bluuebunny/crossref_metadata_2025 huggingface dataset:
Acute idiopathic optic neuritis: not always benign
Authors: Deschamps R. , Gueguen A. , Lecler A. , Lecouturier K. , Lamirel C. , Bensa C. , Marignier R. , Vignal C. , Gout O.
Published: July 2018

Background and purpose

Few recent data are available concerning idiopathic optic neuritis (ON). We aimed to describe a large cohort of patients with idiopathic ON. We compared this cohort with patients with ON related to myelin oligodendrocyte glycoprotein (MOG) or ON related to aquaporin‐4 (AQP4) antibodies.

Methods

This was a monocentric retrospective observational study. Inclusion criteria for idiopathic ON were as follows: age ≥ 16 years, follow‐up of at least 2 years, negative for antibodies against MOG and AQP4 immunoglobulin G, and no magnetic resonance imaging (MRI) lesions suggestive of demyelination (two brain MRI scans, one at baseline and one during follow‐up, and one spinal cord MRI scan).

Results

Among 23 patients with idiopathic ON (female, 82.6%; median age, 36 years; median follow‐up time, 41.4 months), 56.5% had recurrent ON (median time to a second ON episode, 6 months). The final visual acuity in this group (median, 0; mean, 0.43; range, 0–3) was similar to that in the AQP4 group (n = 18; P‐value after Bonferroni correction = 0.936) but worse than that in the MOG group (n = 25; P‐value after Bonferroni correction = 0.019). At the last evaluation, visual acuity levels were ≤0.5 and <0.2, respectively, in 36.8% and 21% of the idiopathic ON group, 58.3% and 26.7% of the AQP4 group, and 0% and 0% of the MOG group.

Conclusion

The recovery of visual acuity among patients with idiopathic ON was poor, similar to that observed in the AQP4 group.
Identification and tracking of Addictovigilance signals in general practice: which interactions between the general practitioners and the French Addictovigilance Network?
Authors: Gentile Gaétan , Jego Maeva , Spadari Michel , Griffiths Karolina , Jouanjus Emilie , Micallef Joëlle
Published: July 2018

Addictovigilance is a health vigilance dedicated to the survey of medicinal or illicit psychoactive substance use disorders (SUDs). France is the only European country to have a vigilance system specifically dedicated to substances with an abuse/addiction potential. The French Addictovigilance system is organized in a network of regional tertiary centres (called Abuse and Dependence Monitoring Centres, CEIP‐Addictovigilance) and works in close collaboration with Regional and National health authorities. Because of the essential and unavoidable nature of their practice in the French Healthcare system, general practitioners (GPs) are key actors to identify and track Addictovigilance signals. They have been involved in several of the pharmacoepidemiological surveys implemented by the French Addictovigilance Network (FAN). Now, they increasingly participate in clinical research projects and studies. In this article, interactions between GPs and the FAN are illustrated with two examples: patients on opioid substitution treatment and patients on opioid analgesics. Collaborations between GPs and the FAN could be further potentiated. In particular, more effective communication on psychoactive SUDs including abuse/addiction is necessary to optimize the implementation of preventive measures for patients on psychoactive substances medications, and to improve the attitudes of GPs and more widely health professionals in the management of any psychoactive user suffering from SUDs. In addition, both adapted training and improved collaborative research could contribute to the optimization (safety, quality) of professional practices.
Effects of multiple stressors on cyanobacteria abundance vary with lake type
Authors: Richardson Jessica , Miller Claire , Maberly Stephen C. , Taylor Philip , Globevnik Lidija , Hunter Peter , Jeppesen Erik , Mischke Ute , Moe S. Jannicke , Pasztaleniec Agnieszka , Søndergaard Martin , Carvalho Laurence
Published: July 2018

Blooms of cyanobacteria are a current threat to global water security that is expected to increase in the future because of increasing nutrient enrichment, increasing temperature and extreme precipitation in combination with prolonged drought. However, the responses to multiple stressors, such as those above, are often complex and there is contradictory evidence as to how they may interact. Here we used broad scale data from 494 lakes in central and northern Europe, to assess how cyanobacteria respond to nutrients (phosphorus), temperature and water retention time in different types of lakes. Eight lake types were examined based on factorial combinations of major factors that determine phytoplankton composition and sensitivity to nutrients: alkalinity (low and medium‐high), colour (clear and humic) and mixing intensity (polymictic and stratified). In line with expectations, cyanobacteria increased with temperature and retention time in five of the eight lake types. Temperature effects were greatest in lake types situated at higher latitudes, suggesting that lakes currently not at risk could be affected by warming in the future. However, the sensitivity of cyanobacteria to temperature, retention time and phosphorus varied among lake types highlighting the complex responses of lakes to multiple stressors. For example, in polymictic, medium‐high alkalinity, humic lakes cyanobacteria biovolume was positively explained by retention time and a synergy between TP and temperature, while in polymictic, medium‐high alkalinity, clear lakes only retention time was identified as an explanatory variable. These results show that, although climate change will need to be accounted for when managing the risk of cyanobacteria in lakes, a “one‐size fits‐all” approach is not appropriate. When forecasting the response of cyanobacteria to future environmental change, including changes caused by climate and local management, it will be important to take this differential sensitivity of lakes into account.
Forecasting effects of tree species reintroduction strategies on carbon stocks in a future without historical analog
Authors: Gustafson Eric J. , Sturtevant Brian R. , de Bruijn Arjan M. G. , Lichti Nathanael , Jacobs Douglass F. , Kashian Daniel M. , Miranda Brian R. , Townsend Philip A.
Published: July 2018

