bluuebunny/crossref_metadata_2025 huggingface dataset:
Upper gastrointestinal cancers
Authors: Phillips Anne Margrethe
Published: May 2019

This chapter examines the aetiology, diagnosis, and management of malignant tumours of the oesophagus, stomach, liver, pancreas, gall bladder, and biliary tree. Surgical, radiotherapy, and chemotherapy treatments are mentioned, in relation to both early-stage and metastatic disease. It highlights the multidisciplinary approach to these tumours. Nursing management of dysphagia and other complex nutritional issues is also covered.
Anatomy of the foot and ankle
Authors: Roberts Dave , Pickering James , Fletcher Jordan
Published: May 2019

The human foot and ankle are uniquely adapted to support the entire weight of the body and provide a platform through which propulsive forces are transmitted to the ground beneath. Far from being passive elements, however, the foot and ankle together represent a dynamic, reactive, and force-generating structure containing a complex arrangement of bones held in inherently unstable configurations by an array of ligaments and muscle tendons. This anatomical complexity, together with the biomechanical demands placed on them, make the foot and ankle particularly susceptible to a variety of injuries and disease processes. This chapter covers the anatomy of the human foot and ankle, including illustrative figures.
Imaging of arthritis in the foot and ankle
Authors: Rowbotham Emma , Wakefield Richard , Grainger Andrew
Published: May 2019

This chapter discusses imaging of the foot and ankle in rheumatological disease, including the advantages and disadvantages of specific techniques by disease. Conventional radiology remains the mainstay for radiological investigation, and a systematic approach to viewing the plain film radiographs is covered. Findings by imaging technique and disease are described. Computerized tomography, nuclear medicine, magnetic resonance imaging, and ultrasound are all analysed.
Applying methods of economic evaluation to public health: Contemporary solutions to traditional challenges
Authors: Edwards Rhiannon T. , McIntosh Emma
Published: May 2019

Chapter 3 opens with a discussion of the role of study design, the gold standard traditionally being a randomized controlled trial, and widens this to consider other types of study design such as cohort studies and natural experiments. Readers are introduced to the idea that many public health interventions are ‘complex interventions’ and there is a need for a ‘systems-based approach’ to understanding their potential effectiveness and cost-effectiveness. The chapter highlights the relevance of behavioural economics to the evaluation of public health interventions. This chapter goes on to summarize a range of challenges faced by economists, used to evaluate healthcare technologies in a healthcare setting, when they start evaluating public health interventions, which are often delivered outside the health sector in, for example, schools and workplaces. UK guidance from NICE is presented on good practice in economic evaluation of public health interventions along with ideas about how such evaluations are best reported in the literature.
The heart and resuscitation
Authors: Harris Tim , Wong Matthew , French James , Kay Sharon , Atkinson Paul
Published: May 2019

Focused echocardiography and point-of-care ultrasound are becoming core skills for doctors working in acute care and arguably a key skill set for those with an interest in resuscitation medicine. Echo is the most useful test now available to define the aetiology of shock and to guide fluid/cardiac resuscitation. This chapter aims to teach the core and intermediate skills required to perform echo as non-cardiologists. These skills do not replace the need for a cardiology opinion or a detailed assessment by a trained sonographer or cardiologist, but simply enable those caring for patients to obtain key real-time information as rapidly as possible. The chapter’s focus is not on comprehensive assessment, but on rapidly identifying the causes of shock and acute heart failure and guiding therapy. The emphasis is therefore different from that found in dedicated textbooks on echocardiography written for trainees in cardiology and is at a simpler level.
Community-level responses to domestic violence and abuse
Authors: Grant Peter , Marshall Amanda
Published: May 2019

This chapter explains the nature and cause of domestic abuse and sexual violence including female genital mutilation/cutting (FGM/C) and summarizes the latest research. It describes ways of engaging men and other perpetrators. The chapter debunks common myths around the topic and gives examples of specific situations. It discusses how to raise awareness at community level to prevent domestic abuse and the principle of ‘do no harm’. The chapter outlines practical steps to implement community-level responses to violence and abuse. It teaches how community members can be informed and aware of local services, some legal backgrounds, and ways of responding appropriately to victims and survivors. It describes ways to pursue justice and reconciliation, including holding to account those in authority, including people of influence, e.g. faith leaders. The chapter elaborates on dealing with specific forms of abuse.
Abdominal
Authors: Monaghan Tanya M. , Thomas James D.
Published: May 2019

This chapter concerns abdominal medicine, and covers abdominal scars, inguinal hernia, femoral hernia, abdominal stomas, jaundice, ascites, chronic liver disease, hepatomegaly and splenomegaly, hepatic encephalopathy, autoimmune hepatitis, primary biliary cholangitis, haemochromatosis, Wilson’s disease, ulcerative colitis, Crohn’s disease, adult polycystic kidney disease, chronic kidney disease, transplanted kidney, single palpable kidney, lymphadenopathy, nephrotic syndrome, hydrocele, and varicocele.
Eyes
Authors: Monaghan Tanya M. , Thomas James D.
Published: May 2019

