bluuebunny/crossref_metadata_2025 huggingface dataset:
Lateral femoral cutaneous nerve block after total hip arthroplasty: a randomised trial
Authors: Thybo K. H. , Mathiesen O. , Dahl J. B. , Schmidt H. , Hägi‐Pedersen D.
Published: July 2016

Background

Peripheral regional nerve blocks are commonly used for pain management after lower extremity surgery, but motor blockade can be a significant concern. The lateral femoral cutaneous nerve (LFCN) is a purely sensory nerve from the lumbar plexus. We hypothesised that an LFCN block would reduce movement‐related pain after total hip arthroplasty (THA) in patients with moderate‐to‐severe pain.

Methods

Sixty patients with visual analogue scale (VAS) score > 40 mm during 30‐degree active flexion of the hip on either the first or second postoperative day after THA were included in this prospective, randomised, blinded, placebo‐controlled trial. Group A received an LFCN block with 8 ml of 0.75% ropivacaine followed after 45 min by an additional LFCN block with 8 ml of saline. Group B received an LFCN block with 8 ml of saline followed after 45 min by an additional LFCN block with 8 ml of 0.75% ropivacaine.

Results

We found a difference of 17 mm (95% CI, 4–31 mm; P < 0.02) in VAS pain score during 30‐degree flexion of the hip 45 min after the first block (primary outcome) in favour of group A. No other significant difference between groups regarding pain during mobilisation and at rest was found. The overall non‐responder rate (< 15 mm pain reduction) was 42%.

Conclusions

LFCN block reduced movement‐related pain in patients with moderate‐to‐severe pain after THA. The substantial non‐responder rate limits recommendations of this block as part of a standard analgesic treatment regimen.
The economic costs of mental health‐related discrimination
Authors: Osumili B. , Henderson C. , Corker E. , Hamilton S. , Pinfold V. , Thornicroft G. , McCrone P.
Published: July 2016

Objective

To estimate and compare the economic costs of mental health‐related discrimination in the domains of health care, relationships and participation in leisure activities in England between 2011 and 2014.

Method

A subsample of the Viewpoint survey was interviewed using the Costs of Discrimination Assessment Questionnaire in 2011 and 2014. Information on the impact of discrimination on healthcare use, help seeking from family and friends and participation in leisure activities was recorded. Pattern of contacts, costs and predictor of costs were examined.

Results

Our findings showed higher costs of health service use for individuals who reported experiences of discrimination in healthcare settings in 2011 compared with those who did not (mean difference £625, P‐value 0.019). Individuals who reported experiences of discrimination in relationships in 2014 had higher healthcare costs than those who did not (mean difference £418, P ‐value 0.034). There was some evidence of a reduction in overall levels of healthcare use, leisure activities and support from families over time. Discrimination did not significantly affect help seeking from family/friends or leisure activities.

Conclusion

There is some evidence that discrimination is related to increased healthcare costs. A prospective study is needed to better understand the consequences of these effects.
Mapping the four‐horned locus and testing the polled locus in three Chinese sheep breeds
Authors: He Xiaohong , Zhou Zhengkui , Pu Yabin , Chen Xiaofei , Ma Yuehui , Jiang Lin
Published: July 2016

Four‐horned sheep are an ideal animal model for illuminating the genetic basis of horn development. The objective of this study was to locate the genetic region responsible for the four‐horned phenotype and to verify a previously reported polled locus in three Chinese breeds. A genome‐wide association study (GWAS) was performed using 34 two‐horned and 32 four‐horned sheep from three Chinese indigenous breeds: Altay, Mongolian and Sishui Fur sheep. The top two significant single nucleotide polymorphisms (SNPs) associated with the four‐horned phenotype were both located in a region spanning positions 132.6 to 132.7 Mb on sheep chromosome 2. Similar locations for the four‐horned trait were previously identified in Jacob, Navajo‐Churro, Damara and Sishui Fur sheep, suggesting a common genetic component underlying the four‐horned phenotype. The two identified SNPs were both downstream of the metaxin 2 (MTX2) gene and the HOXD gene cluster. For the top SNP—OAR2:g.132619300G>A—the strong associations of the AA and AG genotypes with the four‐horned phenotype and the GG genotype with the two‐horned phenotype indicated the dominant inheritance of the four‐horned trait. No significant SNPs for the polled phenotype were identified in the GWAS analysis, and a PCR analysis for the detection of the 1.8‐kb insertion associated with polled sheep in other breeds failed to verify the association with polledness in the three Chinese breeds. This study supports the hypothesis that two different loci are responsible for horn existence and number. This study contributes to the understanding of the molecular regulation of horn development and enriches the knowledge of qualitative traits in domestic animals.
Too many, too few, or too unsafe? Impact of inappropriate prescribing on mortality, and hospitalization in a cohort of community‐dwelling oldest old
Authors: Wauters Maarten , Elseviers Monique , Vaes Bert , Degryse Jan , Dalleur Olivia , Vander Stichele Robert , Christiaens Thierry , Azermai Majda
Published: July 2016

Aims

Little is known about the impact of inappropriate prescribing (IP) in community‐dwelling adults, aged 80 years and older. The prevalence at baseline (November 2008September 2009) and impact of IP (misuse and underuse) after 18 months on mortality and hospitalization in a cohort of community‐dwelling adults, aged 80 years and older (n = 503) was studied.