American chestnut (Castanea dentata) was once an important component forests in the central Appalachians (USA), but it was functionally extirpated nearly a century ago. Attempts are underway to reintroduce blight‐resistant chestnut to its former range, but it is uncertain how current forest composition, climate, and atmospheric changes and disturbance regimes will interact to determine future forest dynamics and ecosystem services. The combination of novel environmental conditions (e.g. climate change), a reintroduced tree species and new disturbance regimes (e.g. exotic insect pests, fire suppression) have no analog in the past that can be used to parameterize phenomenological models. We therefore used a mechanistic approach within the LANDIS‐II forest landscape model that relies on physiological first principles to project forest dynamics as the outcome of competition of tree cohorts for light and water as a function of temperature, precipitation, CO2 concentration, and life history traits. We conducted a factorial landscape simulation experiment to evaluate specific hypotheses about future forest dynamics in two study sites in the center of the former range of chestnut. Our results supported the hypotheses that climate change would favor chestnut because of its optimal temperature range and relative drought resistance, and that chestnut would be less competitive in the more mesic Appalachian Plateau province because competitors will be less stressed. The hypothesis that chestnut will increase carbon stocks was supported, although the increase was modest. Our results confirm that aggressive restoration is needed regardless of climate and soils, and that increased aggressiveness of chestnut restoration increased biomass accumulation. The hypothesis that chestnut restoration will increase both compositional and structural richness was not supported because chestnut displaced some species and age cohorts. Although chestnut restoration did not markedly enhance carbon stocks, our findings provide hope that this formerly important species can be successfully reintroduced and associated ecosystem services recovered.
Geographies of mega‐urbanization
Authors: Lauermann John
Published: July 2018

This paper reviews recent research on mega‐urbanization, showing that it is an increasingly common form of urban growth. This includes research on the spatial expansion of cities through mega‐scale urban agglomerations like mega‐cities and mega‐regions; it also includes research on the intensification of urban land use through mega‐projects. The paper outlines strategies for researching the geographies of mega‐urbanization, based on recent research in urban studies. Empirically, urban researchers are treating mega‐urbanization as an increasingly ordinary part of everyday urban life. Methodologically, urban researchers are adopting longitudinal approaches for assessing the complex temporalities of mega‐projects and for evaluating gaps between planning promises and planning outcomes. Theoretically, urban research is taking a pragmatic approach to mega‐urbanization, viewing it critically but also aiming to constructively intervene in mega‐project planning.
Nutritional intake is associated with activities of daily living and complications in older inpatients with stroke
Authors: Kokura Yoji , Wakabayashi Hidetaka , Nishioka Shinta , Maeda Keisuke
Published: July 2018

Aim

There is no consensus on energy intake in the acute stage and how it relates to improvement in activities of daily living (ADL) in geriatric stroke patients. We examined whether energy intake after admission is related to improvement in ADL and complications.

Methods

This retrospective cohort study evaluated the data from stroke inpatients at five acute care hospitals, including the mean daily energy intake during the first week after admission. Patients were categorized into two groups based on their daily energy intake; cases where the energy intake per day reached the basal energy expenditure calculated by the Harris–Benedict equation were designated as the intake energy sufficiency group. Patient characteristics were compared between groups. We assessed ADL using the Functional Independence Measure; a secondary outcome was the presence of complications.

Results

Of the 192 participants (mean age 79.6 ± 7.6 years) included in the study, 131 patients were admitted for cerebral infarction, 58 for intracerebral hemorrhage and three for subarachnoid hemorrhage. Of the two groups, that with an energy sufficiency had a greater gain in total Functional Independence Measure (median 27 and 9, respectively; P = 0.001) and a lower complication rate (6.7% and 26.5%, respectively; P ≤ 0.001). Multivariate analyses showed that energy sufficiency was independently associated with the total Functional Independence Measure gain and complication rate.

Conclusions

Energy intake during the first week after admission affected improvement of ADL and onset of complications during hospitalization in geriatric stroke inpatients. Geriatr Gerontol Int 2018; 18: 1334–1339.
Enacting person‐centredness in integrated care: A qualitative study of practice and perspectives within multidisciplinary groups in the care of older people
Authors: Riste Lisa K. , Coventry Peter A. , Reilly Siobhan T. , Bower Peter , Sanders Caroline
Published: July 2018

Background

Person‐centredness is important in delivering care for long‐term conditions. New models of care aim to co‐ordinate care through integration of health and social care which require new ways of working, often remotely from the patient.

