bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preoperative Multimodal Analgesia Decreases Postanesthesia Care Unit Narcotic Use and Pain Scores in Outpatient Breast Surgery
Authors: Barker Jenny C. , DiBartola Kaitlin , Wee Corinne , Andonian Nicole , Abdel-Rasoul Mahmoud , Lowery Deborah , Janis Jeffrey E. 
Published: July 2018

Background:
The opioid epidemic demands changes in perioperative pain management. Of the 33,000 deaths attributable to opioid overdose in 2015, half received prescription opioids. Multimodal analgesia is a practice-altering evolution that reduces reliance on opioid medications. Ambulatory breast surgery is an ideal opportunity to implement these strategies.

Methods:
A retrospective review of 560 patients undergoing outpatient breast procedures was conducted. Patients received (1) no preoperative analgesia (n = 333); (2) intraoperative intravenous acetaminophen (n = 78); (3) preoperative oral acetaminophen and gabapentin (n = 95); or (4) preoperative oral acetaminophen, gabapentin and celecoxib (n = 54). Outcomes included postanesthesia care unit narcotic use, pain scores, postanesthesia care unit length of stay, rescue antiemetic use, and 30-day complications.

Results:
Both oral multimodal analgesia regimens significantly reduced postanesthesia care unit narcotic use (oral acetaminophen and gabapentin, 14.3 ± 1.7; oral gabapentin, acetaminophen, and celecoxib, 11.9 ± 2.2; versus no drug, 19.2 ± 1.1 mg oral morphine equivalents; p = 0.0006), initial pain scores (oral acetaminophen and gabapentin, 3.9 ± 0.4; oral gabapentin, acetaminophen, and celecoxib, 3.4 ± 0.7; versus no drug, 5.3 ± 0.3 on a 1 to 10 scale, p = 0.0002) and maximum pain scores (oral acetaminophen and gabapentin, 4.3 ± 0.4; oral gabapentin, acetaminophen, and celecoxib, 3.6 ± 0.7; versus no drug, 5.9 ± 0.3 on a 1 to 10 scale; p < 0.0001). Both oral regimens were better than no medications or intravenous acetaminophen alone in multivariate models after controlling for age, body mass index, American Society of Anesthesiologists class, length of surgery, prior narcotic prescription availability, and intraoperative local anesthetic. Postanesthesia care unit length of stay, antiemetic use, and 30-day complications were not different.

Conclusions:
Preoperative oral multimodal analgesia reduces narcotic use and pain scores in outpatient breast plastic surgery. These regimens are inexpensive, improve pain control, and contribute to narcotic-sparing clinical practice in the setting of a national opioid epidemic.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, III.
Augmentation Gluteoplasty: A Brazilian Perspective
Authors: Rosique Rodrigo G. , Rosique Marina J. F. 
Published: July 2018

Summary:
According to recent data, augmentation gluteoplasty continues to gain popularity in the United States and globally, especially in procedures involving fat grafts. However, serious concerns about its safety have been raised over the past 2 years. Will this trend continue or has it already reached its peak? The answer depends on how the technique is going to be performed hereafter. In this article, the following seven learning objectives for performing gluteal augmentation safely and effectively are covered: (1) the concept of what is a beautiful buttock and how to select the patients who will have better outcomes; (2) diagram each patient’s needs for liposuction and graft; (3) use maneuvers for contouring and projection; (4) compare specific indications for fat graft and gluteal implants; (5) evaluate ptosis grade to indicate whether volume repositioning is sufficient; (6) formulate care protocols for risk management; and (7) develop lasting and high-satisfaction-rate results. It is pivotal to recognize each patient’s body characteristics and ability to achieve a good result, and to work on her expectations preoperatively and accordingly to perform the procedure in the safest manner possible.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, V.
Broken Sacral Neuromodulation Lead Migration Into the Sigmoid Colon: A Case Report
Authors: Shannon Megan B. , Gupta Neil , Eberhardt Joshua , Farooq Ahmer V. 
Published: July 2018

