bluuebunny/crossref_metadata_2025 huggingface dataset:
Automating maintenance for a one‐way transmitting blackboard system used for autonomous multi‐tier control
Authors: Straub Jeremy
Published: October 2016

The blackboard architecture has particular utility in applications where conclusions must be drawn in the absence of human involvement. Through properly crafted rules, this approach can determine what a collection of data may mean. This can be utilized by other onboard software to limit transmission to only relevant data or conclusions. Some applications, such as robotic exploration, may preclude or severely limit the availability of controller‐to‐craft‐agent communications. In this case, the maintenance of the system must be performed autonomously.This paper discusses common maintenance tasks that may be relevant to a long‐running blackboard‐based system (e.g. clearing extraneous data from the blackboard regularly to improve performance, archiving relevant but infrequently used data for performance enhancement). A system for automating these tasks is presented that is suitable for most blackboard‐style systems. Its particular utility to those that cannot be easily accessed is discussed. Quantitative analysis of the value of removing rules from the system is performed and presented, and these results are extrapolated to several prospective blackboard maintenance approaches.
Silicon mediates the changes in water relations, photosynthetic pigments, enzymatic antioxidants activity and nutrient uptake in maize seedling under salt stress
Authors: Sattar Abdul , Cheema Mumtaz Akhtar , Ali Hakoomat , Sher Ahmad , Ijaz Muhammad , Hussain Mubshar , Hassan Waseem , Abbas Tahira
Published: October 2016

It was hypothesized that silicon (Si) could regulate the salinity induced changes for adequate physiological adaptations against salt stress. Therefore, a pot study was conducted to assess the role of soil applied Si to improve the salt tolerance in maize seedling. Fifteen‐day‐old seedlings were subjected to four saline treatments with four replicates, namely control (no NaCl nor Si added), only Si (4 mmol L−1 Si), only salinity (40 mmol L−1 NaCl) and salinity + Si (40 mmol L−1 NaCl with 4 mmol L−1 Si) as salt concentration. Salt stress imposed negative impacts on plant growth attributes (root and shoot length, fresh and dry weight of root and shoot, seedlings biomass), water relations and photosynthetic pigments. In contrast, the supplementation of Si under stressed and normal growing conditions stimulated plant growth attributes, water relations and photosynthetic pigments. An increase in antioxidant enzyme activity was noted under stressed conditions, which was more pronounced in plants that experienced Si application. Silicon application under stressed conditions lowered the total soluble protein contents. It also regulated the ionic contents of the cell by restricting the sodium (Na+) and improving potassium (K+) contents. To conclude that soil applied Si was found a potential nutrient for reducing the negative effects of salinity and improving the growth of maize seedlings.
Helicobacter pylori infection and its related factors in junior high school students in Nagano Prefecture, Japan
Authors: Nakayama Yoshiko , Lin Yingsong , Hongo Minoru , Hidaka Hiroya , Kikuchi Shogo
Published: October 2016

Background

There have been few reports on Helicobacter pylori (H. pylori) infection in asymptomatic Japanese children and adolescents. We hypothesized that the prevalence of H. pylori infection is very low among Japanese children and that clinical variables such as serum pepsinogen and iron levels are associated with H. pylori infection.

Materials and Methods

We conducted a cross‐sectional analysis of a sample of 454 junior high school students aged 12‐15 years in four areas in Nagano Prefecture. A commercial ELISA kit (E‐plate Eiken H. pylori antibody) was used to measure IgG antibody against H. pylori. Serum pepsinogen and iron levels were also measured using standard methods. A urea breath test was performed for seropositive students.

Results

The overall prevalence of H. pylori was 3.1% (14/454). There were no significant differences in H. pylori prevalence among mountain, rural, and urban areas. The mean level of both serum pepsinogen (PG I) and PG II was significantly increased in the seropositive subjects compared with the seronegative subjects. When the cutoff values for adults (PG I: 70 ng/mL and PG I/II ratio: 3) were used, 4 of 14 subjects had PG I ≤70 ng/mL and PG I/II ratio ≤3. The results of a logistic regression analysis showed that low serum iron levels were significantly associated with H. pylori infection (P=.02).

Conclusions

The prevalence of H. pylori infection is as low as 3% among junior high school students aged 12‐15 years in Japan. The disappearance of H. pylori is accelerating in Japanese children.
Is there a role for patients and their relatives in escalating clinical deterioration in hospital? A systematic review
Authors: Albutt Abigail K. , O'Hara Jane K. , Conner Mark T. , Fletcher Stephen J. , Lawton Rebecca J.
Published: October 2016

Background

Measures exist to improve early recognition of, and response to, deteriorating patients in hospital. However, deteriorating patients continue to go unrecognized. To address this, interventions have been developed that invite patients and relatives to escalate patient deterioration to a rapid response team (RRT).

Objective

To systematically review articles that describe these interventions and investigate their effectiveness at reducing preventable deterioration.

Search strategy

Following PRISMA guidelines, four electronic databases and two web search engines were searched to identify literature investigating patient and relative led escalation.

