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  • 1
    Language: English
    In: Pediatrics, February 2012, Vol.129(2), pp.e540-60
    Description: Maternal use of certain drugs during pregnancy can result in transient neonatal signs consistent with withdrawal or acute toxicity or cause sustained signs consistent with a lasting drug effect. In addition, hospitalized infants who are treated with opioids or benzodiazepines to provide analgesia or sedation may be at risk for manifesting signs of withdrawal. This statement updates information about the clinical presentation of infants exposed to intrauterine drugs and the therapeutic options for treatment of withdrawal and is expanded to include evidence-based approaches to the management of the hospitalized infant who requires weaning from analgesics or sedatives.
    Keywords: Evidence-Based Medicine ; Analgesics, Opioid -- Adverse Effects ; Benzodiazepines -- Adverse Effects ; Hypnotics and Sedatives -- Adverse Effects ; Neonatal Abstinence Syndrome -- Therapy ; Street Drugs -- Adverse Effects
    ISSN: 00314005
    E-ISSN: 1098-4275
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  • 2
    Language: English
    In: Social Science & Medicine, 2011, Vol.73(7), pp.1028-1036
    Description: This paper examines how orthopaedic surgeons skilfully design treatment recommendations to display awareness of what individual patients are anticipating or seeking, and suggests limits to those efforts. It adds leverage to our parallel work by demonstrating that even when surgeons incorporate considerations of recipient design to ‘fit’ recommendations to patients’ displayed orientations, an asymmetry between recommendations vs. surgery remains: recommendations surgery are generally proposed early, in relatively simple and unmitigated form, and as stand-alone options. In contrast, recommendations surgery tend to be significantly more complex: they are likely to be delayed, conveyed indirectly, mitigated and justified, and include other possible treatment options. These findings suggest a tension between surgeons’ efforts to design recommendations for specific recipients and an overarching institutional bias favoring surgery. Surgeons’ efforts to anticipate and respond to resistance to recommendations demonstrate a similar pattern: the methods used to counter patient resistance, and the sequential placement of those efforts, depends on whether the recommendation is for surgery or another treatment option. This work contributes to an understanding of treatment recommendations generally by showing how patients are in their accomplishment: because surgeons incorporate considerations of recipient design in response to information provided explicitly or tacitly by patients, patients influence the rendering of recommendations from the beginning. ► This study examines how Canadian orthopaedic surgeons design recommendations to display awareness of what individual patients are anticipating/seeking. ► However, even when surgeons ‘fit’ recommendations to patients’ displayed orientations, an asymmetry between recommendations remains. ► Recommendations surgery are generally proposed early, in relatively simple and unmitigated form and as stand-alone options. ► In contrast, recommendations surgery tend to be delayed, conveyed indirectly, justified and to include other possible treatment options. ► Tension exists between surgeons’ efforts to design recommendations for specific patients and an overarching institutional bias favoring surgery.
    Keywords: Conversation Analysis ; Treatment Recommendations ; Orthopaedic Surgery ; Medical Interaction ; Surgery ; Doctor-Patient Communication ; Canada ; Medicine ; Social Sciences (General) ; Public Health
    ISSN: 0277-9536
    E-ISSN: 1873-5347
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  • 3
    Language: English
    In: Materials Science & Engineering A, 2011, Vol.528(27), pp.8028-8030
    Description: ► Estimating Weibull modulus by using linear regression and unbiased probability estimators. ► Hypothesis testing on two estimated Weibull moduli. ► Percentile tables are generated for this hypothesis test. Probability estimators developed previously by the authors have been used to compare unbiased estimates of the shape parameters (Weibull modulus) from two distributions by the linear regression method for thirteen sample sizes ranging from 10 to 100. Percentiles of the ratio of two estimated Weibull moduli for various confidence levels have been developed. The use of these percentiles for hypothesis testing, i.e., comparison of the two Weibull moduli is demonstrated by using datasets from the literature.
