bluuebunny/crossref_metadata_2025 huggingface dataset:
Masculinity and the sociality of cooking in men’s everyday lives
Authors: Neuman Nicklas , Gottzén Lucas , Fjellström Christina
Published: September 2016

This article explores how 31 Swedish men (22–88 years old) talk about the sociality of domestic cooking in everyday life. We demonstrate how domestic cooking – for oneself, for others and with others – is part of the understanding of contemporary Swedish men and how the expressed sociality of cooking is intertwined with accomplishments of masculinity. The sociality of cooking is not only about homosocial leisure but also a way for men to maintain heterosocial relationships and assume domestic responsibility. We discuss a potential cultural transition in men’s domestic-meal sociality and suggest the need for studies of gendered divisions of domestic work and the sociology of food to analyse how cooking shares similar properties to those of commensality, and the implications of this regarding gender relations.
Onset‐to‐device time of patients who arrive at off‐hours: Importance of prehospital management and public awareness for patients with ST‐segment elevation myocardial infarction
Authors: Mizuguchi Yukio , Shibutani Hiroki , Hashimoto Sho , Yamada Takeshi , Taniguchi Norimasa , Nakajima Shunsuke , Hata Tetsuya , Takahashi Akihiko
Published: September 2016

Aim

The influence of the time of arrival at the hospital on the door‐to‐device (DTD) time has been investigated; however, the influence on the onset‐to‐device (OTD) time is unclear in ST‐segment elevation myocardial infarction (STEMI) patients. The aim of this study was to investigate the relationship between the time of arrival at the hospital and the OTD time in STEMI patients.

Methods

We evaluated 377 STEMI patients who underwent primary percutaneous coronary intervention (pPCI) between January 2008 and December 2014.

Results

During the study period, 222 patients arrived at our hospital between 9 AM and 9 PM (on‐hours group) and 155 patients arrived between 9 PM and 9 AM (off‐hours group). The DTD time was longer in the off‐hours group than in the on‐hours group (50.4 vs 39.3 minutes; P<.001), while the OTD time was longer in the on‐hours group than in the off‐hours group (285.7 vs 184.5 minutes, P<.001). The 30‐day mortality and peak creatinine kinase levels were similar between the groups. Transfer from a non‐pPCI‐capable facility to our hospital was more common in the on‐hours group than in the off‐hours group (49.1% vs 15.5%, P<.001). The OTD time was shorter in patients who directly visited our hospital than in those who were transferred (172.9 vs 338.5 minutes, P<.001).

Conclusions

The OTD time might be markedly longer in STEMI patients who arrive at the hospital during on‐hours than in those who arrive at the hospital during off‐hours because of the underuse of emergency medical services at STEMI onset.
The peril of proportions: robust niche indices for categorical data
Authors: Pierotti Michele E. R. , Martín‐Fernández Josep A. , Barceló‐Vidal Carles
Published: September 2016

Indices of niche breadth and niche overlap for categorical data are typically expressed in terms of proportions of resources use. These are unit‐sum constrained data; hence, direct application of standard general linear modelling methods to such indices can lead to spurious correlations and misleading inference.

To overcome these limitations, we introduce a compositional data analysis (CoDA) approach and derive compositional expressions of niche breadth, niche overlap and specialization. Compositional data analysis is specifically devoted to the analysis of vectors of proportions (i.e. compositions) and represents the appropriate framework for the study of sets of data with unit‐sum constraint as those typically used in the calculation of niche indices.

We show that compositional indices exhibit suitable statistical properties that make them flexible and robust, allowing downstream application of the full toolbox of multivariate analysis techniques to these estimators, a possibility not available with classical indices. In addition, we find that when characterizing niche breadth, niche overlap and specialization in terms of vectors of proportions, these concepts are naturally integrated in a coherent unifying framework.

When data are categorical, we recommend the use of compositional indices for the statistical analysis of specialization metrics, niche breadth and niche overlap. We believe that the unified framework emerging from our compositional approach to niche metrics will allow a more thorough understanding of specialization at multiple levels of biological organization and provide novel insights in complex phenomena such as invasions and niche shifts.
High‐dose methylprednisolone and endothelial glycocalyx in paediatric heart surgery
Authors: Pesonen E. , Keski‐Nisula J. , Andersson S. , Palo R. , Salminen J. , Suominen P. K.
Published: September 2016

Background

Corticosteroids are used in paediatric heart surgery to attenuate systemic inflammatory response. Glycocalyx regulates vascular permeability, shear stress and cell adhesion on the endothelium. Syndecan‐1 serves as a biomarker of glycocalyx degradation. Hydrocortisone decreased endothelial glycocalyx degradation in an experimental model. Our hypothesis was that high‐dose methylprednisolone decreases glycocalyx degradation as measured by plasma sydecan‐1 concentration in children undergoing cardiac surgery.

Methods

Two double‐blinded, randomized, placebo‐controlled trials were conducted. In the first trial (‘neonatal trial’), 40 neonates undergoing open heart surgery received either 30 mg/kg intravenous methylprednisolone (n = 20) or placebo (n = 20). In the second trial (‘VSD trial’), 45 infants and very young children, undergoing ventricular or atrioventricular septal defect correction received one of the following: 30 mg/kg of methylprednisolone intravenously after anaesthesia induction (n = 15), 30 mg/kg methylprednisolone in the cardiopulmonary bypass prime solution (n = 15) or placebo (n = 15). Plasma syndecan‐1 concentrations were measured. Results were expressed both as absolute concentrations and in relative concentrations as multiples of the baseline values of syndecan‐1.

