bluuebunny/crossref_metadata_2025 huggingface dataset:
A Type 1 diabetes technology pathway: consensus statement for the use of technology in Type 1 diabetes
Authors: Choudhary P. , Campbell F. , Joule N. , Kar P. ,   on behalf of Diabetes UK
Published: February 2019

In both adults and children with diabetes, technologies such as continuous subcutaneous insulin infusion using insulin pumps and continuous glucose monitoring can help improve diabetes control, reduce hypoglycaemia and improve quality of life. Access to these technologies in the UK is very variable. Some technologies are recommended by the National Institute for Health and Care Excellence, while others have not been appraised, and new technologies are emerging all the time. Additionally, different guidelines for adults and children further complicate access to diabetes technology in the transition from paediatric to adult care. Against this background, Diabetes UK and NHS England have brought together a multidisciplinary group of experts, including clinicians and people with diabetes, to develop this consensus guideline, combining the different technologies into a common pathway to aid clinical and policy decision‐making. We created a pathway that supports the incremental addition of technology as monotherapy and then dual therapy in the same way that we incrementally add in therapeutic agents to support people with Type 2 diabetes to achieve their personalized glycaemic targets. The pathway emphasizes the importance of structured education, specialist support and appropriate access to psychological therapies, as essential pillars for optimized use of diabetes‐related technology, and recommends the re‐evaluation of its use when the individual is unable either to use the technology appropriately or to achieve the intended outcomes. This pathway is endorsed by UK‐wide clinical and patient associations and we recommend that providers and commissioners use it to ensure the right individual with diabetes has access to the right technology in a timely way to help achieve better outcomes.
Identification of wood‐decay fungi and assessment of damage in log depots of Western Black Sea Region (Turkey)
Authors: Yalçın Mesut , Doğan Hasan Hüseyin , Akçay Çağlar
Published: February 2019

The aim of this study was to determine and quantify the wood‐decay fungi found on logs of forest tree species (beech, oak, hornbeam, Scots pine and fir) stored in log depots located in six different provinces in the Western Black Sea Region of Turkey. Additionally, it was aimed to determine the natural durability of some important wood species against the most commonly detected wood‐decay fungi. Eighteen families, 31 genera and 45 species belonging to the division Basidiomycota were detected; Antrodia crassa was identified for the first time in Turkey. The abundance of Panus neostrigosus, Polyporus meridionalis, Trametes hirsuta, T. versicolor and Stereum hirsutumincreased significantly with the holding time of the logs (r = 0.99, 0.87, 0.53, 0.57 and 0.78, respectively, p < 0.05). The majority of the fungal species were detected on logs stored in depots for 4–6 years (66%). The percentage of fungal species found on the logs with a holding time of three years or less was 29%, whereas the percentage for those detected on logs stored for seven or more years was 31%. Among the wood species, the greatest number of fungal species (29) and highest amount of fungi (2,539) occurred on beech wood. Natural durability tests showed that T. versicolor caused the greatest loss of wood mass, with an average of 23%. Field studies and natural durability tests performed in the laboratory showed that beech wood lost the most mass among the timber species studied.
Quantifying local malignant adaptation in tissue‐specific evolutionary trajectories by harnessing cancer’s repeatability at the genetic level
Authors: Tokutomi Natsuki , Moyret‐Lalle Caroline , Puisieux Alain , Sugano Sumio , Martinez Pierre
Published: February 2019

Cancer is a potentially lethal disease, in which patients with nearly identical genetic backgrounds can develop a similar pathology through distinct combinations of genetic alterations. We aimed to reconstruct the evolutionary process underlying tumour initiation, using the combination of convergence and discrepancies observed across 2,742 cancer genomes from nine tumour types. We developed a framework using the repeatability of cancer development to score the local malignant adaptation (LMA) of genetic clones, as their potential to malignantly progress and invade their environment of origin. Using this framework, we found that premalignant skin and colorectal lesions appeared specifically adapted to their local environment, yet insufficiently for full cancerous transformation. We found that metastatic clones were more adapted to the site of origin than to the invaded tissue, suggesting that genetics may be more important for local progression than for the invasion of distant organs. In addition, we used network analyses to investigate evolutionary properties at the system‐level, highlighting that different dynamics of malignant progression can be modelled by such a framework in tumour‐type‐specific fashion. We find that occurrence‐based methods can be used to specifically recapitulate the process of cancer initiation and progression, as well as to evaluate the adaptation of genetic clones to given environments. The repeatability observed in the evolution of most tumour types could therefore be harnessed to better predict the trajectories likely to be taken by tumours and preneoplastic lesions in the future.
Exploring simple ecological indicators on landings and market trends in the South Brazil Shelf Large Marine Ecosystem
Authors: Pincinato Ruth B. M. , Gasalla Maria A.
Published: February 2019

