bluuebunny/crossref_metadata_2025 huggingface dataset:
Development of Open Journal System 3.0
Authors: Maretta Yoris Adi , Sumaryanto Totok , Utanto Yuli , Kustiono Kustiono , Deliana Sri Maryati
Published: September 2018

This study aims to develop an Open Journal System 3.0 and test the effectiveness of the open journal system 3.0 as a media student learning resources. This research method using research procedures Research and Development. The results showed acquire material expert assessment of the percentage of 94.44% while the assessment of media experts journals obtain a percentage of 97.77%. The results of testing the effectiveness of t count> t table (20 945> 2.000) and significance <0.05 (0.000 <0.05), then Ho is rejected. So we can conclude there are differences in the effectiveness of this research on the development of open journal 3.0 system that is used as a medium for student learning resources. This may imply that the development of open journal 3.0 system influence on student effectiveness in finding learning resources and the ease of downloading the article.
English Grammar on 2013 Curriculum: The Development of Game Based Learning Multimedia
Authors: Setiawan Budi , Asrowi
Published: September 2018

This Research is aimed to find out the effectiveness of game based learning multimedia in order to gain student learning outcomes on English subject with the topic of grammar in the classroom. The research development of multimedia game based learning using the procedure of Raiser and Demsey consisting of 5 stages namely: 1) Analysis which covers needs and theoretical analysis, 2) Design which includes Core and basic competence’s identification, material’s selection and submission, flowchart and story board arrangement, 3) Develop that contains production, media and material’s experts validation and students’ responses and product’s trial after the revision done. 4) Implement that covers the final product’s application towards the experiment class, 5) Evaluate becoming the last stage of all by having a test for both classes which are control and experiment class to see whether is there any differences between the class applying the multimedia game based learning and not. The trial of product development tested had passed several processes covering; the review from media’s expert which includes software changes and visual communication, the review from content’s expert covers material and instructional design, students’ responses towards products’ usage and attractiveness, small group and big group test trial. The result showed that the students at the control class taught by conventional way as in speech has less motivation and lower score compared with the experiment class applying interactive multimedia game based learning. There is an interaction between learning media and learning motivation those effects on students’ learning achievement especially in English grammar. Thus, it can be said that the result of the development of multimedia game based learning is effective to improve students learning outcomes.
Stellenwert der Abdomensonografie in der Hämatologie
Authors: Trenker Corinna , Görg Christian , Jenssen Christian , Klein Stefan , Neubauer Andreas , Dietrich Christoph
Published: September 2018

Bei Erstdiagnose hämatologischer Systemerkrankungen liegen oft nur unspezifische Symptome vor, sodass eine Abdomensonografie häufig im Rahmen der primären Abklärung erfolgt. Die Detektion einer Splenomegalie und pathologischer Lymphome, aber auch anderer Befunde kann wertvolle Hinweise auf die Grunderkrankung geben. Auch bei vermuteten Lymphknotenvergrößerungen wird häufig primär eine Sonografie durchgeführt, die bei Nachweis lymphomverdächtiger Befunde in gleicher Sitzung ein initiales Staging ermöglicht und zur Planung des diagnostischen Vorgehens beiträgt. Aufgrund ihrer schnellen und auch bettseitigen Verfügbarkeit, fehlenden Strahlenbelastung sowie unlimitierten Wiederholbarkeit sind sonografische Untersuchungen auch in der initialen Abklärung von Anämie, Leukopenie, Leukozytose und Thrombozytopenie sowie bei hämatologischen Erkrankungen in der Detektion von Komplikationen, der Verlaufsbeobachtung und Nachsorge ein wertvolles diagnostisches Instrument.
Posterior Tibial Neuropathy Secondary to Pseudoaneurysm of the Proximal Segment of the Anterior Tibial Artery with Delayed Onset
Authors: Rahimizadeh Abolfazl , Davaee Manuchehr , Shariati Majid , Rahimizadeh Shaghayegh
Published: September 2018

Anterior tibial artery is a nonvital artery which is one of the three arteries of the leg. This artery has a short proximal l segment in the popliteal region and a long segment in the anterior compartment of the leg designated as distal segment. With consideration of the deep location of the proximal segment in the popliteal fossa, it is less susceptible to trauma and subsequent formation of an aneurysm. On the contrary, the superficial long distal segment is more susceptible to trauma with high chance of pseudoaneurysm formation at the site of unrecognized injury. In this article, a 38-year-old military man being manifested about a decade after a trivial missile fragment injury with progressive posterior tibial neuropathy is presented. A giant pseudoaneurysm arising from the proximal segment of the anterior tibial artery was confirmed with angiography and the exact size of this pathology was documented with contrasted computed tomographic scan. The aneurysmal sac removal was accomplished after ligation of the corresponding artery proximal and distal to the sac followed by tibial nerve neurolysis which result in full recovery. In careful review we found that neither pseudoaneurysm arising from the proximal tibial artery nor posterior tibial neuropathy due to the compressive effect of the aneurysmal sac of this segment has been reported previously. Our primary purpose for reporting this case is not to describe the rarity of pseudoaneurysm formation at proximal segment of this artery but rather to describe delayed-onset posterior tibial vascular compressive neuropathy due to such an aneurysm. Eventually due to the potential sequel of a pseudoaneurysm, it is important for the surgeons to have high index of suspicion to prevent a missed or delayed diagnosis.
Concomitant Occlusive Vascular Lesions of Legs in Patients with Degenerative Lumbar Diseases: Do These Lesions Influence Treatment?
Authors: Lee Dong , Heo Dong , Cho Kyoung
Published: September 2018

