bluuebunny/crossref_metadata_2025_split huggingface dataset:
Update on the Management of Diarrhea‐Predominant Irritable Bowel Syndrome: Focus on Rifaximin and Eluxadoline
Authors: Rivkin Anastasia , Rybalov Sergey 
Published: March 2016

Diarrhea‐predominant irritable bowel syndrome (IBS‐D) is one of the most common diagnoses made by gastroenterologists. Current pharmacologic treatments for IBS‐D include fiber supplements, antidiarrheal over‐the‐counter medications, probiotics, antispasmodics, antidepressants, and a 5‐hydroxytryptophan 3 receptor antagonist. All of these options have limited efficacy in managing IBS‐D.Rifaximin, a nonabsorbable antibiotic, has been evaluated in patients with IBS‐D. In two randomized, double‐blind, placebo‐controlled phase III trials evaluating rifaximin 550 mg by mouth 3 times/day for 14 days, the primary efficacy end point was achieved by 9% more patients randomized to the rifaximin group compared with placebo (40.7% vs 31.7%, p<0.001, number needed to treat ~11). The primary efficacy end point was defined as the proportion of patients having adequate relief of global IBS symptoms for at least 2 of the 4 weeks during the primary follow‐up period (weeks 3–6). In the phase III trial examining the efficacy and safety of repeated courses of rifaximin in patients who responded to the initial 2‐week course, rifaximin given for up to two additional courses provided a statistically significant incremental benefit (33% vs 25%, p=0.02).Eluxadoline is a gut‐targeting μ and κ opioid receptor agonist and a δ opioid receptor antagonist. The dual mechanism of eluxadoline may explain the antidiarrheal and abdominal pain‐modulating properties and lack of profound constipation. In two identically designed randomized, double‐blind, placebo‐controlled phase III studies, 10.3% more patients in an eluxadoline 100 mg by mouth twice/day group met the primary efficacy end point during the follow‐up 1–12 week period compared with placebo (p<0.001). The primary efficacy end point was a composite response, defined as improvement in worst abdominal pain and stool consistency at the same time on most (50% or more) days during the follow‐up period.This review evaluates evidence for the use of rifaximin and eluxadoline in patients with IBS‐D. Rifaximin provides an additional modality for the management of IBS‐D patients; it has mild to moderate efficacy similar to other currently available treatment options. Rifaximin is relatively safe, lacks significant drug‐drug interactions, and can be used for up to two additional retreatment courses. This may make rifaximin a possible initial or second‐line treatment option. Eluxadoline can also offer relief to patients with IBS‐D. While effective, because of several limitations, including drug‐drug interactions and drug disease contraindications, as well as current lack of clinical experience, it may be tried as a second‐ or third‐line agent.
Supramolecular network polymers formed from polyamidine and carboxy‐terminated telechelic poly(n‐butyl acrylate) via amidinium‐carboxylate salt bridges
Authors: Furusho Yoshio , Endo Takeshi , Higaki Keiko , Kaetsu Katsuhiro , Higaki Yuji , Kojio Ken , Takahara Atsushi 
Published: March 2016

ABSTRACTWe have prepared the amidinium‐carboxylate salt bridge‐based supramolecular network polymers from a carboxy‐terminated telechelic poly(n‐butyl acrylate) and a linear polyamidine having N,N′‐di‐substituted acetamidine group in the main chain. FTIR measurements indicated that the salt bridge was attributed to the three‐dimensional network formation. Virtually, no fluidity was observed for the blend containing equimolar amounts of the carboxyl group and the amidine group, which showed a high G′ value of about 1 MPa at −5 °C. For comparison, the supramolecular network polymers crosslinked by ammonium‐carboxylate salt were prepared using a linear polyethyleneimine instead of the polyamidine. The blend with equimolar amounts of the carboxyl group and the secondary amino group showed liquid‐like fluidity with a G′ value of about 0.01 MPa at −5 °C, which was attributed to the fact that a certain amount of the carboxyl group remained as its free form, as evidenced by FTIR analysis. © 2016 Wiley Periodicals, Inc. J. Polym. Sci., Part A: Polym. Chem. 2016, 54, 2148–2155
Presenilin adopts the ClC channel fold
Authors: Theobald Douglas L. 
Published: March 2016