Objective

To describe how person‐centred care is enacted within multidisciplinary groups (MDGs) created as part of a new service, integrating health and social care for older people.

Methods

We followed the implementation of eight neighbourhood MDGs, observing and interviewing staff from three MDGs at different phases of programme implementation using semi‐structured topic guides.

Results

Thirty‐four MDG meetings were observed and 32 staff interviewed. Three core themes were identified which impacted on enactment of person‐centred care: the structural context of MDGs enabling person‐centred care; interaction of staff and knowledge sharing during the MDG meetings; and direct staff involvement of the person outside the MDG discussion.

Conclusions

This study provides new insights into attempts to enact person‐centred care within a new model of service delivery. Teams did what they could to enact person‐centred care in the absence of the “real” patient within MDG meetings. They were successful in delivering and co‐ordinating some aspects of care (eg prompting medication reviews, referring to social worker, health improvement and arranging further multidisciplinary team meetings for complex cases). This “absence of patients” and time pressures within the MDGs led to reliance on the “virtual” record, enhanced by additional “soft” knowledge provided by staff, rather than ensuring the patient's voice was included.
Isocitrate dehydrogenase 1 mutations in melanoma frequently co‐occur with NRAS mutations
Authors: Linos Konstantinos , Tafe Laura J
Published: July 2018

Aims

Isocitrate dehydrogenase 1 (IDH1) is a metabolic enzyme that converts isocitrate to α‐ketoglutarate. IDH1 mutations are associated with the accumulation of the oncometabolite D‐2‐hydroxyglutarate, which acts as an epigenetic modifier, and the development of multiple malignancies.

Methods and results

From May 2013 to June 2017, 252 melanoma samples from 214 patients with advanced or distant metastatic disease were tested for somatic mutations with the 50‐gene AmpliSeq version 2 Cancer Hotspot Panel. Two hundred and twenty‐six samples were sequenced successfully from 206 patients with 26 samples being characterised as quantity not sufficient. Melanomas from 10 separate patients (4.9%) were positive for IDH1 R132C (nine) or R132S (one). In six cases, the tumours also had a co‐existing NRAS mutation (p.Q61R, Q61L and Q61K in two patients each) (P = 0.0044), whereas three patients had BRAF non‐V600E mutations (V600K, V600G and V600R). Two cases had a TP53 variant, two cases an ATM variant, one a CDKN2A variant and one had an APC variant. The patients’ ages ranged from 45 to 82 years (mean = 65.3, median = 65 years) and three of 10 patients were female (M:F ratio = 2:3). Three patients were stage 3 and seven were stage 4. Two are deceased, five are alive with stable disease (four on pembrolizumab) and three have no evidence of disease.

Conclusion

IDH mutations may define a unique subset of melanoma patients who are eligible for IDH1 targeted therapies or combined therapies, such as MEK inhibitors when there is co‐existing NRAS mutations, or immunotherapy.
Near panmixia at the distribution‐wide scale but evidence of genetic differentiation in a geographically isolated population of the Terek Sandpiper Xenus cinereus
Authors: Rönkä Nelli , Pakanen Veli‐Matti , Blomqvist Donald , Degtyaryev Victor , Golovatin Mikhail , Isakov Gennady , Karlionova Natalia , Lehikoinen Aija , Morozov Vladimir , Paskhalny Sergey , Pauliny Angela , Pinchuk Pavel , Rauhala Pentti , Tomkovich Pavel , Zakharov Evgeny , Koivula Kari , Kvist Laura
Published: July 2018

Populations from different parts of a species range may vary in their genetic structure, variation and dynamics. Geographically isolated populations or those located at the periphery of the range may differ from those located in the core of the range. Such peripheral populations may harbour genetic variation important for the adaptive potential of the species. We studied the distribution‐wide population genetic structure of the Terek Sandpiper Xenus cinereus using 13 microsatellite loci and the mitochondrial DNA (mtDNA) control region. In addition, we estimated whether genetic variation changes from the core towards the edge of the breeding range. We used the results to evaluate the management needs of the sampled populations. Distribution‐wide genetic structure was negligible; the only population that showed significant genetic differentiation was the geographically isolated Dnieper River basin population in Eastern Europe. The genetic variation of microsatellites decreased towards the edge of the distribution, supporting the abundant‐centre hypotheses in which the core area of the distribution preserves the most genetic variation; however, no such trend could be seen with mtDNA. Overall genetic variation was low and there were signs of past population contractions followed by expansion; this pattern is found in most northern waders. The current effective population size (Ne) is large, and therefore global conservation measures are not necessary. However, the marginal Dnieper River population needs to be considered its own management unit. In addition, the Finnish population warrants conservation actions due to its extremely small size and degree of isolation from the main range, which makes it vulnerable to genetic depletion.
Relationships among structural empowerment, innovative behaviour, self‐efficacy, and career success in nursing field in mainland China
Authors: Dan Xin , Xu Suhuan , Liu Jingying , Hou Ruonan , Liu Yanhui , Ma Hongwen
Published: July 2018

Aim

The purpose of the study is to explore the relationships among structural empowerment, innovative behaviour, self‐efficacy, and career success by nurses in mainland China.