Methods

Screening Tool of Older People's Prescriptions (STOPP‐2, misuse) and Screening Tool to Alert to Right Treatment (START‐2, underuse) criteria were cross‐referenced and linked to the medication use (in Anatomical Therapeutic Chemical coding) and clinical problems. Survival analysis until death or first hospitalization was performed at 18 months after inclusion using Kaplan–Meier, with Cox regression to control for covariates.

Results

Mean age was 84.4 (range 80–102) years. Mean number of medications prescribed was 5 (range 0–16). Polypharmacy (≥5 medications, 58%), underuse (67%) and misuse (56%) were high. Underuse and misuse coexisted in 40% and were absent in 17% of the population. A higher number of prescribed medications was correlated with more misused medications (rs = .51, P < 0.001) and underused medications (rs = .26, P < 0.001).

Mortality and hospitalization rate were 8.9%, and 31.0%, respectively. After adjustment for number of medications and misused medications, there was an increased risk of mortality (HR 1.39, 95% CI 1.10, 1.76) and hospitalization (HR 1.26, 95% CI 1.10, 1.45) for every additional underused medication. Associations with misuse were less clear.

Conclusion

IP (polypharmacy, underuse and misuse) was highly prevalent in adults, aged 80 years and older. Surprisingly, underuse and not misuse had strong associations with mortality and hospitalization.
Hypoglycaemia when adding sulphonylurea to metformin: a systematic review and network meta‐analysis
Authors: Andersen Stig Ejdrup , Christensen Mikkel
Published: July 2016

Aims

The risk of hypoglycaemia may differ among sulphonylureas (SUs), but evidence from head‐to‐head comparisons is sparse. Performing a network meta‐analysis to use indirect evidence from randomized controlled trials (RCTs), we compared the relative risk of hypoglycaemia with newer generation SUs when added to metformin.

Methods

A systematic review identified RCTs lasting 12–52 weeks and evaluating SUs added to inadequate metformin monotherapy (≥1000 mg/day) in type 2 diabetes. Adding RCTs investigating the active comparators from the identified SU trials, we established a coherent network. Hypoglycaemia of any severity was the primary end point.

Results

Thirteen trials of SUs and 14 of oral non‐SU antihyperglycaemic agents (16 260 patients) were included. All reported hypoglycaemia only as adverse events. Producing comparable reductions in HbA1C of −0.66 to −0.84% (−7 to −9 mmol/mol), the risk of hypoglycaemia was lowest with gliclazide compared to glipizide (OR 0.22, CrI: 0.05 to 0.96), glimepiride (OR 0.40, CrI: 0.13 to 1.27), and glibenclamide (OR 0.21, CrI: 0.03 to 1.48). A major limitation is varying definitions of hypoglycaemia across studies.

Conclusions

When added to metformin, gliclazide was associated with the lowest risk of hypoglycaemia between the newer generation SUs. Clinicians should consider the risk of hypoglycaemia agent‐specific when selecting an SU agent.
Phylogenetic reconstruction based on COI reshuffles the taxonomy of hyalosphenid shelled (testate) amoebae and reveals the convoluted evolution of shell plate shapes
Authors: Kosakyan Anush , Lahr Daniel J. G. , Mulot Matthieu , Meisterfeld Ralf , Mitchell Edward A. D. , Lara Enrique
Published: July 2016

Species diversity in most protistan groups has been underestimated. Many morpho‐species are in fact complexes that require detailed morphometric studies to be discriminated. However, which traits can be used for species descriptions remains in many cases unclear. The testate amoeba genus Quadrulella produces self‐secreted, siliceous plates with a very characteristic square shape—such plates were assumed to be synapomorphic of the genus. Here we demonstrate that Quadrulella symmetrica (the most common Holarctic species) is not monophyletic. Square plate size and arrangement, test size and general shape are efficient criteria for species discrimination. Based on morphology and sequence data, we describe Quadrulella variabilis sp. nov. from Switzerland, and Quadrulella madibai sp. nov. from South Africa, and confirm the validity of Q. alata. The former species Q. subcarinata does not belong to the genus Quadrulella. We therefore transfer this species to the new genus Mrabella gen. nov. Our results show that hyalosphenids presenting siliceous square shell plates do not form a monophyletic clade. Several possible hypotheses about the origins of square plates are discussed. Additionally, this comprehensive phylogenetic analysis of the family Hyalospheniidae confirms that the genus Nebela is paraphyletic and needs to be divided into genera based on general shell shape: Nebela sensu stricto, Longinebela gen. nov., Planocarina gen. nov., Gibbocarina gen. nov., Cornutheca gen. nov. and Mrabella gen. nov.
Mechanism and properties of coloured nanoscale SiO2 prepared from silica and reactive dyes
Authors: Zhang Liping , Li Min , Tian Anli , Fu Shaohai
Published: July 2016