AbstractPresenilin is an integral membrane aspartate protease that regulates cellular processes by cleaving proteins within the cell membrane. The recent crystal structure of presenilin reveals a conspicuous pore in a bundle of nine α‐helices, which was originally thought to adopt a novel protein fold. However, here I show that the presenilin fold is a variant of the ClC chloride channel/transporter fold. This observation may have important implications for presenilin's postulated biological role as a calcium leak channel.
Increased pin diameter improves torsional stability in supracondylar humerus fractures: An experimental study
Authors: Pradhan Anupam , Hennrikus William , Pace Gregory , Armstrong April , Lewis Gregory 
Published: March 2016

Background Pediatric supracondylar humerus fractures are the most common elbow fractures seen in children, and account for 16 % of all pediatric fractures. Closed reduction and percutaneous pin fixation is the current treatment technique of choice for displaced supracondylar fractures of the distal humerus in children. The purpose of this study was to determine whether pin diameter affects the torsional strength of supracondylar humerus fractures treated by closed reduction and pin fixation. Methods Pediatric sawbone humeri simulating a Gartland type III fracture were utilized. Four different pin configurations were compared. Specimens were subjected to a torsional load producing internal rotation of the distal fragment. The stability provided by 1.25- and 1.6-mm pins was compared. Results The amount of torque required to produce 15° and 25° of rotation was greater using larger diameter pins in all models tested. The two lateral and one medial large pin (1.6 mm) configuration required the highest amount of torque to produce both 15° and 25° of rotation. Conclusions In a synthetic pediatric humerus model of supracondylar humerus fractures, larger diameter pins (1.6 mm) provided increased stability compared with small diameter pins (1.25 mm). Fixation using larger diameter pins created a stronger construct and improved the strength of fixation.
Chlorhexidine-alcohol versus povidone-iodine for pre-operative skin preparation: A systematic review and meta-analysis
Authors: Ayoub Firas , Quirke Michael , Conroy Ronan , Hill Arnold 
Published: March 2016

ABSTRACT

Background:
Surgical site infection (SSI) is a dreaded postoperative complication. Although preoperative skin cleansing in order to prevent surgical site infection (SSI) is standard surgical practice, there is clinical equipoise concerning whether povidone iodine (PI) or chlorhexidine alcohol (CHA) is the antiseptic agent of choice.

Objectives:
To determine whether CHA or PI is the preferred preoperative skin preparation for reducing SSI in clean, clean-contaminated and contaminated surgery.

Search methods:
PubMed, Embase, and gray literature sources were searched for randomized controlled trials (RCTs) comparing both CHA and PI between 1980 and 2014. Comparative RCTs of preoperative CHA versus PI studying SSI in clean, clean-contaminated and contaminated surgery were included. Risk of bias was assessed using Cochrane risk of bias.

Main result:
We identified six eligible studies with an overall 2484 participants. The overall rate of SSI was 6.8% in the CHA group versus 11.0% in the PI group (P < 0.0002). CHA was superior to PI in the prevention of SSI with a pooled RR of 0.62 (95% CI, 0.48–0.81).

Conclusions:
Preoperative surgical skin preparation with CHA is more effective than PI in preventing SSI across clean and clean-contaminated surgery. Further studies should evaluate the effectiveness of CHA versus PI in contaminated surgery.

Highlights:
Mechanical bowel preparation versus no preparation in elective colorectal surgery: A prospective randomized study
Authors: Bhat Altaf Hussain , Parray Fazl Qadir , Chowdri Nisar Ahmad , Wani Rauf Ahmad , Thakur Natasha , Nazki Saalim , Wani Imtiaz 
Published: March 2016

ABSTRACT

Background:
Mechanical bowel preparation (MBP) of gut is routinely done before colorectal surgeries in most surgical departments all over the globe. This gut preparation is aimed at reducing the risk of postoperative infections in patients undergoing colorectal surgery. Even though recent studies are more in favor of operating on gut without bowel preparation, controversies still exist. The aim of our study was to assess whether elective colorectal surgeries can be performed safely without preoperative MBP.