This chapter concerns ophthalmology, and covers red eye, diabetic retinopathy, hypertensive retinopathy, optic disc swelling, glaucoma, optic atrophy, cataracts, central retinal vein occlusion, retinal detachment, age-related macular degeneration, and cytomegalovirus retinitis.
Cancer chemoprevention
Authors: Zirlik Katja , Arber Nadir , Schrijvers Dirk
Published: May 2019

Cancer prevention certainly would be the best approach to cancer. Interventions should be effective, with minimal side effects, convenient, and inexpensive. Cancer chemoprevention is defined as the pharmacologic intervention with the process of carcinogenesis to prevent the development of overt malignant neoplasms in healthy individuals with elevated cancer risk. The present list of candidate cancer types for active chemoprevention is still short and includes SERMs (tamoxifen, raloxifene) and an aromatase-inhibitor (exemestane) for chemoprevention of breast cancers, showing significant reduction of cancer occurrence. The same holds true for reduction of the development of invasive cancers by aspirin, NSAIDs, and COX2-inhibitors in selected populations with increased colorectal cancer risk. There is also reduction of prostate cancers by long-term application of 5-alfa-reductase-inhibitors (finasteride, dutasteride) in selected high-risk populations. Many other potentially active anti-neoplastic compounds have been tested but do not meet all the criteria of efficiency, efficacy, and cost-effectiveness.
Oesophageal cancer
Authors: Thomas Melissa , Haustermans Karin , Cutsem Eric Van , Dirix Piet , Sagaert Xavier , Deroose Christophe M. , Nafteux Philippe , Prenen Hans , Lerut Toni
Published: May 2019

Worldwide, oesophageal cancer, including cancer of the gastro-oesophageal junction (GEJ), is the sixth leading cause of death from cancer. Despite recent advances, treatment of oesophageal cancer remains challenging and is best approached by an experienced multidisciplinary team. Surgery alone is the treatment of choice in early stage carcinoma although in superficial cancers (T1a) endoscopic resection is to be preferred. In locally advanced tumours induction therapy followed by surgery is the preferred treatment. In selected cases definitive chemoradiotherapy could be considered as a valuable alternative. The role of adjuvant chemotherapy is unclear, but could be considered for selected GEJ adenocarcinoma patients. Adjuvant chemoradiotherapy should be considered in all patients with advanced disease or positive margins who did not receive neo-adjuvant radiotherapy. For metastatic disease, the goal is to prolong and maximize quality of life. Regarding the palliative treatment of dysphagia, brachytherapy was shown to be more effective than stenting.
Pulse generator replacement
Authors: Timperley Jonathan
Published: May 2019

This chapter covers pulse generator replacement, from general principles to pocket revision. Indications for pulse generator replacement are briefly covered, including pre-operative checks such as lead configuration and underlying rhythms being confirmed prior to the operation. Patient preparation is described, and the operative technique for removing the old pulse generator and new implantation are described, including common pitfalls. Different techniques, including moving from dual to single chamber or the addition of new leads are outlined, rationales are provided, and methods for carrying out each technique are discussed. The opportunity for pocket revision is described.
Implantable cardioverter defibrillator implantation
Authors: Chelliah Rajesh , Khiani Raj
Published: May 2019

This chapter covers implantable cardioverter defibrillators (ICD) implantation. Pre-procedure considerations such as the operative conditions, counselling, and consent are covered. Patient preparation and the necessary equipment and staff are defined. The implantation procedure is discussed in detail. Device testing and pacing parameters are covered, and methods for defibrillation threshold testing are explained. Problems that cause difficult testing are described, with potential solutions. Post-procedure management is explained, including follow-up and discharge instructions.
Troubleshooting ICDs
Authors: Betts Timothy , Ormerod Julian
Published: May 2019

This chapter covers the causes of inappropriate implantable cardioverter defibrillators (ICD) therapies, and then covers each response in detail. Breaking down the response by key information required, and the most common presentation of each problem, diagnosis and treatment are discussed in turn. The chapter covers tachycardias (atrial, supraventricular, ventricular, etc.), atrial fibrillation or flutter, committed shocks, undersensing, and oversensing. Mechanical issues that may occur at follow up, such as lead damage or battery life problems, are covered. Finally, problems to date and management issues are described.
Perioperative management of devices
Authors: Bashir Yaver , Gamble James , Leeson Paul
Published: May 2019

Expanding use of pacemakers and implantable cardioverter defibrillators (ICDs) has made it common for patients with devices to present for elective or emergency surgery and other interventional procedures. The key issue in perioperative management is the potential for electromagnetic interference (EMI) altering performance of devices, possibly leading to malfunction and/or adverse clinical consequences. This chapter covers the American College of Cardiology, American Heart Association, and UK Medicines and Healthcare Products Regulatory Agency guidelines for perioperative management of pacemakers or ICDs. Assessment, intra-operative management, and post-operative management are all described.
Effect of lensing magnification on type Ia supernova cosmology
Authors: Sakakibara Hinako , Nishizawa Atsushi J , Oguri Masamune , Tanaka Masayuki , Hsieh Bau-Ching , Wong Kenneth C
Published: May 2019

