bluuebunny/crossref_metadata_2025 huggingface dataset:
Deep Learning based multi-omics integration robustly predicts survival in liver cancer
Authors: Chaudhary Kumardeep , Poirion Olivier B. , Lu Liangqun , Garmire Lana X.
Published: March 2017

Identifying robust survival subgroups of hepatocellular carcinoma (HCC) will significantly improve patient care. Currently, endeavor of integrating multi-omics data to explicitly predict HCC survival from multiple patient cohorts is lacking. To fill in this gap, we present a deep learning (DL) based model on HCC that robustly differentiates survival subpopulations of patients in six cohorts. We build the DL based, survival-sensitive model on 360 HCC patients’ data using RNA-seq, miRNA-seq and methylation data from TCGA, which predicts prognosis as good as an alternative model where genomics and clinical data are both considered. This DL based model provides two optimal subgroups of patients with significant survival differences (P=7.13e-6) and good model fitness (C-index=0.68). More aggressive subtype is associated with frequentTP53inactivation mutations, higher expression of stemness markers (KRT19,EPCAM) and tumor markerBIRC5, and activated Wnt and Akt signaling pathways. We validated this multi-omics model on five external datasets of various omics types: LIRI-JP cohort (n=230, C-index=0.75), NCI cohort (n=221, C-index=0.67), Chinese cohort (n=166, C-index=0.69), E-TABM-36 cohort (n=40, C-index=0.77), and Hawaiian cohort (n=27, C-index=0.82). This is the first study to employ deep learning to identify multi-omics features linked to the differential survival of HCC patients. Given its robustness over multiple cohorts, we expect this workflow to be useful at predicting HCC prognosis prediction.
Ankyrin-1 gene exhibits allelic heterogeneity in conferring protection against malaria
Authors: Huang Hong Ming , Bauer Denis C. , Lelliott Patrick M. , Dixon Matthew W. A. , Tilley Leann , McMorran Brendan J. , Foote Simon J. , Burgio Gaetan
Published: March 2017

Allelic heterogeneity is a common phenomenon where a gene exhibit different phenotype depending on the nature of its genetic mutations. In the context of genes affecting malaria susceptibility, it allowed us to explore and understand the intricate host-parasite interactions during malaria infections. In this study, we described a gene encoding erythrocytic ankyrin-1 (Ank-1) which exhibits allelic-dependent heterogeneous phenotypes during malaria infections. We conducted an ENU mutagenesis screen on mice and identified twoAnk-1mutations, one resulted in an amino acid substitution (MRI95845), and the other a truncatedAnk-1protein (MRI96570). Both mutations caused hereditary spherocytosis-like phenotypes and confer differing protection againstPlasmodium chabaudiinfections. Upon further examination, theAnk-1(MRI96570)mutation was found to inhibit intra-erythrocytic parasite maturation, whereasAnk-1(MW95845)caused increased bystander erythrocyte clearance during infection. This is the first description of allelic heterogeneity in ankyrin-1 from the direct comparison between twoAnk-1mutations. Despite the lack of direct evidence from population studies, this data further supported the protective roles of ankyrin-1 mutations in conferring malaria protection. This study also emphasized the importance of such phenomenon to achieve a better understanding of host-parasite interactions, which could be the basis of future studies.
Social interactions within the family enhance the capacity for evolutionary change
Authors: Jarrett BJM , Schrader M , Rebar D , Houslay TM , Kilner RM
Published: March 2017

Classical models of evolution seldom predict evolution in the wild. One explanation is that the social environment has important, yet overlooked, effects on how traits change in response to natural selection. We tested this idea with selection experiments on burying beetles (Nicrophorus vespilloides), sub-social insects that exhibit biparental care. Populations responded to selection for larger adults only when parents cared for their offspring, and responded to selection for smaller adults only when we prevented parents from providing care. Comparative analyses revealed a similar pattern: evolutionary increases in species size within the genusNicrophorusare associated with the obligate provision of care. Synthesising our results with previous studies, we suggest that cooperative social environments enhance the response to selection whereas conflict can prevent further directional selection.
Wnt Signalling Controls the Response to Mechanical Loading during Zebrafish Joint Development
Authors: Brunt L H , Begg K , Kague E , Cross S , Hammond C L
Published: March 2017

Joint morphogenesis requires mechanical activity during development. Loss of mechanical strain causes abnormal joint development, which can impact long term joint health. While cell orientation and proliferation are known to shape the joint, dynamic imaging of developing jointsin vivohave not been possible in other species. Using genetic labelling techniques in zebrafish we were able, for the first time, to dynamically track cell behaviours in intact moving joints. We identify that proliferation and migration, which contribute to joint morphogenesis, are mechanically controlled and are significantly reduced in immobilised larvae. By comparison to strain maps of the developing skeleton we identify canonical Wnt signalling as a candidate to transduce mechanical forces into joint cell behaviours. We show that in the jaw Wnt signalling is reduced specifically in regions of high strain in response to loss of muscle activity. By pharmacological manipulation of canonical Wnt signalling we demonstrate that Wnt acts downstream of mechanical activity and is required for joint patterning and chondrocyte maturation. Wntl6, independent of muscle activity, controls proliferation and migration, but plays no role in chondrocyte intercalation.
Liminality and the entrepreneurial firm
Authors: Gross Nicole , Geiger Susi
Published: March 2017

Purpose

Focussing on the dynamic nature of entrepreneurship, the purpose of this paper is to advance an understanding of entrepreneurial practice in phases of radical change, which the authors conceptualize as periods of liminality. A particular focus on the management of tension is taken to investigate destabilization of practices, sources of resistance and enablers of change during shifts from a familiar past into an unfamiliar and uncertain future.

