bluuebunny/crossref_metadata_2025 huggingface dataset:
Incisional negative pressure therapy reduces complications and costs in pressure ulcer reconstruction
Authors: Papp Anthony A.
Published: December 2018

Complications after pressure ulcer reconstruction are common. A complication rate of 21% to 58% and a 27% wound recurrence has been reported. The aim of this study was to decrease postoperative wound‐healing complications with incisional negative pressure wound therapy (iNPWT) postoperatively. This was a prospective non‐randomised trial with a historic control. Surgically treated pressure ulcer patients receiving iNPWT were included in the prospective part of the study (Treatment group) and compared with the historic patient cohort of all consecutive surgically treated pressure ulcer patients during a 2‐year period preceding the initiation of iNPWT (Control). There were 24 patients in the Control and 37 in the Treatment groups. The demographics between groups were similar. There was a 74% reduction in in‐hospital complications in the Treatment group (10.8% vs 41.7%, P = 0.0051), 27% reduction in the length of stay (24.8 vs 33.8 days, P = 0.0103), and a 78% reduction in the number of open wounds at 3 months (5.4 vs 25%, P = −0.0481). Recurrent wounds and history of previous surgery were risk factors for complications. Incisional negative pressure wound therapy shortens hospital stay, number of postoperative complications, and the number of recurrent open wounds at 3 months after reconstructive pressure ulcer surgery, resulting in significant cost savings.
Facial synthesis of a novel Ag4V2O7/g‐C3N4 heterostructure with highly efficient photoactivity
Authors: Zhang Tongtong , Zhao Danfeng , Wang Yue , Chang Yukun , Zhang Dafeng , Tang Yunxiang , Pu Xipeng , Shao Xin
Published: December 2018

A novel Ag4V2O7/g‐C3N4 heterostructure was synthesized by a facial etching method in ammonia solution using Ag2VO2PO4/g‐C3N4 as a self‐sacrifice precursor. With the concentration of ammonia solution increasing from 0.05 to 0.2 M, phase transformation took place, described as: Ag2VO2PO4/g‐C3N4 → Ag2VO2PO4/Ag4V2O7/g‐C3N4 → Ag4V2O7/g‐C3N4. Compared with pristine Ag2VO2PO4/g‐C3N4, the etched samples of Ag4V2O7/g‐C3N4 and Ag2VO2PO4/Ag4V2O7/g‐C3N4 exhibited dramatically improved activity for the degradation of methylene blue (MB), methyl orange (MO) and imidacloprid under visible light irradiation. When etched with 0.15 M ammonia solution, an Ag4V2O7/g‐C3N4 heterostructure was obtained that exhibited the highest photoactivity. This photocatalyst was nearly 9.1, 3.0, and 24.3 times more efficient than pristine Ag2VO2PO4/g‐C3N4 for degradation of MB, MO and imidacloprid, respectively. The excellent photocatalytic performance can be ascribed to the as‐obtained well‐defined Ag4V2O7/g‐C3N4 heterojunction, which improves the separation and transfer efficiency and prolongs the lifetime of photoinduced charges. In addition, the stability and dominant radicals were investigated.
Reducing inbreeding rates with a breeding circle: Theory and practice in Veluws Heideschaap
Authors: Windig Jack J. , Verweij Marjolein J. W. , Oldenbroek J. Kor
Published: December 2018

Breeding circles allow genetic management in closed populations without pedigrees. In a breeding circle, breeding is split over sub‐populations. Each sub‐population receives breeding males from a single sub‐population and supplies breeding males to one other sub‐population. Donor‐recipient combinations of sub‐populations remain the same over time. Here, we derive inbreeding levels both mathematically and by computer simulation and compare them to actual inbreeding rates derived from DNA information in a real sheep population. In Veluws Heideschaap, a breeding circle has been in operation for over 30 years. Mathematically, starting with inbreeding levels and kinships set to zero, inbreeding rates per generation (ΔF) initially were 0.29%–0.47% within flocks but later converged to 0.18% in all flocks. When, more realistically, inbreeding levels at the start were high and kinship between flocks low, inbreeding levels immediately dropped to the kinship levels between flocks and rates more gradually converged to 0.18%. In computer simulations with overlapping generations, inbreeding levels and rates followed the same pattern, but converged to a lower ΔF of 0.12%. ΔF was determined in the real population with a 12 K SNP chip in recent generations. ΔF in the real population was 0.29%, based on markers to 0.41% per generation based on heterozygosity levels. This is two to three times the theoretically derived values. These increased rates in the real population are probably due to selection and/or the presence of dominant rams siring a disproportionate number of offspring. When these were simulated, ΔF agreed better: 0.35% for selection, 0.38% for dominant rams and 0.67% for both together. The realized inbreeding rates are a warning that in a real population inbreeding rates in a breeding circle can be higher than theoretically expected due to selection and dominant rams. Without a breeding circle, however, inbreeding rates would have been even higher.
EU Geoeconomics: A Framework for Analyzing Bilateral Relations in the European Union
Authors: Sattich Thomas , Inderberg Tor Håkon Jackson
Published: December 2018

