bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reactivation of flagellar motility in demembranated Leishmania reveals role of cAMP in flagellar wave reversal to ciliary waveform
Authors: Mukhopadhyay Aakash Gautam , Dey Chinmoy Sankar 
Published: November 2016

AbstractThe flagellum of parasitic trypanosomes is a multifunctional appendage essential for its viability and infectivity. However, the biological mechanisms that make the flagellum so dynamic remains unexplored. No method is available to access and induce axonemal motility at will to decipher motility regulation in trypanosomes. For the first time we report the development of a detergent-extracted/demembranated ATP-reactivated model for studying flagellar motility in Leishmania. Flagellar beat parameters of reactivated parasites were similar to live ones. Using this model we discovered that cAMP (both exogenous and endogenous) induced flagellar wave reversal to a ciliary waveform in reactivated parasites via cAMP-dependent protein kinase A. The effect was reversible and highly specific. Such an effect of cAMP on the flagellar waveform has never been observed before in any organism. Flagellar wave reversal allows parasites to change direction of swimming. Our findings suggest a possible cAMP-dependent mechanism by which Leishmania responds to its surrounding microenvironment, necessary for its survival. Our demembranated-reactivated model not only serves as an important tool for functional studies of flagellated eukaryotic parasites but has the potential to understand ciliary motility regulation with possible implication on human ciliopathies.
Menstrual, Sexual, and Obstetrical Outcomes after Vaginal Replacement for Vaginal Atresia Associated with Anorectal Malformation
Authors: Skerritt Clare , Vilanova Sánchez Alejandra , Lane Victoria , Wood Richard , Hewitt Geri , Breech Lesley , Levitt Marc 
Published: November 2016

Background The authors of this article became aware of significant differences in the management of two females with a rectovestibular fistula and associated vaginal agenesis. In one patient, a sigmoid colovaginoplasty was performed at the time of the posterior sagittal anorectoplasty (PSARP), and the other underwent repair of the rectovestibular fistula with a primary PSARP, but the surgeons elected to delay the timing of vaginal reconstruction. We decided to review the literature, to establish if recommendations could be made to optimize the management of these children based on current evidence.
Methods A literature review was conducted to determine the management and long-term outcomes in patients with an anorectal malformation and associated vaginal atresia. Specific gynecological outcomes assessed were menstrual egress and adequacy of the vaginal replacement for penile–vaginal intercourse.
Results Eighty-eight cases were included in the review. Age at diagnosis had a bimodal distribution: 0 to 5 years, 56%; >10 years, 37%. Vaginal atresia was recognized before the operation in 45 patients. Types of vaginal atresia encountered were: (a) distal vaginal atresia (n = 17), (b) vaginal agenesis with absent Mullerian development (n = 47), (c) vaginal agenesis with variable Mullerian development (n = 17), and (d) cervico-vaginal agenesis (n = 7). Types of vaginal replacement used were sigmoid colovaginoplasty (n = 26), distal rectal fistula as neovagina (n = 30), terminal ileum (n = 5), vaginal pull-through (n = 9), and others/unknown (n = 8). Two patients followed a perineal dilatation program and nine patients await reconstruction. Median follow-up was 18 months (6 weeks to 31 years). Long-term menstrual outcomes were reported in 18 (21%) patients. Sexual function was reported in 10 (11%) patients. Three pregnancies were reported but none resulted in live births.
Conclusion Vaginal atresia is often missed in association with ARMs. Management should be in collaboration with pediatric gynecologists. Due to a lack of long-term outcome data, no definite conclusion can be drawn for the best technique, tissue, or timing of vaginal replacement. The opportunity to perform vaginal replacement in conjunction with the rectal repair may be worth considering because of a shallower pelvis, nonscarred tissue planes, and the excellent surgical exposure.
Universal screening increases the representation of low-income and minority students in gifted education
Authors: Card David , Giuliano Laura 
Published: November 2016