Design/methodology/approach

An exploratory longitudinal study of a single case firm was conducted to study the entrepreneurial change process during radical transition phases. To understand and theorize liminality and practice renewal in the entrepreneurial firm, the authors leveraged data collection tools from ethnography and engaged in data analysis inspired by grounded theory.

Findings

The authors build a process model of becoming that maps the following processes: destabilizing incumbent practices, sources of resistance and enablers of change, acceptance of upheaval and trying on a new state of being. A research agenda for future research in this area is also formulated.

Originality/value

The research contributes to contemporary entrepreneurship-as-practice research and to research considering the concept of liminality in entrepreneurship. Through processual theory building based on empirical research, the authors highlight that simultaneously handling the practices of the past whilst breeding new trajectories in an unknown future create tensions that can make or break the entrepreneurial firm.
Application of Petri nets towards improved utilization of machines in job shop manufacturing environments
Authors: Pachpor Pravin S. , Shrivastava R.L. , Seth Dinesh , Pokharel Shaligram
Published: March 2017

Purpose

The purpose of this paper is to demonstrate the use of Petri nets in a job shop setup for the improvement in the utilization of machines.

Design/methodology/approach

The study discusses concepts such as reachable state, token and matrix equations set, and demonstrates the improvements in machines’ utilization in a job shop. It makes use of algorithms to generate reachable markings to obtain utilization. The study not only describes the application of theory, but also extends the body of knowledge on Petri nets and job shops.

Findings

In this study, machines’ utilization has been studied in a job shop with six machines and eight products. The study finds that substantial utilization improvement in job shop set up can be obtained through the application of Petri nets. The study also exposes that Petri nets are mostly used for machines, jobs and tools scheduling problems, but its use in machines’ utilization is neglected. The framework and application presented here along with generalizable findings, is the first to report about machine utilization improvement in job shop manufacturing environment.

Practical implications

Job shops are characterized by high unit production cost, low investments, low volume and high variety, complex flows, flexible and skilled work force, general purpose machines, high material handling; resulting in poor utilization of machines. Therefore, the findings of this study can help in reducing such costs through better machine utilization. This can help in increasing the competitiveness of the companies.

Originality/value

The contribution of study lies in investigating and improving stage wise utilization in a job shop setup. It has never been reported before.
Mission statements in academic libraries: a discourse analysis
Authors: Wadas Linda R.
Published: March 2017

Purpose

The purpose of this paper is to determine how academic library mission statements are related to their parent institution mission statements.

Design/methodology/approach

Using a random sample of the US colleges and universities, library and their respective college or university mission statements were compared using discourse analysis.

Findings

This study shows a very weak link between college or university mission statements and library mission statements in the majority of cases.

Originality/value

This paper opens a discussion of the value and purpose of library mission statements with the context of parent institution mission statements.
Application of Hilbert‐like transforms for enhanced processing of full tensor magnetic gradient data
Authors: Schiffler M. , Queitsch M. , Stolz R. , Meyer H.‐G. , Kukowski N.
Published: March 2017

Commonly, geomagnetic prospection is performed via scalar magnetometers that measure values of the total magnetic intensity. Recent developments of superconducting quantum interference devices have led to their integration in full tensor magnetic gradiometry systems consisting of planar‐type first‐order gradiometers and magnetometers fabricated in thin‐film technology. With these systems measuring directly the magnetic gradient tensor and field vector, a significantly higher magnetic and spatial resolution of the magnetic maps is yield than those produced via conventional magnetometers.

In order to preserve the high data quality in this work, we develop a workflow containing all the necessary steps for generating the gradient tensor and field vector quantities from the raw measurement data up to their integration into high­resolution, low­noise, and artefactless two‐dimensional maps of the magnetic field vector. The gradient tensor components are processed by superposition of the balanced gradiometer signals and rotation into an Earth‐centred Earth‐fixed coordinate frame. As the magnetometers have sensitivity lower than that of gradiometers and the total magnetic intensity is not directly recorded, we employ Hilbert‐like transforms, e.g., integration of the gradient tensor components or the conversion of the total magnetic intensity derived by calibrated magnetometer readings to obtain these values. This can lead to a better interpretation of the measured magnetic anomalies of the Earth's magnetic field that is possible from scalar total magnetic intensity measurements. Our conclusions are drawn from the application of these algorithms on a survey acquired in South Africa containing full tensor magnetic gradiometry data.
Two regimes of HIV/AIDS: The MMWR and the socio‐political construction of HIV/AIDS as a ‘black disease’
Authors: Moseby Kevin M.
Published: March 2017

