the Anterior Cruciate Ligament Return to Sport After Injury scale and the pediatric version of the International Knee Documentation Committee subjective form. Physician clearance dates for return to play were obtained from patient records.Results: Higher strength measures were associated with better scores on the Anterior Cruciate Ligament Return to Sport After Injury and the pediatric version of the International Knee Documentation Committee instruments at each follow-up. Differences were found in isometric extension strength (P = .001) and isokinetic extension strength at 180°/s (P = .03) and 300°/s (P = .002) between patients who returned to sports and those who did not. A 6-month isometric extension deficit (mean Limb Symmetry Index = 85.48 ± 23.15) displayed high accuracy (area under the curve = 0.82, 95% confidence interval = 0.68, 0.95) for identifying patients who returned to play after ACLR.Conclusions: Higher strength measures at both 3 and 6 months after ACLR were associated with greater self-reported knee function and greater readiness to return to functional activities at 6 months and ultimately earlier return to sport in adolescent athletes. These results provide evidence that self-reported outcome scores should be used as an additional screening tool in conjunction with quadriceps strength testing to help provide realistic recovery timeframes for adolescent patients.
Logistics and the future: The rise of macrologistics
Authors: Havenga Jan H. 
Published: May 2018

Background: The components of national freight logistics costs are still optimised in isolation, instead of systemic optimisation between logistics and other supply chain elements. The risk is the tragedy of the commons effect, where a positive return for economic activities in isolation could lead to a negative collective result in the long-term. Therefore, there is a need to elevate the systemic view of logistics to the macroeconomic realm.Objectives: The primary objective of this study was to further the macrologistics discipline through its formal definition and to develop an instrumentation construct to support macroeconomic trade-off analysis. The secondary objective was to apply instrumentation outputs to national-level logistics challenges.Method: A review of macrologistics was conducted, followed by a discussion on macrologistics instrumentation, which is twofold: a freight-flow model and a related logistics costs model. A disaggregated national input–output table was developed, followed by gravity modelling, to determine freight flows. Logistics cost calculations relate these flows to the costs of fulfilling associated logistics functions.Results: This review contributes to the developing theory of macrologistics, while the instrumentation outputs improve the systemic understanding of the national freight-flow landscape, enabling informed debate and prioritisation analysis. This systemic view enabled macrologistics proposals to address South Africa’s logistics challenges, including proposals regarding a domestic intermodal strategy externality cost internalisation; international trade facilitation; infrastructure investments; and rail branch line revitalisation.Conclusion: The elevation of logistics to the macroeconomic realm will enable the management of logistics as a national production factor, thereby contributing to reducing national freight logistics costs and improving national competitiveness.
Prevalence of mastitis pathogens in South African pasture-based and total mixed ration-based dairies during 2008 and 2013
Authors: Blignaut David , Thompson Peter , Petzer Inge-Marié 
Published: May 2018