KH560‐modified SiO2 was prepared using tetraethyl orthosilicate (TEOS) and γ‐(2,3‐epoxypropoxy) propytrimethoxysilane (KH560) by the sol–gel method and then coloured with CI Reactive Blue 4 (X‐BR) to prepare coloured nanoscale SiO2. The antisolvent performance and the results of cross‐polarisation/magic angle spinning 13C nuclear magnetic resonance and Fourier transform infrared spectroscopy showed that the reaction of X‐BR with KH560‐modified SiO2 is a two‐step process: X‐BR is firstly adsorbed by KH560‐modified SiO2 via van der Waals forces, and then nucleophilic substitution occurs between dichloro triazine and the epoxy group. The grafting ratio of X‐BR on KH560‐modified SiO2 reached 95% under optimum conditions, i.e. a mass ratio of KH560 to TEOS of 20%, a temperature of 40 °C, a pH of 8.5, and a reaction time of 5 h. X‐ray diffraction analysis and transmission electron microscopy showed that the coloured nanoscale SiO2 was amorphous, with a mean diameter of 216 nm. Experimental application showed that the coloured nanoscale SiO2 had excellent stability to solvents and alkaline solution, and the absorptive capacity of the coloured nanoscale SiO2 in the 200–400 nm region was higher than that of X‐BR. The light fastness of the coloured nanoscale SiO2 reached 5–6 grade.
Impulse control disorder related behaviours during long‐term rotigotine treatment: a post hoc analysis
Authors: Antonini A. , Chaudhuri K. R. , Boroojerdi B. , Asgharnejad M. , Bauer L. , Grieger F. , Weintraub D.
Published: July 2016

Background and purpose

Dopamine agonists in Parkinson's disease (PD) are associated with impulse control disorders (ICDs) and other compulsive behaviours (together called ICD behaviours). The frequency of ICD behaviours reported as adverse events (AEs) in long‐term studies of rotigotine transdermal patch in PD was evaluated.

Methods

This was a post hoc analysis of six open‐label extension studies up to 6 years in duration. Analyses included patients treated with rotigotine for at least 6 months and administered the modified Minnesota Impulse Disorders Interview. ICD behaviours reported as AEs were identified and categorized.

Results

For 786 patients, the mean (±SD) exposure to rotigotine was 49.4 ± 17.6 months. 71 (9.0%) patients reported 106 ICD AEs cumulatively. Occurrence was similar across categories: 2.5% patients reported ‘compulsive sexual behaviour’, 2.3% ‘buying disorder’, 2.0% ‘compulsive gambling’, 1.7% ‘compulsive eating’ and 1.7% ‘punding behaviour’. Examining at 6‐month intervals, the incidence was relatively low during the first 30 months; it was higher over the next 30 months, peaking in the 54–60‐month period. No ICD AEs were serious, and 97% were mild or moderate in intensity. Study discontinuation occurred in seven (9.9%) patients with ICD AEs; these then resolved in five patients. Dose reduction occurred for 23 AEs, with the majority (73.9%) resolving.

Conclusions

In this analysis of >750 patients with PD treated with rotigotine, the frequency of ICD behaviour AEs was 9.0%, with a specific incidence timeline observed. Active surveillance as duration of treatment increases may help early identification and management; once ICD behaviours are present rotigotine dose reduction may be considered.
Fatigue performance of dual‐phase steels for automotive wheel application
Authors: Majumdar S. , Roy S. , Ray K. K.
Published: July 2016

Fatigue performance of ferrite–martensite (FM) and ferrite–bainite (FB) dual‐phase (DP) steels used in automotive wheels has been compared in terms of (i) high‐cycle fatigue performance and failure mechanisms and (b) low‐cycle fatigue performance (Δεt/2 = 0.002 to 0.01) and associated deformation mechanisms. FBDP steel exhibits moderately better high‐cycle fatigue performance, owing to delay in microcrack initiation. In FBDP steel, microcracks initiate predominantly along ferrite grain boundaries, while that at FB interface is significantly delayed in comparison with FMDP steel, where few microcracks appear at FM interface even below the endurance limit. During low‐cycle fatigue, however, FMDP steel performs considerably better than FBDP steel till Δεt/2 ≤ 0.005 attributed to initial cyclic hardening, followed by cyclically stable behaviour exhibited by FMDP steel. In sharp contrast, at all Δεt/2 > 0.002, FBDP steel undergoes continuous cyclic softening. The latter may cause undesirable deformation of wheels in service.
Association between circulating fibroblast growth factor‐23 and age‐related cardiovascular–renal parameters in a healthy Chinese population
Authors: Wang Nan , Bai Xiaojuan , Jin Bo , Han Wen , Sun Xuefeng , Chen Xiangmei
Published: July 2016

Aim

Previous studies showed that circulating fibroblast growth factor‐23 (FGF23) is a new biomarker linked to cardiovascular and kidney diseases. Here, we explored the association between serum FGF23 and aging‐related cardiovascular–renal parameters in a healthy Chinese population.

Methods

A total of 314 healthy participants aged 36–87 years were enrolled. Cardiovascular structure and function were assessed by the left ventricular ejection fraction, the ratio of early diastolic peak flow velocity to late diastolic peak flow velocity at the mitral leaflet tips, carotid intima‐media thickness, the diameter of the bilateral common carotid artery, blood systolic peak and end diastolic velocities, which were measured by M‐mode ultrasonography. Glomerular filtration rate was evaluated using the Chronic Kidney Disease Epidemiology Collaboration equation and Chronic Kidney Disease Epidemiology Collaboration equation for Asians. Serum FGF23, 1, 25‐dihydroxy vitamin D3 and parathyroid hormone were measured by enzyme‐linked immunosorbent assay.

Results

For all participants, intima‐media thickness/diameter of the bilateral common carotid artery gradually decreased with the progression from low to high FGF23 concentration (P < 0.05). After adjusting for all possible confounders, FGF23 remained significantly associated with intima‐media thickness/diameter of the bilateral common carotid artery (P = 0.016). In women, serum FGF23 was significantly associated with serum creatinine, cystatin C and estimated glomerular filtration rate in the Spearman correlation analysis. FGF23 remained significantly associated with serum creatinine (P = 0.046) and estimated glomerular filtration rate (P = 0.034) after full adjustment. However, no such relationship was apparent in men.