Background and Study Aims Vascular narrowing or obstruction reduces blood flow to the lower limbs during exercise or at rest. Symptoms may range from intermittent claudication to pain at rest. Narrowing of these arteries may produce pain in the buttocks, thighs, or legs. These symptoms may resemble those of lumbar radicular pain. Spine surgeons may overlook obstructive vascular lesions of the lower limbs in patients with lumbar degenerative diseases such as spinal stenosis and spondylolisthesis. We investigated the clinical and radiologic risk factors of concomitant vascular pathologic lesions in patients with degenerative lumbar diseases.

Materials and Methods If patients presented with a weak or absent dorsalis pedis artery pulse, edema of both legs, and a past history related to vascular lesions of the lower limbs, we evaluated the veins and arteries of the lower extremities using Doppler sonography. If abnormal vascular findings were detected, computed tomography angiography (CTA) of the lower extremities was performed. Radiologic and clinical risk factors of concomitant occlusive arterial lesions of the lower limb were analyzed by logistic regression analysis.

Results In 2013, 335 patients suspected of having vascular lesions underwent Doppler sonography. Among them, CTA of the lower extremities was performed in 58 patients. The mean age was 69.4 years (35 men and 23 women). Severe narrowing or total occlusion of the leg arteries was detected in 23 patients. Partial obstructive arterial disease of the legs was detected in 14 patients. Occlusion but with good collateral circulation of the leg was found in three patients. Surgical treatment plans were cancelled or changed in 28 patients. The risk factors for occlusive arterial lesions of the legs were an abnormal ankle-brachial pressure index (ABPI), absent dorsalis pedis artery pulse, and lack of response after a pain-blocking procedure.

Conclusion If patients present with a weak or absent dorsalis pedis artery pulse, abnormal ABPI ratio, and no response after a pain-blocking procedure, the clinician should consider the possibility of severe arterial occlusion of the legs. We suggest that the differential diagnosis of obstructive arterial lesions of the legs from lumbar degenerative diseases is important to prevent unnecessary invasive surgical treatment of the lumbar spine.
Somatische Komorbidität bei Schizophrenie: Unentdeckt und unbehandelt?
Authors: Wobrock T. , Falkai P. , Hasan A.
Published: September 2018

Somatische Begleiterkrankungen bei schizophren Erkrankten sind sehr häufig und eine wesentliche Ursache für die erhöhte Mortalität dieser schweren psychiatrischen Erkrankung. Diese Komorbiditäten umfassen eine Vielzahl von Erkrankungsgruppen, wobei das metabolische Syndrom, die koronare Herzkrankheit und Infektionskrankheiten die führenden Entitäten zu sein scheinen. Körperliche Begleiterkrankungen werden jedoch oft nicht erkannt, obwohl eine Vielzahl an wissenschaftlichen Publikationen die enorme Bedeutung dieser Erkrankungen für den Gesamtbehandlungsplan der Schizophrenie dokumentiert. Diese Übersichtsarbeit gibt eine kurze Einführung in dieses wichtige Thema und stellt anhand des metabolischen Syndroms, des Typ-2-Diabetes und der koronaren Herzkrankheit die Risiken zusätzlicher somatischer Erkrankungen dar. Darüber hinaus erfolgt eine Übersicht über andere somatische Erkrankungen bei Schizophrenie und es werden mögliche Ursachen dieser Komorbiditäten diskutiert. Zusammenfassend müssen Psychiater, Hausärzte und alle in der Behandlung der Schizophrenie involvierten Personen die Bedeutung und das Auftreten somatischer Erkrankung erkennen, um in Zukunft eine Reduktion der Mortalität zu ermöglichen.
Pregabalin – Update der klinischen Daten
Authors: Volz H.-P.
Published: September 2018

Pregabalin ist ein Modulator spannungsabhȨngiger Kalzium-KanȨle und besitzt eine Zulassung fɒr die Therapie peripherer und zentraler neuropathischer Schmerzen, als Zusatzmedikation (add-on) bei partiellen epileptischen AnfȨllen und fɒr die Therapie der Generalisierten AngststɆrung (Generalized Anxiety Disorder [GAD]). Die wichtigsten klinischen Studien hierzu wurden in einer ersten Publikation in dieser Zeitschrift (15) dargestellt. Nun werden einige, seinerzeit nur kurz oder ɒberhaupt nicht behandelte Publikationen zu folgenden Themen erɆrtert: 1. Vergleich Pregabalin vs. Venlafaxin retardiert vs. Placebo (6); 2. Vergleich Pregabalin vs. Placebo bei Ȩlteren GAD-Patienten (11); 3. Pregabalin als „add-on舠 bei Therapie- resistenten GAD-Patienten (13); 4. Pregabalin vs. Placebo beim Ausschleichen von Benzodiazepinen (4); 5. Meta-Analyse pharmakotherapeutischer Interventionen bei GAD (5).
Neurobiology of severe psychiatric disorders – new approaches in the molecular research landscape
Authors: Reich-Erkelenz D. , Schmitt A. , Gruber O. , Dechent P. , Brockmöller J. , Tzvetkov M. , Fischer A. , Bickeböller H. , Rossner M. , Nave K.-A. , Falkai P. , Schulze T. G.
Published: September 2018

Over many years, intensive research into the molecular biological basis of psychosis (schizophrenia, bipolar disorder) has been conducted via complementary approaches of clinical and molecular biological techniques and strategies, be it linkage analyses, candidate gene association studies, pharmacogenetics, neuroimaging, or further neurobiological investigations in post-mortem tissue and animal models for risk factors of the diseases.