Effect of gravitational magnification on the measurement of distance modulus of type Ia supernovae is presented. We investigate a correlation between magnification and Hubble residual to explore how the magnification affects the estimation of cosmological parameters. We estimate magnification of type Ia supernovae in two distinct methods: one is based on convergence mass reconstruction under the weak lensing limit and the other is based on the direct measurement from galaxies distribution. Both magnification measurements are measured from Subaru Hyper Suprime-Cam survey catalogue. For both measurements, we find no significant correlation between Hubble residual and magnification. Furthermore, we correct for the apparent supernovae fluxes obtained by Supernova Legacy Survey 3-yr sample using direct measurement of the magnification. We find $\Omega _{\rm m0}= 0.282 ^{+0.109} _{-0.086}$ and $w = -1.132 ^{+0.571}_{-0.340}$ for supernovae samples corrected for lensing magnification when we use photometric redshift catalogue of Mizuki, while $\Omega _{\rm m0}= 0.267 ^{+0.114} _{-0.088}$ and $w = -1.074 ^{+0.504} _{-0.312}$ for DEmP photo-z catalogue. Therefore, we conclude that the effect of magnification on the supernova cosmology is negligibly small for the current surveys; however, it has to be considered for the future supernova survey like LSST.
The COSMOS-UltraVISTA stellar-to-halo mass relationship: new insights on galaxy formation efficiency out to z ∼ 5
Authors: Legrand L , McCracken H J , Davidzon I , Ilbert O , Coupon J , Aghanim N , Douspis M , Capak P L , Le Fèvre O , Milvang-Jensen B
Published: May 2019

Using precise galaxy stellar mass function measurements in the COSMOS field we determine the stellar-to-halo mass relationship (SHMR) using a parametric abundance matching technique. The unique combination of size and highly complete stellar mass estimates in COSMOS allows us to determine the SHMR over a wide range of halo masses from z ∼ 0.2 to 5. At z ∼ 0.2, the ratio of stellar-to-halo mass content peaks at a characteristic halo mass Mh = 1012M⊙ and declines at higher and lower halo masses. This characteristic halo mass increases with redshift reaching Mh = 1012.5M⊙ at z ∼ 2.3 and remaining flat up to z = 4. We considered the principal sources of uncertainty in our stellar mass measurements and also the variation in halo mass estimates in the literature. We show that our results are robust to these sources of uncertainty and explore likely explanation for differences between our results and those published in the literature. The steady increase in characteristic halo mass with redshift points to a scenario where cold gas inflows become progressively more important in driving star formation at high redshifts, but larger samples of massive galaxies are needed to rigorously test this hypothesis.
Structural basis for preferential binding of human TCF4 to DNA containing 5-carboxylcytosine
Authors: Yang Jie , Horton John R , Li Jia , Huang Yun , Zhang Xing , Blumenthal Robert M , Cheng Xiaodong
Published: May 2019

The psychiatric risk-associated transcription factor 4 (TCF4) is linked to schizophrenia. Rare TCF4 coding variants are found in individuals with Pitt-Hopkins syndrome—an intellectual disability and autism spectrum disorder. TCF4 contains a C-terminal basic-helix-loop-helix (bHLH) DNA binding domain which recognizes the enhancer-box (E-box) element 5′-CANNTG-3′ (where N = any nucleotide). A subset of the TCF4-occupancy sites have the expanded consensus binding specificity 5′-C(A/G)-CANNTG-3′, with an added outer Cp(A/G) dinucleotide; for example in the promoter for CNIH3, a gene involved in opioid dependence. In mammalian genomes, particularly brain, the CpG and CpA dinucleotides can be methylated at the 5-position of cytosine (5mC), and then may undergo successive oxidations to the 5-hydroxymethyl (5hmC), 5-formyl (5fC), and 5-carboxyl (5caC) forms. We find that, in the context of 5′-0CG-1CA-2CG-3TG-3′(where the numbers indicate successive dinucleotides), modification of the central E-box 2CG has very little effect on TCF4 binding, E-box 1CA modification has a negative influence on binding, while modification of the flanking 0CG, particularly carboxylation, has a strong positive impact on TCF4 binding to DNA. Crystallization of TCF4 in complex with unmodified or 5caC-modified oligonucleotides revealed that the basic region of bHLH domain adopts multiple conformations, including an extended loop going through the DNA minor groove, or the N-terminal portion of a long helix binding in the DNA major groove. The different protein conformations enable arginine 576 (R576) to interact, respectively, with a thymine in the minor groove, a phosphate group of DNA backbone, or 5caC in the major groove. The Pitt-Hopkins syndrome mutations affect five arginine residues in the basic region, two of them (R569 and R576) involved in 5caC recognition. Our analyses indicate, and suggest a structural basis for, the preferential recognition of 5caC by a transcription factor centrally important in brain development.
Geneshot: search engine for ranking genes from arbitrary text queries
Authors: Lachmann Alexander , Schilder Brian M , Wojciechowicz Megan L , Torre Denis , Kuleshov Maxim V , Keenan Alexandra B , Ma’ayan Avi
Published: May 2019

