bluuebunny/crossref_metadata_2025 huggingface dataset:
Toxic money or paid altruism: the meaning of payments for identity‐release gamete donors
Authors: Gilman Leah
Published: March 2018

Public discourses commonly frame gamete, organ and other forms of bodily donation as altruistic ‘gifts’. However, despite on‐going debates about the ethics of payments to donors, few studies have examined the views of donors themselves regarding the meaning of payments and their compatibility (or not) with understandings of these practices as gifts. This article addresses this issue, analysing 24 in‐depth interviews withUKidentity‐release gamete donors. It was crucial to all participants that their donation be viewed as fundamentally other‐oriented, motivated by the desire to help others. However, whilst egg donors often accommodated payment within this narrative, male participants explained that any money would taint the gift they had given. I argue that sperm donors faced particular challenges to incorporating payment within a gift narrative for two key reasons: first, sperm donors relied on a discourse of ‘pure altruism’, including absolute opposition between gifts and market exchange, in order to present their donation as other‐oriented. In contrast, egg donors were also able to mobilise a discourse of relational giving to present their donations as a personal gift. Second, according to a continued stereotype of sperm donors as financially motivated students, their payments have already been culturally earmarked as side‐line earnings.
Nurses’ elicitation of patient error as a practice in training end‐stage renal patients in automated home peritoneal dialysis
Authors: Larsen Tine
Published: March 2018

As part of a reorganisation of the delivery of health care in Denmark therapies for chronic medical conditions are moved out of hospitals and disease‐specific patient education programmes instituted to train patients to assume responsibility for treating their disease at home, that is, perform tasks and functions traditionally done by healthcare professionals. Drawing on video‐recordings (90:25h) from a programme for self‐management of end‐stage renal disease through automated home peritoneal dialysis, the study employs conversation analysis to examine nurses’ instructional practices for providing patients with the necessary knowledge, skill and competences. Showing training to rely on an error‐based monitoring strategy, the study demonstrates that rather than solely waiting for random errors to emerge, nurses on occasion steer patients towards specific errors to bring about particular instructional opportunities. Surprising given the seriousness of the therapy, this elicitation of error is shown to reflect a deliberate instructional choice; nurses promote select errors to impart patients with an understanding of the procedural logic behind the therapy and medical technology. The study argues that training patients for chronic disease self‐management and providing them with a proficiency level, normally associated with certified professionals, necessitates pushing patients beyond what is strictly accurate and exposing them to medically delicate events.
Integrated and Person‐Centered Care for Community‐Living Older Adults: A Cost‐Effectiveness Study
Authors: Uittenbroek Ronald J. , van Asselt Antoinette D. I. , Spoorenberg Sophie L. W. , Kremer Hubertus P. H. , Wynia Klaske , Reijneveld Sijmen A.
Published: March 2018

Objectives

To assess the cost‐effectiveness of Embrace, an integrated primary care service for older adults.

Data Sources

Care and support claims from health care insurers, long‐term care administration, and municipalities for enrolled older adults between 2011 and 2013.

Study Design

A total of 1,456 older adults, listed with 15 general practitioners practices in the Netherlands, were stratified into risk profiles (“Robust,” “Frail,” and “Complex care needs”) and randomized to Embrace or care‐as‐usual groups. Incremental costs were calculated per quality‐adjusted life year, per day able to age in place, and per percentage point risk profile improvement.

Principal Findings

Total average costs were higher for Embrace compared to care‐as‐usual. Differences in health‐associated outcomes were small and not statistically significant. Probabilities that Embrace is cost‐effective were below 80 percent, except for “risk profile improvements” within risk profile “Complex care needs.” Complete case analysis resulted in smaller differences in total average costs across conditions and differences in health‐associated outcomes remained small.

Conclusions

According to current standards, Embrace is not considered cost effective after 12 months. However, it could be considered worthwhile in terms of “risk profile improvements” for older adults with “Complex care needs,” if society is willing to invest substantially.
Fundamental Limits of Shaking a Baby
Authors: Reimann Richard J.
Published: March 2018

Basic physics places limits on the mechanics involved in shaking a baby. Fundamental definitions and practical limitations are used to compare shaking with car crashes and low‐level falls. First‐order mathematical considerations applied to a 6‐month‐old infant determine an angular velocity limit for head rotation around 75 rad/s and maximum angular acceleration less than 1600 rad/s2 without impact. By comparison, results from a low‐level fall of 0.76 m (30 inches) yield values of 83 rad/s and 13,000 rad/s2 in a practical worst‐case scenario.
Medication use in infants admitted with bronchiolitis
Authors: Oakley Ed , Brys Trusha , Borland Meredith , Neutze Jocelyn , Phillips Natalie , Krieser David , Dalziel Stuart R , Davidson Andrew , Donath Susan , Jachno Kim , South Mike , Williams Amanda , Babl Franz E ,   on behalf of the Paediatric Research in Emergency Departments International Collaborative (PREDICT)
Published: March 2018

Background

There are no medications known that improve the outcome of infants with bronchiolitis. Studies have shown the management of bronchiolitis to be varied.

Objectives

To describe medication use at the seven study hospitals from a recent multi‐centre randomised controlled trial on hydration in bronchiolitis (comparative rehydration in bronchiolitis [CRIB]).

