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To elucidate the relationship between catastrophization and pelvic pain symptomatology in chronic pelvic pain (CPP) patients using standardized questionnaires.CPP patients completed standardized questionnaires which included: genitourinary pain index, patient health questionnaire for anxiety and depression, interstitial cystitis symptom index, and pelvic floor distress inventory. Scores and number of comorbidities were compared to Pain Catastrophizing Scale (PCS) by linear regression. Patients categorized as "extreme catastrophizing" (PCS score ≥30), traditionally associated with worse outcomes in the pain literature [10-11], were also analyzed separately.184 patients were included (mean age 42 years, N = 23 male). Higher number of pain comorbidities was correlated to PCS (P.001) as well as higher scores on all standardized questionnaires (P.001). Forty-four percent of patients (81/184) were extreme catastrophizers and scored significantly worse on all standardized measures when compared to nonextreme catastrophizers. Mean scores for nonextreme vs extreme catastrophizers were: genitourinary pain index (25.7 ± 6.8 vs 32.7 ± 6.5, P.001), interstitial cystitis symptom index (6.5 ± 4.7 vs 9.4 ± 5.8, P.001), pelvic floor distress inventory (88.8 ± 52 vs 121.1 ± 62.8, P.001), patient health questionnaire anxiety (1.7 ± 2.0 vs 3.6 ± 2.1, P.001), and depression (1.4 ± 1.6 vs 3.3 ± 2.0, P.001). Number of comorbidities was not significant predictor of extreme catastrophizing (3.5 vs 3.7 P = .22).Higher scores on standardized questionnaires and more comorbidities was associated with more catastrophizing in CPP patients. This study highlights the significance of standardized questionnaires, including the PCS, to predict which patients may be extreme catastrophizers and thus subject to worse outcomes. Future studies are needed to look at catastrophization as a potentially modifiable and treatable risk factor.

INTRODUCTION AND OBJECTIVE: The COVID-19 pandemic has resulted in 2.5 million deaths globally. Previous studies have suggested the virus may affect the kidneys, resulting in hematuria, proteinuria and acute kidney injury;however, the studies did not differentiate microscopic hematuria (MH) from gross hematuria (GH). In this study, we investigated the clinical outcomes and risk factors associated with GH compared to MH in COVID patients. METHODS: Following IRB approval, 250 consecutive medical records of COVID patients admitted to a tertiary care university hospital from 3/15/20 were analyzed. Patients without a urinalysis during the admission were excluded, the remaining 157 patients were included in the analysis. Patients were divided into three categories based on the presence of hematuria during the admission: none, microscopic hematuria (MH) and gross hematuria (GH). Outcomes including length of hospitalization, ICU admission, intubation, and lab values were compared amongst the categories. Chi-square test was used to compare the categorical variables, while ANOVA and t-test were used for the parametric variables. RESULTS: Of the 157 patients, 66 (42%) did not have hematuria, 36 (22.9%) had MH and 55 (35%) had GH. As seen in Fig.1, GH was associated with worse clinical outcomes such as higher intubation rate at 49.1%, compared to 27.8% in MH (p

INTRODUCTION AND OBJECTIVE:Technological innovations of hydrophilic and antibiotic coated materials in the construction of the three-piece inflatable penile prosthesis (IPP) have resulted in decrea...

Background Despite the recent increase in HIV infections among adolescents, little is known about their HIV knowledge and perceptions. This study, therefore, sought to examine the factors associated with comprehensive HIV knowledge, stigma, and HIV risk perceptions among young adolescents aged 10–14 years in Akwa Ibom State, Nigeria. Additionally, consenting parents and assenting young adolescents were tested for HIV. Methods We used cross-sectional data from the 2017 Akwa Ibom AIDS Indicator Survey to analyze comprehensive HIV knowledge, stigma, and HIV risk perceptions among young adolescents. Demographic characteristics of young adolescents were summarized using descriptive statistics. Chi-square test (or Fisher’s exact test in cases of small subgroup sample sizes) was used to elicit associations between demographics and study outcomes. Separate multivariable logistic regression models were then conducted to determine associations with the study outcomes. Sampling weights were calculated in order to adjust for the sample design. P-values less than 0.05 were considered to be significant. Results A total of 1818 young adolescents were interviewed. The survey highlighted significant low levels of comprehensive HIV knowledge (9.4%) among young adolescents. Adolescent-parent discussions [AOR = 2.19, 95% C.I (1.10–4.38), p = 0.03], schools as sources of HIV information [AOR = 8.06, 95% C.I (1.70–38.33), p p = 0.02] were associated with comprehensive HIV knowledge. Majority (93%) of young adolescents perceived themselves not to be at risk of HIV. Overall, 81.5% of young adolescents reported stigmatizing tendencies towards people living with HIV. HIV prevalence among young adolescents was 0.6%. Conclusions Results indicate low comprehensive HIV knowledge among young adolescents. Our findings suggest that there is a need for increased attention towards young adolescents particularly in the provision of comprehensive, functional sexuality education, including HIV at the family- and school-levels. Consequently, age appropriate interventions are needed to address the epidemiological risks of young adolescents that are influenced by a myriad of social issues.

