bluuebunny/crossref_metadata_2025_split huggingface dataset:
Credit Strategy in Small and Large Companies
Authors: Shipley David D. , Neale C.W. 
Published: December 2017

This article presents information drawn from surveys of US and UK businessmen. It indicates that, despite preconceptions, the quality of credit management among small enterprises compares favourably with that among large companies. However, it finds that from the customer's perspective the credit offerings of many firms in both countries and size classes could be improved. Suggestions are offered concerning the customer-generating characteristics of an attractive credit package, and businessmen in both countries are urged to make more use of facilities for management education. 1 1 The findings reported here are extracted from a broader investigation of marketing strategy conducted by Shipley. Gratitude is extended for the generous financial support provided by Shell UK Limited, Hallmark International Inc., Western Litho Plate Company, The Foundation for Management Education, and North Staffordshire Polytechnic.
Validation of an Innovative Teaching Approach for Entrepreneurship Courses
Authors: Ronstadt Robert , Sexton Donald L. , Bowman-Upton Nancy 
Published: December 2017

Don Sexton and Nancy Bowman-Upton's excellent article represents the first of a series of different authors on the general topic of teaching entrepreneurship. The series on teaching entrepreneurship is focused on what to teach students and particularly, how to teach it. Future coverage can include other areas besides undergraduate and graduate teaching, assuming papers of high quality are forthcoming. Our intent is to expedite the review process, so if you have a paper on teaching entrepreneurship, I can promise you a timely response.
Wnt3a promotes pro-angiogenic features in macrophages in vitro: Implications for stroke pathology
Authors: Fuster-Matanzo Almudena , Manferrari Giulia , Marchetti Bianca , Pluchino Stefano 
Published: December 2017

Wnt3a is implicated in several key cellular processes and its expression has been reported in different cell types. Here, we report a novel function for Wnt3a in macrophages, whose exposure to this ligand shifts them towards a pro-angiogenic phenotype capable, under oxygen and glucose deprivation, of inducing in vitro tubular pattern structures in endothelial cells resembling capillary-like vasculature. These newly acquired angiogenetic features also include increased proliferation and migration and surprisingly, an increase in cell death. This work provides a new link between Wnt3a and macrophage-mediated angiogenesis under glucose and oxygen deprivation in vitro, which are worth further investigation in pathological conditions including stroke, where the stimulation of the angiogenic process might help to recovery after tissue injury Impact statement This work provides a new link between Wnt3a and macrophage-mediated angiogenesis under glucose and oxygen deprivation in vitro. Our results reveal how Wnt3a shifts macrophages towards a pro-angiogenic phenotype, which is able–in absence of both glucose and oxygen–of inducing angiogenesis in vitro, thus pointing to a synergy between the activation of the pathway and the hypoxia scenario. This work also demonstrates that modulation of cell death is key in order to explain the observed angiogenic effects. We consider all these findings of significant importance, since no connection between Wnt3a, macrophages, and angiogenesis has been established so far. Furthermore, we do believe that this work provides new and interesting results, with Wnt signaling pathway emerging as an interesting target mediating beneficial outcomes during the inflammatory response undoubtedly linked to stroke pathology, where angiogenesis has been already proposed as a potential mechanism to promote recovery after the injury.
Changes needed to medicine in the UK before senior UK-trained doctors, working outside the UK, will return: questionnaire surveys undertaken between 2004 and 2015
Authors: Lambert Trevor W , Smith Fay , Goldacre Michael J 
Published: December 2017