Existing EU study approaches have come under stress as comprehensive models of European politics. In this context, bilateral relations between EU members remain under‐researched yet important for understanding the inner workings of the EU. While EU membership puts strong limitations on certain kinds of state behaviour it also leaves room for the pursuit of national interests through economic and legal means. Against this background, the article presents and develops the EU Geoeconomics Framework. Focussed on situations where state and companies share control over vital sectors of the national economy, this framework theorizes the relations between EU member states (MSs). After presenting the main assumptions and focus of EU Geoeconomics, the article develops six testable propositions. It then discusses these propositions as well as the fruitfulness of the framework against the latest developments in EU studies theory. The article concludes by pointing towards a renewed discussion of bilateral relations.
Genetic variants in DNMT1 and the risk of cardiac autonomic neuropathy in women with type 1 diabetes
Authors: Santos‐Bezerra Daniele Pereira , Admoni Sharon Nina , Mori Rosana Cristina , Pelaes Tatiana Souza , Perez Ricardo Vesoni , Machado Cleide Guimarães , Monteiro Maria Beatriz , Parisi Maria Candida , Pavin Elizabeth Joao , Queiroz Marcia Silva , Passarelli Marisa , Machado Ubiratan Fabres , Correa‐Giannella Maria Lucia
Published: December 2018

Aims/Introduction

Epigenetics participate in the pathogenesis of metabolic memory, a situation in which hyperglycemia exerts prolonged deleterious effects even after its normalization. We tested the hypothesis that genetic variants in an epigenetic gene could predispose to diabetes complications.

Material and Methods

We assessed the frequency of five single‐nucleotide polymorphisms in the gene encoding deoxyribonucleic acid methytransferase 1 (DNMT1; rs8112895, rs7254567, rs11085721, rs17291414 and rs10854076), and their associations with diabetic kidney disease, retinopathy, distal polyneuropathy and autonomic cardiovascular neuropathy in 359 individuals with long‐term type 1 diabetes.

Results

None of the single‐nucleotide polymorphisms studied was significantly associated with the presence of chronic complications in the overall population. However, after sex stratification, the minor allele C of rs11085721 conferred risk for cardiovascular neuropathy in women after adjustment for confounding variables (odds ratio 2.32; 95% confidence interval 1.26–4.33; P = 0.006).

Conclusions

The fact that heterozygous mutations in DNMT1 are associated with hereditary sensory autonomic neuropathy provides plausibility to the present finding. If confirmed in independent samples, it suggests that genetic variants in epigenetic genes might predispose to more or fewer epigenetic changes in the face of similar metabolic derangements triggered by hyperglycemia, constituting the “genetics of epigenetics” for microvascular diabetes complications.
External validation of the PREDICT tool in Spanish women with breast cancer participating in population‐based screening programmes
Authors: Aguirre Urko , García‐Gutiérrez Susana , Romero Anabel , Domingo Laia , Castells Xavier , Sala María ,   CAMISS Study Group
Published: December 2018

Rationale, aims, and objectives

To externally validate the PREDICT tool in a cohort of women participating in a population‐based breast cancer screening programme who were diagnosed with breast cancer between 2000 and 2008 in Spain.

Methods

A total of 535 women were included in the validation study. We calculated predicted 5‐year survival using the beta values from the development of the PREDICT model and predicted and observed events for a given risk groups. Model fit, discrimination, and calibration were evaluated. Seeking to improve the model, we also explored the impact on discrimination of the inclusion of additional variables, not in the PREDICT algorithm.

Results

In patients who were oestrogen receptor (ER) positive (negative), PREDICT overestimated (underestimated) the 5‐year overall survival in all the subgroups studied. Analysis of model performance showed good calibration but modest discrimination (C‐index, 0.697 [ER negative] and 0.768 [ER positive]). When updating the model, no additional variables were found to be significant in ER‐negative patients, but for ER‐positive patients, concurrent liver disease was a significant factor, its inclusion improving model discrimination (C‐index, 0.817).

Conclusions

The PREDICT tool does not discriminate well in our population considering only the variables of the original algorithm. More accurate tools are needed to obtain a better discrimination.
Symptom Burden Among Community‐Dwelling Older Adults in the United States
Authors: Patel Kushang V. , Guralnik Jack M. , Phelan Elizabeth A. , Gell Nancy M. , Wallace Robert B. , Sullivan Mark D. , Turk Dennis C.
Published: December 2018

Objectives

To determine the prevalence and impact of common co‐occurring symptoms among community‐dwelling older adults in the United States.

Design

The National Health and Aging Trends Study is a nationally representative, prospective study with annual data collection between 2011 and 2017.

Setting

Community‐based, in‐person interviews (survey response rates, 71%–96%).

Participants

A total of 7,609 community‐dwelling Medicare beneficiaries, 65 years or older.

Measurements

Symptoms assessed at baseline include pain, fatigue, breathing difficulty, sleeping difficulty, depressed mood, and anxiety. Total symptom count ranged from zero to six. Several outcomes were examined, including grip strength, gait speed, and overall lower‐extremity function as well as incidence of recurrent falls (two or more per year), hospitalization, disability, nursing home admission, and mortality.

Results

Prevalence of zero, one, two, three, and four or more symptoms was 25.0%, 26.6%, 20.7%, 14.0%, and 13.6%, respectively. Symptom count increased with advancing age and was higher in women than in men. Pain and fatigue were the most common co‐occurring symptoms. Higher symptom count was associated with decreased physical capacity. For example, participants with one, two, three, and four or more symptoms had gait speeds that were 0.04, 0.06, 0.09, and 0.13 m/s slower, respectively, than those with no symptoms, adjusting for specific diseases, total number of diseases, and other potential confounders (P < .001). The risk of several adverse outcomes also increased with greater symptom count. For example, compared with those with no symptoms, the adjusted risk ratios for recurrent falls were 1.48 (95% confidence interval [CI] = 1.30–1.70), 1.54 (95% CI = 1.32–1.80), 1.90 (95% CI = 1.55–2.32), and 2.38 (95% CI = 2.00–2.83) for older adults with one, two, three, and four or more symptoms, respectively.

