bluuebunny/crossref_metadata_2025 huggingface dataset:
Novel 3D‐printing technique for caps to enable tailored therapeutic endoscopy
Authors: Ko Weon Jin , Song Ga Won , Hong Sung Pyo , Kwon Chang‐il , Hahm Ki Baik , Cho Joo Young
Published: September 2015

Background and Aim

To evaluate the feasibility of a tailored endoscopic cap created using 3D‐printing technology that is customized according to esophagogastric lesions of each patient.

Methods

Tailored endoscopic caps, which were designed and fabricated with a 3D printer, were inserted in 35 patients. The types of cap were side‐hole cap made for cap‐assisted endoscopic mucosal resection (EMRC), oblique‐head cap designed for endoscopic submucosal dissection (ESD), wide‐head cap used for Trucut biopsy (TCB), and narrow‐tip cap to facilitate peroral endoscopic myotomy (POEM).

Results

EMRC in the esophagus and gastroesophageal junction was carried out using a side‐hole cap in seven patients. Median total procedure time for successful removal of lesions was 14 min (range 8–50 min). Gastric ESD was carried out using with an oblique‐head cap in 16 patients, for which the median total procedure time was 53 min. TCB in the esophagus was done using a wide‐head cap in eight patients. While carrying out POEM for tunneling, a narrow‐tip cap was used in four patients with achalasia.

Conclusion

Based on the current proof‐of‐concept study, we anticipate that creating a tailored endoscopic cap is feasible for therapeutic endoscopy.
The Challenges of Research Informed Consent in Socio‐Economically Vulnerable Populations: A Viewpoint From the Democratic Republic of Congo
Authors: Kalabuanga Marion , Ravinetto Raffaella , Maketa Vivi , Muhindo Mavoko Hypolite , Fungula Blaise , Inocêncio da Luz Raquel , Van Geertruyden Jean‐Pierre , Lutumba Pascal
Published: September 2015

In medical research, the ethical principle of respect for persons is operationalized into the process of informed consent. The consent tools should be contextualized and adapted to the different socio‐cultural environment, especially when research crosses the traditional boundaries and reaches poor communities. We look at the challenges experienced in the malaria Quinact trial, conducted in the Democratic Republic of Congo, and describe some lessons learned, related to the definition of acceptable representative, the role of independent witness and the impact of socio‐economic vulnerability.

To ensure children's protection, consent is required by the parents or, in their absence, by a legally mandated representative. In our setting, children's responsibility is often entrusted permanently or temporarily to relatives or friends without a tribunal mandate. Hence, a notion of ‘culturally acceptable representative’ under supervision of the local Ethics Committee may be more suitable.

To ensure protection of illiterate subjects, an independent witness is required to confirm that the consent was freely given. However, in low‐literacy contexts, potential witnesses often don't have any previous relationship with patient and there may be power‐unbalance in their relationship, rather than genuine dialogue.

In poor communities, trial participation may be seen as an opportunity to secure access to healthcare. Poverty may also lead to ‘competition’ to access the research‐related benefits, with a risk of disturbance at societal or household level.

Adjusting consent procedures to sociocultural and socioeconomic realities is essential for fulfilling the underlying ethical principles. This requires a collaborative dialogue between researchers, regulators and ethics committees.
Effects of microclimate on soil bacterial communities across two contrasting timberline ecotones in southeast Tibet
Authors: Yuan Y. L. , Si G. C. , Wang J. , Han C. H. , Zhang G. X.
Published: September 2015

The Sergyemla Mountains have unique timberline patterns. Abies georgei var. smithii (Viguie & Gaussen) and Juniperus saltuaria (Rehder & E. H. Wilson) dominate the north‐facing and south‐facing slopes of a U‐shaped valley, respectively. Although these two timberlines represent the world's highest natural tree lines, little is known about the structure of their soil bacterial communities and the factors that control them. To characterize and compare the soil bacterial communities of two timberline ecotones with different spatial orientations, we investigated their structures by terminal restriction fragment length polymorphism analysis and sequencing methods. We found that the structures of the soil bacterial communities differed significantly between the two opposite slopes, and the difference between the bacterial communities correlated primarily with soil carbon:nitrogen ratios. This probably relates to differences in the microclimate (mean soil temperature) between the two aspects in the world's highest timberline ecotones. In addition, the structures of soil bacterial communities also differed significantly with soil depth, and total nitrogen content had the greatest effect on the bacterial communities. In this region, soil temperature rather than mean annual precipitation has a major effect on the structures of soil bacterial communities. Microclimate differences (mainly differences in soil temperature) between the two opposite slopes might indicate that an amplitude increase of 2°C in soil temperature could change the structures of soil bacterial communities by changing the status of soil carbon and nitrogen in these timberline ecotones.
Launching a Research Career: T‐15 Years and Counting
Authors: Nielsen Robert B.
Published: September 2015

This invited reflection paper offers suggestions for early career researchers—both graduate students and new assistant professors—that are grounded in my own experiences during my quest to launch a research career. Topics include developing both topical and methodological expertise, identifying informal and formal mentors who have experience leading others toward research‐based careers, cultivating a network of colleagues capable of offering insights for improving one's research, and managing other responsibilities in ways that do not supplant productive research activities. Recommendations for graduate students and new assistant professors are offered throughout.
The Ship in Geography and the Geographies of Ships
Authors: Hasty William , Peters Kimberley
Published: September 2015