Significance
A longstanding concern about gifted education in the United States is the underrepresentation of minorities and economically disadvantaged groups. One explanation for this gap is that standard processes for identifying gifted students, which are based largely on the referrals of parents and teachers, tend to miss many qualified students. Consistent with this hypothesis, we find that a universal screening program in a large urban school district led to significant increases in the numbers of poor and minority students who met the IQ standards for gifted status. Our findings raise the question of whether a systemic failure to identify qualified students from all backgrounds may help explain the broader pattern of minority underrepresentation in all advanced K−12 academic programs.
International perceptions of an integrated, multi-sectoral, ecosystem approach to management
Authors: Marshak Anthony R. , Link Jason S. , Shuford Rebecca , Monaco Mark E. , Johannesen Ellen , Bianchi Gabriella , Anderson M. Robin , Olsen Erik , Smith David C. , Schmidt Joern O. , Dickey-Collas Mark 
Published: November 2016

AbstractThe Ecosystem Approach to Management (EAM) has emerged over the past decades, largely to promote biodiversity conservation, and more recently sectoral tradeoffs in the management of marine ecosystems. To ascertain the state of practice of EAM operationalization, a workshop was held, which included a pre-workshop online survey. The survey gauged international participants’ perspectives regarding capacity, knowledge, and application of EAM. When asked about the subject, most survey respondents had a general understanding of EAM, and provided a clear definition. Major perceived challenges to EAM objectives by those surveyed included limited knowledge, conflicting interests, insufficient communication, and limited organizational legal frameworks or governance structures. Of those directly involved in an ecosystem approach, the majority responded that processes were in place or developed for application of integrated knowledge toward assessing key issues within their respective sectors (i.e. fisheries, conservation, energy), and that capacity was generally high. Our results show that most respondents, irrespective of sector or geography, see value in considering an integrated, broader ecosystem approach as they manage their sector. Although many participants were from the North Atlantic region, our results suggest that much of the international community is converging toward continued understanding of broad-scale, integrated approaches to marine resource management.
Outcomes After Primary Repair and Staged Reconstruction of Zone I and II Flexor Tendon Injuries in Children
Authors: Piper Samantha L. , Wheeler Lesley C. , Mills Janith K. , Ezaki Marybeth , Oishi Scott N. 
Published: November 2016

Background:
Delayed diagnosis of flexor tendon injury in children is common, and consequent flexor sheath scarring may necessitate a 2-stage reconstruction. Previous studies show variable outcomes after 2-stage flexor reconstruction in children, especially those below 6 years old. We evaluated functional and subjective outcomes of primary repair and staged reconstruction of zone I and II tendon injuries in children under 6 years of age.

Methods:
A retrospective chart review identified 12 digits in 10 patients who had undergone surgical treatment of a zone I or II flexor tendon injury. Seven digits had a primary repair and 5 had a 2-stage reconstruction. Time delay from injury to surgery for primary repairs averaged 18 weeks and for 2-stage reconstruction averaged 24 weeks. Outcomes included total active motion, tip pinch and grip strength, sensation, and the Pediatric Outcomes Data Collection Instrument (PODCI).

Results:
Average follow-up was 8 years. At final follow-up, mean total active and passive motion of the involved digit was similar between the primary reconstruction and staged groups, and 58% had a “good” or “excellent” American Society for Surgery of the Hand; total active motion (ASSH TAM) result (71% in the primary repair group, 40% in the 2-stage reconstruction group). All regained grip and pinch strength equal to the contralateral hand. The average PODCI Upper Extremity score was 99 (99 in the primary repair group, 98 in the 2-stage reconstruction group) and PODCI Global Function score was 94 (97 in the primary repair group, 91 in the 2-stage reconstruction group). No complications occurred.

Conclusions:
Our small study demonstrates that both primary repair and 2-stage flexor tendon reconstruction have acceptable long-term functional and subjective outcomes in children below 6 years old, although staged reconstruction had a lower overall ASSH TAM score and subcategorical PODCI scores. Although staged reconstruction has acceptable outcomes in this population, prompt primary repair of flexor tendon injuries in children should always be attempted.

Level of Evidence:
Level 4—therapeutic.
Determination of Antidepressants in Hair via UHPLC-MS/MS as a Complementary Informative Tool for Clinical and Forensic Toxicological Assessments
Authors: Ramírez Fernández María del Mar , Wille Sarah M. R. , Hill Virginia , Samyn Nele 
Published: November 2016

Background:
Hair analysis is a complementary approach for the detection of antidepressants (ADs) in clinical and forensic schemes because it yields a picture of long-term exposure over a time window depending on the length of the hair.