Inclusion criteria

Articles investigating the implementation or use of systems involving patients and relatives in the detection of clinical patient deterioration and escalation of patient care to address any clinical or non‐clinical outcomes were included. Articles’ eligibility was validated by a second reviewer (20%).

Data extraction

Data were extracted according to pre‐defined criteria.

Data synthesis

Narrative synthesis was applied to included studies.

Main results

Nine empirical studies and 36 grey literature articles were included in the review. Limited studies were conducted to establish the clinical effectiveness of patient and relative led escalation. Instead, studies investigated the impact of this intervention on health‐care staff and available resources. Although appropriate, this reflects the infancy of research in this area. Patients and relatives did not overwhelm resources by activating the RRT. However, they did activate it to address concerns unrelated to patient deterioration.

Conclusions

Activating a RRT may not be the most appropriate or cost‐effective method of resolving non‐life‐threatening concerns.
Bumblebees depend on ericaceous species to survive in temperate heathlands
Authors: Moquet Laura , Vanderplanck Maryse , Moerman Romain , Quinet Muriel , Roger Nathalie , Michez Denis , Jacquemart Anne‐Laure
Published: October 2016

Bumblebees are the predominant wild pollinators for many plant species in temperate regions. A bumblebee colony requires pollen and nectar throughout its lifetime, but degraded and fragmented habitats may have gaps in the temporal and spatial continuity of floral resources.

Heathlands are open biotopes that provide favourable habitat for bumblebees like Bombus jonellus, a declining species in Belgium. In heathlands, ericaceous species are the main plants that provide pollen and nectar for bumblebees. Although the nectar composition of ericaceous species has been previously studied, data on pollen composition remain scarce.

We examined bumblebee diets (composition of their pollen loads) in Belgian heathlands over the course of a colony lifetime to assess the fidelity of bumblebees for ericaceous species. We compared nutritional values by investigating the chemical composition (amino acids, polypeptides and sterols) of the pollen of the ericaceous and dominant non‐ericaceous species present in pollen loads. No relationship was detected between the abundance of a particular plant species in bumblebee loads and its pollen composition.

The successive flowering periods and the nutritional quality of pollen of ericaceous species offer valuable resources for bumblebees. Ericaceous species represent a large part of bumblebee diets in heathlands, especially in early spring and late summer when the diversity of other flowering species was low.

Bumblebee pollen loads also contained non‐ericaceous flowering species that grow outside heathlands. Thus, land planning must incorporate conservation strategies for the different elements of the landscape matrix, including heathlands, peatlands, meadows and margins.
Interrelationships of child appetite, weight and snacking among Hispanic preschoolers
Authors: Rudy E. , Bauer K. W. , Hughes S. O. , O'Connor T. M. , Vollrath K. , Davey A. , Correa N. E. M. , Chen T.‐A. , Fisher J. O.
Published: October 2016

Background

Snacking among US preschoolers has increased in recent decades, raising questions about whether snacking contributes to dietary excess.

Objectives

This research aimed to characterize snacking contributions to dietary excess and to evaluate associations with appetite and weight among preschool‐aged children.

Methods

This study is a cross‐sectional, observational study of 187 Hispanic low‐income preschoolers. Three 24‐h dietary recalls were used to assess snacking frequency and parameters of dietary excess including energy, saturated fat, trans fats and added sugars. Parental reports of child satiety responsiveness, food responsiveness, and enjoyment of food were obtained. Child height and weight were measured.

Results

Children consumed 28% (395 kcal) of daily energy from snacks eaten at 2.3 ± 1.0 occasions per day. Greater snacking frequency was associated with greater daily intakes of energy (p < 0.05) and added sugars (p < 0.001). Among overweight/obese children, higher enjoyment of food was associated with more frequent snacking and greater energy intake from snacks (p = 0.01). Inverse associations of enjoyment of food with snacking frequency and energy intake were seen among normal weight children (p < 0.05).

Conclusions

More frequent snacking among low‐income Hispanic preschoolers may contribute to excessive intakes of energy and added sugars, particularly among overweight/obese children with greater motivation to eat.
Predictors for clinical deterioration of mental state in patients assessed by telephone‐based mental health triage
Authors: Sands Natisha , Elsom Stephen , Corbett Rebecca , Keppich‐Arnold Sandra , Prematunga Roshani , Berk Michael , Considine Julie
Published: October 2016

Patient safety research focussing on recognizing and responding to clinical deterioration is gaining momentum in generalist health, but has received little attention in mental health settings. The focus on early identification and prompt intervention for clinical deterioration enshrined in patient safety research is equally relevant to mental health, especially in triage and crisis care contexts, yet the knowledge gap in this area is substantial. The present study was a controlled cohort study (n = 817) that aimed to identify patient and service characteristics associated with clinical deterioration of mental state indicated by unplanned admission to an inpatient psychiatric unit following assessment by telephone‐based mental health triage. The main objective of the research was to produce knowledge to improve understandings of mental deterioration that can be used to inform early detection, intervention, and prevention strategies at the point of triage. The results of the study found that the clinical profile of admitted patients was one of complexity and severity. Admitted patients were more likely to have had complex psychiatric histories with multiple psychiatric admissions, severe psychotic symptoms, a history of treatment non‐adherence, and poorer social functioning than non‐admitted patients.
Inflammatory markers in saliva as indicators of gingival inflammation in cerebral palsy children with and without cervical motor control
Authors: Santos Maria Teresa Botti Rodrigues , Diniz Michele Baffi , Guaré Renata Oliveira , Ferreira Maria Cristina Duarte , Gutierrez Gabriela Mancia , Gorjão Renata
Published: October 2016

Aim

To evaluate the relation among gingival inflammation, salivary osmolality, levels of IL‐1β, IL‐6, IL‐8, TNF‐α, and s‐IgA concentrations in children with spastic CP with or without cervical motor control in a cross‐sectional study.