Abstract
Sacral neuromodulation is an effective treatment of urinary incontinence, fecal incontinence, and idiopathic urinary retention. The procedure is considered low risk with overall low complication rates. This report describes a 40-year-old woman who underwent sacral neuromodulation explant and full-system implant for weaning efficacy of her device. During device removal, the tined lead broke and was left in situ. Four months later, she was diagnosed as having a wound infection at the site of the retained lead. Imaging revealed lead fragment migration into the sigmoid colon. A colocutaneous fistula was noted soon thereafter. The retained lead was removed during a colonoscopy and the fistula healed. A retained lead can result in migration through the peritoneum and into the colon. This can be managed with assistance from colorectal or gastroenterology consultants.
Incidence, Risk Factors and Outcomes of Early Acute Kidney Injury After Heart Transplantation: An 18-year Experience
Authors: García-Gigorro Renata , Renes-Carreño Emilio , Corres Peiretti María Angélica , Arribas López Primitivo , Perez Vela Jose Luis , Gutierrez Rodríguez Julián , Delgado Juan Francisco , Cortina Romero Jose María , Montejo González Juan Carlos 
Published: July 2018

Background
Little is known about the incidence of acute kidney injury (AKI), as defined using the Kidney Disease Improving Global Outcome classification, after heart transplantation (HT). Our objective was to evaluate the impact of AKI in a cohort of HT recipients. (Setting: University Hospital.)

Methods
We studied 310 consecutive HT recipients from 1999 to 2017, with AKI being defined according to the Kidney Disease Improving Global Outcome criteria. Risk factors were analyzed by multivariable analyses, and survival by Kaplan-Meier curves and a risk-adjusted Cox proportional hazards regression model.

Results
One hundred twenty-five (40.3%) patients developed AKI, with 73 (23.5%), 18 (5.8%), and 34 (11%) patients having AKI stages 1, 2, and 3, respectively. Cardiac tamponade (odds ratio [OR], 16.82; 95% confidence interval [CI], 1.06-138), acute right ventricular failure (OR, 3.54; 95% CI, 1.82-6.88), and major bleeding (OR, 2.46; 95% CI, 1.18-5.1) were the principal risk factors for AKI. Patients with AKI had a greater hospital mortality (3.8% vs 16%, P < 0.05), especially those requiring renal replacement therapy (46.9% vs 5.4%, P = 0.006). Acute kidney injury requiring renal replacement therapy was independently associated with hospital mortality (OR, 11.03; 95% CI, 4.08-29.8). With a median follow-up after hospital discharge of 6.7 years (interquartile range, 2.4-11.6), overall survival at 1, 5, and 10 years was 95.4%, 85.1%, and 75.4% versus 85.2%, 69.8% and 63.5% among patients without AKI and with AKI stages 2 to 3, respectively (P = 0.08).

Conclusions
The onset of AKI after HT is mainly associated with postoperative complications. Only severe AKI stage predicts worse short-term outcome, with this impact appearing to be lost at long-term follow-up.
Cavitating flow-induced unsteady pressure pulsations in a low specific speed centrifugal pump
Authors: Zhang Ning , Gao Bo , Li Zhong , Jiang Qifeng 
Published: July 2018

With the development of cavitation, the high-energy pressure wave from a cavitation bubble collapsing is detrimental to the stable operation of centrifugal pumps. The present paper concentrates on pressure pulsations under cavitation conditions, and pressure amplitudes at the blade-passing frequency (
f
BPF
) and RMS values in the 0–500 Hz frequency band are combined to investigate cavitation-induced pressure pulsations. The results show that components at
f
BPF
always dominate the pressure spectrum even at the full cavitation stage. For points P1–P7 on the volute side wall, with a decreasing cavitation number, the pressure energy first remains unchanged and then it rises rapidly after the critical point. For point In1 in a volute suction pipe located close to the cavitation region, the pressure energy changes slightly at high cavitation numbers; then for a particular cavitation number range, the pressure energy decreases, and finally increases again. For different flow rates, the pressure energy at the critical point is much lower than the initial amplitude at the non-cavitation condition for In1. This demonstrates that the cavitation cloud in the typical stage is partially compressible, and the emitted pressure wave from a collapsing cavitation bubble is absorbed and attenuated significantly. Finally, this leads to the pressure energy decreasing rapidly for the measuring point In1 near the cavitation region.
Specific histone modifications associate with alternative exon selection during mammalian development
Authors: Hu Q , Greene CS , Heller EA 
Published: July 2018