Methods:
A fast and sensitive ultra-high performance liquid chromatography tandem mass spectrometry method using a BEH C18 column with a mobile phase consisting of ammonium acetate/acetonitrile was developed and validated according to international guidelines for the simultaneous analysis of 24 ADs in hair. Methanol/acetonitrile/ammonium formate buffer 1 mmol/L (25:25:50, vol/vol/vol) was used to extract the drugs from the hair matrix before a solid-phase extraction using cation exchange cartridges was applied. Hair samples (n = 18) obtained from a US workplace drug testing center were analyzed to demonstrate the method applicability.

Results:
The limit of quantification values ranged from 0.006 to 0.05 ng/mg hair, and the calibration curves ranged from the LOQ up to 10 ng/mg hair. The bias and imprecision were <15% for all the compounds except maprotiline (17%). This was evaluated with 2 “in-house” QCs and 1 authentic hair sample from an amitriptyline user. No significant matrix effects for most of the compounds were observed, and the extraction efficiency of the sample cleanup procedure ranged from 40% to 80% (relative standard deviation <15%) [except for demethylcitalopram, didemethylcitalopram, and trazodone (relative standard deviation <33%)]. The method was then successfully applied to the analysis of hair samples from workplace drug testing. The samples were analyzed in 1-cm segments to determine the medication history of the patient. When a sample was reported positive, information concerning the prescription was obtained anonymously for several samples. Concentrations of (minimum–maximum value in ng/mg) citalopram (0.01–132: extrapolated), trazodone (0.01–5.3), sertraline (0.05–0.1), paroxetine (0.02–1.0), bupropion (0.05–0.6), fluoxetine (0.5–8), and amitriptyline (0.2–4.8), including metabolites, are reported.

Conclusions:
This study may be of interest to clinical and forensic laboratories for interpretation because it demonstrates the AD concentration windows in hair and the link to the prescribed drugs.
Gentamicin Pharmacokinetics and Monitoring in Pediatric Patients with Febrile Neutropenia
Authors: Bialkowski Sabina , Staatz Christine E. , Clark Julia , Lawson Rachael , Hennig Stefanie 
Published: November 2016

Background:The pharmacokinetics of gentamicin in pediatric patients with febrile neutropenia is described, and the adequacy of initial dosing of once-daily gentamicin assessed at Queensland's largest Children's Hospital.Methods:Data were retrospectively collected from all pediatrics with febrile neutropenia admitted over a 2-year period who had at least 2 gentamicin concentration–time measurements (a paired set within 1 dosing interval). Gentamicin clearance, volume of distribution, area under the concentration–time curve from 0 to 24 hours postdose (AUC0-24), and maximum concentration values were estimated with log-linear regression using each paired set. The percentage of paired sets associated with gentamicin exposure within predefined hospital targets was calculated, and exposure was examined in relation to the bacterial culture status.Results:Data were collected from 69 patients [median (interquartile range) age 3.7 years (2.2–8.9)] and comprised 121 paired concentration sets characterizing 80 separate admissions. Median (interquartile range) gentamicin clearance and volume of distribution were 8.1 L·h−1·70 kg−1(5.8–12.4) and 21.8 L/70 kg (16.9–29.5), respectively. Predefined hospital exposure targets were achieved for both AUC0-24and maximum concentration for 10% of paired sets; one or the other of these targets were met for 36% of paired sets, and neither target was achieved for 54% of paired sets. Achievement of targets improved with repeated monitoring during the same admission. Median AUC0-24achieved was significantly higher in patients with a confirmed Gram-negative infection compared with those without 71 (50–91) mg·h−1·L−1versus 55 (40.8–67.5) mg·h−1·L−1, respectively (P= 0.003). Over the study period, a median gentamicin dose of 10.8 and 6.4 mg/kg was estimated to be necessary to achieve an AUC target of 80 mg·h−1·L−1in children ≤10 years and >10 years of age.Conclusions:Based on a log-linear method of analysis, current dosing seems to be consistently producing gentamicin exposure below predefined pharmacokinetic targets, suggesting that an increase in the recommended starting dose of gentamicin may be required.
Successful Treatment of Prosthetic Joint Infection Due to Vancomycin-Resistant Enterococci With Tedizolid
Authors: Si Sheng , Durkin Michael J. , Mercier Maureen M. , Yarbrough Melanie L. , Liang Stephen Y. 
Published: November 2016