However, since these approaches could not successfully explain the very heterogeneous disease pattern of schizophrenia or its overlapping spectra with bipolar disorder, we are in the need of a new perspective. Biological psychiatric research has largely focused on cross-sectional data sets without focusing on a phenotype of utmost relevance: the longitudinal course. Large-scale and systematic studies on the genetic and neurobiological underpinnings of the course of psychosis within a framework are lacking. To fill this gap, we are currently establishing such a framework via the DFG funded Clinical Research Group “Genotype-phenotype relationships and neurobiology of the longitudinal course of psychosis”. Here we will establish large cohorts with this phenotype of interest that is longitudinal in nature and also includes information on functional parameters and environmental factors.
Die Rolle von Qualitätsindikatoren in der psychiatrischen Qualitätssicherung und aktueller Stand der Entwicklung von Qualitätsindikatoren
Authors: Zielasek J. , Großimlinghaus I. , Janssen B. , Wobrock T. , Falkai P. , Reich-Erkelenz D. , Riesbeck M. , Gaebel W.
Published: September 2018

Die Entwicklung von sektorenübergreifenden Qualitätsindikatoren für die Versorgung von Menschen mit psychischen Störungen wurde durch den Gemeinsamen Bundesausschuss auf den Weg gebracht. Wir beschreiben diese aktuelle Entwicklung und informieren über den Stand des Projektes zur Entwicklung von Qualitätsindikatoren durch die DGPPN für vier häufige psychische Störungen: Schizophrenie, Demenzen, Alkoholabhängigkeit und unipolare Depressionen.
Schulenorientierte versus Störungsorientierte Psychotherapien in der Psychiatrie
Authors: Berger M. , Hohagen F.
Published: September 2018

Die frühe Phase der Psychotherapieentwicklungen war ganz geprägt von den großen Schulen der Psychoanalyse, Tiefenpsychologie und Verhaltenstherapie. Dementsprechend waren auch die Zulassungsprinzipien der so genannten Richtlinienpsychotherapie ganz auf die Psychotherapieschulen zugeschnitten. In den letzten Dekaden hat sich in der psychotherapeutischen Forschung und Praxis dagegen in weiten Bereichen eine störungsfokussierte Psychotherapie mehr und mehr durchgesetzt, welche, fokussiert auf die psychopathologischen aber auch pathogenetischen Besonderheiten verschiedener konkreter Störungsbilder, psychotherapeutische Elemente aus den unterschiedlichen Schultraditionen symptomzentriert integriert.

In diesem Artikel wird diese Entwicklung exemplarisch nachgezeichnet und auf die Notwendigkeit hingewiesen, dass diese Entwicklungen in der psychotherapeutischen Praxis auch ihre Entsprechung im gesundheitspolitischen Zulassungsreglementarium finden sollte.
Modulare Psychotherapie – Rationale und Grundprinzipien
Authors: Bohus M. , Herpertz S. C. , Falkai P.
Published: September 2018

Die Weiterentwicklung der Psychotherapie hat in den letzten Jahren unerwartet Tempo aufgenommen, doch in der Praxis kommt diese kaum an. Wie sollen Therapeuten die Orientierung behalten, wenn jedes Jahr Dutzende von neuen, evidenzbasierten störungsspezifischen Therapien auf den Markt kommen? Wie können experimentell entwickelte therapeutische Strategien in die tägliche Praxis integriert werden, und wie sollte die Aus- und Weiterbildung in Psychotherapie organisiert werden? Modulare Psychotherapie will Antwort geben auf diese Fragen. Dabei ist Modulare Psychotherapie keine neue Schule, sondern ein duales Organisationsprinzip: Einerseits eine pragmatische Gliederung der derzeit etablierten therapeutischen Strategien und Interventionen und andererseits eine Handreichung in Form von Heurismen, die vorgibt, welche dieser Strategien im Einzelfall zur Anwendung kommen sollten. Die Modulare Psychotherapie erhebt folgerichtig den Anspruch, die Enge der therapeutischen Schulen zu verlassen und den Redundanzen der störungsspezifischen Konzepte einen entsprechenden Rahmen zu geben. Didaktisch gliedert sich die Modulare Psychotherapie in sechs Komponenten: Theoretische Grundlagen; Therapeutische Basiskompetenzen; Therapeutische Interventionen; Störungsspezifische Kompetenzen; Behandlungsheurismen und evaluative Kompetenzen. Was die Aus- und Weiterbildung anbelangt, so arbeitet die DGPPN derzeit an einer Neuausrichtung der Facharztweiterbildung Psychiatrie und Psychotherapie und orientiert sich an den Grundideen der Modularen Psychotherapie.
Determination of range enrichment for improved hen welfare on commercial fixed-range free-range layer farms
Authors: de Koning Carolyn , Kitessa Soressa M. , Barekatain Reza , Drake Kelly
Published: September 2018