    Keywords: Defects ; Flaws ; Weakest Link ; Ceramics ; Castings ; Engineering
    ISSN: 0921-5093
    E-ISSN: 1873-4936
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  • 4
    Language: English
    In: Pediatrics, July 2016, Vol.138(1)
    Description: * Abbreviations: FDA — : US Food and Drug Administration UM — : ultrarapid metabolizer Codeine is a prodrug whose analgesic efficacy derives from a 5% to 10% metabolic conversion to the active drug morphine by the polymorphic cytochrome P450 CYP2D6 enzyme system. Among individuals, codeine metabolism varies in proportion to the number and function of gene alleles. Dosing recommendations achieve therapeutic drug exposures in the great majority of the general population, who are “extensive metabolizers” possessing the wild type phenotype of 1 to 2 fully functional alleles. But codeine fails to provide adequate analgesia in many patients with reduced CYP2D6 function; of greater concern, “ultra-rapid metabolizers” (UMs), who have 〉3 functional genes due to gene copying, are at risk for serious adverse events including respiratory arrest and death. UMs make up 1% to 2% of the general population but as many as 28% in certain Arab, Ethiopian, and North African populations.1 In the past decade, multiple reports have recounted deaths in children receiving standard dosages of codeine for analgesia. Most of the children who had genomic analysis were found to demonstrate a UM phenotype, although 1 child was determined to be an extensive metabolizer.2 The American Academy of … Address correspondence to Mark L. Hudak, MD, Department of Pediatrics, University of Florida College of Medicine–Jacksonville, 653-1 W 8th St, Jacksonville, FL 32209. E-mail: mark.hudak{at}jax.ufl.edu
    Keywords: Codeine ; Pharmacogenetics
    ISSN: 00314005
    E-ISSN: 1098-4275
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  • 5
    Language: English
    In: Journal of the American Chemical Society, 12 October 2011, Vol.133(40), pp.16127-35
    Description: Homogeneously glycosylated proteins are important targets for fundamental research and for biopharmaceutical development. The use of unnatural protein-glycan linkages bearing structural similarity to their native counterparts can accelerate the synthesis of glycoengineered proteins. Here we report an approach toward generating homogeneously glycosylated proteins that involves chemical attachment of aminooxy glycans to recombinantly produced proteins via oxime linkages. We employed the recently introduced aldehyde tag method to obtain a recombinant protein with the aldehyde-bearing formylglycine residue at a specific site. Complex aminooxy glycans were synthesized using a new route that features N-pentenoyl hydroxamates as key intermediates that can be readily elaborated chemically and enzymatically. We demonstrated the method by constructing site-specifically glycosylated variants of the human growth hormone.
    Keywords: Amino Sugars -- Chemistry ; Glycoproteins -- Chemistry ; Human Growth Hormone -- Chemistry
    ISSN: 00027863
    E-ISSN: 1520-5126
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  • 6
    Language: English
    In: Journal of Power Sources, Dec 10, 2014, Vol.269, p.962(13)
    Description: To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jpowsour.2013.12.089 Byline: Nicholas S. Hudak Abstract: A simple method for experimentally determining thermodynamic quantities for flow battery cell reactions is presented. Equilibrium cell potentials, temperature derivatives of cell potential (dE/dT), Gibbs free energies, and entropies are reported here for all-vanadium, iron-vanadium, and iron-chromium flow cells with state-of-the-art solution compositions. Proof is given that formal potentials and formal temperature coefficients can be used with modified forms of the Nernst Equation to quantify the thermodynamics of flow cell reactions as a function of state-of-charge. Such empirical quantities can be used in thermo-electrochemical models of flow batteries at the cell or system level. In most cases, the thermodynamic quantities measured here are significantly different from standard values reported and used previously in the literature. The data reported here are also useful in the selection of operating temperatures for flow battery systems. Because higher temperatures correspond to lower equilibrium cell potentials for the battery chemistries studied here, it can be beneficial to charge a cell at higher temperature and discharge at lower temperature. Proof-of-concept of improved voltage efficiency with the use of such non-isothermal cycling is given for the all-vanadium redox flow battery, and the effect is shown to be more pronounced at lower current densities. Author Affiliation: Advanced Power Sources Research and Development, Sandia National Laboratories, P.O. Box 5800 MS 0613, Albuquerque, NM 87185-0613, USA Article History: Received 24 September 2013; Revised 9 November 2013; Accepted 18 December 2013
    Keywords: Thermodynamics -- Analysis ; Batteries -- Analysis ; Vanadium -- Analysis
    ISSN: 0378-7753
    Source: Cengage Learning, Inc.
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  • 7
    Language: English
    In: The Journal of Urology, 2011, Vol.186(5), pp.1962-1966
    Description: We report our initial clinical experience with the new 3.5 cm artificial urinary sphincter cuff. We reviewed the records of all men who underwent artificial urinary sphincter placement done by a single surgeon since September 2009. A perineal approach was used to ensure cuff placement around the most proximal corpus spongiosum after precise spongiosal measurement with a redesigned measuring tape. Clinical factors and cuff sizes were analyzed. During the 14-month study period 45 of 67 patients (67%) with an artificial urinary sphincter received the 3.5 cm cuff with no difference between primary and revision surgery (73% vs 58%, p = 0.29). Transcorporal cuff placement was reserved for 8 select patients (12%) after prior artificial urinary sphincter cuff erosion or complex urethroplasty. A tandem cuff artificial urinary sphincter was not used. Erectile dysfunction (89% vs 77%, p = 0.28) and prior radiation (47% vs 27%, p = 0.12) were more common in men who received a 3.5 vs a 4.0 cm or greater cuff. A similar proportion of men with a 3.5 cm vs a larger cuff (4 of 45 or 9% vs 2 of 22 or 9%) required explantation for infection and/or erosion. At our center the 3.5 cm cuff has become the predominant size used for primary and revision artificial urinary sphincter placement. Liberal use of the 3.5 cm cuff has simplified and improved artificial urinary sphincter placement without additional morbidity.