The frequency by which genes are studied correlates with the prior knowledge accumulated about them. This leads to an imbalance in research attention where some genes are highly investigated while others are ignored. Geneshot is a search engine developed to illuminate this gap and to promote attention to the under-studied genome. Through a simple web interface, Geneshot enables researchers to enter arbitrary search terms, to receive ranked lists of genes relevant to the search terms. Returned ranked gene lists contain genes that were previously published in association with the search terms, as well as genes predicted to be associated with the terms based on data integration from multiple sources. The search results are presented with interactive visualizations. To predict gene function, Geneshot utilizes gene–gene similarity matrices from processed RNA-seq data, or from gene–gene co-occurrence data obtained from multiple sources. In addition, Geneshot can be used to analyze the novelty of gene sets and augment gene sets with additional relevant genes. The Geneshot web-server and API are freely and openly available from https://amp.pharm.mssm.edu/geneshot.
HawkDock: a web server to predict and analyze the protein–protein complex based on computational docking and MM/GBSA
Authors: Weng Gaoqi , Wang Ercheng , Wang Zhe , Liu Hui , Zhu Feng , Li Dan , Hou Tingjun
Published: May 2019

Protein–protein interactions (PPIs) play an important role in the different functions of cells, but accurate prediction of the three-dimensional structures for PPIs is still a notoriously difficult task. In this study, HawkDock, a free and open accessed web server, was developed to predict and analyze the structures of PPIs. In the HawkDock server, the ATTRACT docking algorithm, the HawkRank scoring function developed in our group and the MM/GBSA free energy decomposition analysis were seamlessly integrated into a multi-functional platform. The structures of PPIs were predicted by combining the ATTRACT docking and the HawkRank re-scoring, and the key residues for PPIs were highlighted by the MM/GBSA free energy decomposition. The molecular visualization was supported by 3Dmol.js. For the structural modeling of PPIs, HawkDock could achieve a better performance than ZDOCK 3.0.2 in the benchmark testing. For the prediction of key residues, the important residues that play an essential role in PPIs could be identified in the top 10 residues for ∼81.4% predicted models and ∼95.4% crystal structures in the benchmark dataset. To sum up, the HawkDock server is a powerful tool to predict the binding structures and identify the key residues of PPIs. The HawkDock server is accessible free of charge at http://cadd.zju.edu.cn/hawkdock/.
Probiotics for paediatric functional abdominal pain disorders: A rapid review
Authors: Ding Fang Chao Linda , Karkhaneh Mohammad , Zorzela Liliane , Jou Hsing , Vohra Sunita
Published: May 2019

Background

Functional abdominal pain disorders (FAPD) are prevalent in the paediatric population, however, there is currently no consensus regarding best practices for treatment. The use of probiotics is becoming popular to treat FAPD. The goal of this rapid review is to synthesize the best evidence on the use of probiotics in children with FAPD.

Methods

Searches were conducted on five main databases. Randomized controlled trials (RCTs) of probiotic use in children (0 to 18 years) with FAPD were searched. Populations of interest were patients with functional abdominal pain (FAP), irritable bowel syndrome (IBS), and functional dyspepsia (FD), recruited based on Rome criteria. Outcomes of interest were changes in abdominal pain severity, frequency, and duration.

Findings

Eleven RCTs with 829 participants with the diagnosis of FAP (n=400), IBS (n=329), FD (n=45), and mixed population (n=55) were included. Of six studies of children with FAP, two (n=103) used Lactobacillus rhamnosus GG (LGG) and reported no significant effects on pain, and four (n=281) used Lactobacillus (L) reuteri DSM 17938, of which three (n=229) reported significant positive effects on either severity or frequency of pain. Of six trials of children with IBS, four (n=219) used LGG, of which three (n=168) reported a positive effect. One (n=48) used bifidobacteria and one used VSL #3 (n=59), both demonstrating positive effects with probiotics. Two studies of FD reported no benefit. No adverse events were attributed to probiotics.

Conclusions

There is preliminary evidence for use of probiotics, particularly LGG, in reducing abdominal pain in children with IBS. There are inconsistent positive effects of other probiotics, including L. reuteri DSM 17938, in reducing pain in patients with FAP, IBS, or FD. More RCTs with rigorous methodology using single or combination probiotics are warranted.
Networks of Networks? Toward an External Perspective on Whole Networks
Authors: Nowell Branda , Hano Mary Clare , Yang Zheng
Published: May 2019

In light of the burgeoning literature in whole, goal-directed networks for managing wicked problems in public management, it is timely to examine the theoretical evolution that has both shaped and constrained our understanding of these networks. In this article, we argue that contemporary study of whole networks has been dominated by an internal theoretical lens aimed at understanding how internal characteristics influence network functioning and effectiveness. This perspective assumes networks operate in differentiated environments rather than emphasizing interdependence as part of a broader ecology—networks of networks. In this article, we draw from population ecology to introduce the concept of network domains and offer evidence drawn from a population of 60 health-oriented networks in three counties to illustrate domain level characteristics. Using an inductive mode of theorizing, we leverage insights from these domains to consider population dynamics and pose propositions for advancing a program of study into domain level characteristics that may shape and constrain whole networks and their members.
Factors related to condomless anal intercourse between men who have sex with men: results from a European bio-behavioural survey
Authors: Sherriff N S , Jones A M , Mirandola M , Gios L , Marcus U , Llewellyn C , Rosinska M , Folch C , Dias S , Toskin I , Alexiev I , Kühlmann-Berenzon S ,   Sialon II Network, Mirandola Massimo , Nöstlinger Christiana , Alexiev Ivailo , Marcus Ulrich , Suligoi Barbara , Caplinskas Saulius , Rosińska Magdalena , Dias Sónia Ferreira , Rafila Alexandru , Staneková Danica , Klavs Irena , Folch Cinta , Velicko Inga , Toskin Igor , Sherriff Nigel
Published: May 2019

Background

Relationship status is an important factor associated with condomless anal intercourse (CAI) amongst men who have sex with men (MSM).

