bluuebunny/crossref_metadata_2025_split huggingface dataset:
Point‐of‐care Ultrasound for Diagnosis of Abscess in Skin and Soft Tissue Infections
Authors: Subramaniam Sathyaseelan , Bober Jacqueline , Chao Jennifer , Zehtabchi Shahriar 
Published: October 2016

AbstractBackgroundTraditionally, emergency department (ED) physicians rely on their clinical examination to differentiate between cellulitis and abscess when evaluating skin and soft tissue infections (SSTI). Management of an abscess requires incision and drainage, whereas cellulitis generally requires a course of antibiotics. Misdiagnosis often results in unnecessary invasive procedures, sedations (for incision and drainage in pediatric patients), or a return ED visit for failed antibiotic therapy.ObjectiveThe objective was to describe the operating characteristics of point‐of‐care ultrasound (POCUS) compared to clinical examination in identifying abscesses in ED patients with SSTI.MethodsWe systematically searched Medline, Web of Science, EMBASE, CINAHL, and Cochrane Library databases from inception until May 2015. Trials comparing POCUS with clinical examination to identify abscesses when evaluating SSTI in the ED were included. Trials that included intraoral abscesses or abscess drainage in the operating room were excluded. The presence of an abscess was defined by drainage of pus. The absence of an abscess was defined as no pus drainage upon incision and drainage or resolution of SSTI without pus drainage at follow‐up. Quality of trials was assessed using the QUADAS‐2 tool. Operating characteristics were reported as sensitivity, specificity, positive likelihood ratio (LR+), and negative likelihood ratio (LR−), with their respective 95% confidence intervals (CI). Summary measures were calculated by generating a hierarchical summary receiver operating characteristic (HSROC) model.ResultsOf 3,203 references identified, six observational studies (four pediatric trials and two adult trials) with a total of 800 patients were included. Two trials compared clinical examination with clinical examination plus POCUS. The other four trials directly compared clinical examination to POCUS. The POCUS HSROC revealed a sensitivity of 97% (95% CI = 94% to 98%), specificity of 83% (95% CI = 75% to 88%), LR+ of 5.5 (95% CI = 3.7 to 8.2), and LR− of 0.04 (95% CI = 0.02 to 0.08).ConclusionExisting evidence indicates that POCUS is useful in identifying abscess in ED patients with SSTI. In cases where physical examination is equivocal, POCUS can assist physicians to distinguish abscess from cellulitis.
Survivin isoform expression in arsenic trioxide‐treated acute promyelocytic leukemia cell line and patients: The odd expression pattern of survivin‐2α
Authors: Zaki Dizaji Majid , Ghaffari Seyed H , Hosseini Elham , Alizadeh Nasrin , Rostami Shahrbano , Momeny Majid , Alimoghaddam Kamran , Ghavamzadeh Ardeshir 
Published: October 2016

AbstractAimSurvivin, an inhibitor of apoptosis protein, is overexpressed in most cancers and is associated with chemotherapy resistance, increased tumor recurrence and shorter patient survival. Several survivin splice variants have been described, and none of their expressions have been defined in acute promyelocytic leukemia (APL).MethodsExpression of the survivin gene isoforms (survivin, ‐2α, ‐2B, ‐ΔΕx3 and ‐3B) were analyzed in 50 peripheral blood and 19 bone marrow samples that were collected at different phases of the disease (diagnostic, remission and relapse) in APL patients treated with arsenic trioxide (ATO) as a front‐line therapy. In addition, the human APL‐derived cell line (NB4) was analyzed for the expression of survivin isoforms and capsase‐3 in response to the ATO.ResultsSurvivin and its variants were overexpressed significantly in patient's bone marrow samples compared to peripheral blood or normal samples. Their expression was decreased after ATO treatment in both NB4 cells (except survivin‐2α) and APL patients along with PML‐RARα copy number reduction. Downregulation of survivin isoforms was associated with an increase in both caspase‐3 gene expression and its enzymatic activity levels. In a patient who did not respond to ATO treatment, expression of survivin isoforms (except survivin‐2α) were highly increased during the induction therapy.ConclusionSurvivin isoforms are upregulated in APL patients, and their expression is diminished during the ATO treatment. In addition, overexpression of survivin and its variants (except survivin‐2α) are associated with unfavorable results, suggesting that they may play an important role in mechanisms underlying the resistance of APL cells to ATO.
Hospital‐wide implementation of an electronic‐workflow solution aiming to make surgical practice improvement easy
Authors: Sakowska Magdalena M. , Thomas Megan V. , Connor Saxon , Roberts Ross 
Published: October 2016