Results

There were no statistically significant differences between the neonate trial groups for absolute syndecan‐1 concentrations. However, operative administration of methylprednisolone to neonates significantly reduced the relative increases of syndecan‐1 at weaning from cardiopulmonary bypass (P = 0.008) and at 6 h post‐operatively (P = 0.018). There were no statistically significant differences in absolute or relative increases of syndecan‐1 between the VSD trial study groups.

Conclusion

High‐dose methylprednisolone reduces shedding of glycocalyx in neonates after complex cardiac surgery but not in older infants after repair of VSD/AVSD with shorter ischaemia times.
Liability and Informed Consent in the Context of Shared Decision Making
Authors: Lindor Rachel A. , Kunneman Marleen , Hanzel Matt , Schuur Jeremiah D. , Montori Victor M. , Sadosty Annie T.
Published: September 2016

The idea of shared decision making (SDM) is gaining traction within emergency medicine, although concerns about potential legal consequences of its use may be slowing its adoption. We describe the similarities and differences between informed consent (IC) requirements and SDM, highlighting their different purposes, scope, and implementation. We also illustrate several areas in which SDM may affect clinicians’ liability risks and suggest that while SDM is likely to reduce net liability risks, it may increase providers’ liability risks in certain situations or with select patients. Overall, engaging in SDM should be understood as clearly distinct from the process of obtaining IC and could reduce clinicians’ risk of liability when applied carefully and thoughtfully.
Unaffected twins discordant for affective disorders show changes in anterior callosal white matter microstructure
Authors: Macoveanu J. , Vinberg M. , Madsen K. , Kessing L. V. , Siebner H. R. , Baaré W.
Published: September 2016

Objective

The neurobiological mechanisms mediating an increased risk to develop affective disorders remain poorly understood. In a group of individuals with a family history of major depressive (MDD) or bipolar disorder (BD), we investigated the microstructural properties of white matter fiber tracts, that is, cingulum bundle, uncinate fasciculus, anterior limb of the internal capsule, and corpus callosum, that facilitate the communication between brain regions implicated in affective disorders.

Method

Eighty‐nine healthy mono‐ or dizygotic twins with a co‐twin diagnosed with MDD or BD (high‐risk) and 57 healthy twins with a co‐twin with no familial history of affective disorders (low‐risk) were included in a diffusion tensor imaging study.

Result

The high‐risk group showed decreased fractional anisotropy (FA), a measure of water diffusion directionality, and increased radial diffusivity in the anterior region of corpus callosum compared to the low‐risk group. This abnormality was not associated with zygosity or type of depressive disorder of co‐twin.

Conclusion

The observed decreased anterior callosal fiber FA in the high‐risk group may be indicative of a compromised interhemispheric communication between left and right frontal regions critically involved in mood regulation. Reduced anterior callosal FA may act as a vulnerability marker for affective disorders in individuals at familial risk.
NUDT15 polymorphisms are better than thiopurine S‐methyltransferase as predictor of risk for thiopurine‐induced leukopenia in Chinese patients with Crohn's disease
Authors: Zhu X. , Wang X.‐D. , Chao K. , Zhi M. , Zheng H. , Ruan H.‐L. , Xin S. , Ding N. , Hu P.‐J. , Huang M. , Gao X.
Published: September 2016

Background

Thiopurine‐induced leukopenia is the most common dangerous adverse event in Asians. NUDT15 R139C was recently proposed to be a promising biomarker for leukopenia with thiopurine therapy in Asians, but this has not been replicated in the Chinese population.

Aim

To investigate the influence of NUDT15 R139C, thiopurine S‐methyltransferase (TPMT), 6‐TGN and 6‐MMPR on thiopurine‐induced leukopenia in Chinese patients with Crohn's disease.

Methods

Clinical and epidemiological characteristics were reviewed from medical records. NUDT15 R139C and TPMT were genotyped. 6‐TGN/6‐MMPR concentrations were measured with high‐performance liquid chromatography (HPLC).

Results

A total of 253 patients were included, 65 (25.7%) of whom experienced leukopenia. The median follow‐up with thiopurine treatment was 38.0 weeks (range, 1–192 weeks). NUDT15 R139C was strongly associated with the incidence of leukopenia (70.2% mutation vs. 12.8% wild type; P=8.61×10−19; odds ratio, 10.80; 95% CI, 5.89–19.83). However, TPMT genotype was not found to be correlated with the incidence of leukopenia (P = 0.44). In subgroup of NUDT15 wild type, there was significant difference of 6TGN concentration between patients with and without leukopenia (413.0 (174.2–831.4) vs. 279.7 (77.3–666.9) pmol/8 × 108 RBC, P = 0.0055). In contrast, no association was found in patients with NUDT15 R139C variant alleles (P = 0.26). 6‐MMPR was not correlated with leukopenia (P = 0.84).