Recent years have seen a change in the relative prevalence of environmental and contagious intramammary pathogens, as well as a change in the relative number of total mixed ration (TMR)-based and pasture (PAS)-based dairies in South Africa. The objectives of the study were to determine and compare the prevalence of mastitis pathogens in TMR and PAS dairies in South Africa during 2008 and 2013; furthermore, the within-herd prevalence of Streptococcus uberis in Str. uberis-positive herds was determined and compared. The prevalence of each pathogen, as well as the within-herd prevalence of Str. uberis, were compared between the two years and the two management systems using bacterial culture results from routinely collected composite cow milk samples submitted to the Onderstepoort Milk Laboratory, Faculty of Veterinary Science, University of Pretoria. Coagulase-negative staphylococci had the highest prevalence in both TMR and PAS dairies for both 2008 (29.60% [95.00% CI: 28.80% – 30.40%] and 26.90% [95.00% CI: 25.50% – 28.30%], respectively) and 2013 (20.20% [95.00% CI: 19.30% – 21.10%] and 22.70% [95.00% CI: 22.20% – 23.10%], respectively), which decreased significantly from 2008 to 2013 in both TMR and PAS dairies (p < 0.001). Streptococcus uberis showed an increase in prevalence in both TMR (p = 0.002) and PAS dairies (p = 0.001) from 2008 (2.36% [95.00% CI: 2.10% – 2.65%] and 2.63% [95.00% CI: 2.16% – 3.16%], respectively) to 2013 (3.10% [95.00% CI: 2.72% – 3.51%] and 3.64% [95.00% CI: 3.45% – 3.83%], respectively). Staphylococcus aureusshowed a significant decrease in both TMR (p = 0.011) and PAS (p < 0.001) dairies from 2008 (4.71% [95.00% CI: 4.34% – 5.10%] and 5.62% [95.00% CI: 4.94% – 6.36%], respectively) to 2013 (3.95% [95.00% CI: 3.52% – 4.40%] and 1.71% [95.00% CI: 1.58% – 1.84%], respectively). The median within-herd prevalence of Str. uberis for the combined dairy systems showed a significant increase from 2008 (1.72% [IQR: 0.88% – 5.00%]) to 2013 (3.10% [IQR: 1.72% – 4.70%]) (p < 0.001). Statistically significant differences were found in the prevalence of most of the major contagious and environmental mastitis pathogens between 2008 and 2013 and between TMR and PAS dairies. The within-herd prevalence of Str. uberis increased from 2008 to 2013, with the highest within-herd prevalence in PAS dairies in 2013.
The impact of resilience and perceived organisational support on employee engagement in a competitive sales environment
Authors: Meintjes Anel , Hofmeyr Karl 
Published: May 2018

Orientation: Understanding the impact of resilience and perceived organisational support on employee engagement in a competitive sales environment.Research purpose: The aim of this study was to explore the relationship between resilience, perceived organisational support and employee engagement among pharmaceutical sales employees in a competitive sales environment; and to establish whether resilience and perceived organisational support hold predictive value for employee engagement.Motivation for the study: Limited research has focused on the unique context of employee engagement as a construct in professional sales. A broader understanding of resilience and perceived organisational support can provide sales organisations with a lever to create an environment where sales employees are more fully engaged.Research design, approach and method: A quantitative, exploratory, cross-sectional survey approach was used. A sample of 125 sales representatives from a South African pharmaceutical organisation participated in the research. The measuring instruments included the Utrecht Work Engagement Scale (UWES), Brief Resilience Scale (BRS) and the Perceived Organisational Support Scale (POS).Main findings: Perceived organisational support, but not resilience impacted employee engagement in a competitive sales environment.Practical and managerial implications: Sales organisations’ interventions to improve sales employee engagement should focus on perceived organisational support.Contribution: The individual role of each construct provided insight into the sales context. The relationship between the constructs offered a different lens through which the drivers of employee engagement in sales can be viewed. This study contributes towards sales literature by including positive psychology and organisational support in a model of employee engagement.
Unclassified congenital deformities of the external ear
Authors: Vathulya Madhubari 
Published: May 2018

ABSTRACTCongenital ear deformities are a common entity. They are found in isolation or as a part of syndrome in patients. They may involve the external, middle or inner ear or in any of these combinations. Three patients of different ages presented with deformities including mirror image duplication of the superior auricle, unclassified deformities of ear lobule (wavy lobule) and deformity of superior auricle with unclassified variety of lateral ear pit. This article highlights that there are further cases of ear deformities that are noticed in the general population who come for cosmetic correction, and hence, there is a need for further modifying the classification of ear deformities.
Versatile use of dermal substitutes: A retrospective survey of 127 consecutive cases
Authors: Nicoletti Giovanni , Tresoldi Marco Mario , Malovini Alberto , Visaggio Marco , Faga Angela , Scevola Silvia 
Published: May 2018