Over the course of the HIV/AIDS epidemic, black Americans have become a central target of US public health prevention efforts. And today, HIV/AIDS is understood to disproportionately affect black Americans. This markedly contrasts with knowledge about the disease and efforts to prevent it in the first decade of the epidemic in the US, when expert and lay understandings and responses centred on white gay males. This article demonstrates that explaining these historical reversals as purely reflective of epidemiological data – or best knowledge available – is insufficient. Drawing on the concept disease regimes and utilising a discursive analysis of epidemiological results and editorial commentary published from 1981 to 1994 in the Morbidity and Mortality Weekly Reports (MMWR), this article argues for a socio‐political explanation for the changing colour of HIV/AIDS. That is, it scrutinises institutional and discursive practices that within the HIV/AIDS prevention field and disease discourse constituted a ‘regime of black American exclusion’ (1981–1992) and a ‘regime of black American inclusion (1993–present day).
The pregnancy outcome of progestin‐primed ovarian stimulation using 4 versus 10 mg of medroxyprogesterone acetate per day in infertile women undergoing in vitro fertilisation: a randomised controlled trial
Authors: Dong J , Wang Y , Chai WR , Hong QQ , Wang NL , Sun LH , Long H , Wang L , Tian H , Lyu QF , Lu XF , Chen QJ , Kuang YP
Published: March 2017

Objective

To investigate the clinical outcome and endocrinological characteristics of progestin‐primed ovarian stimulation (PPOS) using 4 versus 10 mg of medroxyprogesterone acetate (MPA) per day in infertile women with normal ovary reserve.

Design

A randomised parallel controlled trial.

Setting

Tertiary‐care academic medical centre.

Participants

A cohort of 300 infertile women undergoing in vitro fertilisation (IVF)/intracytoplasmic sperm injection (ICSI) treatment.

Methods

Human menopausal gonadotropin (hMG; 225 iu per day) and MPA (group A, 10 mg per day; group B, 4 mg per day) were started simultaneously from cycle day 3 onwards. Ovulation was co‐triggered by human chorionic gonadotropin (hCG; 1000 iu) and gonadotropin‐releasing hormone agonist (GnRH agonist; 0.1 mg) when dominant follicles matured. Viable embryos were cryopreserved for later frozen embryo transfer (FET) in both groups.

Main outcome measures

The primary outcome measure was the number of oocytes retrieved. Secondary outcomes included the incidence of a premature surge in luteinising hormone (LH), the number of viable embryos, and clinical pregnancy outcomes.

Results

The number of oocytes retrieved and viable embryos were similar between two groups (9.8 ± 6.3 versus 9.6 ± 5.9; 4.2 ± 2.6 versus 3.7 ± 3.0; P > 0.05). No significant difference was found in clinical pregnancy rate (58.0 versus 48.7%) and live birth rate per participant (48.7 versus 42.0%; P > 0.05). No premature LH surge and ovarian hyperstimulation syndrome (OHSS) occurred in either group.

Conclusions

Progestin‐primed ovarian stimulation (PPOS) using 4 or 10 mg of MPA per day was comparable in terms of the number of oocytes retrieved and pregnancy outcome after FET. The administration of 4 mg of MPA per day was sufficient to prevent an untimely LH rise in women undergoing IVF/ICSI treatment.

Tweetable abstract

An RCT confirmed similar pregnancy outcome in P‐primed ovarian stimulation with a daily dose of 4 or 10 mg MPA.
Drospirenone‐containing oral contraceptive pills and the risk of venous thromboembolism: a systematic review of observational studies
Authors: Larivée N , Suissa S , Khosrow‐Khavar F , Tagalakis V , Filion KB
Published: March 2017

Background

The effects of fourth‐generation drospirenone‐containing combined oral contraceptives (COCs) on the risk of venous thromboembolism (VTE) are controversial.

Objectives

To assess the methodological strengths and limitations of the evidence on the VTE risk of these COCs.

Search strategy

We searched CINAHL, the Cochrane Library, EMBASE, HealthStar, Medline, and the Science Citation Index.

Selection criteria

Studies were included if they were cohort and case–control studies, reported a venous thrombotic outcome, had a comparator group, reported an effect measure of the association of interest, and were published in English or French.

Data collection and analysis

We assessed study quality using the ROBINS‐I tool and assessed the presence of four common sources of bias: prevalent user bias, inappropriate choice of comparator, VTE misclassification, and confounding.

Main results

Our systematic review included 17 studies. The relative risks of VTE associated with drospirenone‐ versus second‐generation levonorgestrel‐containing COCs ranged from 1.0 to 3.3. Based on ROBINS‐I, three studies had a moderate risk, ten had a serious risk, and four had a critical risk. Nine studies included prevalent users, four included inappropriate comparators, four had VTE misclassification, and five did not account for two or more important confounding factors. The three highest quality studies had relative risks ranging from 1.0 to 1.57.

Author's conclusions

As a result of the methodological limitations of the individual studies, the VTE risk of drospirenone‐containing COCs remains unknown. The highest quality studies suggest there are no or slightly increased harmful effects, but their confidence limits do not rule out an almost doubling of the risk.