Design

Unstimulated whole saliva and the gingival index were collected in 37 and 34 CP children with and without cervical motor control, respectively. The data were dichotomized as follows: (=0) absence of gingival inflammation and (≥0.1) presence of gingival inflammation.

Results

The group without cervical control presented statistically higher mean values of salivary osmolality, s‐IgA, and cytokines. In addition, statistically positive correlation between the gingival index and salivary cytokines was observed in the group with cervical control. Salivary osmolality, salivary cytokines, and s‐IgA from both groups presented a significant positive correlation. Significant differences (P = 0.00336) in the values of salivary osmolality were observed between the CP individuals with (93.9 ± 32.7) and without gingival inflammation (74.4 ± 16.6). ROC analysis was performed, and values of salivary osmolality >80 indicated a sensitivity of 0.54 and a specificity of 0.79.

Conclusions

Children without cervical motor control presented a more pronounced oral inflammatory status that was characterized by higher levels of cytokines.
Incorporation of Al and Na in Hydrothermally Synthesized Tobermorite
Authors: Wang Zehua , Ma Shuhua , Zheng Shili , Wang Xiaohui
Published: October 2016

Calcium silicate hydrate and its Al‐substituted form synthesized by a hydrothermal process were investigated by X‐ray diffraction, compositional analysis, and magic‐angle spinning nuclear magnetic resonance (MAS NMR) spectroscopy, in order to determine the mechanism of Al and Na incorporation in the tobermorite structure with varying molar ratios of Ca/Si and Al/Si. At a high molar ratio of Ca/Si, the silicate chains of tobermorite are ruptured, the degree of polymerization of the silicate chains is lowered, and the high calcium concentration lowers the content of Na2O in the structure. Solid‐state 29Si and 27Al MAS NMR spectroscopy confirm that all Al atoms were incorporated in the silicate chains of tobermorite. The tetrahedrally coordinated Al (Al(IV)) could either act as the bridging tetrahedron () for the dreierketten chain of tobermorite, or be present in Q3 sites that link two dreierketten chains together. Therefore, the degree of polymerization of the silicate chains of tobermorite is increased at high molar ratio of Al/Si. Furthermore, the greater charge deficit due to the replacement of Si4+ by Al3+ ions is compensated by increased adsorption or binding of Na+.
Piezoelectric and ferroelectric properties of (Bi,Na)TiO3–(Bi,Li)TiO3–(Bi,K)TiO3 ceramics for accelerometer application
Authors: Lee Gyoung‐Ja , Kim Byung‐Hoon , Yang Sun‐A , Park Jin‐Ju , Bu Sang‐Don , Lee Min‐Ku
Published: October 2016

The piezoelectric and ferroelectric properties of 0.76(Bi0.5Na0.5)TiO3–0.04(Bi0.5Li0.5)TiO3–0.2(Bi0.5K0.5)TiO3 (abbreviated as 0.76BNT–0.04BLT–0.2BKT) ceramics were investigated to clarify the optimal sintering temperature, and the vibration characteristics were examined for a compression‐mode accelerometer assembly in which 0.76BNT–0.04BLT–0.2BKT ceramics sintered at the optimized temperature served as the piezoelectric elements. The increase in the grain size of the 0.76BNT–0.04BLT–0.2BKT ceramics with the sintering temperature provides a beneficial contribution to the piezoelectric coefficient; however, it detrimentally contributes to the depolarization temperature. The charge sensitivity of the prototype accelerometers was evaluated with changes in the seismic mass and the layer number of the piezoceramics. The deviation between the theoretical and measured values of charge sensitivity was less than 10%.
Reducing patient delay in Acute Coronary Syndrome (RAPiD): research protocol for a web‐based randomized controlled trial examining the effect of a behaviour change intervention
Authors: Farquharson Barbara , Johnston Marie , Smith Karen , Williams Brian , Treweek Shaun , Dombrowski Stephan U , Dougall Nadine , Abhyankar Purva , Grindle Mark
Published: October 2016

Aims

To evaluate the efficacy of a behaviour change technique–based intervention and compare two possible modes of delivery (text + visual and text‐only) with usual care.

Background

Patient delay prevents many people from achieving optimal benefit of time‐dependent treatments for acute coronary syndrome. Reducing delay would reduce mortality and morbidity, but interventions to change behaviour have had mixed results. Systematic inclusion of behaviour change techniques or a visual mode of delivery might improve the efficacy of interventions.