Although interest in the maritime world has been growing steadily within human geography over the past decade, the ship remains a largely neglected figure in its own right. In spite of facilitating the emergence of modern geographical study and being bound intricately to the movement of ideas, goods and people around the globe, past and present, the ship is an elusive, often invisible, and largely forgotten space. In this paper we seek to move the ship from the margins to the centre of geographical research. To do so, we firstly explore the potential of the ship for making geographical knowledge and as a means of understanding the world. We then go on to review studies from within the discipline and also from further afield which employ the ship as a vehicle for knowing and understanding colonialism, commerce, trade and conflict; embodied and resistant performances, and residual materiality, demonstrating the place of the ship in geography. We then contend that the ship could have a greater role in the discipline if it were not only utilised to make empirical and theoretical inroads in relation to broader geographic themes, but if it were the focus of study itself. Here we argue that geographies of ships would allow scholars the opportunity to reframe the history of the discipline, whilst also raising new questions and lines of enquiry relating to mobilities and more‐than‐human geographies, enriching wider academic projects beyond the discipline through employing the ship as a vehicle for novel empirical examinations.
Public Spaces / Public Spheres: Some Geographies of Space and Democracy
Authors: Miles Malcolm
Published: September 2015

In this short paper I question the validity of aligning new public spaces with the idea of a public sphere of democratic determination. I suggest that the current emphasis on public spaces in urban development schemes is nostalgic, repeats the ungrounded advocacy associated with culturally‐led urban redevelopment, and masks a widening democratic deficit. Looking to geographical writing on space as a realm of boundaries and exclusions, I ask whether insights from this can be applied to the problem of what constitutes a democratic public sphere (if one exists). I conclude that occupations of urban spaces constitute a proto‐public sphere but are necessarily ephemeral.
Refugees and the City: An Urban Discussion
Authors: Sanyal Romola
Published: September 2015

There has been resurgence in interest in both popular media and academic research on refugees as subjects of incarceration in camps and as a growing population in cities. While the urbanization of refugees is not new, it has become a growing concern for policy‐makers, aid agencies and scholars as the numbers of refugees moving to cities have accelerated. There has been debate over the urbanity of camps due to protracted refugee crises and increasingly, there is recognition that despite the efforts of host governments, self‐ settlement of refugees is taking place in cities. The two issues therefore make the city an important framework to interrogate the spaces of refugees. This paper attempts to show the complexity of refugee politics and socializing in camps and in cities by showing a variety of refugee spaces and practices in different parts of the world and using urban debates‐particularly urban informality to draw links between refugee spaces and cities. The aim is to debunk universalizing myths about refugees and refugee camps as subjects and spaces of bare life and bio‐politics alone. Instead it draws parallels between the urban poor and refugees to offer a perspective on the close and complex relationship cities, refugee spaces and their residents have with each other.
Mycotoxins in farm silages – a 2‐year Irish national survey
Authors: McElhinney C. , Danaher M. , Elliott C. T. , O'Kiely P.
Published: September 2015

Toxicogenic fungal moulds have been previously identified in Irish farm silages and are known to be capable of producing mycotoxins. Mycotoxins are detrimental to animal health and performance and can be transferred through feed to animal produce. The objectives of this study were to identify and quantify the challenge posed to livestock from mycotoxins in Irish silages and determine whether conventional chemical characteristics could be used as indicators of mycotoxin occurrence. Over the 2‐year period, 300 silages were sampled on 150 farms and these consisted of round‐baled grass silages (n = 115) and pit silages of either grass (n = 175) or maize (n = 10). There was no significant difference in mycotoxin concentrations across silage types in either year, except for baled silage containing higher concentrations of enniatin B compared with pit silage in Year 1. Conventional chemical characteristics of silages were generally not reliable predictors for mycotoxin incidences; however, dry‐matter digestibility, crude protein, fermentation products and ash did predict the incidence of enniatins and beauvericin. The incidence and concentration of the twenty measured mycotoxins were generally low and individual mycotoxin concentrations recorded were considerably lower than current EU directive or guidance thresholds. Non‐regulated mycotoxins measured were similar to or lower than concentrations reported in the literature. Based on current knowledge and the concentrations of individual mycotoxins detected in this study, the challenge to Irish livestock and livestock products from animal consuming silage is generally low. However, the additive or synergistic effects of multiple mycotoxins in silage are unknown.
Training reduced subjectivity of comparative yield method of estimation of grassland biomass
Authors: Balehegn M. , Berhe K.
Published: September 2015