Methods

A retrospective analysis of extant data of infants between 2 months (corrected for prematurity) and 12 months of age admitted with bronchiolitis identified through the CRIB trial. CRIB study records, medical records, pathology and radiology databases were used to collect data using a standardised form and entered in a single site database. Medications investigated included salbutamol, adrenaline, steroids, ipratropium bromide, normal saline, hypertonic saline, steroids and antibiotics.

Results

There were 3456 infants available for analysis, of which 42.0% received at least one medication during hospitalisation. Medication use varied by site between 27.0 and 48.7%. The most frequently used medication was salbutamol (25.5%). Medication use in general, and salbutamol use in particular, increased by 8.2 and 9.3%, respectively, per month after 4 months of age; from 22.9 and 3.6% at 4 months to 81.4 and 68.8% at 11 months. In infants admitted to the intensive care unit (ICU) compared with those not admitted to ICU 81.6 and 39.5%, respectively, received medication at one point during the hospital stay.

Conclusions

Medication was used for infants with bronchiolitis frequently and variably in Australia and New Zealand. Medication use increased with age. Better strategies for translating evidence into practice are needed.
Methyl salicylate and trans‐anethole affect the pheromonal activity of homofarnesal, the female sex pheromone of azuki bean beetle
Authors: Chiluwal Kashinath , Kim Junheon , Bae Soon Do , Roh Gwang Hyun , Park Chung Gyoo
Published: March 2018

Plant essential oils (EOs) exhibit an array of biological activities against insect pests. However, their negative influences on the pheromonal activity of azuki bean beetle (ABB), Callosobruchus chinensis L. have not received research attentions. ABB is a field‐to‐storage pest of legumes, and its female produces the sex pheromone known as homofarnesal with two isomeric components: 2E‐ and 2Z–homofarnesal, (2E,6E)‐7‐ethyl‐3,11‐dimethyl‐2,6,10‐dodecatrienals and (2Z,6E)‐7‐ethyl‐3,11‐dimethyl‐2,6,10‐dodecatrienals. We evaluated the effects of three EOs and their two major components on the attractiveness of male ABBs to synthetic homofarnesal (2E‐:2Z–homofarnesal = 6:4) using Y‐tube olfactometry in laboratory and rocket traps in the semi‐open polyhouse. Y‐tube olfactometry showed the significant negative effect of EOs of Illicium verum, Croton anisatum at 10 and 100 ng, and Gaultheria fragrantissima at 100 ng against homofarnesal (100 ng) in attracting male ABBs. Similarly trans‐anethole (at 10 and 100 ng) and methyl salicylate (at 100 ng) also ascertained significant negative effect against homofarnesal (100 ng) in Y‐tube olfactometry. When 10 mg of each of trans‐anethole and methyl salicylate was released at the downstream of 30 mg homofarnesal lure in rocket traps, highly significant effect was achieved against attractiveness of homofarnesal to ABB males. This study ascertained significant level of negative effect of the tested EOs and their major components to homofarnesal, tracing out a new opportunity of integrating them in ABB management programs both in field and storage.
Review of Leptocimbex formosanus group (Hymenoptera: Cimbicidae) with two new Chinese species
Authors: Yan Yuchen , Niu Gengyun , Lan Bocheng , Wei Meicai
Published: March 2018

Leptocimbex formosanus group of Leptocimbex Semenov , Cimbicidae is defined and the relationships and characteristics are provided. Two new species of this group are described from Hunan and Yunnan Provinces in China: Leptocimbex shinoharai Yan & Wei sp. nov. and L. naitoi Yan & Wei sp. nov. Redescriptions of the three known species of L. formosanus group (L. formosanus Enslin , L. dendrobii Rohwer and L. nigropropodea Wei & Deng ) and a key to all known species of this group are provided.
Relative deprivation of temporary agency workers in the public sector: The role of public service motivation and the possibility of standard employment
Authors: Jung Heung‐Jun , Noh Sung‐Chul , Kim Ilju
Published: March 2018

Although public service organisations have increasingly relied on nonstandard employees, little research has investigated their work experiences and job attitudes. This paper examines the mechanism by which temporary agency workers' experience of relative deprivation affects their organisational attachment toward their client firm in the public sector. Based on data collected from temporary help agencies working with an international airport in Korea, we found that the perceived likelihood of standard employment mediated the negative relationship of relative deprivation to organisational attachment. Moreover, the indirect relationship of relative deprivation with organisational attachment via perceived likelihood of standard employment was strong and significant among those with high public service motivation but was not significant for those with low public service motivation. We discuss the implications of this study in building a better understanding of relative deprivation and nonstandard work arrangements in the public sector.
Talent responses to talent status awareness—Not a question of simple reciprocation
Authors: Ehrnrooth Mats , Björkman Ingmar , Mäkelä Kristiina , Smale Adam , Sumelius Jennie , Taimitarha Susanna
Published: March 2018

How to manage talent effectively is a key question in organisations. Yet we still know relatively little about talent's psychological reactions to their exclusive status. Based on psychological contract theory and research on status, this study analyses a sample of 321 employees identified as talent by their organisations, only some of whom were aware of their exclusive talent status. The results provide evidence that talent status awareness moderates the relationship between a range of employer inducements and talent obligations, such that it increases the importance of some inducements while diminishing that of others. The study contributes to the talent management literature by isolating specific effects of talent status awareness and calling into question extant evidence of its direct positive effects on talent attitudes. The findings also have implications for talent status communication, talent management, and future theorising of talent reactions to their exclusive status.
Vitamin D administration leads to a shift of the intestinal bacterial composition in Crohn's disease patients, but not in healthy controls
Authors: Schäffler Holger , Herlemann Daniel PR , Klinitzke Paul , Berlin Peggy , Kreikemeyer Bernd , Jaster Robert , Lamprecht Georg
Published: March 2018

OBJECTIVE

Dysbiosis is a common feature in the pathogenesis of inflammatory bowel diseases (IBD). Environmental factors, such as vitamin D deficiency, seem to play a role in the intestinal inflammation of IBD. The aim of this study was to investigate whether vitamin D administration has an impact on the bacterial composition in Crohn's disease (CD) compared to healthy controls (HC).