Methods

A multi-centre bio-behavioural survey with MSM was conducted in 13 European cities (n = 4901) exploring factors associated with CAI via bivariate and multivariate multilevel logistic regression analyses.

Results

Likelihood of CAI with casual partners was associated with being ‘out’ to a majority (AOR = 1.19;95% CI 1,1.42); knowing their HIV status (AOR = 1.86; 95% CI 1.25,2.76); using substances (1–2 AOR = 1.39; 95% CI 1.16,1.63, 2+ AOR = 1.81; 95% CI 1.35,2.42); being older (AOR = 0.98; 95% CI 0.97,0.99); successful sero-communication (AOR = 0.79; 95% CI 0.67,0.94); and, not having a recent HIV test (AOR = 0.78; 95% CI 0.66,0.92). CAI with steady partners was associated with successful sero-communication (AOR = 2.72; 95% CI 2.72,3.66); not having a recent HIV test (AOR = 1.26; 95% CI 1.09,1.46), and; being older (AOR = 0.99; 95% CI 0.98,0.99).

Conclusions

Understandings of partner type and/or relationship status in relation to CAI amongst MSM can potentially play an important role in the development of culturally appropriate HIV/STI prevention and risk-reduction efforts targeting at-risk MSM. Our results speak to the need to consider segmented and tailored public health and health promotion initiatives for MSM with differing CAI behaviours and relationship profiles.
In the name of competitiveness: a discursive institutionalist analysis of the EU’s approach to labour market structural reform, 2007–2016
Authors: Miró Joan
Published: May 2019

This article explores the evolving interplay between different discourses on competitiveness, on the one hand, and different approaches to labour market reform on the other, all in the context of the European Union policymaking during the last decade (2007–2016). It asks how the idea of competitiveness has been used in EU policymaking in order to legitimize reforms in labour markets. Theoretically, the article builds on the discursive turn in institutional research. Methodologically, it applies a clause-based semantic text analysis of the Council’s country-specific recommendations on labour market policy issued to a selection of 10 Eurozone Member States. By developing this temporal comparative analysis, the article seeks to trace the potential impact of the euro crisis on the uses of the idea of competitiveness in labour market policy. The resulting analysis sheds light on the institutionally embedded perception of international competitiveness that prioritizes the cost-based (rather than quality-based) elements of the notion.
Pulmonary hypertension and right ventricular function in Nigerian children with sickle cell anaemia
Authors: Peter Igoche D , Asani Mustafa O , Abdullahi Shehu U , Aliyu Ibrahim , Obaro Stephen K , Bode-Thomas Fidelia
Published: May 2019

Background

Pulmonary hypertension (PH), a complication of sickle cell anaemia (SCA), results in considerable morbidity. This study aims to determine the prevalence and associations of echocardiography-suggested PH in children with SCA.

Methods

We performed a cross-sectional comparative study involving 100 systematically sampled SCA subjects 3–14 y of age in their steady state with matched haemoglobin AA phenotype controls. Clinical, laboratory and echocardiography data (including tricuspid regurgitation velocity [TRV], mean pulmonary arterial pressure [mPAP] and tricuspid annular plane systolic excursion [TAPSE]) were obtained from all patients. Statistical analyses were performed using SPSS version 22 (IBM, Armonk, NY, USA). A p-value <0.05 was considered statistically significant.

Results

Of the 100 SCA subjects studied, 22 (22%) had echocardiographic findings suggestive of PH compared with none in the controls. The median TAPSE was significantly lower in the PH group (2.55 cm [interquartile range {IQR} 2.2–2.8]) compared with the no PH group (2.77 cm [IQR 2.4–3.2]) (p=0.03). No significant correlation existed between mPAP and age, nor any laboratory parameters studied. The odds ratio (OR) suggested PH significantly increased with an increase in the frequency of hospitalizations for vaso-occlusive crises within a 12-month period (OR 15.15 [95% CI 1.57 to 146.35], p=0.02) and a lifetime history of blood transfusion (OR 5.44 [95% CI 1.09 to 27.24], p=0.04).