Background COVID-19 has created barriers to the delivery of health care services, including dental care. This study sought to quantify the change in dental visits in 2020 compared with 2019. Methods This retrospective, observational study examined the percentage change in weekly visits to dental offices by state (inclusive of the District of Columbia), nationally, and by county-level COVID-19 incidence using geographic information from the mobile applications of 45 million smartphones during 2019 and 2020. Results From March through August 2020, weekly visits to dental offices were 33% lower, on average, than in 2019. Weekly visits were 34% lower, on average, in counties with the highest COVID-19 rates. The greatest decline was observed during the week of April 12, 2020, when there were 66% fewer weekly visits to dental offices. The 5 states (inclusive of the District of Columbia) with the greatest declines in weekly visits from 2019 through 2020, ranging from declines of 38% through 53%, were California, Connecticut, District of Columbia, Massachusetts, and New Jersey. Conclusions Weekly visits to US dental offices declined drastically during the early phases of the COVID-19 pandemic. Although rates of weekly visits rebounded substantially by June 2020, rates remain about 20% lower than the prior year as of August 2020. These findings highlight the economic challenges faced by dentists owing to the pandemic. Practical Implications States exhibited widespread variation in rates of declining visits during the pandemic, suggesting that dental practices may need to consider different approaches to reopening and encouraging patients to return depending on location.

Very few cases of villous adenomas of the bladder or urinary tract have been described. To our knowledge this is the first account of resection of an urachal villous adenoma via robotic laparoscopy, which is a safe and efficacious surgical approach. At this time, there is not enough evidence to suggest that progression of disease to carcinoma is the typical course. Nonetheless, follow-up cystoscopy is recommended after complete removal of the adenoma to monitor for recurrence. This case report reviews the current literature and describes a novel approach to treatment of this exceedingly rare entity.

Objectives To systematically review the literature on economic evaluations of dental sealants and examine the costs and effectiveness of caries prevention using sealants. Methods Of 21 full-text articles examined, a total of 13 were included in this study. These studies are grouped by the type of intervention as follows: (i) sealants compared with no sealants; (ii) sealants compared with other forms of caries prevention; (iii) resin-based sealants compared with glass-ionomer sealants; (iv) different sealing strategies in primary teeth; (v) different sealing strategies in permanent teeth; and (vi) sealants based on school- or clinic-based setting of delivery. All currency is reported in constant 2010 US$. Results Cost-effectiveness analyses differed due to varying study designs, assumptions, sealant delivery settings, outcomes, caries risk assessment and study durations. Findings varied on the cost-effectiveness of sealants compared with other caries-preventive strategies. Under the assumption of equal caries risk, always sealing primary molars appeared to be the most effective strategy, whereas risk-based sealing was the optimal strategy with differing caries risk. Studies that assessed sealing strategies in permanent teeth reported that risk-based sealing was more cost-effective than not sealing, but they differed on the cost-effectiveness of risk-based seal compared with non-risk-based seal. Sealants delivered in school settings had mixed results on costs but were as equally effective as sealants delivered in private practices. Conclusions The cost-effectiveness of sealants is dependent on the conditions of delivery. The list of cost-effectiveness ratios for each intervention can support policy makers to estimate expected returns on their investments in dental sealants.