AbstractAlternative splicing (AS) is frequent during early mouse embryonic development. Specific histone post-translational modifications (hPTMs) have been shown to regulate exon splicing by either directly recruiting splice machinery or indirectly modulating transcriptional elongation. In this study, we hypothesized that hPTMs regulate expression of alternatively spliced genes for specific processes during differentiation. To address this notion, we applied an innovative machine learning approach to relate global hPTM enrichment to AS regulation during mammalian tissue development. We found that specific histone modifications, H3K36me3 and H3K4me1, play a dominant role in skipped exon selection among all the tissues and developmental time points examined. In addition, we used iterative random forest model to identify interactions of several hPTMs that associated with skipped exon selection during tissue development. Collectively, our data demonstrated a link between hPTMs and alternative splicing which will drive further experimental studies on the functional relevance of these modifications to alternative splicing.
Rns regulates nonpilus adhesin EtpA in human EnterotoxigenicE.coli(ETEC)
Authors: Madhavan T.P.Vipin 
Published: July 2018

AbstractRns, an araC family of transcriptional activator (AFTR) is known to regulate many of the known pili in human ETEC. Apart from pili, Rns is also known to regulate some nonpilus genes believed to have role in virulence. EtpA is a nonpilus adhesin, encoded with inetpBACoperon in ETEC genome. Using a combination of qRT-PCR and gel shift assay, we show that Rns binds to upstream of etpBAC operon and upregulates the expression of EtpA. This is the first report of Rns regulating a known virulence factor in ETEC.
The effect of anti-IL-6 receptor antibody for the treatment of McH-lpr/lpr-RA1 mice that spontaneously developed ankylosing arthritis
Authors: Izumiyama Takuya , Mori Yu , Takeda Kazu , Mori Naoko , Mori Shiro , Kodama Tetsuya , Itoi Eiji 
Published: July 2018

Abstract[Background]McH-lpr/lpr-RA1 mice are a new strain of mice which spontaneously develop arthritis in the ankle, leading finally to ankylosis. There is no published data that drug treatment has been trialed on these mice.[Objectives]This study examined the effect of the mouse anti-IL-6 receptor antibody, MR16-1, for the treatment of ankylosis in McH-lpr/lpr-RA1 mice.[Methods]Male McH-lpr/lpr-RA1 mice were randomly divided into control and treatment groups. MR16-1 was administered from 10 weeks of age for the treatment group. Saline was applied for the control group. The drug was administered once a week, at an initial dose of 2 mg, then maintained at 0.5 mg once per week thereafter. The effects were evaluated by the histopathological synovitis score, in vivo imaging using indocyanine green liposomes, and analysis of the gene expression of inflammatory cytokines.[Results]Tissue analyses were carried out at 14, 17 and 20 weeks of age. The synovitis scores of treated groups were significantly lower compared with those of the control group at every age. The kappa coefficient was 0.77. However, progression of ankylosis persisted in the MR16-1 treated group. In vivo imaging using indocyanine green liposomes showed significant decreases in signal intensities of treated groups at week 14, but no significant differences were observed at week 18. Blood serum amyloid A levels in treated groups were significantly lower at 17 weeks of age. The gene expression levels of Tnf and Il17 were also significantly lower in MR16-1 treated groups.[Conclusions]Administration of the anti-IL-6 receptor antibody is effective for the treatment of synovitis and bone destruction of McH-lpr/lpr-RA1 mice. McH-lpr/lpr-RA1 mice may be a suitable experimental model for the development of new treatments for spondyloarthritis. IL6 signal blockade could contribute to the treatment of spondyloarthritis, and further studies should be carried out to confirm its potential in the prevention of deformity associated with ankylosis.
Impacts of landscape composition, marginality, and climatic stability on the patterns of endemism of Cerrado woody plants
Authors: Vidal Júnior João de Deus , Souza Anete Pereira de , Koch Ingrid 
Published: July 2018