Method

A cross‐sectional study was designed, and participants were recruited from 6 tertiary hospitals in Tianjin, China. The study used an anonymous questionnaire, filled voluntarily by 460 nurses in spring 2017. Structural equation modelling analyses were conducted.

Results

The results reveal that innovative behaviour is positively associated with career success and self‐efficacy, which, in turn, mediates the relationship between structural empowerment and career success. Structural empowerment is positively associated with innovative behaviour and career success. Self‐efficacy is positively associated with career success and mediates the relationship between innovative behaviour and career success.

Conclusion

Higher perceived structural empowerment, innovative behaviour, and self‐efficacy can increase career success of Chinese nurses.
Work‐related stress among nursing staff working in government hospitals and primary health care centres
Authors: Alenezi Ali Mohammed , Aboshaiqah Ahmad , Baker Omar
Published: July 2018

Aim

Work‐related stress (WRS) in the nursing working environment is prevalent and significantly affects the performance of nurses and organizations. Poor nursing and administrative performance affects the delivery of safety and quality patient care. Thus, this study aims to compare the sources and factors of stress among nurses from hospitals and primary health care centres.

Methods

A cross‐sectional study was conducted in five government hospitals and four sectors of primary health care centres in Saudi Arabia. Through a survey, the Nursing Stress Scale was completed by 347 nurses from February to March 2016.

Results

Workload is perceived as the most common source of WRS, whereas inadequate preparation is regarded as the least. Other major sources are conflicts with physicians and nurses in primary centres and the lack of support and uncertainty concerning treatment in hospitals. The nurses' age, marital status, nationality, and job position are the significantly identified factors that contribute to stress.

Conclusion

Overall, the sources and factors of WRS significantly vary with nurses' working environment. Hence, understanding the perception of nurses towards their working environment can be a strategic basis in modifying policies in occupational stress management.
The effect of workload on nurses' non‐observance errors in medication administration processes: A cross‐sectional study
Authors: Jin Haizhe , Chen Han , Munechika Masahiko , Sano Masataka , Kajihara Chisato
Published: July 2018

Aim

This study, based on actual medical error cases involving nurses, sought to identify non‐observance errors—defying the standard operating procedures—in medication administration processes, and clarify the relationship between nursing workload and such behaviours.

Methods

Based on a cross‐sectional survey, non‐observance error cases were collected from three Japanese hospitals between January and December 2014, using self‐reported data from participating nurses. Standard operating procedures and actual error content were compared to identify non‐observance errors and workload. The statistical analysis was used to determine the relationship between non‐observance error and workload.

Results

A total of 637 error cases were found in administering medication, of which 163 (25.6%) were workload‐related non‐observance errors. Individual analysis of the 163 cases identified seven workload issues that caused non‐observance error and six categories of non‐observance errors. The relationship between workload and such errors was also clarified.

Conclusion

Our findings clarify the influence of workload on non‐observance errors and may also help identify adjacent areas for specific improvements.
Management characteristics and corporate performance of Chinese chemical companies: the moderating effect of managerial ability
Authors: Wang Wei‐Kang , Lu Wen‐Min , Kweh Qian Long , Lee Jhong‐Jhe
Published: July 2018

This study examines the association between management characteristics and corporate performance, as well as how it is moderated by managerial ability among 103 Chinese chemical companies for the period 2008–2010. While we measure management characteristics from the perspectives of human quality, team structure, and economic incentives, we employ dynamic data envelopment analysis to gauge managerial ability. Our ordinary least squares regression results show that management characteristics are positively related to corporate performance, which is proxied by Tobin's Q. Furthermore, we find that managerial ability can further strengthen the positive relationship between management characteristics and corporate performance. In addition, we include graphs highlighting the moderating effects of managerial ability on the relationship between management characteristics and corporate performance. Overall, this study provides a greater understanding of the upper‐echelon theory and insights of managerial ability in a dynamic context.
Thermo‐mechanical properties of mullite ceramics: New data
Authors: Krenzel Thomas F. , Schreuer Jürgen , Laubner Derek , Cichocki Michel , Schneider Hartmut
Published: July 2018

Coefficients of elastic stiffnesses and thermal expansion of hot isostatically pressed, reaction‐sintered and technical fused‐mullite ceramics were measured between 100 and 1673 K in comparison with single crystal mullite employing resonant ultrasound spectroscopy and dilatometry, respectively. Additionally, chemical and phase compositions and the microstructure of the ceramics were studied using X‐ray diffraction techniques and scanning electron microscopy. Our studies revealed that despite polycrystallinity and slight porosity of up to 1.6%, the elastic behavior of the hot isostatically pressed ceramics is near to ideal aggregate elastic properties of mullite single crystal, for example, their bulk moduli fit within 0.7% to B = 170.0 GPa of single crystal mullite. On the other hand, with B = 155 GPa, the reaction‐sintered mullite behaves significantly softer. The difference can be explained with more tight grain to grain contacts in hot isostatically pressed ceramics as compared to reaction‐sintered materials. The thermal expansion of both types of ceramics almost coincides with the corresponding averaged behavior of single crystal mullite. For example, between 573 and 1273 K, the volume expansion coefficients of all these materials are (18.0 ± 0.3)·10−6 K−1. Obviously, the microstructural features are less important for the macroscopic thermal expansion. Due to heterogeneous microstructure and high α‐alumina and zirconia contents, the corresponding properties of fused‐mullite refractory deviate strongly from those of the other mullite materials.
Measuring emotional support in family networks: Adapting the Family Network Method for individuals with a mild intellectual disability
Authors: Giesbers Sanne A. H. , Tournier Tess , Hendriks Lex , Hastings Richard P. , Jahoda Andrew , Embregts Petri J. C. M.
Published: July 2018

