bluuebunny/crossref_metadata_2025 huggingface dataset:
Improving emergency department medical clinical handover: Barriers at the bedside
Authors: Marmor Gerrard Oren , Li Michael Yonghong
Published: March 2017

Objective

The present paper describes our experience of developing and piloting a best practice model of medical clinical handover. Secondary aims were to improve reliability of communication, identify negative effects on patient care and assess staff adherence and acceptance of the process.

Methods

We described existing handover practice. We designed and implemented a process incorporating bedside handover, the Identification, Situation, Background, Assessment, Requirements and Requests (ISBAR) tool and handover documentation. We audited the process and surveyed doctors before and after the intervention regarding their practice and preferences.

Results

Existing handover practice was remote from the patient, neither standardised nor documented. The new process resulted in a median 87% (95% CI 70.4–92.1) of handovers in the presence of the patient. ISBAR elements were consistently communicated, median 100% (95% CI 91.8–100). Risk events were directly identified in a median 8.3% (95% CI 0.0–13.8) of bedside handovers. Handover documentation did not improve. FACEM and registrar perception that bedside handover improves patient care fell from 71%, 80% to 56%, 58%, respectively. Preference for bedside handover fell from 79% and 80%, respectively, to being evenly divided between bedside and centralised models; 80.9% of respondents reported that ISBAR improved communication.

Conclusion

Bedside handover using ISBAR resulted in improved patient involvement, communication and a non‐significant trend to improved patient safety. Despite a majority of doctors acknowledging these findings, preference remained for a centralised handover using ISBAR. Gaining staff acceptance of a process change is essential to its success. A barrier to acceptance could be that staff are time‐poor. We suggest handover processes can be strengthened by adequate staffing and small, incremental improvements to existing models combined with auditing of outcomes.
Identification of Microbial Profile of Koji Using Single Molecule, Real‐Time Sequencing Technology
Authors: Hui Wenyan , Hou Qiangchuan , Cao Chenxia , Xu Haiyan , Zhen Yi , Kwok Lai‐Yu , Sun Tiansong , Zhang Heping , Zhang Wenyi
Published: March 2017

Koji is a kind of Japanese traditional fermented starter that has been used for centuries. Many fermented foods are made from koji, such as sake, miso, and soy sauce. This study used the single molecule real‐time sequencing technology (SMRT) to investigate the bacterial and fungal microbiota of 3 Japanese koji samples. After SMRT analysis, a total of 39121 high‐quality sequences were generated, including 14354 bacterial and 24767 fungal sequence reads. The high‐quality gene sequences were assigned to 5 bacterial and 2 fungal plyla, dominated by Proteobacteria and Ascomycota, respectively. At the genus level, Ochrobactrum and Wickerhamomyces were the most abundant bacterial and fungal genera, respectively. The predominant bacterial and fungal species were Ochrobactrum lupini and Wickerhamomyces anomalus, respectively. Our study profiled the microbiota composition of 3 Japanese koji samples to the species level precision. The results may be useful for further development of traditional fermented products, especially optimization of koji preparation. Meanwhile, this study has demonstrated that SMRT is a robust tool for analyzing the microbial composition in food samples.
Delayed pseudoprogression of lung adenocarcinoma accompanied with interstitial lung disease during chemotherapy after nivolumab treatment
Authors: Kumagai Toru , Kimura Madoka , Inoue Takako , Tamiya Motohiro , Nishino Kazumi , Imamura Fumio
Published: March 2017

A 62‐year‐old Japanese female with primary lung adenocarcinoma received seven cycles of nivolumab as an eighth line of chemotherapy until she presented with hemoptysis. After transcatheter arterial embolization therapy, she received subsequent chemotherapy with paclitaxel and S−1. Four weeks later, a chest computed tomography examination revealed infiltrative shadows mainly in the right lung field, in addition to enlargement of the lung metastasis in the right middle lung lobe. Bronchofiberscopic examination revealed infiltration of lymphocytes without any malignant cells in the right segment 1 of the lung, which suggested interstitial lung disease. Corticosteroid therapy not only improved the infiltrative shadows but also reduced the lung metastasis. Even after the infiltrative shadows improved, the lung metastasis reduced further. This phenomenon resembles manifestation of pseudoprogression during treatments with immune checkpoint inhibitors, such as nivolumab.
Seabird population changes following mammal eradications on islands
Authors: Brooke M. de L. , Bonnaud E. , Dilley B. J. , Flint E. N. , Holmes N. D. , Jones H. P. , Provost P. , Rocamora G. , Ryan P. G. , Surman C. , Buxton R. T.
Published: March 2017

Seabirds are among the most threatened groups of birds, and predation by invasive mammals is one of the most acute threats at their island breeding stations. Island restoration projects increasingly involve the eradication of invasive non‐native mammals, with benefits for seabirds and other island fauna. To date, demonstrated benefits of invasive mammal eradication include increased seabird nesting success and enhanced adult survival. However, the recovery dynamics of seabird populations have not been documented. Drawing on data from across the world, we assemble population growth rates (λ) of 181 seabird populations of 69 species following successful eradication projects. After successful eradication, the median growth rate was 1.119 and populations with positive growth (λ > 1;n = 151) greatly outnumbered those in decline (λ < 1;n = 23, and seven showed no population change). Population growth was faster (1) at newly established colonies compared to those already established, (2) in the first few years after eradication, (3) among gulls and terns compared to other seabird groups, and (4) when several invasive mammals were eradicated together in the course of the restoration project. The first two points suggest immigration is important for colony growth, the third point reflects the relative lack of philopatry among gulls and terns while the fourth reinforces current best practise, the removal of all invasive mammals where feasible.
Incidence and risk factors of venous thromboembolism during postpartum period: a population‐based cohort‐study
Authors: Galambosi Päivi J. , Gissler Mika , Kaaja Risto J. , Ulander Veli‐Matti
Published: March 2017

Introduction

The awareness of the incidence and timing of postpartum venous thromboembolic events guides the use of thromboprophylaxis. Our aims were to assess the incidence and mortality of venous thromboembolic events and identify its associated risk factors during different postpartum periods.

