bluuebunny/crossref_metadata_2025 huggingface dataset:
Cpk2, a catalytic subunit of cyclic AMP-PKA, regulates growth and pathogenesis in rice blast
Authors: Selvaraj Poonguzhali , Shen Qing , Yang Fan , Naqvi Naweed I.
Published: August 2017

The cAMP-Protein Kinase A signalling, anchored on CpkA, is necessary for appressorium development and host penetration, but indispensable for infectious growth inMagnaporthe oryzae. In this study, we identified and characterized the gene encoding the second catalytic subunit,CPK2, whose expression was found to be lower compared toCPKAat various stages of pathogenic growth inM. oryzae. Deletion ofCPK2 caused no alterations in vegetative growth, conidiation, appressorium formation, or pathogenicity. Surprisingly, thecpkAΔcpk2Δ double deletion strain displayed significant reduction in growth rate and conidiation compared to the single deletion mutants. Interestingly, loss ofCPKAandCPK2resulted in morphogenetic defects in germ tubes (with curled/wavy and serpentine growth pattern) on hydrophobic surfaces, and a complete failure to produce appressoria therein, thus suggesting an important role forCPK2-mediated cAMP-PKA in surface sensing and response pathway.CPKApromoter-drivenCPK2expression partially suppressed the defects in host penetration and pathogenicity in thecpkAΔ. Such ectopicCPK2expressing strain successfully penetrated the rice leaves, but was unable to produce proper secondary invasive hyphae, thus underscoring the importance of CpkA in growth and differentiationin planta. The Cpk2-GFP localized to the nucleus and cytoplasmic vesicles in conidia and the germ tubes. The Cpk2-GFP colocalized with CpkA-mCherry on vesicles in the cytosol, but such overlap was not evident in the nucleus. Our studies indicate that CpkA and Cpk2 share overlapping functions, but also play distinct roles during pathogenesis-associated signalling and morphogenesis in the rice blast fungus.
Intrauterine position probabilities in mice, rats and gerbils
Authors: Mulley John F , Kuncheva Ludmila I
Published: August 2017

The position of a developing embryo or foetus relative to members of the same or opposite sex can have profound effects on its resulting anatomy, physiology and behavior. Here we treat intrauterine position as a combinatorial problem and determine the theoretical probability of having 0, 1 or 2 adjacent foetuses of the opposite sex for species with random and biased distribution of genders in uterine horns (mice and gerbils), and where the influence of an “upstream” male has been proposed to be a factor (rats). As overall litter size increases the probabilities of having 0, 1, or 2 adjacent foetuses of the opposite sex approaches and eventually settles at 0.25, 0.5, 0.25 respectively. However, at biologically-relevant litter sizes probabilities are more variable and the general effect of an increase in litter size is to increase the probability that any particular foetus will be flanked by two members of the opposite sex. When gender ratios within a uterine horn are no longer balanced, the probability that there are 0 adjacent foetuses of the opposite sex increases.
Observation of an optical vortex beam from a helical undulator in the XUV region
Authors: Kaneyasu Tatsuo , Hikosaka Yasumasa , Fujimoto Masaki , Iwayama Hiroshi , Hosaka Masahito , Shigemasa Eiji , Katoh Masahiro
Published: August 2017

The observation of an optical vortex beam at 60 nm wavelength, produced as the second-harmonic radiation from a helical undulator, is reported. The helical wavefront of the optical vortex beam was verified by measuring the interference pattern between the vortex beam from a helical undulator and a normal beam from another undulator. Although the interference patterns were slightly blurred owing to the relatively large electron beam emittance, it was possible to observe the interference features thanks to the helical wavefront of the vortex beam. The experimental results were well reproduced by simulation.
2-[4-(Dimethylamino)phenyl]-3,3-difluoro-3H-naphtho[1,2-e][1,3,2]oxazaborinin-2-ium-3-uide
Authors: Dziuk Błażej , Ośmiałowski Borys , Skotnicka Agnieszka , Ejsmont Krzysztof , Zarychta Bartosz
Published: August 2017

In the title compound, C19H17BF2N2O, a twist about the N—C single bond is observed, making the cross conjugation not as efficient as in the case of a planar structure. The borone complex has tetrahedral geometry. In the crystal, molecules are conected by weak C—H...F hydrogen bonds.
Characteristics of real backdaters
Authors: Tee Kienpin , Wiley Marilyn
Published: August 2017

Purpose

Recent findings show that CEOs tend to backdate their stock option grants so that a past date on which the stock price was particularly low is picked to be the grant date. Using cases now settled concerning a group of firms that were caught backdating, this paper aims to examine further whether backdating firms have higher levels of operating efficiency and corporate governance, lower levels of bankruptcy risk, more ability to increase shareholder wealth, and lower levels of market price risk. This paper also compares the characteristics of backdating firms during the pre-Sarbanes-Oxley Act of 2002 (SOX) and post-SOX periods.

Design/methodology/approach

This sample of backdater firms comprises those caught backdating who have settled their cases, according to data provided by Risk Metrics Group, a non-profit organization that keeps track of most securities class actions. A matched sample of 28 non-backdating, comparison-group firms was constructed to perform univariate and multivariate comparisons.