Objective To report the changes to UK medicine which doctors who have emigrated tell us would increase their likelihood of returning to a career in UK medicine. Design Questionnaire survey. Setting UK-trained medical graduates. Participants Questionnaires were sent 11 years after graduation to 7158 doctors who qualified in 1993 and 1996 in the UK: 4763 questionnaires were returned. Questionnaires were sent 17 and 19 years after graduation to the same cohorts: 4554 questionnaires were returned. Main outcome measures Comments from doctors working abroad about changes needed to UK medicine before they would return. Results Eleven years after graduation, 290 (6%) of respondents were working in medicine abroad; 277 (6%) were doing so 17/19 years after graduation. Eleven years after graduation, 53% of doctors working abroad indicated that they did not intend to return, and 71% did so 17/19 years after graduation. These respondents reported a number of changes which would need to be made to UK medicine in order to increase the likelihood of them returning. The most frequently mentioned changes cited concerned ‘politics/management/funding’, ‘pay/pension’, ‘posts/security/opportunities’, ‘working conditions/hours’, and ‘factors outside medicine’. Conclusions Policy attention to factors including funding, pay, management and particularly the clinical–political interface, working hours, and work–life balance may pay dividends for all, both in terms of persuading some established doctors to return and, perhaps more importantly, encouraging other, younger doctors to believe that the UK and the National Health Service can offer them a satisfying and rewarding career.
Biomechanical Comparison of Single- Versus Double-Row Capsulolabral Repair for Shoulder Instability: A Review
Authors: Yousif Matthew John , Bicos James 
Published: December 2017

Background: The glenohumeral joint is the most commonly dislocated joint in the body. Failure rates of capsulolabral repair have been reported to be approximately 8%. Recent focus has been on restoration of the capsulolabral complex by a double-row capsulolabral repair technique in an effort to decrease redislocation rates after arthroscopic capsulolabral repair. Purpose: To present a review of the biomechanical literature comparing single- versus double-row capsulolabral repairs and discuss the previous case series of double-row fixation. Study Design: Narrative review. Methods: A simple review of the literature was performed by PubMed search. Only biomechanical studies comparing single- versus double-row capsulolabral repair were included for review. Only those case series and descriptive techniques with clinical results for double-row repair were included in the discussion. Results: Biomechanical comparisons evaluating the native footprint of the labrum demonstrated significantly superior restoration of the footprint through double-row capsulolabral repair compared with single-row repair. Biomechanical comparisons of contact pressure at the repair interface, fracture displacement in bony Bankart lesion, load to failure, and decreased external rotation (suggestive of increased load to failure) were also significantly in favor of double- versus single-row repair. Recent descriptive techniques and case series of double-row fixation have demonstrated good clinical outcomes; however, no comparative clinical studies between single- and double-row repair have assessed functional outcomes. Conclusion: The superiority of double-row capsulolabral repair versus single-row repair remains uncertain because comparative studies assessing clinical outcomes have yet to be performed.
Discharge and Readmission Rates with Atypical Antipsychotic Agents
Authors: Goren Jessica L , Levin Gary M 
Published: December 2017

Objective Newer atypical antipsychotic agents offer many advantages over conventional antipsychotic agents, including a decreased adverse effect burden, improved compliance, and superior efficacy. However, the atypical antipsychotic agents are considerably more expensive than conventional agents. We conducted a retrospective review to determine whether one atypical antipsychotic agent provided a significant advantage with regard to discharge or readmission rates in the inpatient population of a state psychiatric facility. In addition, we assessed whether one atypical antipsychotic agent was associated with an increased use of concomitant medications. Methods All records for patients started on clozapine, risperidone, or olanzapine at any time during 1997 were reviewed. Each inpatient started on a study medication had his or her records reviewed for 1 full year after the medication start date. Each record was assessed for discharge status and concomitant psychotropic medication use. For those patients discharged, the readmission status was followed. Results Patients treated with clozapine had the highest discharge rate (54%) and lowest readmission rate (16%) compared with risperidone (39% and 26%, respectively; p = 0.75) and olanzapine (39% and 26%, respectively; p = 0.88). Conclusions The highest discharge rate was seen in patients receiving clozapine. Treatment with risperidone was associated with the highest readmission rate and concomitant psychotropic use. Although the results are limited because of a small sample size, these findings provide some insight into the long-term efficacy of atypical antipsychotics and some potential differences in recidivism rates. These findings also suggest the need and importance of further study in this area.
Atrial Fibrillation Induced by Oral Methylprednisolone
Authors: Juni Samuel , Kerstein Moshe 
Published: December 2017