An observational study on range enrichment was conducted on three commercial fixed-range, free-range layer farms comprising four flocks in South Australia (flock sizes ranged from 3000 to 11700 hens). Two strategies were compared; a ‘standard’ Control treatment, typical of the type of range used in the commercial industry and a highly ‘enriched’ treatment. Both treatments were implemented on the same range with no subdivisional fences. The highly enriched side of the range incorporated shade shelters, alongside a continuum of additional enrichment structures (e.g. dust baths, peck objects and hay bales). Range treatments were investigated to determine the effects on motivating hens to use the range more effectively, and their potential to lead to a decrease in abnormal behaviours, such as injurious feather pecking and cannibalism. Additionally, two farms with high levels of tree coverage were also observed. Farms were visited monthly for 6 months. At each visit several measures were recorded live: the numbers of hens out on the range, location of hens on the range and plumage score of birds outdoors and indoors. Enrichment structure utilisation on the range was measured via video recordings and continuous counts of the number of hen visits to enrichment structures within 1 h. It was found that more hens used the ‘enriched’ side of the range, in comparison with the ‘standard’ Control range treatment (P ≤ 0.01). Overhead cover provided by constructed shelters and dust bathing pits were instrumental in enticing birds out onto the range (306 ± 27 s.e.m. and 366 ± 24 s.e.m., average number hen visits). Hay bales were also highly utilised (116 ± 14 s.e.m., average number hen visits), even though the hen numbers attracted to the hay bales were not as high as shelters and dust baths. It was also observed on one property that natural cover provided by trees attracted the greatest number of hens (1652 ± 358 s.e.m., average number of hen visits). Prevailing weather conditions and the age of the flock strongly influenced the number of hens utilising the range outdoors. Furthermore, hens outside on the range had better plumage scores with lower feather loss and decreased areas of bare skin compared with birds scored in the shed.
Porcine bile powder supplementation of a high fat broiler diet in relation to growth performance and nutrient digestion
Authors: Lammasak Kanokporn , Kijpakorn Suwanna , Angkanaporn Kris
Published: September 2018

The aim of the study was to examine the effect of pig bile powder supplementation on the digestibility of nutrients, fat digestion and growth performance of starter broilers fed on a high fat diet. A total of 1110, day-old, male broiler chicks (Arbor Acres) were randomly allocated into six treatment groups with five replicates per treatment. The chicks were fed on a corn-soybean meal basal diet with a starter formulation until Day 14, followed by a grower formulation until Day 21. In group 1 (T1), the basal diet contained 30 g/kg crude palm oil whereas the diet used in group 2 (T2) had 60 g/kg crude palm oil. Chicks in group 3 (T3) were fed on T2 diet supplemented with 5.0 g/kg soy lecithin as the positive control. Chicks in groups 4–6 (T4–T6) received diets used in T2, supplemented with 1.25, 2.5 and 5.0 g/kg lyophilised pig bile powder, respectively. On Days 4, 7, 14 and 21, chicks were killed, portal blood was collected and analysed for fatty acids, pancreas collected for measurement of pancreatic lipase activity, bile and jejunal contents for bile acid determination and ileal content for determining digestibility of fat and protein. The results showed (1) there was no difference in bodyweight and feed intake among T2–T6, (2) pancreatic lipase activity of chicks in T4 and T5 was highest in all periods. Total bile acid concentrations in the gall bladder and jejunum in T4 was lower than those in T2 in all periods, and Days 4 and 7, respectively, (3) digestibility of protein and fat in T3 and T4 was higher in all the period than that of T2, T5 and T6, (4) increased fat content in the diet did not cause a significant increase in any fatty acids in the portal plasma when compared T1 and T2. In conclusion, 2.5 g/kg porcine bile powder supplemented in high fat diet increased pancreatic lipase activity and total bile acid concentrations in gall bladder, resulting in increased ileal digestibility of fat and protein.
Cracking open death: death conversations in primary care
Authors: Llewellyn Rebecca , Jaye Chrystal , Egan Richard , Cunningham Wayne , Young Jessica , Radue Peter
Published: September 2018

ABSTRACT INTRODUCTION Research supports talking about death outside the end-of-life context. Benefits include allaying death anxiety to increased engagement in health promotion interventions. Nonetheless, the focus on death conversations remains centred on the imminently dying. This qualitative study investigated New Zealanders’ perspectives on the value of, opportunities for, and barriers to death conversations in primary healthcare. METHODS Twenty-one participants were interviewed. Participants were young older adults (54–65 years) not receiving palliative care or diagnosed with a terminal illness. Most were women who identified ethnically as New Zealand European. An immersion–crystallisation approach to thematic development was used to accommodate the multidisciplinary research framework. RESULTS Four core themes were identified: ‘a need to talk about death’; ‘the role of the GP’; ‘broaching the topic’; and ‘media’. CONCLUSION A cultural silence on death has rendered both the medical and lay community insufficiently prepared for frank and meaningful engagement with the topic, exacerbated by restricted consultation timeframes. The ease of death conversations may be facilitated by taking a family-centred approach, using community organisations and settings, and harnessing conversation entry points provided by the media. Future research should aim to develop tailored resources and frameworks to support general practitioners’ meaningful engagement with the topic of death both within and outside of the end-of-life context.
Doctor self-disclosure in the consultation
Authors: Mann Brett
Published: September 2018

