bluuebunny/crossref_metadata_2025 huggingface dataset:
Editorial: Global mental health: challenges & opportunities
Authors: Joshi Paramjit T.
Published: October 2018

There are few human tragedies that stir sympathy and concern more deeply than to see the suffering of children from around the world, often giving rise to spontaneous feelings and impulses of wanting to help. However, such impulses need to be harnessed in a productive manner. Knowledge and training in the psychopathology and phenomenology of mental illness is not enough. New, innovative, evidence‐based treatments and interventions are equally important if we are to adequately address the needs of our youth who carry the burden of a psychiatric and/or behavioral condition.

This edition of CAMH includes papers that address both the challenges and opportunities in terms of the way in which interventions underpinned by research can work to improve global mental health and how we can better understand the environmental, familial, cultural and societal underpinnings of global child mental health problems.
Static computer‐aided implant surgery (s‐CAIS) analysing patient‐reported outcome measures (PROMs), economics and surgical complications: A systematic review
Authors: Joda Tim , Derksen Wiebe , Wittneben Julia Gabriela , Kuehl Sebastian
Published: October 2018

Objective

To systematically evaluate the scientific literature for patient‐reported outcome measures (PROMs) in static computer‐aided implant surgery (s‐CAIS).

Methods

A PICO strategy was executed using an electronic (MEDLINE, EMBASE, CENTRAL), plus manual search up to 15‐06‐2017 focusing on clinical studies investigating s‐CAIS with regard to patients’ pain & discomfort, economics and/or intra‐operative complications. Search strategy was assembled from multiple conjunctions of MeSH Terms and unspecific free‐text words. Assessment of risk of bias in selected studies was made at a “trial level” applying the Cochrane Collaboration Tool and the Newcastle–Ottawa Assessment Scale, respectively.

Results

The systematic search identified 112 titles. Seventy abstracts were screened, and 14 full texts were included for analysis. A total of 484 patients were treated with s‐CAIS for placement of 2,510 implants. Due to the heterogeneity of the included studies, meta‐analyses could not be performed.

Conclusions

The number of identified studies investigating s‐CAIS for PROMs was low. Scientifically proven recommendations for clinical routine cannot be given at this time; however, the number of clinical complications with s‐CAIS seems to be negligible and comparable to conventional implant surgery. s‐CAIS may offer a beneficial treatment option in edentulous cases if a flapless approach is applicable. Nevertheless, the economic effects in terms of time efficiency and treatment costs are unclear. Clinical investigations with well‐designed RCTs investigating PROMs with standardized parameters are compellingly necessary for the field of s‐CAIS.
A systematic review of the survival and complication rates of zirconia‐ceramic and metal‐ceramic multiple‐unit fixed dental prostheses
Authors: Sailer Irena , Strasding Malin , Valente Nicola Alberto , Zwahlen Marcel , Liu Shiming , Pjetursson Bjarni Elvar
Published: October 2018

Objectives

The aim of the present review was to compare the outcomes, that is, survival and complication rates of zirconia‐ceramic and/or monolithic zirconia implant‐supported fixed dental prostheses (FDPs) with metal‐ceramic FDPs.

Materials and Methods

An electronic MEDLINE search complemented by manual searching was conducted to identify randomized controlled clinical trials, prospective cohort studies and retrospective case series on implant‐supported FDPs with a mean follow‐up of at least 3 years. Patients had to have been examined clinically at the follow‐up visit. Assessment of the identified studies and data extraction was performed independently by two reviewers. Failure and complication rates were analyzed using robust Poisson regression models to obtain summary estimates of 5‐year proportions.

Results

The search provided 5,263 titles and 455 abstracts. Full‐text analysis was performed for 240 articles resulting in 19 studies on implant FDPs that met the inclusion criteria. The studies reported on 932 metal‐ceramic and 175 zirconia‐ceramic FDPs. Meta‐analysis revealed an estimated 5‐year survival rate of 98.7% (95% CI: 96.8%–99.5%) for metal‐ceramic implant‐supported FDPs, and of 93.0% (95% CI: 90.6%–94.8%) for zirconia‐ceramic implant‐supported FDPs (p < 0.001). Thirteen studies including 781 metal‐ceramic implant‐supported FDPs estimated a 5‐year rate of ceramic fractures and chippings to be 11.6% compared with a significantly higher (p < 0.001) complication rate for zirconia implant‐supported FDPs of 50%, reported in a small study with 13 zirconia implant‐supported FDPs. Significantly (p = 0.001) more, that is, 4.1%, of the zirconia‐ceramic implant‐supported FDPs were lost due to ceramic fractures compared to only 0.2% of the metal‐ceramic implant‐supported FDPs. Detailed analysis of factors like number of units of the FDPs or location in the jaws was not possible due to heterogeneity of reporting. No studies on monolithic zirconia implant‐supported FDPs fulfilled the inclusion criteria of the present review. Furthermore, no conclusive results were found for the aesthetic outcomes of both FDP‐types.