Conclusions

Symptoms frequently co‐occur among community‐dwelling older adults and are strongly associated with increased risk of a range of adverse outcomes. Symptoms represent a potential treatment target for improving outcomes and should be systematically captured in health records. J Am Geriatr Soc 67:223–231, 2019.
Application of two projective techniques in the study of consumer perception of antiperspirant/deodorants
Authors: Gámbaro Adriana , Roascio Antonella , Boinbaser Lucía , Pérez Suhey , Parente Emma
Published: December 2018

The present study aimed to identify the main aspects involved in consumers' perception of four types of antiperspirants/deodorants (APDs); cream, aerosol, roll‐on and stick; and compared the findings by using projective techniques; word association (WA) and product personality profiling (PPP) tasks. To apply the PPP task, participants had to imagine that each type of APDs was a person and describe it by gender, age, marital status, children, physical complexion, personality, work/profession/occupation, transport used, physical activity performed, and diet type. The different terms obtained were grouped into 16 categories in the WA task and in 36 subcategories in the PPP task. Both techniques provided data on different and complementary aspects of the products studied. While WA provided information on the characteristics of the different forms of APDs, the PPP gave information about the image that consumers have of each product. Both techniques could be used independently or in a complementary way.

Practical applications

This work provides information about consumers' perceptions of different types of antiperspirants/deodorants. It is shown that each applied task provides information which can be used for different purposes. The word association task provided information which could be applied in the optimization and/or development of one of these cosmetic forms, while the product personality profiling task gave information that could be used in marketing, either to reaffirm it, to revert it or to introduce a new product into the market.
Computed tomographic angiography and ultrasonography in the diagnosis and evaluation of acute pancreatitis in dogs
Authors: French John M. , Twedt David C. , Rao Sangeeta , Marolf Angela J.
Published: December 2018

Background

Acute pancreatitis in dogs is an under‐diagnosed disease. Current diagnostic methods are insufficient at identifying sequelae and lack prognostic capability. Computed tomographic angiography (CTA) is accurate for diagnosis and prognostication of pancreatitis in humans.

Objectives

In comparison to ultrasound (US), CTA will (1) better diagnose more severe pancreatitis and sequelae and (2) provide assessment of patient outcome by identification of pancreatic contrast enhancement patterns.

Animals

Twenty‐six client‐owned dogs suspected to have acute pancreatitis.

Methods

US and CTA examinations performed at time of admission were compared to determine the detection of pancreatic changes and sequelae. CTA findings also were compared to outcome indicators for prognosis of dogs with acute pancreatitis. Specific canine pancreatic lipase (cPL) samples were obtained and compared with CTA findings.

Results

Ten of 26 dogs had heterogeneous contrast enhancement of the pancreas. Compared to US, CTA better identified portal vein thrombosis (P = .003). Patients with heterogeneous contrast enhancement had longer hospitalization (P = .01), including hospital stays for >5 days (P = .02), had more relapses, and were more likely to have portal vein thrombosis (P = .002). Patients with heterogeneous contrast enhancement had increased spec cPL (P = .006).

Conclusions and Clinical Importance

In comparison to US, CTA better identified dogs with more severe acute pancreatitis and those with portal vein thrombosis, factors that may predict longer hospitalization and increased risk of relapse. The presence of heterogeneous contrast enhancement and portal vein thrombosis may change therapy for patients with acute pancreatitis.
Morphological analysis of pectoral fin spine for identifying ecophenotypic variation of Persian Sturgeon Acipenser persicus
Authors: Bakhshalizadeh Shima , Bani Ali
Published: December 2018

One goal of fisheries management is to identify stocks and ecophenotypics of individual specimens correctly. Discrimination of Persian sturgeon Acipenser persicus ecophenotypics due to geographic variation was attempted based on calcified anatomical structures. Morphological characteristics of the pectoral fin spine were analysed in stocks from the eastern and western parts of the south Caspian Sea to explore if polymorphism could be discerned between regions within the Caspian Sea using ten key features which were measured. These key features were measured and used for multivariate analysis. Principal component analysis (PCA), discriminant function analysis and cluster analysis were used to visualize differences between regions, to follow any shape differences in the spines and to classify into the groups. On the basis of morphometrics between spines, 82.9% of the individuals were correctly classified into one of the two regions. PCA showed the largest differences between the eastern and western regions were the density and arch of pectoral fin spine. Fish from the eastern region had a heavier and more curved pectoral fin spine when compared to those from the western part. The results from this study indicate that the morphological traits of pectoral fin spine of the Persian sturgeons can be used to discriminate between regions with a reliability rate of about 83%. Therefore, the morphological differences are discernible in spite of the volume of artificial rearing and release of fish in the south.
Extending the paleogeographic range and our understanding of the Neoarchean Monteville impact spherule layer (Transvaal Supergroup, South Africa)
Authors: Simonson Bruce M. , Beukes Nicolas J. , Biller Sandra
Published: December 2018