METHODS

A prospective, longitudinal, controlled interventional analysis was conducted in seven patients with CD in clinical remission and 10 HC to investigate the effect of orally administrated vitamin D on the intestinal bacterial composition using 16S ribosomal RNA gene amplicon sequencing. Clinical parameters were assessed.

RESULTS

In contrast to HC, microbial communities of CD patients changed significantly during early vitamin D administration. However, a further increase in vitamin D level was associated with a reversal of this effect and additionally with a decrease in the bacterial richness in the CD microbiome. Specific species with a high abundancy were found during vitamin D administration in CD, but not in HC; the abundancy of Alistipes, Barnesiella, unclassified Porphyromonadaceae (both Actinobacteria), Roseburia, Anaerotruncus, Subdoligranulum and an unclassified Ruminococaceae (all Firmicutes) increased significantly after 1‐week vitamin D administration in CD.

CONCLUSIONS

Vitamin D has a specific influence on the bacterial communities in CD, but not in HC. Administration of vitamin D may have a positive effect in CD by modulating the intestinal bacterial composition and also by increasing the abundance of potential beneficial bacterial strains.
Associations of sleep duration and prediabetes prevalence in a middle‐aged and elderly Chinese population with regard to age and hypertension: The China Health and Retirement Longitudinal Study baseline survey
Authors: Yan Mingming , Fu Zhen , Qin Tingting , Wu Nanjin , Lv Yalan , Wei Qinyun , Jiang Hongwei , Yin Ping
Published: March 2018

Background

The aim of the present study was to examine the age‐specific associations between self‐reported sleep duration and prevalent prediabetes in middle‐aged and elderly Chinese with or without hypertension.

Methods

In all, 2985 Chinese adults aged ≥45 years from the China Health and Retirement Longitudinal Study (CHARLS) baseline survey were selected for analysis. Sleep duration was assessed by structured questionnaires and then categorized into three groups (≤6, 6–8, and >8 h). The prevalence of prediabetes was defined using fasting plasma glucose (100–125 mg/dL) and/or HbA1c (5.7%–6.4%) in conjunction with no previous diabetes diagnosis and no antidiabetic medication. Relationships between self‐reported sleep duration and prevalent prediabetes were examined according to age (45–60 years, middle‐aged; ≥60 years, elderly) and hypertension groups using Poisson regression models to estimate prevalence ratios (PRs) and 95% confidence intervals (CI).

Results

Compared with the reference group of 6–8 h sleep/night, short sleep (≤6 h/night) was associated with an increased risk of prediabetes in the whole sample (PR 1.09, 95% CI 1.01–1.17) after adjusting for confounders. This association was more pronounced in elderly participants without hypertension (PR 1.27, 95% CI 1.07–1.51).

Conclusion

This study suggests that participants with a short sleep period are at a moderately increased risk of prediabetes, particularly in elderly subjects without hypertension. Aging and hypertension may be important in the relationship between short sleep and impaired glucose metabolism.
Long‐term outcomes in patients with nasopharyngeal carcinoma treated with reduced‐volume conformal radiotherapy: A retrospective cohort study
Authors: Billan Salem , Bakouche Veronique , Borzov Egor , Gil Ziv , Abdah‐Bortnyak Roxolyana
Published: March 2018

Introduction

While the optimal target volumes for primary nasopharyngeal tumour are still subject to debate, we evaluated primary tumour volumes in nasopharyngeal carcinoma (NPC) patients treated according to an institutional protocol with a reduced volume approach and compared them to those determined by Radiation Therapy Oncology Group (RTOG)‐0615 guidelines.

Methods

This single‐centre retrospective analysis included 36 NPC patients treated between 2/2007 and 3/2014. Planning target volume (PTV)‐P 50 (50 Gy isodose to the primary tumour) included the gross tumour and the entire nasopharyngeal mucosa (clinical target volume [CTV]–P 50) with 5 mm margins. The PTV‐P 50 volumes, as determined by our protocol, were compared to those obtained with RTOG‐0615 PTV‐P 59.4 (59.4 Gy to the primary tumour). Clinical outcomes were also analysed.

Results

Median (range) follow‐up: 48 (21–108) months; 88.9% were males; median age was 53 (27–86) years; 14%, 53%, and 33% had stage II, III, and IV disease at diagnosis, respectively. Median volume of PTV‐P 50: 209.0 (92.6–568.0) cc. Median volume of RTOG‐0615 PTV‐P 59.4‐P: 292.0 (123.6–425.1) cc. The PTV‐P volume was significantly smaller than that delineated according to the RTOG‐0615 protocol (p < 0.001). Isolated local relapse as first site of recurrence occurred in five patients: two with stage III, two with IVA and one with IVB disease; all had advanced local disease at diagnosis. All local recurrences occurred in the PTV‐P 69‐70 region.