Findings

This study found that backdating firms on average have a higher price risk than non-backdating firms, and that increasing the percentage of shares owned by the major shareholders reduces the possibility of management conducting backdating activities.

Originality/value

No previous studies have used a sample of real backdating culprits. Previous studies have usually used likely backdating traits to identify a group of suspected backdaters. In contrast, the current study, by using a group of firms whose deliberate backdating behavior had led to lawsuits that have been settled in court, investigated the characteristics of known backdaters.
Spotting the lone actor: combating lone wolf terrorism through financial investigations
Authors: Tierney Michael
Published: August 2017

Purpose

In 2014, Paul Gill et al. introduced a study of 119 lone-actor terrorism cases, and found that lone-actor extremists could be more accurately identified by their behavioural characteristics and activities, rather than their extremist ideologies. The study was said to have significant impact on intelligence analysis in the field of counterterrorism. The purpose of this paper is to apply Gill et al.’s findings to financial intelligence investigations, to assist investigators with the detection and prevention of lone-actor terrorist financing.

Design/methodology/approach

This article provides an overview of the key findings provided by Gill et al. It then discusses the indicators of lone-actor terrorism in the context of financial intelligence investigations, and sets out methods to improve financial intelligence investigations to better identify and stop lone-actor terrorism in the future.

Findings

By applying traditional financial intelligence techniques, which focus on assessing an individual’s activity and behaviour, with open-source intelligence gathering, financial intelligence investigators will be better equipped to identify lone-actor terrorism and its financing moving forward.

Originality/value

This article will be of value to investigators specializing in terrorism and financial crime, as it will assist them in the identification of a proliferating security threat, the lone-actor terrorist. While the article relies on the findings provided by Gill et al., it takes a new approach by applying those findings specifically to the financial intelligence sector, to improve investigations related to terrorism.
De-normalizing corruption in the Indonesian public sector through behavioral re-engineering
Authors: Prabowo Hendi Yogi , Cooper Kathie , Sriyana Jaka , Syamsudin Muhammad
Published: August 2017

Purpose

Based on the authors’ study, the purpose of this paper is to ascertain the best approach to mitigate corruption in the Indonesian public sector. To do so, the paper uses three behavioral perspectives: the Schemata Theory, the Corruption Normalization Theory and the Moral Development Theory.

Design/methodology/approach

This paper is part of the authors’ study to examine corruption patterns in Indonesia in the past 10 years through examination of reports from various institutions as well as other relevant documents addresses corruption-related issues to explore various options for mitigating corruption through behavioral re-engineering. For the purpose of gaining various perspectives on anti-corruption measures, this study also uses expert interviews and focus group discussions with relevant experts in Indonesia and Australia on various corruption-related issues.

Findings

The authors establish that despite the fall of the New Order regime nearly two decades ago, corruption remains entrenched within the post-Suharto Governments. The normalized corruption in Indonesia is a legacy of the New Order regime that shaped societal, organizational and individual schemata in Indonesia. The patrimonial style of leadership in particular within the regional governments resulted in increasing rent-seeking activities within the decentralized system. The leadership style is also believed to have been supporting the normalization of corruption within the public sector since the New Order era. The three-decade-old systematic normalization of corruption in the Indonesian public sector can only be changed by means of long and systematic de-normalization initiatives. To design the best intervention measures, decision makers must first identify multiple factors that constitute the three normalization pillars: institutionalization, rationalization and normalization. Measures such as periodical reviews of operational procedures, appointment of leaders with sound morality, anti-corruption education programs, administering “cultural shocks”, just to name a few, can be part of multifaceted strategies to bring down the normalization pillars.

Research limitations/implications

The discussion on the options for de-normalization of corruption in Indonesia is focused on corruption within the Indonesian public institutions by interviewing anti-fraud professionals and scholars. A better formulation of strategic approaches can be developed by means of interviews with incarcerated corruption offenders from the Indonesian public institutions.

Practical implications

This paper contributes to the development of corruption eradication strategy by suggesting options for de-normalizing corruption in the Indonesian public sector so that resources can be allocated more effectively and efficiently to mitigate the problem.

Originality/value

This paper highlights the importance of behavior-oriented approaches in mitigating corruption in the Indonesian public sector.
Combatting the global crime of bribery: a report on Canadian foreign official anti-bribery policy
Authors: Leasure Peter
Published: August 2017

Purpose

The purpose of this paper is to provide an updated review of Canadian foreign official anti-bribery policy.

Design/methodology/approach

To achieve this objective, seven factors were examined. Several factors have been emphasized by the Organisation for Economic Co-operation and Development, and others are original.

Findings

The results indicate that while Canada is making progress towards strengthening its foreign official anti-bribery policy, significant weaknesses still remain.

Originality/value

This study adds to the literature in this area by utilizing several new factors which attempt to gauge the effectiveness of foreign official anti-bribery policy.
Contingency theory, climate change, and low-carbon operations management
Authors: Furlan Matos Alves Marcelo Wilson , Lopes de Sousa Jabbour Ana Beatriz , Kannan Devika , Chiappetta Jabbour Charbel Jose
Published: August 2017

Purpose

Drawing on the theory of contingency, the aim of this work is to understand how supply chain-related contingencies, arising from climate change, are related to changes in the organisational structure of firms. Further, the authors explore how this relationship influences the perception of sustainability managers on the adoption of low-carbon operations management practices and their related benefits.