Conclusion

For implant‐supported FDPs, conventionally veneered zirconia should not be considered as material selection of first priority, as pronounced risk for framework fractures and chipping of the zirconia veneering ceramic was observed. Monolithic zirconia may be an interesting alternative, but its clinical medium‐ to long‐term outcomes have not been evaluated yet. Hence, metal ceramics seems to stay the golden standard for implant‐supported multiple‐unit FDPs.
Immediate loading vs. early/conventional loading of immediately placed implants in partially edentulous patients from the patients’ perspective: A systematic review
Authors: Huynh‐Ba Guy , Oates Thomas W. , Williams Mary Ann H.
Published: October 2018

Objectives

This systematic review aimed at answering the followingPICOquestion: In patients receiving immediate (Type 1) implant placement, how does immediate compare to early or conventional loading in terms of Patient‐Reported Outcome Measures (PROMs)?

Material and Methods

Following search strategy development, theOVID, PubMed,EMBASE, and Cochrane Database of Systematic Reviews databases were search for the relevant literature. All levels of evidence including randomized controlled trials, prospective and retrospective cohort studies, and case series of at least five patients were considered for possible inclusion. An additional manual search was performed by screening the reference lists of relevant studies and systematic reviews published up to May 2017. The intervention considered was the placement of immediate implant.

Study selection and data extraction were performed independently by two reviewers.

Results

The search yielded a list of 1,102 references, of which nine were included in this systematic review. The limited number of studies included and the heterogeneity of the data identified prevented the performance of a meta‐analysis. Three studies, one of which was a randomized controlled trial, allowed the extraction of comparative data specific to the aim of the present systematic review. The remaining studies allowed only data extraction for one single treatment modality and were viewed as single cohort studies. Overall, irrespective of thePROMs chosen, patients’ satisfaction was overall high with little difference between the two loading protocols. Moreover, studies indicated a positive impact on oral health‐related quality of life following immediate implant placement and loading.

Conclusions

Within the limitations of the present systematic review, immediate implant placement and loading in single tooth edentulous space seems to be a well‐accepted treatment modality from the patients’ perspective and is worthy of consideration in clinical practice. However, the paucity of comparative data limits any definitive conclusions as to which loading protocol; immediate or early/conventional, should be given preference based onPROMs.
Number of implants placed for complete‐arch fixed prostheses: A systematic review and meta‐analysis
Authors: Daudt Polido Waldemar , Aghaloo Tara , Emmett Thomas W. , Taylor Thomas D. , Morton Dean
Published: October 2018

Objectives

The main purpose of this systematic review was to evaluate outcomes related to the number of implants utilized to support complete‐arch fixed prostheses, both for the maxilla and the mandible.

Materials and methods

This review followed the reporting guidelines of the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA). A focused question using the PICO format was developed, questioning whether “In patients with an implant supported fixed complete dental prosthesis, do implant and prosthetic survival outcomes differ between five or more compared to fewer than five supporting implants?”. A comprehensive search of the literature was formulated and performed electronically and by hand search. Two independent reviewers selected the papers and tabulated results. Primary outcomes analyzed were implant and prosthesis survival. Implant distribution, loading, and type of retention were observed as secondary outcomes, as they relate to the number of implants. A meta‐analysis was performed to compare results for studies by number of implants.

Results

The search strategy identified 1,579 abstracts for initial review. Based on evaluation of the abstracts, 359 articles were identified for full‐text evaluation. From these, 93 were selected and included in this review, being nine RCTs, 42 prospective and 42 retrospective. Of the 93 selected studies, 28 reported number of implants for the maxilla, 46 for the mandible, and 19 for both maxilla and mandible. The most reported number of implants for the “fewer than five” group is 4 for the maxilla, and 3 and 4 for the mandible, whereas for the “five or more” implants group, the most reported number of implants was 6 for the maxilla and 5 for the mandible. No significant differences in the primary outcomes analyzed were identified when fewer than five implants per arch were compared with five or more implants per arch (p > 0.05), in a follow‐up time ranging from 1 to 15 years (median of 8 years).

Conclusions

Evidence from this systematic review and meta‐analysis suggests that the use of fewer than five implants per arch, when compared to five or more implants per arch, to support a fixed prosthesis of the completely edentulous maxilla or mandible, present similar survival rates, with no statistical significant difference at a p < 0.05 and a confidence interval of 95%.
Effects of a toothpaste containing 0.3% triclosan in the maintenance phase of peri‐implantitis treatment: 2‐Year randomized clinical trial
Authors: Stewart Bernal , Shibli Jamil Awad , Araujo Mauricio , Figueiredo Luciene Cristina , Panagakos Fotinos , Matarazzo Flavia , Mairink Renata , Onuma Tatiana , Faveri Marcelo , Retamal‐Valdes Belén , Feres Magda
Published: October 2018

Objective

To evaluate the effects of a toothpaste containing 0.3% triclosan in volunteers that have been treated for peri‐implantitis and were enrolled in a maintenance program.

Material and methods

Subjects presenting at least one implant with peri‐implantitis were selected. They received anti‐infective surgical therapy, and sixty days post‐surgery (baseline) were randomized into two groups, brushing twice/day for 2 years (a) with a toothpaste containing 0.3% triclosan+2.0% PVM/MA copolymer (GantrezTM)+1,450 ppm fluoride (test) or (b) with a toothpaste containing 1,450 ppm fluoride (control). They received clinical and microbiological monitoring at baseline, 3, 6, 12, 18, and 24 months, and professional maintenance every 3 months.