Conclusions

In Chinese patients, it is strongly recommended to detect NUDT15 genotype rather than TPMT before initiating thiopurine drugs. 6TGN concentration should be routinely monitored in CD patients with NUDT15 wild type. As for CT genotype, starting at low dose and careful monitoring for leukopenia and 6TGN levels is recommended.
Hydroxycarbamide treatment and brain MRI/MRA findings in children with sickle cell anaemia
Authors: Nottage Kerri A. , Ware Russell E. , Aygun Banu , Smeltzer Matthew , Kang Guolian , Moen Joseph , Wang Winfred C. , Hankins Jane S. , Helton Kathleen J.
Published: September 2016

Silent cerebral infarction (SCI) is the most common neurological abnormality among children with sickle cell anaemia (SCA). The effect of hydroxycarbamide (also termed hydroxyurea) on the development and progression of SCI is unclear. We evaluated brain magnetic resonance imaging/angiography (MRI/MRA) in children with SCA receiving long‐term hydroxycarbamide therapy. Fifty participants (median 9·4 years, range 1·1–17·3) enrolled in the Hydroxyurea Study of Long‐Term Effects (HUSTLE; NCT00305175) underwent brain MRI/MRA and laboratory evaluations before hydroxycarbamide initiation and after 3 and 6 years of treatment to maximum tolerated dose. SCI and vascular stenosis were evaluated. At baseline, 3 and 6 years, SCI were present in 19/50 (38%), 20/49 (41%), and 7/17 (41%), respectively. At 3 years, one child developed a SCI lesion, and another progressed (single lesion to multiple). Lower haemoglobin (Hb) (80 g/l vs. 86 g/l, P = 0·049), fetal Hb (5·0% vs. 10·4%, P < 0·001) and oxygen saturation (97% vs. 98%, P = 0·027) before hydroxycarbamide initiation were associated with SCI. No patients had vascular stenosis identified on MRA, transient ischaemic attack or stroke. Our data indicate that children receiving hydroxycarbamide over a 3‐ to 6‐year period have a low rate of new or worsening cerebrovascular disease. Further studies are needed to confirm that hydroxycarbamide can prevent the onset and progression of SCI.
New developments in anti‐sickling agents: can drugs directly prevent the polymerization of sickle haemoglobin in vivo?
Authors: Oder Esther , Safo Martin K. , Abdulmalik Osheiza , Kato Gregory J.
Published: September 2016

The hallmark of sickle cell disease is the polymerization of sickle haemoglobin due to a point mutation in the β‐globin gene (HBB). Under low oxygen saturation, sickle haemoglobin assumes the tense (T‐state) deoxygenated conformation that can form polymers, leading to rigid erythrocytes with impaired blood vessel transit, compounded or initiated by adhesion of erythrocytes to endothelium, neutrophils and platelets. This process results in vessel occlusion and ischaemia, with consequent acute pain, chronic organ damage, morbidity and mortality. Pharmacological agents that stabilize the higher oxygen affinity relaxed state (R‐state) and/or destabilize the lower oxygen affinity T‐state of haemoglobin have the potential to delay the sickling of circulating red cells by slowing polymerization kinetics. Relevant classes of agents include aromatic aldehydes, thiol derivatives, isothiocyanates and acyl salicylates derivatives. The aromatic aldehyde, 5‐hydroxymethylfurfural (5‐HMF) increases oxygen affinity of sickle haemoglobin and reduces hypoxia‐induced sickling in vitro and protects sickle cell mice from effects of hypoxia. It has completed pre‐clinical testing and has entered clinical trials as treatment for sickle cell disease. A related molecule, GBT440, has shown R‐state stabilization and increased oxygen affinity in preclinical testing. Allosteric modifiers of haemoglobin as direct anti‐sickling agents target the fundamental pathophysiological mechanism of sickle cell disease.
The genetic make‐up of ovarian development and function: the focus on the transcription factor FOXL2
Authors: Elzaiat M. , Todeschini A.‐L. , Caburet S. , Veitia R.A.
Published: September 2016

In a 46 XY individual, the presence of the Y chromosome harboring the testis‐determining factor (SRY) triggers testis determination and differentiation. In a 46 XX individual, the absence of SRY and the activation of genes associated with the female pathway lead to ovarian development. The latter process has long been considered as a default pathway. However, recent studies have cast doubts on this dogma. Here, after a brief overview of the main steps of ovarian development, we focus on three genes WNT4, RSPO1 and FOXL2 that are essential for ovarian determination, differentiation and/or maintenance. Special attention is paid to FOXL2 whose mutations are responsible for the blepharophimosis syndrome, often associated with female infertility, and for cancer. We highlight the cooperation of WNT4, RSPO1 and FOXL2 within a regulatory network and the need for further research to better understand their role in defining and maintaining ovarian identity.
Acute stress alters individual risk taking in a time‐dependent manner and leads to anti‐social risk
Authors: Bendahan S. , Goette L. , Thoresen J. , Loued‐Khenissi L. , Hollis F. , Sandi C.
Published: September 2016

Decision‐making processes can be modulated by stress, and the time elapsed from stress induction seems to be a crucial factor in determining the direction of the effects. Although current approaches consider the first post‐stress hour a uniform period, the dynamic pattern of activation of the physiological stress systems (i.e., the sympathetic nervous system and hypothalamic‐pituitary‐adrenal axis) suggests that its neurobehavioural impact might be heterogeneous. Here, we evaluate economic risk preferences on the gain domain (i.e., risk aversion) at three time points following exposure to psychosocial stress (immediately after, and 20 and 45 min from onset). Using lottery games, we examine decisions at both the individual and social levels. We find that risk aversion shows a time‐dependent change across the first post‐stress hour, evolving from less risk aversion shortly after stress to more risk averse behaviour at the last testing time. When risk implied an antisocial outcome to a third party, stressed individuals showed less regard for this person in their decisions. Participants’ cortisol levels explained their behaviour in the risk, but not the antisocial, game. Our findings reveal differential stress effects in self‐ and other‐regarding decision‐making and highlight the multidimensional nature of the immediate aftermath of stress for cognition.
Anticoagulation in Patients With Acute Renal Failure Treated With Continuous Renal Replacement Therapies
Authors: Davenport Andrew
Published: September 2016