Conclusions

Serum FGF23 was correlated with aging‐related cardiovascular–renal parameters even in healthy people. Measurement of serum FGF23 can provide valuable information to predict cardiovascular–renal function in healthy people, especially in older female adults. Geriatr Gerontol Int 2017; 17: 1221–1231.
Comparison of the morbidity and mortality of cystectomy and ileal conduit urinary diversion for neurogenic lower urinary tract dysfunction according to the approach: Laparotomy, laparoscopy or robotic
Authors: Deboudt Constance , Perrouin‐Verbe Marie‐Aimée , Le Normand Loic , Perrouin‐Verbe Brigitte , Buge François , Rigaud Jérôme
Published: July 2016

Objectives

To evaluate and compare the morbidity and mortality of cystectomy–ileal conduit urinary diversion in patients with neurogenic lower urinary tract dysfunction according to the surgical approach, and to evaluate predictive factors of early and late morbidity.

Methods

This was a single‐center retrospective study based on 65 patients operated between May 2005 and December 2011. The surgical approach consisted of: laparotomy (n = 11), laparoscopy (n = 14) and robotic (n = 40). Evaluation of early (<30 days) and late (>30 days) morbidity and mortality was carried out according to the Clavien–Dindo classification.

Results

The operating time was longer (P = 0.007) and the mean time to return of bowel function was shorter (P = 0.012) in the robotic group. The early complication rate for the overall population was 41.5%: minor complications in 32.3% of cases and major complications in 9.2% of cases. A tendency towards a lower minor complication rate was observed in favor of robotic surgery (P = 0.08), with a reduction of the postoperative hemorrhagic complication rate (P = 0.03). The late complication rate for the overall population was 43.1%: minor complications in 20% and major complications in 23.1%. A lower surgical revision rate under general anesthesia was observed in favor of robotic surgery (P = 0.03). No predictive factor of early and late morbidity was identified.

Conclusion

Robotic cystectomy–ileal conduit urinary diversion in patients with neurogenic lower urinary tract dysfunction is feasible and safe. Its morbidity in experienced hands seems to be limited and comparable with laparoscopy or open surgery.
Laboring Under Chávez: Populism for the Twenty-first Century
Authors: Posner Paul W.
Published: July 2016

This analysis addresses two interrelated questions: what were labor conditions like under Hugo Chávez? and what do those conditions suggest about the relationship between populism and leftism in Latin America? The answer to the first question is unequivocal. Despite its socialist rhetoric, the Chávez regime fragmented and weakened organized labor, undermined collective bargaining, and exploited vulnerable workers in cooperatives. Thus the regime's primary foible was not its radical leftism but its pursuit of populist control at the expense of the leftist goals of diminishing the domination of marginalized groups and expanding their autonomous participation in civil society. This appraisal of labor politics under Chávez indicates substantial tension between the realization of these leftist goals and populist governance. It further suggests the need to distinguish more clearly between leftism and populism and their respective impacts on democracy.
Caring for our carers: An international perspective on policy developments in the UK
Authors: Yeandle Sue
Published: July 2016

The UK has led the world in highlighting the needs of carers, and was the first adopter of many policies to help people caring for sick, frail or disabled relatives or friends. But it risks falling behind internationally in the policies it offers, argues Sue Yeandle, and needs to up its game in implementing recent legislative reforms.
Pseudo Phase Diagram and Microwave Dielectric Properties of Li2O–MgO–TiO2 Ternary System
Authors: Zhang Yi‐Ding , Zhou Di
Published: July 2016

Li2O–MgO–TiO2 ternary system is an important microwave dielectric ceramic material with excellent properties and prospect in both scientific research and application. A phase diagram of the Li2O–MgO–TiO2 ternary system was established in this article, based on earlier research results and our present work. Microwave dielectric properties with compositions in different regions of the phase diagram have been analyzed. We found that the 0.33 Li2MgTi3O8–0.67 Li2TiO3 ceramics sintered at 1200°C exhibited excellent dielectric properties: Q × f value = 80 476 GHz (at 7.681 GHz), εr = 24.7, τf = +3.2 ppm/°C. We also designed two ceramic systems in the Li‐rich region of the Li2O–MgO–TiO2 ternary system, which received little attention in the past decades, because many excellent single‐phase ceramics, such as Li2MgTiO4, Li2MgTi3O8 and MgTiO3, have been found in the Ti‐rich region. The ceramic systems have low sintering temperatures but also relatively poor dielectric properties.
Online Collaboration in Design Education: an Experiment in Real‐Time Manipulation of Prototypes and Communication
Authors: Dreamson Neal
Published: July 2016

The features of collaboration in design education include effective and efficient communication and reflection, and feasible manipulation of design objects. For collaborative design, information and communication technology offers educators the possibility to change design pedagogy. However, there is a paucity of literature on relative advantages and disadvantages of online collaboration for real‐time manipulation of design objects and prototypes, particularly in web design education. Using survey instrumentations, this study investigated online collaborative design practices with an application by measuring experiences of communication and interaction among twelve designers who are enrolled in a Master's programme in interactive design. The study identified barriers to online collaboration design: (1) real‐time manipulation of design objects and prototypes may increase complexity of communication interaction; (2) records of communication and invisibility of team members may attenuate quality and frequency of critical feedback to each other; (3) students’ attitudes towards collaboration, individual students’ learning goals, and completing tasks in a timely manner could reduce their engagement and increase their reliance on teacher intervention.
To remember: Radiotherapy – a successful treatment for early Dupuytren′s disease
Authors: Eberlein B. , Biedermann T.
Published: July 2016