    Keywords: Urethra ; Urinary Incontinence ; Stress ; Male ; Urinary Sphincter ; Artificial ; Prostheses and Implants ; Medicine
    ISSN: 0022-5347
    E-ISSN: 1527-3792
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  • 8
    In: Sociology of Health & Illness, May 2011, Vol.33(4), pp.634-653
    Description: In medical interactions, it may seem straightforward to identify ‘small talk’ as casual or social talk superfluous to the institutional work of dealing with patients’ medical concerns. Such a broad characterisation is, however, extremely difficult to apply to actual talk, and more specificity is necessary to pursue analyses of how small talk is produced and what it achieves for participants in medical interactions. We offer an approach to delineating a subgenre of small talk called topicalised small talk (TST), derived on the basis of conversation analytically‐informed analyses of routine consultations involving orthopaedic surgeons and older patients. TST is a line of talk that is referentially independent from their institutional identities as patients or surgeons, oriented instead to an aspect of the personal biography of one (or both), or to some neutral topic available to interactants in any setting (e.g. weather). Importantly, TST is an achievement of both patient and surgeon in that generation and pursuit of topic is mutually accomplished. In an exploratory but systematic analysis, when this approach was applied to a purposive sample of surgeon‐patient interactions, TST was much more prevalent in visits with White than African American patients. Accounts for possible ethnic differences in TST are suggested.
    Keywords: Small Talk ; Medical Interaction ; Ethnic Differences In Talk ; Conversation Analysis
    ISSN: 0141-9889
    E-ISSN: 1467-9566
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  • 9
    Language: English
    In: The Journal of Urology, May 2012, Vol.187(5), pp.1691-1695
    Description: We examined the association of previous transurethral manipulation with stricture complexity and disease duration among men referred for bulbar urethral reconstruction. We retrospectively reviewed the records of 340 consecutive urethroplasties performed by a single surgeon between July 2007 and October 2010. Only men treated with initial open surgery for bulbar strictures were included in analysis, thus excluding those with hypospadias, lichen sclerosus, pelvic radiation, prior urethroplasty, incomplete data, or pure penile or posterior urethral stenosis. Cases were divided into 2 groups based on the history of transurethral treatment for urethral stricture before urethroplasty, including group 1—0 or 1 and group 2—2 or greater treatments. Of 101 patients with bulbar urethral stricture and all data available 50 and 51 underwent 0 to 1 and 2 or greater previous transurethral treatments, respectively. Repeat transurethral manipulation was strongly associated with longer strictures and the need for complex reconstruction. Repeat transurethral manipulation of bulbar urethral strictures was also associated with an eightfold increase in disease duration between stricture diagnosis and curative urethroplasty. Repeat transurethral manipulation of bulbar strictures is associated with increased stricture complexity and a marked delay to curative urethroplasty.
    Keywords: Urethra ; Urethral Stricture ; Urethral Stenosis ; Grafts ; Treatment Failure ; Medicine
    ISSN: 0022-5347
    E-ISSN: 1527-3792
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  • 10
    Language: English
    In: Journal of Power Sources, 10 December 2014, Vol.269, pp.962-974
    Description: A simple method for experimentally determining thermodynamic quantities for flow battery cell reactions is presented. Equilibrium cell potentials, temperature derivatives of cell potential (d /d ), Gibbs free energies, and entropies are reported here for all-vanadium, iron–vanadium, and iron–chromium flow cells with state-of-the-art solution compositions. Proof is given that and can be used with modified forms of the Nernst Equation to quantify the thermodynamics of flow cell reactions as a function of state-of-charge. Such empirical quantities can be used in thermo-electrochemical models of flow batteries at the cell or system level. In most cases, the thermodynamic quantities measured here are significantly different from standard values reported and used previously in the literature. The data reported here are also useful in the selection of operating temperatures for flow battery systems. Because higher temperatures correspond to lower equilibrium cell potentials for the battery chemistries studied here, it can be beneficial to charge a cell at higher temperature and discharge at lower temperature. Proof-of-concept of improved voltage efficiency with the use of such non-isothermal cycling is given for the all-vanadium redox flow battery, and the effect is shown to be more pronounced at lower current densities.
    Keywords: Flow Battery ; Thermodynamics ; Entropy ; Formal Potential ; Nernst Equation ; Non-Isothermal ; Engineering
    ISSN: 0378-7753
    E-ISSN: 1873-2755
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