Measuring grassland biomass using objective, quick and accurate methods is important for practical purposes in agriculture and ecology. Most existing techniques are either expensive or require advanced technical skills making them unaffordable and impractical for farmers in developing countries. The comparative yield method is a quick technique that involves the estimation of grassland biomass from visual scores. Despite its potential for use by farmers with minimal technical skills, it has been criticized for being subjective, thus limiting its use for research purposes only. We hypothesized that training and establishment of agreed‐upon ground rules can reduce this subjectivity. We compared data collected by 36 farmers in northern Ethiopia, who participated under three instruction groups. Group 1 was involved both in the selection of reference plots and calibration plots and agreed‐on ground rules. Group 2 was shown the reference plots and orientated about the ground rules. Group 3 was neither shown reference plots nor orientated on ground rules. Levene's test for equality of variance was performed among the estimations made by individuals. Mean values of scores and biomass measurements varied among groups. The variability of records was higher in groups 3 and 2 than in group 1, indicating the need for training and agreed‐upon ground rules to achieve objectivity. We conclude that with minimal training and agreement on ground rules, the comparative yield method can be used by farmers and ecologists in developing countries to estimate grassland biomass with better precision and accuracy.
Factors Influencing Migraine Recurrence After Infusion and Inpatient Migraine Treatment in Children and Adolescents
Authors: Cobb‐Pitstick Katherine M. , Hershey Andrew D. , O'Brien Hope L. , Kabbouche Marielle A. , LeCates Susan , White Shannon , Vaughn Polly , Manning Paula , Segers Ann , Bush Judith , Horn Paul S. , Kacperski Joanne
Published: September 2015

Objective

To evaluate factors that influence migraine recurrence after outpatient infusion or inpatient treatment for intractable migraine.

Background

Recurrence of migraine after acute treatment in an infusion center or an inpatient setting is not well documented in children and adolescents. Given the multifactorial pathogenesis of migraines, multiple factors may influence migraine recurrence. It has been reported that treatment with steroids may reduce the risk of migraine recurrence. The efficacy of steroids as a therapeutic adjunct has not been established. Studies in the adult population have yielded conflicting results.

Methods

This study is a retrospective chart review of patients presenting for treatment of an intractable migraine to the outpatient infusion unit or inpatient unit at Cincinnati Children's Hospital Medical Center (CCHMC). Data collected included: age, gender, location of treatment (outpatient, inpatient), migraine duration, diagnosis, severity, the addition of steroids to treatment protocols, and recurrence of migraine at 48 and 72 hours after discharge. Data were analyzed using Fisher's exact tests, logistic regression with backward elimination for variable selection, and least squares means slicing with associated odds ratios.

Results

Charts from 207 pediatric patients were analyzed. Using logistic regression analysis: location, gender, diagnosis, and age were all found to be significant predictors of migraine recurrence (P < .05). Patients treated in the inpatient setting were significantly less likely to experience recurrence compared to patients treated in an outpatient infusion unit (OR = 0.32; 95% CI 0.17‐0.61, P = .0002). Male patients with a diagnosis of episodic migraine were significantly less likely to experience recurrence than male patients with chronic migraine (OR 0.17; 95% CI 0.04‐0.73; P = .0074). The inclusion of steroids in this study population showed no significant reduction in migraine recurrence. The probability of recurrence decreased with age for episodic migraine patients, while the probability increased with age for chronic migraine patients.

Conclusions

Recurrence is an important consideration when treating intractable migraines. Age, gender, diagnosis, and location of treatment correlate with migraine recurrence, but the inclusion of steroids does not. Considering these factors in the management of migraines may improve the outcome of these patients and reduce the risk of recurrence.
Value of the “Test & Treat” Strategy for Uninvestigated Dyspepsia at Low Prevalence Rates of Helicobacter pylori in the Population
Authors: Agréus Lars , Talley Nicholas J. , Jones Michael
Published: September 2015

Background and Aim

In populations with a low prevalence rate of Helicobacter pylori (H. pylori) infection from Western countries, guidelines for the management of uninvestigated dyspepsia generally recommend that the “test and treat” strategy should be avoided in favor of empiric proton‐pump inhibitor therapy in younger patients (on average < 50 years of age) without alarm symptoms and signs. The prevalence of H. pylori infection has fallen from about 30% to about 10% in Sweden and other countries. We aimed to explore whether the rationale for test and treat is relevant in contemporary clinical practice.

Materials and Methods

In settings with an infection rate in the adult population of 30% and 10%, we modeled the positive and negative predictive values for indirect (nonendoscopy) tests on current H. pylori infection with a presumed sensitivity and specificity of 95%. We then calculated the difference in false‐negative and false‐positive test outcome, and eradication prescription rates in the two scenarios.

Results

While the positive predictive value for the test decreased from 0.89 to 0.68 when the prevalence of H. pylori fell from 30% to 10%, there were only 1% more false‐negative tests and 1% less false‐positive tests. The eradication prescription rate would decrease by 18% with a 10% prevalence rate.

Conclusion

The recommendation to stop applying “test and treat” at lower prevalence rates of H. pylori should be reconsidered. The test and treat strategy is the preferred approach for most patients who present with dyspepsia.
Clinical information needs and access in primary health care: a comparative cross‐sectional study of rural and non‐rural primary care physicians
Authors: Naeem Salman Bin , Bhatti Rubina
Published: September 2015

Background

Primary care physicians (PCPs) need a wide range of clinical information (CI) resources to manage their patients. Continued access to these resources in their practice settings provides self‐reliance and a better approach towards clinical decision making.

Objective

To compare the PCPs CI needs and access to CI in rural versus non‐rural practice setting.