To identify clinical and urodynamic factors leading to spontaneous voiding in men with detrusor underactivity (DU) and suspected bladder outlet obstruction who underwent an outlet de-obstruction procedure.We identified 614 men who underwent an outlet procedure at our institution from 2005 to 2014. Men were stratified by bladder contractility index (BCI). The primary outcome was spontaneous voiding after surgery. Data were analyzed in Statistical analysis system software.Of the 131 men who underwent preoperative urodynamics, 122 (mean age 68 years) had tracings available for review. DU (BCI 100) was identified in 54% (66 of 122), of whom only 68% (45 of 66) voided spontaneously before surgery, compared with 82% (46 of 56) of men with BCI ≥ 100. At a mean follow-up of 6.4 months postoperatively, 79% (52 of 66) of men with DU were able to void spontaneously, compared with 96% (54 of 56) of men with BCI ≥ 100. In men with a BCI 100 unable to void before surgery, 57% (12 of 21) recovered spontaneous voiding after surgery. On logistic regression for the outcome postoperative spontaneous voiding, significant preoperative characteristics, and urodynamic factors included preoperative spontaneous voiding (odds ratio [OR] = 9.460; 95% confidence interval [CI] = 2.955-30.289), increased maximum flow rate (Qmax; OR = 1.184; 95% CI = 1.014-1.382), increased detrusor pressure at maximum flow (Pdet@Qmax; OR = 1.032; 95% CI = 1.012-1.052), DU with BCI 100 (OR = 0.138; 95% CI = 0.030-0.635), and obstruction with bladder outlet obstruction index 40 (OR = 5.595; 95% CI = 1.685-18.575).Outlet de-obstruction improves spontaneous voiding in men with DU and may benefit men who do not meet the urodynamic threshold for obstruction.

Polycystic ovary syndrome (PCOS) is a common endocrine disorder affecting approximately 10% of reproductive-aged women worldwide. Diagnosis requires two of the following: hyperandrogenism, oligo/anovulation and polycystic ovaries. In addition to reproductive dysfunction, many women with PCOS display metabolic abnormalities associated with hyperandrogenism. Recent studies have reported that the gut microbiome is altered in women with PCOS and rodent models of the disorder. However, it is unknown whether the gut microbiome plays a causal role in the development and pathology of PCOS. Given its potential role, we hypothesized that exposure to a healthy gut microbiome would protect against development of PCOS. A co-housing study was performed using a letrozole-induced PCOS mouse model that recapitulates many reproductive and metabolic characteristics of PCOS. Since mice are coprophagic, co-housing results in repeated, non-invasive inoculation of gut microbes in co-housed mice via the fecal-oral route. In contrast to letrozole-treated mice housed together, letrozole-treated mice co-housed with placebo mice showed significant improvement in both reproductive and metabolic PCOS phenotypes. Using 16S rRNA gene sequencing, we observed that the gut microbial composition of letrozole-treated mice co-housed with placebo mice differed from letrozole mice housed together. In addition, our analyses identified several bacterial taxa including Coprobacillus, Dorea and Adlercreutzia associated with the improved PCOS phenotype in letrozole-treated mice co-housed with placebo mice. These results indicate that disruption of the gut microbiome may play a causal role in PCOS and that manipulation of the gut microbiome may be a potential treatment option for PCOS.SignificancePCOS is a common cause of female infertility and ~80% of women with PCOS have metabolic dysregulation that predisposes them to type 2 diabetes and cardiovascular disease. Since treatment options for the metabolic symptoms of PCOS are limited, there is a need to develop novel therapeutic options. The gut microbiome has emerged as an important player in human health and has been shown to play a causal role in obesity. In this study, we found that exposure to a healthy gut microbiome through co-housing protected against the development of reproductive and metabolic dysregulation in a PCOS mouse model. These results suggest that manipulation of the gut microbiome may be a potential treatment option for women with PCOS.

Vertebral osteosarcoma (OSA) is the most common primary vertebral tumor in dogs, however studies examining the survival time after surgical decompression of these tumors are limited. There is also limited information regarding the benefit of adjunctive treatments such as radiation therapy or chemotherapy in these patients. The goal of this study was to determine survival time of dogs with primary vertebral OSA after palliative decompressive surgery alone and combined with radiation therapy and/or chemotherapy. Records from 22 client-owned dogs diagnosed with primary vertebral OSA and treated with decompressive surgery were collected retrospectively from eight referral institutions. Survival time was assessed for dogs treated with surgery alone as well as dogs who received adjunctive radiation therapy and/or chemotherapy. Median survival time in the 12 dogs treated with surgery alone was 42 days (range: 3-1333 days). The three dogs treated with surgery and chemotherapy had a median survival time of 82 days (range: 56-305 days). Only one dog was treated with surgery and radiation therapy; this dog survived 101 days. Six dogs were treated with surgery, radiation therapy and chemotherapy; these dogs had a median survival time of 261 days (range: 223-653 days). Cause of death in all cases that survived the initial postoperative period was euthanasia secondary to confirmed or suspected tumor regrowth. The results of this study suggest that definitive radiation therapy, possibly combined with concurrent chemotherapy, significantly improves survival in dogs treated with palliative decompressive surgery for vertebral OSA and should be the treatment of choice in selected cases.