Simple ecological indicators were applied to landings and market data from the South Brazil Shelf Large Marine Ecosystem to investigate pressures on the ecosystem over time to contribute to fisheries and ocean assessments in data‐poor ecosystems. The indicators showed an increase in larger, long‐lived and piscivorous pelagic species landings as well as an increase in offshore fishing over the past few decades. Indicators based on market data showed a decrease of not only the target species but also of some long‐lived and large‐size coastal species, resulting in an increase of previously undesired fish species in the markets. Each of the selected indicators expressed part of the picture, while putting all together resulted in a more comprehensive view of the historical behaviour of this system.
Optimum plant density of Digitaria eriantha for herbage accumulation and hydrological performance in a summer dominant rainfall zone
Authors: Boschma Suzanne P. , Murphy Sean R. , Harden Steven
Published: February 2019

In the frost‐prone, summer dominant rainfall zone of northern NSW and southern Queensland, sown tropical grass pastures commonly establish with plant densities >26 plants per m2, yet the optimum density for maximum herbage accumulation and hydrological performance is not known. A replicated, field study was established in northern NSW in November 2011, using five densities of Digitaria eriantha (digit grass): 0, 1, 4, 9 and 16 plants per m2 and a range of agronomic and hydrologic measures was assessed. The results showed that the largest differences between plant densities in herbage accumulation, root depth, soil water extraction and rainfall refill efficiency occurred during the first 2 years; after this time, digit grass pastures with densities of ≥4 plants per m2 responded similarly. Plant frequency increased with increasing plant density but the treatments did not converge. During the first two growing seasons, there was no effect of plant density on water use efficiency; however, by the third growing season, pastures with 4 plants per m2 were the most water efficient. Overall, the results indicated that 1 plant per m2 was too low to efficiently use resources, 16 plants per m2 utilized the resources quickly then tended to stall, while 4–9 plants per m2 was a good compromise between agronomic and hydrological response, achieving both herbage accumulation and sustainability goals. A practical management advantage of pastures with 4–9 plants per m2 is they allow soil water resources to be available for a longer period of time and potentially provide the opportunity to establish legumes in the ensuing 24‐month period.
Association between sarcopenia and sleep disorder in older patients with diabetes
Authors: Ida Satoshi , Kaneko Ryutaro , Nagata Hiroaki , Noguchi Yoshinori , Araki Yasuha , Nakai Mari , Ito Sho , Ishihara Yuki , Imataka Kanako , Murata Kazuya
Published: February 2019

Aim

In the present study, we aimed to examine the association between sarcopenia and sleep disorder in older patients with diabetes using the Japanese version of SARC‐F (SARC‐F‐J).

Methods

Outpatients with diabetes (aged ≥65 years) at the Ise Red Cross Hospital were included in the present study. We used the Japanese version of the Pittsburgh Sleep Quality Index, which is a self‐administered questionnaire, to measure sleep disorder. To evaluate sarcopenia, we used SARC‐F‐J, a self‐administered questionnaire, comprising five items. For multiple logistic regression analysis, the dependent variable was sleep disorder and the explanatory variable was sarcopenia, and these were used for calculating the odds ratios of sarcopenia with regard to sleep disorder.

Results

In total, 318 patients were included in this study (189 men and 129 women). The prevalence of sarcopenia was 22.5% and that of sleep disorder was 44.8%. Adjusted odds ratios of sarcopenia and sleep disorder were 6.04 in men (95% CI 1.71–21.36, P = 0.005) and 6.33 in women (95% CI 1.91–20.97, P = 0.003).