Tweetable abstract

Systematic review of drospirenone: best studies show no or slightly increased VTE risk (versus levonorgestrel).
Distribution of invariant natural killer T cells and dendritic cells in late pre‐term birth without acute chorioamnionitis
Authors: Negishi Yasuyuki , Shima Yoshio , Takeshita Toshiyuki , Takahashi Hidemi
Published: March 2017

Problem

Acute chorioamnionitis (aCAM) is an important cause of pre‐term birth. However, little is known about the pathogenesis of late pre‐term birth without aCAM that was the most common category of pre‐term birth. Here we analyze the kinetics of immune cells obtained from the decidua of women with late pre‐term births with and without aCAM.

Method of study

Deciduas were obtained from women who underwent labor with late pre‐term birth without aCAM (PB‐n/aCAM) or with aCAM (PB‐w/aCAM). The population of DEC‐205+ dendritic cells (DCs), macrophages, invariant natural killer T (iNKT) cells, NK cells, CD8+ T cells, and CD4+ T cells were analyzed by flow cytometry.

Results

The number of iNKT cells was higher in the decidua obtained from women with PB‐n/aCAM than PB‐w/aCAM. DEC‐205+ DCs obtained from women with PB‐n/aCAM preferentially induced iNKT cell proliferation.

Conclusion

iNKT cell accumulation with DEC‐205+ DCs in PB‐n/aCAM suggests that iNKT cells contribute to the onset of PB‐n/aCAM.
Perceived warmth and competence of others shape voluntary deceptive behaviour in a morally relevant setting
Authors: Azevedo Ruben T. , Panasiti Maria Serena , Maglio Rosita , Aglioti Salvatore Maria
Published: March 2017

The temptation to deceive others compares to a moral dilemma: it involves a conflict between the temptation to obtain some benefit and the desire to conform to personal and social moral norms or avoid aversive social consequences. Thus, people might feel different levels of emotional and moral conflict depending on the target of the deception. Here we explored, in a morally relevant setting, how social judgements based on two fundamental dimensions of human social cognition – ‘warmth’ and ‘competence’ – impact on the decision to deceive others. Results revealed independent effects for warmth and competence. Specifically, while people are less inclined to deceive for self‐gain those individuals they perceive as warm, they also tend to lie more to highly competent others. Furthermore, the perceived warmth and competence modulated the general tendency to reduce deceptive behaviour when there was a risk of disclosure compared to when the lying was anonymous, highlighting the importance of these judgements in social evaluation processes. Together, our results demonstrate that the emotional costs and personal moral standards that inhibit engagement in deceptive behaviour are not stable but rather malleable according to the target and the consequences of the deception.
What Do We Know About the Effects of Macroprudential Policy?
Authors: Galati Gabriele , Moessner Richhild
Published: March 2017

The literature on the effectiveness of macroprudential policy tools is still in its infancy and has so far provided only limited guidance for policy decisions. In recent years, however, increasing efforts have been made to fill this gap. Progress has been made in embedding macroprudential policy in theoretical models. There is increasing empirical work on the effect of some macroprudential tools on a range of target variables, such as quantities and prices of credit, asset prices, and on the amplitude of the financial cycle and financial stability. In this paper we provide a critical review of recent progress in theoretical and empirical research on the effectiveness of macroprudential instruments.
Hospital admissions by the oldest old: Past trends in one of the most ageing countries in the world
Authors: Brandão Daniela , Ribeiro Oscar , Freitas Alberto , Paúl Constança
Published: March 2017

Aim

To examine discharges of octogenarians, nonagenarians and centenarians from Portuguese public hospitals, namely admission type, principal diagnoses, comorbidities and length of stay.

Methods

The present study used administrative data from public acute care hospitals in the Portuguese National Health Service. All discharges of persons aged ≥80 years between 2000 and 2014 were analyzed. HCUP Clinical Classifications Software was considered to aggregate principal diagnosis, and comorbidities were assessed using the Charlson Comorbidity Index computed using International Classification of Diseases 9th Revision Clinical Modification codes.

Results

A total of 2 494 924 discharges of persons aged 80 years or older were registered. Most (73.7%) referred to inpatient episodes, of which 73% were unplanned and medical (non‐surgical). Pneumonia (12.2%), acute cerebrovascular disease (7.1%) and non‐hypertensive cardiac heart failure (5.3%) were the most common principal diagnoses among inpatient episodes. Congestive heart failure and diabetes without chronic complications were the two most frequent comorbidities (16.6%), and discharge diagnoses with higher median length of stay were tuberculosis, burns, and infective arthritis and osteomyelitis.

Conclusions

The number of hospitalizations of the oldest old has suffered a significant increase in the past few years, reinforcing the need for healthcare services being prepared to the specificities of the oldest old population. Geriatr Gerontol Int 2017; 17: 2255–2265.
1. INDIA IN A WORLD: DILEMMAS OF SOVEREIGNTY
Authors: BOSE NEILESH
Published: March 2017

Azfar Moin's The Millennial Sovereign: Sacred Kingship and Sainthood in Islam prompts a consideration not only of the histories of Islam and early modern connected histories of Central and South Asia, but also of current debates about local and global history‐writing. Moin's work intersects with a strand of comparative world history—following Victor Lieberman's Strange Parallels—but also engages strands of historical anthropology, bringing to light a range of compelling stakes for global historians, historians of South Asia, and scholars of nationalism alike. Though Moin's work pushes the boundaries of connected histories centered on South Asia, his focus on a trans‐regional millennial science avoids questions of the local within new global histories.
4. IMPERIAL SOVEREIGNTY IN MUGHAL AND BRITISH FORMS
Authors: GILMARTIN DAVID
Published: March 2017