Design/methodology/approach

To achieve this goal, this research uses NVivo software to gather evidence from interviews conducted with ten high-level managers in sustainability and related areas from seven leading companies located in Brazil.

Findings

The authors present four primary results: a proposal of an original framework to understand the relationship between contingency theory, changes in organisational structure to embrace low-carbon management, adoption of low-carbon operations practices and benefits from this process; the discovery that an adequate low-carbon management structure is vital to improve the organisations’ perceptions of potential benefits from a low-carbon strategy; low-carbon management initiatives tend to emerge from an organisation’s existing environmental management systems; and controlling and monitoring climate contingencies at the supply chain level should be permanent and systematic.

Originality/value

Based on the knowledge of the authors, to date, this work is the first piece of research that deals with the complexity of putting together contingency theory, climate-change contingencies at the supply chain level, organisational structure for low-carbon management and low-carbon operations management practices and benefits. This research also highlights evidence from an emerging economy and registers future research propositions.
Variation in rates of inpatient admission and lengths of stay experienced by adults with learning disabilities in England
Authors: MacDonald Anne
Published: August 2017

Purpose

The purpose of this paper is to provide a commentary from a Scottish perspective on some of the issues raised in the paper “Variation in rates of inpatient admission and lengths of stay experienced by adults with learning disabilities in England”.

Design/methodology/approach

The policy context in relation to people with learning disabilities in Scotland is reviewed, alongside an update about a current Scottish Government project focussed on understanding and addressing the issue of people with learning disabilities whose discharge from hospital is delayed.

Findings

As regards to people with learning disabilities who are inpatients in hospitals in Scotland, there are similar themes in common with those in the paper by Elaine James and colleagues; however Scottish policy has developed differently from that in England in this area.

Originality/value

This commentary adds to the discussion by contributing a Scottish perspective on issues and outlines work being done to address the need for people with learning disabilities and complex needs in Scotland to live within their local communities.
Learning disability market position statements, are they fit for purpose?
Authors: Giraud-Saunders Alison
Published: August 2017

Purpose

The purpose of this paper is to provide a commentary on the issues raised in the article “Learning disability market position statements (MPS), are they fit for purpose?”

Design/methodology/approach

The commentary draws on the literature and the author’s experience in developing commissioning.

Findings

Published documents such as MPS and joint strategic needs assessments do not give an encouraging picture of progress in commissioning with and for people with learning disabilities. Actual commissioning practice may or may not be stronger than the documents suggest; however, more robust planning may help to sustain progress through times of organisational and social change.

Originality/value

The commentary sets MPS in the context of other guidance on commissioning and development of services. It addresses questions about the need for published statements and the factors that help or hinder development of commissioning.
Streamflow Hydrology Estimate Using Machine Learning (SHEM)
Authors: Petty T.R. , Dhingra P.
Published: August 2017

Continuity and accuracy of near real‐time streamflow gauge (streamgage) data are critical for flood forecasting, assessing imminent risk, and implementing flood mitigation activities. Without these data, decision makers and first responders are limited in their ability to effectively allocate resources, implement evacuations to save lives, and reduce property losses. The Streamflow Hydrology Estimate using Machine Learning (SHEM) is a new predictive model for providing accurate and timely proxy streamflow data for inoperative streamgages.SHEMrelies on machine learning (“training”) to process and interpret large volumes (“big data”) of historic complex hydrologic information. Continually updated with real‐time streamflow data, the model constructs a virtual dataset index of correlations and groups (clusters) of relationship correlations between selected streamgages in a watershed and under differing flow conditions. Using these datasets,SHEMinterpolates estimated discharge and time data for any indexed streamgage that stops transmitting data. These estimates are continuously tested, scored, and revised using multiple regression analysis processes and methodologies. TheSHEMmodel was tested in Idaho and Washington in four diverse watersheds, and the model's estimates were then compared to the actual recorded data for the same time period. Results from all watersheds revealed a high correlation, validating both the degree of accuracy and reliability of the model.
Gateway effects and electronic cigarettes
Authors: Etter Jean‐François
Published: August 2017

Background

E‐cigarettes are alleged to be a gateway to cigarette smoking in non‐smokers. This study examines whether the gateway theory has value, whether the criteria to establish causality have been met and what type of evidence is required to test this theory.

Analysis

Experiments are impractical, and we may not be able to test properly the gateway effects via observational studies that simply adjust for confounders. Multivariate models cannot eliminate all the variance in propensity to smoke captured by the variable ‘vaping’ because of the proximity of these two behaviours. It may be difficult to prove that vaping precedes smoking when product use co‐occurs and when, in fact, smoking usually precedes vaping. The gateway theory is not compatible with either (1) the decrease in smoking prevalence observed in adolescents in countries where vaping increased or (2) an increase in smoking among teenagers after age restrictions were imposed on e‐cigarette purchases. A spurious gateway effect can be produced artificially by mathematical models in which a propensity to use substances is correlated with opportunities to use substances. Finally, neither nicotine medications nor smokeless tobacco produce gateway effects. Available data are compatible with a common liability model in which people who are liable to use nicotine are more likely to use both e‐cigarettes and cigarettes.