Design

A three‐arm web‐based, parallel randomized controlled trial of a theory‐based intervention.

Methods

The intervention comprises 12 behaviour change techniques systematically identified following systematic review and a consensus exercise undertaken with behaviour change experts. We aim to recruit n = 177 participants who have experienced acute coronary syndrome in the previous 6 months from a National Health Service Hospital. Consenting participants will be randomly allocated in equal numbers to one of three study groups: i) usual care, ii) usual care plus text‐only behaviour change technique‐based intervention or iii) usual care plus text + visual behaviour change technique‐based intervention. The primary outcome will be the change in intention to phone an ambulance immediately with symptoms of acute coronary syndrome ≥15‐minute duration, assessed using two randomized series of eight scenarios representing varied symptoms before and after delivery of the interventions or control condition (usual care). Funding granted January 2014.

Discussion

Positive results changing intentions would lead to a randomized controlled trial of the behaviour change intervention in clinical practice, assessing patient delay in the event of actual symptoms.

Trial registration

Registered at ClinicalTrials.gov: NCT02820103.
Developing an Easy Read Version of the Adult Social Care Outcomes Toolkit (ASCOT)
Authors: Turnpenny Agnes , Caiels James , Whelton Beckie , Richardson Lisa , Beadle‐Brown Julie , Crowther Tanya , Forder Julien , Apps Joanna , Rand Stacey
Published: October 2016

Background

This study reports the experiences of developing and pre‐testing an Easy Read version of the Adult Social Care Outcomes Toolkit (ASCOT) for self‐report by people with intellectual disabilities.

Methods

The study has combined survey development and pre‐testing methods with approaches to create accessible information for people with intellectual disabilities. A working group assisted researchers in identifying appropriate question formats, pictures and wording. Focus groups and cognitive interviews were conducted to test various iterations of the instrument.

Results

Substantial changes were made to the questionnaire, which included changes to illustrations, the wording of question stems and response options.

Conclusions

The process demonstrated the benefits of involving people with intellectual disabilities in the design and testing of data collection instruments. Adequately adapted questionnaires can be useful tools to collect information from people with intellectual disabilities in survey research; however, its limitations must be recognized.
Credit Ratings and Earnings Management around IPOs
Authors: Gounopoulos Dimitrios , Pham Hang
Published: October 2016

This study examines the impact of having a credit rating on earnings management (EM) through accruals and real activities manipulation by initial public offering (IPO) firms. We find that firms going public with a credit rating are less likely to engage in income‐enhancing accrual‐based and real EM in the offering year. The monitoring by a credit rating agency (CRA) and the reduced information asymmetry due to the provision of a credit rating disincentivise rated issuers from managing earnings. We also suggest that the participation of a reputable auditing firm is crucial for CRAs to effectively restrain EM. Moreover, we document that for unrated issuers, at‐issue income‐increasing EM is not linked to future earnings and is negatively related to post‐issue long‐run stock performance. However, for rated issuers, at‐issue income‐increasing EM is positively associated with subsequent accounting performance and is unrelated to long‐run stock performance following the offering. The evidence indicates that managers in unrated firms generally manipulate earnings to mislead investors, while managers in rated firms tend to exercise their accounting and operating discretion for informative purposes.
Effect of the extract and compound from Solanum nigrum Linn on Tetranychus cinnabarinus
Authors: Chen Y. J. , Dai G. H.
Published: October 2016

The carmine spider mite Tetranychus cinnabarinus (Boisduval) is a serious pest affecting various glasshouse vegetables, fruits and crops and causes significant damage to crop yields and quality by piercing and sucking foliar tissues. The control of this mite primarily involves the application of synthetic chemical pesticides. In this study, a Solanum nigrum L. extract was evaluated for its potential acaricidal activity against adult female T. cinnabarinus in laboratory conditions, and the S. nigrum extract showed marked efficacy in controlling the carmine spider mite both in vitro and in potted seedlings. Furthermore, the active compound, a phytostanol ester (β‐sitosterol‐3‐O‐heptadeca‐8Z, 11Z‐dienoate), was isolated from the petroleum ether‐soluble fraction of S. nigrum extract via repeated column chromatography and identified based on its physiochemical properties and spectral data. At 7 days after treatment in a potted seedling experiment, the LC50 values of the S. nigrum extract and active compound were found to be 4.70 and 1.85 g/l, respectively. All of these results demonstrated that the S. nigrum extract and its active component exhibit the potential for use as new natural acaricides for controlling carmine spider mites.
A Brief Dietary Assessment Predicts Executive Dysfunction in an Elderly Cohort: Results from the Einstein Aging Study
Authors: Sundermann Erin E. , Katz Mindy J. , Lipton Richard B. , Lichtenstein Alice H. , Derby Carol A.
Published: October 2016

Objectives

To examine the association between diet and executive function, episodic memory and global verbal cognition in the Einstein Aging Study (EAS) cohort and determine whether race modifies this relationship.

Design

Cross‐sectional.

Setting

Community.

Participants

EAS participants without dementia who completed the Rapid Eating and Activity Assessment for Patients (REAP) (N = 492).