Dupuytren′s disease (DD) is a common fibroproliferative condition of the hand which tends to cause progressive digital flexion contracture. Therapeutic strategies to treat the disease include radiotherapy, injections of collagenase clostridium histolyticum, needle fasciotomy and extended surgical intervention dependent on involvement and duration of the disease. We have reviewed the literature with the aim to assess the conditions and effects of radiotherapy in DD. In early stages of the disease, radiotherapy resulted in regression of symptoms/a lack of progression found on average in 40% (range 10–85%)/81% (range 50–100%) of the patients with recurrence rates of only 12–31% after long‐term follow‐up (>4 years). These results proved to be significantly better than in the untreated patients with natural course of the disease (about 50% progression after a follow‐up of 5–6 years). Long‐term side‐effects (skin dryness) are observed on average in one quarter of the patients, but are well tolerated. Local occurrence of malignancies has not been reported yet. Due to severe functional impairment leading to individual suffering and the high economic burden, treatment of DD in early stages is necessary and radiation therapy represents an effective, safe and economic treatment option.
Proteolysis of α‐synuclein fibrils in the lysosomal pathway limits induction of inclusion pathology
Authors: Sacino Amanda N. , Brooks Mieu M. , Chakrabarty Paramita , Saha Kaustuv , Khoshbouei Habibeh , Golde Todd E. , Giasson Benoit I.
Published: July 2016

Progression of α‐synuclein inclusion pathology may occur through cycles of release and uptake of α‐synuclein aggregates, which induce additional intracellular α‐synuclein inclusion pathology. This process may explain (i) the presence of α‐synuclein inclusion pathology in grafted cells in human brains, and (ii) the slowly progressive nature of most human α‐synucleinopathies. It also provides a rationale for therapeutic targeting of extracellular aggregates to limit pathology spread. We investigated the cellular mechanisms underlying intraneuronal α‐synuclein aggregation following exposure to exogenous preformed α‐synuclein amyloid fibrils. Exogenous α‐synuclein fibrils efficiently attached to cell membranes and were subsequently internalized and degraded within the endosomal/lysosomal system. However, internalized α‐synuclein amyloid fibrils can apparently overwhelm the endosomal/lysosomal machinery leading to the induction of intraneuronal α‐synuclein inclusions comprised of endogenous α‐synuclein. Furthermore, the efficiency of inclusion formation was relatively low in these studies compared to studies using primary neuronal‐glial cultures over‐expressing α‐synuclein. Our study indicates that under physiologic conditions, endosomal/lysosomal function acts as an endogenous barrier to the induction of α‐synuclein inclusion pathology, but when compromised, it may lower the threshold for pathology induction/transmission.

image

Cover Image for this issue: doi: 10.1111/jnc.13787.
Hospital Characteristics are Associated With Readiness to Attain Stage 2 Meaningful Use of Electronic Health Records
Authors: Kim Jungyeon , Ohsfeldt Robert L. , Gamm Larry D. , Radcliff Tiffany A. , Jiang Luohua
Published: July 2016

Purpose

To examine the difference between rural and urban hospitals as to their overall level of readiness for stage 2 meaningful use of electronic health records (EHRs) and to identify other key factors that affect their readiness for stage 2 meaningful use.

Methods

A conceptual framework based on the theory of organizational readiness for change was used in a cross‐sectional multivariate analysis using 2,083 samples drawn from the HIMSS Analytics survey conducted with US hospitals in 2013.

Findings

Rural hospitals were less likely to be ready for stage 2 meaningful use compared to urban hospitals in the United States (OR = 0.49) in our final model. Hospitals’ past experience with an information exchange initiative, staff size in the information system department, and the Chief Information Officer (CIO)’s responsibility for health information management were identified as the most critical organizational contextual factors that were associated with hospitals’ readiness for stage 2. Rural hospitals lag behind urban hospitals in EHR adoption, which will hinder the interoperability of EHRs among providers across the nation. The identification of critical factors that relate to the adoption of EHR systems provides insights into possible organizational change efforts that can help hospitals to succeed in attaining meaningful use requirements.

Conclusion

Rural hospitals have increasingly limited resources, which have resulted in a struggle for these facilities to attain meaningful use. Given increasing closures among rural hospitals, it is all the more important that EHR development focus on advancing rural hospital quality of care and linkages with patients and other organizations supporting the care of their patients.
Plasma biomarkers to study mechanisms of liver injury in patients with hypoxic hepatitis
Authors: Weemhoff James L. , Woolbright Benjamin L. , Jenkins Rosalind E. , McGill Mitchell R. , Sharpe Matthew R. , Olson Jody C. , Antoine Daniel J. , Curry Steven C. , Jaeschke Hartmut
Published: July 2016

Background & Aims

Hypoxic hepatitis is a clinical condition precipitated by prolonged periods of oxygen deprivation to the liver. It can have several underlying causes. Despite its prevalence in critically ill patients, which can reach upwards of 10%, very little is known about the mechanisms of injury. Thus, we set out to measure previously identified circulating biomarkers in an attempt to describe mechanisms of injury following hypoxic hepatitis.

Methods

Plasma from patients diagnosed with hypoxic hepatitis was collected for this study. Biomarkers of hepatocellular injury, mitochondrial damage and cell death were measured. These results were compared against results obtained from well‐characterized acetaminophen overdose patients.

