bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Needs Assessment of Brain Death Education in Pediatric Critical Care Medicine Fellowships*
Authors: Ausmus Andrew M. , Simpson Pippa M. , Zhang Liyun , Petersen Tara L. 
Published: April 2018

Objectives:
To assess the current training in brain death examination provided during pediatric critical care medicine fellowship.

Design:
Internet-based survey.

Setting:
United States pediatric critical care medicine fellowship programs.

Subjects:
Sixty-four pediatric critical care medicine fellowship program directors and 230 current pediatric critical care medicine fellows/recent graduates were invited to participate.

Interventions:
Participants were asked demographic questions related to their fellowship programs, training currently provided at their fellowship programs, previous experience with brain death examinations (fellows/graduates), and perceptions regarding the adequacy of current training.

Measurements and Main Results:
Twenty-nine program directors (45%) and 91 current fellows/graduates (40%) responded. Third-year fellows reported having performed a median of five examinations (interquartile range, 3–6). On a five-point Likert scale, 93% of program directors responded they “agree” or “strongly agree” that their fellows receive enough instruction on performing brain death examinations compared with 67% of fellows and graduates (p = 0.007). The responses were similar when asked about opportunity to practice brain death examinations (90% vs 54%; p < 0.001). In a regression tree analysis, number of brain death examinations performed was the strongest predictor of trainee satisfaction. Both fellows and program directors preferred bedside demonstration or simulation as educational modalities to add to the fellowship curriculum.

Conclusions:
Pediatric critical care medicine fellows overall perform relatively few brain death examinations during their training. Pediatric critical care medicine fellows and program directors disagree in their perceptions of the current training in brain death examination, with fellows perceiving a need for increased training. Both program directors and fellows prefer additional training using bedside demonstration or simulation. Since clinical exposure to brain death examinations is variable, adding simulated brain death examinations to the pediatric critical care medicine fellowship curriculum could help standardize the experience.
Sera From Children After Cardiopulmonary Bypass Reduces Permeability of Capillary Endothelial Cell Barriers
Authors: Pierce Richard W. , Zahr Riad Abou , Kandil Sarah , Faustino E. Vincent S. , Pober Jordan S. 
Published: April 2018

Objectives:
Children undergoing cardiopulmonary bypass develop clinically impactful capillary leak of unclear etiology. A widely held hypothesis that exposure of circulating cells to the cardiopulmonary bypass circuit induces the release of inflammatory mediators that act to disrupt intercellular junctions of capillary endothelial cells inducing paracellular capillary leak either directly or through new gene expression.

Design:
Cohort study.

Setting:
Tertiary pediatric hospital.

Patients:
Twenty children undergoing surgery with cardiopulmonary bypass for congenital heart disease. Serum was collected before cardiopulmonary bypass, 2 hours after cardiopulmonary bypass, and 18 hours after cardiopulmonary bypass.

Interventions:
None.

Measurements and Main Results:
We analyzed the effects of 10% patient sera on the “function, structure, and gene expression” of cultured human dermal and pulmonary microvascular endothelial cells. Changes in barrier “function” were measured using transendothelial electrical resistance. Associations between changes in transendothelial electrical resistance and subject characteristics were analyzed using linear mixed effects model with area under the resistance curve as outcome. Changes in junctional “structure” were assessed by analyzing the organization of the endothelial cell junctional proteins claudin-5 and VE-cadherin using immunofluorescence microscopy. Changes in inflammatory “gene expression” were measured using real-time quantitative reverse transcription-polymerase chain reaction. All serum samples induced a transient, 120-minute increase in transendothelial electrical resistance followed by persistent loss of barrier function. Unexpectedly, sera collected postcardiopulmonary bypass–induced significantly less loss of barrier function in both dermal and pulmonary capillary endothelial cell compared with precardiopulmonary bypass sera. Consistent with the transendothelial electrical resistance results, claudin-5 and vascular endothelial-cadherin junctional staining showed less disruption in cultures treated with postcardiopulmonary bypass sera. Expression of genes commonly associated with inflammation was largely unaffected by patient sera.