Conclusions

Echocardiography-suggested PH is common in children with SCA and is associated with poorer right ventricular function, frequent vaso-occlusive crises and blood transfusions.
Prevalence of ‘Candidatus Liberibacter solanacearum’ Haplotypes in Potato Tubers and Psyllid Vectors in Idaho From 2012 to 2018
Authors: Dahan Jennifer , Wenninger Erik J. , Thompson Brandon D. , Eid Sahar , Olsen Nora , Karasev Alexander V.
Published: May 2019

‘Candidatus Liberibacter solanacearum’ (Lso) is an uncultured, phloem-associated bacterium causing a severe tuber disease in potato called zebra chip (ZC). Seven haplotypes of Lso have been described in different hosts, with haplotypes A and B found associated with infections in potato and tomato. In the field, Lso is transmitted by the potato psyllid (Bactericera cockerelli), and between 2011 and 2015, a significant change in Lso haplotype prevalence was previously reported in Idaho: from exclusively A haplotype found in tested psyllids in 2012 to mainly B haplotype found in collected psyllids in 2015. However, prevalence of Lso haplotypes in Idaho was not analyzed in potato tubers exhibiting symptoms of ZC. To fill in this knowledge gap, prevalence of Lso haplotypes was investigated in potato tubers harvested in southern Idaho between 2012 and 2018, and it was found to change from exclusively A haplotype in the 2012 season to an almost equal A and B haplotype distribution during the 2016 season. During the same period, haplotype distribution of Lso in psyllid vectors collected using yellow sticky traps also changed, but in psyllids, the shift from A haplotype of Lso to B haplotype was complete, with no A haplotype detected in 2016 to 2018. The changes in the haplotype prevalence of the Lso circulating in potato fields in southern Idaho may be, among other factors, responsible for a decrease in the ZC incidence in Idaho potato fields between an outbreak of the disease in 2012 and a very low level of ZC afterward.
Evaluation and current treatments for urinary incontinence
Authors: Hooper Gwendolyn L.
Published: May 2019

Although aging and urinary incontinence are often associated, urinary incontinence is not a normal part of aging. As the population ages, the challenge of urinary incontinence will place a greater demand on the healthcare system. NPs can effectively direct treatments to mitigate the symptoms of urinary incontinence, improving patient quality of life.
On-site Observational Learning in Faculty Development: Impact of an International Program on Clinical Teaching in Medicine
Authors: Saiki Takuya , Imafuku Rintaro , Pickering Joyce , Suzuki Yasuyuki , Steinert Yvonne
Published: May 2019

Introduction:

Local faculty development programs may not suffice for physicians to learn about global standards in clinical teaching. This report describes the evaluation of a 1-week international faculty development program in Canada, incorporating on-site observations of clinical teaching with guided reflection, for Japanese clinical teachers. Participants' perceptions of learning processes and outcomes are described.

Methods:

Twenty-nine Japanese clinical teachers from 9 different teaching hospitals located in the Gifu province participated in this program from 2014 to 2017. The program evaluation consisted of end-of-program reflection reports and semistructured interviews conducted 3 months after the visit, which were thematically analyzed.

Results:

Three themes related to learning processes emerged: the benefits of observing clinical teaching in a familiar specialty but unfamiliar context; the value of reflection in linking previous experiences with observations; and the role of group interaction and verbalization in creating a sense of community. Three additional themes related to learning outcomes emerged: enhanced knowledge about teaching, with a renewed emphasis on the value of learner respect and trust; increased confidence in teaching competence; and a sense of frustration related to difficulty in changing the status quo.

Discussion:

An international faculty development program incorporating on-site observational learning in hospital settings with guided reflections can be effective in learning about clinical teaching; follow-up activities in the home country are also recommended. The key elements of this program, including international experiences, on-site observational learning, and guided reflections, should be considered more frequently in faculty development programs in medicine.
Application of Health Psychology: Development of a Practitioner Training Intervention in Anaphylaxis
Authors: Walklet Elaine , Mahoney Béré , Bradley Eleanor , O'Hickey Steve
Published: May 2019

Adrenaline autoinjectors (AAIs) improve outcomes and reduce fatalities in patients with anaphylaxis, but many patients neither carry them nor know how to use them. Practitioner training in evidence-based strategies designed to increase patient adherence could improve the likelihood of AAI adherence and increase confidence among practitioners to initiate discussions about practical and perceptual barriers to AAI adherence. This article reports the development of a new practitioner training intervention, grounded in health psychology theory and evidence designed for practitioners in contact with patients with anaphylaxis to encourage adherence to AAIs. Potential implications for the design, implementation, and evaluation of future practitioner training in strategies they can use to encourage anaphylaxis patients' AAI adherence are discussed. Although designed for those working with anaphylaxis patients, this step-by-step process to encouraging adherence could be adapted for practitioners working with patients living with other long-term conditions.
Minority Physician Assistant Faculty: A Phenomenological Assessment of Factors Leading to Retention in the Faculty Role
Authors: LeLacheur Susan F. , Bester Vanessa , Oxendine Lisa Huggins , Guidry Carolyn Bradley , Ryujin Darin , Samuels Kenya , Maldonado Ana , Bowen Denise , Himmerick Kristine
Published: May 2019