Conclusions

Despite its weaknesses and scant empirical support, the gateway theory of smoking initiation has had enormous political influence. Policies based on this theory will not have the intended effects if the association between vaping and smoking is explained by common liabilities.
Defending the social value of knowledge as a safeguard for public trust
Authors: Holzer Felicitas S.
Published: August 2017

The ‘socially valuable knowledge’ (SVK) principle has been widely acknowledged as one of the most important guiding principles for biomedical research involving human subjects. The principle states that the potential of producing socially valuable knowledge is a necessary requirement, although not sufficient, for the ethical conduct of research projects. This is due to the assumption that the social value of knowledge avoids exploitation of research subjects and justifies the use of health resources. However, more recently, several authors have started interrogating the validity of SVK in research and offered various lines of argument against the SVK principle as a necessary constraint to research. In this article, I will reconstruct the main arguments of this discussion between defenders and debunkers of the SVK principle and offer a third way to consider the social value of knowledge in research studies. I will argue that the social value of knowledge can be supported by an independent justification. This justification of the SVK principle addresses the rationality and common interest of researchers. Thus, I will introduce the SVK principle as a safeguarding principle for public trust based on a conceptual framework by Alex John London. My approach justifies keeping the principle as a precautionary and rational requirement for human health research that all rational stakeholders can agree upon.
A pragmatic analysis of vulnerability in clinical research
Authors: Wendler David
Published: August 2017

Identifying which subjects are vulnerable, and implementing safeguards to protect them, is widely regarded as essential to clinical research. Commentators have endorsed a number of responses to these challenges and have thereby made significant progress in understanding vulnerability in clinical research. At the same time, this literature points to a central contradiction which calls into question its potential to protect vulnerable subjects in practice. Specifically, analysis suggests that all human subjects are vulnerable and vulnerability in clinical research is comparative and context dependent, in the sense that individuals are vulnerable relative to others and in some contexts only. Yet, if everyone is vulnerable, there seems to be no point in citing the vulnerability of some individuals. Moreover, the conclusion that everyone is vulnerable seems inconsistent with the claims that vulnerability is comparative and context dependent, raising concern over whether it will be possible to develop a comprehensive account of vulnerability that is internally consistent. The solution to this dilemma lies in recognition of the fact that the practical significance of claims regarding vulnerability depends on the context in which they are used. The claims that appear to lead to the central contradiction are in fact accurate conclusions that follow from different uses of the term ‘vulnerability’. The present manuscript describes this ‘pragmatic’ approach to vulnerability in clinical research and considers its implications for ensuring that subjects receive appropriate protection.
Association between infection with Helicobacter pylori and atopy in young Ethiopian children: A longitudinal study
Authors: Taye B. , Enquselassie F. , Tsegaye A. , Amberbir A. , Medhin G. , Fogarty A. , Robinson K. , Davey G.
Published: August 2017

Background

Epidemiological evidence from developed countries indicates that Helicobacter pylori infection correlates with a reduced risk of atopy and allergic disorders; however, limited data are available from low‐income countries.

Objective

We examined associations between H. pylori infection in early childhood and atopy and reported allergic disorders at the age of 6.5 years in an Ethiopian birth cohort.

Methods

A total of 856 children (85.1% of the 1006 original singletons in a population‐based birth cohort) were followed up at age six and half years. An interviewer‐led questionnaire administered to mothers provided information on demographic and lifestyle variables. Questions on allergic disease symptoms were based on the International Study of Asthma and Allergies in Children (ISAAC) core allergy and environmental questionnaire. Serum samples were analysed for total IgE levels and anti‐H. pylori cytotoxin‐associated gene A (CagA) IgG antibody using commercially available ELISA kits. Stool samples were analysed for H. pylori antigen using a rapid immunochromatographic test. The independent effects of H. pylori infection (measured at age of 3, 5 and 6.5 years) on prevalence and incidence of atopy and reported allergic disorders (measured at age of 6.5 years) were determined using multiple logistic regression.

Results

In cross‐sectional analysis, current H. pylori infection at age 6.5 years was inversely, though not significantly, related to prevalence of atopy and “any allergic condition” at age 6.5 years. However, detection of H. pylori infection at any point up to age 6.5 years was associated with a significantly reduced odds of both atopy and “any allergic condition” (adjusted OR AOR, 95% CI, 0.54; 0.32‐0.92, P = .02, and .31; 0.10‐0.94, P = .04, respectively). In longitudinal analyses, H. pylori infection at age 3 was inversely associated with incidence of atopy (AOR, 95% CI, 0.49; 0.27‐0.89, P = .02). Furthermore, among H. pylori‐infected children, those with a CagA+ strain had a more pronounced reduction in odds of atopy (AOR = 0.35 vs 0.63 for CagA+ vs CagA‐), and this reduction reached borderline significance.

