bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patient and Organizational Factors Associated With Delays in Antimicrobial Therapy for Septic Shock*
Authors: Amaral Andre C. K. B. , Fowler Robert A. , Pinto Ruxandra , Rubenfeld Gordon D. , Ellis Paul , Bookatz Brian , Marshall John C. , Martinka Greg , Keenan Sean , Laporta Denny , Roberts Daniel , Kumar Anand 
Published: July 2016

Objectives:
To identify clinical and organizational factors associated with delays in antimicrobial therapy for septic shock.

Design:
In a retrospective cohort of critically ill patients with septic shock.

Setting:
Twenty-four ICUs.

Patients:
A total of 6,720 patients with septic shock.

Interventions:
None.

Measurements and Main Results:
Higher Acute Physiology Score (+24 min per 5 Acute Physiology Score points; p < 0.0001); older age (+16 min per 10 yr; p < 0.0001); presence of comorbidities (+35 min; p < 0.0001); hospital length of stay before hypotension: less than 3 days (+50 min; p < 0.0001), between 3 and 7 days (+121 min; p < 0.0001), and longer than 7 days (+130 min; p < 0.0001); and a diagnosis of pneumonia (+45 min; p < 0.01) were associated with longer times to antimicrobial therapy. Two variables were associated with shorter times to antimicrobial therapy: community-acquired infections (–53 min; p < 0.001) and higher temperature (–15 min per 1°C; p < 0.0001). After adjusting for confounders, admissions to academic hospitals (+52 min; p< 0.05), and transfers from medical wards (medical vs surgical ward admission; +39 min; p < 0.05) had longer times to antimicrobial therapy. Admissions from the emergency department (emergency department vs surgical ward admission, –47 min; p< 0.001) had shorter times to antimicrobial therapy.

Conclusions:
We identified clinical and organizational factors that can serve as evidence-based targets for future quality-improvement initiatives on antimicrobial timing. The observation that academic hospitals are more likely to delay antimicrobials should be further explored in future trials.
Electroencephalographic Response to Sodium Nitrite May Predict Delayed Cerebral Ischemia After Severe Subarachnoid Hemorrhage
Authors: Garry Payashi S. , Rowland Matthew J. , Ezra Martyn , Herigstad Mari , Hayen Anja , Sleigh Jamie W. , Westbrook Jon , Warnaby Catherine E. , Pattinson Kyle T. S. 
Published: July 2016

Objectives:
Aneurysmal subarachnoid hemorrhage often leads to death and poor clinical outcome. Injury occurring during the first 72 hours is termed “early brain injury,” with disruption of the nitric oxide pathway playing an important pathophysiologic role in its development. Quantitative electroencephalographic variables, such as α/δ frequency ratio, are surrogate markers of cerebral ischemia. This study assessed the quantitative electroencephalographic response to a cerebral nitric oxide donor (intravenous sodium nitrite) to explore whether this correlates with the eventual development of delayed cerebral ischemia.

Design:
Unblinded pilot study testing response to drug intervention.

Setting:
Neuroscience ICU, John Radcliffe Hospital, Oxford, United Kingdom.

Patients:
Fourteen World Federation of Neurosurgeons grades 3, 4, and 5 patients (mean age, 52.8 yr [range, 41–69 yr]; 11 women).

Interventions:
IV sodium nitrite (10 μg/kg/min) for 1 hour.

Measurements and Main Results:
Continuous electroencephalographic recording for 2 hours. The alpha/delta frequency ratio was measured before and during IV sodium nitrite infusion. Seven of 14 patients developed delayed cerebral ischemia. There was a +30% to +118% (range) increase in the alpha/delta frequency ratio in patients who did not develop delayed cerebral ischemia (p < 0.0001) but an overall decrease in the alpha/delta frequency ratio in those patients who did develop delayed cerebral ischemia (range, +11% to –31%) (p = 0.006, multivariate analysis accounting for major confounds).