Measurements

The previously validated REAP is based on the 2000 U.S. dietary guidelines. REAP scores were dichotomized as less‐healthy (<median) or healthier (≥median) diet. Nine neurocognitive tests underwent principle component analysis, revealing three significant orthogonal components: episodic memory, executive function, and global cognition. Impaired cognitive function in each domain was defined as 2 standard deviations (SD) or more below the mean on any task or a total score of 1.5 SD or more below the mean. Using logistic regression, the association between diet and cognitive impairment was assessed, adjusting for age, education, sex, cardiovascular comorbidities, hypertension, body mass index, diabetes mellitus, depressive symptoms, race, and the interaction between race and diet group.

Results

The sample was 60% female and 74% white and had a mean age of 80. In the entire sample, impaired executive function was associated with the interaction between race and diet group (P = .08), whereas other cognitive domains were not. In race‐stratified analyses, healthier diet was associated with lower odds of impaired executive function in whites (odds ratio (OR) = 0.44, 95% confidence interval (CI) = 0.21–0.93, P = .03), as were healthier scores on the saturated fat subscale (OR = 0.34, 95% CI = 0.16–0.71, P = .004). In blacks, REAP scores were not associated with cognitive domains.

Conclusion

Healthy diet was associated with lower risk of executive dysfunction in whites. Race differences may be due to greater vascular risk in blacks or differences in generalizability of the REAP.
Cardioprotective potential of curcumin against norepinephrine‐induced cell death: a microscopic study
Authors: MANGHANI C. , GUPTA A. , TRIPATHI V. , RANI V.
Published: October 2016

Cardiomyopathy and associated heart failure continues to be one of the most severe complications that threaten a large population. Curcumin, one of the three curcuminoids of the spice turmeric, is very well known for a multitude of health benefits and functions. Norepinephrine (NE), a catecholamine and also a stress hormone may cause the cardiomyocytes to develop increased sensitivity to death with its increasing concentrations. In this study, we investigated the cardioprotective effect of curcumin in NE‐induced cardiac apoptosis using several fluorescent and nonfluorescent microscopic techniques like DAPI, PI, Giemsa, PicroSirius and TUNEL. The aim of the study was to assess the effect of curcumin in preventing the occurrence of features underlying apoptosis such as nuclear disruption, chromatin condensation, DNA fragmentation and alterations in mitochondrial membrane permeability. Our results show that curcumin protects the cardiomyocytes against apoptosis significantly and also helps them to revert to their normal physiological state. Hence, we propose that curcumin has the potential to act as a therapeutic agent for the attenuation of NE‐induced cardiac cell death and modulation of apoptosis in H9c2 cardiomyocytes.
A Mixed‐Methods Study of Vicarious Posttraumatic Growth In Certified Nurse‐Midwives
Authors: Beck Cheryl Tatano , Rivera Jamie , Gable Robert K.
Published: October 2016

Introduction

The purpose of this mixed‐methods study was to investigate vicarious posttraumatic growth in certified nurse‐midwives (CNMs) who have struggled after attending traumatic births. Vicarious posttraumatic growth involves positive changes in a clinician's life due to caring for patients who are traumatized.

Methods

A convergent parallel mixed‐methods design was used. The American College of Nurse‐Midwives (ACNM) sent out e‐mails to all CNM members with a link to the electronic survey. CNMs completed the Posttraumatic Growth Inventory and the Core Beliefs Inventory in the quantitative portion. For the qualitative portion CNMs responded to a statement asking them to describe their experiences of any positive changes in their beliefs or life after attending traumatic births. IBM SPSS 23.0 and Krippendorff's content analysis were used to analyze the quantitative and qualitative data, respectively.

Results

The sample consisted of 425 CNMs who completed the quantitative portion and 315 (74%) who completed the qualitative portion. CNMs reported a small degree of both disruption of their core beliefs and vicarious posttraumatic growth. Personal Strength was the dimension of the Posttraumatic Growth Inventory that reflected the highest growth, followed by Appreciation of Life, Relating to Others, Spiritual Change, and New Possibilities. In the qualitative findings, Personal Strength was also the category of vicarious posttraumatic growth most frequently described.

Discussion

This study confirmed a positive relationship between the degree that a CNM's core beliefs are challenged and the amount of vicarious posttraumatic growth that is experienced. The qualitative comments of the CNMs matched the quantitative scores of the Posttraumatic Growth Inventory.
Provider Perspectives on Safety in Primary Care in Albania
Authors: Gabrani Jonila Cyco , Knibb Wendy , Petrela Elizana , Hoxha Adrian , Gabrani Adriatik
Published: October 2016

Purpose

The purpose of this study was to determine the safety attitudes of specialist physicians (SPs), general physicians (GPs), and nurses in primary care in Albania.

Design

The study was cross‐sectional. It involved the SPs, GPs, and nurses from five districts in Albania. A demographic questionnaire and the adapted Safety Attitudes Questionnaire (SAQ)‐Long Ambulatory Version A was used to gather critical information regarding the participant's profile, perception of management, working conditions, job satisfaction, stress recognition, safety climate, and perceived teamwork.