Background

Informal supportive networks of individuals with intellectual disability have become increasingly important. The aim of this paper is to describe how the Family Network Method – Intellectual Disability (FNM‐ID) offers a way to gather the perspective of people with mild intellectual disability on their family support.

Method

TheFNMis designed to explore how individuals define their family contexts, and more specifically how they perceive existing supportive relationships in these contexts.

Results

By carefully piloting ways of questioning people with mild intellectual disability, systematic adaptations were made to the originalFNM. Data obtained by theFNM‐IDcan be analysed using social network analysis. Thereby, theFNM‐IDprovides rich, theoretically significant information on emotional support in the family networks of individuals with mild intellectual disability.

Conclusions

TheFNM‐IDis a useful and successfully adapted tool for other researchers and professionals to systematically explore the family support experiences of individuals with mild intellectual disability.
Accurate blood pressure measuring devices: Influencing users in the 21st century
Authors: O'Brien Eoin , Alpert Bruce S. , Stergiou George S.
Published: July 2018

Hypertension is now recognized as a major global cause of morbidity and death. All decisions relating to the epidemiology, diagnosis, and management of hypertension are dependent on being able to measure blood pressure accurately. Scientists have developed protocols to assess the accuracy of blood pressure–measuring devices, but little attention has been given to informing users which devices are accurate and inaccurate. This article identifies a recipient audience of researchers, clinicians, and scientists, the public, healthcare executives and administrators, and consumer and regulatory bodies, and discusses how best to communicate the results of device accuracy to these groups with the aim of improving the accurate measurement of blood pressure.
The quest for accuracy of blood pressure measuring devices
Authors: O'Brien Eoin , Stergiou George S. , Turner Martin J.
Published: July 2018

The accuracy of blood pressure (BP) measuring devices is fundamental to good practice and scientific research. International guidelines on BP measurement are provided for clinicians who diagnose and treat patients with hypertension, clinical researchers who conduct trials on the efficacy of BP lowering drugs and interventional strategies, epidemiologists who conduct population surveys to determine the demographic consequences of hypertension on society, and researchers who perform meta‐analyses on published research to further influence the practice of medicine and the provision of resources. Although the outcomes of the endeavors of all these groups are dependent on the accuracy of BP measurements, the equipment is often of doubtful accuracy and the methodology of measurement is often poorly described and frequently not standardized. Thus, the fundamental element of hypertension evaluation has been largely ignored by both clinical practitioners and scientific researchers. Here, the authors briefly review the development of efforts to improve and validate the accuracy of BP measuring devices and highlight the deficiencies that persist. We conclude that, to protect the public from the serious consequences of inaccurate BP measurements, the following steps are required: (1) regulatory requirement for mandatory independent validation of all BP measuring devices using a universal protocol; (2) accreditation of laboratories for the performance of BP device validations; (3) online evaluation of validation studies with detection of protocol violations prior to publication of results; and (4) establishment of an independent scientific forum for the listing of accurate BP measuring devices.
Cuff challenges in blood pressure measurement
Authors: Palatini Paolo , Asmar Roland
Published: July 2018

The characteristics of the optimal cuff for blood pressure (BP) measurement are still the subject of much debate. The choice of the appropriate cuff in obese individuals depends not only on the arm circumference but also on its shape because a conically shaped arm makes it difficult to fit the cuff to the arm. When a large‐size cylindrical cuff is used in conical arms, an overestimation of the true BP is likely to occur with BP discrepancies that may be as large as 10 mm Hg. With the advent of automatic oscillometric devices, the choice of the appropriate cuff became even more controversial because with oscillometric BP measurement the reference point is not the artery occlusion but the oscillometric peak signal. To overcome the problem of miscuffing in obese individuals, special cuffs that can accommodate a wide range of arm sizes have been designed. Using these cuffs, accurate oscillometric BP measurements can be obtained over a wide range of arm circumferences using a unique software algorithm. These wide‐range cuffs coupled to oscillometric devices may represent a good option for BP measurement in very obese subjects. However, their reliability should be confirmed in larger populations and different settings.
Surgical treatment of peri‐implantitis lesions with or without the use of a bone substitute—a randomized clinical trial
Authors: Renvert Stefan , Roos‐Jansåker Ann‐Marie , Persson Gösta Rutger
Published: July 2018

Aim

To assess whether the treatment outcome differed between surgical debridement, with or without a bone substitute.