Conclusion

These data are consistent with the hypothesis that early exposure to H. pylori is inversely associated with atopy and allergic conditions. A possible modest protective association against atopy was observed in those infected with a more virulent CagA+ strain of H. pylori.
Homozygous nonsense mutation in SCHIP1/IQCJ‐SCHIP1 causes a neurodevelopmental brain malformation syndrome
Authors: Elsaid M.F. , Chalhoub N. , Ben‐Omran T. , Kamel H. , AL Mureikhi M. , Ibrahim K. , Elizabeth Ross M. , Abdel Aleem A.K.
Published: August 2017

We report a consanguineous Arab family with 3 affected siblings who display a disorder of global developmental delay, learning difficulties, facial dysmorphism, hearing impairments, and cataract. The clinical phenotype was associated with characteristic brain magnetic resonance imaging (MRI) features of axonal guidance defects involving anterior commissure agenesis as well as scattered areas of polymicrogyria‐cobblestone complex. Whole genome sequencing revealed a novel nonsense mutation (159609921C>T) that segregated in the family consistent in an autosomal recessive pattern. This mutation located in the C‐terminal region shared by the Schwanomin‐Interacting Protein1 (SCHIP1) isoforms including the IQCJ‐SCHIP1. The in vitro expression of SCHIP1 and IQCJ‐SCHIP1 truncated mutant isoforms (NM_001197109.1; p.R209* and NM_001197114.1; p.R501*, respectively) were markedly reduced as compared to their full‐length versions suggesting protein stability/folding impairment. The pathogenic nature of this mutation is supported by a previously reported mouse knockout of Schip1 isoforms, which phenocopied the human axon guidance abnormality. This is the first report of a SCHIP1/IQCJ‐SCHIP1 point mutation in humans associated with a neurological‐developmental phenotype.
Maxillary sinus augmentation with leukocyte and platelet‐rich fibrin and deproteinized bovine bone mineral: A split‐mouth histological and histomorphometric study
Authors: Nizam Nejat , Eren Gülnihal , Akcalı Aliye , Donos Nikolaos
Published: August 2017

Objectives

To evaluate the effect of leukocyte and platelet‐rich fibrin (L‐PRF) in combination with deproteinized bovine bone mineral (DBBM) on bone regeneration in maxillary sinus augmentation.

Material and methods

Thirteen patients (nine males and four females, mean age ± SD; 49.92 ± 10.37) were enrolled to the study. 26 maxillary sinus augmentation procedures were randomly performed using DBBM and L‐PRF mixture (test) or DBBM alone (control) in a split‐mouth design. The same surgical procedures were performed in both groups, and bone biopsies were harvested from the implant sites 6 months postoperatively for histological and histomorphometric evaluations as the primary outcome of the study. Implants were placed and then loaded in the augmented sites after 6 months. The secondary outcomes included clinical and radiographic data and were obtained pre‐ and postoperatively.

Results

There was no qualitative difference in histological analyses among the groups. In all samples, a newly formed bone was in direct contact with the residual material. The percentages of newly formed bone (test; 21.38 ± 8.78% and control; 21.25 ± 5.59%), residual bone graft (test; 25.95 ± 9.54% and control; 32.79 ± 5.89%), bone graft in contact with the newly formed bone (test; 47.33 ± 12.33% and control; 54.04 ± 8.36%), and soft tissue (test; 52.67 ± 12.53% and control; 45.96 ± 8.36%) were similar among the groups (p < .05). Similar radiographic bone height in the augmented area was observed, and implant survival rate was 100% for both groups.

Conclusions

Both techniques were effective for maxillary sinus augmentation, and after 6 months of healing, the addition of L‐PRF in DBBM did not improve the amount of regenerated bone or the amount of the graft integrated into the newly formed bone under histological and histomorphometric evaluation.
Long‐term outcomes after selective dorsal rhizotomy: a retrospective matched cohort study
Authors: Munger Meghan E , Aldahondo Nanette , Krach Linda E , Novacheck Tom F , Schwartz Michael H
Published: August 2017

Aim

To examine long‐term outcomes of selective dorsal rhizotomy (SDR) 10 to 17 years after surgery.

Method

Participants who underwent SDR had spastic diplegic cerebral palsy (CP), completed baseline gait analysis, and were 16 to 25 years old at follow‐up. Non‐SDR participants (i.e. controls) were matched on important clinical parameters at baseline but did not undergo SDR. All study participants completed six surveys assessing pain, quality of life, participation, function, and mobility. Treatment history for lower extremity surgery and antispasticity injections was tabulated. A subset of each study group returned for three‐dimensional gait analysis, including kinematics, metabolic energy cost, and physical examination. Gait Deviation Index (GDI) was calculated to measure gait quality.

Results

The study cohort had 24 participants with SDR and 11 without SDR. Of these, 13 patients with SDR (five males, eight females; median [IQR] age 17y 2mo [16y 8mo–17y 9mo]) and eight without SDR (three males, five females; median [IQR] age 19y 2mo [17y 3mo–21y 11mo]) completed baseline and follow‐up gait analysis. Spasticity significantly decreased in those with SDR (p<0.05). Gait Deviation Index improved more in participants without SDR than those with SDR (Δnon‐SDR=12.8 vs ΔSDR=9.1; p=0.01). Compared with the SDR group, participants without SDR underwent significantly more subsequent interventions (p<0.05).