Results

A total of 102 subjects were enrolled (test: 48; control: 54). The control group showed loss of clinical attachment (CA) around treated implants over the course of the study (p < 0.05), while the test group was stable for this parameter. The difference between groups (0.55 mm) for CA change between baseline and 24 months (primary outcome variable) was statistically significant (p < 0.05). Red complex pathogens were only reduced in the test group at 24 months. The implants with no history of peri‐implantitis in the test group had a significant reduction in the percentage of sites with bleeding on probing and in mean probing depth, throughout the study (p < 0.05). This improvement was not observed in the control group.

Conclusion

A toothpaste containing 0.3% triclosan was more effective than a toothpaste without triclosan in maintaining a healthy peri‐implant environment around treated implants and implants with no history of peri‐implantitis during a 2‐year maintenance program (ClinicalTrials.govNCT03191721).
Polarity protein Canoe mediates overproliferation via modulation of JNK, Ras‐MAPK and Hippo signalling
Authors: Ma Zhiwei , Li Ping , Hu Xingjie , Song Haiyun
Published: October 2018

Objectives

Over the past decade an intriguing connection between cell polarity and tumorigenesis has emerged. Multiple core components of the junction complexes that help to form and maintain cell polarity display both pro‐ and anti‐tumorigenic functions in a context‐dependent manner, with the underlying mechanisms poorly understood.

Materials and Methods

With transgenic fly lines that overexpress or knock down specific signalling components, we perform genetic analysis to investigate the precise role of the polarity protein Canoe (Cno) in tumorigenesis and the downstream pathways.

Results

We show that overexpression of cno simultaneously activates JNK and Ras‐MEK‐ERK signalling, resulting in mixed phenotypes of both overproliferation and cell death in the Drosophila wing disc. Moderate alleviation of JNK activation eliminates the effect of Cno on cell death, leading to organ overgrowth and cell migration that mimic the formation and invasion of tumours. In addition, we find that the Hippo pathway acts downstream of JNK and Ras signalling to mediate the effect of Cno on cell proliferation.

Conclusions

Our work reveals an oncogenic role of Cno and creates a new type of Drosophila tumour model for cancer research.
Learning about Type 1 diabetes and learning to live with it when diagnosed in adulthood: two distinct but inter‐related psychological processes of adaptation A qualitative longitudinal study
Authors: Due‐Christensen M. , Willaing I. , Ismail K. , Forbes A.
Published: October 2018

Aim

To explore the experiences of adults with newly diagnosed Type 1 diabetes in order to understand the adaptive processes that occur in the early phase of the condition.

Methods

We conducted longitudinal semi‐structured interviews with 30 adults newly diagnosed with Type 1 diabetes (age range 20–67 years; 16 men; median diabetes duration 23.5 months), recruited from hospitals in Denmark and the UK. The data were analysed using a narrative approach.

Results

The narratives could be grouped into three thematic areas: the diagnosis; learning about diabetes; and learning to live with diabetes. Diabetes was characterized as a major disruptor to the established and future life plans of participants, causing significant emotional distress. The narratives showed how early experiences triggered the development of ongoing psychological problems (fear of complications or hypoglycaemia) and diabetes distress, and that navigating different social scenarios (relationships and employment) could be challenging, leading to suboptimal self‐management behaviours. The narratives also showed that health professionals often did not attend effectively to participants’ emotional needs after diagnosis, and that the language used frequently triggered negative feelings, such as fear or a sense of failure.

Conclusions

Many of the common psychosocial problems associated with Type 1 diabetes seem to gestate in the early phase of life with the condition. There appear to be opportunities to enhance the support provided in this phase to minimize these problems.
GlucoTab‐guided insulin therapy using insulin glargine U300 enables glycaemic control with low risk of hypoglycaemia in hospitalized patients with type 2 diabetes
Authors: Aberer Felix , Lichtenegger Katharina M. , Smajic Edin , Donsa Klaus , Malle Oliver , Samonigg Judith , Höll Bernhard , Beck Peter , Pieber Thomas R. , Plank Johannes , Mader Julia K.
Published: October 2018

Aims

To investigate efficacy, safety and usability of the GlucoTab system for glycaemic management using insulin glargine U300 in non‐critically ill hospitalized patients with type 2 diabetes (T2D).

Materials and Methods

In this open, non‐controlled single‐arm pilot study, glycaemic control at the general ward of a tertiary care hospital was guided by a mobile decision support system (GlucoTab) for basal‐bolus insulin dosing using the novel basal insulin analogue insulin glargine U300 for the first time. Glycaemic control was surveilled with capillary glucose measurements and continuous glucose monitoring (CGM). The primary endpoint was efficacy of glycaemic management, defined as the percentage of blood glucose measurements within the target range of 3.9 to 7.8 mmol/L.