ABSTRACT
Doctors’ self-disclosures to patients are an important dynamic in consultations. These can be categorised as unavoidable, inadvertent or deliberate. It is important in facilitating therapeutic outcomes to reflect on the types of messages unavoidably communicated by the doctor’s appearance, speech and practice and consulting room environments, and to recognise self-disclosures caused by disruptive doctor transferences, so these transferences can be processed and minimised. Deliberate choices by doctors to disclose personal information and experiences are common. Without awareness and understanding, this can be unhelpful. Guidelines are provided to facilitate self-disclosures that build the doctor–patient relationship and improve therapeutic outcomes.
Mild traumatic brain injury in New Zealand: factors influencing post-concussion symptom recovery time in a specialised concussion service
Authors: Forrest Rachel H. J. , Henry Janis D. , McGarry Penelope J. , Marshall Robert N.
Published: September 2018

ABSTRACT INTRODUCTION By 2020, traumatic brain injuries (TBIs) are predicted to become the third largest cause of disease burden globally; 90% of these being mild traumatic brain injury (mTBI). Some patients will develop post-concussion syndrome. AIM To determine whether the time between sustaining a mTBI and the initial assessment by a specialised concussion service, along with the post-concussion symptoms reported at the assessment, affected recovery time. METHODS A retrospective medical record review of clients who had completed the Rivermead Post-Concussion Questionnaire (RPQ) at their initial assessment and were discharged from a large metropolitan concussion service in New Zealand was undertaken over a 6-month period in 2014 (n = 107). Using correlations, General Linear Mixed-effects Models (GLMM) and linear regressions, we explored associations between factors including ethnicity, gender and accident type, along with individual RPQ symptom scores and cluster scores, with time from injury to initial assessment by the specialised concussion service and initial assessment to discharge. RESULTS Time from injury to initial assessment by a specialist concussion service was correlated with proportionally more psychological symptoms present at initial assessments (r = 0.222, P = 0.024); in particular, feeling depressed or tearful (r = 0.292, P = 0.003). Time to discharge was correlated with individual RPQ symptom proportions present at initial assessment for headaches (r = –0.238, P = 0.015), sensitivity to noise (r = 0.220, P = 0.026), feeling depressed or tearful (r = 0.193, P = 0.051) and feeling frustrated or impatient (r = 0.252, P = 0.003), along with the psychological cluster proportion (r = 0.235, P = 0.017) and the total RPQ score (r = 0.425, P < 0.001). CONCLUSION Prompt diagnosis and treatment of mTBI may minimise the severity of post-concussion symptoms, especially symptoms associated with mental health and wellbeing.
Evaluating a model of delivering specialist palliative care services in rural New Zealand
Authors: Landers Amanda , Dawson Danielle , Doolan-Noble Fiona
Published: September 2018

ABSTRACT INTRODUCTIONVarious methods of delivering specialist palliative care to rural areas have been discussed in the literature, but published evaluations of these models are sparse. This study surveyed the stakeholders of a rural specialist palliative care service (SPCS) to help identify potential gaps and inform planning regarding the future vision. METHODSA survey was sent to all relevant stakeholders across the West Coast of New Zealand, including staff in primary care, aged residential care and the hospital. It focused on understanding the local model of palliative care, the quality of the current service and perceived gaps. RESULTSThirty-three per cent of the surveys were returned, from a cross-section of health-care providers. The medical respondents rated the quality of the service higher than nursing and allied health participants. All of the groups reported feeling the specialist palliative care team (SPCT) was under-resourced. Additional educational opportunities were considered essential. DISCUSSIONStakeholders found the service easy to access, but improvements in communication, educational opportunities and forward planning were identified as being needed. This information helps the West Coast SPCT plan its future direction and develop a higher-quality service that meets the needs of all stakeholders.
Understanding the structure and processes of primary health care for young indigenous children
Authors: Strobel Natalie A. , McAuley Kimberley , Matthews Veronica , Richardson Alice , Agostino Jason , Bailie Ross , Edmond Karen M. , McAullay Daniel
Published: September 2018

ABSTRACT

INTRODUCTION
Primary health care organisations need to continuously reform to more effectively address current health challenges, particularly for vulnerable populations. There is growing evidence that optimal health service structures are essential for producing positive outcomes.

AIM
To determine if there is an association between process of care indicators (PoCIs) for important young indigenous child health and social issues and: (i) primary health-care service and child characteristics; and (ii) organisational health service structures.

METHODS
This was a cross-sectional study of 1554 clinical child health audits and associated system assessments from 74 primary care services from 2012 to 2014. Composite PoCIs were developed for social and emotional wellbeing, child neurodevelopment and anaemia. Crude and adjusted logistic regression models were fitted, clustering for health services. Odds ratios and 95% confidence intervals were derived.

RESULTS
Overall, 32.0% (449) of records had a social and emotional wellbeing PoCI, 56.6% (791) had an anaemia PoCI and 49.3% (430) had a child neurodevelopment PoCI. Children aged 12–23 months were significantly more likely to receive all PoCIs compared to children aged 24–59 months. For every one point increase in assessment scores for team structure and function (aOR 1.14, 95% CI 1.01–1.27) and care planning (aOR 1.14, 95% CI 1.01–1.29) items, there was a 14% greater odds of a child having an anaemia PoCI. Social and emotional wellbeing and child neurodevelopment PoCIs were not associated with system assessment scores.