The Monteville spherule layer (MSL) was deposited in the Griqualand West Basin (GWB) on the Kaapvaal Craton approximately 2.63 Ga. The spherules were generated by a large impact and reworked by impact‐generated waves and/or currents. The MSL has been intersected in three previously undescribed cores. Two of the cores, GKF‐1 and GKP‐1, were drilled ~30 km west of the southernmost outcrop of the MSL. The third core, BH‐47, was drilled ~250 km south and east of the GWB. The MSL contains medium to coarse sand‐size spherules like those described previously in all three cores but each one was emplaced in a different way. In GKF‐1, the MSL is 90 cm thick and contains large rip‐up clasts of basinal carbonate and early diagenetic pyrite. In GKP‐1, the MSL is only 1.5 cm thick and consists largely of fine carbonate sand, yet it contains pyrite intraclasts up to ~1 cm long. In BH‐47, the MSL consists of a lower coarse sandy zone ~37 cm thick rich in spherules, carbonate peloids/ooids, pyrite intraclasts, and quartzose sand and an upper, finer sandy zone ~46 cm thick; neither zone contains any large intraclasts. The new occurrences triple the known extent of the MSL from ~15,000 to ~46,000 km2, support the oceanic impact model for the formation of the MSL, demonstrate that it is a persistent regional time‐stratigraphic marker, place new constraints on the Kaapvaal paleoshoreline at the time of impact, and support the existence of Vaalbara.
Contradiction, Liturgy, and Freedom: Romano Guardini's Search for Meaning after the Cataclysm of World War I
Authors: Zaborowski Holger
Published: December 2018

This essay examines the early thought of Romano Guardini (1886‐1968). It focuses on his magisterial book The Spirit of the Liturgy and discusses its genesis, its historical, biographical, and intellectual context, and its theological and philosophical significance. In so doing, it shows how Guardini reacted to World War I and the cataclysm of his time in turning to the church and its liturgical life in order to provide a source of meaning to a disoriented generation.
Microbes: possible link between modern lifestyle transition and the rise of metabolic syndrome
Authors: Moossavi S. , Bishehsari F.
Published: December 2018

The rapid decrease in infectious diseases globally has coincided with an increase in the prevalence of obesity and other components of metabolic syndrome. Insulin resistance is a common feature of metabolic syndrome and can be influenced by genetic and non‐genetic/environmental factors. The emergence of metabolic syndrome epidemics over only a few decades suggests a more prominent role of the latter. Changes in our environment and lifestyle have indeed paralleled the rise in metabolic syndrome. Gastrointestinal tract microbiota, the composition of which plays a significant role in host physiology, including metabolism and energy homeostasis, are distinctly different within the context of metabolic syndrome. Among humans, recent lifestyle‐related changes could be linked to changes in diversity and composition of ‘ancient’ microbiota. Given the co‐adaptation and co‐evolution of microbiota with the immune system over a long period of time, it is plausible that such lifestyle‐related microbiota changes could trigger aberrant immune responses, thereby predisposing an individual to a variety of diseases. Here, we review current evidence supporting a role for gut microbiota in the ongoing rise of metabolic syndrome. We conclude that population‐level shifts in microbiota can play a mediatory role between lifestyle factors and pathogenesis of insulin resistance and metabolic syndrome.
The impact of age on oral squamous cell carcinoma: A longitudinal cohort study of 2,782 patients
Authors: Xu Qiaoshi , Wang Chong , Li Bo , Kim Kyojin , Li Jinzhong , Mao Minghui , Qin Lizheng , Li Hua , Huang Xin , Xing Rudong , Han Zhengxue , Feng Zhien
Published: December 2018

Background

The purposes of this study were to assess the influence of age on oral squamous cell carcinoma patients and sought to analyze the reasons that may contribute to this difference.

Methods

This study enrolled 2,782 patients included 2,443 patients in a retrospective cohort to find the influence of age and 339 patients in a prospective cohort to testify these findings. The patients were divided into young age‐group (≤40 years old), moderate age‐group (41–75 years old), and advanced age‐group (>75 years old). All patients were diagnosed as oral squamous cell carcinoma and were surgically treated in our hospital. Chi‐square test, Kaplan–Meier analysis, and Cox proportional‐hazards regression model were performed for statistical analysis.

Results

Younger patients started smoking (p < 0.001) and drinking (p < 0.001) earlier than the older patients and consumed more tobacco (p = 0.005) and alcohol (p = 0.156). Patients with advanced age had worse outcomes in both recurrence (p = 0.002) and survival (p < 0.001). They also had more severe comorbidity (p < 0.001) and were more likely to receive conservative treatment (p = 0.011).