Although continuous renal replacement therapy (CRRT) provides greater cardiovascular and cerebrovascular stability compared to standard intermittent hemodialysis and/ or hemofiltration, to provide adequate solute removal, the CRRT circuit must function continuously. Patients with acute renal failure are usually prothrombotic, with activation of the contact coagulation cascade and reduction in the natural anticoagulants. Thus clotting within the extracorporeal circuit can be problematic. Coagulation requires activation of the coagulation protein enzymes, calcium, platelets, and contact with phospholipid cell surface or, in the case of the CRRT circuit, plastic tubing and the dialyzer membrane. This results in a platelet plug stabilized by cross‐linking strands of fibrin. Anticoagulation regimes are either directed at trying to prevent contact activation of clotting factors and platelets or the administration of agents designed to prevent coagulation by blocking the coagulation cascade or platelet activation.
Effect of Low Dialysate Flow Rate on Hemodialyzer Mass Transfer Area Coefficients for Urea and Creatinine
Authors: Leypoldt John K. , Cheung Alfred K.
Published: September 2016

Recent work has shown that the dialyzer mass transfer area coefficient (KoA) for urea increases when the dialysate flow rate is increased from 500 to 800 mL/min. In this study we determined urea and creatinine clearances for two commercial dialyzers containing polysulfone hollow fibers in vitro at 37°C, a nominal blood flow rate of 300 mL/ min, and dialysate flow rates (Qd) ranging from 100 to 800 mL/min. A standard bicarbonate dialysis solution was used in both the blood and dialysate flow pathways, and clearances were calculated from solute concentrations in the input and output flows on both the blood and dialysate sides. Urea and creatinine KoA values, calculated from the mean of the blood and dialysate side clearances, increased (p < 0.01) with increasing Qd over the entire range studied. The increase in both urea and creatinine KoA with increasing Qd was proportional to the KoA value. These data show that changes in Qd alter small solute clearances greater than predicted assuming a constant KoA.
Normalization of Dialysis Dose for Daily Dialysis
Authors: Gotch Frank A.
Published: September 2016

The equilibrated Kt/V (eKtV) is widely used in hemodialysis (HD) as a measure of the intensity (magnitude) of an individual dialysis treatment. Adequate eKt/V for thrice‐weekly hemodialysis (twHD) has been extensively studied, and a value in the range 1.0 – 1.1 per treatment (3.0 – 3.3 weekly) is generally considered to represent adequate therapy for this specific frequency of dialysis. However, for other schedules, summing eKt/V's and time‐averaging the clearance is not appropriate. This was first demonstrated several years ago by the observation that a weekly eKt/V of 2.0 in continuous ambulatory peritoneal dialysis (CAPD) is therapeutically equal to a weekly eKt/V of 3.0 in twHD. That paradox has been resolved by the standard Kt/V (stdKt/V), which accounts for the first order nature of solute removal by dialysis, and which correctly predicts a normalized weekly stdKt/V of 2.0 for both CAPD and twHD.

The equivalent renal clearance (EKR) has also been advanced as a method to normalize dose for varying treatment schedules. However, mathematical consideration shows that EKR is an exact time‐averaged clearance. Analysis of data reported for daily dialysis by Piccoli et al. in the present issue of Hemodialysis International shows that the EKRct/V calculated for daily dialysis is identical to the sum of eKt/V's for the individual dialyses. We therefore conclude that EKR is not a suitable parameter for normalizing the dialysis dose, because it fails to reflect the effect of dialysis frequency in HD therapy.
Daily Dialysis and Flexible Schedules: How to Assess Kt/V and EKRc?
Authors: Piccoli Giorgina B. , Calderini Mario , Bechis Francesca , Pacitti Alfonso , Iacuzzo Candida , Mezza Elisabetta , Quaglia Marco , Burdese Manuel , Gai Massimo , Anania Patrizia , Jeantet Alberto , Segoloni Giuseppe Paolo
Published: September 2016

Despite the growing interest in daily hemodialysis (DHD), logistic and economic factors limit its dissemination. Not the least of these factors is the lack of uniform criteria for measuring efficiency.

From November 1998 to November 2000, 19 patients were on DHD in our unit. The dialysis prescription was bicarbonate buffer; 6 sessions per week; 2 – 3 hours; blood flow 250 – 350 mL/min; individual K, HCO3, and Na levels; membrane 1.6 – 2 m2 (polysulfone, polycarbonate). The prescription represented the minimum dialysis requirement; patients were free to add up to 30 minutes per session, further increase or any decreases needed confirmation by the caregivers.

The aim of the study was to assess Kt/Vurea variability in this clinical setting, and to identify the minimum number of dialysis sessions required to obtain a reliable estimate of weekly Kt/Vurea [relative error (RE) < 10%].

We studied 169 dialysis sessions in 13 clinically stable patients on DHD for ≥ 3 months, with ≥ 3 Kt/Vurea measurements within 2 weeks (median: 10; range: 3 – 32 sessions), tested in the same laboratory. To assess variability, we employed the simplest formula (the Lowrie Kt/Vurea), the widely used Daugirdas II formula, and the derived single‐pool equivalent renal clearance (EKRc), according to Casino.