Azfar Moin's recent work on millennial sovereignty in Mughal India prompts a consideration of the evolution of sovereignty in modern South Asia more broadly. Although the sovereign principles of the Mughals differed from those of the British Indian empire, which ultimately succeeded it, these empires shared important similarities in their linking of sovereign authority to visions of a cosmos in immanent interaction with human affairs. This article explores these similarities and differences and speculatively considers their implications for both similarities and differences in Mughal and British principles of statecraft. These similarities and differences provide an important backdrop for thinking about the meanings attached to popular sovereignty in modern India as well.
Childhood predictors of written expression in late adolescents with 22q11.2 deletion syndrome: a longitudinal study
Authors: Hamsho N. , Antshel K. M. , Eckert T. L. , Kates W. R.
Published: March 2017

Background

22q11.2 deletion syndrome (22q11DS) is the second most prevalent genetic syndrome and has a characteristic academic and behavioural phenotype. The primary objective of the current study was to examine the childhood predictors of written expression achievement in adolescents with 22q11DS. Written expression is an important skill that can impact an individual's overall academic performance, potentially resulting in increased levels of stress and exacerbation of psychiatric symptoms.

Methods

A total of 119 participants were included in this study. Sixty‐nine late adolescents with 22q11DS and 50 controls (consisting of a combined sample of 23 unaffected siblings of youth with 22q11DS and 27 community controls) participated in a 6‐year longitudinal research project and received neuropsychological test batteries every 3 years. The Written Expression subtest of the Wechsler Individual Achievement Test – Second Edition was the primary outcome measure in the current project.

Results

Findings indicated differences in childhood predictors of adolescent written expression between participants in the 22q11DS group and participants in the control group. Whereas childhood verbal IQ scores predicted adolescent written expression for participants in the control group, childhood executive function and language skills were unique predictors of adolescent written expression in individuals with 22q11DS.

Conclusions

Childhood predictors of late adolescent written expression in 22q11DS differ in meaningful ways from predictors in the non‐22q11DS population. These results offer some guidance on the underlying factors that may be useful to consider when developing written expression interventions for children with 22q11DS.
Barriers and Facilitators to Implementing Functional Family Therapy in a Community Setting: Client and Practitioner Perspectives
Authors: McPherson Kerri E. , Kerr Susan , Casey Beth , Marshall John
Published: March 2017

While Functional Family Therapy (FFT) is known to be effective in addressing adolescent behavioral problems, there has been little exploration of issues relevant to its transport from the tightly controlled setting of clinical trials into routine service delivery. This study sought the views of key stakeholders, clients, and practitioners, on barriers and facilitators to the successful implementation of FFT. Undertaken in a community setting in Scotland, interviews were carried out with 12 adolescents, 14 parents/caregivers, and 6 practitioners. Results focus on: Referral process and pre‐intervention contact; Engagement of families; Structure and delivery; Organizational factors. Although barriers to engagement were identified, FFT was viewed as an acceptable, appropriate and feasible intervention with the potential to improve adolescent wellbeing in ‘real‐world’ settings.
Nodular colloid milium mimicking keloid
Authors: Azimi Seyyede Zeinab , Zargari Omid , Rudolph Robert I
Published: March 2017

Colloid milium is a rare cutaneous deposit disease that usually presents clinically by the development of yellowish translucent or flesh‐colored papules or plaques on sun‐exposed skin. Histologically, it is characterized by the presence of colloid in the dermal papillae. In this case report, we present a 52‐year‐old man who presented with a nodule on his upper lip that mistakenly was diagnosed and treated as keloid.
Qualitative evaluation of a delirium prevention and management programme
Authors: Kang Yun , Moyle Wendy , Cooke Marie , O'Dwyer Siobhan
Published: March 2017

Aims and objectives

To evaluate the effect of an educational programme on registered nurses’ knowledge and attitude in delirium care for hospitalised older adults with and without dementia, and to examine the strengths and weaknesses of the programme from the participants’ perspectives.

Background

Providing care for patients with delirium or delirium superimposed on dementia often poses particular challenges such as distinguishing between delirium and dementia for nurses.

Design

A descriptive qualitative study was used.

Methods

A delirium educational programme based on adult learning principles was provided to the participants. A purposive sample of 12 registered nurses who participated in the educational programme undertook individual interviews. Content analysis was conducted to identify unique and common themes indicative of registered nurse perceptions.

Results

Registered nurses reported improved knowledge and attitude towards the delirium care of hospitalised older adults with dementia and at risk of delirium. Active learning in the programme facilitated the participants’ learning processes. This active learning included deep learning, collaborative learning and application of new concepts to practice. Most participants felt that they had inadequate management support to apply their new knowledge in practice, and this included staff resource and policies and protocols.

Conclusion

The qualitative findings indicated that the delirium education had benefited the participants by improving their knowledge and attitude towards the delirium care of hospitalised older adults with dementia and at risk of delirium. This study provided an understanding of the strengths and limitations of the educational programme delivered to registered nurses in South Korea.