Methods

A comparative cross‐sectional survey was conducted in the Government health centres of the District of Multan, Pakistan. PCPs were classified into rural and non‐rural according to their practice setting using the State Office of Rural Health definition. Rural means ‘more than 10 miles from a population centre of 30 000 or more’.

Results

The CI needs of rural and non‐rural PCPs were the same, but rural PCPs had significantly less access to nearly all CI resources when compared to non‐rural PCPs. Age was a major determining factor of perceived information needs for continuing medical education but not for accessing CI.

Discussion

Primary care physicians in rural settings face innumerable difficulties in accessing the required CI due to non‐existence of libraries and poor information infrastructure.

Conclusion

Despite no difference in information needs, rural PCPs have significantly less access to CI resources. The study suggests ways to address the inequality in provision of CI resources.
Microstructures and Properties of 3Y‐TZP/Ba0.5Sr0.5Fe12O19 Composites Prepared by Two Methods
Authors: Zhang Chao , Guo Ruisong , Wang Shanshan , Liu Zhichao , Guo Weina , Wu Chen , Cai Guanglan
Published: September 2015

Two composites of Ba0.5Sr0.5Fe12O19 grains dispersed in a 3 mol% yttria‐doped zirconia (3Y‐TZP) matrix are prepared by two methods. The mechanical and electromagnetic properties of the both composites are investigated. The maximum values of the bending strength and the fracture toughness are 786 MPa and 8.6 MPa m1/2, respectively. The maximum value of the magnetization is 17.2 emu/g. In addition, the distribution of the Ba0.5Sr0.5Fe12O19 phase is described using the box dimension of the fractal theory. The impedance spectra of the both composites are fitted using the equivalent circuit model with a constant phase element (CPE). The obtained p value of the CPE can indirectly reflect the morphology of the Ba0.5Sr0.5Fe12O19 phase in both composites according to the universal relaxation law.
Bone health management of Australian breast cancer survivors receiving hormonal therapy
Authors: Roberts R. , Miller M. , O'Callaghan M. , Koczwara B.
Published: September 2015

Breast cancer survivors are at risk of bone loss due to hormonal treatment. We conducted a case note audit to investigate patterns of care and adherence to guidelines for initial management of risk of bone loss in 42 women receiving hormonal therapy. All those receiving aromatase inhibitors (n = 14) and 10 on tamoxifen had a bone density assessment. Eleven (26%) women had osteopenia and four (9.5%) osteoporosis. Management was variable and not always aligned with the guidelines.
Function and expression of CD1d and invariant natural killer T‐cell receptor in the cotton rat (Sigmodon hispidus)
Authors: Fichtner Alina Suzann , Paletta Daniel , Starick Lisa , Schumann Richard F. , Niewiesk Stefan , Herrmann Thomas
Published: September 2015

The cotton rat (Sigmodon hispidus) belongs to the rodent family of Cricetidae and provides a powerful model to study the pathogenesis of human respiratory viruses and measles virus. Recent studies in other rodent models have suggested a role for invariant natural killer T (iNKT) cells in antiviral immunity and vaccination against respiratory virus infections. Using new experimental tools, we provide the first evidence for a functional CD1d cell molecule (crCD1d) and iNKT T‐cell receptor in cotton rats. The crCD1d cDNA sequence was identified and crCD1d transductants showed that monoclonal antibody WTH‐2 stains crCD1d as efficiently as mouse or rat CD1d. The expression of crCD1d was clearly weaker for thymocytes and B cells, and higher for T cells, which is different to what is found in murine species. The antigen‐presenting capacity of crCD1d was demonstrated with crCD1d–immunoglobulin dimers loaded with the glycolipid PBS57, which bound iNKT T‐cell receptors. Evidence for functional cotton rat iNKT cells was provided by detection of interferon‐γ and interleukin‐4 in cultures of splenocytes stimulated with PBS57 and α‐galactosylceramide and by specific staining of about 0·2% of splenocytes with PBS57‐loaded crCD1d dimers. Canonical AV14/AJ18 rearrangements were identified and found to contain multiple members of the AV14 (AV11) family. One of them was expressed and found to bind CD1d dimers. In summary, these data provide the first evidence for functional CD1d molecules and iNKT T‐cell receptors in cotton rats and provide the tools to analyse them both in the cotton rat model of infectious diseases.
Symptoms in patients with skin changes due to chronic venous insufficiency often lead to emergency care service: an Italian observational study
Authors: Ruggiero Michele , Grande Raffaele , Naso Agostino , Butrico Lucia , Rubino Paolo , Placida Girolamo Domenico , Cannistrà Marco , Serra Raffaele
Published: September 2015

Chronic venous insufficiency (CVI) is the most advanced form of chronic venous disease (CVD), and is often associated with skin changes such as hyperpigmentation, eczema, lipodermatosclerosis and venous skin ulceration that cause discomfort, pain, sleep disturbances, absenteeism in the workplace, disability and deteriorated quality of life (QoL). The purpose of this study is to evaluate the prevalence of CVI and skin changes in patients who turn to Continuous Assistance Services due to the presence of disturbing symptoms of their condition.

Data were evaluated by consulting the medical records, during a 16‐month period, available with three Continuous Assistance Services of the Italian territory.