Chest pain in acute coronary syndrome (ACS) unresponsive to nitrates is routinely treated by intravenous (IV) morphine. In the past two decades, several studies have emerged, suggesting poorer outcomes in patients receiving this treatment; however, morphine remains the drug of choice for these patients as per the American College of Cardiology/American Heart Association guidelines on ACS management. The results of various studies that examined the impact of morphine on myocardial infarct size, antiplatelet therapy absorption time, and patient mortality are discussed. There is mounting evidence suggesting that morphine may increase adverse events in ACS patients, therefore, the development of more precise criteria for IV morphine administration in ACS patients is needed.

Pelvic organ prolapse (POP) is a common condition for which approximately 200,000 US women annually undergo surgical repair [Am J Obstet Gynecol 188:108-115, 2003]. After surgical correction, persistent or new lower urinary tract symptoms (LUTS) can be present. We provide guidance on the current tools to predict, counsel, and subsequently handle postoperative LUTS. The current literature is reviewed regarding LUTS diagnosis and management in the setting of prolapse surgery with an emphasis on newer developments in this area.1. More severe stages of prolapse are positively correlated with obstructive symptoms [Am J Obstet Gynecol 185:1332-1337, 2001], but not with other LUTS [Adv Urol 2013:5673753, 2013, Eur J Obstet Gynecol Reprod Biol 177:141-145, 2014, Am J Obstet Gynecol 199:683, 2008, Int Urogynecol J 21:1143-1149, 2010]. 2. One-week ambulatory pessary trial is an effective way to approximate postoperative results-one study correctly predicted persistent urgency and frequency in addition to occult stress urinary incontinence in 20% of study population [Obstet Gynecol Int 2012:392027, 2012]. 3. No preoperative overactive bladder (OAB) symptom was the best predictor for the absence of de novo OAB symptoms postoperatively [Int Urogynecol J 21:1143-1149, 2010]. 4. Urge incontinence patients respond favorably to sacral neuromodulation [Neurourol Urodyn 26: 29-35, 2007], botulinum toxin, and anticholinergic therapy [Res Rep Urol 8:113-122, 2016 , N Engl J Med, 367:1803-1813, 2012]. 5. Primary bladder outlet obstruction (BOO) can be treated effectively with alpha antagonists or anticholinergics, timed voiding, and pelvic physiotherapy as first-line therapy. Counseling regarding postoperative LUTS is key when planning POP surgery. A thorough understanding of patient history is crucial to successful repair. Patients with significant preoperative symptoms, history of neurologic disease, pelvic floor dysfunction, bladder neck obstruction, or higher stages of anterior wall prolapse may be higher risk for postoperative LUTS. UDS with or without reduction and an ambulatory pessary trial can help prognosticate. Patients will likely maintain a positive therapeutic relationship postoperatively for LUTS if counseled preoperatively.

The detector system for the Euclid Near-Infrared Spectrometer and Photometer (NISP) instrument is a 4×4 mosaic focal plane of 16 H2RG (2K×2K pixels) infrared Sensor Chip Assemblies (SCAs) and 16 SIDECAR ASIC Sensor Chip Electronics (SCE) modules. Teledyne has successfully completed the fabrication, testing, and delivery of 24 sciencegrade flight candidate SCAs to the NASA Jet Propulsion Laboratory (JPL). These SCAs were made with Teledyne’s TRL-9 substrate-removed MBE mercury cadmium telluride (HgCdTe) 2.3 μm cutoff detector material and low-noise H2RG CMOS readout chip. The SCAs are mounted on a buttable molybdenum package that enables close packing of the 16 flight SCAs in the NISP focal plane. In this paper, we present the test results of the 24 Euclid flight candidate SCAs. The key detector performance parameters that are critical to the NISP instrument are: high in-band quantum efficiency with good spatial uniformity, low readout noise, low dark current with tight distribution, low pixel crosstalk, low persistence, and good detector surface metrology profile. All 24 SCAs exceed the Euclid NISP performance and interface requirements. The additional acceptance testing at JPL and NASA Goddard’s Detector Characterization Lab has also been completed. 20 flight SCAs have been delivered to European Space Agency (ESA).