Conclusions

Compared with young patients, older patients had worse prognosis, and it was related with their more severe comorbidity and received more conservative treatment. Young adults smoking and drinking earlier and heavier than old patients, it may relate with their occurrence of oral squamous cell carcinoma.
The weakest link: sensitivity to climate extremes across life stages of marine invertebrates
Authors: Pandori Lauren L. M. , Sorte Cascade J. B.
Published: December 2018

Predicting the effects of climate change on Earth's biota becomes even more challenging when acknowledging that most species have life cycles consisting of multiple stages, each of which may respond differently to extreme environmental conditions. There is currently no clear consensus regarding which stages are most susceptible to increasing environmental stress, or ‘climate extremes’. We used a meta‐analytic approach to quantify variation in responses to environmental stress across multiple life stages of marine invertebrates. We identified 287 experiments in 29 papers which examined the lethal thresholds of multiple life stages (embryo, larva, juvenile and adult) of both holoplanktonic and meroplanktonic marine invertebrates subjected to the same experimental conditions of warming, acidification and hypoxia stress. Most studies considered short acute exposure to stressors. We calculated effect sizes (log response ratio) for each life stage (unpaired analysis) and the difference in effect sizes between stages of each species (paired analysis) included in each experiment. In the unpaired analysis, all significant responses were negative, indicating that warming, acidification and hypoxia tended to increase mortality. Furthermore, embryos, larvae and juveniles were more negatively affected by warming than adults. The paired analysis revealed that, when subjected to the same experimental conditions, younger life stages were more negatively affected by warming than older life stages, specifically among pairings of adults versus juveniles and larvae versus embryos. Although responses to warming are well documented, few studies of the effects of acidification and hypoxia met the criteria for inclusion in our analyses. Our results suggest that while most life stages will be negatively affected by climate change, younger stages of marine invertebrates are more sensitive to extreme heating events.
A qualitative evaluation of the effects of Metacognitive Reflection and Insight Therapy: ‘Living more consciously’
Authors: de Jong Steven , Hasson‐Ohayon Ilanit , van Donkersgoed Rozanne , Aleman André , Pijnenborg Gerdina Hendrika Maria
Published: December 2018

Objectives

Extensive research showed that one of the major difficulties that people with schizophrenia spectrum disorders are struggling with involves their ability to reflect on their own and others’ mental activities, also defined as metacognition. Several new psychotherapies have been developed to assist patients (re)gain metacognitive capacity, including Metacognitive Reflection and Insight Therapy (MERIT). The current study investigated the client's subjective experience of psychotherapy, to determine whether service users found MERIT effective and whether these gains align with quantitative findings, which processes they considered responsible for these benefits, in which ways participants found MERIT similar or different from other interventions, and whether they experienced non‐desirable factors and outcomes.

Design

All participants who had participated in a randomized controlled trial investigating the efficacy of MERIT were offered a structured post‐therapy interview by an independent assessor. Fourteen out of 18 (77%) participants, all of whom had completed therapy, responded.

Results

Most participants (10/14) indicated that they had experienced the therapy as beneficial to their recovery, and in general contributed to their understanding of their own thinking, which maps closely onto the quantitative findings reported elsewhere. They mainly attributed these changes to their own active role in therapy, the intervention letting them vent and self‐express, and forming an alliance with the therapist.

Conclusions

Participants reports of change map closely onto the quantitative findings from the randomized controlled trial. Findings are discussed in the frameworks of the metacognitive model of psychosis and the integrative intersubjective model of psychotherapy for psychosis emphasizing the role of the clients as active agent of change.

Practitioner points

The use of a systematic, qualitative interview at the conclusion of therapy may yield important information regarding process and outcome.

Analysis of the interview revealed that clients’ perceptions regarding change within themselves closely maps onto quantitative findings.

MERIT may not be the appropriate intervention for all clients; some may prefer a more solution‐oriented approach such as CBTp or Metacognition‐Oriented Social Skills training.

Self‐expressing with a trained clinician may be therapeutic in itself.
African‐American parents’ and daughters’ beliefs about HPV infection and the HPV vaccine
Authors: Galbraith‐Gyan Kayoll V. , Lechuga Julia , Jenerette Coretta M. , Palmer Mary H. , Moore Angelo D. , Hamilton Jill B.
Published: December 2018

Objective

To increase our understanding about the health beliefs of African‐American parents and their daughters toward HPV infection and HPV vaccine acceptance.

Methods

The Health Belief Model was used as a guiding framework. Principles of grounded theory, theoretical sampling, and constant comparison analysis were used to qualitatively analyze data generated from personal interviews of African‐American parents (n = 30) and their 12‐ to 17‐year‐old daughters (n = 34).

Results

Mothers and daughters perceived low susceptibility to HPV infection and perceived the HPV vaccine as beneficial in protecting against genital warts and cervical cancer. Compared to daughters, parents placed particular emphasis on the vaccine's protection against genital warts. A major HPV vaccine acceptance barrier among parents and daughters was the politicization of the HPV vaccine by government figures. In addition, concerns about unknown side effects, safety, and effectiveness of HPV vaccination emerged. Cues to action varied among parents and daughters, and self‐efficacy was higher among parents than daughters.

Conclusion

Understanding the health beliefs that promote HPV vaccine acceptance, while identifying and addressing beliefs that are barriers among parents and daughters, will assist in the development of appropriate HPV vaccine promotion initiatives for African‐American parents and daughters.
The effect of an aggressive behavior prevention program on kindergarten students
Authors: Akcan Arzu , Ergun Ayse
Published: December 2018

Objectives

This quasi‐experimental study with a pretest‐posttest control group was conducted to determine the effects of the “Aggressive Behavior Prevention Program (ABPP)” on kindergarten students. The program was based on Social Cognitive Theory.

Design and Sample

The study was carried out with 90 children (intervention group = 45, control group = 45) who were registered in the kindergarten of a primary school. The ABPP was implemented with children and their families for 12 weeks. Data were collected with a subscale of Aggressiveness of the Eyberg Child Behavior Inventory, the subscales of overt and relational aggression of the Preschool Social Behavior Scale‐Teacher Form, and the Victimisation Scale.