BackgroundIn measuring quality of health‐care delivery, digital infrastructure is essential. The aim at this tertiary centre was to create a hospital‐wide workflow system that collected data prospectively as part of daily practice.MethodsIn moving towards an electronic health record, a hospital‐wide integrated workflow system was introduced in 2013, which electronically managed the perioperative patient journey while simultaneously facilitating surgical audit. Analysis of its implementation was carried out presenting early outcomes using general surgery as an example.ResultsTheatre‐bookings (44 953) were made with compliance approaching 90% for all services. Of 7179 general surgical operations over 24 months, 5785 (80%) had an operation note created using the new system. Cumulative summation of uptake of synoptic operative reporting (SOR) for laparoscopic cholecystectomy (LC) was 81% with documentation being superior in terms of antibiotic use and steps to safe cholecystectomy (P < 0.001). A LC SOR took 4 min to complete (interquartile ranges 2–5 min, n = 425) and was immediately available on the day of surgery compared to narrative operative reports taking 2 days (interquartile ranges 1–5 days, n = 174) (P < 0.001). From July 2014 to November 2015, 557 (10%) complications were recorded for 5749 general surgical operations with 99% of complications being reviewed.ConclusionThe rapid and sustained uptake of both theatre‐bookings and SOR likely reflect high end‐user satisfaction with the system. Service metrics indicate a significant improvement in the time of delivery. The ability to seamlessly complete the audit cycle at an individual, department and hospital level has been achieved.
Sertraline use in the first trimester and risk of congenital anomalies: a systemic review and meta‐analysis of cohort studies
Authors: Shen Zi‐Qi , Gao Shan‐Yan , Li Shawn Xiang , Zhang Tie‐Ning , Liu Cai‐Xia , Lv Hai‐Chen , Zhang Yuan , Gong Ting‐Ting , Xu Xin , Ji Chao , Wu Qi‐Jun , Li Da 
Published: October 2016

AimTo perform a meta‐analysis of available cohort studies on the association between sertraline use by pregnant women in the first trimester and the findings of congenital anomalies in infants.MethodsA comprehensive search of articles published from the index date up to 31st December 2015 investigating the aforementioned associations was conducted on PubMed and Web of Science. Mesh headings used included the terms “serotonin reuptake inhibitor,” “sertraline,” “congenital anomalies” and “obstetrical outcome.”ResultsTwelve cohort studies that involved 6 468 241 pregnant women were identified. We summarized odds ratios (ORs) and 95% confidence intervals (CIs) of congenital anomalies using the random‐effects model. Pregnant women who used sertraline in the first trimester had a statistically significant increased risk of infant cardiovascular‐related malformations (OR = 1.36; 95% CI = 1.06–1.74; I2 = 64.4%; n = 12) as well as atrial and/or ventricular septal defects (OR = 1.36, 95% CI = 1.06–1.76; I2 = 62.2%; n = 8). Additionally, positive but nonsignificant associations between sertraline use and congenital anomalies of the nervous system (OR = 1.39; 95% CI = 0.83–2.32; I2 = 0%; n = 5), digestive system (OR = 1.23; 95% CI = 0.76–1.98; I2 = 0%; n = 5), eye, ear, face and neck (OR = 1.08; 95% CI = 0.33–3.55; I2 = 32.1%; n = 3), urogenital system (OR = 1.03; 95% CI = 0.73–1.46; I2 = 0%; n = 5), and musculoskeletal system (OR = 0.97; 95% CI = 0.69–1.36; I2 = 0%; n = 5) were observed.ConclusionThis meta‐analysis suggested that the use of sertraline use by pregnant women in the first trimester had an increased risk of cardiovascular‐related malformations as well as atrial and/or ventricular septal defects in infants. Meanwhile, nonsignificant associations between sertraline use and other congenital anomalies were found. More cohort studies are warranted to provide detailed results of other congenital anomalies.
SUSTAINABILITY AND OUTREACH: A COMPARATIVE STUDY OF MFIs IN SOUTH ASIA AND LATIN AMERICA AND THE CARIBBEAN
Authors: Churchill Sefa Awaworyi , Marr Ana 
Published: October 2016