Results

At peak injury, ALT measured 4082±606 U/L and gradually decreased over 5 days, corresponding to the clinically observed pattern of hypoxic hepatitis. Levels of GDH showed a similar pattern, but neither ALT nor GDH were significantly higher in these patients than in acetaminophen patients. Plasma levels of DNA fragments mimicked hepatocellular injury as measured by ALT and miRNA‐122. Interestingly, we found a significant increase in caspase‐cleaved cytokeratin‐18; however, the full‐length form greatly exceeded the cleaved form at the time of maximum injury (45837±12085 vs 2528±1074 U/L). We also found an increase in acHMGB1 at later time points indicating a possible role of inflammation, but cytokine levels at these times were actually decreased relative to early time points.

Conclusions

The mechanism of injury following hypoxic hepatitis involves mitochondrial damage and DNA fragmentation. Importantly, necrosis, rather than apoptosis, is the main mode of cell death.
The evolutionary scenario of hepatocellular carcinoma in Italy: an update
Authors: Bucci Laura , Garuti Francesca , Lenzi Barbara , Pecorelli Anna , Farinati Fabio , Giannini Edoardo G. , Granito Alessandro , Ciccarese Francesca , Rapaccini Gian Lodovico , Di Marco Maria , Caturelli Eugenio , Zoli Marco , Borzio Franco , Sacco Rodolfo , Cammà Calogero , Virdone Roberto , Marra Fabio , Felder Martina , Morisco Filomena , Benvegnù Luisa , Gasbarrini Antonio , Svegliati‐Baroni Gianluca , Foschi Francesco Giuseppe , Missale Gabriele , Masotto Alberto , Nardone Gerardo , Colecchia Antonio , Bernardi Mauro , Trevisani Franco ,   the Italian Liver Cancer (ITA.LI.CA) group
Published: July 2016

Background & Aims

Epidemiology of hepatocellular carcinoma is changing worldwide. This study aimed at evaluating the changing scenario of aetiology, presentation, management and prognosis of hepatocellular carcinoma in Italy during the last 15 years.

Methods

Retrospective analysis of the ITA.LI.CA (Italian Liver Cancer) database including 5192 hepatocellular carcinoma patients managed in 24 centres from 2000 to 2014. Patients were divided into three groups according to the date of cancer diagnosis (2000–2004, 2005–2009 and 2010–2014).

Results

The main results were as follows: (i) progressive patient aging; (ii) progressive expansion of non‐viral cases and, namely, of “metabolic” hepatocellular carcinomas; (iii) increasing proportion of hepatocellular carcinoma diagnosed during a correct (semi‐annual) surveillance programme; (iv) favourable cancer stage migration; (v) increased use of radiofrequency ablation to the detriment of percutaneous ethanol injection; (vi) improved outcomes of ablative and transarterial treatments; (vii) improved overall survival (adjusted for the lead time in surveyed patients), particularly after 2009, of both viral and non‐viral patients presenting with an early‐ or intermediate‐stage hepatocellular carcinoma.

Conclusions

During the last 15 years several aetiological and clinical features of hepatocellular carcinoma patients have changed, as their management. The observed improvement of overall survival was owing both to the wider use of semi‐annual surveillance, expanding the proportion of tumours that qualified for curative treatments, and to the improved outcome of loco‐regional treatments.
The response of phytoplankton and zooplankton to river damming in three cascading reservoirs of the Tana River, Kenya
Authors: Okuku Eric Ochieng , Tole Mwakio , Kiteresi Linet Imbayi , Bouillon Steven
Published: July 2016

River damming reduces the ecological heterogeneity of ecosystems, with a resultant shift of communities adapted to lotic conditions to those better adapted to the newly created lentic environment. Whereas the response of phytoplankton and zooplankton community composition and structure to river damming has been extensively studied in individual reservoirs, this study assessed three cascading reservoirs on the Tana River, Kenya. A total of five sampling campaigns were carried out in 2011, 2012 and 2013 for different sampling sites within each of the reservoirs, as well as upstream and downstream of the reservoirs. Plankton communities within each of the three reservoirs, and upstream of the reservoirs, were compared, indicating (i) the disappearance of 13 phytoplankton and 2 zooplankton taxa; (ii) the appearance (invasion) by 26 phytoplankton and 33 zooplankton taxa; and (iii) an opportunistic presence of 7 phytoplankton and 6 zooplankton taxa. Thirty‐two genera of potentially harmful algae were also encountered, suggesting a potential future threat of harmful algal blooms. A significant reduction in phytoplankton diversity and taxa evenness was also observed, as well as increases in overall abundance in the reservoirs, compared to the river upstream of the study reservoirs. However, these ecological indices were restored to the original levels observed upstream of the study reservoirs at sites hundreds of kilometres downstream of the reservoirs.
Regulation of inflammation by lipid mediators in oral diseases
Authors: Sommakia S , Baker OJ
Published: July 2016