Relevance to clinical practice

Registered nurses in South Korea should need not only appropriate education, but also adequate resources, policies and guidelines as well as support from managers and from all other healthcare professionals.
Vertebral Artery Diameter and Flow: Nature or Nurture
Authors: Tarnoki Adam Domonkos , Fejer Bence , Tarnoki David Laszlo , Littvay Levente , Lucatelli Pierleone , Cirelli Carlo , Fanelli Fabrizio , Sacconi Beatrice , Fagnani Corrado , Medda Emanuela , Farina Filippo , Meneghetti Giorgio , Horvath Tamas , Pucci Giacomo , Schillaci Giuseppe , Stazi Maria Antonietta , Baracchini Claudio
Published: March 2017

BACKGROUND AND PURPOSE

In contrast with the carotid arteries, the vertebral arteries (VAs) show considerable variation in length, caliber, and vessel course. This study investigated whether the variation in diameter and flow characteristics of the VAs might be inherited.

METHODS

A total of 172 Italian twins from Padua, Perugia, and Terni (54 monozygotic, 32 dizygotic) recruited from the Italian Twin Registry underwent B‐mode and pulsed‐wave Doppler ultrasound assessment of their VAs. VA diameters, peak systolic velocity (PSV) and end diastolic velocity (EDV) were assessed at the level of a horizontal V2 segment. Univariate quantitative genetic modeling was performed.

RESULTS

Fourteen percent of the sample had VA hypoplasia. Within pair correlation in monozygotic twins was higher than in dizygotics (.552 vs. .229) for VA diameter. Age‐ and sex‐adjusted genetic effect, under the most parsimonious model, accounted for 54.7% (95% CI: 42.2‐69.1%) of the variance of VA diameter, and unshared environmental effect for 45.3% (95% CI: 30.9‐57.8%). No heritability was found for the PSV of VA, but shared (34.1%; 95% CI: 16.7‐53.7%) and unshared (65.9%; 95% CI: 45.9‐83.1%) environmental factors determined the variance. EDV of VA is moderately genetically influenced (42.4%; 95% CI: 16.1‐64.9%) and also determined by the unshared environment (57.6%; 95% CI: 34.7‐83.7%).

CONCLUSIONS

The diameter of the VAs is moderately genetically determined. Different factors influence the PSV and EDV of VAs, which may highlight the complex hemodynamic background of VA flow and help to understand the vertebral flow anomalies found by ultrasound.
Life after LEAP: How to implement advice on introducing peanuts in early infancy
Authors: Fleischer David M
Published: March 2017

The increase in food allergies worldwide has led to mounting concern among healthcare providers, families, schools, and the food industry. Of particular interest is the growing prevalence of peanut allergy. The Learning Early About Peanut Allergy (LEAP) study confirms that the early introduction of peanut significantly decreases the risk of developing peanut allergy among high‐risk children. However, a number of issues, such as a unified definition of high risk and whether or not to screen patients before peanut introduction, remain. This article will review the LEAP findings and the new peanut allergy prevention guidelines, and then briefly discuss recommendations on the introduction of other allergenic foods based on results from other food allergy prevention randomised controlled trials.
Effects of Dietary Geniposide on Growth, Flesh Quality, and Lipid Metabolism of Grass Carp, Ctenopharyngodon idella
Authors: Sun Wentong , Li Xiaoqin , Xu Huaibing , Chen Jianan , Xu Xiaoying , Leng Xiangjun
Published: March 2017

The aim of this study was to investigate effects of dietary geniposide (GP) on growth performance, flesh quality, and lipid metabolism of grass carp, Ctenopharyngodon idella (95.2 ± 0.6 g), fed seven different diets, including a control diet; Eucommia ulmoides (EU)–supplemented diet (20 g/kg); and GP‐supplemented diets containing 100, 200, 400, 600, and 800 mg/kg GP, respectively. Weight gain rate was significantly improved (P < 0.05) and feed conversation ratio was significantly decreased (P < 0.05) by supplementation of EU. Grass carp fed 100–800 mg/kg GP‐supplemented diets showed significantly higher total collagen and alkaline‐insoluble collagen content in muscle than control (P < 0.05). Contents of total collagen and the alkaline‐insoluble collagen content in the skin of grass carp were significantly increased by dietary 600–800 mg/kg GP and EU (P < 0.05). Fish fed diets containing 600–800 mg/kg GP showed significantly lower muscle crude lipid content than the EU, control, and 100–400 mg/kg GP groups (P < 0.05). Fish fed 400–800 mg/kg GP diets had significantly higher muscle fiber density and lower muscle fiber diameter and serum triglyceride level than the control (P < 0.05). In conclusion, supplementation of GP could improve flesh quality, but not growth of grass carp. The supplemental level of GP for improving flesh quality was estimated to be a 400–600 mg/kg diet.
Re‐evaluating models for estimating prey consumption by leopards
Authors: Lumetsberger T. , Ghoddousi A. , Appel A. , Khorozyan I. , Waltert M. , Kiffner C.
Published: March 2017