Results

A total of 30 patients with T2D (12 female; age, 67 ± 11 years; HbA1c, 70 ± 26 mmol/mol; BMI, 31.8 ± 5.6 kg/m2; length of study, 8.5 ± 4.5 days) were included. In total, 894 capillary glucose values and 49 846 data points of CGM were available, of which 56.1% of all measured capillary glucose values and 54.3% of CGM values were within the target area (3.9‐7.8 mmol/L). Overall capillary mean glucose was 8.5 ± 1.2 and 8.4 ± 1.2 mmol/L assessed by CGM. Time within glucose target improved continuously during the course of treatment, while time within hypoglycaemia (<3.9 mmol/L) decreased substantially. The GlucoTab‐suggested total daily dose was accepted by staff in 97.3% of situations.

Conclusions

Treatment with GlucoTab using insulin glargine U300 in hospitalized patients with T2D is effective and safe.
FGF21 decreases food intake and body weight in obese Göttingen minipigs
Authors: Christoffersen Berit , Straarup Ellen M. , Lykkegaard Kirsten , Fels Johannes J. , Sass‐Ørum Kristian , Zhang Xujia , Raun Kirsten , Andersen Birgitte
Published: October 2018

Aims

The aim of this study was to assess the effect of FGF21 on food intake, body weight, body composition, glucose homeostasis, bone mineral density (BMD), cortisol and growth hormone (GH) in obese minipigs. The pig is a unique model for studying FGF21 pharmacology as it does not express UCP1, unlike mice and humans.

Methods

Twelve obese Göttingen minipigs with a mean body weight of 91.6 ± 6.7 kg (mean ± SD) received subcutaneously either vehicle (n = 6) or recombinant human FGF21 (n = 6) once daily for 14 weeks (0.1 mg/kg for 9.5 weeks and 0.3 mg/kg for 4.5 weeks).

Results

Treatment of obese minipigs with FGF21 led to a 50% reduction in food intake and a body weight loss of, on average, 18 kg compared to the vehicle group after 14 weeks of dosing. Glucose tolerance and insulin sensitivity, evaluated by intravenous glucose tolerance test, were significantly improved in the FGF21 group compared to the vehicle group at the end of the study. The plasma cortisol profile was unaffected by FGF21, whereas a small decrease in peak GH values was observed in the FGF21‐treated animals after 7 to 9.5 weeks of treatment compared to the vehicle group. Whole‐body BMD was not affected by 13 weeks of FGF21 dosing.

Conclusion

Despite a lack of UCP‐1 in obese minipigs, FGF21 treatment induced a significant weight loss, primarily a result of reduction in food intake, with no adverse effect on BMD or plasma cortisol.
Vitiligo surgery: A journey from tissues via cells to the stems!
Authors: Razmi T Muhammed , Afra T. P. , Parsad Davinder
Published: October 2018

Depigmented patches in vitiligo, a common dermatosis, cause a great psychological distress to the patients. Hence, apart from halting the disease process, the strategies to impart normal skin colour to these white patches carry an important role in the management of vitiligo. Surgical procedures are often required for stable vitiligo lesions not responding to medical therapies. It involves “shuffling” of melanocytes from the pigmented skin to the depigmented areas. During the last fifty years, the vitiligo surgery has evolved from tissue transplantation via cellular transplantation to reach a stage where the use of stem cells or immunomodulatory cells is contemplating. We would like to depict this wonderful journey of vitiligo surgery through this viewpoint.
Dopamine (DRD2) and Serotonin (HTR2A, 2C) Receptor Gene Polymorphisms do not influence early response to Risperidone in South Indian Patients with Schizophrenia
Authors: Alladi Charanraj Goud , RajKumar Ravi Philip , Adithan Surendiran , Marie‐Claire Cynthia , Bellivier Frank , Shewade Deepak Gopal
Published: October 2018

Treatment response to antipsychotic drugs is variable and conflicting results have been obtained while studying the influence of DRD2 and HTR2 genetic variants on antipsychotic drug efficacy. To explore further, the present study aimed to assess the influence of DRD2 ‐141 C Ins/Del, Taq1A and HTR2A ‐1438 G/A, 102T/C and HTR2C ‐759 C/T genetic polymorphisms in response to risperidone in patients with schizophrenia. The study was conducted among the n = 320 South Indian patients with schizophrenia who received risperidone treatment (4–8 mg per day) for a minimum of four weeks. Genotyping was done by real‐time PCR. Antipsychotic response was assessed using CGI‐I score in cross‐sectional group, PANSS score in prospective group at baseline and after receiving the risperidone therapy. DRD2 ‐141 C Ins/Del (n = 310, Ins/Ins = 177, Ins/Del+ Del/Del = 133, OR 0.70, 95% CI 0.4–1.2 p 0.2), Taq1A (n = 320, AA = 35, AG = 132, GG = 153, p 0.2), HTR2A ‐1438 G/A (n = 320, AA = 39, AG = 164, GG = 117, p 0.2), HTR2A 102T/C (n = 320, CC = 115, CT = 165, TT = 40, p 0.1) HTR2C ‐759 C/T (females n = 132, CC = 65, CT+TT = 67, OR 1.3, 95% CI 0.6–2.8, p 0.5; males n = 186, C = 120, T = 66, OR 1.2, 95% CI 0.6–2.4, p 0.4) genetic polymorphisms did not show any association with antipsychotic response to risperidone. DRD2 ‐141 C Ins/Del, Taq1A, HTR2A ‐1438 G/A, 102T/C and HTR2C ‐759 C/T genetic variants are not associated with antipsychotic response to risperidone.
Novel features of LH1‐RC from Thermochromatium tepidum revealed from its atomic resolution structure
Authors: Yu Long‐Jiang , Suga Michihiro , Wang‐Otomo Zheng‐Yu , Shen Jian‐Ren
Published: October 2018