Interpretation

Patients in both the SDR and non‐SDR groups showed improved gait quality more than 10 years after surgery. Participants without SDR had a larger improvement in gait pathology but underwent significantly more intervention. There were no differences between groups in survey measures. These results suggest differing treatment courses provide similar outcomes into early adulthood.

What this paper adds

Selective dorsal rhizotomy (SDR) and non‐SDR groups had significant improvement in gait pathology over time.

The non‐SDR group had significantly better gait compared with the SDR group at follow‐up.

The groups had similar levels of energy cost, pain, and quality of life.

Non‐SDR participants underwent significantly more orthopaedic surgery and antispasticity injections than SDR participants.

Use of a clinically similar control group highlights that different treatment courses may result in similar outcomes into young adulthood.
A population‐based study of communicative participation in preschool children with speech‐language impairments
Authors: Cunningham Barbara Jane , Hanna Steven E , Oddson Bruce , Thomas‐Stonell Nancy , Rosenbaum Peter
Published: August 2017

Aim

To develop statistical models of communicative participation development of preschool children and explore variations by level of function.

Method

This was a secondary analysis of data from a longitudinal study of preschool children with speech and language impairments (n=46 872; age range 18–67mo, mean age [SD] 41.76mo [11.92]; 67% male) accessing publicly funded services in Ontario, Canada. Two measures were used: Focus on the Outcomes of Communication Under Six (FOCUS), measuring changes in communicative participation skills, and the Communication Function Classification System (CFCS), classifying communicative function into one of five levels. We used mixed effects modeling to fit growth curves for children in each CFCS level. Models allowed for variation in initial FOCUS score at 18 months, rate of growth with age, and rate of acceleration/deceleration with age.

Results

Starting FOCUS score (18mo) varied inversely with CFCS level at entry to the program. Growth was initially rapid and then leveled off for children in Levels I to III. Growth was less rapid for children in Level IV, but leveled off, and was slow but continual for children in Level V.

Interpretation

This work can help us to move beyond traditional impairment‐based thinking and shows that children can make meaningful communicative changes regardless of their function.
Comparing emergency department presentations among children with cerebral palsy with general childhood presentations: a data linkage study
Authors: Meehan Elaine , Williams Katrina , Reid Susan M , Freed Gary L , Babl Franz E , Sewell Jillian R , Vidmar Suzanna , Donath Susan , Reddihough Dinah S
Published: August 2017

Aim

The aims of this study were to estimate the proportion of emergency department presentations attributable to children with cerebral palsy (CP), investigate the frequency of emergency department presentations in a CP cohort, and compare emergency department presentations among children with CP with those of other children.

Method

This was a retrospective cohort study. The Victorian Cerebral Palsy Register was linked to the Victorian Emergency Minimum Dataset. Data on emergency department presentations for the CP cohort occurring between 2007 and 2014 and population control data were obtained.

Results

The CP cohort (n=1748) had 7015 emergency department presentations during the 7‐year period, accounting for 0.4% of the 1.69 million age‐specific presentations during that time. The number of annual presentations per 1000 children rose with increasing CP severity. Compared with presentations among the general population, higher proportions of presentations among the CP cohort were preceded by ambulance arrivals (27% vs 8%), triaged as urgent (66% vs 32%), and required hospital admission (38% vs 12%).

Interpretation

The marked differences in presentations between the CP cohort and the general population in the proportions that were urgent and required ambulance arrivals and hospital admissions was an important finding. Strategies to ensure appropriate use of services, including encouragement to seek earlier assistance from primary care providers, may prevent problems escalating to the need for urgent care.

What this paper adds

Children with cerebral palsy (CP) account for 0.4% of childhood emergency department presentations.

More emergency department presentations among children with CP require ambulance arrival.

More CP emergency department presentations are urgent and require hospital admission.

Traditional emergency department triage scales seem less accurate for this group.
Efficacy and safety of teneligliptin added to canagliflozin monotherapy in Japanese patients with type 2 diabetes mellitus: A multicentre, randomized, double‐blind, placebo‐controlled, parallel‐group comparative study
Authors: Kadowaki Takashi , Inagaki Nobuya , Kondo Kazuoki , Nishimura Kenichi , Kaneko Genki , Maruyama Nobuko , Nakanishi Nobuhiro , Gouda Maki , Iijima Hiroaki , Watanabe Yumi
Published: August 2017

Dipeptidyl peptidase‐4 (DPP‐4) inhibitors and sodium glucose co‐transporter 2 (SGLT2) inhibitors are frequently used in combination for the treatment of type 2 diabetes mellitus (T2DM). We examined the efficacy and safety of teneligliptin (a DPP‐4 inhibitor) added to canagliflozin (an SGLT2 inhibitor) monotherapy in Japanese patients with poorly controlled T2DM as part of the development of a fixed‐dose combination of teneligliptin and canagliflozin.