Methods:
Patients undergoing elective colorectal surgeries were prospectively randomized into two groups with the help of random number table method; Group-1 had mechanical bowel preparation with polyethylene glycol (MBP group) before surgery, and Group-2 had no mechanical bowel preparation (NMBP group) before surgery. All patients in the study groups were followed up for at least 2 months after surgery for wound infection, anastomotic leak and intra-abdominal infections.

Results:
Two hundred fourteen patients were included in this hospital-based systematic prospective randomized trial: 104 patients in Group-1 and 98 patients in Group-2. Twelve patients were excluded from the study. The type of surgical procedure and type of anastomosis did not significantly differ between two groups. There was no difference in surgical infections between two groups. The overall infection rate was 39.4% in Group-1 and 32.6% in Group-2 (p = 0.31). Wound infection (p = 0.45), anastomotic leak (p = 0.45) and intra-abdominal/pelvic collection (p = 0.62) occurred in 3.8%, 3.8% and 6.7% versus 6.1%, 2% and 5.1% in Group-1 (MBP group) and Group-2 (NMBP group) respectively. Our results showed that MBP does not offer any specific benefit in elective colorectal surgeries but in real sense may add to some problems, which, however, did not achieve a statistical significance.

Conclusions:
Our study proved that no advantage is gained by pre-operative mechanical bowel preparation in elective colorectal surgery and can be easily avoided in order to save patients from unwanted exhaustion, distress and adverse effects related to it. It is actually the mindset that makes us to believe that MBP will reduce the incidence of infections rather than the evidence from literature. We conclude from our study that all types of elective colorectal surgeries can be performed safely without subjecting patients to mechanical bowel preparation before surgery.

Highlights:
Efficacy of atrial substrate modification based on dominant frequency of paroxysmal atrial fibrillation
Authors: Kumagai Koji , Minami Kentaro , Kutsuzawa Daisuke , Oshima Shigeru 
Published: March 2016

AbstractBackgroundThe endpoint of ablation procedures is suggested to be non‐inducibility of paroxysmal atrial fibrillation (PAF). However, the prognosis of induced AF/atrial tachycardia (AT) after pulmonary vein isolation (PVI) in PAF patients remains unclear.MethodsA total of 122 PAF patients were divided into the following 3 groups: Group 1, 79 without AF/AT induced after PVI; Group 2, 21 with AF/AT induced or sustained after PVI, and followed by a high‐dominant frequency (DF) and continuous complex fractionated atrial electrogram (CFAE) site ablation and, if necessary, linear ablation; and Group 3, 22 with external cardioversion of AF/AT induced or sustained after PVI. High‐DF (DF≥8 Hz) and continuous CFAE (fractionated intervals≤50 ms) sites were targeted. The ablation endpoint was non‐inducibility of PAF.ResultsIn Group 2, AF terminated in 2 patients with a high‐DF and continuous CFAE site ablation. In 4 patients, AF induced after cardioversion did not terminate with left atrium linear ablation, and required additional cardioversion. Common atrial flutter in 2 patients terminated with cavotricuspid isthmus ablation. An AT terminated with a roofline ablation. Finally, no AF/AT could be induced in any of the patients in Group 2 after all the procedures. The cumulative freedom from AF/AT recurrence without antiarrhythmic drugs in Groups 1 and 2 was significantly greater than that in Group 3 after 1 procedure during 12 months of follow‐up (90% and 91% vs. 64%, Log‐rank test P=0.001 and P=0.033, respectively).ConclusionsAtrial substrate ablation may improve the clinical outcome after ablation in patients after PVI with residual arrhythmia inducibility.
Objectivity and Reflection in Heidegger's Theory of Intentionality
Authors: MCKINNEY TUCKER 
Published: March 2016

ABSTRACT:Heidegger claims that Dasein's capacity for adopting intentional stances toward the world is grounded in the reflective structure of its being, which dictates that Dasein exists for the sake of a possibility of itself. Commentators have glossed this reflective structure in terms of the idea that our subjection to the normative demands of intentionality is grounded in a basic commitment to upholding an identity-concept, such as an occupation or a social role. I argue that this gloss has serious adverse implications for Heidegger's philosophical project and for the internal coherence of his theory of intention. I recommend an alternative gloss on the reflective structure of existence, according to which sustaining a robust claim to openness to the world specifies the universal, formal object of intentional stance-taking. The reflective structure of existence should be understood through the concept ofself-maintenancerather than that ofself-definition.
What is the Future of Pediatric Neurology in Canada? Resident and Faculty Perceptions of Training and Workforce Issues
Authors: Doja Asif , Clarkin Chantalle , Whiting Sharon , Moharir Mahendranath 
Published: March 2016