Abstract
Few antibiotic options exist for the management of infections due to vancomycin-resistant enterococci. We describe a case involving the safe and successful use of tedizolid, a new oxazolidinone, to treat vancomycin-resistant enterococci prosthetic joint infection.
A Comparative Study to Determine Functional and Clinical Outcome Differences Between Patients Receiving Outpatient Direct Physical Therapy Versus Home Physical Therapy Followed by Outpatient Physical Therapy After Total Knee Arthroplasty
Authors: Warren Meghan , Kozik Jennifer , Cook Jon , Prefontaine Paul , Ganley Kathleen 
Published: November 2016

BACKGROUND:
Rehabilitation outcomes for patients with total knee arthroplasty (TKA) after hospital discharge are not well understood.

PURPOSE:
The purpose of this retrospective cohort study was to describe outpatient physical therapy (PT) after TKA and compare short-term (2 months) functional and clinical outcomes of patients following TKA who were discharged from the hospital to home and received (a) outpatient PT immediately (OP) or (b) home health PT before outpatient PT (HH).

METHODS:
The medical records of 109 men and women postoperative TKA discharged home were abstracted for the 6-minute walk test (6MWT), Knee Osteoarthritis and Outcome Score (KOOS), and knee range of motion (ROM) preoperatively and after discharge from all postoperative PT. Patients received outpatient clinic-based PT immediately after discharge from the hospital (OP) (n = 87) or home health PT before continued rehabilitation in an outpatient setting (HH) (n = 22).

RESULTS:
Despite demographic differences between OP and HH preoperatively, adjusted models revealed no significant differences among KOOS, 6MWT, or knee ROM between OP and HH upon completion of postoperative PT. Patients in OP completed PT on average 20 days sooner (p = .0007), although the amount of time in outpatient PT (p = .55) and the number of outpatient PT visits (p = .68) were similar between groups.

CONCLUSION:
Gains in function were achieved by patients in OP and HH independent of the postoperative PT setting, although OP achieved gains sooner.
Osteoporosis Preventive Practice Between Veteran and Nonveteran Older Adults
Authors: Nahm Eun-Shim , Charters Kathleen , Yoo Eunhae , Keldsen Linda M. , Zhu Shijun 
Published: November 2016

BACKGROUND:
Veterans are prone to bone-related illnesses due to multiple risk factors such as prior injuries. The aim of this study was to compare trends in osteoporosis preventive practices between veteran and nonveteran older adults.

METHODS:
This was a secondary data analysis using selected baseline data and discussion postings from an online bone health trial including participants (N = 866) recruited from My HealtheVet (MHV) and SeniorNet (SN). Data were analyzed using descriptive statistics, parametric statistics, and content analysis.

FINDINGS:
Overall, MHV participants were younger and included more men than SN participants. However, they reported higher rates of bone health issues, spent less time exercising, took fewer calcium and vitamin D supplements, and were less likely to discuss bone health with their care providers. More MHV participants discussed pain and disability as barriers to bone health behaviors and fear of deteriorating health as motivators. In addition, more MHV participants found that participating in the original study was helpful for changing health behaviors.

CONCLUSION:
Overall, the findings suggest a disparity in bone health between veterans and nonveterans and a significant potential for using eHealth programs for veterans.
Long-Term Follow-Up on Health-Related Quality of Life After Mechanical Circulatory Support in Children
Authors: Fleck Thilo P. K. , Dangel Georg , Bächle Felix , Benk Christoph , Grohmann Jochen , Kroll Johannes , Siepe Matthias , Höhn Rene , Kirschner Janbernd , Beyersdorf Friedhelm , Stiller Brigitte 
Published: November 2016

Objective:
The objective of this study was to evaluate health-related quality of life in long-term survivors of mechanical circulatory support after acute cardiopulmonary failure.

Design:
Prospective follow-up study.