Conclusions

We found a statistically significant association between sarcopenia and sleep disorder in older patients with diabetes using SARC‐F‐J. Therefore, older patients with diabetes should be cautioned regarding sleep disorder if they are diagnosed with sarcopenia. Geriatr Gerontol Int 2019; 19: 399–403.
A Rapid Method for Analyzing Well Log Records in Preparation for Water Resource Mapping
Authors: Thomsen Kurt O.
Published: February 2019

The needs of subregional and local entities for water resource management are immediate, and required information is not forthcoming in a timely and relatively inexpensive manner. The following method allows one to use all available well record data to produce baseline hydrogeologic unit maps using geographic information system querying and mapping techniques. Subjective borehole and geophysical strata descriptions are converted to objective equivalent numerical values by establishing the average hydraulic conductivity of the combined soils making up the stratum of interest. These hydraulic conductivity values are then used to assign each stratum to a hydrogeologic unit based on typical ranges of hydraulic conductivity for aquifers, aquitards and aquicludes. The resulting data are queried and mapped to provide a preliminary description of a shallow aquifer system composed of unconsolidated materials. This method can be used to provide information to make initial estimates of the configuration of the shallow aquifer system and to plan for groundwater sustainability. Two examples of maps for an area in northeastern Illinois that were prepared using the resulting database are presented.
Making infection prevention and control everyone's business? Hospital staff views on patient involvement
Authors: Sutton Elizabeth , Brewster Liz , Tarrant Carolyn
Published: February 2019

Context

Ensuring an infection‐free environment is increasingly seen as requiring the contribution of staff, patients and visitors. There is limited evidence, however, about how staff feel about collaborating with patients and relatives to co‐produce that environment.

Aims

This study aims to understand how hospital staff perceive the involvement of patients and relatives in infection prevention and control (IPC) and the main challenges for staff in working together with patients and relatives to reduce the threat of infection.

Methods

Qualitative semi‐structured interviews were conducted with 35 frontline health‐care professionals and four executive staff, from two hospital trusts.

Findings

We found that staff were more supportive of approaches that encourage co‐operation from patients and relatives, than of interventions that invoked confrontation. We identified challenges to involvement arising from staff concerns about shifting responsibility for IPC onto patients. Staff were not always able to work with patients to control infection risks as some patients themselves created and perpetuated those risks.

Conclusions

Our work highlights that IPC has particular features that impact on the possibilities for involving patients and relatives at the point of care. Staff acknowledge tensions between the drive to involve patients and respect their autonomy, and their duty to protect patients from risk of unseen harm. The role that patients and relatives can play in IPC is fluctuating and context dependent. Staff responsibility for protecting patients from the risk of infection may sometimes need to take priority over prerogatives to involve patients and relatives in the co‐production of IPC.
Chitinozoans and scolecodonts from the Silurian and Devonian of Japan
Authors: Vandenbroucke Thijs R. A. , Hints Olle , Williams Mark , Wallis Simon , Velleman Jules , Kurihara Toshiyuki , Tanaka Gengo , Komatsu Toshifumi , Männik Peep , Siveter David J. , de Backer Tim
Published: February 2019

Silurian and Devonian chitinozoans and scolecodonts are recorded from strata of the Hida‐Gaien Terrane, central Honshu. Silurian chitinozoans include Eisenackitina, Bursachitina, and the species Angochitina elongata. The latter provides a precise biostratigraphical tie between the Japanese succession and the Type Ludlow Series of the Welsh Borderland, UK, and indicates a Ludlow age (Gorstian or early Ludfordian) for the upper member of the Yoshiki Formation in the Ichinotani Valley. Chitinozoans from other Yoshiki Formation localities contain other specimens of Lagenochitinidae. Scolecodonts are more common than chitinozoans in the palynological residues, but are mostly represented by fragments or minor apparatus elements with a low biostratigraphical value. However, material from the Yoshiki and Fukuji Formations includes several species of Mochtyella as well as representatives of Oenonites, Kettnerites, Lunoprionella, Vistulella? and possibly other placognath taxa. Scolecodonts are also present in the Silurian Middle Member of the Gionyama Formation, Kyushu, including a well‐preserved jaw of Pistoprion, and fragments of putative Kettnerites and Oenonites. These finds of scolecodonts suggest close similarity in assemblages between Paleozoic polychaete faunas of Japanese terranes and those of Baltica‐Laurentia.
A simple topographical model to predict Golden Eagle Aquila chrysaetos space use during dispersal
Authors: Fielding Alan H. , Haworth Paul F. , Anderson David , Benn Stuart , Dennis Roy , Weston Ewan , Whitfield D. Philip
Published: February 2019