Results

The ABPP significantly decreased levels of aggression among kindergarten students (p = 0.019). No significant difference was found between the two groups for peer victimization.

Conclusions

This is the first study in Turkey implemented by a nurse based in school and it is important because it offers an example for nurses’ practice and research. Findings suggest that the ABPP is effective in reducing the aggression of children.
Non‐endogenous ketocarotenoid accumulation in engineeredSynechocystissp. PCC 6803
Authors: Menin Barbara , Santabarbara Stefano , Lami Andrea , Musazzi Simona , Villafiorita Monteleone Francesca , Casazza Anna Paola
Published: December 2018

The cyanobacteriumSynechocystissp. PCC 6803 is a model species commonly employed for biotechnological applications. It is naturally able to accumulate zeaxanthin (Zea) and echinenone (Ech), but not astaxanthin (Asx), which is the highest value carotenoid produced by microalgae, with a wide range of applications in pharmaceutical, cosmetics, food and feed industries. With the aim of finding an alternative and sustainable biological source for the production of Asx and other valuable hydroxylated and ketolated intermediates, the carotenoid biosynthetic pathway ofSynechocystissp. PCC 6803 has been engineered by introducing the 4,4′ β‐carotene oxygenase (CrtW) and 3,3′ β‐carotene hydroxylase (CrtZ) genes fromBrevundimonassp. SD‐212 under the control of a temperature‐inducible promoter. The expression of exogenous CrtZ led to an increased accumulation of Zea at the expense of Ech, while the expression of exogenous CrtW promoted the production of non‐endogenous canthaxanthin and an increase in the Ech content with a concomitant strong reduction of β‐carotene (β‐car). When bothBrevundimonassp. SD‐212 genes were coexpressed, significant amounts of non‐endogenous Asx were obtained accompanied by a strong decrease in β‐car content. Asx accumulation was higher (approximately 50% of total carotenoids) whenCrtZwas cloned upstream ofCrtW, but still significant (approximately 30%) when the position of genes was inverted. Therefore, the engineered strains constitute a useful tool for investigating the ketocarotenoid biosynthetic pathway in cyanobacteria and an excellent starting point for further optimisation and industrial exploitation of these organisms for the production of added‐value compounds.
Counter–Urbanisation as the Growth of Small Towns: Is the Capital Region of India Prepared?
Authors: Jain Manisha , Korzhenevych Artem
Published: December 2018

India’s increased pace of urbanisation is evident, but the question remains as to whether India can harness its developmental potential by providing social infrastructure to meet its projected growth. This paper investigates the urbanisation trajectory with respect to the provision of social infrastructure in the Capital Region of India. First, it applies the differential urbanisation model and predicts counter‐urbanisation to be the next stage of development. Second, using socio‐economic indicators, the paper finds high literacy rates and non‐agricultural employment in small towns. Third, it explains deconcentration of large cities as an outcome of congested social infrastructure provision. Fourth, it determines that small towns continue to have poor provision of social infrastructure. This paper recommends the integration of spatial planning with social infrastructure planning, the empowerment of lower‐tier authorities for social infrastructure delivery, and measures for raising local government revenue in the region and in similar regions throughout the Global South.
The feasibility and efficacy of subcutaneous plerixafor for mobilization of peripheral blood stem cells in allogeneic HLA–identical sibling donors: results of the HOVON‐107 study
Authors: de Greef Georgine E. , Braakman Eric , van der Holt Bronno , Janssen Jeroen J.W.M. , Petersen Eefke , Vucinic Vladimir , Thuss Nicole , Grootes Meriam , Cornelissen Jan J.
Published: December 2018

Background

Plerixafor (PFX) mobilizes CD34+ cells into circulation by disrupting the CXCR4 binding of the hematopoietic stem cell in its bone marrow niche.

Study design and Methods

in the prospective HOVON‐107 study (www.hovon.nl) 23 allogeneic HLA–identical sibling donors received one or two subcutaneous (sc) injections of plerixafor 0.320 mg/kg.The primary endpoint, was defined as feasibility to mobilize a minimum of 2.0 x106 CD34+ cells/kg recipient weight obtained by leukopheresis in at least 90% of the donors.

Results

median 3.3 x 106 CD34+ cells/kg (1.9‐6.5) were collected after 1 (n=12) or 2 (n=10) sc injections of PFX. Side effects occurred in 15/23 (65%) donors: most were grade 1‐2; in 5 donors grade 3 and all resolved. All grafts were directly transplanted. Compared to 10 grafts obtained with G‐CSF the number of CD34+ cells was 2.4 fold lower but the percentage of phenotypically most immature CD34+ subset was higher (31% vs 15%). The total number of CD3+ cells in the graft seemed higher after PFX‐mobilization, but CD4/CD 8 ratios, and frequencies of Th2, Th17 and regulatory T‐cells or NK cells were comparable. All patients engrafted and no increase in incidence or severity of acute or chronic graft versus host disease was observed.