ABSTRACTAimAlthough various theories have been proposed to explain the outstanding endemism of plants in the Cerrado, four hypotheses about the mechanisms of diversification and distribution are most supported: (1) plateau/valley, (2) stable/unstable climate, (3) core/peripheral distribution, and (4) soil fertility. The first argues that plateaus harbor more ancient lineages than valleys and therefore presents higher endemism. The second theory suggests that climatic stable environments maintained more paleoendemic species. The third scenario attributes the distribution of endemism to gradients of conditions available to locally adapted species and predicts higher endemism in nuclear than in marginal areas. The last theory suggests that lower fertility soils account for higher endemism due to the habitat specialization of its species. We compared endemism patterns with the predictions of each theory to discuss their importance.LocationBrazil.Time periodQuaternary.Major taxa studiedAngiosperms.MethodsWe mapped the endemism using records of 311 plant species of the Cerrado and applied spatial analysis and distribution models to summarize the importance of each predictor of endemism.ResultsWe identified 28 areas in which the higher endemism of Cerrado plants were concentrated and presented a map of its distribution. We found correlations among endemism, climate stability, elevation, and marginality, which supported the plateau/valley, core/peripheral, and stable/unstable hypotheses. No association between soil fertility and endemism was detected. We propose that plateaus are more stable climatic environments, and this characteristic along with their elevation and centrality are predictive of endemism.Main conclusionsWe concluded that most of the endemism is concentrated in overlapping areas of stability of species, which are concentrated in higher elevation central regions. Soil fertility was not linked to endemism. We recommend that central plateaus in the Cerrado require special attention in conservation to optimize the protection of endemic species in the biome.
The role of geographical distance on the relationship between cultural intelligence and knowledge transfer
Authors: Vlajcic Davor , Marzi Giacomo , Caputo Andrea , Dabic Marina 
Published: July 2018

PurposeThe purpose of this paper is to investigate the ways in which the geographical distance between headquarters and subsidiaries moderates the relationship between cultural intelligence and the knowledge transfer process.Design/methodology/approachA sample of 103 senior expatriate managers working in Croatia from several European and non-European countries was used to test the hypotheses. Data were collected using questionnaires, while the methodology employed to test the relationship between the variables was partial least square. Furthermore, interaction-moderation effect was utilized to test the impact of geographical distance and, for testing control variables, partial least square multigroup analysis was used.FindingsCultural intelligence plays a significant role in the knowledge transfer process performance. However, geographical distance has the power to moderate this relationship based on the direction of knowledge transfer. In conventional knowledge transfer, geographical distance has no significant impact. On the contrary, data have shown that, in reverse knowledge transfer, geographical distance has a moderately relevant effect. The authors supposed that these findings could be connected to the specific location of the knowledge produced by subsidiaries.Practical implicationsMultinational companies should take into consideration that the further away a subsidiary is from the headquarters, and the varying difference between cultures, cannot be completely mitigated by the ability of the manager to deal with cultural differences, namely cultural intelligence. Thus, multinational companies need to allocate resources to facilitate the knowledge transfer between subsidiaries.Originality/valueThe present study stresses the importance of cultural intelligence in the knowledge transfer process, opening up a new stream of research inside these two areas of research.
Knowledge transfer within relationship portfolios: the creation of knowledge recombination rents
Authors: Pellegrini Massimiliano Matteo , Caputo Andrea , Matthews Lee 
Published: July 2018