Many large raptors exploit or rely on anabatic and orographic winds which provide vertical lift, to supplement or provide the energy fuelling flight. Airspace is therefore a critical habitat for such large raptors and its use is subject to the underlying terrestrial topography, because particular topographical features are more likely to provide wind‐energetic lift. Accordingly, ridges and/or ‘rugged topography’ are common preferred features in habitat use by large raptors. Our study aimed to provide a simple model of space use for a large raptor, the Golden Eagle Aquila chrysaetos, based on thousands of GPS telemetry records during juvenile dispersal of 92 birds tagged as nestlings between 2007 and 2016 across upland Scotland. Model development was based on the hypothesis that four topographical variables would be influential: slope, aspect, altitude and distance from ridge. The telemetry dataset was divided into training and two testing components. The first testing set was derived by a temporal split resulting in approximately equal sample size on records and some temporal overlap in individuals’ records with training data. The second testing set involved no individuals from the training set. Aspect was removed early in training model development because it was not influential. The model found that young Golden Eagles preferred, or used according to availability, space above slopes greater than 10°, at an altitude of ≥ 300 m, and within 300 m of a ridge. The test data were highly correlated with those from the training data in the model variables, and performance as regard to expected preferences from the model was improved in both test datasets, indicating the model was robust. Given the apparent universal nature of large raptor dependence on topography, that topography is relatively immutable according to time and use, and that topographical data are readily available, we commend our approach to other habitat preference studies of Golden Eagles and other large raptors elsewhere.
Inflammatory biomarkers, vascular procedures of lower limbs, and wound healing
Authors: Sapienza Paolo , Mingoli Andrea , Borrelli Valeria , Brachini Gioia , Biacchi Daniele , Sterpetti Antonio V. , Grande Raffaele , Serra Raffaele , Tartaglia Elvira
Published: February 2019

Abnormal, persistent inflammation after bypass surgery could prevent healing of an ischaemic foot lesion. In 37 patients with peripheral arterial disease (PAD) (Rutherford Grade III Category 5) who underwent infrapopliteal vein graft and midfoot amputation, plasma levels of fibrinogen, C‐reactive protein (CRP), interleukin‐1 (IL‐1), interleukin‐6 (IL‐6), tumour necrosis factor‐α (TNF‐α), and matrix metalloproteinase‐2 and ‐9 (MMP‐2 and MMP‐9) were determined preoperatively and during the follow up. Nine patients without clinical and Doppler evidence of arterial disease, who underwent post‐traumatic midfoot primary amputation, were included in the experiment group, and 15 age‐matched healthy volunteers served as control. In patients who had midfoot amputation for trauma, all wounds healed. Seven (19%) wounds in patients with an occluded graft healed, and five (13%) required major amputation because of a non‐healing wound. Time required for complete healing of the lesion was similar between trauma and PAD patients (8 ± 2 months vs 11 ± 6, respectively, P = NS). Univariate analysis demonstrated that, in PAD patients, the postoperative high levels of TNF‐α, IL‐6, and MMP‐2 and ‐9 were predictive for wound healing failure at 3, 6, and 9 months (P < 0.05), respectively. Furthermore, the subgroup of patients who experienced occlusion of the vein graft during follow up had a significant increase of MMP‐2, ‐9, IL‐6, and TNF‐α at 3, 6, and 9 months (P < 0.05), respectively. Monitoring inflammatory markers allows the determination of patients at risk of healing failure of midfoot amputation after distal revascularisation and might predict the fate of the vein graft.
MicroRNA‐876‐5p inhibits cell proliferation, migration and invasion by targeting c‐Met in osteosarcoma
Authors: Xie Weixin , Xiao Jie , Wang Tao , Zhang Dongmei , Li Zhanchun
Published: February 2019

Recently, aberrant expression of miR‐876‐5p has been reported to participate in the progression of several human cancers. However, the expression and function of miR‐876‐5p in osteosarcoma (OS) are still unknown. Here, we found that the expression of miR‐876‐5p was significantly down‐regulated in OS tissues compared to para‐cancerous tissues. Clinical association analysis indicated that underexpression of miR‐876‐5p was positively correlated with advanced clinical stage and poor differentiation. More importantly, OS patients with low miR‐876‐5p level had a significant shorter overall survival compared to miR‐876‐5p high‐expressing patients. In addition, gain‐ and loss‐of‐function experiments demonstrated that miR‐876‐5p restoration suppressed whereas miR‐876‐5p knockdown promoted cell proliferation, migration and invasion in both U2OS and MG63 cells. In vivo studies revealed that miR‐876‐5p overexpression inhibited tumour growth of OS in mice. Mechanistically, miR‐876‐5p reduced c‐Met abundance in OS cells and inversely correlated c‐Met expression in OS tissues. Herein, c‐Met was recognized as a direct target of miR‐876‐5p using luciferase reporter assay. Notably, c‐Met restoration rescued miR‐876‐5p attenuated the proliferation, migration and invasion of OS cells. In conclusion, these findings indicate that miR‐876‐5p may be used as a potential therapeutic target and promising biomarker for the diagnosis and prognosis of OS.
miR‐181c‐5p mediates simulated microgravity‐induced impaired osteoblast proliferation by promoting cell cycle arrested in the G2 phase
Authors: Sun Zhongyang , Li Ying , Wang Han , Cai Min , Gao Shanshan , Liu Jing , Tong Liangcheng , Hu Zebing , Wang Yixuan , Wang Ke , Zhang Lijun , Cao Xinsheng , Zhang Shu , Shi Fei , Zhao Jianning
Published: February 2019