Lipid mediators (LM) of inflammation are a class of compounds derived from ω‐3 and ω‐6 fatty acids that play a wide role in modulating inflammatory responses. Some LM possess pro‐inflammatory properties, while others possess proresolving characteristics, and the class switch from pro‐inflammatory to proresolving is crucial for tissue homeostasis. In this article, we review the major classes of LM, focusing on their biosynthesis and signaling pathways, and their role in systemic and, especially, oral health and disease. We discuss the detection of these LM in various body fluids, focusing on diagnostic and therapeutic applications. We also present data showing gender‐related differences in salivary LM levels in healthy controls, leading to a hypothesis on the etiology of inflammatory diseases, particularly Sjögren's syndrome. We conclude by enumerating open areas of research where further investigation of LM is likely to result in therapeutic and diagnostic advances.
Near–Infrared‐Responsive Peptide that Targets Collagen Fibrils to Induce Cytotoxicity
Authors: Honda Masayuki , Odawara Aoi , Suzuki Ikuro , Shimada Morio , Yoshikawa Kohki , Okada Tomoko
Published: July 2016

A novel conjugate, PHG10 dye, was synthesized using a collagen peptide and a near–infrared (NIR)‐responsive dye to achieve targeted cytotoxicity. The collagen peptide motif, ‐(Pro‐Hyp‐Gly)10‐ (PHG10), was incorporated for targeting collagen fibrils that are excessively produced by activated fibroblasts around tumor cells. PHG10 dye was purified by HPLC and identified by MALDI‐MS. The phototoxicity and cytotoxicity of PHG10 dye were examined using human glioma cells (HGCs). Fluorescent images indicated that PHG10 dye preferably assembled to collagen‐coated HGCs compared with noncoated HGCs. Under irradiation with NIR light, effective cytotoxicity was observed on collagen‐coated HGCs within 20 min. Because phototoxicity and cytotoxicity are dependent on the assembled amount of PHG10 dye, the targeting of collagen fibrils by the collagen peptide motif PHG10 is assured.
Helminth–microparasite co‐infection in wildlife: lessons from ruminants, rodents and rabbits
Authors: Ezenwa V. O.
Published: July 2016

Co‐infection is now recognized as the natural state of affairs in most hosts and co‐infecting parasites interact in a variety of ways that can impact host health and parasite fitness. Interactions between helminths and microparasites have captured particular attention in this regard owing to the ubiquity of helminth infections in many host populations. The mechanistic underpinnings and health implications of co‐infection are typically studied in laboratory and clinical settings, but recently studies of wild species have begun to tackle similar issues. Case studies from three wild mammal groups—ruminants, rodents and rabbits—serve to highlight how wild studies are contributing to the broader co‐infection literature. This work suggests that wildlife research can generate new and unique insights about helminth–microparasite co‐infection that are fostered in part by studying parasite interactions in a natural context. For this reason, increased integration of wild studies with research in human, laboratory and veterinary animal populations can help pave the way towards a more complete understanding of the issue of co‐infection.
Anisakis – immunology of a foodborne parasitosis
Authors: Nieuwenhuizen Natalie E.
Published: July 2016

Anisakis species are marine nematodes which can cause zoonotic infection in humans if consumed in raw, pickled or undercooked fish and seafood. Infection with Anisakis is associated with abdominal pain, nausea and diarrhoea and can lead to massive infiltration of eosinophils and formation of granulomas in the gastrointestinal tract if the larvae are not removed. Re‐infection leads to systemic allergic reactions such as urticarial or anaphylaxis in some individuals, making Anisakis an important source of hidden allergens in seafood. This review summarizes the immunopathology associated with Anisakis infection. Anisakiasis and gastroallergic reactions can be prevented by consuming only fish that has been frozen to −20°C to the core for at least 24 hours before preparation. Sensitization to Anisakis proteins can also occur, primarily due to occupational exposure to infested fish, and can lead to dermatitis, rhinoconjunctivitis or asthma. In this case, exposure to fish should be avoided.
Dental utilization for Medicaid‐enrolled children with cystic fibrosis
Authors: Sarvas Elise W. , Huebner Colleen E. , Scott JoAnna M. , Aps Johan K.M. , Chi Donald L.
Published: July 2016

Objectives

Despite a multitude of risk factors, children with cystic fibrosis (CF) have lower reported dental caries prevalence. A potential explanation is preventive dental care use, but no studies to date have examined dental use for children with CF.

Methodology

Iowa Medicaid data were analyzed for children age 3 to 17 years (N = 156,268). Poisson regression models were used to compare utilization rates for any dental care and also for specific categories of dental care, by CF status.

Results

Children with CF were significantly less likely to use any dental care than children without CF (incident rate ratio: 0.819, 95% CI: 0.80 to 0.84, p < .001). There were no significant differences in use across specific categories of dental care.

Conclusions

Medicaid‐enrolled children with CF are less likely to use dental care than children without CF. These findings suggest that use of dental care use is an unlikely explanation for lower purported caries rates among children with CF.
The Feasibility of the Double‐Dividend Hypothesis in a Democratic Economy
Authors: Lai Yu‐Bong
Published: July 2016

The two dividends in the double‐dividend hypothesis are assumed to be independent. This assumption can be misleading when it comes to formulating policy. I construct a model where the pollution tax rate is voted for by heterogeneous people. In addition to the revenue‐recycling effect, the equilibrium pollution tax rate depends on two opposite forces: the tax‐cutting effect and the profit effect. The two forces show that an instrument that exploits a greater revenue‐recycling effect can cause a more severe environmental deterioration, thereby resulting in the infeasibility of the hypothesis. The introduction of the interdependence between the two dividends can also mean that non‐revenue‐raising instruments are more efficient than revenue‐raising instruments.
Stealing or Sharing? Cross‐Cultural Issues of Plagiarism in an Open‐Source Era
Authors: Haitch Russell
Published: July 2016