The variability of Kt/Vurea per session was high (Lowrie: RE = 2.5% – 22.1%; Daugirdas II and EKRc: RE = 3.6% – 24%). Averaging several dialysis sessions leads to a more reliable estimate of weekly efficiency (6 sessions: RE = 0; 3 sessions, Lowrie formula: Kt/Vurea RE = 1.1% – 9.7%; Daugirdas II and EKRc: RE = 1.6% – 10.6%). In patients with wide time variations, variability may be lower if weekly efficiency is determined on the basis of “average hourly Kt/Vurea,” which is calculated by dividing Kt/Vurea by the number of hours in the studied sessions, and then multiplying by the hours of dialysis performed in the whole week (Lowrie formula, Kt/Vurea: RE = 4.8% – 16.6% for 1 session, 2.1% – 7.3% for 3 sessions). Once again, the RE decreases sharply when data from 3 sessions are considered. Therefore, for flexible DHD, we suggest averaging the data from ≥ 3 sessions for weekly Kt/Vurea assessment.
Lipid Metabolism and Cardiovascular Morbidity and Mortality in Hemodialysis Patients: Role of Factors Modulating Cytosolic Calcium
Authors: Gadallah Merit F. , El-Shahawy Mohamed , Andrews George , Torres–Rivera Carlos , Hanna Dina , Blatt Marc , Ibrahim Magued , Morkos Atef , Abbassian Mohammad , Cooper Mark
Published: September 2016

Animal studies indicate that insulin resistance and glucose intolerance leading to dyslipidemia in uremic rats are associated with increased cytosolic calcium ([Ca++ i]). The resistance and intolerance are reversed with verapamil, but recur after its discontinuation. This finding suggests that hyperparathyroid‐induced [Ca ++ i] increase is responsible for the metabolic derangement.

We retrospectively examined, over a 12‐year period, the effects of factors that lower [Ca ++i] on total serum cholesterol and triglycerides in 332 hemodialysis (HD) patients. Because the study was retrospective, detailed lipid profiles were not available. We therefore relied on morbidity and mortality outcomes related to atherosclerotic vascular disease. Patients with diabetes mellitus were excluded, because their dyslipidemia and vascular disease are mediated via a different mechanism.

Four groups emerged: group I [high parathormone (PTH) in the absence of calcium channel blockers (CCBs), n = 107], representing the highest [Ca++ i]; group II (high PTH in the presence of CCBs, n = 76) and group III (lower PTH in the absence of CCBs, n = 66), representing intermediate [Ca ++ i]; and group IV (lower PTH in the presence of CCBs, n = 83) representing the lowest [Ca ++i]. The theoretically lower [Ca ++ i] was achieved via CCB therapy or lower PTH, or both.

The mean serum cholesterol in group I was 322 ± 24 mg/dL and the level of triglycerides was 398 ± 34 mg/dL. Group II had mean serum cholesterol of 196 ± 16 mg/dL and triglycerides of 157 ± 17 mg/dL. Group III had a mean serum cholesterol of 202 ± 19 mg/dL and triglycerides of 160 ± 15 mg/dL. Group IV had a mean serum cholesterol of 183 ± 9 mg/dL and triglycerides of 94 ± 6 mg/dL. The differences in cholesterol and triglyceride levels among four groups were significant (p < 0.001) by one‐way analysis of variance (ANOVA). The incidence of cardiovascular morbidity and mortality events was 61% in group I, 24% in group II, 28% in group III, and 18% in group IV (χ 2 = 47.7, p < 0.001).

We conclude that, in non diabetic HD patients, hyperparathyroidism, especially in the absence of CCBs, is associated with severe dyslipidemia and increased risk of cardiovascular morbidity and mortality. Dyslipidemia may be related to a hyperparathyroid‐induced increase in cytosolic calcium [Ca++i]. Lowering [Ca++i] by decreasing PTH or by blocking calcium entry into cells (via CCBs), or both, is associated with less dyslipidemia and improved long‐term cardiovascular morbidity and mortality. Prospective randomized studies, with actual measurement of [Ca ++i], are needed to verify the results of this study.
Overview of Blood Coagulation
Authors: Green David
Published: September 2016

The endothelium is the principal anti‐thrombotic mechanism, providing a non wettable surface and generating potent vasodilators (nitric oxide and prostacyclin) and clotting inhibitors [thrombomodulin and tissue factor pathway inhibitor (TFPI)]. When the integrity of the endothelium is breached, vasoconstriction occurs through neural and chemical (endothelin, thromboxane) mechanisms, and platelet adhesion is facilitated (von Willebrand factor). Activation of platelets accompanied by microparticle formation provides a thrombogenic surface for subsequent coagulation reactions. The initial generation of small amounts of thrombin greatly amplifies subsequent clotting factor activation and results in substantial thrombin formation. Thrombin activates an inhibitor of fibrinolysis [thrombin activatable fibrinolysis inhibitor (TAFI)] which prevents the binding of plasminogen to fibrin. Mechanisms to limit clot formation include inhibition of the tissue factor–factor VIIa complex by TFPI, inhibition of activated factors V and VIII by activated protein C, and binding of thrombin by thrombomodulin, heparin cofactor II, and anti‐thrombin. Clot dissolution is promoted by plasminogen activators (tissue plasminogen activator and urokinase) and by plasminogen.
Phosphorus Clearance Using Two Hemodialyzers Placed in Parallel
Authors: Rosner Mitchell H. , Helmandollar Allen , Evans Ryan , Abdel-Rahman Emaad
Published: September 2016

Control of hyperphosphatemia is a major goal in patients with end‐stage renal disease. However, removal of retained inorganic phosphorus during hemodialysis remains a major problem. We compared clearances and total phosphate removal in large patients treated with two F‐80 dialyzers (Fresenius Medical Care of North America, Lexington, MA, U.S.A.) placed in parallel, and small patients dialyzed with a single F‐80 dialyzer (SD). Clearances were obtained using total dialysate collections. Eight dialysate collections (5 patients) using double parallel dialyzers (DD group) were compared with 5 dialysate collections (4 patients) using single dialyzers (SD group). Blood and dialysate flow rates and time of dialysis treatment were identical between the groups.