Materials and Methods

Forty‐one adults with three‐ or four‐wall peri‐implant bone defects were enrolled in a 1‐year RCT. Surgical debridement (control group), or in combination with a bone substitute (Endobon®) (test group) was performed.

Results

Radiographic evidence of defect fill (primary outcome) was only significant in the test group (P = 0.004). At year 1, no bleeding on probing (BOP) in the control and test groups were 7/20 (35%) and 10/21 (47.6%), respectively (χ2 = 0.67, P = 0.41). Plaque scores did not differ by study group at baseline (P = 0.31), or at year 1 (P = 0.08). Mid‐buccal soft tissue recession changes did not differ by groups (P = 0.76). Successful treatment outcome (defect fill ≥1.0 mm, PPD values at implant ≤5 mm, no BOP, and no suppuration was identified in 1/20 (5.0%) control, and 9/21 (42.9%) test individuals (F = 7, 9, P < 0.01). Number needed to treat analysis identified an absolute risk reduction of 32.8% in benefit of the test procedure. (F = 7, 9, P < 0.01).

Conclusions

Successful treatment outcome using a bone substitute was more predictable when a composite therapeutic endpoint was considered.
What confidence should we have in GRADE?
Authors: Mercuri Mathew , Baigrie Brian S.
Published: July 2018

Rationale, Aims, and Objectives

Confidence (or belief) that a therapy is effective is essential to practicing clinical medicine. GRADE, a popular framework for developing clinical recommendations, provides a means for assigning how much confidence one should have in a therapy's effect estimate. One's level of confidence (or “degree of belief”) can also be modelled using Bayes theorem. In this paper, we look through both a GRADE and Bayesian lens to examine how one determines confidence in the effect estimate.

Methods

Philosophical examination.

Results

The GRADE framework uses a criteria‐based method to assign a quality of evidence level. The criteria pertain mostly to considerations of methodological rigour, derived from a modified evidence‐based medicine evidence hierarchy. The four levels of quality relate to the level of confidence one should have in the effect estimate. The Bayesian framework is not bound by a predetermined set of criteria. Bayes theorem shows how a rational agent adjusts confidence (ie, degree of belief) in the effect estimate on the basis of the available evidence. Such adjustments relate to the principles of incremental confirmation and evidence proportionism. Use of the Bayesian framework reveals some potential pitfalls in GRADE's criteria‐based thinking on confidence that are out of step with our intuitions on evidence.

Conclusions

A rational thinker uses all available evidence to formulate beliefs. The GRADE criteria seem to suggest that we discard some of that information when other, more favoured information (eg, derived from clinical trials) is available. The GRADE framework should strive to ensure that the whole evidence base is considered when determining confidence in the effect estimate. The incremental value of such evidence on determining confidence in the effect estimate should be assigned in a manner that is theoretically or empirically justified, such that confidence is proportional to the evidence, both for and against it.
Identification of a novel PLCD1 mutation in Chinese Han pedigree with hereditary leukonychia and koilonychia
Authors: Xue Ke , Zheng Yajie , Shen Changbing , Cui Yong
Published: July 2018

Background

Hereditary leukonychia is a rare nail dystrophy characterized by distinctive whitening of the nail plate. Mutations in the PLCD1 gene have been identified as a major causative factor in hereditary leukonychia (HL). However, few reports have analyzed the relationship between genotype and phenotype, especially in Chinese HL patients. Our study aims to explore the typical clinical features of hereditary leukonychia cases in Chinese Han pedigree and the correlations with PLCD1 gene mutation.

Patients and methods

In this study, two Chinese patients presented with leukonychia and koilonychia. Whole‐exome sequencing (WES) was performed to screen for the mutations in PLCD1 gene and other candidate genes for hereditary leukonychia. Parents with PLCD1 mutation were selected for Sanger sequencing.

Results

A novel heterozygote missense mutation in exon 9 of PLCD1 gene was identified in the proband and his mother. Whole‐exome sequencing revealed both, the proband (III.5) and his mother (II.4) carrying c.1451A>G mutation, while other family members had a normal sequence of the PLCD1 gene.

Conclusion

For the first time, a hereditary leukonychia case with PLCD1 mutation has been described in Chinese Han pedigree. This finding suggests the PLCD1 mutation maybe involved in hereditary leukonychia.
The diagnosis and management of idiosyncratic drug‐induced liver injury
Authors: Hassan Ammar , Fontana Robert J.
Published: July 2018