Objective To report a case of atrial fibrillation (AF) due to oral methylprednisolone. Case Summary A 45-year-old white man with chronic intermittent paroxysmal supraventricular tachycardia (PSVT) reacted to oral methylprednisolone by developing a PSVT episode that elicited an 18-hour episode of AF. AF was resolved by discontinuing methylprednisolone and administering oral nadolol, and no recurrence was reported for 6 years. Discussion This appears to be the first published report linking AF to oral methylprednisolone. Based on an analysis of the literature, it is suggested that AF may be triggered by any autonomic paroxysmal event in some individuals. Accepting the clinical evidence linking methylprednisolone to PSVT, the case is elaborated as having involved an initial atrial paroxysmal reaction to the drug, which then triggered AF. Conclusions Clinicians may wish to consider history of arrhythmias, and to monitor them, when prescribing oral methylprednisololne.
The Management of Dog Bites
Authors: McDermitt Beth A , Romanchak Nancy L , Ponte Charles D 
Published: December 2017

Objective To review the contemporary management of dog bites with an emphasis on clinical presentation, wound care, microbiology, antimicrobial prophylaxis, and treatment. Data Sources The published literature was searched by use of MEDLINE (1990-December 2000) and bibliographic reviews of relevant textbooks and review articles. Data Selection and Extraction Review articles, case reports, appropriate meta-analyses, and relevant textbook chapters dealing with mammalian bites and their management were evaluated. All pertinent information was synthesized and incorporated into the present review. Data Synthesis The incidence of serious and fatal dog bites has increased because of the acquisition of larger, more aggressive breeds. School-age children and young adults are at the highest risk. Most bites occur on the upper extremities, although head and neck bites are also common. The risk of infection is greatest for crush injuries, puncture wounds, and hand wounds. Infection tends to develop within 24–36 hours of the injury. Complications include osteomyelitis, septic arthritis, tenosynovitis, and septicemia. Most infections are polymicrobial and involve organisms isolated from the skin of the patient and the indigenous oral flora of the dog. Bites should be initially managed under accepted wound care protocols. Wound closure remains controversial and should be reserved for facial and head wounds. Immobilization and elevation are essential for therapeutic success. Prophylactic antibiotics should be reserved for bites at high risk for infection and the immunocompromised host. Whether for prophylaxis or treatment, empiric antimicrobial therapy should be directed against the most common bacteria: Pasteurella spp., streptococci, staphylococci, and anaerobes. Duration and route are dependent on the location and severity of the wound. Conclusions Dogs remain the major cause of mammalian bites in the US. It is important for clinicians to have an understanding of the contemporary management of dog bites. Good wound care is central to the prevention and treatment of complications. Appropriate antimicrobial therapy should be directed against both aerobic and anaerobic flora. Careful monitoring is imperative, and antibiotic changes should be made based on clinical response and, if appropriate, the results of culture and sensitivity reports.
The Role of Leukotriene Modifiers in the Management of Exercise-Induced Bronchoconstriction
Authors: Kelly Charles B , Rodgers Philip T 
Published: December 2017