Conclusion

A reduced volume approach for radiotherapy in primary NPC provided acceptable long‐term local control.
A high‐density SNP chip for genotyping great tit (Parus major) populations and its application to studying the genetic architecture of exploration behaviour
Authors: Kim J.‐M. , Santure A. W. , Barton H. J. , Quinn J. L. , Cole E. F. ,   Great Tit HapMap Consortium, Visser M. E. , Sheldon B. C. , Groenen M. A. M. , van Oers K. , Slate J.
Published: March 2018

High‐density SNP microarrays (“SNP chips”) are a rapid, accurate and efficient method for genotyping several hundred thousand polymorphisms in large numbers of individuals. While SNP chips are routinely used in human genetics and in animal and plant breeding, they are less widely used in evolutionary and ecological research. In this article, we describe the development and application of a high‐density Affymetrix Axiom chip with around 500,000 SNPs, designed to perform genomics studies of great tit (Parus major) populations. We demonstrate that the per‐SNP genotype error rate is well below 1% and that the chip can also be used to identify structural or copy number variation. The chip is used to explore the genetic architecture of exploration behaviour (EB), a personality trait that has been widely studied in great tits and other species. No SNPs reached genomewide significance, including at DRD4, a candidate gene. However, EB is heritable and appears to have a polygenic architecture. Researchers developing similar SNP chips may note: (i) SNPs previously typed on alternative platforms are more likely to be converted to working assays; (ii) detecting SNPs by more than one pipeline, and in independent data sets, ensures a high proportion of working assays; (iii) allele frequency ascertainment bias is minimized by performing SNP discovery in individuals from multiple populations; and (iv) samples with the lowest call rates tend to also have the greatest genotyping error rates.
Proteome and acylome analyses of the functional interaction network between the carbazole‐degradative plasmid pCAR1 and host Pseudomonas putida KT2440
Authors: Vasileva Delyana , Suzuki‐Minakuchi Chiho , Kosono Saori , Yoshida Minoru , Okada Kazunori , Nojiri Hideaki
Published: March 2018

Understanding the interplay between a plasmid and its host system is a bottleneck towards prediction of the fate of plasmid‐harbouring strains in the natural environments. Here, we studied the impact of the conjugative plasmid pCAR1, involved in carbazole degradation, on the proteome of Pseudomonas putida KT2440 using SILAC method. Furthermore, we investigated two acyl lysine modifications (acetylation and succinylation) that respond to the metabolic status of the cell and are implicated in regulation of various cellular processes. The total proteome analysis revealed that the abundance of key proteins involved in metabolism, signal transduction and motility was affected by pCAR1 carriage. In total, we identified 1359 unique acetylation sites on 637 proteins and 567 unique succinylation sites on 259 proteins. Changes in the acylation status of proteins involved in metabolism and translation by pCAR1 carriage were detected. Remarkably, acylation was identified on proteins involved in important plasmid functions, including partitioning and carbazole degradation, and on nucleoid‐associated proteins that play a key role in the functional interaction with the chromosome. This study provides a novel insight on the functional consequences of plasmid carriage and improves our understanding of the plasmid‐host cross‐talk.
Effect of applied magnetic fields on motility and magnetotaxis in the uncultured magnetotactic multicellular prokaryote ‘CandidatusMagnetoglobus multicellularis’
Authors: Keim Carolina N. , Duarte de Melo Roger , Almeida Fernando P. , Lins de Barros Henrique G. P. , Farina Marcos , Acosta‐Avalos Daniel
Published: March 2018

Magnetotactic bacteria are found in the chemocline of aquatic environments worldwide. They produce nanoparticles of magnetic minerals arranged in chains in the cytoplasm, which enable these microorganisms to align to magnetic fields while swimming propelled by flagella. Magnetotactic bacteria are diverse phylogenetically and morphologically, including cocci, rods, vibria, spirilla and also multicellular forms, known as magnetotactic multicellular prokaryotes (MMPs). We used video‐microscopy to study the motility of the uncultured MMP ‘Candidatus Magnetoglobus multicellularis’ under applied magnetic fields ranging from 0.9 to 32 Oersted (Oe). The bidimensional projections of the tridimensional trajectories where interpreted as plane projections of cylindrical helices and fitted as sinusoidal curves. The results showed that ‘Ca. M. multicellularis’ do not orient efficiently to low magnetic fields, reaching an efficiency of about 0.65 at 0.9–1.5 Oe, which are four to six times the local magnetic field. Good efficiency (0.95) is accomplished for magnetic fields ≥10 Oe. For comparison, unicellular magnetotactic microorganisms reach such efficiency at the local magnetic field. Considering that the magnetic moment of ‘Ca. M. multicellularis’ is sufficient for efficient alignment at the Earth's magnetic field, we suggest that misalignments are due to flagella movements, which could be driven by photo‐, chemo‐ and/or other types of taxis.
Variations of pulmonary vein drainage critical for lung resection assessed by three‐dimensional computed tomography angiography
Authors: Shiina Nobuyuki , Kaga Kichizo , Hida Yasuhiro , Sasaki Tsukasa , Hirano Satoshi , Matsui Yoshiro
Published: March 2018

Background

It is important to understand pulmonary vein drainage pattern variations and their frequency in order to perform safe anatomical pulmonary resection.