Material and methods

A population‐based controlled cohort study by combining four large registers in 2001–2011. All women with a recent delivery were identified. The incidence, risk factors and mortality of venous thromboembolic events 0–180 days after delivery were assessed by using all healthy delivered women as the control group. The incidence was compared with that of the nonpregnant women.

Results

Among the 634 292 delivered women, 1169 had venous thromboembolic events 0–180 days postpartum. The incidence of venous thromboembolic events was highest during the first week postpartum: 37‐fold compared with nonpregnant women, declining to two‐fold immediately after that. Almost half of the venous thromboembolic events occurred between 43 and 180 days postpartum. The incidence of venous thromboembolic events was four‐fold compared with that of nonpregnant women. Three venous thromboembolic events‐related deaths occurred. Older age, higher body mass index, thrombophilia, multiple pregnancy, gestational diabetes, anemia, chorioamnionitis, threatening premature birth, in vitro fertilization with ovarian hyperstimulation, primiparity, cesarean section, cardiac/renal diseases, and varicose veins were associated with an increased risk for postpartum venous thromboembolic events. The risk remained elevated for 180 days in women with thrombophilia, cesarean section, multiple pregnancy, varicose veins, and cardiac disease.

Conclusions

The risk of venous thromboembolic events remained elevated compared with that of the nonpregnant women after the usually defined postpartum period (6 weeks). The results might assist in selecting women in need of thromboprophylaxis.
Morphology of the copulatory organ in Ortalis canicollis (Aves: Cracidae) and early evolution of the phallus in birds
Authors: Previatto Diego Matiussi , Gonçalves Gustavo Leite , Ortiz Marcela Carvalho , de Melo‐Soares Carla Danielle , Posso Sérgio Roberto
Published: March 2017

We studied the morphology of the copulatory organ of Ortalis canicollis and its evolution in birds. The phallus of O. canicollis is intromittent, with a blind tubular cavity and two distinct regions when erect: the base of the phallus, which shows the mucosa smooth and lined by a pseudostratified columnar epithelium, and the tubular portion, which shows the mucosa lined by a keratinized stratified squamous epithelium with little knobs. The phallus includes two vascular bodies at the cranial portion in the urodeum. A fibrocartilaginous body anchors the tubular portion therefrom up to the eversible portion. A branched elastic ligament inserts on different regions of the tubular portion. The phallus is plesiomorphic in birds and it has disappeared in Megapodius, Leipoa and Neoaves. The asymmetric phallus evolved early and it was retained in the basal branches of birds. The intromittent phallus is plesiomorphic in birds (found in Archosauria's ancestor), but Crypturellus, Numididae, Odontophoridae and Phasianidae have developed a non‐intromittent phallus a posteriori. The blind tubular cavity and the fibrocartilaginous body evolved as an adaptive convergence many times in birds. Therefore, this study shed some light on morphological aspects of the phallus and contributed to understand its evolution in birds.
Isorhapontigenin, a bioavailable dietary polyphenol, suppresses airway epithelial cell inflammation through a corticosteroid‐independent mechanism
Authors: Yeo Samuel Chao Ming , Fenwick Peter S , Barnes Peter J , Lin Hai Shu , Donnelly Louise E
Published: March 2017

Background and Purpose

Chronic obstructive pulmonary disease (COPD) is a corticosteroid‐resistant airway inflammatory condition. Resveratrol exhibits anti‐inflammatory activities in COPD but has weak potency and poor pharmacokinetics. This study aimed to evaluate the potential of isorhapontigenin, another dietary polyphenol, as a novel anti‐inflammatory agent for COPD by examining its effects in vitro and pharmacokinetics in vivo.

Experimental Approach

Primary human airway epithelial cells derived from healthy and COPD subjects, and A549 epithelial cells were incubated with isorhapontigenin or resveratrol and stimulated with IL‐1β in the presence or absence of cigarette smoke extract. Effects of isorhapontigenin and resveratrol on the release of IL‐6 and chemokine (C‐X‐C motif) ligand 8 (CXCL8), and the activation of NF‐κB, activator protein‐1 (AP‐1), MAPKs and PI3K/Akt/FoxO3A pathways were determined and compared with those of dexamethasone. The pharmacokinetic profiles of isorhapontigenin, after i.v. or oral administration, were assessed in Sprague–Dawley rats.