Conclusions:
Administration of sodium nitrite after severe subarachnoid hemorrhage differentially influences quantitative electroencephalographic variables depending on the patient’s susceptibility to development of delayed cerebral ischemia. With further validation in a larger sample size, this response may be developed as a tool for risk stratification after aneurysmal subarachnoid hemorrhage.
Regional hyperthermia for high-risk soft tissue sarcoma treatment: present status and next questions
Authors: Issels Rolf , Lindner Lars H. 
Published: July 2016

Purpose of review
Recent developments of neo-adjuvant chemotherapy treatment strategies for high-risk soft tissue sarcoma (STS) with special emphasis on regional hyperthermia (RHT) are reviewed.

Recent findings
Attempts to improve outcomes using up-front strategies in addition to surgery have essentially focused on neo-adjuvant and adjuvant chemotherapy or preoperative radiochemotherapy. Unfortunately, the results are either confounded by retrospective analyses of nonrandomized studies with small sample size or are negative showing no substantial clinical benefit in the few randomized trials. RHT targets the region of tumor burden by heat. The pleotropic effects on malignant cells and tumor stroma to counteract tumor growth and progression have been recently summarized as hallmarks of hyperthermia. An updated analysis of a completed EORTC-ESHO Intergroup randomized phase 3 trial for the most common types of high-risk STS demonstrates a significantly improved long-term overall survival for patients receiving RHT in combination with neo-adjuvant chemotherapy added to standard surgery and postoperative radiation.

Summary
By comparison with other strategies, RHT combined with preoperative and postoperative chemotherapy improves overall survival and adds an important but underused standard for high-risk STS.
Obstructive anomalies of the gynecologic tract
Authors: Patel Vrunda , Gomez-Lobo Veronica 
Published: July 2016

Purpose of review
This review discusses current diagnosis, management and outcomes of obstructive anomalies of the gynecologic tract.

Recent findings
In this review, we will discuss the clinical presentation of obstructive anomalies, surgical management and reproductive outcomes following surgical intervention.

Summary
Identification of obstructive anomalies of the gynecologic tract is crucial when evaluating patients presenting with or without menses and cyclical pain. Surgical management is often the preferred modality for treatment, although menstrual suppression is recommended in certain circumstances.
Four steps to preserving adolescent confidentiality in an electronic health environment
Authors: Williams Rebekah L. , Taylor Julia F. 
Published: July 2016

Purpose of review
Best practices in adolescent care require the ability to provide confidential services, particularly for reproductive health care. As systems implement electronic health records and patients use health portals to access information and communicate with their healthcare team, special attention should be paid to protection of adolescent confidentiality in the electronic environment.

Recent findings
Professional organizations have issued guidance for electronic health records and portal use, but implementation has varied widely between systems, with multiple risks for breaches of confidentiality. Despite interest from patients and families, adolescent health portal use remains low.

Summary
Understanding the legal and electronic environments in which we care for adolescent patients allows us to educate, advocate, and implement our electronic tools in a way that respects our adolescent patients’ need for confidential care, the importance of their caregivers in promoting their health, and the legal rights of both.
Multidisciplinary Oncoplastic Approach Reduces Infection in Chest Wall Resection and Reconstruction for Malignant Chest Wall Tumors
Authors: Khalil Haitham H. , Malahias Marco N. , Balasubramanian Balapathiran , Djearaman Madava G. , Naidu Babu , Grainger Melvin F. , Kalkat Maninder 
Published: July 2016

Background:
Management of complex thoracic defects post tumor extipiration is challenging because of the nature of pathology, the radical approach, and the insertion of prosthetic material required for biomechanical stability. Wound complications pose a significant problem that can have detrimental effect on patient outcome. The authors outline an institutional experience of a multidisciplinary thoracic oncoplastic approach to improve outcomes.

Methods:
Prospectively collected data from 71 consecutive patients treated with chest wall resection and reconstruction were analyzed (2009–2015). The demographic data, comorbidities, operative details, and outcomes with special focus on wound infection were recorded. All patients were managed in a multidisciplinary approach to optimize perioperative surgical planning.