Light‐harvesting‐1 (LH1)‐reaction center (RC) super‐complex is a membrane protein–pigment complex existing in purple photosynthetic bacteria, where LH1 absorbs light energy and transfers them rapidly and efficiently to RC to initiate the charge separation and electron transfer reactions. The structure of LH1‐RC has been reported at relatively low resolutions from several different species of bacteria previously, but was solved at an atomic resolution recently from a thermophilic photosynthetic bacterium Thermochromatium tepidum. This high‐resolution structure revealed the detailed organization of the super‐complex including a number of unique features that are important for its functioning, such as a more intact RC structure, transporting routes for quinones to replace the bound QB as well as for the in‐and‐out of the closed LH1 ring, detailed coordinating environment of the Ca2+ ions in LH1 important for the remarkable red shift of the absorption spectrum, as well as for the enhanced thermostability. These results thus greatly advance our understanding on the mechanisms of energy transfer, quinone exchange, the red shift in the LH1‐Qy transition and the enhanced thermal stability, in this super‐complex.
Genetic diversity is retained in a bottlenecked Cinereous Vulture population in Turkey
Authors: Çakmak Emel , Akin Pekşen Çİğdem , Kİrazli Cİhangİr , Yamaç Elİf , Bensch Staffan , Bİlgİn Cemal Can
Published: October 2018

Vulture populations worldwide have suffered precipitous declines in recent decades. The Cinereous VultureAegypius monachus, a highly philopatric scavenger distributed across southern Europe and the central Asian plateau, is threatened in many parts of its range. Turkey holds the second largest population of this species in the Western Palaearctic, but there has been no research on its genetic structure and the possible implications of this structure for the future of the species. Here we report nuclear diversity and relatedness determined by short tandem repeat genotyping of 81 individuals from the four largest colonies. Our results demonstrated no significant genetic structuring, suggesting a single panmictic metapopulation connected by frequent dispersal. Furthermore, we show that the study population has retained moderate levels of genetic diversity, despite passing through a recent demographic bottleneck. We estimated the effective population size to be 112 individuals (95% confidence interval 74–201). Our results imply that the observed lack of increase in population size since the 1990s has not been caused by lowered fitness due to genetic inbreeding but rather by increased mortality via demographic processes. In the short term, we suggest that conservation efforts should treat the Turkish subpopulations as a single management unit and aim to increase population size through effective protection, especially during the breeding season.
Factors affecting population regulation of a colonial vulture
Authors: Zuberogoitia Iñigo , Martínez José Enrique , González‐Oreja José Antonio , Pérez de Ana Juan Manuel , Zabala Jabi
Published: October 2018

Two hypotheses have been proposed to link population regulation to density‐dependent changes in demographical parameters: the habitat heterogeneity hypothesis (HHH) states that, as population density rises, an increasing proportion of individuals are forced to occupy low‐quality territories, which provokes a decline in average per‐capita survival and/or productivity although some individuals show no decline in fecundity; and the individual adjustment hypothesis (IAH), which suggests that increased densities lead to reductions in survival and/or fecundity by enhancing agonistic interactions, which affect all individuals to a similar extent. However, density‐dependent effects can be affected by density‐independent factors (DIF), such as weather. We test the effects of density dependence on annual reproductive success in Griffon VulturesGyps fulvusat four spatial scales, nest‐site, cliff, colony and metacolony, in northern Spain from 2008 to 2015. Our results showed most support for theHHHat all scales. At the colony and cliff scale,IAHandDIFhad similar importance, whereas there was little evidence ofIAHat the metacolony and the nest scale. The best protected eyries (caves, potholes and sheltered ledges) produced the most fledglings and were used preferentially, whereas low‐quality eyries (exposed ledges or open crevices) were used only when the number of breeders increased. The significant interaction between breeding failure and density found for the more exposed eyries suggests that at higher densities, breeding pairs are forced to use poorer nesting areas, and the negative effect of density at the cliff scale could be due to the combined effect of a higher proportion of pairs using low‐quality eyries and the negative effect of rainfall.
Perturbaciones de la demanda y ajustes del empleo: ¿La protección del empleo provoca rigidez?
Authors: SOFI Irfan Ahmad , KUNROO Mohd Hussain
Published: October 2018

Con datos de panel de ámbito estatal del sector manufacturero de la India (2000–2012), y tomando la rotación laboral como indicador indirecto de los ajustes del empleo, los autores calculan el efecto de las perturbaciones de la demanda en dichos ajustes en los estados según la severidad de su legislación de protección del empleo (LPE). Concluyen que la LPE no dificulta los ajustes; ante perturbaciones negativas, el aumento de las tasas de separación del empleo es relativamente superior en los estados con mayor protección laboral, y la rotación laboral correlaciona negativamente con la LPE, un posible indicio de los efectos beneficiosos de la LPE para empresas y trabajadores.
Nurses’ use of conscientious objection and the implications for conscience
Authors: Lamb Christina , Evans Marilyn , Babenko‐Mould Yolanda , Wong Carol , Kirkwood Ken
Published: October 2018

Aims

To explore the meaning of conscience for nurses in the context of conscientious objection (CO) in clinical practice.