Key Results

Isorhapontigenin concentration‐dependently inhibited IL‐6 and CXCL8 release, with IC50 values at least twofold lower than those of resveratrol. These were associated with reduced activation of NF‐κB and AP‐1 and, notably, the PI3K/Akt/FoxO3A pathway, that was relatively insensitive to dexamethasone. In vivo, isorhapontigenin was rapidly absorbed with abundant plasma levels after oral dosing. Its oral bioavailability was approximately 50% higher than resveratrol.

Conclusions and Implications

Isorhapontigenin, an orally bioavailable dietary polyphenol, displayed superior anti‐inflammatory effects compared with resveratrol. Furthermore, it suppressed the PI3K/Akt pathway that is insensitive to corticosteroids. These favourable efficacy and pharmacokinetic properties support its further development as a novel anti‐inflammatory agent for COPD.
Cortisol in Neonatal Mother's Milk Predicts Later Infant Social and Cognitive Functioning in Rhesus Monkeys
Authors: Dettmer Amanda M. , Murphy Ashley M. , Guitarra Denisse , Slonecker Emily , Suomi Stephen J. , Rosenberg Kendra L. , Novak Melinda A. , Meyer Jerrold S. , Hinde Katie
Published: March 2017

Milk provides not only the building blocks for somatic development but also the hormonal signals that contribute to the biopsychological organization of the infant. Among mammals, glucocorticoids (GCs) in mother's milk have been associated with infant temperament. This study extended prior work to investigate rhesus monkey (Macaca mulatta) mother–infant dyads (N = 34) from birth through 8 months postpartum. Regression analysis revealed that cortisol concentrations in milk during the neonatal period predicted impulsivity on a cognitive task, but not global social behaviors, months later. During this time period, sex‐differentiated social behavior emerged. For female infants, milk cortisol concentrations predicted total frequency of play. Collectively, these findings support and extend the “lactational programming” hypothesis on the impact of maternal‐origin hormones ingested via milk.
A Priori True and False Conditionals
Authors: Quelhas Ana Cristina , Rasga Célia , Johnson‐Laird Philip N.
Published: March 2017

The theory of mental models postulates that meaning and knowledge can modulate the interpretation of conditionals. The theory's computer implementation implied that certain conditionals should be true or false without the need for evidence. Three experiments corroborated this prediction. In Experiment 1, nearly 500 participants evaluated 24 conditionals as true or false, and they justified their judgments by completing sentences of the form, It is impossible that A and ___ appropriately. In Experiment 2, participants evaluated 16 conditionals and provided their own justifications, which tended to be explanations rather than logical justifications. In Experiment 3, the participants also evaluated as possible or impossible each of the four cases in the partitions of 16 conditionals: A and C, A and not‐C, not‐A and C, not‐A and not‐C. These evaluations corroborated the model theory. We consider the implications of these results for theories of reasoning based on logic, probabilistic logic, and suppositions.
Sector‐Specific Development and Policy Vulnerability in the Philippines
Authors: Ricks Jacob I.
Published: March 2017

Why does a state build institutional capacity in certain sectors rather than others? Despite having gained leverage explaining the emergence of institutions in the developmental states of East Asia, we have comparatively weak accounts for sub‐national variation in institutional strength, a much more common phenomenon. Investigating the surprising achievements of the Philippines’ National Irrigation Administration, this article advances a theory of sectoral success in the face of a generally poor developmental record. The author demonstrates that executives will only construct institutional capacity when facing strong political pressure combined with resource scarcity. Such vulnerability permits politicians to exercise discretion in choosing which policies to pursue, allowing them to avoid upsetting their coalitions. Once a politician achieves some degree of policy success, he or she is then able to avoid engaging in similar reforms in other fields. Thus we see pockets of institutional capacity in states that otherwise struggle with developmental tasks.
Treatment with LY2409021, a glucagon receptor antagonist, increases liver fat in patients with type 2 diabetes
Authors: Guzman Cristina B. , Zhang Xiaotian M. , Liu Rong , Regev Arie , Shankar Sudha , Garhyan Parag , Pillai Sreekumar G. , Kazda Christof , Chalasani Naga , Hardy Thomas A.
Published: March 2017

Aims

To evaluate whether treatment with LY2409021, a novel, selective glucagon receptor antagonist, is associated with changes in hepatic fat and other safety variables related to the benefit–risk profile for chronic use in patients with type 2 diabetes (T2D).

Methods

Safety and efficacy were assessed in patients with T2D taking metformin and sulphonylurea who were randomized to LY2409021 20 mg (n = 65), placebo (n = 68), or sitagliptin 100 mg (n = 41). Key endpoints included change from baseline to month 6 in hepatic fat fraction (HFF), assessed by magnetic resonance imaging; hepatic aminotransferases; blood pressure; lipid profile; fasting plasma glucose; and glycated haemoglobin (HbA1c).

Results

A significant increase in HFF was seen with LY2409021 vs sitagliptin (least squares [LS] mean difference 3.72%; P < .001) and placebo (4.44%; P < .001), accompanied by significant elevations in alanine aminotransferase levels with LY2409021 vs sitagliptin (6.8 U/L; P = .039) and vs placebo (10.7 U/L; P < .001). No patients had concomitant elevations in bilirubin levels. LY2409021 treatment showed significant HbA1c reductions vs placebo (LS mean difference −0.77%; P < .001) but not sitagliptin (−0.20%; P = .383). Similar results were observed for fasting plasma glucose. LY2409021 was also associated with significant increases in systolic blood pressure vs sitagliptin (4.9 mm Hg; P = .030) and vs placebo (4.3 mm Hg; P = .029), as well as significant increases in body weight and total cholesterol. All effects of LY2409021 were reversible.