DISCUSSION
Ensuring young indigenous children aged 24–59 months are receiving quality care for important social and health indicators is a priority. Processes of care and organisational systems in primary care services are important for the optimal management of anaemia in indigenous children.
The complexity of food for people with multiple long-term health conditions
Authors: Francis Helen , Carryer Jenny , Wilkinson Jill
Published: September 2018

ABSTRACT

INTRODUCTION
The prevalence of long-term health conditions (LTCs) continues to increase and it is normal for people to have several. Lifestyle is a core feature of the self-management support given to people with LTCs, yet it seems to fail to meet their needs. From a larger study exploring the experiences of this group, this paper reports on the role of food and mealtimes, and the effect of the nutritional advice on the lives of people with several LTCs.

METHODS
The experiences of 16 people with several advanced LTCs were explored using multiple qualitative case studies. Over an 18-month period, contact with participants included monthly conversations, two longer, semi-structured interviews and one interview with their primary care clinicians. The data were analysed inductively using thematic analysis.

RESULTS
There was profound social, psychological and cultural significance of food to the participants. These aspects of food were then described using the Whare Tapa Wha model of health. The approach to food and nutrition participants experienced in health care was closely associated with conventional weight management. They found this advice largely irrelevant and therefore ineffective.

DISCUSSION
The pressure people with several LTCs experience during clinical encounters has perverse effects on wellbeing and reinforces an overall sense of failure. This research challenges the assumption that all people have the will, agency and income to follow the advice they receive about nutrition and exercise. Considering people’s needs using the Whare Tapa Wha model of health offers clinicians a framework to re-conceptualise the core features of self-management support and provide realistic, compassionate care that will optimise the quality of life for people with multiple LTCs.
Local clinical pathways: from ‘good ideas’ to ‘practicality’ for general practitioners
Authors: Reyneke Anel , Jaye Chrystal , Stokes Tim
Published: September 2018

ABSTRACT INTRODUCTION There has been increased interest in the utility of clinical pathways by primary health care in New Zealand, although evaluation of their use has been limited. AIM To identify barriers and facilitators for the use of clinical pathways in one health region. METHODS Interviews with 15 general practitioners in the Western Bay of Plenty. A qualitative thematic analysis was undertaken, informed by the Diffusion of Innovation Framework. RESULTS Four themes were identified: learning to use the pathways, persuasion and decision to use, implementation and sustainability. Barriers to using the pathways included time pressure; scepticism; difficulty in portraying patients’ clinical picture within a set pathway; technical difficulties and lack of support in obtaining knowledge; and practical implementation of the pathways in daily work. Facilitators included endorsement by opinion leaders; pathways directing workup and treatment stepwise towards referral; centralised information with resources available in the consultation; and reported increased acceptance of referrals by secondary care if pathways were used. DISCUSSION The development and implementation of health care initiatives requires an understanding of the local context. Knowledge about the specific, locally appreciated barriers and facilitators can inform future health-care developments. The Diffusion of Innovation Framework offers a practical model to understand effective implementation.
Assessment of river otter abundance following reintroduction
Authors: Ellington E. Hance , Flournoy Paul D. , Dwyer Chris P. , Witt Mark D. , Gehrt Stanley D.
Published: September 2018

Context
By the early 1900s, river otters (Lontra canadensis) were extirpated across large parts of their range in North America. Over the last several decades they have made a remarkable recovery through widespread reintroduction programs. River otters were reintroduced in Ohio, USA, between 1988 and 1993, and restricted and limited harvesting of this population began in 2005. While circumstantial evidence points to rapid population growth following the reintroduction, changes in population size over time is unknown.

Aims
We sought to model river otter population growth following reintroduction, and to assess the impact of harvesting.

Methods
We used empirical and literature-based data on river otter demographics in Ohio to estimate abundance from 1988–2008 using an age- and sex-specific stochastic Leslie matrix model. Additionally, we used statistical population reconstruction (SPR) methods to estimate population abundance of river otters in Ohio from 2006 to 2008.

Results
Our Leslie matrix model predicted a population size of 4115 (s.d. = 1169) in 2005, with a population growth rate (λ) of 1.28 in 2005. Using SPR methods we found that both trapper effort and initial population abundance influenced our population estimates from 2006 to 2008. If we assumed that river otter pelt price was an accurate index of trapper effort, and if the initial population was between 2000 and 4000, then we estimated the λ to be 1.27–1.31 in 2008 and the exponential rate to be 0.17–0.21 from 2006 to 2008. Conversely, if the river otter population in 2005 was 1000, then we estimated λ to be 1.20 in 2008 and the exponential rate to be 0.08 from 2006 to 2008.

Conclusions
The river otter population in Ohio appears to have had the potential to grow rapidly following reintroduction. The ultimate effect of the harvesting regime on population abundance, however, remains clouded by limited data availability and high variability.