Objective To demonstrate the prevalence of small fiber polyneuropathy (SFPN) in patients with refractory chronic pelvic pain (CPP). Design Retrospective study of prospective database. Subjects Participants were complex CPP patients recruited from subspecity referral clinics defined as those who were refractory to initial treatment and/or exhibited comorbid pain syndromes at initial presentation. Methods Comprehensive treatment history for CPP was obtained, and participants referred as above; 3-mm punch biopsies were obtained of the lower extremity and sent to diagnostic reference labs to evaluate for SFPN. The reported lab sensitivity and specificity for SFPN are 78-92% and 65-90%, respectively. Results Twenty-five of 39 patients (64%) were positive for SFPN. Comorbid conditions noted in our population included gastroesophageal reflux disease (46%), migraine (38%), irritable bowel syndrome (33%), lower back pain (33%), fibromyalgia (38%), endometriosis (15%), interstitial cystitis (18%), vulvodynia (5%), and other chronic pain syndromes (36%). Conclusions The prevalence of SFPN in our specialty referral patients with complex CPP is remarkably high vs published general population prevalence data (53/100,000). Identification of SFPN in this complex population shifts the focus from undefined syndromes to symptom complexes with linked potentially treatable mechanisms (e.g., SFPN, central sensitization). Most CPP patients with SFPN are undiagnosed. Considering the diagnosis may expand treatment options beyond conventional or so-called adjuvant analgesics. Treatment may expand to therapies such as IV lidocaine, IVIG, or other immunomodulatory options. In addition, the value to the patient of receiving a diagnosis for a multisystem or refractory pain syndrome, often attributed to negative psychologic factors, cannot be underestimated. Identifying SFPN should be contemplated in CPP patients who present with multisystem pain or who have not responded to initial evaluation and management.

Purpose – The purpose of this paper is to examine the performance of salespeople when selling new products (namely, electronic goods) in a business-to-business context by incorporating the organizations’ perceived psychological climate into goal orientation theory. Design/methodology/approach – The current study uses the goal orientation theory to examine the performance of 158 salespeople based on new electronic product sales. Organizational psychological climate perceptions (i.e. customer orientation, sales supportiveness and sales innovativeness) are included as variables that can moderate salespeople’s performance. This study used partial least squares to examine its proposed model. Findings – This study found that the learning goal orientation and the performance-prove goal orientation positively affect salespeople’s self-efficacy to sell new products, whereas a performance-avoid goal orientation negatively affects efficacy. In addition, new product selling self-efficacy itself has a positive influence on new product sales performance. As for the moderator, sales supportiveness and customer orientation have the ability to moderate the relationship between self-efficacy and performance. Practical implications – This study has implications for sales managers or product managers who are responsible for promoting new products. First, this study’s findings suggest that managers should consider employing performance-prove goal-oriented staff and learning goal oriented staff to sell new products. Second, management can attempt to develop a more supportive climate for the sales team, such as assisting the team in obtaining needed resources from other departments. Finally, management needs to let salespeople know that they are doing their best to understand what new products existing and potential customers will need in the near future. Originality/value – This current research is one of the first to examine how the perceived psychological climates of organizations (i.e. sales supportiveness, sales innovativeness and customer orientation) may moderate salespeople’s performance when selling new products. Second, this research examines how different types of goal orientation affect salespeople’s self-efficacy when selling new products. Previous results have not always been consistent regarding the influence of a performance-prove goal orientation. Last but not least, this study tests how new product selling self-efficacy mediates the relationships between goal orientations and new product sales performance as scholars have suggested that more research into the mediating role of self-efficacy is needed.

Salespeople play a pivotal role in promoting new products. Therefore, managers need to know what control mechanism (i.e., output-based control, behavior-based control, or knowledge-based control) can improve their salespeople’s new product sales performance. Furthermore, managers may be able to assist salespeople in performing better by having a strong market orientation. The literature has been inconsistent regarding the effects of sales management control mechanisms and has not yet incorporated market orientation into a sales management control framework. The current study surveyed 315 Taiwanese salespeople from publicly traded electronics companies with the aim of contributing to the sales management literature. The results show that sales management controls can directly affect salespeople’s innovativeness, which, in turn, affects new product sales performance. However, sales management controls cannot affect performance directly. Furthermore, market orientation can positively moderate the relationship between salespeople’s innovativeness and new product sales performance.