Japanese patients treated with canagliflozin (100 mg) for ≥12 weeks were randomized to receive add‐on teneligliptin (20 mg; C + T group) or placebo (C + P group) for 24 weeks. The primary endpoint was change in glycated haemoglobin (HbA1c) from baseline to Week 24. The between‐group differences in reductions from baseline to Week 24 were significantly greater in the C + T group for HbA1c (−0.94%; P < .001). The incidence of adverse events was similar in both groups (55.8% and 49.4% in the C + T and C + P groups, respectively). No episodes of hypoglycaemia were reported. Teneligliptin added to ongoing canagliflozin monotherapy improved glycaemic control and was well tolerated in Japanese patients with inadequately controlled T2DM.
Sodium‐glucose cotransporter‐2 inhibition improves incretin sensitivity of pancreatic β‐cells in people with type 2 diabetes
Authors: Ahn Chang Ho , Oh Tae Jung , Kwak Soo Heon , Cho Young Min
Published: August 2017

Aim

To test the hypothesis that dapagliflozin, a sodium‐glucose cotransporter‐2 inhibitor, improves β‐cell responses to incretin hormones (or β‐cell incretin sensitivity) by alleviating glucose toxicity in people with type 2 diabetes mellitus (T2DM).

Methods

A total of 19 people with T2DM underwent a 3‐hour hyperglycaemic clamp study with incretin infusion before and after 8‐week treatment with dapagliflozin added to the background treatment. In addition, 10 people with normal glucose tolerance (NGT) underwent a single hyperglycaemic clamp study. The hyperglycaemic clamp was targeted at 15.5 mmol/L for 3 hours, with synthetic glucagon‐like peptide‐1 (GLP‐1) and glucose‐dependent insulinotropic polypeptide (GIP) infusion over a 60‐ to 180‐minute and a 120‐ to 180‐minute period, respectively.

Results

Compared with baseline, the C‐peptide response to GLP‐1 (incremental area under the curve [iAUC] of C‐peptide60‐120 minutes) significantly increased (83.6 ± 42.1 to 106.6 ± 45.7 nmol/L × min; P = .011), and the C‐peptide response to GIP/GLP‐1 (iAUC of C‐peptide120‐180 minutes) tended to increase after dapagliflozin treatment (82.5 ± 58.4 to 101.9 ± 50.3 nmol/L × min; P = .087), whereas both the insulin responses to GLP‐1 and GIP/GLP‐1 increased significantly. First‐phase C‐peptide response, which reflects β‐cell function, significantly increased after dapagliflozin treatment; however, all these improved values in the participants with T2DM were far lower than those in the participants with NGT. In addition, the improvement in insulin responses to hyperglycaemia was correlated with the improvement in insulin responses to incretin infusion.

Conclusions

Dapagliflozin improved β‐cell responses to incretin hormones as well as glucose during the hyperglycaemic clamp in patients with inadequately controlled T2DM.
Factors associated with polypharmacy in elderly home‐care patients
Authors: Komiya Hitoshi , Umegaki Hiroyuki , Asai Atsushi , Kanda Shigeru , Maeda Keiko , Shimojima Takuya , Nomura Hideki , Kuzuya Masafumi
Published: August 2017

Aim

Polypharmacy, which is often observed in elderly patients, has been associated with several unfavorable outcomes, including an increased risk of potentially inappropriate medications, medication non‐adherence, drug duplication, drug–drug interactions, higher healthcare costs and adverse drug reactions. A significant association between polypharmacy and adverse outcomes among older people living in the community has also been confirmed. A reduction in the number of medications should thus be pursued for many older individuals. Nevertheless, the factors associated with polypharmacy in elderly home‐care patients have not been reported. Here, we investigated those factors in elderly home‐care patients in Japan.

Methods

We used the data of the participants in the Observational Study of Nagoya Elderly with Home Medical investigation. Polypharmacy was defined as the current use of six or more different medications. We carried out univariate and multivariate logistic regression analyses to assess the associations between polypharmacy and each of several factors.

Results

A total of 153 home‐care patients were registered. The mean number of medications used per patient was 5.9, and 51.5% of the patients belonged to the polypharmacy group. The multivariate model showed that the patients’ scores on the Charlson Comorbidity Index and the Mini‐Nutrition Assessment Short Form were inversely associated with polypharmacy, and potentially inappropriate medication was most strongly associated with polypharmacy (odds ratio 4.992).

Conclusions

The present findings showed that polypharmacy was quite common among the elderly home‐care patients, and they suggest that home‐care physicians should prescribe fewer medications in accord with the deterioration of home‐care patients’ general condition. Geriatr Gerontol Int 2018; 18: 33–41.
Chemically strengthened glass by ion exchange: Strength evaluation
Authors: Macrelli Guglielmo
Published: August 2017

A linear fracture mechanics model is considered for strength evaluation of glass submitted to ion exchange below glass transition temperature. Former models of the ion exchange process were based on rough zero‐order (constant) and first‐order (linear) approximations of the residual stress field generated by the larger ions invading the glass matrix. In this study, the effective stress field generated by the invading ions is taken into account for strength evaluation. Both stress non‐relaxation approximation and stress relaxation are analyzed and discussed. A comparison of results predicted by the introduced models with experimental data of glass strength before and after ion exchange is presented. The hypothesis of conservation of surface flaws geometry (shape and depth) after ion exchange is critically discussed.
Hypokalaemia Occurring During Insulin‐induced Hypoglycaemia
Authors: Strakosch C. R. , Stiel J. N. , Györy A. Z.
Published: August 2017