Biomass regression models and associated correction factors derived from feeding trials are essential to convert frequency of prey occurrence from scats into biomass and numbers of prey individuals consumed by carnivores. These dietary analyses form a substantial part of many research projects on predator–prey relationships and human–carnivore conflicts. So far, diet studies of leopard (Panthera pardus) applied the linear biomass model developed for puma (Puma concolor). Recent works, however, suggested that non‐linear biomass models are more meaningful for estimating prey biomass and numbers, and presented a generalized model of biomass consumption for all tropical felids. This model accounted for partial consumption of prey, but did not include ecological factors limiting prey consumption by felids. Hence, using 35 feeding trials we developed a leopard specific regression equation by setting a consumption limit for leopard per prey. This new correction factor takes into account the proportion of inedible matter of prey and daily food intake. Besides refining the leopard specific biomass models, our study also showed the saturation in scat production with consumption of larger prey, which was described in recent studies. A reanalysis of prey consumption by leopards from published diet studies by using our new regression models suggests a significant decrease in estimated absolute numbers of prey individuals consumed. This finding and the higher share of larger prey in leopard diet may affect subsequent analyses using prey profiles, and may affect decisions made in biodiversity conservation and management, especially in the area of human–carnivore conflict.
Differences in bone mineral density between normal‐weight children and children with overweight and obesity: a systematic review and meta‐analysis
Authors: van Leeuwen J. , Koes B.W. , Paulis W.D. , van Middelkoop M.
Published: March 2017

Objective

This study examines the differences in bone mineral density between normal‐weight children and children with overweight or obesity.

Methods

A systematic review and meta‐analysis of observational studies (published up to 22 June 2016) on the differences in bone mineral density between normal‐weight children and overweight and obese children was performed. Results were pooled when possible and mean differences (MDs) were calculated between normal‐weight and overweight and normal‐weight and obese children for bone content and density measures at different body sites.

Results

Twenty‐seven studies, with a total of 5,958 children, were included. There was moderate and high quality of evidence that overweight (MD 213 g; 95% confidence interval [CI] 166, 261) and obese children (MD 329 g; 95%CI [229, 430]) have a significantly higher whole body bone mineral content than normal‐weight children. Similar results were found for whole body bone mineral density. Sensitivity analysis showed that the association was stronger in girls.

Conclusions

Overweight and obese children have a significantly higher bone mineral density compared with normal‐weight children. Because there was only one study included with a longitudinal design, the long‐term impact of childhood overweight and obesity on bone health at adulthood is not clear.
Anterior Lumbar Interbody Fusion in Left‐sided Inferior Vena Cava and Right‐sided Aortic Arch
Authors: Phan Kevin , Fang Bernard A M , Maharaj Monish M , Lennox Andrew F , Mobbs Ralph J
Published: March 2017

Spinal fusion via anterior lumbar interbody fusion (ALIF) can offer symptomatic relief to patients that suffer severe low back pain, radiculopathy, and claudication. However, a detailed working knowledge of the thoracic, abdominal, and lumbar anatomy, particularly of the vasculature, is vital. We report the case of a 68‐year‐old man who presented with radiculopathy and progressively worsening low back pain despite 9 months of unsuccessful conservative therapy and pain management. Preoperative computed tomography and magnetic resonance imaging revealed a rare anatomical variation, with an anomalous left‐sided inferior vena cava and anomalous aorta. The patient was surgically treated with ALIF at L4,5 and L5S1 via an altered surgical window. Given the anomalous anatomy of the patient, instead of performing the procedure after mobilizing both of the transposed abdominal great vessels, the inferior vena cava and the abdominal aorta, the ALIF was uneventfully performed in the window between these vessels. There were no perioperative or postoperative complications. At 12‐week postoperative follow‐up, X‐ray imaging demonstrated successful implantation of ALIF cages with no recurrence of symptoms. A detailed working knowledge of anatomy is important, particularly if anatomical variations are present. This has implications for preoperative surgical planning, which is integral to the safety and the success of procedures.
Clinical Comparison of Extensile Lateral Approach and Sinus Tarsi Approach Combined with Medial Distraction Technique for Intra‐Articular Calcaneal Fractures
Authors: Zhou Hai‐chao , Yu Tao , Ren Hao‐yang , Li Bing , Chen Kai , Zhao You‐guang , Yang Yun‐feng
Published: March 2017

Objective

To study and compare the clinical outcomes of open reduction and internal fixation via extensile L‐shape incision and limited open reduction via the sinus tarsi approach using the medial distraction technique for intra‐articular calcaneal fractures.

Methods

We performed a retrospective review of 65 intra‐articular calcaneal fractures treated operatively between March 2012 and February 2015. Patients were divided into two groups: 28 were in the sinus tarsi approach group and 37 were in the extensile lateral approach group. All patients were asked to return for a research visit that included radiography and clinical evaluation. The postoperative function was evaluated using the ankle and hindfoot score of the American Orthopaedic Foot and Ankle Society (AOFAS) and the visual analogue scale (VAS).