Methods

Variations and frequencies were assessed using three‐dimensional computed tomography angiography (3D‐CT) in 194 patients. In cases where the tumor or lymph node caused atelectasis or compression of hilar structures, the involved lobes were excluded from the analyses.

Results

We confirmed variant drainage patterns in 15/189 (8.0%) patients in the right upper lobe (RUL), 29/189 (15.3%) in the right middle lobe (RML), 18/192 (9.5%) in the right lower lobe (RLL), and 5/187 (2.6%) in the left upper lobe (LUL). There was no variant type in the left lower lobe (LLL). There were 14 (7.4%) cases of anomalous superior posterior pulmonary vein of RUL (V2) drainage: V2 draining to the superior pulmonary vein (SPV) (n = 2, 1.1%), V2 to the inferior pulmonary vein (IPV) (n = 7, 3.7%), V2 to the left atrium (LA) (n = 2, 1.1%), and V6 to the apical pulmonary vein of the RLL (n = 3, 1.6%). There was a posterior pulmonary vein, V3 to RML pulmonary vein in one case (0.5%). The RML pulmonary vein drained into the IPV in 14 (7.4%) and into the LA in 15 (7.9%) cases. The right V6 directly drained into the LA in 15 (7.9%) and V6 into the SPV in 3 (1.6%) cases. The lingular pulmonary vein drained into the IPV in one case (0.5%) and into the LA in two cases (1.1%). The inferior lingular pulmonary vein V5 drained into the IPV and into the LA in one case (0.5%), respectively.

Conclusion

We describe anomalous pulmonary venous drainage patterns and their frequencies particular to anatomic surgical resection. 3D‐CT is useful to find such variations.
Effect of pre‐operative methylprednisolone on orthostatic hypotension during early mobilization after total hip arthroplasty
Authors: Lindberg‐Larsen V. , Petersen P. B. , Jans Ø. , Beck T. , Kehlet H.
Published: March 2018

Background

Orthostatic hypotension (OH) and intolerance (OI) are common after total hip arthroplasty (THA) and may delay early mobilization. The pathology of OH and OI includes a dysregulated post‐operative vasopressor response, by a hitherto unknown mechanism. We hypothesized that OI could be related to the inflammatory stress response which is inhibited by steroid administration. Consequently, this study evaluated the effect of a pre‐operative high‐dose methylprednisolone on OH and OI early after THA.

Methods

Randomized, double‐blind, placebo‐controlled study in 59 patients undergoing elective unilateral THA with spinal anesthesia and a standardized multimodal analgesic regime. Patients were allocated (1 : 1) to pre‐operative intravenous (IV) methylprednisolone (MP) 125 mg or isotonic saline (C). OH, OI and cardiovascular responses to sitting and standing were evaluated using a standardized mobilization protocol pre‐operatively, 6, and 24 h after surgery. Systolic and diastolic arterial pressure and heart rate were measured non‐invasively (Nexfin®). The systemic inflammation was monitored by the C‐reactive protein (CRP) response.

Results

At 6 h post‐operatively, 11 (38%) versus 11 (37%) patients had OH in group MP and group C, respectively (RR 1.02 (0.60 to 1.75; P = 1.00)), whereas OI was present in 9 (31%) versus 13 (43%) patients (RR 0.76 (0.42 to 1.36; P = 0.42)), respectively.

At 24 h post‐operatively, the prevalence of OH and OI did not differ between groups, though CRP levels were significantly reduced in group MP (P < 0.001).

Conclusion

Pre‐operative administration of 125 mg methylprednisolone IV did not reduce OH or OI compared with placebo despite a reduced inflammatory response.
Socioeconomic status and risk of intensive care unit admission with sepsis
Authors: Storm L. , Schnegelsberg A. , Mackenhauer J. , Andersen L. W. , Jessen M. K. , Kirkegaard H.
Published: March 2018

Background

A recent study showed higher risk of bacteremia among individuals with low socioeconomic status (SES). We hypothesized that patients with a low SES have a higher risk of intensive care unit (ICU) admission with sepsis compared to patients with higher SES.

Methods

This was a case–control study on patients with sepsis admitted to the ICU at Aarhus University Hospital, Denmark (2008–2010). Three hundred eighty‐three sepsis patients were matched on sex, age, and zip code with controls retrieved from the background population. SES was defined as highest accomplished educational level, yearly income, cohabitation status, and occupation. The odds ratio (OR) of being admitted with sepsis to the ICU was calculated using conditional logistic regression, adjusting for the Charlson Comorbidity Index and the remaining socioeconomic variables.

Results

The adjusted odds of being admitted to the ICU with sepsis were significantly higher among individuals living alone (OR 1.72, 95% confidence interval (CI) 1.33–2.24, P < 0.001) compared to individuals living with a cohabitant. Individuals outside the labor force had an adjusted OR of 3.50 (CI 2.36–5.18, P < 0.001) compared to individuals in the labor force. Individuals with a medium level of education had an increased risk of admission to the ICU with sepsis compared to a high level of education (adjusted OR 1.43, CI 1.02–2.00, P = 0.04). There was no significant association between income and risk of ICU admission with sepsis after adjustment.