The overall population of the referring centres consisted of 1186 patients [739 females (62·31%) and 447 males (37·69%)]. Seventy‐nine patients (6·66%) consulted the emergency unit for venous symptoms related to CVD. Patients with more severe disease (CVI, categories C4–C6) represented the majority accounting for 60·75%, while patients with moderate disease (C3) accounted for 35·44% and patients with mild disease (C1–C2 stages) accounted for 3·79%.

The main finding of this study is that despite CVI not being a disease that commonly requires medical emergency/urgency intervention, patients with CVI, especially in advanced stage with skin changes, may turn to Continuous Assistance Service for treating bothersome symptoms related to their condition.
The Role of the Nonpneumatic Antishock Garment in Reducing Blood Loss and Mortality Associated with Post‐Abortion Hemorrhage
Authors: Manandhar Shila , El Ayadi Alison M. , Butrick Elizabeth , Hosang Robert , Miller Suellen
Published: September 2015

Maternal mortality attributable to post‐abortion hemorrhage is often associated with delays in reaching or receiving definitive care. The nonpneumatic antishock garment (NASG), a low‐technology first‐aid device, has been shown to decrease blood loss and mortality among women experiencing hypovolemic shock secondary to obstetric hemorrhage etiologies. Women experiencing post‐abortion hemorrhage face longer delays in receiving definitive treatment as a result of abortion‐related stigma and lack of access to quality abortion care; thus the NASG has the potential to make an even greater impact within this population. We conducted a secondary analysis of data collected in Egypt, Nigeria, Zambia, and Zimbabwe in NASG trials, limiting our analytic sample to women who experienced post‐abortion hemorrhage (n = 953). Blood loss significantly decreased when the NASG was added to standard hemorrhage management during the intervention phase, and there was a large, although not statistically significant, 52 percent decrease in mortality during the NASG phase. The results indicate that adding the NASG to post‐abortion care among women experiencing severe hemorrhage and hypovolemic shock would decrease blood loss and mortality.
Dementia caregiver burden association with community participation aspect of social capital
Authors: Papastavrou Evridiki , Andreou Panayiota , Middleton Nicos , Tsangari Haritini , Papacostas Savvas
Published: September 2015

Aims

This study explores dementia caregiver burden and depression in the context of social capital and investigates the relationship of caregivers' burden with the perceptions of social capital of a non‐caregivers' group.

Background

Social capital is the range of social contact that gives access to social, emotional and practical support, but little is known about dementia patients and their care by the family in that context.

Design

A cross‐sectional correlational study was undertaken.

Methods

Seventy family dementia caregivers matched to non‐caregivers from the same neighbourhood participated in the study; three instruments were used to collect the data: the Zarit Burden Interview, the Centre for Epidemiological Studies‐Depression scale and the Social Capital Questionnaire. Paired sample t‐tests and correlation analysis were performed to examine all the hypotheses of interest. The data collection period was between October 2010–July 2011.

Results

Overall social capital scores were higher for the non‐caregivers and lower for the caregivers with significant differences in each group. The correlation between caregiver burden and social capital showed that the overall burden score is significantly negatively related with the social capital factor ‘non‐caregivers’ participation in the community'.

Conclusion

Understanding the relation between caregiver burden and social capital will enhance nurses' capacity to explore the concept, the meaning and the politics of social capital to the benefit of dementia caregivers in the community.
Intrinsic survival advantage of social insect queens depends on reproductive activation
Authors: Rueppell O. , Königseder F. , Heinze J. , Schrempf A.
Published: September 2015

The central trade‐off between reproduction and longevity dominates most species' life history. However, no mortality cost of reproduction is apparent in eusocial species, particularly social insects in the order Hymenoptera: one or a few individuals (typically referred to as queens) in a group specialize on reproduction and are generally longer lived than all other group members (typically referred to as workers), despite having the same genome. However, it is unclear whether this survival advantage is due to social facilitation by the group or an intrinsic, individual property. Furthermore, it is unknown whether the correlation between reproduction and longevity is due to a direct mechanistic link or an indirect consequence of the social role of the reproductives. To begin addressing these questions, we performed a comparison of queen and worker longevity in the ant Cardiocondyla obscurior under social isolation conditions. Survival of single queens and workers was compared under laboratory conditions, monitoring and controlling for brood production. Our results indicate that there is no intrinsic survival advantage of queens relative to workers unless individuals are becoming reproductively active. This interactive effect of caste and reproduction on life expectancy outside of the normal social context suggests that the positive correlation between reproduction and longevity in social insect queens is due to a direct link that can activate intrinsic survival mechanisms to ensure queen longevity.
Co‐evolutionary dynamics between public good producers and cheats in the bacterium Pseudomonas aeruginosa
Authors: Kümmerli R. , Santorelli L. A. , Granato E. T. , Dumas Z. , Dobay A. , Griffin A. S. , West S. A.
Published: September 2015