Conclusions:
Contrary to the hypothesis, sera taken from children after cardiopulmonary bypass induces less capillary barrier disruption relative to sera taken from children before cardiopulmonary bypass, and none of the sera induced significant changes in expression of inflammatory genes.
Anti–nerve growth factor therapy attenuates cutaneous hypersensitivity and musculoskeletal discomfort in mice with osteoporosis
Authors: Suzuki Miyako , Millecamps Magali , Ohtori Seiji , Mori Chisato , Stone Laura S. 
Published: April 2018

Abstract

Introduction:
The prevalence of osteoporosis is increasing with the aging population and is associated with increased risk of fracture and chronic pain. Osteoporosis is currently treated with bisphosphonate therapy to attenuate bone loss. We previously reported that improvement in bone mineral density is not sufficient to reduce osteoporosis-related pain in an ovariectomy (OVX)-induced mouse model of osteoporosis, highlighting the need for new treatments. Targeting of nerve growth factor (NGF) with sequestering antibodies is a promising new direction for the treatment of musculoskeletal pain including back pain and arthritis. Its efficacy is currently unknown for osteoporotic pain.

Objective:
To investigate the efficacy of anti-NGF antibody therapy on osteoporotic pain in an OVX-induced mouse model.

Methods:
Ovariectomy- and sham-operated mice were injected with an anti-NGF antibody (10 mg/kg, intraperitoneally, administered 2×, 14 days apart), and the effect on behavioural indices of osteoporosis-related pain and on sensory neuron plasticity was evaluated.

Results:
Treatment with anti-NGF antibodies attenuated OVX-induced hypersensitivity to mechanical, cold, and heat stimuli on the plantar surface of the hind paw. The OVX-induced impairment in grip force strength, used here as a measure of axial discomfort, was partially reversed by anti-NGF therapy. No changes were observed in the rotarod or open-field tests for overall motor function and activity. Finally, anti-NGF treatment attenuated the increase in calcitonin gene-related peptide–immunoreactive dorsal root ganglia neurons observed in OVX mice.

Conclusion:
Taken together, these data suggest that anti-NGF antibodies may be useful in the treatment of prefracture hypersensitivity that is reported in 10% of patients with osteoporosis.
Preliminary Study on Molecular Subtypes of Breast Cancer Based on Magnetic Resonance Imaging Texture Analysis
Authors: Sun Xinru , He Bing , Luo Xin , Li Yuhua , Cao Jinfeng , Wang Jinlan , Dong Jun , Sun Xiaoyu , Zhang Guangxia 
Published: April 2018

Objective
The aim of the study was to investigate the molecular subtypes of breast cancer based on the texture features derived from magnetic resonance images (MRIs).

Methods
One hundred seven patients with preoperative confirmed breast cancer were recruited. One hundred eight breast lesions were divided into 4 subtypes according to the status of estrogen receptor, progesterone receptor, human epidermal growth factor receptor type 2, and Ki67. Fisher discriminant analysis was performed on the texture features that extracted from the enhanced high-resolution T1-weighted images and diffusion weighted images to establish the classification model of molecular subtypes.

Results
The differentiation accuracies of Fisher discriminant analysis on the enhanced high-resolution T1-weighted images were 82.8% and 86.4% for 1.5T and 3.0T imaging. Fisher discriminant analysis on diffusion weighted imaging texture features were achieved with a classification ability of 73.4% and 88.6%. The combined discriminant results for 2 kinds magnetic resonance images were 95.0%, 97.7% in 1.5T and 3.0T imaging, respectively.

Conclusions
The fine results indicated a promising approach to predict the molecular subtypes of breast cancer.
Dual-Energy Computed Tomography in Patients With Small Hepatocellular Carcinoma: Utility of Noise-Reduced Monoenergetic Images for the Evaluation of Washout and Image Quality in the Equilibrium Phase
Authors: Matsuda Megumi , Tsuda Takaharu , Kido Teruhito , Tanaka Hiroaki , Nishiyama Hikaru , Itoh Toshihide , Nakao Kenichi , Hirooka Masashi , Mochizuki Teruhito 
Published: April 2018

Purpose
This study aimed to evaluate the utility of virtual monoenergetic images for detecting washout of small (≤2 cm) hepatocellular carcinoma (HCC) in the equilibrium phase.