ABSTRACTPrevious studies indicate that microfinance institutions (MFIs) in Latin America and the Caribbean (LAC) have different operational strategies to MFIs in South Asia (SA). Given the recent emphasis placed on the feasibility of MFIs to achieve the dual goals of outreach and sustainability concurrently, we examine and compare the relationship between sustainability and outreach of MFIs in LAC with MFIs in SA. Our results indicate that trade‐offs exist between outreach and sustainability in both regions. However, the severity of trade‐off is dependent on which goal MFIs decide to focus on in each region.
AN ATTEMPT TO EXPLAIN DIFFERENCES IN ECONOMIC GROWTH: A STOCHASTIC FRONTIER APPROACH
Authors: Aguiar Diana , Costa Leonardo , Silva Elvira 
Published: October 2016

ABSTRACTTotal factor productivity (TFP), factor accumulation, and growth are analysed for a panel of 40 countries in 2001–11. TFP growth and technical inefficiency are estimated using a stochastic frontier model. Environmental variables are found to have an important role in explaining differences in inefficiency across countries. Over 2001–11, the general improvement in technical efficiency of countries is almost outweighed by technological regress. Results indicate that differences in factor accumulation between OECD and emerging economies are more important than differences in TFP change to explain differences in economic growth. Results also indicate negative and significant random shocks for the OECD countries.
Insulin‐like growth factor axis targeting in cancer and tumour angiogenesis – the missing link
Authors: van Beijnum Judy R. , Pieters Wietske , Nowak‐Sliwinska Patrycja , Griffioen Arjan W. 
Published: October 2016

ABSTRACTNumerous molecular players in the process of tumour angiogenesis have been shown to offer potential for therapeutic targeting. Initially denoted to be involved in malignant transformation and tumour progression, the insulin‐like growth factor (IGF) signalling axis has been subject to therapeutic interference, albeit with limited clinical success. More recently, IGFs and their receptors have received attention for their contribution to tumour angiogenesis, which offers novel therapeutic opportunities. Here we review the contribution of this signalling axis to tumour angiogenesis, the mechanisms of resistance to therapy and the interplay with other pro‐angiogenic pathways, to offer insight in the renewed interest in the application of IGF axis targeting agents in anti‐cancer combination therapies.
Are youth offenders responsive to changing sanctions? Evidence from the Canadian Youth Criminal Justice Act of 2003
Authors: Zhang Lihui 
Published: October 2016

AbstractThis paper examines youth offenders’ responses to changing sanctions, using evidence from the Canadian Youth Criminal Justice Act (YCJA), which replaced the Young Offenders Act on April 1, 2003. Using police reported and court based official statistics and the difference‐in‐difference strategy, it is found that Canadian youth offenders were less likely to be charged by police and less likely to receive a custodial sentence following the YCJA. These changes were relatively large for less serious crime and small or insignificant for more serious crime. In response to these changes in the certainty of sanctions, less serious youth crime increased while the direction of change for more serious youth crime was less clear. Empirical analysis on youth self‐reported crime corroborates the findings on youth crime reported to police, particularly for boys.
Asymmetric spiders: Supplier heterogeneity and the organization of firms
Authors: Nowak Verena , Schwarz Christian , Suedekum Jens 
Published: October 2016

AbstractWe consider a property rights model of a firm with two heterogeneous suppliers and analyze which sourcing mode (outsourcing or vertical integration) is chosen for which of the asymmetric inputs. If components are close substitutes, the firm tends to outsource the technologically more important input while keeping the less important one inside its boundaries. This pattern can be reversed, however, if the two inputs are strongly complementary. The firm also tends to outsource low‐cost inputs and components with low sophistication. These theoretical predictions are consistent with numerous case studies and recent empirical evidence on the internal organization of firms.
Energy price shocks and external balances
Authors: Huynh Bao Tan 
Published: October 2016

AbstractThis paper studies the impact of a wide set of energy price shocks on external balances using a two‐country framework comprising multiple sectors and endogenous energy production with convex costs. The paper disentangles different demand and supply shocks in the energy market through their distinct impact on external balances. It provides a theoretical confirmation of Kilian et al. (2009) and a theoretical foundation to the determining role of the non‐energy trade balance in the transmission of energy price shocks. The presence of durables also highlights the immediate channel through which energy prices impact the non‐energy trade balance.
The citizen‐candidate model with imperfect policy control: Strategic delegation and polarization
Authors: Aytimur R. Emre , Boukouras Aristotelis , Schwager Robert 
Published: October 2016