The production of beneficial public goods is common in the microbial world, and so is cheating – the exploitation of public goods by nonproducing mutants. Here, we examine co‐evolutionary dynamics between cooperators and cheats and ask whether cooperators can evolve strategies to reduce the burden of exploitation, and whether cheats in turn can improve their exploitation abilities. We evolved cooperators of the bacterium Pseudomonas aeruginosa, producing the shareable iron‐scavenging siderophore pyoverdine, together with cheats, defective in pyoverdine production but proficient in uptake. We found that cooperators managed to co‐exist with cheats in 56% of all replicates over approximately 150 generations of experimental evolution. Growth and competition assays revealed that co‐existence was fostered by a combination of general adaptions to the media and specific adaptions to the co‐evolving opponent. Phenotypic screening and whole‐genome resequencing of evolved clones confirmed this pattern, and suggest that cooperators became less exploitable by cheats because they significantly reduced their pyoverdine investment. Cheats, meanwhile, improved exploitation efficiency through mutations blocking the costly pyoverdine‐signalling pathway. Moreover, cooperators and cheats evolved reduced motility, a pattern that likely represents adaptation to laboratory conditions, but at the same time also affects social interactions by reducing strain mixing and pyoverdine sharing. Overall, we observed parallel evolution, where co‐existence of cooperators and cheats was enabled by a combination of adaptations to the abiotic and social environment and their interactions.
Impact of automated dispensing cabinets on medication selection and preparation error rates in an emergency department: a prospective and direct observational before‐and‐after study
Authors: Fanning Laura , Jones Nick , Manias Elizabeth
Published: September 2015

Rationale, aims and objectives

The implementation of automated dispensing cabinets (ADCs) in healthcare facilities appears to be increasing, in particular within Australian hospital emergency departments (EDs). While the investment in ADCs is on the increase, no studies have specifically investigated the impacts of ADCs on medication selection and preparation error rates in EDs. Our aim was to assess the impact of ADCs on medication selection and preparation error rates in an ED of a tertiary teaching hospital.

Methods

Pre intervention and post intervention study involving direct observations of nurses completing medication selection and preparation activities before and after the implementation of ADCs in the original and new emergency departments within a 377‐bed tertiary teaching hospital in Australia. Medication selection and preparation error rates were calculated and compared between these two periods. Secondary end points included the impact on medication error type and severity.

Results

A total of 2087 medication selection and preparations were observed among 808 patients pre and post intervention. Implementation of ADCs in the new ED resulted in a 64.7% (1.96% versus 0.69%, respectively, P = 0.017) reduction in medication selection and preparation errors. All medication error types were reduced in the post intervention study period. There was an insignificant impact on medication error severity as all errors detected were categorised as minor.

Conclusion

The implementation of ADCs could reduce medication selection and preparation errors and improve medication safety in an ED setting.
A Novel‐Modified Provisional Bifurcation Stenting Technique: Jailed Semi‐Inflated Balloon Technique
Authors: Çaylı Murat , Şeker Taner , Gür Mustafa , Elbasan Zafer , Şahin Durmus Yildiray , Elbey Mehmet Ali , Çil Habib
Published: September 2015

Objective

We proposed a new technique for the treatment of coronary bifurcation lesions, called jailed semi‐inflated balloon technique (JSBT).

Background

Currently, provisional approach is recommended to treat most of coronary bifurcation lesions. However, it is associated with the risk of side branch (SB) occlusion after main vessel (MV) stenting due to plaque or carina shift into the SB. The SB occlusion may cause peri‐procedural myonecrosis or hemodynamic compromise. Therefore, strategies are needed to reduce the SB occlusion during provisional approach.

Methods

Between September 2014 and April 2015, we selected 137 patients (104 male, 33 female; mean age 63.6 ± 11.7 years) with 148 distinct coronary bifurcation lesions underwent percutaneous coronary intervention using JSBT. All patients were followed with hospital visits or telephone contact up to 1 month.

Results

The majority of the patients had acute coronary syndrome (64.2%) and Medina 1.1.1. bifurcation lesions (62.8%). The lesion localization was distal left main (LM) coronary artery in 28 patients. After the MV stenting, thrombolysis in myocardial infarction (TIMI) 3 flow was established in 100% of both MV and SB. There was no SB occlusion in any patient. There was no major adverse cardiac event during in‐hospital stay and 1 month follow‐up.

Conclusions

The JSBT technique can be successfully performed in both LM and non‐LM bifurcation lesion. This technique provides high rate of procedural success, excellent SB protection during MV stenting and excellent immediate clinical outcome. (J Interven Cardiol 2015;28:420–429)
Analysis of the Association between Catechol-O-Methyltransferase Val158Met and Male Sexual Orientation
Authors: Yu Wei , Tu Dan , Hong Fuchang , Wang Jing , Liu Xiaoli , Cai Yumao , Xu Ruiwei , Zhao Guanglu , Wang Feng , Pan Hong , Wu Shinan , Feng Tiejian , Wang Binbin
Published: September 2015

Introduction

Male sexual orientation is thought to have a genetic component. However, previous studies have failed to generate positive results from among candidate genes. Catechol-O-methyltransferase (COMT), located on chromosome 22, has six exons, spans 27 kb, and encodes a protein of 271 amino acids. COMT has an important role in regulating the embryonic levels of catecholamine neurotransmitters (such as dopamine, norepinephrine, and epinephrine) and estrogens. COMT is also thought to be related to sexual orientation.