Improving racial and ethnic diversity in the physician assistant (PA) profession is important to providing better care for underserved communities. The recruitment and retention of minority PA faculty is one aspect of helping to attract and retain a more diverse student body. Previous research has indicated that minority status is associated with the increased attrition of PA faculty but has not provided insight into the specific factors involved in the retention or attrition of minority PA faculty. The purpose of this qualitative research study was to describe the experience of minority PA faculty through a critical race theory lens. We used a phenomenological approach using structured interviews of minority PA faculty. Better understanding of the experience of minority PA faculty might lead to improved efforts at recruiting and supporting a more diverse faculty workforce. We conducted 13 interviews of PA faculty representing a variety of underrepresented minorities, geographic regions, types of schools, and stages of their careers. Major themes that emerged across the participants' experiences included opportunities for success in the form of both internal and external support systems and mentorship. As a corollary, barriers to the retention of minority PA faculty including a lack of institutional support, gaps in mentorship, and lack of a solid support network were cited.
The Illness Experiences of Chinese Patients Living With Lymphoma
Authors: Ruan Jiayin , Qian Ying , Zhuang Yiyu , Zhou Yunxian
Published: May 2019

Background

Lymphoma patients encounter many problems. Studies investigating the illness experiences of Chinese patients with lymphoma are limited.

Objective

The objectives of this study were to explore the illness experiences of lymphoma patients in China and describe the impacts of this disease on the everyday lives of these individuals.

Methods

A descriptive qualitative design was used. The data were collected through face-to-face semistructured interviews and analyzed using the conventional content analysis method.

Results

Nine men and 7 women participated in this study. The following 6 themes emerged: (1) cancer diagnosis reactions, (2) self-image altered, (3) interpersonal relationships influenced, (4) career development hindered, (5) life philosophy changed, and (6) personal growth achieved.

Conclusions

This study contributes new knowledge to the understanding of the illness experiences of lymphoma patients within the Chinese social and cultural context. This study also reveals how these individuals cope with the complex problems they face.

Implications for Practice

Nurses could help Chinese patients with lymphoma accept the disease and its treatments by emphasizing the importance of family integrity. Information, such as how to act in response to workplace discrimination, should be provided to patients by oncology nurses.
Incongruence Between Implicit Attachment Schemes and Unconscious Attachment Representations
Authors: Petrowski Katja , Schurig Susan , Kirchmann Helmut , Singh Sashi , Banse Rainer , Imhoff Roland , Strauss Bernhard
Published: May 2019

Assessments based on reaction time and language-based interviews postulate that unconscious attachment processes be measured. Nevertheless, a possible empirical equivalence of these two approaches has not yet been investigated. To fill this void, the Adult Attachment Interview and the Implicit Association Test were implemented with a group of patients with panic disorder (n = 157, mean age = 29, SD = 2.47) based on the Structured Clinical Interview for DSM-IV, axis I and II disorders and a group of healthy individuals (n = 138). In total, the securely attached individuals showed significantly more positive attitudes toward their mother than the insecurely attached individuals. In the healthy individuals, the secure and disorganized classifications showed significantly more positive attitudes toward the mother in comparison with the insecure attachment classification, as well as the patient group. In summary, implicit attachment patterns based on reaction times are not equivalent to an attachment representation based on language markers. For the disorganized attachment representation, no differences were present between the information processing of the memory/association network and the autobiographic memory function.
Frequency of and Factors Associated With Prescription Medication Sharing Within Families
Authors: Renny Madeline H. , Thaker Riddhi H. , Dayan Peter S.
Published: May 2019

Objectives

Limited literature has investigated caregiver sharing of prescription medications with children. Our primary aim was to determine the frequency of and factors associated with prescription medication sharing within families. Our secondary aim was to determine the source and type of medications shared.

Methods

We conducted a survey of a convenience sample of caregivers of children 1 to 17 years in a pediatric emergency department. The survey was developed through literature review, iterative feedback, and pilot testing on caregivers. We used logistic regression to identify factors associated with any history of medication sharing with a child in the home (primary outcome).

Results

We enrolled 550 primary caregivers; 68 of the 535 analyzed (12.7%; 95% confidence interval [CI], 10.0–15.8) reported prescription medication sharing with their child/children. Of those who shared, 50 (73.5%) shared asthma medications and 14 (20.6%) shared antibiotics. Of the caregivers who shared prescription medications, 70.6% shared a medication for one child with another child, whereas 33.8% of caregivers shared their own or another adult's medication with their child. A child in the home with asthma (adjusted odds ratio [aOR], 3.35; CI, 1.82–6.17), a greater number of children in the household (aOR, 1.29; CI, 1.04–1.60), and a caregiver who previously shared medications with other family members and/or friends (aOR, 4.10; CI, 1.84–9.15) were factors independently associated with medication sharing.