Conclusion

In this cohort of patients with T2D, chronic glucagon receptor antagonism with LY2409021 was associated with glucose‐lowering but also demonstrated increases in hepatic fat, hepatic aminotransferases, and other adverse effects.
Implementation of augmented reality in operative dentistry learning
Authors: Llena C. , Folguera S. , Forner L. , Rodríguez‐Lozano F. J.
Published: March 2017

Objective

To evaluate the efficacy of augmented reality (AR) in the gaining of knowledge and skills amongst dental students in the design of cavity preparations and analyse their degree of satisfaction.

Material and methods

AR cavity models were prepared for use with computers and mobile devices. Forty‐one students were divided into two groups (traditional teaching methods vs AR). Questionnaires were designed to evaluate knowledge and skills, with the administration of a satisfaction questionnaire for those using AR. The degree of compliance with the standards in cavity design was assessed. The Mann‐Whitney U‐test was used to compare knowledge and skills between the two groups, and the Wilcoxon test was applied to compare intragroup differences. The chi‐square test in turn was used to compare the qualitative parameters of the cavity designs between the groups. Statistical significance was considered for P<.05 in all cases.

Results

No significant differences were observed in level of knowledge before, immediately after or 6 months after teaching between the two groups (P>.05). Although the results corresponding to most of the studied skills parameters were better in the experimental group, significant differences (P<.05) were only founded for cavity depth and extent for Class I and divergence of the buccal and lingual walls for the Class II. The experience was rated as favourable or very favourable by 100% of the participants. The students showed preference for computers (60%) vs mobile devices (10%).

Conclusions

The AR techniques favoured the gaining of knowledge and skills and were regarded as a useful tool by the students.
Bilateral Rolandic operculum processing underlying heartbeat awareness reflects changes in bodily self‐consciousness
Authors: Blefari Maria Laura , Martuzzi Roberto , Salomon Roy , Bello‐Ruiz Javier , Herbelin Bruno , Serino Andrea , Blanke Olaf
Published: March 2017

Exteroceptive bodily signals (including tactile, proprioceptive and visual signals) are important information contributing to self‐consciousness. Moreover, prominent theories proposed that visceral signals about internal bodily states are equally or even more important for self‐consciousness. Neuroimaging studies have described several brain regions which process signals related to bodily self‐consciousness (BSC) based on the integration of exteroceptive signals (e.g. premotor cortex, angular gyrus, supramarginal gyrus and extrastriate body area), and that another brain region, the insula/operculum which is involved in interoception and interoceptive awareness, processes signals critical for self‐awareness. Providing evidence for the integration of exteroceptive and interoceptive bodily signals, recent behavioral experiments have demonstrated that the manipulation of interoceptive (e.g. cardiac) signals, coupled with exteroceptive (e.g. visual) signals, also modulates BSC. Does this integration occur within or outside the structures described above? To this end, we adapted a recently designed protocol that uses cardio‐visual stimulation to induce altered states of BSC to fMRI. Additionally, we measured neural activity in a classical interoceptive task. We found six brain regions (bilateral Rolandic operculum, bilateral supramarginal gyrus, right frontal inferior operculum and left temporal superior gyrus) that were activated differently during the interoception task as opposed to a control task. The brain regions which showed the highest selectivity for BSC based on our cardio‐visual manipulation were found in the bilateral Rolandic operculum. Given our findings, we propose that the Rolandic operculum processes integrated exteroceptive–interoceptive signals that are necessary for interoceptive awareness as well as BSC.
Persistence of antibiotic resistance plasmids in bacterial biofilms
Authors: Ridenhour Benjamin J. , Metzger Genevieve A. , France Michael , Gliniewicz Karol , Millstein Jack , Forney Larry J. , Top Eva M.
Published: March 2017

The emergence and spread of antibiotic resistance is a crisis in health care today. Antibiotic resistance is often horizontally transferred to susceptible bacteria by means of multidrug resistance plasmids that may or may not persist in the absence of antibiotics. Because bacterial pathogens often grow as biofilms, there is a need to better understand the evolution of plasmid persistence in these environments. Here we compared the evolution of plasmid persistence in the pathogen Acinetobacter baumannii when grown under antibiotic selection in biofilms versus well‐mixed liquid cultures. After 4 weeks, clones in which the plasmid was more stably maintained in the absence of antibiotic selection were present in both populations. On average plasmid persistence increased more in liquid batch cultures, but variation in the degree of persistence was greater among biofilm‐derived clones. The results of this study show for the first time that the persistence of MDR plasmids improves in biofilms.
Transcriptional activation of Hedgehog pathway components in aggressive haemangioma
Authors: Wendling‐Keim Danielle S. , Wanie Lynn , von Schweinitz Dietrich , Grantzow Rainer , Kappler Roland
Published: March 2017