Impaired osteoblast proliferation plays fundamental roles in microgravity‐induced bone loss, and cell cycle imbalance may result in abnormal osteoblast proliferation. However, whether microgravity exerts an influence on the cell cycle in osteoblasts or what mechanisms may underlie such an effect remains to be fully elucidated. Herein, we confirmed that simulated microgravity inhibits osteoblast proliferation. Then, we investigated the effect of mechanical unloading on the osteoblast cell cycle and found that simulated microgravity arrested the osteoblast cell cycle in the G2 phase. In addition, our data showed that cell cycle arrest in osteoblasts from simulated microgravity was mainly because of decreased cyclin B1 expression. Furthermore, miR‐181c‐5p directly inhibited cyclin B1 protein translation by binding to a target site in the 3′UTR. Lastly, we demonstrated that inhibition of miR‐181c‐5p partially counteracted cell cycle arrest and decreased the osteoblast proliferation induced by simulated microgravity. In conclusion, our study demonstrates that simulated microgravity inhibits cell proliferation and induces cell cycle arrest in the G2 phase in primary mouse osteoblasts partially through the miR‐181c‐5p/cyclin B1 pathway. This work may provide a novel mechanism of microgravity‐induced detrimental effects on osteoblasts and offer a new avenue to further investigate bone loss induced by mechanical unloading.
The digestive tube of Piaractus brachypomus: gross morphology, histology/histochemistry of the mucosal layer and the effects of parasitism by Neoechinorhynchus sp.
Authors: de Oliveira Maria I. B. , de Matos Lorena V. , da Silva Lídia A. , Chagas Edsandra C. , da Silva Grazyelle S. , Gomes Ana L. S.
Published: February 2019

The objective of the present study was to describe the histology and histochemistry of the mucosal layer of the digestive tube of Piaractus brachypomus, and the histopathology associated with parasitism by Neoechinorhynchus sp. The digestive tube of P. brachypomus consists of three macroscopically distinct portions: short, rectilinear and elastic‐walled ooesophagus, J‐shaped siphon stomach and a long intestine with rectilinear and curved portions, defined by patterns of villi as foregut, midgut, and hindgut. Histological and histochemical differences were observed in the mucosal layers of the different digestive tube regions, such as intense production of neutral and acidic mucous substances in the pseudostratified mucosal epithelium of the oesophagus; positive periodic acid Schiff reagent (PAS)reactions at the apex of the columnar epithelial cells of the stomach and increased intensity of histochemical reactions in the hindgut region. Neoechinorhynchus sp. was present in 85.7% of specimens examined, with a mean intensity of 7.4 ± 6.2 (±) and abundance of 6.33. Good health of the fish indicated by high relative condition factor values (
Kn) and occurrence of only mild to moderate alteration in the mucosal layer indicated that Neoechinorhynchus sp. exhibits low pathogenicity towards P. brachypomus hosts in farming environments, with low levels of infection.
Evaluation of sensory, textural, and nutritional attributes of shiitake mushrooms (Lentinula edodes) as prepared by five types of drying methods
Authors: Zhao Yuanyuan , Bi Jinfeng , Yi Jianyong , Jin Xin , Wu Xinye , Zhou Mo
Published: February 2019

The effect of freeze drying (FD), far‐infrared radiation drying (FIRD), heat pump drying (HPD), hot air drying (HAD), and hot air combined instant controlled pressure drop drying (DIC) were compared on the drying efficiency and quality attributes of dried shiitake mushrooms. The results showed that in comparison with the HPD, HAD, and DIC, the FIRD shiitake mushroom exhibited better appearance with less shrinkage and lower ΔE (6.10), lower hardness (34.82 N), and higher rehydration ratio (7.55), which were more resemble to those of the FD sample. Besides, a significantly higher (p < 0.05) retention of protein was found in the FD and FIRD sample (2.47 mg/g and 2.30 mg/g), as well as higher retention of polysaccharide (1.79 mg/g and 1.39 mg/g). In addition, FIRD shiitake mushroom were superior to FD product in terms of saving drying time as 66.25% and exhibiting maximum numbers of flavor components, among which specific sulfides showed the highest percentage (24.59%). Therefore, the FIRD dried shiitake mushroom obtained a better overall quality among the products dried by the five drying methods.