Conclusion

Individuals living alone, being outside the labor force, or having a medium level of education had significantly higher risk of ICU admission with sepsis.
Profiling of m6A RNA modifications identified an age‐associated regulation of AGO2 mRNA stability
Authors: Min Kyung‐Won , Zealy Richard W. , Davila Sylvia , Fomin Mikhail , Cummings James C. , Makowsky Daniel , Mcdowell Catherine H. , Thigpen Haley , Hafner Markus , Kwon Sang‐Ho , Georgescu Constantin , Wren Jonathan D. , Yoon Je‐Hyun
Published: March 2018

Gene expression is dynamically regulated in a variety of mammalian physiologies. During mammalian aging, there are changes that occur in protein expression that are highly controlled by the regulatory steps in transcription, post‐transcription, and post‐translation. Although there are global profiles of human transcripts during the aging processes available, the mechanism(s) by which transcripts are differentially expressed between young and old cohorts remains unclear. Here, we report on N6‐methyladenosine (m6A) RNA modification profiles of human peripheral blood mononuclear cells (PBMCs) from young and old cohorts. An m6A RNA profile identified a decrease in overall RNA methylation during the aging process as well as the predominant modification on proteincoding mRNAs. The m6A‐modified transcripts tend to be more highly expressed than nonmodified ones. Among the many methylated mRNAs, those of DROSHA and AGO2 were heavily methylated in young PBMCs which coincided with a decreased steady‐state level of AGO2 mRNA in the old PBMC cohort. Similarly, downregulation of AGO2 in proliferating human diploid fibroblasts (HDFs) also correlated with a decrease in AGO2 mRNA modifications and steady‐state levels. In addition, the overexpression of RNA methyltransferases stabilized AGO2 mRNA but not DROSHA and DICER1 mRNA in HDFs. Moreover, the abundance of miRNAs also changed in the young and old PBMCs which are possibly due to a correlation with AGO2 expression as observed in AGO2‐depleted HDFs. Taken together, we uncovered the role of mRNA methylation on the abundance of AGO2 mRNA resulting in the repression of miRNA expression during the process of human aging.
Algorithm Analysis of the DSM‐5 Alcohol Withdrawal Symptom
Authors: Martin Christopher S. , Vergés Alvaro , Langenbucher James W. , Littlefield Andrew , Chung Tammy , Clark Duncan B. , Sher Kenneth J.
Published: March 2018

Background

Alcohol withdrawal (AW) is an important clinical and diagnostic feature of alcohol dependence. AW has been found to predict a worsened course of illness in clinical samples, but in some community studies, AW endorsement rates are strikingly high, suggesting false‐positive symptom assignments. Little research has examined the validity of the DSM‐5 algorithm for AW, which requires either the presence of at least 2 of 8 subcriteria (i.e., autonomic hyperactivity, tremulousness, insomnia, nausea, hallucinations, psychomotor agitation, anxiety, and grand mal seizures), or, the use of alcohol to avoid or relieve these symptoms.

Methods

We used item and algorithm analyses of data from waves 1 and 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (current drinkers, n = 26,946 at wave 1) to study the validity of DSM‐5 AW as operationalized by the Alcohol Use Disorder and Associated Disabilities Interview Schedule‐DSM‐IV (AUDADIS‐IV).

Results

A substantial proportion of individuals given the AW symptom reported only modest to moderate levels of alcohol use and alcohol problems. Alternative AW algorithms were superior to DSM‐5 in terms of levels of alcohol use and alcohol problem severity among those with AW, group difference effect sizes, and predictive validity at a 3‐year follow‐up. The superior alternative algorithms included those that excluded the nausea subcriterion; required withdrawal‐related distress or impairment; increased the AW subcriteria threshold from 2 to 3 items; and required tremulousness for AW symptom assignment.

Conclusions

The results indicate that the DSM‐5 definition of AW, as assessed by the AUDADIS‐IV, has low specificity. This shortcoming can be addressed by making the algorithm for symptom assignment more stringent.
Loss of plasticity in life‐history strategy associated with secondary invasion into stressful environments in invasive narrowleaf plantain (Plantago lanceolata L.)
Authors: Wan Justin S. H. , Fazlioglu Fatih , Bonser Stephen P.
Published: March 2018

Adaptation to changing environments is a fundamental process occurring throughout a species’ range, particularly under novel and stressful conditions at the range‐edges of invasive species. However, the evolutionary consequences associated with adaptation are still poorly understood. Secondary invasion into stressful areas may incur fitness costs that could limit range expansion. In addition, developmental plasticity is predicted to be lost under strong selection in stressful habitats. We assessed populations across a range transect of an invasive plant (Plantago lanceolata L.) for a loss of developmental plasticity and for adaptation costs, where there was prior expansion inland into stressful and novel areas from relatively benign areas closer to the coast. In the glasshouse, we grew plants from seed originating from two secondary invasion locations (near‐edge and edge), and from the range centre location representing the area of primary invasion. Plants were exposed to high or low nutrient treatment, and novel copper stress and control (no copper) treatment to assess adaptation costs associated with secondary invasion. In addition, we compared the costs in near‐edge and edge plants. Developmental plasticity in life‐history traits was lost for secondary invasion plants compared to plants from the range centre. Plants from secondary invasion locations expressed a slower life‐history under both nutrient treatments. In contrast, range‐centre plants were able to switch to a faster life‐history under high nutrient treatment. Our copper treatment had only slight effects on plants, where they expressed intermediate specific leaf area (SLA) under copper treatment. Near‐edge plants had the lowest plant size and reproduction. The loss of plasticity associated with secondary invasion may have implications on evolution in range‐edge populations. Phenotypic plasticity may have initially mediated ecological adaptation to stressful habitats; however, adaptation to stressful conditions can also have the consequence of inhibiting further range expansion in invasive species.
The prevalence of second canals in the mesiobuccal root of maxillary molars: A cone beam computed tomography study
Authors: Fernandes Nelson Alexander , Herbst Dirk , Postma Thomas Corne , Bunn Belinda Kathleen
Published: March 2018