AbstractWe present a modified citizen‐candidate model where the implemented policy arises from a compromise between the government and an unelected external power. We show that the two‐candidate equilibria of this model differ significantly from the original: however small the cost of candidacy, the distance between the candidates' policies, both ideal and implemented, remains strictly above a threshold. Moreover, there may be one‐candidate equilibria in which the only candidate is not the one most preferred by the median voter. Both results point out that, even with negligible cost of entry, there are limits to strategic delegation.
Psychosocial problems of children whose parents visit the emergency department due to intimate partner violence, substance abuse or a suicide attempt
Authors: Hoytema van Konijnenburg E. M. M. , van der Lee J. H. , Teeuw A. H. , Lindeboom R. , Brilleslijper‐Kater S. N. , Sieswerda‐Hoogendoorn T. , van Goudoever J. B. , Lindauer R. J. L. ,   on behalf of the aftERcare‐group
Published: October 2016

AbstractBackgroundHigh levels of maltreatment are found in children who are identified because their parents visit the emergency department due to partner violence, substance abuse or suicide attempt. However, it is unknown if these children experience psychosocial problems. This study aims to assess their levels of post‐traumatic stress, anxiety, depression, behavioural problems and health‐related quality of life.MethodsA cross‐sectional study was conducted in six hospitals. All consecutive families of which a parent visited the emergency department due to partner violence, substance abuse or suicide attempt between 1 July 2012 and 1 March 2014 with children aged 1.5–17 years were approached for participation. Parents and children aged 8 years and older filled out questionnaires measuring post‐traumatic stress [13‐item version of Children's Revised Impact of Event Scale (CRIES‐13)], anxiety, depression (Revised Child Anxiety and Depression Scale), behavioural problems [Child Behavior Checklist (CBCL) and Youth Self‐Report (YSR)] and health‐related quality of life (PedsQL). Scores of participants were compared with reference data obtained in children in similar age ranges from representative Dutch community samples (CRIES‐13, Revised Child Anxiety and Depression Scale, PedsQL and CBCL) and to a normed cutoff score (CRIES‐13).ResultsOf 195 eligible families, 89 (46%) participated in the study. Participating children did not score different from community children, both on child‐reported and parent‐reported instruments. Standardized mean differences of total sum scores were 0 (CRIES‐13 and CBCL 1.5–5), 0.1 (YSR), 0.2 (CBCL 6–18) and −0.3 (PedsQL) and not statistically different from community children. Thirty‐five percent of the participating children scored above the cutoff score on the CRIES‐13, indicating post‐traumatic stress disorder, but this difference was not statistically significant from community children (mean difference 8%; 95% CI −4–22%).ConclusionsWe found no differences in psychosocial problems between children whose parents visited the emergency department due to partner violence, substance abuse or suicide attempt and children from community samples. Because 35% of the children scored in the range of post‐traumatic stress disorder, we advise healthcare providers to pay attention to post‐traumatic stress symptoms
Alcohol hyper‐responsiveness in chronic rhinosinusitis with nasal polyps
Authors: De Schryver Els , Derycke Lara , Campo Paloma , Gabriels Eline , Joos Guy F. , Van Zele Thibaut , Bachert Claus , Hellings Peter W. , Gevaert Philippe 
Published: October 2016