Objective To review the use of leukotriene modifiers in exercise-induced bronchoconstriction (EIB). Data Source A MEDLINE search (1966–March 2001) identified pertinent English-language publications on EIB in humans. Study Selection Selection of prospective clinical studies was limited to those that focused on prevention of EIB with leukotriene modifiers, including both leukotriene receptor antagonists and 5-lipoxygenase inhibitors. Data Synthesis Leukotriene modifiers have been shown to attenuate EIB in patients with mild to intermittent, stable asthma from exacerbations after exercise, especially those with a predicted forced expiratory volume in 1 second (FEV1) >80% and who did not require corticosteroids. Extrapolation to patients with more severe forms of asthma cannot be made because of the lack of currently available data in these types of patients. Children may benefit from the oral dosage forms of leukotriene modifiers if they have difficulty using a metered-dose inhaler. The current literature supports a lack of a tolerance effect with leukotriene modifiers, as opposed to tachyphylaxis seen with beta2-adrenergic drugs after repeated dosing. As many as 25% of EIB patients will not respond to therapy with leukotriene modifiers. Montelukast has the greatest volume of data and the most positive benefits of the available leukotriene modifiers. Conclusions Evidence supports the use of leukotriene modifiers for protection of EIB in patients with stable, mild to intermittent asthma with a predicted FEV1 ≥80% if beta-agonists are intolerable or ineffective. Potential benefits include the lack of a tolerance effect, the long duration of action exhibited by some leukotriene modifiers, and the availability of a tablet form. Beta2-adrenergic drugs should remain the first-line therapy for EIB; however, leukotriene modifiers may provide a valuable alternative in those few who cannot use short-acting beta-agonists. Long-term safety studies of leukotriene modifiers in children and the elderly with EIB are necessary before widespread use can be advocated in the pediatric and geriatric populations.
Adverse Reactions to Metoclopramide in Young Children: A 6-Year Retrospective Study and Review of the Literature
Authors: Lifshitz Matityahu , Gavrilov Vladimir 
Published: December 2017

Objective To report our experience with children admitted to the emergency department between the years 1994 and 1999 for adverse reactions to metoclopramide. Patients and Methods The medical records of 52 children admitted for adverse reactions to metoclopramide were analyzed retrospectively. All the patients had been prescribed metoclopramide for the treatment of nausea and vomiting. Results The patients' ages ranged from 1.5 to 4.5 years (median 2.4 y). All had manifested various dystonic symptoms that occurred several hours after ingestion of 1 or 2, rarely more, doses of metoclopramide. Thirty-two patients had received metoclopramide 0.1 mg/kg/dose, 11 children 0.2 mg/kg/dose, 7 pateints 0.3 mg/kg/dose; for the remaining 2 children, the dosage was not known. The prominent clinical sign in all the children was oculogyric crisis. All the patients who had received a two- to threefold overdose, as well as those infants for whom the dosage was not known, experienced drowsiness. All 52 children were treated intravenously with a single dose of procyclidine hydrochloride 0.1 mg/kg. Extrapyramidal symptoms were abolished 15–30 minutes after treatment, and the children were discharged home 2–3 hours after treatment, free of symptoms. Conclusions Young children are especially susceptible to adverse reactions from metoclopramide, particularly oculogyric crisis. Therefore, physicians should use this drug with great caution. Our study indicates that it is fairly safe to treat oculogyric crisis in children with a single intravenous injection of procyclidine hydrochloride 0.1 mg/kg.
Use of Digoxin Monitoring in a Hospital Setting as an Essential Tool in Optimizing Therapy
Authors: Mayan Haim , Bloom Einat , Hoffman Amnon 
Published: December 2017

Objective To determine what triggers the use of digoxin therapeutic drug monitoring (TDM) that adheres to established indications and the change in digoxin dosage after the result of monitoring is obtained. Methods This prospective study included 86 patients admitted to 6 medicine wards and 2 intensive cardiac care unit wards in a tertiary-care center. Data on patients' demographics, drug therapy, serum chemistry values, indications for digoxin therapy, indications for ordering the drug assay, timing of the blood sample relative to administration of the last dose, and physicians' decisions after attaining serum digoxin concentrations were collected. Results Eighty-six digoxin assays were evaluated. Indications for the use of a digoxin assay were mostly routine without a clear indication (66%); in only 22% of the assays were orders considered clinically justified. Eleven patients had concentrations >2 ng/mL, but only 8 patients had digoxin intoxication. In only 31% of patients did the medical staff respond to the results. In only 21% of patients with subtherapeutic drug concentrations was there a change in digoxin dose. Conclusions Although there are clear indications for the use of digoxin TDM, physicians seem to routinely order these blood tests. The clinicians did not adequately use the digoxin concentration data to optimize therapy. The assistance of a clinical pharmacist or pharmacologist is warranted for use of the assays, to optimize digoxin therapy.
Impact of Clozapine versus Haloperidol on Conditional Release Time and Rates of Revocation in a Forensic Psychiatric Population
Authors: Stoner Steven C , Lea Jessica S Wehner , Dubisar Beth M , Roebuck-Colgan Kathleen , Vlach David M 
Published: December 2017