Results:
Pathology included sarcoma (78%), locally advanced breast cancer (15%), and desmoids (6%), with age ranging from 17 to 82 years (median, 42 years) and preponderance of female patients (n = 44). Chest wall defects were located anterior and anterolateral (77.5%), posterior (8.4%), and apical axillary (10%) with skeletal defect size ranging from 56 to 600 cm2 (mean, 154 cm2). Bony reconstruction was performed using polyprolene mesh, methyl methacrylate prosthesis, and titanium plates. Soft tissue reconstructions depended on size, location, and flap availability and were achieved using regional, distant, and free tissue flaps. The postoperative follow-up ranged from 5 to 70 months (median, 32 months). All flaps survived with good functional and aesthetic outcome, whereas 2 patients experienced surgical site infection (2.8%).

Conclusions:
Multidisciplinary thoracic oncoplastic maximizes outcome for patients with large resection of chest wall tumors with reduction in surgical site infection and wound complications particularly in association with rigid skeletal chest wall reconstruction.
Infant Mandibular Distraction for Upper Airway Obstruction: A Clinical Audit
Authors: Adhikari Ashim N. , Heggie Andrew A.C. , Shand Jocelyn M. , Bordbar Patrishia , Pellicano Anastasia , Kilpatrick Nicky 
Published: July 2016

Background:
Mandibular distraction osteogenesis (MDO) is an effective method of treating upper airway obstruction (UAO) in micrognathic infants. The short-term outcomes include relief of UAO, avoidance of tracheostomy, and prompt discharge from hospital. However, it is a significant surgical procedure with potential associated morbidities. This study describes a cohort of infants managed using MDO over a twelve-year period.

Methods:
A retrospective chart review was undertaken for children who had MDO before the age of 5 years between 2000 and 2012. This was followed by a clinical review of the same cohort specifically looking for dental anomalies, nerve injuries, and scar cosmesis.

Results:
Seventy-three children underwent MDO at a mean age of 2 months [interquartile range (IQR), 1.7–4.2] for nonsyndromic infants and 3.3 months (IQR, 2.1–7.4) for those with syndromes. Infants were discharged from hospital, on average, 15 days after procedure. After MDO, of the 9 who were previously tracheostomy dependent, 5 (56%) were decannulated within 12 months and none of the nontracheostomy-dependent children required further airway assistance. The majority of children required supplemental feeding preoperatively but, 12 months postoperatively, 97% of the nonsyndromic infants fed orally. Thirty-nine children (53%) were reviewed clinically [median age, 5.1 y (IQR, 3.9–6.5)] with 18 being syndromic. Many of the mandibular first permanent and second primary molars had developmental defects, but there was a low rate of neurosensory deficit and good scar cosmesis.

Conclusions:
This study contributes further to the evidence base underpinning the management of micrognathic infants with UAO.
Risk Factors for Institutionalization After Traumatic Brain Injury Inpatient Rehabilitation
Authors: Eum Regina S. , Brown Allen W. , Watanabe Thomas K. , Zasler Nathan D. , Goldstein Richard , Seel Ronald T. , Roth Elliot J. , Zafonte Ross D. , Glenn Mel B. 
Published: July 2016

Objective:
To create a profile of individuals with traumatic brain injury (TBI) who received inpatient rehabilitation and were discharged to an institutional setting using characteristics measured at rehabilitation discharge.

Methods:
The Traumatic Brain Injury Model Systems National Database is a prospective, multicenter, longitudinal database for people with moderate to severe TBI. We analyzed data for participants enrolled from January 2002 to June 2012 who had lived in a private residence before TBI. This cross-sectional study used logistic regression analyses to identify sociodemographic factors, lengths of stay, and cognitive and physical functioning levels that differentiated patients discharged to institutional versus private settings.