The aim of this study was to determine the prevalence of MB2 canals in permanent maxillary molars utilising CBCT; in patients attending a university hospital. A total of 200 patient scans, (100 female and 100 male patients), were enrolled in the study. In total, 800 teeth were analysed, and teeth with additional canals in their MB roots (MB2) were identified. First maxillary molar teeth exhibited the highest prevalence of MB2 canals, 92% and 87%, for teeth 16 and 26, respectively. Second maxillary molar teeth showed a lower prevalence of MB2 canals, 69% and 65%, for the 17 and 27, respectively. There were no associations of significance between the prevalence of MB2 canals and patient age or gender. Root morphology and anatomy of permanent maxillary first and second molar teeth was found to be highly variable. The prevalence of additional canals in the MB roots is a frequent finding which has previously been underreported.
Geriatric Psychotropic Stewardship Team to de‐escalate inappropriate psychotropic medications in general medicine inpatients: An evaluation
Authors: Pellicano Olivia A , Tong Erica , Yip Gary , Monk Louise , Loh Xiang , Ananda‐Rajah Michelle , Dooley Michael
Published: March 2018

Objectives

To assess the feasibility and effectiveness of a Geriatric Psychotropic Stewardship Team (GPST) and to achieve inpatient de‐escalation of inappropriate psychotropic medications in patients aged over 65 years on a general medicine ward.

Methods

A multidisciplinary GPST conducted twice‐weekly rounds on general medicine inpatients known to be taking psychotropic medications. A consensus recommendation was generated, with subsequent treating team action recorded.

Results

A total of 125 patients taking 180 psychotropic medications were identified for GPST review. Of these, 32 medications (18%) had been ceased by the treating team prior to GPST review. Adoption of GPST recommendations at 24 hours and at discharge occurred for 85 medications (57%) and 79 medications (53%), respectively.

Conclusions

This study demonstrates the feasibility of a structured multidisciplinary approach in the de‐escalation of inappropriate psychotropic medications in older hospital patients on a general medicine ward. Further studies are required to assess scalability and long‐term clinical outcomes.
Patients’ experiences and preferences for opt‐in models and health professional involvement in biobanking consent: A cross‐sectional survey of Australian cancer outpatients
Authors: Fradgley Elizabeth A. , Chong Shu Er , Cox Martine E. , Gedye Craig , Paul Christine L.
Published: March 2018

Background

Many biobanks rely upon patients’ willingness to donate biospecimens and healthcare professionals to initiate opt‐in consent processes. This study explored if: (1) patients accept opt‐in or opt‐out consent models with varying levels of professional involvement; (2) professionals discuss participation with specific patient groups; and (3) this discussion is associated with patient knowledge of biobanking processes.

Methods

Outpatients completed surveys at a tertiary cancer center in New South Wales, Australia. Eligible participants were English‐speaking adults who recently had cancer‐related surgery. Participants completed 27 questions exploring acceptable consent models, biobanking experiences, knowledge, and willingness. Logistic regression and chi‐square tests examined differences in the characteristics and knowledge of participants who were offered the opportunity to participate versus those who were not.

Results

A total of 113 outpatients participated (97% response). Most participants (92%) found opt‐out, patient‐initiated consent acceptable; however, high acceptability was reported for all models except for opt‐in, patient‐initiated consent (58%). University or technical qualifications (P  =  0.001) was associated with increased odds (OR = 4.5) of being offered biobanking. The majority did not know what occurred to samples after surgery (59.3%) or pathology review (81.4%) and ability to answer these questions was associated with discussion of participation (P < 0.001). Of the few outpatients who discussed biobanking with their doctor (29%), all consented.

Conclusion

Professional‐initiated, opt‐in consent resulted in a few educated patients being approached; greater professional initiation of consent would be fruitful as most patients were willing to participate if asked. However, other consent approaches minimizing professional involvement were as acceptable to participants warranting further consideration.
Efficacy, safety and predictive indicators of apatinib after multilines treatment in advanced nonsquamous nonsmall cell lung cancer: Apatinib treatment in nonsquamous NSCLC
Authors: Wu Di , Liang Li , Nie Ligong , Nie Jun , Dai Ling , Hu Weiheng , Zhang Jie , Chen Xiaoling , Han Jindi , Ma Xiangjuan , Tian Guangming , Han Sen , Long Jieran , Wang Yang , Zhang Ziran , Xin Tao , Fang Jian
Published: March 2018

Aim

Patients with advanced nonsquamous nonsmall cell lung cancer (NSCLC) who experienced progression with two or more lines chemotherapy have no treatment options that clearly confer a survival benefit. As a novel vascular endothelial growth factor receptor‐2 tyrosine kinase inhibitor, apatinib has a certain antitumor effect for various solid tumors. The present study evaluated the efficacy and safety of apatinib in advanced nonsquamous NSCLC as salvage treatment in Chinese real‐world practice.