Practical applications

Shiitake mushrooms are wildly planted edible fungi, which are consumed mostly in dried form around the word. Recently, the demand of efficient application have promoted an increasingly use of novel drying technologies in mushroom processing. This study presents comprehensive evaluations on some vital quality attributes of shiitake mushrooms using five drying methods that already commercialized in China. FIRD was more suitable to produce dried shiitake mushrooms with desirable appearance and texture, as well as relatively rich flavor and nutrients.
Behaviour problems in people with intellectual disabilities: validation of the French version of the Behaviour Problems Inventory – Short Form
Authors: Oubrahim L. , Combalbert N.
Published: February 2019

Objective

The risk for the development of severe behaviour problems by individuals with intellectual disability (ID) is a well‐known concern. However, there are currently no reliable instruments for assessing these behaviours in French. The Behaviour Problems Inventory – Short Form (BPI‐S) assesses these three types of behaviour in people with ID: self‐injurious behaviour (eight items), aggressive/destructive behaviours (10 items) and stereotypic behaviours (12 items). The purpose of this study was to conduct a psychometric study of a French version of the BPI‐S.

Method

Data were collected on 305 children, adolescents and young adults with ID 50 care workers in seven specialised institutions in France as informants. We examined the scale's factorial structure (using confirmatory factor analysis), internal consistency and inter‐rater reliability. We also established preliminary French norms.

Results

Our results show that the French BPI‐S has a factorial structure similar to that of the English version. It has good internal consistency. The internal consistency of the frequency ratings was 0.91 and 0.62 for the severity ratings. The BPI‐S has a good inter‐rater reliability with acceptable coefficients for the frequency ratings (Self Injurious Behaviour (SIB) = 0.81; Aggressive–Destructive behaviour = 0.66; Stereotyped behaviours = 0.75) and for the severity ratings (SIB = 0.92; Aggressive–Destructive behaviour = 0.54). The data also show that the frequency and severity of behaviours differ based on the level of ID.

Conclusions

The French version of the BPI‐S has good psychometric properties for assessing problem behaviours in children, adolescents and young adults. This scale can be used for research and clinical evaluation of disorders associated with ID.
A Conflict of Values: Nurses’ Willingness to Work Under Threatening Conditions
Authors: Ganz Freda DeKeyser , Margalith Ilana , Benbenishty Julie , Hirschfeld Miriam , Wagner Nurit , Toren Orly
Published: February 2019

Purpose

The purpose of this study was to determine the willingness of Israeli registered nurses to work under threatening conditions, their perceived level of threat, and perceptions of peer willingness to report to work.

Design

This descriptive study was based on a convenience sample of registered nurses working in four hospitals throughout Israel from internal medicine, surgical, emergency, and intensive care units.

Methods

A questionnaire designed by the investigators was administered to registered nurses while on duty. The questionnaire consisted of three sections: personal characteristics, perceived level of personal threat from five situations (caring for a patient with a dangerous infection, terror attack, war, radiation or chemical disaster, or natural disaster), and perceived personal and peer willingness to work under these threats.

Findings

A convenience sample of 249 registered nurses from four hospitals responded. The highest level of perceived threat was a natural disaster (earthquake; M = 2.15, SD = 0.9). Terror (M = 0.83, SD = 0.6) and war (M = 1.01, SD = 0.6) received the lowest mean perceived threat scores. Most respondents were not willing to work during a natural disaster but were willing to care for patients with dangerous infections and during times of war. Weak positive statistically significant correlations were found between the level of perceived threat and willingness to work for all of the threats, except for terror (Spearman rank correlation = .16–.35).

Conclusions

Local culture, perceptions of the level of threat, and perceived peer responsiveness are associated with registered nurses’ willingness to work under threat.