Methods

The onsite data collectors distributed questionnaires at the primary care clinics and then collected them. Descriptive statistics were used to summarize the responses. The significance of mean difference among SPs, GPs, and nurses was tested using analysis of variance.

Findings

Five hundred twenty‐three questionnaires were completed. The concept of patient safety in relation to job satisfaction received the highest ratings. Stress recognition had low ratings. There was a high level of teamwork in SPs, GPs, and nurses. Healthcare staff agreed that it was difficult to discuss errors in their primary healthcare center. Physicians in contrast to nurses were most likely to affirm that they do not make errors in hostile situations.

Conclusions

Errors are difficult to discuss. It was clear that primary care staff, such as physicians, never considered the likelihood of errors occurring during tense situations.

Clinical Relevance

Staff at primary healthcare centers are used to adverse events and errors. Despite the demand for safety improvement and the existing evidence on the epidemiology of outpatient medical errors, most research has only been conducted in hospital settings. Many patients are put at risk and some are harmed as a result of adverse events in primary care. Adequate communication and technical skills should be utilized by primary care providers (PCPs) for improvement of patient safety. The patient safety measures should include assessment of the safety attitudes of PCPs.
Use of new targeted cancer therapies in children: effects on dental development and risk of jaw osteonecrosis: a review
Authors: Hernandez Magali , Phulpin Bérengère , Mansuy Ludovic , Droz Dominique
Published: October 2016

New targeted cancer therapies such as bisphosphonates, denosumab, and bevacizumab are routinely used in adult for the past decades. Their introduction into pediatric medicine is more recent that means there is a paucity of data on long‐term effects on dental development and on the risk of osteonecrosis of jaw. This study aimed to outline adverse effects of new targeted cancer therapies on oral cavity including dental abnormalities observed in pediatric population treated with these molecules and the risk of osteonecrosis of the jaw (ONJ). The impact of bisphosphonates and denosumab on bone remodeling (inhibition of osteoclasts) could interfere with teeth exfoliation and eruption processes, causing a tooth eruption delay. This hypothesis was confirmed, bisphosphonate‐treated rats presented tooth eruption delay, and bisphosphonate therapy was associated with a mean delay of 1.67 years in tooth eruption in children with osteogenesis imperfecta. Another study showed that the inhibition of RANK/RANKL by denosumab was associated with a lack of tooth eruption in animals. Several animal studies reported that bisphosphonate could also induce dental abnormalities including defective amelogenesis and dentinogenesis in rats, but there is no evidence of such effects in children; only one case of enamel hypoplasia in a child treated for idiopathic arterial calcification with bisphosphate was reported. To date, there has been no reported case of ONJ in children treated with bisphosphonates, denosumab, or bevacizumab.
From ideals to resignation – interprofessional teams perspectives on everyday life processes in psychiatric inpatient care
Authors: Molin Jenny , Graneheim Ulla Hällgren , Ringnér Anders , Lindgren Britt‐Marie
Published: October 2016

Accessible summary

What is known on the subject?

Psychiatric inpatient care has been described by both ward staff and patients as being demanding and disorganized, lacking opportunities for quality interactions in everyday life through joint activities.

Qualitative research on interprofessional teams' perspectives on everyday life processes in psychiatric inpatient care is lacking.

What this paper adds to existing knowledge?

Staff have ideals about care and collaboration, but the obstacles they face in everyday life, such as a poor environment, power asymmetry, lacking structure and the demands of managing chaos, mean that they appear to resign and shift focus from the patients' best interests to self‐survival.

Different professions in general describe the same obstacles in everyday life on the wards but there are also profession‐specific perspectives on distancing and feelings of abandonment. To our knowledge, these findings have not been reported in the international evidence.

What are the implications for practice?

Given these findings we suggest interventions such as Protected Engagement Time as well as reflective dialogues within interprofessional teams.

This would help staff to resume their caring role in everyday life in psychiatric inpatient care and put their ideals into practice.

Introduction

Patients and ward staff describe psychiatric inpatient care as demanding, characterized by unpredictable events, yet research on interprofessional teams perspectives of everyday life processes in psychiatric inpatient care lacks.

Aim

This study aims to explore everyday life processes in psychiatric inpatient care, as reported by staff in interprofessional teams.

Method

A grounded theory design was used and 36 participants were interviewed.

Results

The analysis resulted in a process‐oriented core category From ideals to resignation. Related to this core category were three further categories: Knowing where to go, Walking a path of obstacles and Shifting focus from the patient's best interests to self‐survival. The staff had ideals about care and collaboration, but a poor environment, power asymmetry, lacking structure and demands of managing chaos meant that they appeared to resign from putting their ideals into practice.

Discussion

Different professions in general describe the same obstacles in everyday life on the wards but there are also profession‐specific perspectives on distancing and feelings of abandonment. To our knowledge similar findings have not been reported in the international evidence.