Infantile hemangioma is a vascular neoplasm and is one of the most common tumors diagnosed in young children. Although most hemangiomas are harmless and involute spontaneously, some show severe progression, leading to serious complications, such as high‐output cardiac failure, ulcerations, compression of the trachea or deprivation amblyopia, depending on their size and localization. However, the pathogenesis and cause of hemangioma are largely unknown to date. The goal of this study was to identify markers that could predict hemangiomas with aggressive growth and severe progression that would benefit from early intervention. By using a PCR‐based screening approach, we first confirmed that previously known markers of hemangioma, namely FGF2 and GLUT1, are highly expressed in hemangioma. Nevertheless, these genes did not show any differential expression between severely progressing tumors and mild tumors. However, transcriptional upregulation of several Hedgehog signalling components, comprising the ligand Sonic Hedgehog (SHH), the transcription factor GLI2 and its target gene FOXA2 were detected in extremely aggressive hemangioma specimens during the proliferation phase. Notably, GLI2 was even overexpressed in involuting hemangiomas if they showed an aggressive growth pattern. In conclusion, our data suggest that overexpression of the Hedgehog components SHH, GLI2 and FOXA2 might be used as markers of an aggressive hemangioma that would benefit from too early intervention, while FGF2 and GLUT1 are more general markers of hemangiomas.
The nuclear factor (erythroid‐derived 2)‐like 2 (NRF2) antioxidant response promotes melanocyte viability and reduces toxicity of the vitiligo‐inducing phenol monobenzone
Authors: Arowojolu Omotayo A. , Orlow Seth J. , Elbuluk Nada , Manga Prashiela
Published: March 2017

Vitiligo, characterised by progressive melanocyte death, can be initiated by exposure to vitiligo‐inducing phenols (VIPs). VIPs generate oxidative stress in melanocytes and activate the master antioxidant regulator NRF2. While NRF2‐regulated antioxidants are reported to protect melanocytes from oxidative stress, the role of NRF2 in the melanocyte response to monobenzone, a clinically relevant VIP, has not been characterised. We hypothesised that activation of NRF2 may protect melanocytes from monobenzone‐induced toxicity. We observed that knockdown of NRF2 or NRF2‐regulated antioxidants NQO1 and PRDX6 reduced melanocyte viability, but not viability of keratinocytes and fibroblasts, suggesting that melanocytes were preferentially dependent upon NRF2 activity for growth compared to other cutaneous cells. Furthermore, melanocytes activated the NRF2 response following monobenzone exposure and constitutive NRF2 activation reduced monobenzone toxicity, supporting NRF2's role in the melanocyte stress response. In contrast, melanocytes from individuals with vitiligo (vitiligo melanocytes) did not activate the NRF2 response as efficiently. Dimethyl fumarate‐mediated NRF2 activation protected normal and vitiligo melanocytes against monobenzone‐induced toxicity. Given the contribution of oxidant‐antioxidant imbalance in vitiligo, modulation of this pathway may be of therapeutic interest.
Changes in sediment seed‐bank composition of invaded macrophyte communities in a thermal river
Authors: Vojtkó Anna E. , Mesterházy Attila , Süveges Kristóf , Valkó Orsolya , Lukács Balázs A.
Published: March 2017

Thermal waters, characterised by high water temperatures throughout the year, harbour a special flora atypical of temperate climatic conditions that are adapted to the combination of high water temperatures and low oxygen and carbonate contents. However, these ecosystems are susceptible to the invasion of tropical macrophytes because conditions in thermal waters are similar to those of in warmer latitudes.

We studied the vegetation and viable seed bank in an alien‐dominated upstream section of a thermal river in Hungary, and a native‐dominated downstream section of the same river where temperature was cooler and less stable. Our hypotheses were as follows: (1) alien and native plant species are clearly separated along the river, and this separation is driven by environmental factors (water temperature, conductivity and sediment characteristics); and (2) the species composition of seed banks reflects that of the established macrophytes, and thus, the seed‐bank composition would differ in the up‐ and downstream reaches.

We defined 20 sampling units in two sections of the Hévíz River in West Hungary. The vegetation was surveyed in every sampling unit, and environmental variables (sediment and water) were recorded. Five sediment cores were taken from each sampling unit and incubated in a greenhouse under waterlogged conditions.

The mean seed‐bank density was lower than any of the previously published values for aquatic plant communities. In total, fewer species germinated from the seed bank than the number of species observed in the vegetation. Moreover, the Sørensen similarity index, comparing the vegetation and seed‐bank species composition, was extremely low. The lowest seed‐bank density and diversity were detected in the alien‐dominated upstream river section, where significantly fewer native species were present in the seed bank.

Despite favourable conditions for alien macrophytes to establish in this thermal river, they did not build up considerable persistent seed banks. We conclude that the dominance of aliens modified the species composition of both the vegetation and the seed bank, mainly by depleting the seed bank of native species. Therefore, future efforts to restore native vegetation from the seed bank may require a number of different strategies.
Plant mycorrhizal status, but not type, shifts with latitude and elevation in Europe
Authors: Bueno C. Guillermo , Moora Mari , Gerz Maret , Davison John , Öpik Maarja , Pärtel Meelis , Helm Aveliina , Ronk Argo , Kühn Ingolf , Zobel Martin
Published: March 2017

Aim

Identifying the factors that drive large‐scale patterns of biotic interaction is fundamental for understanding how communities respond to changing environmental conditions. Mycorrhizal symbiosis is a key interaction between fungi and most vascular plants. Whether plants are obligately (OM) or facultatively (FM) mycorrhizal, and which mycorrhizal type they form – arbuscular mycorrhizal (AM), ectomycorrhizal (ECM), ericoid mycorrhizal (ERM) or non‐mycorrhizal (NM) – can have strong implications for plant species distribution at the continental scale and on the responses of plants to environmental gradients.