PurposeThe purpose of this paper is to clarify the underdeveloped conceptualization of a particular type network rents, defined as knowledge recombination rents, related to the possibility for a firm to transfer and recombine knowledge within and across its portfolio of inter-organizational relationships.Design/methodology/approachAdopting a contingency approach, the authors develop a comprehensive model with propositions drawn from an original synthesis of the extant literature on the management of inter-organizational relationships.FindingsThe authors summarize the most important internal and external variables that explain how knowledge recombination rents arise within a firm’s portfolio of inter-organizational relationships. The authors create a seven-proposition model that considers: an “internal fit,” related to internal contingencies of the firm, specifically life stage and its strategy; an “external fit,” related to external contingencies of the network of the firm, specifically past experience and current portfolio structure.Research limitations/implicationsThe model is theory driven. Future research should validate empirically the relations proposed, especially in different industries and contexts.Practical implicationsThe model, beyond the fact of being theoretically sounded, is also completely practical oriented. Indeed, the authors developed a comprehensive model articulated in seven propositions which relationship managers can easily use to analyze and manage their portfolios of inter-organizational relationships.Originality/valueThe model allows us to assert that the value of an inter-organizational relationship is neither fixed nor just related to the single dyadic interaction; rather before engaging with a relationship is crucial to ponder possible benefits and harms. This is the central element in the contribution that develops an easy-to-use and comprehensive model based on best practices.
Unlocking innovation in the sport industry through additive manufacturing
Authors: Meier Marlon , Tan Kim Hua , Lim Ming K. , Chung Leanne 
Published: July 2018

Purpose
Fast-changing customer demands and rising requirements in product performance constantly challenge sports equipment manufacturers to come up with new and improved products to stay competitive. Additive manufacturing (AM), also referred to as 3D printing, can enhance the development of new products by providing an efficient approach of rapid prototyping. The purpose of this paper is to analyse the current adoption of AM technologies in the innovation process of the sports industry, i.e. level of awareness; how it is implemented; and it impact on the innovation process.

Design/methodology/approach
This work followed a qualitative research approach. After conducting a research of the current literature, this paper presents findings that include case studies from different companies, as well as a semi-structured interview with an outdoor sports equipment manufacturer. Companies from all over the world and of different sizes from under 100 employees to over 70,000 employees were considered in this research.

Findings
Literature research shows that AM brings many possibilities to enhance the innovation process, and case studies indicated several obstacles that hinder the technology from fully unfolding. AM is still at the early stage of entering the sports equipment industry and its potential benefits have not been fully exploited yet. The findings generated from the research of real-life practices show that AM provides several benefits when it comes to the innovation process, such as a faster development process, an optimised output, as well as the possibility to create new designs. However, companies are not yet able to enhance the innovation process in a way that leads to new products and new markets with AM. Limitations, including a small range of process able material and an inefficient mass production, still restrain the technology and lead to unused capability. Nevertheless, future prospects indicate the growing importance of AM in the innovation process and show that its advancement paves the way to new and innovative products.

Research limitations/implications
Limitations exist in the qualitative approach of this study, which does not include the quantitative verification of the results.

Originality/value
Very few studies have been conducted to investigate how firms can harvest AM to increase their innovation capabilities. How firms can use AM to shorten product development time is an emerging topic in business and operations but has not been studied widely. This paper aims to address this gap.
Servant leadership and transformational leadership: from comparisons to farewells
Authors: Andersen Jon Aarum 
Published: July 2018

Purpose
The purpose of this paper is to question the usefulness of comparisons between theories on servant leadership and transformational leadership.

Design/methodology/approach
A review of scholarly works on these two theories is presented from the original works of Greenleaf, Burns and Bass to the current research.

Findings
Based on the four categories of construct clarity, two competing alternatives are identifiable in the scholarship of both servant and transformational leadership. There are thus 16 versions of each theory.

Research limitations/implications
The literature review contains no new empirical data. The many versions available today of each theory do not make comparisons meaningful. The prevalence of several versions of theories on servant leadership and transformational leadership implies that they are no longer specific and useful theories.

Originality/value
Critical comments are presented on the usefulness of comparisons between servant leadership and transformational leadership. Thus, the value of these theories is also questioned.