Clinical Relevance

When faced with a threat to personal safety or security, many registered nurses might not be willing to work as usual. What is perceived as threatening is influenced by the local culture and environment. Therefore, managers should be aware of potential cultural and peer influences on this possible conflict of values.
Verification of the reliability of current perception threshold and pain threshold testing by application of an electrical current stimulus to mandibular mucosa in young adults
Authors: Furuse Nobuhiko , Kimoto Suguru , Nakashima Yoshio , Ogawa Takahiro , Furokawa So , Okubo Masakazu , Yamaguchi Hidenori , Kawai Yasuhiko
Published: February 2019

Background

There is little evidence regarding the reliability of CPT and PT measurements to gauge mandibular perception. Thus, this study aimed to evaluate the test‐retest reliability of CPT and PT values obtained from the mandibular oral mucosa and to test the bilateral differences in CPT and PT values obtained from the mental foramen region and buccal shelf region by a single operator.

Methods

CPT and PT values were obtained from the mental foramen and buccal shelf regions of 20 volunteers (10 males and 10 females; average age: 26.4 ± 2.6 years) by using the Neurometer CPT/C® device to deliver electrical stimulation.

Results

Relative and absolute reliabilities were confirmed over two measurements of CPT and PT over a 7‐ to 10‐day measurement interval. Intra‐class correlation coefficients (ICCs) for CPT and PT table obtained from the mental foramen region were >0.8, while most ICC for the buccal shelf region were <0.8. Standard error of measurement, minimal detectable change and Bland‐Altman analyses showed that the CPT and PT measurements had no systematic error and could serve as useful methods. At all frequencies, the bilateral difference in CPT and PT values at the mental foramen and buccal shelf region was not significant.

Conclusion

CPT and PT measurements using a custom‐made device that applied an electrical current to the mental foramen region have appropriate reliability to assess intra‐oral sensitivity to electrical stimulation in young adults.
Conceptualization and Measurement of Adolescent Prosocial Behavior: Looking Back and Moving Forward
Authors: El Mallah Shereen
Published: February 2019

The struggle to cast a net around the numerous ways prosocial behavior is expressed lends itself to the absence of widely accepted methods of measurement. Additionally, research intent on evaluating the psychometric properties of current approaches has been somewhat limited. Weaving together seminal as well as contemporary research, the current review focuses on how these conceptual and measurement issues pertain to adolescent studies (in an intentional effort to offset the somewhat disproportionate focus directed toward prosocial development in infants, children, and adults). Recommendations to address current limitations and attain a more nuanced understanding of the construct are presented and discussed.
Strengthening Local Credit Markets Through Lender‐Level Index Insurance
Authors: Collier Benjamin L.
Published: February 2019

This article considers lender‐level index insurance as a means of expanding access to credit in disaster‐prone communities. In this approach, the lender transfers the disaster risk of loans in its portfolio by contracting on an observable measure of the catastrophe. I develop and calibrate a dynamic, stochastic model using data from a community lender in Peru that is vulnerable to El Niño–related flooding. The modeled lender can insure against El Niño using an index‐based product that is available for purchase by financial intermediaries in Peru. I examine how premium rates, basis risk, and background risk may influence the lender's insurance decision and credit supply. Overall, the results suggest that lender‐level index insurance holds promise for reducing disaster‐related credit supply shocks and expanding credit access in vulnerable communities.
Polymorphic characterization and implications on biopharmaceutics properties of potential anti-inflammatory drug candidate eremantholide C from Lychnophora trichocarpha (Brazilian Arnica)
Authors: Caldeira Tamires G , Saúde-Guimarães Dênia A , De Lacerda Dâmaris L R , Mussel Wagner Da Nova , Yoshida Maria Irene , De Souza Jacqueline
Published: February 2019

Objectives

To perform the polymorphic and physicochemical characterization of the potential anti-inflammatory drug, eremantholide C (EREC), as well as to evaluate the influence of these characteristics on its biopharmaceutics classification.

Methods

Eremantholide C was obtained from chloroformic extract of Lychnophora trichocarpha and crystallized in two distinct solvents: chloroform (EREC 1) and ethyl acetate (EREC 2). To evaluate the polymorphism, EREC samples were submitted to melting point, purity, infrared spectroscopy, differential scanning calorimetry (DSC), X-ray powder diffraction, optical microscopy and scanning electron microscopy analysis. In addition, EREC samples crystallized after intrinsic dissolution study were submitted to DSC and X-ray powder diffraction analysis.

Key findings

EREC 1 showed fusion at 234.7–241.6 °C, while EREC 2 showed fusion at 238.6–243.7 °C. No polymorphic transitions were observed during the intrinsic dissolution experiment. A single sharp endothermic peak was obtained for the EREC samples. X-ray diffraction showed no crystallographic differences between the EREC samples. EREC 1 and EREC 2 showed birefringence under polarized light and indefinite morphology; however, the shape of the crystals was common to the two samples.