Methods
We performed 120-kVp–equivalent linear-blended (M120) and monoenergetic reconstructions from 40 to 90 keV by standard (40, 50, 60, 70, 80, 90) and novel noise-reduced (nMERA: 40+, 50+, 60+, 70+, 80+, 90+) monoenergetic reconstruction algorithms. Image quality and tumor visibility of delayed washout of HCCs in the equilibrium phase were compared between standard monoenergetic reconstruction algorithm and nMERA by objective and subjective analyses.

Results
Contrast-to-noise ratio of the tumor at 40+ was the highest, whereas the score of tumor visibility peaked at 50+. The score of overall image quality at 40+ was significantly lower than those on all other image series, and the image quality among other image series were not significantly different.

Conclusions
Virtual monoenergetic image reconstructed with nMERA 50+ was most appropriate to detect washout of small HCCs.
Adult Living Donor Liver Transplantation for Patients With Portal Vein Thrombosis: A Single-center Experience
Authors: Miura Kohei , Sugawara Yasuhiko , Uchida Koushi , Kawabata Seiichi , Yoshii Daiki , Isono Kaori , Hayashida Shintaro , Ohya Yuki , Yamamoto Hidekazu , Kobayashi Takashi , Wakai Toshifumi , Inomata Yukihiro , Hibi Taizo 
Published: April 2018

Background
Living donor liver transplantation (LDLT) for patients with portal vein thrombosis (PVT) is associated with several technical challenges for its complicated procedures and poor outcomes. Some institutions still consider preexisting PVT as a relatively contraindication for LDLT.

Methods
Between April 2010 and May 2016, 129 adults underwent LDLT at our institution, and 28 (21.7%) of whom had preexisting PVT. Portal vein thrombosis was diagnosed using preoperative imaging techniques and intraoperative findings. The characteristics and outcomes of the cases were retrospectively evaluated.

Results
The type of PVT included Yerdel grade 1 in 21 (75.0%) cases, grade 2 in 3 (10.7%) cases, and grade 3 in 4 (14.3%) cases. There were no cases of Yerdel grade 4 PVT. After removing thrombus inside the vessel, we performed simple portal vein anastomosis in 25 (89.3%) cases, patch technique with vascular graft in 1 case (3.6%), and an interposition technique with vascular graft in 2 cases (7.1%). Compared with the non-PVT group, cold ischemic time was longer (P = 0.012) and the rate of postoperative PVT was higher (P = 0.001) in PVT group. In the comparison between the recipient without and with postoperative PVT, the existence of preoperative PVT was the independent risk factor in the multivariate analysis (hazard ratio, 7.511; 95% confidence interval 1.382-40.820; P = 0.020).

Conclusions
Although it had a technically complicated operation, LDLT could be safely performed in the patients with PVT in our institution.
Biotic interactions limit the geographic range of an annual plant: herbivory and phenology mediate fitness beyond a range margin
Authors: Benning John W. , Eckhart Vincent M. , Geber Monica A. , Moeller David A. 
Published: April 2018

AbstractSpecies’ range limits offer powerful opportunities to study environmental factors regulating distributions and probe the limits of adaptation. However, we rarely know what aspects of the environment are actually constraining range expansion, much less which traits are mediating the organisms’ response to these environmental gradients. Though most studies focus on climatic limits to species’ distributions, biotic interactions may be just as important. We used field experiments and simulations to estimate contributions of mammal herbivory to a range boundary in the annual plantClarkia xantianassp.xantiana.A steep gradient of increasing probability of herbivory occurs across the boundary, and herbivory drives several-fold declines in lifetime fitness at and beyond the boundary. By including in our analyses data from a sister taxon with more rapid phenology, we show that delayed phenology drivesC. xantianassp.xantiana’ssusceptibility to herbivory and low fitness beyond its border.
Catalysis of cataract-associated human γD crystallin aggregation via dynamic disulfide exchange
Authors: Serebryany Eugene , Yu Shuhuai , Trauger Sunia A. , Budnik Bogdan , Shakhnovich Eugene I. 
Published: April 2018