Location

Europe, north of 43° latitude and excluding Russia, Belarus and Moldova.

Time period

Undefined.

Major taxa studied

Vascular plants.

Methods

Using published sources, we compiled the most complete dataset yet of plant mycorrhizal and geographical information for Europe, comprising 1442 plant species. We mapped the European distributions of plant mycorrhizal status (OM and FM) and type (AM, ECM, ERM and NM) and analysed their relationships with climatic, edaphic and plant productivity drivers on a 50 km × 50 km equal‐area grid.

Results

The distribution of mycorrhizal types in Europe was driven by mean temperature, soil pH and productivity. AM plant species predominated throughout the region, but at higher latitudes the share of NM and, to a lesser extent, ECM and ERM species increased. FM species predominated over OM species, and this increased with latitude and was dependent on temperature drivers. The high share of OM species in the central European mountains indicates a possible influence of historical glacial refugia.

Main conclusions

Our results challenge the prevailing view of parallel trends in the latitudinal and elevational distribution of mycorrhizal types and demonstrate distinctive responses of plants with different mycorrhizal status to climatic, edaphic and biogeographical drivers at the European scale.
Fatty acid profile in two berseem clover (Trifolium alexandrinum L.) cultivars: Preliminary study of the effect of part of plant and phenological stage
Authors: Cabiddu Andrea , Wencelová Monica , Bomboi Giovanni , Decandia Mauro , Molle Giovanni , Salis Lorenzo
Published: March 2017

Grazing animals have diets rich in polyunsaturated fatty acids (PUFA), in particular α‐linolenic acid (C18:3n‐3), so pasture is the richest and most environmentally sustainable source of unsaturated fatty acids for animal products. The concentration of PUFA in forages varies with species, cultivar, phenological stage, silage making technique, regrowth interval, nitrogen fertilization level and other management factors. An experiment was carried out by a randomized block design with three replicates, to study the influence of part of plant and phenological stage on the fatty acid profile of two widespread berseem clover cultivars (Trifolium alexandrinum L. ‘Sacromonte’ and ‘Marmilla’). In the present study, ‘Sacromonte’ showed a higher proportion of leaves (94 vs 85% on a dry matter yield [DM] basis; P < 0.05) and lower proportion of stems (6 vs 15% on a DM basis; P < 0.05) if compared with ‘Marmilla’ during the vegetative stage. Leaves were characterized by higher levels of monounsaturated fatty acids (0.50 vs 0.23 mg g−1 DM) and PUFA (10.33 vs 3.84 mg g−1 DM) if compared to stems (P < 0.01) in both cultivars. Total unsaturated fatty acids represent 10.83 and 4.04 mg g−1 DM in leaves and stems, respectively (P < 0.01). No influence of phenological stage in different parts of plant was detected in terms of total unsaturated fatty acid and PUFA. These results are the first to point out the change of fatty acids profile in different parts of berseem clover plant during the vegetative and reproductive stages, but need to be confirmed in a long‐term study.
Investigating strategies used by hospital pharmacists to effectively communicate with patients during medication counselling
Authors: Chevalier Bernadette A. M. , Watson Bernadette M. , Barras Michael A. , Cottrell William Neil
Published: March 2017

Background

Medication counselling opportunities are key times for pharmacists and patients to discuss medications and patients’ concerns about their therapy. Communication Accommodation Theory (CAT) describes behavioural, motivational and emotional processes underlying communication exchanges. Five CAT strategies (approximation, interpretability, discourse management, emotional expression and interpersonal control) permit identification of effective communication.

Objective

To invoke CAT to investigate communication strategies used by hospital pharmacists during patient medication counselling.

Design

This was a theory‐based, qualitative study using transcribed audiorecordings of patients and hospital pharmacists engaged in medication counselling.

Setting and participants

Recruited pharmacists practised in inpatient or outpatient settings. Eligible patients within participating pharmacists’ practice sites were prescribed at least three medications to manage chronic disease(s).

Main outcome measures

The extent to which pharmacists accommodate, or not, to patients’ conversational needs based on accommodative behaviour described within CAT strategies.

Results

Twelve pharmacists engaged four patients (48 total interactions). Exemplars provided robust examples of pharmacists effectively accommodating or meeting patients’ conversational needs. Non‐accommodation mainly occurred when pharmacists spoke too quickly, used terms not understood by patients and did not include patients in the agenda‐setting phase. Multiple strategy use resulted in communication patterns such as “information‐reassurance‐rationale” sandwiches.