More professors and institutions want to move from a detect‐and‐punish to an educate‐and‐prevent model for dealing with plagiarism. Understanding the causes of plagiarism, especially among international students, can aid in efforts to educate students and prevent plagiarism. Research points to a confluence of causal factors, such as time pressure, language differences, and unclear rules. Though not the primary factor, ethical differences between cultures are also germane. Overall, the plight of international students summons institutions to examine their ethical norms of attribution. Plagiarism has a cultural history tied to concepts of individual creativity, but its future may look quite different in an era with increased communal sharing of ideas and images.
Does Globalisation Affect Crime? Theory and Evidence
Authors: Ghosh Arghya , Robertson Peter E. , Robitaille Marie‐Claire
Published: July 2016

Globalisation sceptics argue that trade liberalisation has high social costs, including an increase in expropriative behaviour such as civil conflict, coercion of labour and crime. We show that a theoretical relationship between trade and expropriation exists, but the sign differs for developed and developing economies. We verify this empirically using data on crime rates. Specifically, we find that trade liberalisation, as measured by both higher openness and lower import duty rates, tends to increase burglaries and theft in very labour‐abundant countries. For other countries, however, we find that trade liberalisation has either a small negative effect on crime or no effect, depending on the country's capital abundance.
A review of the roles of keratinocyte‐derived cytokines and chemokines in the pathogenesis of atopic dermatitis in humans and dogs
Authors: Asahina Ryota , Maeda Sadatoshi
Published: July 2016

Background

Dysfunction of the physical and chemical barriers of the skin may play roles in the pathogenesis of atopic dermatitis (AD) by facilitating penetration of antigens through the skin and consequently evoking aberrant immune reactions. It is now emerging that keratinocytes are actively involved in cutaneous immune reactions by producing various soluble factors initiated by inflammatory stimuli, including mechanical injury or activation of Toll‐like receptors and protease‐activated receptors. Among the soluble factors, keratinocyte‐derived cytokines and chemokines skew Type 2 helper T (Th2) cell‐dominant immune reactions, with the recruitment of Th2 cells.

Objective

To review the roles of keratinocyte‐derived cytokines and chemokines in the pathogenesis of AD in humans and dogs.

Conclusion and clinical importance

Keratinocyte‐derived cytokines such as thymus and activation‐regulated chemokine, granulocyte‐macrophage colony stimulating factor, thymic stromal lymphopoietin and interleukin‐33 are involved in the pathogenesis of human AD and possibly in canine AD. These cytokines and chemokines may possibly be used as subjective clinical markers and therapeutic targets for both human and canine AD.
A double blind, randomized, placebo controlled trial of the efficacy, quality of life and safety of food allergen‐specific sublingual immunotherapy in client owned dogs with adverse food reactions: a small pilot study
Authors: Maina Elisa , Cox Eric
Published: July 2016

Background

Food allergen‐specific sublingual immunotherapy (FA‐SLIT) has emerged as a novel and successful approach for desensitizing human patients to specific food allergens. It has not been tested in dogs.

Objective

To investigate the efficacy, quality of life (QoL), tolerability and safety ofFA‐SLITin dogs with adverse food reactions (AFR).

Methods

Dogs with provenAFRwere randomized to treatment (T group;n = 7) or placebo (P group;n = 6) to receive eitherFA‐SLIT(based on the results of a food elimination trial) or glycerinated saline, respectively. The treatment was continued daily for 6 months with fortnightly dosage escalations. To evaluate the treatment, pruritus Visual Analog Scale (pVAS), Canine Atopic Dermatitis Extent and Severity Index (CADESI‐04), QoL, faecal consistency scores, owner assessment, overall tolerability scores and blood analyses were assessed.

Results

Eleven dogs completed the study, two dogs in the T group were withdrawn by the owner afterFA‐SLITexacerbated clinical signs ofAFR. Statistical tests showed significant protection against food challenge induced clinical signs followingFA‐SLITtherapy, as indicated by reducedpVASandCADESIscores (P < 0.05). The QoL did not differ between groups. The treatment was rated as effective or quite effective by 80% of the owners, whereas placebo was rated as ineffective by all owners.

Conclusions and clinical importance

FA‐SLITwas effective, well tolerated and safe. No severe adverse events were recorded; erythema and pruritus were reported in association with only 0.7% of the dispensed doses. Larger clinical trials with more extended maintenance immunotherapy periods will be needed to provide more precise estimates of efficacy and frequency of adverse events.
Experimental Investigation of Fish Farm Hydrodynamics on 1:15 Scale Model Square Aquaculture Cages
Authors: Turner Adam A. , Jeans Tiger L. , Reid Gregor K.
Published: July 2016

Hydrodynamic drag and wake properties of square aquaculture cage arrays were studied to improve understanding of nutrient dynamics from fish cages to guide the design of integrated multitrophic aquaculture (IMTA). A 1:15 scale model array (2 × 3) of square cages was developed and deployed in a large recirculating flume tank. Drag measurements were measured for individual cages within the array relative to current velocity. Results showed the highest drag for the first row of cages, with drag reducing significantly through rows 2 and 3. A wake velocity study observed velocity deficits, wake topology, wake recovery, and turbulence in the flow fields. High-velocity deficits were measured directly behind cages within the array, causing flow to be accelerated around and below the cages. The presence of a shear layer in the wake of the cages caused high levels of turbulence downstream. These results can be used to help predict patterns of nutrients released from cages into the environment and aid in the placement of nutrient extractive species in IMTA systems.