Drug‐induced liver injury (DILI) is an uncommon but important cause of liver disease that can arise after exposure to a multitude of drugs and herbal and dietary supplements. The severity of idiosyncratic DILI varies from mild serum aminotransferase elevations to the development of severe liver injury that can progress to acute liver failure resulting in death or liver transplantation within days of DILI onset. Chronic liver injury that persists for more than 6 months after DILI onset is also becoming increasingly recognized in up to 20% of DILI patients. Host demographic (age, gender, race), clinical and laboratory features at DILI onset have been associated with the severity and outcome of liver injury in DILI patients. In addition to cessation of the suspect drug, other medical interventions including the use of N‐acetylcysteine and corticosteroids in selected patients have shown some clinical benefit, but additional prospective studies are needed. A number of promising diagnostic, prognostic and mechanistic serum and genetic biomarkers may help improve our understanding of the pathogenesis and treatment of idiosyncratic DILI.
Molecular bloodmeal analyses reveal that Trypanosoma cruzi‐infected, native triatomine bugs often feed on humans in houses in central Brazil
Authors: Minuzzi‐Souza T. T. C. , Silva L. R. , Hagström L. , Hecht M. , Nitz N. , Gurgel‐Gonçalves R.
Published: July 2018

The identification of bloodmeal sources in triatomine bugs (Hemiptera: Reduviidae) is important in understanding vector–host associations and in measuring the risk for Chagas' disease transmission. The bloodmeal sources of triatomines infected with Trypanosoma cruzi (Trypanosomatida: Trypanosomatidae) caught in houses in central Brazil (Goiás State and the Federal District) were investigated during 2012–2014. Mitochondrial cytochrome b amplicons were used to identify bloodmeals through high‐resolution melting and DNA sequencing. Most bugs were found to have fed on either humans (45.7%) or chickens (43.1%). Human blood was detected in Triatoma sordida (n = 22/50 bugs), Triatoma pseudomaculata (n = 7/11 bugs), Panstrongylus megistus (n = 10/24 bugs), Panstrongylus geniculatus (n = 1/3 bugs) and Rhodnius neglectus (n = 18/28 bugs) (all: Hemiptera: Reduviidae). Sequencing identified Necromys (Rodentia: Cricetidae) mouse blood in P. geniculatus and Tropidurus (Squamata: Tropiduridae) lizard blood in T. pseudomaculata and T. sordida. These findings reveal new vector–host associations. The present results suggest frequent contact between humans and T. cruzi‐infected triatomines in central Brazil and indicate that Chagas' disease transmission by native vectors is an ongoing threat.
The preliminary effects of laughter therapy on loneliness and death anxiety among older adults living in nursing homes: A nonrandomised pilot study
Authors: Kuru Alıcı Nilgün , Zorba Bahceli Pınar , Emiroğlu Oya Nuran
Published: July 2018

Objectives

This study evaluated the preliminary effect of laughter therapy on the level of loneliness and death anxiety of older adults.

Methods

This was a quasi‐experimental study with a nonequivalent control group pretest–posttest design. The study participants were older adults living in two nursing homes set up by foundations located in the capital of Turkey. A total of 50 older adults formed the intervention group (n = 20) and control group (n = 30). The intervention group received laughter therapy twice a week for 5 weeks. The control group received no intervention. Data were collected using a socio‐demographic form, the De Jong Gierveld Loneliness Scale (DJGLS) and the Turkish Death Anxiety Scale (TDAS).

Results

After laughter therapy, the DJGLS total and subscale (emotional and social loneliness) scores decreased among older adults in the intervention group (p < 0.005). While there were no significant differences for overall TDAS, death uncertainty and pain subscales scores between the intervention and control group after laughter therapy, there was a significant decrease in TDAS exposure subscale scores of the intervention group (p < 0.005).

Discussion

The results suggest that laughter therapy can be used to decrease levels of loneliness and death anxiety among older adults living in nursing homes.

Implications for Practice

Anxiety regarding death and loneliness are important issues that affect quality of life in older adults. This first pilot study demonstrates the beneficial effects of laughter therapy on loneliness and death anxiety in nursing home residents. Nurses can incorporate laughter therapy into routine programmes in nursing homes.
Prophylactic recombinant thrombomodulin treatment prevents hepatic sinusoidal obstruction syndrome in high‐risk pediatric patients that undergo hematopoietic stem cell transplants
Authors: Yamamoto Shohei , Toyama Daisuke , Sugishita Yumiko , Kaneko Ryota , Okamoto Naoko , Koganesawa Masaya , Fujita Sachio , Akiyama Kosuke , Matsuno Ryosuke , Isoyama Keiichi
Published: July 2018

Hepatic SOS is a potentially life‐threatening complication of conditioning for allogeneic HSCT. rTM is a new drug for treating DIC. We report our experience of the use of rTM as a prophylaxis against SOS in high‐risk pediatric patients that underwent HSCT. We evaluated the cases of 19 pediatric hematology and oncology patients who underwent HSCT at our institution between 2007 and 2016. The patients who received HSCT after 2012 (n = 8) were treated with rTM as a prophylaxis against SOS together with UDCA and LMWH, whereas the others (n = 11) were only treated with UDCA and LMWH. Although SOS occurred by post‐HSCT day 35 in 3 (27%) patients in the control group, SOS was not seen in the rTM group. Two of the former three patients suffered severe SOS, and one died of the condition. The mean peak level of PAI‐1 (a marker of endothelial damage) was significantly lower in the rTM group. rTM appears to be a safe prophylaxis for SOS. The present findings suggest that prophylactic rTM after HSCT might help to prevent SOS.
Women on wheels: Gender and cycling in Solo, Indonesia
Authors: Song Lily , Kirschen Mariel , Taylor John
Published: July 2018