Discussion and conclusions

Most pharmacists effectively employed all five CAT strategies to engage patients in discussions. Pharmacists’ communication could be improved at the initial agenda‐setting phase by asking open‐ended questions to invite patients’ input and allow patients to identify any medication‐related concerns or issues.
Commentary on Entangled Empathy by Lori Gruen
Authors: Meyers Diana Tietjens
Published: March 2017

This essay explores four aspects of Gruen's theory. The first section considers her analysis of the concepts of sympathy, pity, and emotional contagion. The second section outlines the main features of her conception of empathy and highlights some worries about empathy that her theory addresses. The third section examines empathy's contributions to moral epistemology. The fourth section queries Gruen's contention that empathy is morally motivating.
What an [En]tangled Web We Weave: Emotions, Motivation, and Rethinking Us and the “Other”
Authors: Cherry Myisha
Published: March 2017

In Entangled Empathy, Lori Gruen offers an alternative ethic for our relationships with animals. In this article, I examine Gruen's account of entangled empathy by first focusing on entangled empathy's relation to the moral emotions of sympathy, compassion, and other emotions. I then challenge Gruen's account of how entangled empathy moves us to attend to others. Lastly, and without intending to place humans at the center of the conversation, I reflect on the ways entangled empathy can help us solve some human problems—particularly the racial divide in the United States.
Mefenamic acid decreases inflammation but not joint lesions in experimental osteoarthritis
Authors: Aguiar Grazielle C. , Queiroz‐Junior Celso M. , Sitta Giovana L. , Amaral Flávio A. , Teixeira Mauro M. , Caliari Marcelo V. , Ferreira Anderson J.
Published: March 2017

Mefenamic acid is a non‐steroidal anti‐inflammatory drug able to control the symptoms of osteoarthritis (OA), but its effects on protection of cartilage and bone are still unclear. This study aimed to investigate whether the control of inflammation by mefenamic acid translates into decreased joint lesions in experimental OA in rats. OA was induced by injecting 1 mg of monosodium iodoacetate (MIA) into the joints of rats. The animals were treated with mefenamic acid (50 mg/kg, daily, oral gavage) either pre‐MIA injection (preventive) or post‐MIA injection (therapeutic). Joint swelling and hyperalgesia were evaluated at baseline and 1, 3, 14 and 28 days after induction of OA. Intra‐articular lavage and kinetics of cell migration into the synovium were measured 3 and 28 days after OA induction. Histopathological analysis, Osteoarthritis Research Society International (OARSI) score, total synovium cells count, cartilage area and levels of proteoglycans in joints were also evaluated. Mefenamic acid prevented joint oedema and hyperalgesia induced by MIA in the acute phase (3 days) of the disease. In the chronic phase (28 days), preventive and therapeutic regimens decreased the number of mononuclear cells in the joint cavity. In contrast, thickening of the synovium, bone resorption, loss of cartilage and levels of proteoglycans were unaffected by mefenamic acid when it was administered either preventively or therapeutically. Thus, mefenamic acid had anti‐inflammatory effects but did not reduce the progression of OA lesions, thereby indicating that it is only effective for symptomatic control of OA.
Home blood pressure monitoring among adults—American Heart Association Cardiovascular Health Consumer Survey, 2012
Authors: Ayala Carma , Tong Xin , Neeley Eunice , Lane Rashon , Robb Karen , Loustalot Fleetwood
Published: March 2017

Home blood pressure monitoring (HBPM) among hypertensive adults was assessed using the 2012 American Heart Association Cardiovascular Health Consumer Survey. The prevalence of hypertension was 25.5% and 53.8% of those reported HBPM. Approximately 63% of hypertensive adults 65 years and older reported HBPM followed by 51% and 34.6% (35–64 and 18–34 years, respectively; P=.001). Those who had seen a healthcare professional within a year reported HBPM compared with those who had not (54.8% vs 32.8%, P=.047). Those who believed that lowering blood pressure can reduce risk of heart attack and stroke had a higher percentage of HBPM compared with those who did not (55.5% vs 33.1%, P=.01). Age and the belief that lowering blood pressure could reduce cardiovascular disease risk were significant factors associated with HBPM. Half of the adult hypertensive patients reported HBPM and its use was greater among those who reported a positive attitude toward lowering blood pressure to reduce cardiovascular disease risk.
Prevalence of metabolic syndrome in Chinese psoriasis patients: A hospital‐based cross‐sectional study
Authors: Gui Xin‐Yu , Yu Xiao‐Ling , Jin Hong‐Zhong , Zuo Ya‐Gang , Wu Chao
Published: March 2017

Aims/Introduction

Psoriasis, a chronic autoimmune skin disorder, is believed to contribute to cardiovascular diseases and metabolic syndrome. Psoriasis's association with the components of metabolic syndrome has been reported previously. However, large‐scale cross‐sectional studies about psoriasis and metabolic syndrome are rare in China.

Materials and Methods

We assessed the prevalence of metabolic syndrome in Chinese psoriasis patients and controls.

Results

A total of 859 psoriasis patients and 1,718 controls were recruited in an age‐ and sex‐matched cross‐sectional study. Metabolic syndrome occurred in 14.3% of the psoriasis patients as opposed to 10.0% of the control participants (P = 0.001). Psoriasis patients had a higher prevalence of overweight/obesity, hyperglycemia and dyslipidemia when compared with controls. Meanwhile, psoriasis patients with metabolic syndrome were older, and had an older age of onset and a longer disease duration when compared with those without metabolic syndrome.