Purpose – This paper aims to examine diners’ luxury restaurant consumption behavior by incorporating diner expectations into a modified Mehrabian–Russell model. Consumers dine at luxury restaurants for reasons beyond fulfilling basic needs. However, little is known about the factors that contribute to diners’ emotions and loyalty toward luxury restaurants. Design/methodology/approach – To examine the proposed six hypotheses, qualitative and quantitative studies were performed. Following exploratory qualitative research, 310 consumers who dined at Taiwan’s five-star hotel restaurants were recruited for the main study. Data were analyzed using structural equation modeling. Findings – The results show that restaurants’ stimuli influence diners’ positive and negative emotions (organisms), which, in turn, affect their loyalty toward luxury restaurants (responses). Furthermore, customers with different levels of expectation react differently to stimuli. Practical implications – This study offers new empirical support for the proposition that diner expectation plays a role in building customer loyalty and, thereby, shades both theoretical and managerial understanding of the luxury restaurant consumption process. Originality/value – This study conceptualizes diners’ loyalty toward luxury restaurants (e.g. revisiting and recommending luxury restaurants) by examining the influence of restaurants’ stimuli, diners’ emotions and customers’ expectations toward luxury restaurants. Additionally, this study offers some managerial implications for practitioners.

Extracorporeal membrane oxygenation (ECMO) remains one of the most intensive therapies for newborns in the United States. However, there is limited information on resource utilization for neonates receiving ECMO.We conducted a retrospective data analysis of the Kids' Inpatient Database from 1997 to 2012. Bivariate and multivariate analysis was completed to identify predictors of LOS, hospital costs and mortality. Cardiac and non-cardiac diagnoses of neonates receiving ECMO were also included in the bivariate and multivariable analysis.Of the 5151 ECMO cases, survival to discharge was 62%. 22% had a principal cardiac diagnosis. After adjusting for covariates, increased mortality was associated with treatment in the midwest compared to the northeast region (aOR=2.0, p0.01) and decreased among neonates with a non-cardiac diagnosis (aOR=0.4, p0.01). Living in midwest was associated with longer LOS by 13days and increased hospital costs by 63,000 dollars (p0.01). When stratified by non-cardiac diagnoses, infants with a diagnosis of congenital diaphragmatic hernia was associated with increased mortality (2.3, p0.01) and longer LOS (25, p0.01) and increased costs (11,100, p0.01).Neonates who received ECMO in certain regions of the United States were associated with poorer survival outcomes as well as increased LOS and hospital costs.Retrospective study.Level III.

Conventional practice involves obtaining a blood culture during or immediately after a fever to increase diagnostic yield. There are no data to support this practice in children.Retrospective single-center case-control study of children (0-18 years) who had blood cultures performed as part of routine care. Cases had an a priori defined pathogen isolated from blood culture (n = 410) and were age-matched with contemporaneous controls with a sterile blood culture (n = 410). The predictive value of fever (before and after blood culture), C-reactive protein and hematologic indices were analyzed by multivariate regression and area under the receiver operating characteristic curves (AUCs) in neonatal, general pediatric and pediatric oncology patients.One thousand one hundred seventy-two (6.7%) of 17,607 blood cultures were positive, of which 410 (35%) cultured pathogen(s). Three hundred and twenty four (79%) cases and 275 (67.1%) controls had a fever (≥37.5°C) during the 12 hours pre- or post-collection. Fever 2-6 hours before a blood culture was neither sensitive nor specific for predicting bacteremia in neonatal or pediatric patients and marginally predictive in oncology patients (AUC 0.59-0.63). Cultures obtained 2-6 hours before fever were nonpredictive in neonates (AUC 0.56-0.59), marginally predictive in pediatric patients (AUC 0.64-0.67) and moderately predictive in oncology patients (AUC 0.70). C-reactive protein was marginally predictive in neonates (AUC 0.60). Hematologic indices were nonpredictive in all groups.Fever before obtaining blood culture was neither sensitive nor specific for culture positivity; timing of pediatric blood cultures relative to fever is unimportant. Bacteremia precedes a fever, but this is of limited clinical applicability.