Design

Interpretive phenomenology was used to guide this study.

Data sources

Data were collected from 2016 ‐ 2017 through one‐on‐one interviews from eight nurses in Ontario. Iterative analysis was conducted consistent with interpretive phenomenology and resulted in thematic findings.

Review methods

Iterative, phased analysis using line‐by‐line and sentence highlighting identified key words and phrases. Cumulative summaries of narratives thematic analysis revealed how nurses made meaning of conscience in the context of making a CO.

Results

Conscience issues and CO are current, critical issues for nurses. For Canadian nurses this need has been recently heightened by the national legalization of euthanasia, known as Medical Assistance in Dying in Canada. Ethics education, awareness, and respect for nurses’ conscience are needed in Canada and across the profession to support nurses to address their issues of conscience in professional practice.

Conclusion

Ethical meaning emerges for nurses in their lived experiences of encountering serious ethical issues that they need to professionally address, by way of conscience‐based COs.

Impact

This is the first study to explore what conscience means to nurses, as shared by nurses themselves and in the context of CO. Nurse participants expressed that support from leadership, regulatory bodies, and policy for nurses’ conscience rights are indicated to address nurses’ conscience issues in practice settings.
Combination of edible vegetable oil and artificial fruit to reduce Bactrocera dorsalis oviposition in chilli fruits
Authors: Hidayat Yusup , Ferera Rindy Friesca , Ramadhan Ahmad Faiq , Kurniawan Wawan , Yulia Endah , Rasiska Siska
Published: October 2018

Bactrocera dorsalis (Hendel) is a major pest of a wide variety of fruits and vegetables. This study aimed to evaluate the potency of combining edible vegetable oil application and artificial fruit provision to reduce the oviposition of B. dorsalis in chilli fruits. Experiments were conducted in laboratory using a 20‐L plastic container provided with chilli fruits and in semi field using a fruit‐bearing chilli plant caged with insect screen. The laboratory test revealed that the combination of coconut oil application and artificial fruit provision significantly reduced fruit fly visits, eggs laid and the number of infested chilli fruits no matter when the chilli fruits were without prepuncture or with prepuncture. Further study using a caged chilli plant also found that this combination had significant effects on fruit fly visits and infestation in chilli fruits. These results provide an indication that coconut oil and artificial fruit can work together to reduce fruit fly attacks on chilli fruits. Combining the use of coconut oil and artificial fruit is likely to create an integrated behavioural manipulation (push and pull) of female B. dorsalis that lead to a much lower fruit fly infestation in chilli fruits.
Dietetics students’ experiences of dietetics workforce preparation and preparedness: a systematic review and qualitative synthesis
Authors: Morgan K. , Campbell K. L. , Reidlinger D. P.
Published: October 2018

Background

Dietetics students are a widely researched group. As emerging dietitians, they can provide valuable insights to inform how dietetics education programmes may be enhanced to meet contemporary healthcare needs. This review aimed to systematically synthesise dietetics students’ experiences of dietetics workforce preparation.

Methods

MEDLINE, CINAHL, Embase, PsycINFO, ERIC, Informit and ProQuest Dissertations and Theses Global were searched to identify research published until June 2017. Studies investigating dietetics students’ experiences of dietetics workforce preparation, and employing qualitative data collection and analysis methods were included. Data analysis was guided by thematic synthesis, where themes were constructed through an iterative and inductive process. Study quality was appraised using the RATS Qualitative Research Review Guidelines.

Results

From the 3301 records identified, five studies met the inclusion criteria and the views of 120 dietetics students from two countries over a 9‐year period were synthesised. The overarching theme of ‘navigating through the ups and downs’ was underpinned by four main themes: enduring hurdles; reconciling expectations; transforming self; and making and breaking connections. Quality appraisal results rated selection bias as being inadequate/inappropriate across all studies.

Conclusions

Dietetics students undertake a transformational journey through dietetics education. They are inspired by seeing what is possible through meaningful encounters with practitioners in diverse settings. However, they are challenged by competitive environments and perceived ideals that are embedded in the profession. Strategies that focus on exposing dietetics students to inspirational practitioners, increasing and celebrating diversity in academic/placement settings, and incentivising collaboration across dietetics education, could act as catalysts to enhance the experience of future dietetics students and the nutrition‐related health of those they will serve.
New insights into the mechanisms underlying recurrent pregnancy loss
Authors: Ewington Lauren J. , Tewary Shreeya , Brosens Jan J.
Published: October 2018