Conclusions

The prevalence of metabolic syndrome is higher in the Chinese psoriatic population, which can favor cardiovascular events. The present study strengthens the value of treating psoriasis patients not only dealing with the skin lesions, and we suggest appropriate screening and relevant health education be carried out in the treatment of psoriasis patients.
The political economy of the agro‐export boom under the Kirchners: Hegemony and passive revolution in Argentina
Authors: Lapegna Pablo
Published: March 2017

Since the mid‐1990s, the economy and politics of Argentina have been closely intertwined with the expansion of agro‐exports—a process initiated with neoliberalization and continued under “post‐neoliberal” governments. The administrations of Néstor Kirchner and Cristina Fernández de Kirchner are among the left‐of‐centre, neo‐developmental governments that were elected to power in Latin America in recent decades. This paper engages Gramsci's concepts of passive revolution and hegemony to analyse the political economy of the agrarian boom in Argentina, focusing on the frictions and contradictions of this national‐popular project. I inspect the political economy of the agro‐export boom, scrutinizing the political alliances and conflicts of the Kirchner governments, and the dilemmas that they have created for peasant movements. Between 2003 and 2015, peasant organizations supported the Kirchners as they discursively confronted Argentine agribusiness. Yet the neo‐developmental approach of their administrations did little to address the socio‐environmental impacts of the agro‐export boom and the glaring material inequalities of rural Argentina, and instead supported authoritarian governors and favoured global agribusiness corporations.
The political economy of land struggle in Brazil under Workers' Party governments
Authors: Sauer Sérgio , Mészáros George
Published: March 2017

This paper analyses the agrarian policies of the governments of Presidents Lula (2003–2010) and Dilma Rousseff (2011–2016) in the light of the contradiction between the historical support for land reform and agrarian social movements by the Workers' Party (PT) on the one hand, and the PT's more recent electoral and political alliances with agribusiness on the other. After more than a decade of progressive administrations, key government programmes have only accounted for marginal gains and in some cases setbacks, symbolized by the failure to expand the expropriation of new land and settle landless families on an adequate scale. The collapse of those alliances and 2016's impeachment process of President Rousseff marks the end of that cycle, highlighting strategic and policy failures. The paper examines government actions, the historical causes and roots of land conflicts, and struggles for land and territory, as well as the difficulties of mobilization. The paper focuses upon political disputes, particularly new processes of criminalization, economic disputes, surrounding the role of agribusiness, and the challenges related to struggles for land and territorial rights in a situation ruled by a progressive party and governments.
A coup foretold: Fernando Lugo and the lost promise of agrarian reform in Paraguay
Authors: Ezquerro‐Cañete Arturo , Fogel Ramón
Published: March 2017

This paper offers a political economy interpretation of the “parliamentary coup” that took place in Paraguay in June 2012. It situates this analysis in the wider historical context of the protracted transition to democracy between 1989 and 2008, the rural class structure of the country, the changing character of contemporary agro‐extractive capitalism, and the long‐standing class struggle for redistributive land reform. By examining the Paraguayan agrarian reform impasse under the short‐lived government of Fernando Lugo (2008–2012) through an “interactive state/society” framework, this paper attempts to locate the sources of current social and political conflict in the country, and the demands of rival social groups. In doing so, the paper argues that the rise and fall of Lugo occurred in the context of structural legacies from the Stroessner era (1954–1989) that have remained largely unchanged and that coexist today with an expanding agro‐extractivist development model. They lead to the conceptualization of the continued “predatory” or “oligarchic” state in the country.
The Frente Amplio and agrarian policy in Uruguay
Authors: Piñeiro Diego E. , Cardeillac Joaquín
Published: March 2017

In this paper, we propose three lines of interpretation to understand the actions of the Frente Amplio (FA) in Uruguay, which after more than 10 years in power has not transformed the uneven agrarian structure that it inherited. We suggest that in order to gain access to power, the FA opted to move to the centre of the political spectrum and implement agrarian policies in which agribusiness and family farming coexist. Another possible interpretation to understanding the absence of a policy more focused on supporting family farming, and on limiting the expansion of the financial capital and transnational corporations, is to see it as resulting from the internal tensions within the coalition. However, the FA, in accordance with its own history, did carry out a policy of protection and promotion of labour and civil rights of rural wage workers.
Hypochlorous acid gel technology—Its impact on postprocedure treatment and scar prevention
Authors: Gold Michael H. , Andriessen Anneke , Dayan Steven H. , Fabi Sabrina G. , Lorenc Z. Paul , Henderson Berg Meagan‐Helen
Published: March 2017

Background

A pre‐and postprocedure regime aimed at prevention of infection, reduction of inflammation and risk of scarring, is to enable optimal outcomes.

Objectives

The role of a hypochlorous acid containing spray and translucent scar gel formulation that combines modified silicon oil with hypochlorous acid, was explored for pre‐ and postprocedure treatment and scar management.

Methods

For this purpose a literature review was conducted to explore the value of the technology used in pre‐and postprocedural regimes. A panel of dermatologists and plastic surgeons who practice in the United States discussed the summarized search results, taking into account their current clinical practice. A nominal group process for consensus was used, followed by online reviews of the manuscript.

Results

Based on panel discussions, consensus was reached regarding clinical recommendations given for postprocedure treatment and scar management. The hypochlorous acid products are produced with electrolysis and are classified among biocidal substances. The technology has demonstrated efficacy and safety for pre‐and postprocedure use. The safety of hypochlorous solution use demonstrated to be comparable to that of standard local antiseptics. Small studies demonstrated better results with the scar gel compared to silicone gel regarding the appearance of hypertrophic and keloid scars, relief of associated pruritus and pain.

Conclusions

A postprocedure regime using this technology, aimed at preventing infection, reducing inflammation, and promoting healing is proposed to have benefits over current regimes as it appears to be effective, safe, and well tolerated.