AbstractSeveral mutations in human γD-crystallin (HγD), a long-lived eye lens protein, cause misfolding and aggregation, leading to cataract. Surprisingly, wild-type HγD catalyzes aggregation of its cataract related W42Q variant while itself remaining soluble – the inverse of the classical prion-like scenario whereby misfolded polypeptides catalyze aggregation of natively folded ones. The search for a biochemical mechanism of catalysis of W42Q aggregation by WT has revealed that WT HγD can transfer a disulfide bond to the W42Q variant. The transferred disulfide kinetically traps an aggregation-prone intermediate made accessible by the W42Q mutation, facilitating light-scattering aggregation of the W42Q variant. The aggregating variant thus becomes a disulfide sink, removing the disulfides from solution. Such redox “hot potato” competitions among wild-type and mutant or modified polypeptides may be relevant for many long-lived proteins that function in oxidizing environments. In these cases aggregation may be forestalled by inhibiting disulfide flow toward damaged polypeptides.
Controlled cycling and quiescence enables homology directed repair in engraftment-enriched adult hematopoietic stem and progenitor cells
Authors: Shin Jiyung , Wyman Stacia K. , Dewitt Mark A. , Bray Nicolas L , Vu Jonathan , Corn Jacob E. 
Published: April 2018

SummaryHematopoietic stem cells (HSCs) are the source of all blood components, and genetic defects in these cells are causative of disorders ranging from severe combined immunodeficiency to sickle cell disease. However, genome editing of long-term repopulating HSCs to correct mutated alleles has been challenging. HSCs have the ability to either be quiescent or cycle, with the former linked to stemness and the latter involved in differentiation. Here we investigate the link between cell cycle status and genome editing outcomes at the causative codon for sickle cell disease in adult human CD34+ hematopoietic stem and progenitor cells (HSPCs). We show that quiescent HSPCs that are immunophenotypically enriched for engrafting stem cells predominantly repair Cas9-induced double strand breaks (DSBs) through an error-prone non-homologous end-joining (NHEJ) pathway and exhibit almost no homology directed repair (HDR). By contrast, non-quiescent cycling stem-enriched cells repair Cas9 DSBs through both error-prone NHEJ and fidelitous HDR. Pre-treating bulk CD34+ HSPCs with a combination of mTOR and GSK-3 inhibitors to induce quiescence results in complete loss of HDR in all cell subtypes. We used these compounds, which were initially developed to maintain HSCs in culture, to create a new strategy for editing adult human HSCs. CD34+ HSPCs are edited, allowed to briefly cycle to accumulate HDR alleles, and then placed back in quiescence to maintain stemness, resulting in 6-fold increase in HDR/NHEJ ratio in quiescent, stem-enriched cells. Our results reveal the fundamental tension between quiescence and editing in human HSPCs and suggests strategies to manipulate HSCs during therapeutic genome editing.
An enhanced framework for assessing the operational performance of public-private partnership school projects
Authors: Saeed Ali Mohammed , Duffield Colin , Hui Felix Kin Peng 
Published: April 2018

Purpose
A study of the current practices for evaluating the ex-post performance of public-private partnership (PPP) school projects in Australia via literature review and qualitative case studies has found that no consistent approach exists for evaluating operational performance. A detailed critique of international PPP audits and practices has identified existing gaps in ex-post performance evaluation. Through a process of comparative analysis and industry confirmation, a performance analysis technique aligned with international practice has been developed that can be utilised by the educational departments across Australia to evaluate the ex-post performance of PPP projects (PPPs). The paper aims to discuss these issues.

Design/methodology/approach
This paper opted for qualitative archival analysis of case studies using pattern matching, explanation building, time series, and comparative analysis. The data used for document analysis included value reports, project summaries, and contract documents, as well as local and international audit guidelines.

Findings
This paper reviewed current practices, identified a range of processes, and reported the best practices. However, consideration of the approaches taken in the UK and Australia for evaluating operational performance indicates that current techniques lack consistency.

Research limitations/implications
The developed ex-post performance measurement framework is limited to Australian PPP school projects and, at this stage, cannot be generalised to other social PPP projects.

Practical implications
The paper includes implications for the development of better performance evaluation practices and audits.

Social implications
An enhanced framework for measuring operational performance will increase the accountability of taxpayers in the content of their utilisation by the government.