Conclusion

stem cell mobilization with sc PFX 0.320 mg/kg in allogeneic sibling donors is feasible with limited toxicity for donors. 14 allogeneic donors were mobilized with PFX 0.320 mg intravenously according to the same protocol. Due to the limited numbers, these results are in the supplementary section.
Application of a recursive partitioning decision tree algorithm for the prediction of massive transfusion in civilian trauma: the MTPitt prediction tool
Authors: Seheult Jansen N. , Anto Vincent P. , Farhat Nadim , Stram Michelle N. , Spinella Philip C. , Alarcon Louis , Sperry Jason , Triulzi Darrell J. , Yazer Mark H.
Published: December 2018

BACKGROUND

A supervised machine learning algorithm was used to generate decision trees for the prediction of massive transfusion at a Level 1 trauma center.

METHODS

Trauma patients who received at least one unit of RBCs and/or low‐titer group O whole blood between January 1, 2015, and December 31, 2017, were included. Massive transfusion was defined as the transfusion of 10 or more units of RBCs and/or low‐titer group O whole blood in the first 24 hours of admission. A recursive partitioning algorithm was used to generate two decision trees for prediction of massive transfusion using a training data set (n = 550): the first, MTPitt, was based on demographic and clinical parameters, and the second, MTPitt+Labs, also included laboratory data. Decision tree performance was compared with the Assessment of Blood Consumption score and the Trauma Associated Severe Hemorrhage score.

RESULTS

The incidence of massive transfusion in the validation data set (n = 199) was 7.5%. The MTPitt decision tree had a higher balanced accuracy (81.4%) and sensitivity (86.7%) compared to an Assessment of Blood Consumption Score of 2 or higher (77.9% and 66.7%, respectively) and a Trauma Associated Severe Hemorrhage score of 9 or higher (75.0% and 73.3%, respectively), although the 95% confidence intervals overlapped. Addition of laboratory data to the MTPitt decision tree (MTPitt+Labs) resulted in a higher specificity and balanced accuracy compared to MTPitt without an increase in sensitivity.

CONCLUSIONS

The MTPitt decisions trees are highly sensitive tools for identifying patients who received a massive transfusion and do not require computational resources to be implemented in the trauma setting.
Seasonal variability is not observed in the rates of high anti‐A and anti‐B titers in plasma, apheresis platelet, and whole blood units tested by different methods
Authors: Harm Sarah K. , Yazer Mark H. , Bub Carolina B. , Cohn Claudia S. , Jacob Eapen K. , Kutner Jose M. , Mair David C. , Raval Jay S. , Shaz Beth H. , Ziman Alyssa , Dunbar Nancy M. ,   on behalf of the Biomedical Excellence for Safer Transfusion (BEST) Collaborative
Published: December 2018

BACKGROUND

ABO‐incompatible platelet transfusions are common, and transfusions with ABO‐incompatible plasma are increasing with the use of group A plasma and group O whole blood (WB) in emergencies. Many centers screen blood products for anti‐A and/or anti‐B titers to help prevent hemolysis from ABO‐incompatible transfusions, yet titer methods and definition of high titers are not standardized.

STUDY DESIGN AND METHODS

This international multicenter study collected data on anti‐A and anti‐B titer practices for plasma, apheresis platelet (AP), and WB units from January 2015 through December 2017 to determine the prevalence of high‐titer units using local definitions.

RESULTS

A total of 87,701 plasma, AP and WB units were screened for high‐titer anti‐A and/or anti‐B. High‐titer detection rates for group A plasma ranged 0%–13.6%; group A AP 2.7%–9.3%; group O AP 2.3%–65.7%; and group O WB 6.4%–20.7%. At the one center that collected group B AP, the high‐titer rate was 10.9%. High‐titer rates varied from month to month, as well as between years for a given month. There was no clear pattern of when high‐titer units were donated.

CONCLUSION

The prevalence of high‐titer plasma, AP, and WB units varies by titer method and local definition of high titer. Even at the lowest titer threshold of 50, a significant proportion of units had a high‐titer antibody, although the clinical relevance of this finding needs further investigation.
Factors associated with red blood cell, platelet, and plasma transfusions among inpatient hospitalizations: a nationally representative study in the United States
Authors: Goel Ruchika , Patel Eshan U. , White Jodie L. , Chappidi Meera R. , Ness Paul M. , Cushing Melissa M. , Takemoto Clifford M. , Shaz Beth H. , Frank Steven M. , Tobian Aaron A. R.
Published: December 2018

BACKGROUND

Demographic and hospital‐level factors associated with red blood cell (RBC), plasma, and platelet transfusions in hospitalized patients across the U.S. are not well characterized.

METHODS

We conducted a retrospective analysis of the National Inpatient Sample (2014). The unit of analysis was a hospitalization; sampling weights were applied to generate nationally‐representative estimates. The primary outcome was having ≥ 1 RBC transfusion procedure; plasma and platelet transfusions were similarly assessed as secondary outcomes. For each component, factors associated with transfusion were measured using adjusted prevalence ratios (adjPR) and 95% confidence intervals (95% CI) estimated by multivariable Poisson regression.

RESULTS

The prevalence of RBC, plasma, and platelet transfusion was 5.8%, 0.9%, and 0.7%, respectively. RBC transfusions were associated with older age (≥ 65 vs. < 18 years; adjPR = 1.80; 95% CI = 1.66–1.96), female sex (adjPR = 1.13; 95% CI = 1.12–1.14), minority race/ethnic status, and hospitalizations in rural hospitals compared to urban teaching hospitals. Prevalence of RBC transfusion was lower among hospitalizations in the Midwest compared to the Northeast (adjPR = 0.73; 95% CI = 0.67–0.80). All components were more likely to be transfused in patients with a primary hematologic diagnosis, patients with a higher number of total diagnoses, patients who experienced a higher number of other procedures, and patients who eventually died in the hospital. In contrast to RBC transfusions, prevalence of platelet transfusion was greater in urban teaching hospitals (vs. rural; adjPR = 1.71; 95% CI = 1.49–1.98) and lower in blacks (vs. whites; adjPR = 0.80; 95% CI = 0.76–0.85).