SummaryBackgroundAn important percentage of subjects diagnosed with chronic upper airway disease report alcohol‐induced worsening of their symptoms. The prevalence and characteristics of respiratory reactions provoked by alcohol‐containing drinks have not been fully investigated yet.ObjectiveThe aim of this study was to estimate the prevalence and characteristics of alcohol hyper‐responsiveness in patients with chronic airway disease and healthy controls. Furthermore, nasal inflammation was evaluated in nasal polyp patients with and without hyper‐responsiveness.MethodsWe evaluated the prevalence and characteristics of alcohol‐induced respiratory complaints in 1281 subjects. Chronic rhinosinusitis with nasal polyps (CRSwNP) patients with and without NSAID exacerbated respiratory disease (NERD), chronic rhinosinusitis patients without nasal polyps (CRSsNP), allergic rhinitis (AR) patients and healthy controls were approached by means of a questionnaire. Inflammatory markers (eosinophilic cationic protein (ECP), IL‐5, IgE, SAE‐specific IgE, IL‐17, TNFα and IFNγ) in tissue were then compared between alcohol hyper‐responsive and non‐hyper‐responsive CRSwNP patients.ResultsThe highest prevalence of nasal and bronchial alcohol hyper‐responsiveness was observed in patients with NERD, followed by CRSwNP, and less frequent in CRSsNP, AR and healthy controls. Alcohol hyper‐responsiveness is significantly more prevalent in CRSwNP patients suffering from recurrent disease and in patients with severe symptomatology. In nasal tissue of the hyper‐responsive CRSwNP group, we observed significantly higher nasal levels of the eosinophilic biomarker ECP.Conclusion and Clinical RelevanceNasal hyper‐responsiveness to alcohol is significantly more prevalent in severe eosinophilic upper airway disease.
Mechanism involved in interleukin-21-induced phagocytosis in human monocytes and macrophages
Authors: Vallières F , Girard D 
Published: October 2016

Summary
The interleukin (IL)-21/IL-21 receptor (R) is a promising system to be exploited for the development of therapeutic strategies. Although the biological activities of IL-21 and its cell signalling events have been largely studied in immunocytes, its interaction with human monocytes and macrophages have been neglected. Previously, we reported that IL-21 enhances Fc gamma receptor (FcRγ)-mediated phagocytosis in human monocytes and in human monocyte-derived macrophages (HMDM) and identified Syk as a novel molecular target of IL-21. Here, we elucidate further how IL-21 promotes phagocytosis in these cells. Unlike its ability to enhance phagocytosis of opsonized sheep red blood cells (SRBCs), IL-21 did not promote phagocytosis of Escherichia coli and zymosan by monocytes and did not alter the cell surface expression of CD16, CD32 and CD64. In HMDM, IL-21 was found to enhance phagocytosis of zymosan. In addition, we found that IL-21 activates p38, protein kinase B (Akt), signal transducer and activator of transcription (STAT)-1 and STAT-3 in monocytes and HMDM. Using a pharmacological approach, we demonstrate that IL-21 enhances phagocytosis by activating some mitogen-activated protein kinases (MAPKs) and phosphoinositide 3-kinase (PI3K)–Akt and Janus kinase (JAK)–STAT pathways. These results obtained in human monocytes and macrophages have to be considered for a better exploitation of the IL-21/IL-21R system for therapeutic purposes.
Long‐term outcomes in patients with multiple endocrine neoplasia type 1 and pancreaticoduodenal neuroendocrine tumours
Authors: Donegan D. , Singh Ospina N. , Rodriguez‐Gutierrez R. , Al‐Hilli Z. , Thompson G.B. , Clarke B.L. , Young W.F. 
Published: October 2016

SummaryBackgroundIn patients with multiple endocrine neoplasia type 1 (MEN‐1), pancreaticoduodenal (PD) neuroendocrine tumours (NETs) are associated with early mortality, yet the best treatment strategy remains uncertain.AimTo assess patient important outcomes (mortality and metastasis) of PD‐NETs and predictors of outcomes in patients with MEN‐1.MethodsRetrospective cohort of patients with MEN‐1 who attended the Mayo Clinic, Rochester, MN from 1997 to 2014.ResultsWe identified 287 patients with MEN‐1; 199 (69%) patients had 217 PD‐NETs. Among those with a PD‐NETs, 129 (65%) had surgery of which 90 (70%) had their primary surgery performed at Mayo Clinic. The median postoperative follow‐up was 8 years during which 13 (14%) patients died. The mean (±standard deviation) age of death was 51 (±9) years. Tumour size, metastasis at surgery or tumour type were not predictive of mortality, but for every year older at surgery, the odds of metastasis increased by 6%. Surgery was not performed in 70 (35%) patients. Among those who were observed/medically managed without known metastatic disease, mean tumour growth was 0·02 cm/year (range, −0·13–0·4 cm/year). Four patients (7%) died at a median age of 77 (range, 51–89) years.ConclusionPD‐NETs are common in patients with MEN‐1 and are associated with early mortality even after surgical intervention. Active surveillance is a viable option in nonaggressive PD‐NETs, although definitive factors identifying such patients are lacking. Therefore, counselling regarding risks and benefits of current treatment options remains integral to the care of patients with MEN‐1.