Recurrent pregnancy loss (RPL), defined as multiple consecutive miscarriages, is a devastating disorder for which there are no good treatment options. Two opposing paradigms have emerged to explain RPL. The prevailing clinical viewpoint is that RPL is caused by a spectrum of subclinical disorders, ranging from thrombophilia to anatomical, endocrine and immunological disorders, that somehow converge on a ‘fragile’ early pregnancy state, leading to miscarriage. A new paradigm, based on emerging concepts around early implantation events, challenges the conventional thinking around RPL. It purports that the high incidence of embryonic aneuploidies and mosaicism coupled with a cycling endometrium necessitates the introduction of multiple ‘quality control’ checkpoints in the first trimester of pregnancy to limit maternal investment in a failing pregnancy. Here we review the evidence underpinning both paradigms and examine how new thinking around RPL may lead to more effective preventative strategies.
Influence of sudden salinity variation on the physiology and domoic acid production by two strains of Pseudo‐nitzschia australis
Authors: Ayache Nour , Hervé Fabienne , Martin‐Jézéquel Véronique , Amzil Zouher , Caruana Amandine M. N.
Published: October 2018

Several coastal countries including France have experienced serious and increasing problems related to Pseudo‐nitzschia toxic blooms. These toxic blooms occur in estuarine and coastal waters potentially subject to fluctuations in salinity. In this study, we document for the first time the viability, growth, photosynthetic efficiency, and toxin production of two strains of Pseudo‐nitzschia australis grown under conditions with sudden salinity changes. Following salinity variation, the two strains survived over a restricted salinity range of 30–35, with favorable physiological responses, as the growth, effective quantum yield and toxin content were high compared to the other conditions. In addition, high cellular quotas of domoic acid (DA) were observed at a salinity of 40 for the strain IFR‐PAU‐16.1 in comparison with the other strain IFR‐PAU‐16.2 where the cell DA content was directly released into the medium. On the other hand, the osmotic stress imposed at lower salinities, 20 and 10, resulted in cell lysis and a sudden DA leakage in the medium. Intra‐specific variability was observed in growth and toxin production, with the strain IFR‐PAU‐16.1 apparently able to withstand higher salinities than the strain IFR‐PAU‐16.2. On the whole, DA does not appear to act as an osmolyte in response to sudden salinity changes. Since most of the shellfish harvesting areas of bivalve molluscs in France are located in areas where the salinity generally varies between 30 and 35, Pseudo‐nitzschia australis blooms might potentially impact public health and commercial shellfish resources in these places.
The Vagrancy Law Challenge and the Vagaries of Legal Change
Authors: Weinrib Laura
Published: October 2018

This essay reflects on the relationship between the diffuse legal struggle to dismantle vagrancy laws during the 1960s and the larger history of twentieth-century social movement advocacy. In Vagrant Nation, Risa Goluboff persuasively links the demise of vagrancy laws to the cultural and constitutional turmoil of the 1960s. It is possible, however, to interpret that decade's upheaval, which rendered explicit social stratification increasingly vulnerable, as an impediment to a budding anti-vagrancy law consensus instead of a prerequisite for legal change. On this alternative reading, the uncoordinated legal efforts to overturn vagrancy laws in a decade dominated by more contentious litigation campaigns may have contributed to a tepid decision by the Supreme Court, which ultimately invalidated vagrancy laws on narrow legalistic grounds. Indeed, the relatively protracted dismantlement of the vagrancy law regime raises the question whether bottom-up constitutionalism lacks potency in the absence of an intermediary organization with a well-defined litigation strategy.
Transcriptomic basis for reinforcement of elm antiherbivore defence mediated by insect egg deposition
Authors: Altmann Simone , Muino Jose M. , Lortzing Vivien , Brandt Ronny , Himmelbach Axel , Altschmied Lothar , Hilker Monika
Published: October 2018

Plant responses to insect egg depositions are known to shape subsequent defensive responses to larvae hatching from the eggs. Elm (Ulmus minor) leaves, on which elm leaf beetles laid their eggs, mount a more efficient defence against larvae hatching from the eggs. However, the molecular mechanisms of this egg‐mediated, improved defence are insufficiently understood and have so far only been studied in annual plants. We analysed the dynamics of transcriptomic changes in larval feeding‐damaged elm leaves with and without prior egg deposition using de novo assembledRNA‐seq data. Compared to egg‐free leaves, egg deposition‐treated leaves showed earlier and/or faster transcriptional regulations, as well as slightly enhanced differential transcriptional regulation after the onset of larval feeding. These early responding transcripts were overrepresented in gene ontology terms associated with post‐translational protein modification, signalling and stress (defence) responses. We found evidence of transcriptional memory in initially egg deposition‐induced transcripts whose differential expression was reset prior to larval hatching, but was more rapidly induced again by subsequent larval feeding. This potential memory effect of prior egg deposition, as well as the earlier/faster and enhanced feeding‐induced differential regulation of transcripts in egg deposition‐treated leaves, may contribute to the egg‐mediated reinforcing effect on the elm's defence against larvae. Hence, our study shows that a plant's experience of a stress‐indicating environmental cue (here: insect eggs) can push the dynamics of the plant's transcriptomic response to subsequent stress (here: larval feeding). Such experience‐mediated acceleration of a stress‐induced plant response may result in improved stress resistance.
Physician resilience: a grounded theory study of obstetrics and gynaecology residents
Authors: Winkel Abigail F , Robinson Annie , Jones Aubrie‐Ann , Squires Allison P
Published: October 2018

Objective

Enhancing physician resilience has the promise of addressing the problem of burnout, which threatens both doctors and patients and increases in residents with each year of training. Programmes aimed at enhancing physician resilience are heterogeneous and use varied targets to measure efficacy, because there is a lack of clarity regarding this concept. A more robust understanding of how resilience is manifested could enhance efforts to create and measure it in physicians in training.