Implications
The considerable uncertainty surrounding population estimates of river otters in Ohio under the harvesting regime was largely driven by lack of additional data. This uncertainty clouds our understanding of the status of river otters in Ohio, but a more robust, long-term monitoring effort would provide the data necessary to more precisely monitor the population.
Converging evidence for functional and structural segregation within the left ventral occipitotemporal cortex in reading
Authors: Lerma-Usabiaga Garikoitz , Carreiras Manuel , Paz-Alonso Pedro M.
Published: September 2018

The ventral occipitotemporal cortex (vOTC) is crucial for recognizing visual patterns, and previous evidence suggests that there may be different subregions within the vOTC involved in the rapid identification of word forms. Here, we characterize vOTC reading circuitry using a multimodal approach combining functional, structural, and quantitative MRI and behavioral data. Two main word-responsive vOTC areas emerged: a posterior area involved in visual feature extraction, structurally connected to the intraparietal sulcus via the vertical occipital fasciculus; and an anterior area involved in integrating information with other regions of the language network, structurally connected to the angular gyrus via the posterior arcuate fasciculus. Furthermore, functional activation in these vOTC regions predicted reading behavior outside of the scanner. Differences in the microarchitectonic properties of gray-matter cells in these segregated areas were also observed, in line with earlier cytoarchitectonic evidence. These findings advance our understanding of the vOTC circuitry by linking functional responses to anatomical structure, revealing the pathways of distinct reading-related processes.
IL-33 promotes recovery from acute colitis by inducing miR-320 to stimulate epithelial restitution and repair
Authors: Lopetuso Loris R. , De Salvo Carlo , Pastorelli Luca , Rana Nitish , Senkfor Henry N. , Petito Valentina , Di Martino Luca , Scaldaferri Franco , Gasbarrini Antonio , Cominelli Fabio , Abbott Derek W. , Goodman Wendy A. , Pizarro Theresa T.
Published: September 2018

Significance

We clarify that the normal, inherent function of IL-33 following acute, resolving colitis is protection, inducing proliferation and restitution of ST2L-bearing intestinal epithelial cells (IECs). Importantly, this response occurs in otherwise healthy, immunocompetent C57BL/6J (B6) mice and may be different in other models possessing genetic and/or immunologic abnormalities that predispose to colitis, similar to patients with inflammatory bowel disease. Mechanistically, although the molecular processes responsible for control of microRNA (miR) biogenesis in response to challenge remain largely unknown, we report that IL-33 augments epithelial miR-320, which increases IEC proliferation and wound closure that is significantly diminished upon specific miR-320 inhibition. This study provides the rationale for the potential therapeutic use of either IL-33 or miR-320A to obtain optimal gut mucosal healing and the resolution of inflammation.
Behavior of homing endonuclease gene drives targeting genes required for viability or female fertility with multiplexed guide RNAs
Authors: Oberhofer Georg , Ivy Tobin , Hay Bruce A.
Published: September 2018

Significance

Homing endonuclease gene (HEG)-based gene drive can bring about population suppression when genes required for viability or fertility are targeted. However, these strategies are vulnerable to failure through mechanisms that create alleles resistant to cleavage but that retain wild-type gene function. We show that resistance allele creation can be prevented through the use of guide RNAs designed to cleave a gene at four target sites. However, homing rates were modest, and the HEGs were unstable during homing. In addition, use of a promoter active in the female germline resulted in levels of HEG carryover that compromised the viability or fertility of HEG-bearing heterozygotes, thereby preventing drive. We propose strategies that can help to overcome these problems in next-generation HEG systems.
Crimping-induced structural gradients explain the lasting strength of poly
l
-lactide bioresorbable vascular scaffolds during hydrolysis
Authors: Ramachandran Karthik , Di Luccio Tiziana , Ailianou Artemis , Kossuth Mary Beth , Oberhauser James P. , Kornfield Julia A.
Published: September 2018

Significance

The molecular basis of the mysterious ability of the clinically approved bioresorbable vascular scaffold to maintain radial strength after 9 mo of hydrolysis—despite a ∼40% reduction in the poly
l
-lactide molecular weight
Mn
—is an unexpected gradient in degradation revealed by X-ray microdiffraction. Hydrolysis is slowest in the 100- × 30-µm region where stress is concentrated during arterial contractions. This favorable gradient in hydrolysis arises from gradients in morphology created during crimping onto the angioplasty balloon: Small regions that undergo elongational deformation (<3% of scaffold) resist hydrolysis after deployment. This remarkably small amount of material (too low to detect in
Mn
measurements) has a disproportionate impact on strength because it forms precisely where the scaffold is most vulnerable to failure.
Control of CCND1 ubiquitylation by the catalytic SAGA subunit USP22 is essential for cell cycle progression through G1 in cancer cells
Authors: Gennaro Victoria J. , Stanek Timothy J. , Peck Amy R. , Sun Yunguang , Wang Feng , Qie Shuo , Knudsen Karen E. , Rui Hallgeir , Butt Tauseef , Diehl J. Alan , McMahon Steven B.
Published: September 2018

Significance

The deubiquitylase USP22 is frequently overexpressed in cancer and contributes to tumorigenesis by driving cell cycle progression. Current models define USP22 as functional mediator of gene regulation and chromatin modification, working within the SAGA transcriptional cofactor complex. Here we report a catalytic role for USP22 distinct from its well-characterized transcription regulatory capacity. USP22 directly stabilizes the essential G1-cyclin, CCND1, protecting it from proteasome-mediated degradation via deubiquitylation. Our findings reveal a pathway that regulates CCND1, while also raising the possibility that simulteously targeting USP22 may allow the use of less toxic doses of the new wave of cancer therapies that target the cyclin/CDK complex. Finally, these results provide a mechanistic explanation for the effects of USP22 in cancer cell cycle control.
Modified mevalonate pathway of the archaeon
Aeropyrum pernix
proceeds via
trans
-anhydromevalonate 5-phosphate
Authors: Hayakawa Hajime , Motoyama Kento , Sobue Fumiaki , Ito Tomokazu , Kawaide Hiroshi , Yoshimura Tohru , Hemmi Hisashi
Published: September 2018