Aims

This study aimed to investigate the relationship between the COMT Val158Met variant and male sexual orientation. We performed association analysis of the COMT gene single nucleotide polymorphism, Val158Met, in 409 homosexual cases and 387 heterosexual control Chinese men. COMT polymorphism status was determined using a polymerase chain reaction-based assay.

Methods

Polymerase chain reaction was performed to genotype the COMT Val158Met polymorphism.

Main Outcome Measures

The frequency differences of the genotype and alleles distribution between the male homosexual and control groups.

Results

Significant differences, both in genotype and alleles, between male homosexual individuals and controls indicated a genetic component related to male homosexuality. The Val allele recessive model could be an interrelated genetic model of the cause of male homosexuality.

Conclusion

The COMT Val158Met variant might be associated with male sexual orientation and a recessive model was suggested.
Effects of fine‐scale surface heterogeneity on rock outcrop plant community structure
Authors: do Carmo Flávio Fonseca , de Campos Iara Christina , Jacobi Claudia Maria
Published: September 2015

Questions

To what extent do fine‐scale substrate variations affect the structure and diversity of rock outcrop vascular plant communities? How can we define the appropriate scale to measure fine‐scale substrate heterogeneity in rocky systems?

Location

Nine rock outcrops in the Iron Quadrangle, a priority area for biodiversity conservation in southeast Brazil.

Methods

Geomorphology and rock mechanics methods were adapted to determine the appropriate scale to measure rock surface heterogeneity on granitoid, quartzitic and ironstone (canga) outcrops. Then, a roughness index was calculated from 60 microtopographic profiles in each lithotype to investigate the response of the plant community to this scale. The relation between surface heterogeneity and plant community richness, abundance, total plant cover and dominant species cover was quantified through linear regressions. A cluster analysis compared the percentage cover of functional groups in each outcrop, and diversity profiles were built based on Rényi's alpha. PERMANOVA was used to test for significant difference in the relative cover among the functional groups.

Results

The roughness index, scaled at 1 cm, had the best power to diagnose the presence of vascular plants. High surface heterogeneity was caused by high frequency of fissures, cracks and rock fragments. Linear regression models indicated that the community parameters are strongly related to variations in surface roughness. The community patterns revealed by the cluster analysis and the diversity profiles matched those of the roughness analysis. Dominant functional groups differed strongly between ‘smooth’ and ‘coarse’ microtopography. Desiccation‐tolerant species prevailed in smooth outcrops, while sclerophytes and graminoids were better represented in coarse outcrops.

Conclusions

The composition of plant functional groups was affected by rock microrelief, and roughness was a significant predictor of plant community parameters. Functional group proportions reflected different adaptive plant strategies to two main stressful bedrock features: water shortage and mechanical resistance to root growth.
Fatty liver disease and lifestyle in youngsters: diet, food intake frequency, exercise, sleep shortage and fashion
Authors: Trovato Francesca M. , Martines Giuseppe Fabio , Brischetto Daniela , Catalano Daniela , Musumeci Giuseppe , Trovato Guglielmo M.
Published: September 2015

Background & Aims

Fatty liver is associated with alcohol habits and/or overweight/obesity. We challenged several lifestyle features associated with fatty liver and, particularly, with non‐alcoholic fatty liver disease (NAFLD). Among them, sleep shortage as a result of nightlife habits and a preference for plus‐size fashion were assessed. The latter consists of fashionable plus‐sized clothing for actual individuals' size and reflects a frequent attitude of some social or age groups, conceivably indicating more global and widespread trend and behaviour.

Methods

We studied a group of 708 non‐diabetic youngsters, 458 women and 250 men, 21.72 ± 3.71 years old (range 15–35 years), referred for minor digestive ailments for clinical assessment, ultrasound detection of fatty liver and nutritional counselling. Details of personal history regarding lifestyle, food intake frequency and alcohol intake, dietary and physical exercise profile, sleep duration and clothing preferences were recorded.

Results

The prevalence of NAFLD in this cohort of youngsters is 67/708 (9.4%). Even if it is quantitatively very low in both groups, the average alcohol intake, always below 20 g/day, is greater in NAFLD subjects (5.83 ± 4.32 g) vs. subjects with normal liver (2.02 ± 3.20 g). The number of meals/day and adherence to a Mediterranean diet profile are smaller in NAFLD subjects. By multiple regression, BMI, sedentary life, plus‐sized clothing for their actual size, sleep shortage and lower frequency of daily food intake are associated with the presence of NAFLD.