Results:
Older age, living alone before TBI, and lower levels of function at rehabilitation discharge (independence in locomotion, bladder management, comprehension, and social interaction) were significantly associated with higher institutionalization rates and provided the best models identifying factors associated with institutionalization. Institutionalization was also associated with decreased independence in bed-chair-wheelchair transfers and increased duration of posttraumatic amnesia.

Conclusions:
Individuals institutionalized after inpatient rehabilitation for TBI were older, lived alone before injury, had longer posttraumatic amnesia durations, and were less independent in specific functional characteristics. Research evaluating the effect of increasing postdischarge support and improving treatment effectiveness in these functional areas is recommended.
Genome-wide association analysis of pain severity in dysmenorrhea identifies association at chromosome 1p13.2, near the nerve growth factor locus
Authors: Jones Amy V. , Hockley James R.F. , Hyde Craig , Gorman Donal , Sredic-Rhodes Ana , Bilsland James , McMurray Gordon , Furlotte Nicholas A. , Hu Youna , Hinds David A. , Cox Peter J. , Scollen Serena 
Published: July 2016

Abstract
Dysmenorrhea is a common chronic pelvic pain syndrome affecting women of childbearing potential. Family studies suggest that genetic background influences the severity of dysmenorrhea, but genetic predisposition and molecular mechanisms underlying dysmenorrhea are not understood. In this study, we conduct the first genome-wide association study to identify genetic factors associated with dysmenorrhea pain severity. A cohort of females of European descent (n = 11,891) aged 18 to 45 years rated their average dysmenorrhea pain severity. We used a linear regression model adjusting for age and body mass index, identifying one genome-wide significant (P < 5 × 10−8) association (rs7523086, P = 4.1 × 10−14, effect size 0.1 [95% confidence interval, 0.074–0.126]). This single nucleotide polymorphism is colocalising with NGF, encoding nerve growth factor. The presence of one risk allele corresponds to a predicted 0.1-point increase in pain intensity on a 4-point ordinal pain scale. The putative effects on NGF function and/or expression remain unknown. However, genetic variation colocalises with active epigenetic marks in fat and ovary tissues, and expression levels in aorta tissue of a noncoding RNA flanking NGF correlate. Participants reporting extreme dysmenorrhea pain were more likely to report being positive for endometriosis, polycystic ovarian syndrome, depression, and other psychiatric disorders. Our results indicate that dysmenorrhea pain severity is partly genetically determined. NGF already has an established role in chronic pain disorders, and our findings suggest that NGF may be an important mediator for gynaecological/pelvic pain in the viscera.
Structure in the variability of the basic reproductive number (R0) for Zika epidemics in the Pacific islands
Authors: Champagne Clara , Salthouse David Georges , Paul Richard , Cao-Lormeau Van-Mai , Roche Benjamin , Cazelles Bernard 
Published: July 2016

AbstractBefore the outbreak that reached the Americas in 2015, Zika virus (ZIKV) circulated in Asia and the Pacific: these past epidemics can be highly informative on the key parameters driving virus transmission, such as the basic reproduction number (R0). We compare two compartmental models with different mosquito representations, using surveillance and seroprevalence data for several ZIKV outbreaks in Pacific islands (Yap, Micronesia 2007, Tahiti and Moorea, French Polynesia 2013-2014, New Caledonia 2014). Models are estimated in a stochastic framework with state-of-the-art Bayesian techniques.R0for the Pacific ZIKV epidemics is estimated between 1.5 and 4.1, the smallest islands displaying higher and more variable values. This relatively low range ofR0suggests that intervention strategies developed for other flaviviruses should enable as, if not more effective control of ZIKV. Our study also highlights the importance of seroprevalence data for precise quantitative analysis of pathogen propagation, to design prevention and control strategies.
An examination of the conditions, characteristics and strategies pertaining to the rise of emerging markets multinationals
Authors: Yeganeh Kia Hamid 
Published: July 2016