Insulin‐induced hypoglycaemia was used to test pituitary function in six patients with suspected pituitary deficiency. In each, a fall in serum potassium concentration of from 0·63 to 1·48 mEq/litre (mean fall 1·10 mEq/ litre ± 0·30 SEM) was observed during the two hour period following administration of 0·15 units of insulin per kilogram body weight. In several patients the resulting hypokalaemia was at a level which has been associated with cardiac complications.
Thorotrast‐induced Haemangioendothelial Sarcoma—A Lesson from the Past
Authors: Quinlan M. F. , Scopa J.
Published: August 2017

Complications following a carotid arteriogram done in 1947 with Thorotrast are described in a 47‐year‐old man who sub‐sequently died from them in 1970. They included a local cervical granuloma with associated haemangioendothelial sarcoma, chromosome changes characteristic of radiation damage and widespread haemangioendothelial sarcomatous deposits in brain, lung, liver, probably arising from multicentric primary sites in the bone marrow.

A survey of the use of Thorotrast as a contrast medium in Australia and New Zealand showed that its use was extremely limited. The principal complications seen have been two cervical granulomas and one hepatoma.
Complement and the Clinician
Authors: Palmer D. G.
Published: August 2017

The estimation of complement in serum, and in other body fluids, particularly synovial fluid, now has an established place in the assessment, prognosis and response to treatment of those diseases associated with immunological phenomena. Some knowledge of the complement sequence itself, the patterns characteristic of various disease processes and the interacting factors which may affect the levels of the various components have been summarised. Disease states closely resembling lupus erythematosus have been associated with genetically determined deficiencies of classic pathway components and deficiencies of terminal sequence components may lead to severe recurrent infections.
Chinese Health Improvement Profile for people with severe mental illness: A cluster‐randomized, controlled trial
Authors: Bressington Daniel , Chien Wai Tong , Mui Jolene , Lam Kar Kei Claire , Mahfoud Ziyad , White Jacquie , Gray Richard
Published: August 2017

The aim of the present study was to establish the feasibility of conducting a full‐scale trial and to estimate the preliminary effect of a Chinese Health Improvement Profile (CHIP) intervention on self‐reported physical well‐being of people with severe mental illness (SMI). The study used a parallel‐group, open‐label, cluster‐randomized, controlled trial (RCT) design. Twelve community psychiatric nurses (CPN) and their corresponding 137 patients with SMI were randomized into the CHIP or treatment‐as‐usual (TAU) groups. After training, the CPN completed the CHIP at baseline and 12 months, and the findings were used to devise an individualized care plan to promote health behaviour change. Patients were assessed at baseline and 6 and 12 months after starting the intervention. There was an observed positive trend of improvement on the physical component subscale of SF12v2 in the CHIP group compared to the TAU group after 12 months, but the difference did not reach statistical significance (P = 0.138). The mental component subscale showed a similar positive trend (P = 0.077). CHIP participants were more satisfied with their physical health care than TAU patients (P = 0.009), and the CPN were positive about the usefulness/acceptability of the intervention. There were significant within‐group improvements in the total numbers of physical health risks, as indicated by the CHIP items (P = 0.005). The findings suggest that it is feasible to conduct a full‐scale RCT of the CHIP in future. The CHIP is an intervention that can be used within routine CPN practice, and could result in small–modest improvements in the physical well‐being of people with SMI.
A sanctuary of safety: A study of how patients with dual diagnosis experience caring conversations
Authors: Priebe Åsa , Wiklund Gustin Lena , Fredriksson Lennart
Published: August 2017

The prevalence of dual diagnosis, that is, the combination of psychiatric illnesses and substance use disorders, is high. As a vast majority of previous research in this context focusses on the effects of different treatment methods, rather than interpersonal issues, the purpose of the present study was to explore and illuminate in what way patients with a dual diagnosis experience conversations with nurses in an outpatient clinic to be caring. Five patients were interviewed regarding their experiences of caring conversations. The analysis and interpretation were inspired by a previously‐used hermeneutical process. These yielded three themes: (i) reciprocity creates safety and communion; (ii) suffering is made visible and understandable; and (iii) self‐esteem is restored. When synthesized, these themes gave rise to a main theme – a sanctuary of safety – where suffering is alleviated and dignity and self‐esteem are restored. It is concluded that the caring conversation contributes to experiences of safeness. In this specific context, safety appears to be more fundamental than trust for patients’ recoveries. The caring conversation also contributes to recovery, as it supports the individual's learning and understanding as a way to cope with problems, which also enables patients to make informed decisions about their own care. The caring conversation contributes to the alleviation of suffering and restoration of dignity and self‐esteem for patients with a dual diagnosis. However, there is a need for further research focussing on how the caring conversation can contribute to psychiatric nurses’ caring expertise.