Conclusions

Prescription medication sharing within families is common and most often involves asthma medications. We identified several factors associated with prescription medication sharing that could be used to target caregivers for preventative interventions.
Current Approach to the Evaluation and Management of Hair-Thread Tourniquets
Authors: Gottlieb Michael , Holladay Dallas , Spearman Daniel
Published: May 2019

Hair-thread tourniquet syndrome is a rare, painful condition that occurs when a strand of hair or thread becomes wrapped around toes, fingers, or other appendages. This causes focal edema, which eventually reduces arterial blood flow and can lead to ischemia and necrosis. A thorough physical examination and assessment of risk factors are important. Treatment involves depilatory agents or targeted incision at the bedside or in the operating room. Successfully treated cases can be discharged with local wound care. Parents should be advised on prevention strategies and ensure close follow-up for reexamination.
Western Trauma Association critical decisions in trauma: Preferred triage and initial management of the burned patient
Authors: Vercruysse Gary A. , Alam Hasan B. , Martin Matthew J. , Brasel Karen , Moore Eugene E. , Brown Carlos V. , Bettencourt Amanda , Schulz John , Palmieri Tina , Haith Linwood , Inaba Kenji
Published: May 2019

This is a recommended management algorithm from the Western Trauma Association addressing the management of victims of burn injury. Because there is a paucity of published prospective randomized clinical trials that have generated Class I data, these recommendations are based primarily on published retrospective studies, clinical guidelines, and the expert opinion of members of the Western Trauma Association in conjunction with partner members of the American Burn Association. The algorithm and accompanying comments represent one safe and sensible approach that can be followed at most trauma centers. We recognize that there may be patient or institutional factors that warrant deviation from the published algorithm. We would encourage institutions to use this document as a starting point toward a dialog with local burn centers to collaboratively create a patient-centered care experience for the victims of minor burn injuries arriving at local trauma centers.
Gap initiation with 20.35 mm: an initiator integrating the Al/CuO
x
multilayer film and traditional electronic plug to enhance the ignition ability
Authors: Ni Debin , Yu Guoqiang , Shi Shengnan , Xu Dong , Chu Enyi , Yu Chunpei , Zhen Zilong , Zhang Wenchao
Published: May 2019

In order to enhance the ignition ability and reliability of traditional electronic initiators, a novel electronic initiator has been designed to integrate with a nanothermite multilayer film and an electrode plug. The Al/CuO
x
nanothermite multilayer film with different thickness is deposited on the surface of the electrode plug by magnetron sputtering which uses Pt–W wire as electronic resistance. The exothermicity of Al/CuO
x
nanothermite multilayer film is so favourable that the ignition ability of electronic initiator is significantly improved. The full firing-voltage sensitivity of the electronic initiator is 10.8 V. The thickness of Al/CuO
x
multilayer film has negligible effects on the ignition time and ignition energy, but leads to great impacts on the function time, the maximum length of combustion flame and ignition ability. The electrical ignition experiments have exhibited outstanding ignition ability, since the electronic initiator can easily fire the insensitive ignition composition of boron-potassium nitrate (B-KNO
3
) tablet in a gap of 20.35 mm. It proves that this novel proposal of remoulding the traditional electronic ignition devices will distinctly improve the ignition ability and reliability of electronic initiator.
Acherontiscus caledoniae
: the earliest heterodont and durophagous tetrapod
Authors: Clack Jennifer A. , Ruta Marcello , Milner Andrew R. , Marshall John E. A. , Smithson Timothy R. , Smithson Keturah Z.
Published: May 2019

The enigmatic tetrapod
Acherontiscus caledoniae
from the Pendleian stage of the Early Carboniferous shows heterodontous and durophagous teeth, representing the earliest known examples of significant adaptations in tetrapod dental morphology. Tetrapods of the Late Devonian and Early Carboniferous (Mississippian), now known in some depth, are generally conservative in their dentition and body morphologies. Their teeth are simple and uniform, being cone-like and sometimes recurved at the tip. Modifications such as keels occur for the first time in Early Carboniferous Tournaisian tetrapods.
Acherontiscus
, dated as from the Pendleian stage, is notable for being very small with a skull length of about 15 mm, having an elongate vertebral column and being limbless. Cladistic analysis places it close to the Early Carboniferous adelospondyls, aïstopods and colosteids and supports the hypothesis of ‘lepospondyl’ polyphyly. Heterodonty is associated with a varied diet in tetrapods, while durophagy suggests a diet that includes hard tissue such as chitin or shells. The mid-Carboniferous saw a significant increase in morphological innovation among tetrapods, with an expanded diversity of body forms, skull shapes and dentitions appearing for the first time.
Rate dynamics of ectotherm responses to thermal stress
Authors: Kovacevic Aleksandra , Latombe Guillaume , Chown Steven L.
Published: May 2019

Critical thermal limits (CTLs) show much variation associated with the experimental rate of temperature change used in their estimation. Understanding the full range of variation in rate effects on CTLs and their underlying basis is thus essential if methodological noise is not to overwhelm or bias the ecological signal. We consider the effects of rate variation from multiple intraspecific assessments and provide a comprehensive empirical analysis of the rate effects on both the critical thermal maximum (CT
max
) and critical thermal minimum (CT
min
) for 47 species of ectotherms, exploring which of the available theoretical models best explains this variation. We find substantial interspecific variation in rate effects, which takes four different forms (increase, decline, no change, mixed), with phylogenetic signal in effects on CT
max
, but not CT
min
. Exponential and zero exponential failure rate models best explain the rate effects on CT
max
. The majority of the empirical rate variation in CT
min
could not be explained by the failure rate models. Our work demonstrates that rate effects cannot be ignored in comparative analyses, and suggests that incorporation of the failure rate models into such analyses is a useful further avenue for exploration of the fundamental basis and implications of such variation.