In recent years, some upscale restaurants have invited guest chefs to provide diners with cuisines that are out of the ordinary (e.g., new menus and/or dishes that use unique ingredients) for a limited period of time (e.g., Cheshes, 2015; Naylor, 2010). As suggested by Cheshes (2015), when executed successfully, this collaboration can bring new cuisines to diners without having them travel far, can allow chefs to learn from one another, and can help restaurants explore new opportunities without taking on too much risk.\ud Although the use of guest chefs by high-end restaurants is on the rise, scholars have not explored the impact of guest chefs and this phenomenon’s implications to the hospitality literature. Kuroshima (2010), Pratten (2003a; 2003b), and Zopiatis (2010) suggested that chefs are crucial to restaurant performance. The existing literature on restaurants has emphasized service quality and atmosphere; nevertheless, relevant studies on chefs have been scarce. To contribute to the hospitality literature, the current study incorporates “perceived restaurant-guest chef fit” into Deng and Li’s (2014) image transfer model to explore a recently growing phenomenon and to provide practitioners with suggestions on how to use guest chefs effectively.

The industry of pet-related products and services has increased 10 times since the late 1990s, yet little is known about how pet owners consume pet-related services, let alone how best to segment owners into distinctive groups and market petrelated products to them strategically. To examine the segments within this market, this study forms its framework by incorporating factors from human–pet relationships, consumption values, information search behaviors and retail selection preferences. The main study included 578 Taiwanese pet owners. By using pet-related services, this research identified three segments of pet owners through cluster analysis. With this study's findings, the owners’ characteristics are elaborated with potential strategic implications for the service industry. The contributions of this research's findings are discussed in light of recent consumer studies literature.

Luxury brand market has grown considerably despite of the global financial crisis which started in 2008 (Hung et al., 2012). In the perceptions of the owners and others, luxury brands signify quality, style, reputation, and limited accessibility (Berthon, Pitt, Parent, and Berthon, 2009). However, current studies on the consumption of luxury goods mainly focused on physical goods (e.g., clothes and accessories) and few have examined service-based products. To narrow the gaps in the literature, this research explores young Chinese consumers’ intention to stay at luxury hotels when traveling.

Promoting new membership programmes can be a rewarding, yet challenging task for hotels. However, high-performance sales teams can improve consumer perceptions of new membership programmes in the market and allow hotels to remain competitive. Few studies have explored how hotel sales personnel approach the task of selling new membership programmes, and studies examining the moderating influence of market orientation are also rare. The current study contributes to the hospitality sales management literature by using the goal orientation theory to examine the new membership programmes sales performance of 168 salespeople. ‘Market orientation’\ud was included as a variable that could moderate salespeople’s performance. The results show that learning goal orientation and performance-prove goal orientation positively influence salespeople’s performance, but performance-avoid goal orientation\ud negatively influences sales performance. Furthermore, hotels’ levels of market orientation (high or low) can moderate the relationship between goal orientation and sales performance.

Taipei City has officially been selected the 2016 World Design Capital (WDC) this year, campaigning under the slogan “Adaptive City: Design in Motion”. A successful design capital should demonstrate the different design thinking of the city. This study aimed to provide the value-added creation of friendly thinking through engineering techniques that emphasize the safety of public parks, thus forming the content of the creative design of Taipei City to develop characteristics that improve the city. First, this study investigated the functions and composition of public parks and the meaning of friendly design. The user-tool system model was applied to analyzed children playground in order to obtain the item of playground design need. Finally the friendly design guidelines for playgrounds are proposed according to entrance, perimeter containment, route, zones, equipment, signage, and surface materials.

To achieve the goal of green environment related to an adaptive city of Taipei which is the World Design Capital 2016. We should discuss the effect of wind environment around the buildings at the beginning of design and planning phase of buildings first, for wind environment is the most important factor concerns with greenhouse and heat island effect. This research was based on a method of CFD done by Autodesk Ecotect Analysis software for simulating city building layout, study the two different building massing layout of Shezi Island in Taiwan. Results of simulation showed that the layout characterized by street block type, and therefore affect the residents’ health, activities and psychological feelings; while the case of three-sided building layout surrounded by urban of open space, on the other hand, can provide more comfortable, healthy places for rest and outdoor activities.