Originality/value
This paper presents an enhanced ex-post performance measurement framework for education departments across Australia.
Linking leadership practices to performance of the US federal agencies
Authors: Lee Hyung-Woo 
Published: April 2018

PurposeThe mechanism by which leadership influences organizational performance has largely been unexplained. This study intends to fill this gap. This study identified the six specific leadership practices: promoting inter-unit collaboration, managing diversity, providing performance feedback, ensuring goal directedness, developing employees, and resource provision. This study also identified a number of generic functions of leadership, that is, promoting cooperation, clarifying employees’ roles, and improving skills in organization. Then the mediating effects of the three generic functions were tested in order to link the specific leadership practices to organizational performance. The paper aims to discuss these issues.Design/methodology/approachStructural equation modeling was used for analyzing the data from the 2014 Federal Employee Viewpoint Survey to investigate the mediating model.FindingsThe effects of the six specific leadership practices on organizational performance were mediated by the three generic leadership functions.Originality/valueThe result of this study delineated the linking paths between leadership practices and organizational performance which has largely remained as a black box. Moreover, since the specific leadership practices are categorized by the generic functions that are instrumental for organizational performance, it provides theoretical and empirical grounds for managerial prescriptions for improving organizational performance.
Non-linear approach to Random Walk Test in selected African countries
Authors: Abakah Emmanuel Joel Aikins , Alagidede Paul , Mensah Lord , Ohene-Asare Kwaku 
Published: April 2018

PurposeThe purpose of this paper is to re-examine the weak form efficiency of five African stock markets (South Africa, Nigeria, Egypt, Ghana and Mauritius) using various tests to assess the impact of non-linearity effect and thin trading which are prevalent in African markets on market efficiency.Design/methodology/approachThe weekly returns of S&P/IFC return indices for five African countries over the period 2000-2013 were obtained from DataStream and analyzed. The study adopted the newly developed Non-Linear Fourier unit root test advanced by Enders and Lee (2004, 2009) which allows for an unknown number of structural breaks with unknown functional forms and non-linearity in data generating process of stock prices series to test the Random Walk Hypothesis (RWH) for the five markets, and an augment regression model.FindingsIn light of the empirical evidence the author(s) using Non-linear Fourier Unit Root Test only fail to reject the RWH for South Africa, Nigeria and Egypt leading to the conclusion that these markets follow the RWH and weak-form efficient whilst Ghana and Mauritius are weak-form inefficient. Besides, evaluating non-linear models without adjusting for thin trading effect shows that, South Africa and Ghana markets are weak-form efficient while Nigeria, Egypt and Mauritius are not. However, after accounting for thin trading effect, the author(s) find that South Africa and Egypt markets follow the RWH. The findings imply that market efficiency results depend on the methodology used.Originality/valueThis paper provides further evidence on stock market efficiency in emerging markets. The finding suggests that thin trading and non-linearity effect influences markets efficiency tests in African stock markets. Thus, recent structural adjustment and liberalization policies have not enhanced stock market operations in Africa. This paper therefore has implications for policy makers and international investors.
The “Pearl of the Orient” as a dark tourism destination in Malaysia
Authors: Tan Geraldine Anne , Lim Sonia 
Published: April 2018

Purpose
The purpose of this paper is to examine the potential of Penang in being a dark tourism destination in Malaysia with the influence of urban tourism development.

Design/methodology/approach
A systematic review was conducted to serve as a foundation by highlighting the number of dark tourism studies conducted in Southeast Asia (SEA).

Findings
The results projected a total of 23 dark tourism studies conducted within the SEA region. These papers revolve around the following key themes that were conducted in these countries: tourists’ behaviour (motivation, satisfaction and experience), nation building and narratives, dark tourism development (management, marketing and implications), theoretical underpinnings and the role of dark tourism. Amongst these, it was found that tourists’ behaviour is the most studied with eight papers while the least is on nation building and theoretical underpinnings of dark tourism with three papers each.

Research limitations/implications
The lack of dark tourism studies in SEA results in insufficient existing literature which justifies the need of exploring Penang as a potential dark tourism destination.

Originality/value
This paper builds on prior dark tourism studies that are significantly related to urban tourism but takes a step further by exploring the Asian settings. Specifically, into Malaysia which is more than just an SEA country, but a multicultural one which is rich and diverse with its culture and heritage that leads to many unique tourists’ destinations. This paper extends the geographical scope of the dark tourism literature as it focuses on Penang in Malaysia.