Results

No significant difference was found in demographics between the two groups. The corrected value of the calcaneal varus angle between the two groups is statistically significant (P < 0.05). The overall wound complication rate was 3.6% in the minimally invasive group versus 13.5% in the extensile group. Four patients in the extensile lateral approach group had developed hindfoot varus deformity at last follow‐up. At the last follow‐up, the average AOFAS ankle and the hindfoot score of the minimal group was 88.4 ± 6.6, and the VAS score was 1.9 ± 0.7, while that of the extensile lateral approach group was 83.2 ± 5.6 and 2.3 ± 1.0, respectively.

Conclusion

Limited open reduction via the sinus tarsi approach for intra‐articular calcaneal fractures could reduce the incidence of wound complications effectively, and the medial distraction technique is helpful for correcting the calcaneus varus deformity.
Sorting Out Support for Democracy: A Q‐Method Study
Authors: Carlin Ryan E.
Published: March 2017

Support for democracy is crucial to democratic stability. Yet the nature and range of democratic belief systems, and whether these belief systems are idiosyncratic to specific individuals and polities or are more general, remain largely unknown. Such unknowns complicate an already daunting measurement task. Extant survey‐based measures are fraught with validity problems and say little about the democratic beliefs individuals most strongly hold or reject. To address these problems, this study blends focus groups, interviews, and Q‐sort methodology to examine patterns of subjective, behavioral renderings of democratic support profiles. It finds seven shared profiles of beliefs concerning democracy, alternative regimes, and political and civil freedoms across Chile and Argentina. Their resemblance to democratic belief systems found with other methods bolsters their validity and generalizability. The analyses reveal the relative weight of each orientation within each belief profile and their intensity across profiles. In so doing, they identify which items are crucial for within‐ and across‐case comparisons. Altogether, these insights should inform survey‐based approaches to detecting and describing the democratic support profiles latent in the polity.
Semiparametric Dose Finding Methods
Authors: Clertant M. , O’Quigley J.
Published: March 2017

We describe a new class of dose finding methods to be used in early phase clinical trials. Under some added parametric conditions the class reduces to the family of continual reassessment method (CRM) designs. Under some relaxation of the underlying structure the method is equivalent to the cumulative cohort design, the modified toxicity probability interval method or Bayesian optimal interval design classes of methods, which are non-parametric in nature whereas the CRM class can be viewed as being strongly parametric. The class proposed is characterized as being semiparametric since it corresponds to the CRM with a nuisance parameter. Performance is good, matching that of the CRM class and improving on it in some cases. The structure allows theoretical questions to be more easily investigated and to understand better how different classes of methods relate to one another.
Planar Multibranch Open-Loop Robotic Manipulators Subjected to Ground Collision
Authors: Shafei A. M. , Shafei H. R.
Published: March 2017

In this article, a recursive approach is used to dynamically model a tree-type robotic system with floating base. Two solution procedures are developed to obtain the time responses of the mentioned system. A set of highly nonlinear differential equations is employed to obtain the dynamic behavior of the system when it has no contact with the ground or any object in its environment (flying phase); and a set of algebraic equations is exploited when this tree-type robotic system collides with the ground (impact phase). The Gibbs–Appell (G–A) formulation in recursive form and the Newton’s impact law are applied to derive the governing equations of the aforementioned robotic system for the flying and impact phases, respectively. The main goal of this article is a systematic algorithm that is used to divide any tree-type robotic system into a specific number of open kinematic chains and derive the forward dynamic equations of each chain, including its inertia matrix and right-hand side vector. Then, the inertia matrices and the right-hand side vectors of all these chains are automatically integrated to construct the global inertia matrix and the global right-hand side vector of the whole system. In fact, this work is an extension of Shafei and Shafei (2016, “A Systematic Method for the Hybrid Dynamic Modeling of Open Kinematic Chains Confined in a Closed Environment,” Multibody Syst. Dyn., 38(1), pp. 21–42.), which was restricted to a single open kinematic chain. So, to show the effectiveness of the suggested algorithm in deriving the motion equations of multichain robotic systems, a ten-link tree-type robotic system with floating base is simulated.
Pore surface grafting of porous low-k dielectrics by selective polymers
Authors: Rezvanov Askar , Zhang Liping , Watanabe Mitsuhiro , Krishtab Mikhail B. , Zhang Lin , Hacker Nigel , Verdonck Patrick , Armini Silvia , de Marneffe Jean-François G. N. G.
Published: March 2017

Polymer grafting of pore sidewalls is studied as a protecting agent against processing damage. Polymethyl-methacrylate (PMMA), an improved polystyrene (PS-pro), and a tailored plasma damage management polymer (PDM) are considered as potential candidates. PMMA and PS-pro show nonhomogeneous grafting properties, while PDM coat the pore sidewalls uniformly through the bulk of the porous low-k film. A k ∼ 2.2 porous spin-on glass is used as a vehicle for processing damage study. Approximately one monolayer is grafted on the pore walls, leading to a k-value increase up to Δk ∼ 0.2. Using grafted PDM, the porous low-k chemical stability in 0.5% diluted hydrofluoric acid is significantly improved. Concerning plasma damage, at constant etch depth methyl depletion is decreased, mainly in capacitive coupled plasma discharge showing high polymerizing character, leading to similar damage depth as found for a reference organo-silicate glass 2.7 low-k. However, moisture uptake is not improved, leading to significant drift in the dielectric constant.