Methods

Twenty‐eight patients were enrolled in this observational study from October 2015 to May 2017. Progression‐free survival (PFS) and overall survival (OS) were graphed by Kaplan–Meier curve and intergroup comparisons were carried out by log‐rank test. Objective response rate (ORR), disease control rate (DCR) and adverse effects (AEs) were also evaluated.

Results

Seven patients obtained partial response, and 18 obtained stable disease, representing an ORR of 26% and a DCR of 93%. Median PFS and OS were 3 (95% confidence interval [CI] 2.6–3.4) and 7.4 (95% CI 1.3–13.5) months, respectively. The efficacy analysis showed that Eastern Cooperative Oncology Group (ECOG) performance status 0–1 was correlated with prolonged OS and PFS (P < 0.05), and hypertension during apatinib treatment was correlated with prolonged OS (P < 0.05). Cox regression showed that ECOG performance status (P < 0.01) (RR = 0.231) (95% CI 0.083‐0.642) and hypertension during apatinib treatment (P = 0.05) were predictive indicators for apatinib treatment. Grade 3–4 AEs with incidences of 10% or greater were hypertension (21%), hand‐foot syndrome (14%) and proteinuria (11%) which could be relieved by dose reduction.

Conclusion

In conclusion, apatinib has a certain therapeutic effect in patients with advanced nonsquamous NSCLC. ECOG performance status and hypertension during apatinib might be predictive indicators for treatment efficacy.
The Politics of Transition in Fiji: Is it Charting a Democratic Course?
Authors: Carnegie Paul , Tarte Sandra
Published: March 2018

Fiji is undergoing a period of political and economic change. At this stage, the jury is out on the course being charted by the FijiFirst government as it grapples with the dual challenges of political reform and economic development. With the 2018 general election on the horizon, the following article considers where Fiji is placed on the authoritarian‐democratic spectrum. By drawing on the comparative literature about transition “from above” and competitive authoritarianism, we focus on the character of reform in Fiji since the re‐institution of elections in 2014. Our contention is that the shift that skews the system in favour of an incumbent government often occurs between elections in a less than noticeable manner. The article argues that while there is an appearance of progress in Fiji, overall the situation is less democratic and more precarious than it seems.
A modified Continuous Quality Improvement approach to improve culturally and socially inclusive care within rural health services
Authors: Mitchell Olivia , Malatzky Christina , Bourke Lisa , Farmer Jane
Published: March 2018

Background

The sickest Australians are often those belonging to non‐privileged groups, including Indigenous Australians, gay, lesbian, bisexual, transsexual, intersex and queer people, people from culturally and linguistically diverse backgrounds, socioeconomically disadvantaged groups, and people with disabilities and low English literacy. These consumers are not always engaged by, or included within, mainstream health services, particularly in rural Australia where health services are limited in number and tend to be generalist in nature.

Objective

The aim of this study was to present a new approach for improving the sociocultural inclusivity of mainstream, generalist, rural, health care organisations.

Design

This approach combines a modified Continuous Quality Improvement framework with Participatory Action Research principles and Foucault's concepts of power, discourse and resistance to develop a change process that deconstructs the power relations that currently exclude marginalised rural health consumers from mainstream health services. It sets up processes for continuous learning and consumer responsiveness.

Results

The approach proposed could provide a Continuous Quality Improvement process for creating more inclusive mainstream health institutions and fostering better engagement with many marginalised groups in rural communities to improve their access to health care.

Conclusion

The approach to improving cultural inclusion in mainstream rural health services presented in this article builds on existing initiatives. This approach focuses on engaging on‐the‐ground staff in the need for change and preparing the service for genuine community consultation and responsive change. It is currently being trialled and evaluated.
Bronchiectasis in the Kimberley region of Western Australia
Authors: Barton Justin , Scott Lydia , Maguire Graeme
Published: March 2018

Objective

To review the work‐up and inpatient management of non‐cystic fibrosis bronchiectasis exacerbations against best practice guidelines in the Kimberley, a remote region of Western Australia, with the ultimate goal of improving treatment in the region.^

Design

Retrospective cohort study and audit of remote adult bronchiectasis hospital admissions between 2011 and 2016.

Setting

Remote hospital inpatients.

Participants

Thirty‐two patients and 110 hospital admissions were included. Patients were ≥15 years old, had computed tomography confirmed bronchiectasis and at least one hospital admission for acute respiratory illness prior to January 2011.

Main outcomes measured

The 5‐year mortality and compliance to a Lung Foundation position statement on non‐cystic fibrosis bronchiectasis which suggests investigating for an underlying cause at diagnosis and during exacerbations prolonged antibiotics (10–14 days) and prolonged hospital admissions (≥7 days) are required.

Results

The overall 5‐year mortality was 21.8%, with the median age at death of 37 years (interquartile range, 27–63). The median duration of hospital admission was shorter than the recommended 3 days (interquartile range, 2–5) with 11 of 100 (11%) patients admitted for ≥7 days. The median duration of antibiotics was also shorter than the recommended 7 days (interquartile range, 4–10), with 31 of the 98 (32%) patients prescribed ≥10 days and 6 of the 98 (6%) prescribed ≥14 days of therapy.

Conclusion

We found under‐treatment and under‐investigation of non‐cystic fibrosis bronchiectasis in the Kimberley region. Five‐year mortality was high, consistent with other rural Australian Indigenous cohorts.§ Following this audit, a strategy to improve awareness, as well as update and promote regional guidelines has been developed.