Implications

In order to support interprofessional teams to work according to their ideals, interventions such as Protected Engagement Time and reflective dialogues within the teams are suggested.
Alien versus predators: effective induced defenses of an invasive frog in response to native predators
Authors: Pujol‐Buxó E. , García‐Guerrero C. , Llorente G. A.
Published: October 2016

Inducible defenses enhance fitness of prey living in environments with unpredictable predation risk, but these plastic reactions depend on the detection of the threat by the prey. To anuran larvae confronted with unknown predators, only prey‐borne cues are noticeable, generally triggering either an incomplete set of reactions or no response at all. Thus, we should expect a certain disadvantage for establishing invasive anurans if tadpoles are unable to recognize local predators. Here, we test the presence and effectiveness of inducible defenses in tadpoles of the invasive frog Discoglossus pictus confronting two native predators. Using both lab and mesocosm experiments, we also evaluate the effects these predators may exert on the invasive frog populations. Interestingly, although D. pictus has been introduced from another continent, its native (African) and invasive (European) ranges are included in the same ecoregion (Mediterranean Basin), sharing several genera and species of aquatic predators. In both experiments and using both invertebrates, tadpoles responded to the native predators, and our results match those usually reported in similar predator‐prey systems using combinations of native species. Moreover, these reactions seem clearly effective in reducing mortality and injury rates of D. pictus tadpoles. We believe that the introduced frog is highly benefiting from a previous knowledge of populations of these or similar predator species. Therefore, even though native and invasive ranges of D. pictus are in different continents, the similarity of predator communities of both areas may be advantageous for its establishment and expansion.
Fossorial and durophagous: implications of molluscivory for head size and bite capacity in a burrowing worm lizard
Authors: Baeckens S. , García‐Roa R. , Martín J. , Ortega J. , Huyghe K. , Van Damme R.
Published: October 2016

Limbless animals that burrow head‐first are often considered to be evolutionarily constrained in the development of a large head, due to limitations imposed while penetrating the soil. Whilst animals with a small head experience less resistance when digging, they are believed to have a weak bite, hence restricting their potential dietary spectrum to soft prey. Yet, recent findings established molluscivory in the fossorial worm lizard Trogonophis wiegmanni (Amphisbaenia), suggesting a high bite capacity for this burrowing species necessary to crush snail shells. To tackle this burrow/crush dilemma, we examined the relationship between head morphology, bite force and gastropod diet in T. wiegmanni males and females. In vivo bite force analyses and shell hardness measurements were used to assess the potential dietary spectrum of the amphisbaenians. In addition, phylogenetic analyses were performed to put T. wiegmanni's head size and bite force into an interspecific comparative context. Our results show a strong positive relation between head size and bite force, and we found no evidence for sexual dimorphism. In sharp contrast to other durophagous lizards, T. wiegmanni combines a relatively small body and a (disproportionally) small head with relatively high biting forces. In fact, T. wiegmanni is able to crush a wide array of the most abundant gastropod shells in their environment. However, the head size of the strongest biters imposes a limitation towards a common alternative snail‐feeding strategy: entering the opening of the gastropod shell. This study shows that head size, and consequently bite force, increases the number and variety of gastropods that can be consumed by ‘shell‐crushing’, but reduces the number and variety of snails that can be consumed by ‘shell‐entering’, and vice versa. The cranial design of (durophagous) limbless burrowers may therefore not only evolve under constraints for efficient soil penetration, but also through selection for diet.
Early and dynamic colonization of Central America drives speciation in Neotropical army ants
Authors: Winston Max E. , Kronauer Daniel J. C. , Moreau Corrie S.
Published: October 2016

The emergence of the Isthmus of Panama is one of the most important events in recent geological history, yet its timing and role in fundamental evolutionary processes remain controversial. While the formation of the isthmus was complete around 3 million years ago (Ma), recent studies have suggested prior intercontinental biotic exchange. In particular, the possibility of early intermittent land bridges facilitating colonization constitutes a potential mechanism for speciation and colonization before full closure of the isthmus. To test this hypothesis, we employed genomic methods to study the biogeography of the army ant genus Eciton, a group of keystone arthropod predators in Neotropical rainforests. Army ant colonies are unable to disperse across water and are therefore ideally suited to study the biogeographic impact of land bridge formation. Using a reduced representation genome sequencing approach, we show that all strictly Central American lineages of Eciton diverged from their respective South American sister lineage between 4 and 7 Ma, significantly prior to the complete closure of the isthmus. Furthermore, three of the lineage pairs form extensive and coincident secondary contact zones in Costa Rica and Nicaragua, with no evidence of gene flow. Such a discrete and repeated biogeographic pattern indicates at least two waves of army ant dispersal into Central America that were separated by significant genetic divergence times. Thus, by integrating phylogenomic, population genomic and geographic evidence, we show that early colonization of Central America across the emerging Isthmus of Panamá drove parallel speciation in Eciton army ants.
Habituation and Hermeneutics: Toward a Thomistic Account of Pre‐Understanding
Authors: Walkey Jeffrey
Published: October 2016