CONCLUSIONS

Nationally, there is heterogeneity in factors associated with transfusion between each blood component, including by hospital type and location. This variability presents patient blood management programs with potential opportunities to reduce transfusions.
Maintenance rituximab for relapsing thrombotic thrombocytopenic purpura: a case report
Authors: Saleem Rabia , Rogers Zora R. , Neunert Cindy , George James N.
Published: December 2018

BACKGROUND

Appropriate management to prevent relapses of acquired, autoimmune thrombotic thrombocytopenic purpura (TTP) is not clear. Rituximab (375 mg/m2/week × 4) is effective treatment for acute episodes but it is not consistently effective for prevention of relapses. Maintenance rituximab, 375 mg/m2/3 months for 2 years, is commonly used to prevent progression of follicular lymphoma, but the outcome of maintenance rituximab to prevent TTP relapses has been rarely reported.

CASE REPORT

An 8‐year‐old girl was diagnosed with acquired TTP in 2008; her ADAMTS13 activity was less than 5%, with a functional inhibitor of greater than 8 Bethesda units/mL. She achieved remission with therapeutic plasma exchange, corticosteroids, and rituximab (375 mg/m2/week × 4). During the following 6 years she had seven additional episodes. Each episode responded to therapeutic plasma exchange, sometimes requiring additional treatments (corticosteroids, rituximab, and cyclophosphamide). However, these treatments, as well as splenectomy and trials of cyclophosphamide and mycophenolate mofetil during clinical remissions, failed to prevent relapses. Her ADAMTS13 activity remained 8% or less throughout all of her remissions. Maintenance rituximab was begun in 2013: 500 mg (313 mg/m2) every 2–3 months × 5, then 600 mg (375 mg/m2) every 6 months × 2. After 1 year, her ADAMTS13 was 26%; after 2 years, 51%. During the past 3 years since stopping rituximab, she has remained well, with normal ADAMTS13 activity (70%–78%).

CONCLUSION

Maintenance rituximab treatment may be effective for prevention of relapses in patients with acquired, autoimmune TTP, even when splenectomy and intensive immunosuppression, including multiple conventional courses of rituximab, fail to prevent subsequent relapses.
Global Climate Socialism (GCS)
Authors: Mörner Nils-Axel
Published: December 2018

Climate has always changed, and will always change. The present global warming (1970-2000) is real, but driven by natural forces (NGW) not anthropogenic (CO2) forces (AGW). Observational facts and physical laws set the frames of what is possible, and what must be discarded as nonsense. Despite this the IPCC concept of AGW forcing has gained remarkable international recognition; not because of its own merits but thanks to a very effective lobbying campaign. It has rather taken the form of a new world order with obeying, paying and silence in the center, all strong signs of the establishment of a global climatic socialism system.
Two-Stage Cultivation of Dunaliella tertiolecta with Glycerol and Triethylamine for Lipid Accumulation: a Viable Way To Alleviate the Inhibitory Effect of Triethylamine on Biomass
Authors: Liang Ming-Hua , Xue Lu-Lu , Jiang Jian-Guo
Published: December 2018

Microalgae are promising alternatives for sustainable biodiesel production. Two-stage cultivation with glycerol and triethylamine enhanced the lipid productivity of
Dunaliella tertiolecta
, indicating that two-stage cultivation is an efficient strategy for biodiesel production from microalgae. It was found that glycerol significantly enhanced cell biomass of
D. tertiolecta
, and the presence of glycerol alleviated the inhibitory effect of triethylamine on algal growth. Glycerol, the major byproduct from biodiesel production, was used for the biomass accumulation of
D. tertiolecta
at the first stage of cultivation. Triethylamine, as a lipid inducer, was used for lipid accumulation at the second stage of cultivation. Two-stage cultivation with glycerol and triethylamine enhanced lipid productivity and alleviated the inhibitory effect of triethylamine on the algal growth of
D. tertiolecta
, which is an efficient strategy for lipid production from
D. tertiolecta
.
Identification of the Receptor Used by the Ecotropic Mouse GLN Endogenous Retrovirus
Authors: Tsang Jhen , Ribet David , Heidmann Thierry , Dewannieux Marie
Published: December 2018

Endogenous retroviruses are genomic traces of past infections present in all vertebrates. Most of these elements degenerate over time and become nonfunctional, but the mouse genome still contains several families with full infection abilities. The GLN retrovirus is one of them, and its members encode particles that are able to infect only mouse cells. Here, we identified the cellular protein used as a receptor by GLN for cell entry. It is SLC19A1, the reduced folate carrier. We show that GLN infection is limited to mouse cells due to both a mutation in the mouse gene preventing the glycosylation of SLC19A1 and also other residues conserved within the rat but not in the hamster and human proteins. Like all other gammaretroviruses whose receptors have been identified, GLN uses a member of the solute carrier superfamily for cell entry, highlighting the role of these proteins for retroviral infection in mammals.