PurposeThis paper aims to examine the conditions, characteristics and strategies pertaining to the rise of emerging markets’ multinationals (EMNEs).Design/methodology/approachThe paper relies on both academic and professional resources to offer a holistic understanding of EMNEs by reviewing, analyzing and classifying their underlying conditions, characteristics, internationalization motivations, strategies and competitive advantages.FindingsThe analysis indicates that EMNEs ascended as a result of major socio-economic transformations in the past two decades after the Cold War; follow an accelerated path of expansion; implement flexible and decentralized organizational configurations; enjoy strong political connections; do not internationalize according to the ownership-location-internalization paradigm, rather follow the linkage-leverage-learning pattern; benefit from multiple sources of competitive advantage and adopt five main types of international strategies; are becoming more sophisticated and represent serious threats to their counterparts from advanced economies.Research limitations/implicationsAs emerging markets and their multinationals are highly heterogeneous, the findings and suggestions remain context-bound.Practical implicationsThe paper synthesizes the EMNEs literature, bridges theory and practice and offers an integrative outline that can be useful for international business managers.Originality/valueThe paper takes an all-inclusive approach and provides insights into multiple societal and organizational facets of EMNEs.
Impact of marketing effectiveness and capabilities, and export market orientation on export performance
Authors: Kayabasi Aydin , Mtetwa Thandiwe 
Published: July 2016

Purpose
The purpose of this paper is to examine the relationships between marketing effectiveness, marketing capabilities, export market orientation and export performance.

Design/methodology/approach
The research analyses whether export market orientation, marketing effectiveness and marketing capabilities are antecedents of export performance with structural equation modelling. Data to test the model were obtained through a structured survey of 443 export companies operating in the Aegean region of Turkey. After explanatory and confirmatory factor analysis, the structural model was tested.

Findings
The findings suggest that export market orientation has a significant impact on marketing capabilities and marketing effectiveness, and that marketing effectiveness has a significant impact on export performance. This indicates that export market orientation is central to the development of marketing capabilities, while marketing effectiveness contributes to explaining export performance.

Research limitations/implications
There are several limitations of the research. The first significant limitation is that the variables had various sub-dimensions. The second limitation is about sampling of the research that it is not specific to a particular sector.

Practical implications
This paper provides useful insights to exporters on market orientation, focal dimensions of marketing effectiveness and marketing capabilities that would help them enhance their export performance.

Originality/value
Using the resource-based view, this paper contributes to the explanation for export performance by assessing the role of export market orientation behaviour on marketing capabilities and marketing effectiveness.
Tensile property of highly twisted cotton yarns under varied relative humidity
Authors: Htike Htet Htet , Kang Jian , Sukigara Sachiko 
Published: July 2016

Purpose
– The traditional Japanese cotton-crepe fabric chijimi has been used for summer clothing for over a century because of its good skin comfort. The high extensibility of this fabric relies on the high-twist cotton yarns used in the weft direction. The purpose of this paper is to show the effect of environmental humidity on the extensibility of highly twisted cotton yarns to help in choosing weft yarn suitable for woven fabric.

Design/methodology/approach
– Four highly twisted cotton yarns are examined under 10-90 percent RH and in 25°C water. Cyclic tensile tests are performed to obtain the tensile energy, resilience, extensibility at maximum applied load (EM), and residual strain.

Findings
– Comparing the same yarn-count samples Y1 and Y2, the EM of Y2 (2,200 T/m) is larger than that of Y1 (1,000 T/m) under all RH conditions, and the difference increases at humidity over 60 percent RH. For fabric crepe samples woven by Y1 (warp) and Y2 (weft), the extensibility (EM-1) in the weft direction is in the range 16-26 percent, which is equivalent to that of outer-knitted fabrics. The extensibility and recovery of chijimi is largely dominated by the twist of weft yarns, which is also influenced by changes in relative humidity.

Originality/value
– The skin comfort of Takashima chijimi has been of interest, but the high extensibility of this cotton fabric has not been given much attention. The results of this study show that yarn twist is key to controlling extensibility in high-humidity environments.