Methods

A qualitative study used grounded theory methodology to analyse semi‐structured interviews with a purposive, intensity sample of obstetrics and gynaecology residents in an urban academic health centre. Longitudinal engagement through two sets of interviews 3‐6 months apart allowed for variations in season and context. Thematic saturation was achieved after enrollment of 18 residents representing all 4 years of postgraduate training. A three‐phase coding process used constant comparison, reflective memos and member checking to support the credibility of the analysis.

Results

A conceptual model for resilience as a socio‐ecological phenomenon emerged. Resilience was linked to professional identity and purpose served to root the individual and provide a base of support through adversity. Connections to others inside and outside medicine were essential to support developing resilience, as was finding meaning in experiences. The surrounding personal and professional environments had strong influences on the ability of individuals to develop personal resilience.

Conclusions

Physician resilience in this context emerged as a developmental phenomenon, influenced by individual response to adversity as well as surrounding culture. This suggests that both programmes teaching individual skills as well as systematic and cultural interventions could improve a physician's capacity to thrive.
Diagnostic work up to assess early response indicators in invasive pulmonary aspergillosis in adult patients with haematologic malignancies
Authors: Heinz Werner J. , Vehreschild Jörg J. , Buchheidt Dieter
Published: October 2018

In immunocompromised patients with acute leukaemia as well as in allogeneic hematopoietic stem cell transplant patients, pulmonary lesions are commonly seen. Existing guidelines provide useful algorithms for diagnostic procedures and treatment options, but they do not give recommendations on how to evaluate early success or failure and if or when it is best to change therapy. Here, we review the diagnostic techniques currently used in association with clinical findings and propose an approach using a combination of computer tomography, clinical and all available biomarkers and inflammation parameters, especially those positive at baseline, to assess early response in invasive pulmonary aspergillosis. Computed tomography scans should be carried out at regular intervals during early and long‐term follow‐up. Imaging on day seven, or even earlier in clinically unstable patients, combined with an additional testing of biomarkers and inflammatory markers in between, is needed for a reliable assessment at day 14. If no improvement is seen after 2 weeks of therapy or the clinical condition is deteriorating, a change of antifungal therapy should be considered. Alleged breakthrough infections or treatment failure should undergo early diagnostic workup, including tissue biopsies when possible, to retrieve fungal cultures for resistance testing.
Predictors and outcomes of patients switching from maintenance haemodialysis to peritoneal dialysis in Australia and New Zealand: Strengthening the argument for ‘peritoneal dialysis first’ policy
Authors: Nguyen Anh N. L. , Prasad Kafle Mukunda , Sud Kamal , Lee Vincent W
Published: October 2018

Aims

(1) To determine incidence and reasons for transfer from maintenance haemodialysis (HD) to peritoneal dialysis (PD); (2) To compare mortality of HD patients transferred to PD with those who initiated and remained on PD.

Methods

A 1:2 matched cohort of ANZDATA included patients dialyzing over 3 months dividing into 2 groups. Group A (HD to PD) was compared to group B (initiated and remained on PD) and matched PD group (Group C). We compared mortality by total time on dialysis regardless of modality.

Results

Of 20 882 patients, there were 911 in group A. The transfer rate from HD to PD was 5%, 6.7% and 7.4% at 1,4 and 8 years, respectively. Median time before switching of patients in Group A was 5.9 (4.0–10.9) months. The commonest reported reason for transfer was patient preference (63.8%). Mortality was significantly worse in Group A if dialysis vintage was ≤6 months and from 12–24 months (P < 0.05), whereas there was no difference in mortality if dialysis vintage was 6–12 months or ≥ 24 months (P = 0.073 and P = 0.153, respectively). Overall, mortality of patients in group A was higher than that in group B after adjusting for age, race, chronic lung disease, peripheral vascular disease, cerebrovascular disease, diabetes, haemoglobin and phosphate (hazard ratio = 1.335, 95% confidence interval = 1.172–1.520).

Conclusion

Haemodialysis patients transferred to PD had higher mortality than those initiated on PD, strengthening the case for PD first policy.
Child fever management: A comparative study of Australian parents with limited and functional health literacy
Authors: Alqudah Muahammad , Cowin Leanne , George Ajesh , Johnson Maree
Published: October 2018

Health literacy, or the ability to read and understand health information, is critical to the health of children. In this study, we compared the fever management knowledge of parents attending the emergency department with a child with fever. A cross‐sectional survey of 33 parents/carers with limited health literacy and 122 with functional health literacy was undertaken. There were no differences in the overall proportion of correct responses to knowledge or management questions posed by the two scales between the two groups. Both groups presented with limited knowledge and poor practices (<60% correct in both scales) in relation to fever knowledge and management in their children. Although health literacy impacts health utilization, we did not find any differences in these groups. Inappropriate practices, such as when to give medications, were evident. Educational programs, responsive to health literacy, are urgently needed to address these information needs for parents. An assessment of parents' health literacy level can guide the selection of information that can be easily read, understood, and acted upon to deliver the best health outcomes for children.