This paper explores the question of how to promote cycling among women who face disproportionate mobility and accessibility barriers in rapidly urbanizing contexts by analyzing empirical findings from a multi‐method research study based in Solo, Indonesia. Building on and applying a combination of critical gender, geography, and development perspectives, it focuses on the perceptions, attitudes, and behaviors of women residing in low‐income neighbourhoods with little access to public transportation networks in Solo as an ‘indicator species for bike‐friendly cities’. Based on research and analytic findings, the paper further contemplates alternative policy and planning approaches to promoting cycling in more gender‐inclusive and responsive terms.
Affective processes as mediators of links between close relationships and physical health
Authors: Farrell Allison K. , Imami Ledina , Stanton Sarah C.E. , Slatcher Richard B.
Published: July 2018

Close relationships are known to predict physical health outcomes. The time has come for a shift toward achieving a better understanding of the underlying mechanisms. One promising group of psychological mechanisms is affective processes, such as discrete emotions, emotion regulation, and affect reactivity. In this paper, we discuss the evidence linking relationship functioning with both the positive and negative valences of each affective process, considering the contributions of different types of close relationships across the lifespan, and the evidence for each affective process impacting physical health. We note evidence suggesting that affective processes may also have a causal impact on relationship function. When available, we review literature testing full mediational pathways, from relationship functioning to affective processes to physical health, as the ideal methodology for testing these links. Finally, we identify core themes and propose key future directions for this research.
Genomic full‐length sequence of HLA‐B*15:178 was identified by full‐length group‐specific sequencing
Authors: He L.‐M. , Yang H. , Xu Y.‐P. , Hong W.‐X.
Published: July 2018

Genomic full‐length sequence of HLA‐B*15:178 was identified by a group‐specific sequencing approach from China.
Evaluating a wayfinding video
Authors: Shaw Nicole , Hitch Danielle , Lyons Nikki , Alharthi Khalid , Grant Briony , Laupert Ben
Published: July 2018

Background

Many occupational therapy students experience anxiety and distraction when entering a new setting at the beginning of a clinical placement. Orientation processes may provide students with the information they need to feel more comfortable in an unfamiliar clinical setting. The aim of this project was to evaluate a revised wayfinding video for first‐ and second‐year occupational therapy students, with a particular focus on reducing anxiety.

Methods

A revised version of a wayfinding video (with a duration of 3 minutes and 40 seconds) was created by final‐year occupational therapy students and then evaluated using a paper‐based descriptive survey. All data were analysed using a content analysis approach.

Results

A total of 71 responses were received, demonstrating a response rate of 47%. The students indicated that the video addressed the main sources of pre‐placement anxiety and supported their pre‐existing anxiety management strategies. Anxiety‐reducing features of the video included an overview and visual introduction to the facility, hearing the positive experiences of other students, the provision of placement expectations and an introduction to the student coordinators. All but two of the students indicated that they would watch the video if it were attached to their welcome pack.

Many occupational therapy students experience anxiety and distraction when entering a new setting

Conclusions

The revised wayfinding video addressed many of the students’ anxieties about commencing placement and now forms part of a broader suite of student orientation materials. There are several limitations to the development of wayfinding videos, but they are surmountable via collaboration and investment in careful planning.
Developmental role of the tomato Mediator complex subunit MED18 in pollen ontogeny
Authors: Pérez‐Martín Fernando , Yuste‐Lisbona Fernando J. , Pineda Benito , García‐Sogo Begoña , Olmo Iván del , de Dios Alché Juan , Egea Isabel , Flores Francisco B. , Piñeiro Manuel , Jarillo José A. , Angosto Trinidad , Capel Juan , Moreno Vicente , Lozano Rafael
Published: July 2018

Pollen development is a crucial step in higher plants, which not only makes possible plant fertilization and seed formation, but also determines fruit quality and yield in crop species. Here, we reported a tomato T‐DNA mutant, pollen deficient1 (pod1), characterized by an abnormal anther development and the lack of viable pollen formation, which led to the production of parthenocarpic fruits. Genomic analyses and the characterization of silencing lines proved that pod1 mutant phenotype relies on the tomato SlMED18 gene encoding the subunit 18 of Mediator multi‐protein complex involved in RNA polymerase II transcription machinery. The loss of SlMED18 function delayed tapetum degeneration, which resulted in deficient microspore development and scarce production of viable pollen. A detailed histological characterization of anther development proved that changes during microgametogenesis and a significant delay in tapetum degeneration are associated with a high proportion of degenerated cells and, hence, should be responsible for the low production of functional pollen grains. Expression of pollen marker genes indicated that SlMED18 is essential for the proper transcription of a subset of genes specifically required to pollen formation and fruit development, revealing a key role of SlMED18 in male gametogenesis of tomato. Additionally, SlMED18 is able to rescue developmental abnormalities of the Arabidopsis med18 mutant, indicating that most biological functions have been conserved in both species.