AbstractBackground: Pediatric neurology trainee numbers have grown considerably in Canada; recent research, however, has shown that the number of pediatric neurology graduates is outpacing the need for future pediatric neurologists. The purpose of this study was to seek the opinion of pediatric neurology program directors and trainees regarding possible solutions for this issue. Methods: Two focus groups were convened during the Canadian Neurological Sciences Federation annual congress in June 2012; one consisted of current and former program directors, and the other of current pediatric neurology trainees. Groups were asked for their perceptions regarding child neurology manpower issues in Canada as well as possible solutions. Focus groups were audio-recorded and transcribed for analysis. Theme-based qualitative analysis was used to analyze the transcripts. Results: Major themes emerging from both focus groups included the emphasis on community pediatric neurology as a viable option for trainees, including the need for community mentors; recognizing the needs of underserviced areas; and establishing academic positions for community preceptors. The need for career mentoring and support structures during residency training was another major theme which arose. Program directors and trainees also gave examples of ways to reduce the current oversupply of trainees in Canada, including limiting the number of trainees entering programs, as well as creating a long-term vision of child neurology in Canada. Conclusions: A nationwide dialogue to discuss the supply and demand of manpower in academic and community pediatric neurology is essential. Career guidance options for pediatric neurology trainees across the country merit further strengthening.
Solutal Marangoni instability in layered two-phase flows
Authors: Picardo Jason R. , Radhakrishna T. G. , Pushpavanam S. 
Published: March 2016

In this paper, the instability of layered two-phase flows caused by the presence of a soluble surfactant (or a surface-active solute) is studied. The fluids have different viscosities, but are density matched to focus on Marangoni effects. The fluids flow between two flat plates, which are maintained at different solute concentrations. This establishes a constant flux of solute from one fluid to the other in the base state. A linear stability analysis is performed, using a combination of asymptotic and numerical methods. In the creeping flow regime, Marangoni stresses destabilize the flow, provided that a concentration gradient is maintained across the fluids. One long-wave and two short-wave Marangoni instability modes arise, in different regions of parameter space. A well-defined condition for the long-wave instability is determined in terms of the viscosity and thickness ratios of the fluids, and the direction of mass transfer. Energy budget calculations show that the Marangoni stresses that drive long- and short-wave instabilities have distinct origins. The former is caused by interface deformation while the latter is associated with convection by the disturbance flow. Consequently, even when the interface is non-deforming (in the large-interfacial-tension limit), the flow can become unstable to short-wave disturbances. On increasing the Reynolds number, the viscosity-induced interfacial instability comes into play. This mode is shown to either suppress or enhance the Marangoni instability, depending on the viscosity and thickness ratios. This analysis is relevant to applications such as solvent extraction in microchannels, in which a surface-active solute is transferred between fluids in parallel stratified flow. It is also applicable to the thermocapillary problem of layered flow between heated plates.
Re-Inventing Infectious Disease: Antibiotic Resistance and Drug Development at the Bayer Company 1945–80
Authors: Gradmann Christoph 
Published: March 2016

This paper analyses how research on antibiotic resistance has been a driving force in the development of new antibiotics. Drug resistance, while being a problem for physicians and patients, offers attractive perspectives for those who research and develop new medicines. It imposes limits on the usability of older medicines and simultaneously modifies pathologies in a way that opens markets for new treatments. Studying resistance can thus be an important part of developing and marketing antibiotics.The chosen example is that of the German pharmaceutical company Bayer. Before World War Two, Bayer had pioneered the development of anti-infective chemotherapy, sulpha drugs in particular, but had missed the boat when it came to fungal antibiotics. Exacerbated by the effects of war, Bayer’s world market presence, which had been considerable prior to the war, had plummeted. In this critical situation, the company opted for a development strategy that tried to capitalise on the problems created by the use of first-generation antibiotics. Part and parcel of this strategy was monitoring what can be called the structural change of infectious disease. In practice, this meant to focus on pathologies resulting from resistance and hospital infections. In addition, Bayer also focused on lifestyle pathologies such as athlete’s foot. This paper will follow drug development and marketing at Bayer from 1945 to about 1980. In this period, Bayer managed to regain some of its previous standing in markets but could not escape from the overall crisis of anti-infective drug development from the 1970s on.
Selenium status and risk of prostate cancer in a Danish population
Authors: Outzen Malene , Tjønneland Anne , Larsen Erik H. , Friis Søren , Larsen Signe B. , Christensen Jane , Overvad Kim , Olsen Anja 
Published: March 2016