ABSTRACT
Background: Dermal substitutes are currently largely used for the treatment of huge skin loss in patients in critical general health conditions, for the treatment of severe burns and to promote the healing process in chronic wounds. Aims: The authors performed a retrospective assessment of their experience with bioengineered skin to possibly identify the most appropriate clinical indication and management for each substitute. Materials and Methods: The study involved 109 patients with 127 skin defects repaired with dermal substitutes over a 9 years period, from 2007 to 2016. Hyalomatrix® was used in 63 defects, whereas Integra® and Nevelia® were used in 56 and 8 defects, respectively. Results: The statistical analysis failed to reveal a correlation between the choice of a specific dermal substitute and any possible clinical variable except in the soft-tissue defects of the scalp where Hyalomatrix® was electively used. Conclusions: In the authors’ experience, the scalp defects followed a radical excision of skin tumours that included the periosteum. Here, the preliminary cover with a hyaluronan three-dimensional scaffold constantly allowed for the regeneration of a derma-like layer with a rich vascular network fit for supporting a split-thickness skin graft. Nevertheless, the authors still prefer Integra® when the goal is a better cosmetic outcome and Hyalomatrix® when a faster wound healing is required, especially in the management of deep wounds where the priority is a fast obliteration with a newly formed tissue with a rich blood supply. However, these clinical indications still are anecdotally based.
Can drains be avoided in lipo-abdominoplasty?
Authors: Bhave Khair Medha Anand 
Published: May 2018

ABSTRACT
Context: Seroma formation is a common complication after lipoabdominoplasty. Conventionally, drains have been placed to prevent seroma; however, there are problems with drains, namely, pain, compromised mobilisation, breakage, tissue irritation and infection. Strategies to prevent seroma, such as the use of glue or quilting sutures have all been attempted with variable and unpredictable benefit. Aims: The author extrapolated the experience with own liposuction protocols to lipoabdominoplasty and began doing away with drains from the year 2006 onwards unless absolutely indicated. Incidence of complications is evaluated here. Settings and Design: This retrospective study is the report of our experience with 204 lipoabdominoplasties performed since 2006 upto December 2016. Subjects and Methods: Consecutive abdominoplasty patients were evaluated for seroma formation, wound dehiscence till suture removal. Nuances of operative details that helped avoid drains were contemplated. Results: Only one patient who had drainless abdominoplasty had seroma formation and wound dehiscence. Conclusions: We found that (a) ‘toilet liposuction’, (a term the author would like to introduce) (b) multilayer wound closure without tension, (c) avoidance of gliding surfaces d) continuous use of pressure garment for 4 days post-operative and (e) reducing the amount of infiltration are the key factors in avoidance of collections and thus seroma formation. If such a technique is diligently followed, desired results are obtained; yet there is no need to insert drains in most patients. Reducing the need of drains permits early ambulation and better patient comfort without seroma and other complications.
Reconstruction of Type II abdominal wall defects: Anterolateral thigh or tensor fascia lata myocutaneous flaps?
Authors: Srinivas Jammula S. , Panagatla Prakash , Damalacheru Mukunda Reddy 
Published: May 2018

ABSTRACT
Introduction: Reconstruction of complex abdominal wall defects is both challenging and technically demanding for plastic surgeon. Objectives in abdominal wall reconstruction are consistent and include restoration of abdominal wall integrity, protection of intra abdominal viscera and prevention of herniation. Materials: We conducted a retrospective study on five patients in whom lateral thigh flaps such as anterolateral thigh (ALT) flaps and tensor fascia lata (TFL) myocutaneous flaps as pedicled or free flaps were used for complex abdominal wall Type II defects over a 5-years period between 2007 and 2012. Results: In two patients, free flaps were used for reconstruction of the upper abdomen and both were ALT. In three patients of lower abdominal defects, one patient had bilateral pedicled ALT flaps, one pedicled TFL myocutaneous and one free TFL myocutaneous in view of ipsilateral electric burn scars. There were no flap losses. Patients were followed up beyond 6 months and found to have a good abdominal contour and only one of five had clinical evidence of herniation. Conclusion: It can be concluded that flap from the Lateral thigh (ALT or TFL) is flap of choice for large Type II abdominal defects. Including vascularised fascia in the flap maintains abdominal wall integrity and use of synthetic mesh is not necessary. Upper abdominal defects need free flaps and in lower abdominal defects a pedicled flap suffices.