Significance

Herein, the partially identified “modified” mevalonate pathway of the majority of archaea is elucidated using information from comparative genomic analysis. Discovery of two enzymes, mevalonate 5-phosphate dehydratase and
trans
-anhydromevalonate 5-phosphate decarboxylase, from a hyperthermophilic archaeon,
Aeropyrum pernix
, shows that the pathway passes through a previously unrecognized metabolite,
trans
-anhydromevalonate 5-phosphate. The distribution of the known mevalonate pathways among archaea and other organisms suggests that the
A. pernix
-type pathway, which is probably conserved among the majority of archaea, is the evolutionary prototype for the other mevalonate pathways involving diphosphomevalonate decarboxylase or its homologs.
Snapshots of a modified nucleotide moving through the confines of a DNA polymerase
Authors: Kropp Heike Maria , Dürr Simon Leonard , Peter Christine , Diederichs Kay , Marx Andreas
Published: September 2018

DNA polymerases have evolved to process the four canonical nucleotides accurately. Nevertheless, these enzymes are also known to process modified nucleotides, which is the key to numerous core biotechnology applications. Processing of modified nucleotides includes incorporation of the modified nucleotide and postincorporation elongation to proceed with the synthesis of the nascent DNA strand. The structural basis for postincorporation elongation is currently unknown. We addressed this issue and successfully crystallized KlenTaq DNA polymerase in six closed ternary complexes containing the enzyme, the modified DNA substrate, and the incoming nucleotide. Each structure shows a high-resolution snapshot of the elongation of a modified primer, where the modification “moves” from the 3′-primer terminus upstream to the sixth nucleotide in the primer strand. Combining these data with quantum mechanics/molecular mechanics calculations and biochemical studies elucidates how the enzyme and the modified substrate mutually modulate their conformations without compromising the enzyme’s activity significantly. The study highlights the plasticity of the system as origin of the broad substrate properties of DNA polymerases and facilitates the design of improved systems.
Effects of protein size, thermodynamic stability, and net charge on cotranslational folding on the ribosome
Authors: Farías-Rico José Arcadio , Ruud Selin Frida , Myronidi Ioanna , Frühauf Marie , von Heijne Gunnar
Published: September 2018

Significance

There is increasing interest to understand how proteins fold as they are synthesized on the ribosome. However, we still lack basic knowledge such as how protein size, net charge, and thermodynamic stability impact cotranslational folding. Here, we have studied eight proteins of increasing size and provide a comprehensive picture of how the location in the ribosome exit tunnel where a protein folds correlates with protein size. Moreover, we demonstrate that the force exerted on the nascent chain by protein folding varies linearly with the thermodynamic stability of the folded state, and that the ribosome environment disfavors folding of domains of high net-negative charge. These findings establish important basic facts about cotranslational folding.
Praxis, symbol and language
Authors: Sinha Chris
Published: September 2018

This article focuses on the interweaving of constructive praxis with communication inontogenesis, inphylogenesisand in biocultural niche evolution (ecogenesis), within anEvoDevoSocioframework. I begin by discussing the nature of symbolization, its evolution from communicative signaling and its elaboration into semantic systems. I distinguish between thesymbol-readyand thelanguage-readybrain, leading to a discussion of linguistic conceptualization and itsdual groundingin organism and language system. There follows an outline account of the interpenetration in the human biocultural niche-complex ofsemiosphereandtechnosphere,mediated by the evolution of the niche of infancy. Symbolization (the foundation of the semiosphere) is by definition normative; the normative character of the technosphere is demonstrated by the interrelations in human development between affordance, action schema and canonical functional object schema. A model of the neuro-computational implementation of dual grounding is proposed.
Relating the evolution of Music-Readiness and Language-Readiness within the context of comparative neuroprimatology
Authors: Seifert Uwe
Published: September 2018

Language- and music-readiness are demonstrated as related within comparative neuroprimatology by elaborating three hypotheses concerning music-readiness (MR): The (musicological) rhythm-first hypothesis (MR-1), the combinatoriality hypothesis (MR-2), and the socio-affect-cohesion hypothesis (MR-3). MR-1 states that rhythm precedes evolutionarily melody and tonality. MR-2 states that complex imitation and fractionation within the expanding spiral of the mirror system/complex imitation hypothesis (MS/CIH) lead to the combinatorial capacities of rhythm necessary for building up a musical lexicon and complex structures; and rhythm, in connection with repetition and variation, scaffolds both musical form and content. MR-3 states that music’s main evolutionary function is to self-induce affective states in individuals to cope with distress; rhythm, in particular isochrony, provides a temporal framework to support movement synchronization, inducing shared affective states in group members, which in turn enhances group cohesion. This document reviews current behavioural and neurocognitive research relevant to the comparative neuroprimatology of music-readiness. It further proposes to extend MS/CIH through the evolution of the relationship of the language- and music-ready brain, by comparing “affective rhythm” and prosody – i.e. by comparatively approaching the language- and music-emotion link in neuroprimatology.