Human existence entails that our encounter with the world is mediated by the context, historicity, and concrete particularities of that existence. Consequently, this situatedness, which contributes to our pre‐understanding, makes us more or less capable of “seeing” the truth of the world we encounter. The hermeneutical principle of pre‐understanding is sometimes presupposed to be ambivalent toward, if not in opposition to, traditional metaphysics. The present essay shows how traditional metaphysics, specifically of a Thomistic sort, need not be pitted against hermeneutics, but rather, offers the ground for understanding the way in which pre‐understanding, as our habituation into and connaturality with truth, and ultimately, God, is that means by which right interpretation is made possible.
Baseline impedance measured during high‐resolution esophageal impedance manometry reliably discriminates GERD patients
Authors: Ravi K. , Geno D. M. , Vela M. F. , Crowell M. D. , Katzka D. A.
Published: October 2016

Background

Baseline impedance measured with ambulatory impedance pH monitoring (MII‐pH) and a mucosal impedance catheter detects gastroesophageal reflux disease (GERD). However, these tools are limited by cost or patient tolerance. We investigated whether baseline impedance measured during high‐resolution impedance manometry (HRIM) distinguishes GERD patients from controls.

Methods

Consecutive patients with clinical HRIM and MII‐pH testing were identified. Gastroesophageal reflux disease was defined by esophageal pH <4 for ≥5% of both the supine and total study time, whereas controls had an esophageal pH <4 for ≤3% of the study performed off PPI. Baseline impedance was measured over 15 seconds during the landmark period of HRIM and over three 10 minute intervals during the overnight period of MII‐pH.

Key Results

Among 29 GERD patients and 26 controls, GERD patients had a mean esophageal acid exposure time of 22.7% compared to 1.2% in controls (P<.0001). Mean baseline impedance during HRIM was lower in GERD (1061 Ω) than controls (2814 Ω) (P<.0001). Baseline mucosal impedance measured during HRIM and MII‐pH correlated (r=0.59, P<.0001). High‐resolution esophageal manometry baseline impedance had high diagnostic accuracy for GERD, with an area under the curve (AUC) of 0.931 on receiver operating characteristics (ROC) analysis. A HRIM baseline impedance threshold of 1582 Ω had a sensitivity of 86.2% and specificity of 88.5% for GERD, with a positive predictive value of 89.3% and negative predictive value of 85.2%.

Conclusions & Inferences

Baseline impedance measured during HRIM can reliably discriminate GERD patients with at least moderate esophageal acid exposure from controls. This diagnostic tool may represent an accurate, cost‐effective, and less invasive test for GERD.
Biology and evolution of arbuscular mycorrhizal symbiosis in the light of genomics
Authors: Kamel Laurent , Keller‐Pearson Michelle , Roux Christophe , Ané Jean‐Michel
Published: October 2016

Arbuscular mycorrhizal (AM) fungi associate with the vast majority of land plants, providing mutual nutritional benefits and protecting hosts against biotic and abiotic stresses. Significant progress was made recently in our understanding of the genomic organization, the obligate requirements, and the sexual nature of these fungi through the release and subsequent mining of genome sequences. Genomic and genetic approaches also improved our understanding of the signal repertoire used by AM fungi and their plant hosts to recognize each other for the initiation and maintenance of this association. Evolutionary and bioinformatic analyses of host and nonhost plant genomes represent novel ways with which to decipher host mechanisms controlling these associations and shed light on the stepwise acquisition of this genetic toolkit during plant evolution. Mining fungal and plant genomes along with evolutionary and genetic approaches will improve understanding of these symbiotic associations and, in the long term, their usefulness in agricultural settings.

Contents

Summary
531

I.
Introduction
531

II.
Genomics of arbuscular mycorrhizal fungi
532

III.
Genomic insights into the obligate nature of arbuscular mycorrhizal fungi
532

IV.
Interdisciplinary approaches to unravel the host–symbiont interactome
534

V.
Evolution of mycorrhizal associations revealed by comparative genomics
534

Acknowledgements
535

References
535
Between GERD and NERD: the relevance of weakly acidic reflux
Authors: de Bortoli Nicola , Ottonello Andrea , Zerbib Frank , Sifrim Daniel , Gyawali C. Prakash , Savarino Edoardo
Published: October 2016

Nonerosive reflux disease (NERD) is a common condition and the most frequent phenotype of gastroesophageal reflux disease (GERD). NERD is extremely heterogeneous and includes patients with negative endoscopy but abnormal esophageal acid exposure and/or positive reflux–symptom association analysis (hypersensitive esophagus). This segregation is only possible owing to the use of impedance–pH monitoring. Indeed, weakly acidic reflux represents one of the most common causes of refractory symptoms in patients evaluated off antisecretory therapy and, more importantly, during antisecretory drug treatment. Patients with heartburn who do not have any type of reflux underlying their symptoms (functional heartburn) must be excluded from the category of GERD. The drawbacks of impedance–pH are mainly due to the day‐to‐day variability of the test and the fact that the accuracy of the symptom–reflux correlation scores is often far from perfect. Some histopathological characteristics, such as dilated intercellular spaces, can be helpful in distinguishing patients with NERD through esophageal biopsies. Patients with NERD in whom acid is the main pathogenetic factor respond successfully to proton pump inhibitor therapy, while those with hypersensitive esophagus to weakly acidic reflux could be treated with reflux inhibitors or surgery, although further controlled studies are required.