Background Clozapine remains the cornerstone of treatment for treatment refractory schizophrenia. Clozapine has been shown to improve quality of life and cognitive functioning and to reduce hospital days in psychiatric patients. The impact of clozapine in a forensic population of psychiatric patients has not been studied. Methods This study is a naturalistic, retrospective database analysis of forensic patients hospitalized at the Northwest Missouri Psychiatric Rehabilitation Center from January 1, 1990 to August 1, 1999 who were treated with clozapine or haloperidol. Patients were either court ordered for hospitalization as having been found not guilty by reason of insanity or as incompetent to proceed to trial. Results Data from 84 patients (69 male, 15 female) were included in the analysis. The primary Axis I diagnoses were substance abuse (n = 61) and schizophrenia (n = 46). Patients had been treated with haloperidol (n = 78) and clozapine (n = 21), and some had received each agent as monotherapy during their course of treatment (n = 15). Assault (n = 22), armed criminal action (n = 18), and burglary (n = 18) were the primary forensic reasons for admission. Of those eligible to obtain a conditional release, 33% of haloperidol-treated patients and 38% of clozapine-treated patients obtained their conditional release on those medications. Haloperidol-treated patients were more likely to have their conditional release revoked (58.8%) versus those treated with clozapine (0%). Clozapine-treated patients were also more likely to stay on conditional release for longer periods of time. Global Assessment of Functioning (GAF) scores improved in both treatment groups; however, of 15 patients converted from haloperidol to clozapine, 93% (n = 14) saw improvements in GAP scores. Conclusions Clozapine and haloperidol effectively reduce psychosis and aggression. In our study, clozapine-treated patients were more likely to obtain a conditional release and stayed on conditional release for longer periods of time. Although the need exists to study this patient population more closely from a longitudinal standpoint, one may suspect that these findings represent a potential decrease in healthcare costs for the treatment of forensic psychiatric patients.
Liposomal Amphotericin B for Visceral Leishmaniasis in a Kidney Allograft Patient
Authors: Valente Marina , Marroni Massimo , Sfara Claudio , Francisci Daniela , Malincarne Lisa , Gubbiotti Giampiero , Cozzari Massimo , Tordini Giacinta , Stagni Giuliano 
Published: December 2017

Objective To report a case of visceral leishmaniasis treated with liposomal amphotericin B (LAB) after probable failure with amphotericin B lipid complex (ABLC). Case Summary A 62-year-old white renal transplant recipient was admitted for pyrexia, hepato-splenomegaly, and pancytopenia. Leishmania amastigotes were detected from bone marrow aspirate and in circulating blood monocytes and neutrophils. The patient, who weighed 56 kg, received ABLC at a starting dose of 200 mg/d (3.6 mg/kg of body weight per day) for 13 days, achieving a total dose of 2,600 mg (46 mg/kg) without clinical improvement. The patient was switched to 100 mg/d (1.8 mg/kg) of LAB for 10 days, after which a dose of 250 mg (4.5 mg/kg) was repeated on days 17,24,31, and 38. Twenty-four hours after the first dose of LAB, the patient showed an excellent clinical response. On the following days, there was a progressive increase in hemoglobin concentration and leukocyte and platelet counts. Three months later, the patient was asymptomatic. Discussion Although treatment with ABLC appears to be effective for the treatment of Indian patients with visceral leishmaniasis, experience with immunocompromised patients is limited. This is the first case of a renal transplant recipient in which ABLC was used to treat visceral leishmaniasis without remarkable efficacy, but with infusion-related adverse effects perhaps due to the use of higher doses. Conclusions A randomized comparative trial is needed to compare LAB with ABLC in the treatment of visceral leishmaniasis in patients who have received kidney allografts.