The DD group's Kt/V urea was 1.46 ± 0.13; SD group's Kt/V urea was 1.35 ± 0.09 (p = 0.2). Absolute phosphorus removal was 1594 ± 300 mg for the DD group, compared to 1108 ± 285 mg in the SD group (p = 0.03). Urea clearance in the DD group was 285 ± 25 mL/minute and 251 ± 27 mL/ min in the SD group (p = 0.082). Phosphorus clearance was 178 ± 32 mL/min in the DD group and 149 ± 38 mL/min in the SD group (p = 0.039). There was no correlation between phosphorus clearance and dialyzer reuse. The bulk of phosphorus removal was achieved during the first 2 hours of hemodialysis. This finding is consistent with the hypothesis that there are at least two pools of body phosphorus.

Using hemodialyzers placed in parallel led to higher phosphate clearance and total phosphorus removal. This higher phosphate removal may be related in part to increasing the concentration gradient for transfer out of a second compartment.
Outcomes of Severe Methanol Intoxication Treated with Hemodialysis: Report of Seven Cases and Review of Literature
Authors: Spalding Charles T. , Briones Felicia , Tzamaloukas Antonios H.
Published: September 2016

To identify factors associated with the outcome of severe methanol intoxication treated with hemodialysis, we analyzed the clinical course of 7 patients admitted with serum methanol level higher than 50 mg/dL, and therefore requiring hemodialysis. Four patients (group A) had adverse outcomes (1 death, 3 severe neurological deficits and/or blindness) and 3 patients (group B) had no adverse outcomes. Compared to group B, group A appeared to have a longer delay between ingestion of methanol and arrival at the emergency department (ED), a longer wait in the ED until ethanol infusion was started (3.6 ± 2.7 vs 1.3 ± 0.9 hr, p < 0.05), and, on admission, higher serum methanol (504 ± 219 vs 321 ± 228 mg/dL, p < 0.05), higher serum osmolality (460.5 ± 98.2 vs 397.6 ± 52.3 mOsm/kg, p < 0.05), higher serum osmolal gap (162.6 ± 76.7 vs 105.6 ± 52.9 mOsm/kg, p < 0.05), lower arterial pH (6.86 ± 0.08 vs 7.38 ± 0.16, p < 0.01), lower serum bicarbonate (4.6 ± 1.6 vs 19.9 ± 5.7 mmol/L, p < 0.01), and higher serum anion gap (36.5 ± 1.3 vs 14.3 ± 6.7 mEq/L, p < 0.01). Delay in the ED until hemodialysis was started did not differ (group A 6.4 ± 2.6 hr, group B 5.3 ± 3.5 hr), while duration of hemodialysis until serum methanol levels became permanently undetectable was longer in group A (15.0 ± 0.5 vs 8.4 ± 4.4 hr, p < 0.01). The ingested dose of methanol and the delay between ingestion and initiation of therapy to block methanol metabolism (ethanol infusion) and remove methanol from the body (hemodialysis) appear to be the critical factors influencing the outcome of methanol intoxication. Early diagnosis and initiation of treatment before substantial parts of the ingested methanol have been metabolized are of paramount importance in ensuring a favorable outcome.
A digital advocate? Reactions of rural people who experience homelessness to the idea of recording clinical encounters
Authors: Grande Stuart W. , Castaldo Mary Ganger , Carpenter‐Song Elizabeth , Griesemer Ida , Elwyn Glyn
Published: September 2016

Background

Are the benefits of recording clinical encounters shared across different groups, or do they vary based on social position? Studies show that educated patients record their clinical visits to enhance their experience, but very little is known about recording benefits among “hard‐to‐reach” populations.

Objective

To examine the reactions of homeless people to the idea of using a smartphone to record their own clinical encounter, either covertly or with permission from their physician.

Method

We conducted semi‐structured interviews with individuals at a temporary housing shelter in Northern New England. A thematic analysis identified themes that were iteratively refined into representative groups.

Results

Eighteen (18) interviews were conducted, 12 with women and six with men. Initial reactions to clinical recordings were positive (11 of 18). A majority (17 of 18) were willing to use recordings in future visits. A thematic analysis characterized data in two ways: (i) by providing reliable evidence for review, they functioned as an advocacy measure for patients; (ii) by promoting transparency and levelling social distance, this technology modified clinical relationships.

Discussion

Recordings permitted the sharing of data with others, providing tangible proof of behaviour and refuting misconceptions. Asking permission to record appeared to modify relationships and level perceived social distance with clinicians.

Conclusions

We found that while many rural, disadvantaged individuals felt marginalized by the wide social distance between themselves and their clinicians, recording technology may serve as an advocate by holding both patients and doctors accountable and by permitting the burden of clinical proof to be shared.
Health information sources for different types of information used by Chinese patients with cancer and their family caregivers
Authors: Xie Bo , Su Zhaohui , Liu Yihao , Wang Mo , Zhang Ming
Published: September 2016

Context

Little is known about the information sources of Chinese patients with cancer and their family caregivers, yet this knowledge is critical for providing patient‐centred care.

Objective

To assess and compare the information sources used by Chinese patients with cancer and their family caregivers.

Design

The validated Health Information Wants Questionnaire (HIWQ) was translated and administered in March 2014.