AbstractLow-Se status may be associated with a higher risk of notably advanced prostate cancer. In a Danish population with a relatively low Se intake, we investigated the association between pre-diagnostic Se status and (1) the risk of total, advanced and high-grade prostate cancer and (2) all-cause and prostate cancer-specific mortality among men with prostate cancer. Within the Danish ‘Diet, Cancer and Health’ cohort, including 27 179 men, we identified 784 cases with incident prostate cancer through 2007. Each case was risk set-matched to one control. Two-thirds (n 525) of the cases had advanced disease at the time of diagnosis, and among these 170 had high-grade disease; 305 cases died (n 212 from prostate cancer) during follow-up through 2012. Plasma Se was not associated with total or advanced prostate cancer risk, but higher Se levels were associated with a lower risk of high-grade disease (HR 0·77; 95 % CI 0·64, 0·94; P=0·009). In survival analyses, a higher level of plasma Se was associated with a lower risk of all-cause (HR 0·92; 95 % CI 0·85, 1·00; P=0·04), but not prostate cancer-specific mortality. Higher levels of selenoprotein P were associated with a lower risk of high-grade disease (HR 0·85; 95 % CI 0·74, 0·97; P=0·01), but not with the risk of or mortality from advanced prostate cancer. In conclusion, levels of plasma Se and selenoprotein P were not associated with the risk of total and advanced prostate cancer, but higher levels of these two biomarkers were associated with a lower risk of high-grade disease.
The Politics of Tax States in the Canadian Provinces after the Golden Age
Authors: Haddow Rodney 
Published: March 2016

AbstractThis article evaluates the impact of partisanship, globalization and postindustrialism on provincial revenues since 1980. It is often argued that the first of these no longer has an effect, while the second and third erode fiscal capacity. These arguments are assessed with multilevel models, hitherto little used for macro-level estimations in political science. This approach is particularly suited to testing these influences. The study finds that partisanship is, in fact, strongly associated with provincial revenues. Globalization and postindustrialism have a more muted effect, though alternative estimations support somewhat different conclusions regarding the former. The social preconditions of partisanship's impact, moreover, deserve more attention.
Effects of head and tail as swinging appendages on the dynamic walking performance of a quadruped robot
Authors: Zhang Xiuli , Gong Jiaqing , Yao Yanan 
Published: March 2016

SUMMARYWe designed a quadruped robot with a one-degree-of-freedom (1-DOF)-pitch head, a 1-DOF-roll tail, and 14 active DOFs in total, which are controlled via a central pattern generator (CPG) based on a Hopf oscillator. Head and tail movements are coupled to the leg movements with fixed phase differences. Experiments show that tail swinging in roll can equilibrate feet–ground reaction forces (GRF), reducing yaw errors and enabling the robot to maintain its direction when trotting. Head swing in pitch has the potential to increase flight time and stride length of the swinging legs and increase the robot's forward velocity when running in bounds.
GRADING IN GROUPS
Authors: Morreau Michael 
Published: March 2016

Abstract:Juries, committees and experts panels commonly appraise things of one kind or another on the basis of grades awarded by several people. When everybody's grading thresholds are known to be the same, the results sometimes can be counted on to reflect the graders’ opinion. Otherwise, they often cannot. Under certain conditions, Arrow's ‘impossibility’ theorem entails that judgements reached by aggregating grades do not reliably track any collective sense of better and worse at all. These claims are made by adapting the Arrow–Sen framework for social choice to study grading in groups.