Conclusions

Onset and continuation of fatty liver disease, beyond food and exercise quantity and quality, with their effects on obesity, may also be associated with other aspects of lifestyle.
Statistical Regularization for Identification of Structural Parameters and External Loadings Using State Space Models
Authors: Sun Hao , Feng Dongming , Liu Yang , Feng Maria Q.
Published: September 2015

A novel numerical approach is presented, in the time domain, to simultaneously identify structural parameters and unmeasured input loadings using incomplete output measurement only. The identification problem is formulated as an optimization process, wherein the objective function is defined as the discrepancy between the measured and the predicted data, and is solved by a damped Gauss‐Newton method. Because the proposed algorithm is a time domain technique, forward analyses are required to obtain predicted system responses so as to compute the discrepancy. Therefore, we propose an input force estimation scheme in the identification process to complete the task of input‐output forward analyses, for the case of output‐only measurement. The relationship between the unknown input loadings and the output measurement is established through a state space model, which basically formulates an ill‐posed least squares problem. A statistical Bayesian inference‐based regularization technique is presented to solve such a least squares problem. Finally, the proposed approach is illustrated by both numerical and experimental examples using output‐only measurements of either acceleration or strain time histories. The results clearly show the robustness and the applicability of the proposed algorithm to simultaneously identify structural parameters and unmeasured input loadings with a high accuracy.
Analysis of ectoparasites (chigger mites, gamasid mites, fleas and sucking lice) of the Yunnan red‐backed vole (Eothenomys miletus) sampled throughout its range in southwest China
Authors: PENG P.‐Y. , GUO X.‐G. , SONG W.‐Y. , HOU P. , ZOU Y.‐J. , FAN R. , HE X.‐S.
Published: September 2015

The Yunnan red‐backed voleEothenomys miletus(Rodentia: Cricetidae) is an endemic rodent species and reservoir host of zoonoses in southwest China. Based on a large host sample (2463 voles collected from 39 localities between 2001 and 2013), a general analysis of four categories of ectoparasite (fleas, sucking lice, chigger mites and gamasid mites) onE. miletusacross its entire range of distribution was made. This analysis identified a total of 71 895 ectoparasites belonging to 320 species (30 species of flea, 9 of sucking louse, 106 of gamasid mite and 175 of chigger mite) with a high prevalence (87%), mean abundance (29.19) and mean intensity (33.69). Of the 18 vector species of zoonoses found onE. miletus, the fleaCtenophthalmus quadratus(Siphonaptera: Hystrichopsyllidae) and chigger miteLeptotrombidium scutellare(Trombidiformes: Trombiculidae) were the dominant species; these are the main vectors of zoonoses in China. All of the dominant parasite species showed an aggregated distribution pattern. Male voles harboured more species of parasite than females. Chigger mites represented the most abundant species group on voles and their prevalence was positively correlated with mean abundance (r= 0.73;P< 0.05). As a single rodent species,E. miletushas a high potential to harbour abundant ectoparasites with high species diversity and high rates of infestation. The sex of the vole affects ectoparasite infestation.
‘Risk or Right’: a discourse analysis of midwifery and obstetric colleges’ homebirth position statements
Authors: Licqurish Sharon , Evans Alicia
Published: September 2015

Within the context of global debates about safety and ethics of supporting women to give birth at home, it is important to analyse documents governing midwifery and obstetric practice and influence decision‐making around place of birth. In Australia, the United States and the United Kingdom, relatively small numbers of women choose to give birth at home despite their midwifery colleges' support. In the United States and Australia, the obstetric colleges do not support homebirth and these countries have lower numbers of women who birth at home, compared with the United Kingdom. There are numerous regulatory and industry challenges for midwives attending homebirths. This paper reports on a Foucauldian analysis of Australian obstetric and midwifery colleges' position statements about homebirth, who have conflicting views, with the view to understanding their arguments and underlying assumptions. The documents highlighted tensions between competing discourses of risk and autonomy and differences in academic argument. Opportunities for strengthening their statements are highlighted. The methodology is applicable for future analysis of similar documents governing practice in other countries.
The effects of camicinal, a novel motilin agonist, on gastro‐esophageal function in healthy humans—a randomized placebo controlled trial
Authors: Hobson R. , Farmer A. D. , Dewit O. E. , O'Donnell M. , Hacquoil K. , Robertson D. , Barton M. E. , Dukes G. E.
Published: September 2015

Background

A proportion of patients with foregut dysmotility fail to respond to standard interventions. Motilin agonists may be beneficial in this group. We aimed to determine the effect of camicinal, a novel motilin agonist, on gastrointestinal physiology in healthy volunteers.

Methods

Healthy male subjects were randomly assigned to receive a single dose of 125 mg camicinal or placebo in a double‐blind cross‐over design. Esophageal function and reflux indices were assessed using high‐resolution manometry (pre and 1.5‐h post dose) and 24‐h ambulatory multichannel intraluminal impedance/pH. After a standardized meal, subjects ingested a wireless motility capsule from which compartmental transit times and motility indices were derived. Subjects were restudied with the alternate intervention after 7 days.

Key Results

The study subjects (12 male, mean age 47.4 years, range 22–55) tolerated the drug well, except one who exhibited mild abdominal pain on both placebo and camicinal. In comparison to placebo, gastric emptying time (GET) was accelerated following camicinal (−115.4 min, 95% confidence interval −194.4, −36.4, p = 0.009). No effect was demonstrable on esophageal function, small bowel, colonic, or whole bowel transit times and motility indices. With camicinal, as part of a post hoc analysis, there was a trend association between the percentage reduction in GET and total number of acidic reflux events (r = 0.56, p = 0.09).

Conclusions & Inferences

Camicinal decreases GET and was generally well‐tolerated. In health, the direct effects of camicinal are on accelerating GET with a potential secondary benefit of reducing reflux events, which warrant further exploration in patient cohorts.