Setting

The oncology department of a general hospital in south‐west China.

Participants

A convenience sample of 198 individuals, including 79 patients with cancer (mean age=55.24, SD=13.80) and 119 family caregivers (mean age=46.83, SD=14.61).

Main outcome measures

Ratings on the HIWQ items assessing information sources for different types of information.

Results

The interaction between information source and group was significant (F3,576=6.32, P<.01). Caregivers obtained more information than patients from the Internet. Caregivers and patients did not differ in the amount of information they obtained from doctors/nurses, interpersonal contacts or mass media. The interaction between information type and information source was significant (F18,3456=6.38, P<.01). Participants obtained more information of all types from doctors/nurses than from the other three sources and obtained more information from interpersonal contacts than from mass media or the Internet.

Conclusions

The information sources of Chinese patients with cancer and their family caregivers were similar, with an important difference that caregivers obtained more online information than patients. These findings have important implications for patient care and education in China where the family typically plays a major role in the care and decision making.
Developing countries and systemic pension reforms: Reflections on some emerging problems
Authors: Wang Xinmei , Williamson John B. , Cansoy Mehmet
Published: September 2016

Since 1981 close to forty countries have introduced systemic pension reforms that have replaced all or part of prior pay‐as‐you‐go (PAYG) schemes with privately managed funded defined contribution (FDC) pillars or systems. However, over the past decade about half of these countries have subsequently cutback on, or entirely eliminated, these FDC schemes. In this article we explore some of the reasons why this reversal is often taking place in developing countries. As part of our analysis we propose a new pension reform typology that goes beyond the commonly used dichotomy between PAYG and pension privatization. We identify and discuss four factors that are of particular relevance to those seeking to understand the pension policy reversals that have been taking place in many developing countries: low pension coverage and incentive incompatibility, triple burden costs, tradeoffs between pension reforms and social pensions, and difficulties with annuitization.
Leadership and emotional intelligence in nursing and midwifery education and practice: a discussion paper
Authors: Carragher Jean , Gormley Kevin
Published: September 2016

Aim

A discussion of the concepts of leadership and emotional intelligence in nursing and midwifery education and practice.

Background

The need for emotionally intelligent leadership in the health professions is acknowledged internationally throughout the nursing and midwifery literature. The concepts of emotional intelligence and emotional‐social intelligence have emerged as important factors for effective leadership in the healthcare professions and require further exploration and discussion. This paper will explore these concepts and discuss their importance in the healthcare setting with reference to current practices in the UK, Ireland and internationally.

Design

Discussion paper.

Data sources

A search of published evidence from 1990–2015 using key words (as outlined below) was undertaken from which relevant sources were selected to build an informed discussion.

Implications for nursing/midwifery

Fostering emotionally intelligent leadership in nursing and midwifery supports the provision of high quality and compassionate care. Globally, leadership has important implications for all stakeholders in the healthcare professions with responsibility for maintaining high standards of care. This includes all grades of nurses and midwives, students entering the professions, managerial staff, academics and policy makers.

Conclusion

This paper discusses the conceptual models of leadership and emotional intelligence and demonstrates an important link between the two. Further robust studies are required for ongoing evaluation of the different models of emotional intelligence and their link with effective leadership behaviour in the healthcare field internationally. This is of particular significance for professional undergraduate education to promote ongoing compassionate, safe and high quality standards of care.
Reproductive biology and feeding habits of the prickly dogfishOxynotus bruniensis
Authors: Finucci B. , Bustamante C. , Jones E. G. , Dunn M. R.
Published: September 2016

The reproductive biology and diet of prickly dogfishOxynotus bruniensis, a deep‐sea elasmobranch, endemic to the outer continental and insular shelves of southern Australia and New Zealand, and caught as by‐catch in demersal fisheries, are described from specimens caught in New Zealand waters. A total of 53 specimens were obtained from research surveys and commercial fisheries, including juveniles and adults ranging in size from 33·5 to 75·6 cm total length (LT). Estimated size‐at‐maturity was 54·7 cmLTin males and 64·0 cmLTin females. Three gravid females (65·0, 67·5 and 71·2 cmLT) were observed, all with eight embryos. Size‐at‐birth was estimated to be 25–27 cmLT. Vitellogenesis was not concurrent with embryo development. Analysis of diet from stomach contents, includingDNAidentification of prey using the mitochondrial genescox1 andnadh2, revealed thatO. bruniensispreys exclusively on the egg capsules of holocephalans, potentially making it the only known elasmobranch with a diet reliant solely upon other chondrichthyans. Based on spatial overlap with deep‐sea fisheries, a highly specialized diet, and reproductive characteristics representative of a low productivity fish, the commercial fisheries by‐catch ofO. bruniensismay put this species at relatively high risk of overfishing.
Seasonal dynamics in community structure, abundance, body size and sex ratio in two species of Neotropical annual fishes
Authors: Lanés L. E. K. , Godoy R. S. , Maltchik L. , Polačik M. , Blažek R. , Vrtílek M. , Reichard M.
Published: September 2016