Setting:
Single-institutional in a center for congenital heart disease and pediatric cardiology.

Patients:
Fifty patients who underwent 58 mechanical circulatory support therapies in our institution from 2001 to 2012. Median age was 2 (0–213) months, and median supporting time was 5 (1–234) days. Indication groups: 1) extracorporeal life support in low cardiac output: 30 cases (52%); 2) extracorporeal cardiopulmonary resuscitation: 13 cases (22%); 3) extracorporeal membrane oxygenation in acute respiratory distress syndrome: four cases (7%); and 4) ventricular assist devices: 11 cases (19%).

Interventions:
Health-related quality of life was measured using standardized questionnaires according to the age group and completed by either parent proxies in children under 7 years old or the survivors themselves.

Measurements and Main Results:
Fifty percentage of the patients were discharged home, and 22 long-term survivors (44%) were studied prospectively for health-related quality of life. Median follow-up period was 4.5 (0.3–11.3) years. Median age at follow-up was 5 (0.6–29) years old. Nineteen long-term survivors filled in the health-related quality of life questionnaires and were classified into three age groups: 0–4 years (n = 7): median health-related quality of life score, 69 (59–86) points; 4–12 years (n = 7): median health-related quality of life score, 50 (48–85) points; older than 12 years (n = 5): median health-related quality of life score, 90 (80–100) points.

Conclusion:
Long-term survivors’ health-related quality of life as reported by their parents is lower than that of healthy children. However, the self-assessed health-related quality of life of the patients older than 12 years in our group is comparable to a healthy control population.
Brief Report: Prolonged Viral Suppression Over a 12-Year Follow-up of HIV-Infected Patients: The Persistent Impact of Adherence at 4 Months After Initiation of Combined Antiretroviral Therapy in the ANRS CO8 APROCO-COPILOTE Cohort
Authors: Protopopescu Camelia , Carrieri Maria P. , Raffi François , Picard Odile , Hardel Lucile , Piroth Lionel , Jadand Corinne , Pierret Janine , Spire Bruno , Leport Catherine ,   the ANRS CO8 APROCO-COPILOTE Study Group
Published: November 2016

Abstract:
The effect of early adherence on long-term viral suppression was assessed among 1281 patients with HIV starting a protease inhibitor-containing regimen in 1997–1999, followed up to 12 years. Association between 4-month adherence (3-level score) and prolonged viral suppression was evaluated using a multivariate mixed logistic model in 891 eligible patients. High 4-months adherence [odds ratio (95% confidence interval): 3.72 (1.98 to 6.98)] was associated with long-term prolonged viral suppression, irrespective of maintenance adherence. This unexpected long-term virological impact of early adherence reinforces the message that, when starting antiretrovirals, all means should be mobilized to ensure optimum early adherence to achieve prolonged antiretroviral success.
WeCareAdvisor™
Authors: Kales Helen C. , Gitlin Laura N. , Stanislawski Barbara , Marx Katherine , Turnwald Molly , Watkins Daphne C. , Lyketsos Constantine G. 
Published: November 2016

Background/Objectives:
Behavioral and psychological symptoms of dementia (BPSD) are nearly universal in dementia and associated with multiple negative outcomes. Current real-world management is largely pharmacologic, despite poor risk/benefit. The WeCareAdvisor was designed to enable family caregivers to assess, manage, and track BPSD using nonpharmacologic strategies.

Design:
In-depth qualitative data were collected from family caregivers of people with dementia to inform: (1) style of approach and “look and feel” of the tool, and (2) the types of psychoeducation most needed by caregivers.

Results:
We conducted 4 focus groups and a technology survey (n=26) as well as additional individual semistructured interviews (n=12) with family caregivers. Main themes of the qualitative work included: (1) need to minimize difficulty and training time; (2) importance of “one-stop shopping” for information; and (3) necessity for information to be tailored to the caregiver and person with dementia. This information was then combined with effective existing evidence-based behavioral strategies to create a web-based tailored caregiver-support tool.

Conclusions:
The WeCareAdvisor was designed with input on functionality and content by end-users, family caregivers. The randomized controlled trial of WeCareAdvisor will test whether the tool improves outcomes including caregiver upset and burden and frequency and severity of BPSD.