Objective To assess the effect of rituximab plus methotrexate (MTX) compared with MTX alone on patient-reported outcomes (PROs) and health-related quality of life (HRQOL) in patients with active early rheumatoid arthritis (RA) previously untreated with MTX. Methods Patients with active early RA were randomized to groups receiving placebo, rituximab 500 mg, or rituximab 1,000 mg. Rituximab was given by intravenous infusion on days 1 and 15. From week 24, patients with a Disease Activity Score in 28 joints–erythrocyte sedimentation rate of ≥2.6 were eligible for retreatment. Physical function was assessed by Health Assessment Questionnaire (HAQ) disability index (DI) and Short Form 36 (SF-36) scores. Patients achieving a minimal clinically important difference (MCID) for PROs were determined. Additional PROs, including fatigue and pain, were assessed. Results A total of 748 patients were randomized and received the study drug. Patient characteristics were well balanced. At week 52, treatment with rituximab in both dose groups showed significant improvements in the HAQ DI compared to the MTX alone group (−0.905 and −0.916 in the rituximab 500 mg plus MTX and 1,000 mg plus MTX groups, respectively, versus −0.628 in the MTX alone group; P < 0.0001). Higher proportions of patients achieved MCID in the HAQ DI in the rituximab plus MTX groups compared to MTX alone. Treatment with rituximab plus MTX led to a significant reduction in the SF-36 physical component summary for both rituximab dose groups, but did not show statistically significant differences in the SF-36 mental component summary. Compared to the MTX alone group, both doses of rituximab plus MTX were associated with significant reductions in the patient global assessment of disease activity and pain, and a significantly higher improvement in Functional Assessment of Chronic Illness Therapy–Fatigue scores from baseline to 52 weeks. Conclusions Rituximab plus MTX was associated with significant improvement in physical function and HRQOL outcomes compared with MTX alone in patients previously untreated with MTX.

Screening and brief intervention (SBI) for alcohol consumption in primary care have been shown to be effective in reducing drinking. This role has not been taken up by community pharmacists. This study aimed to explore attitudes, knowledge, barriers and incentives towards involvement of community pharmacists in New Zealand with problem drinkers.A postal survey (three mailshots) of community pharmacies was undertaken in Auckland, New Zealand, followed by a 10% random sample non-responder-follow-up.A response rate of 39.1% to the postal survey was obtained. In general, knowledge of alcohol content of drinks and recommended safe drinking limits was poor. Respondents were generally well motivated towards undertaking this role, but lacked knowledge, skills and confidence. On follow-up, non-responders were found to be less knowledgeable, but had similar attitudes to respondents, indicating potential for extrapolation with regard to beliefs and views on this subject.This novel study has found that there is potential for involvement of community pharmacists in New Zealand in SBI for problem drinkers. Lack of knowledge can be remedied relatively easily; greater hurdles such as lack of skills, and lack of confidence may be offset by the high level of motivation of this group. This is an area where community pharmacists can further their professional scope of practice by being in an essential position to provide this service.

9577 Background: PRM can enhance our understanding of patients’ needs and facilitate cancer treatment decision making. Few studies have explored the relationships between brief PRM and outcomes in early stage colon cancer. Our aims were 1) to determine the effects of prospectively collected PRM on cancer-specific (CSS) and overall survival (OS) and 2) to examine if this association is modified in the elderly. Methods: Patients diagnosed with stage 1 to 3 colon cancer in 2008, evaluated at 1 of 5 regional cancer centers in British Columbia, and provided baseline PRM were included. PRM consisting of a series of short, self-administered scales that described patient-reported health, QOL, functional status and social supports were collected at baseline and correlated with CSS and OS using regression models that controlled for known prognostic factors such as tumor and nodal stage. We subsequently assessed for effect modification by age, stratifying the cohort into younger (YP; /=70 years). Results: In total, 223 patients were included: 94 (42%) were EP, 111 (49%) were women, and 152 (68%) were white. Compared to YP, EP were more frequently widowed (27 vs 9%, p=0.0005) and reported having children (92 vs 81%, p=0.03), but they were less likely to receive chemotherapy (57 vs 90%, p0.05). No other PRM correlated with OS or CSS (all p>0.05). Conclusions: For early stage colon cancer, self-reported functional status was independently associated with OS. Additional PRM failed to enhance prognostication, suggesting that more comprehensive tools may be required to improve patient assessments.