Seven ephemeral pools on the coastal plain of southern Brazil were found to be inhabited by three annual and 22 non‐annual fish species. Two common annual species (Austrolebias minuano and Cynopoecilus fulgens) exhibited clear seasonal dynamics, with the appearance of young fishes in the austral autumn (May to June) and a decline in abundance over the seasonal cycle. The third annual species, Austrolebias wolterstorffii, was rare. No seasonal dynamics were observed in non‐annual fishes. The relative abundance of non‐annual fishes compared with annual fishes increased over the seasonal cycle, but they coexisted widely. The size structure of annual fishes suggested the presence of a single age cohort in most pools though a second age cohort was registered in one pool in August, coinciding with a large flooding. Strong sexual dimorphism in body size was found in C. fulgens throughout the seasonal cycle, while no sexual dimorphism in body size was found in A. minuano. Female‐biased sex ratios were recorded in both common annual fish species in the last three sampling dates (in spring), but not during the first two sampling dates (in winter). The natural lifespan of annual fishes was <8 months. Annual fishes disappeared before habitat desiccation in half of the pools, while non‐annual fishes were still present.
Synaptopathies: synaptic dysfunction in neurological disorders – A review written by students for students, and a story of success for ISN schools
Authors: Schulz Jörg B. , Hausmann Laura
Published: September 2016

One of the major endeavors of the International Society for Neurochemistry (ISN) is the promotion and support of young researchers, for instance at ‘schools’ that offer young students an opportunity to closely interact with renowned researchers as well as with each other. As a result of the 13th International Society for Neurochemistry Advanced School on ‘Synapses’ held in Mission Beach, Australia, prior to the Biennial Meeting of the International Society for Neurochemistry in August 2016 in Cairns, we are pleased to publish this comprehensive Review article, written from students for students.

Read the highlighted article ‘Synaptopathies: synaptic dysfunction in neurological disorders – A review from students to students’ on page 785.
Different Origins of Xenophile and Xenophobic Orientations in Human Personality Structure: A Theoretical Perspective and Some Preliminary Findings
Authors: Barbarino Maria‐Luisa , Stürmer Stefan
Published: September 2016

Building on an integration of research findings on proactive intergroup behavior from multiple fields of inquiry (biology, paleoanthropology, social psychology) as well as research on the HEXACO personality framework, a prospective study among adolescents investigated the relations between personality traits and xenophile and xenophobic orientations (Total N = 455, 219 males, Mage = 17.66 years). Path models corroborate that xenophile orientations and xenophobic orientations were predicted by two distinct subsets of major personality traits: High scores in endeavor‐related traits (i.e., Openness to Experience, Extraversion, and Conscientiousness) predicted greater xenophile orientations, whereas low scores in altruism/cooperation‐related traits (i.e., Honesty‐Humility, Agreeableness, and Emotionality) predicted greater xenophobic orientations. Conclusions on the effects of personality traits were complemented by a distinct pattern of gender effects suggesting higher levels of xenophobic orientations among male adolescents and higher levels of xenophile orientations among females. Theoretical and practical implications of these findings are discussed.
Self‐Expansion and Intergroup Contact: Expectancies and Motives to Self‐Expand Lead to Greater Interest in Outgroup Contact and More Positive Intergroup Relations
Authors: Paolini Stefania , Wright Stephen C. , Dys‐Steenbergen Odilia , Favara Irene
Published: September 2016

Sixty years of research on intergroup contact demonstrates that positive interactions across group boundaries can improve intergroup attitudes and can contribute to forging tolerant, integrated, multicultural societies. However, to fully realize the benefits of growing diversity around the globe, individuals need to exploit opportunities for intergroup contact that are available to them. Yet, it is relatively unknown why people might deliberately engage in cross‐group interactions and how individuals’ expectations and motives prepare them to develop positive interpersonal relationships with outgroup members. In this article, we begin to address these research gaps. We discuss the self‐expansion model and present new evidence that is consistent with this model. Two studies, one correlational in a cross‐cultural setting and the other experimental, show the value of high self‐expansion expectancies and motivation in promoting interest in and producing more and higher quality interactions across group boundaries. We discuss implications of these findings for policy and intervention.
A Cook's Tour Abroad: Long‐Term Effects of Intergroup Contact on Positive Outgroup Attitudes
Authors: Livert David
Published: September 2016

This mixed‐methods, longitudinal study documents the short‐ and long‐term impact of a cook's tour of Vietnam by 14 U.S. chef students. Over 3 weeks, travelers engaged in myriad intergroup interactions to experience Vietnam's cuisine and culture, exemplifying a positive intergroup orientation consistent with allophilia and xenophilia. Measures included a pretrip questionnaire, daily journal, and posttrip questionnaire, as well as participant observation. Short‐term attitude change included significant increases in positive affect toward the Vietnamese, negative stereotypes, and intergroup understanding. Nearly 10 years later, the author interviewed 10 of the original trip participants. Consistent with allophilia theory, participants expressed continued affection, kinship, and enthusiasm toward the Vietnamese people and remained motivated to engage the Vietnamese culture and cuisine. Additional evidence of allophilic specificity, openness to experience, and deprovincialism is also discussed.
The Historical and Relational Contexts of the Study of Positive Behaviors across Group Boundaries
Authors: Nadler Arie
Published: September 2016

The article begins by placing the present emphasis against the background of developments in two fields of social psychological research: intergroup relations and prosocial behavior. This interest in cross‐group positive behaviors emanates, partly at least, from developments in Social Psychology the sociocultural environment in which it has developed. Subsequently, the meaning of positive behavior is considered within a specific intergroup relational context. From a broad perspective, intergroup relations are positive, neutral, or negative. Negative relations can be characterized by direct violence or structural violence. Allophilia and xenophilia are seen as most appropriate in relatively neutral relational contexts, social change in contexts of structural violence, and the healing conflict‐related psychological scars in direct violence. A final section discusses three possible future research directions: Effects of power relations, in‐group identity, and Internet‐based interactions on cross‐group positive behaviors. A discussion of the important implications of the research concludes this article.