Conclusions

Eremantholide C does not present classical or morphological polymorphism; therefore, there is no influence of crystalline transitions in the solubility and consequently in its biopharmaceutics classification and oral absorption process.
The effect of oral contraceptive pill cessation on hepatocellular adenoma diameter: A retrospective cohort study
Authors: Haring Martijn P. D. , Gouw Annette S. H. , de Haas Robbert J. , Cuperus Frans J. C. , de Jong Koert P. , de Meijer Vincent E.
Published: February 2019

Background & Aims

Hepatocellular adenomas (HCA) are rare, hormone‐driven, benign liver tumours. HCA >50 mm are associated with haemorrhage and malignant transformation. Guidelines recommend cessation of oral contraceptive pills (OCP) for size reduction; however, it is currently unknown how HCA respond to cessation of OCP. We sought to investigate the effect of OCP cessation on HCA size.

Methods

A retrospective cohort study was performed including HCA patients who stopped OCP intake within 6 months of imaging between 2005 and 2018. Biometrics and hormonal medication use were evaluated with self‐designed questionnaires. Response of the largest HCA was evaluated according to Response Evaluation Criteria in Solid Tumours (RECISTv1.1). Cox regression was performed for analysis of factors influencing HCA regression.

Results

Seventy‐eight HCA patients were included, diagnosed at a median (interquartile range) age of 32 (26‐41) years. Follow‐up was 1.6 (0.4‐2.9) years. HCA size at diagnosis ranged 10‐167 mm. After a median time of 1.3 (0.6‐2.6) years after OCP cessation, 37.2% of HCA showed ≥30% regression, 5.1% complete regression, 56.4% stability and 1.3% progression. No HCA‐induced complications were observed during follow‐up. Cox regression analysis demonstrated a significant association of HCA size with rate of regression; 50 ≤ HCA < 100 mm (HR 2.4, 95% CI 1.1‐5.3; P < 0.05), HCA ≥ 100 mm (HR 8.3, 95% CI 3.3‐21.6; P < 0.001).

Conclusions

Ninety‐eight per cent of HCA remained stable or regressed after OCP cessation. A longer wait‐and‐see period was associated with a larger proportion of regressing HCA, without HCA‐related complications during follow‐up.
Comparing resident–patient encounters and case presentations in a family medicine clinic
Authors: Skelly Kelly , Rosenbaum Marcy , Barlow Patrick , Priebe Garrick
Published: February 2019

Objectives

Oral case presentations following resident–patient interactions provide the primary mechanism by which faculty supervisors assess resident competence. However, the extent to which these presentations capture the content and quality of resident–patient communication during the encounter remains unknown. We aimed to determine whether: (i) the resident–patient encounter content matched information conveyed in the case presentation; (ii) the quality of resident–patient communication was accurately conveyed, and (iii) supervisors addressed effective and ineffective communication processes.

Methods

A total of 22 pairs of resident–patient encounters and family medicine resident case presentations were video‐ or audiorecorded, transcribed and compared for content. Resident–patient communication was assessed using adapted versions of the Calgary–Cambridge Guide to the Medical Interview and Explanation and Planning Scale.

Results

Interviews and presentations contained largely congruent content, but social history and the patient's perspective were consistently excluded from case presentations. Although six of 19 specific communication skills were used in over 80% of resident encounters, the effective use of communication skills was widely variable. In most presentations, the quality of resident–patient communication was not explicitly conveyed to the supervisor. Although resident presentations provided ‘cues’ about communication issues, supervisors rarely responded.

Conclusions

This study lends support to direct observation in workplace‐based learning of communication skills. When content areas such as the patient's perspective and education are excluded, supervisors cannot address them. In addition, presentations provided minimal insight about the quality of resident–patient encounters and limited the ability to address communication skills. These skills could be enhanced by attending to communication cues during case presentations, making increased use of direct observation and feedback, and promoting faculty development to address these missed teaching opportunities.
In vitro combination between antifungals and diphenyl diselenide against Cryptococcus species
Authors: Rossato Luana , Loreto Erico S. , Venturini Tarcieli P. , de Azevedo Maria Isabel , Al‐Hatmi Abdullah M. S. , Santurio Janio M. , Alves Sydney H.
Published: February 2019

Cryptococcus species are an encapsulated fungal pathogen that cause cryptococcal meningitis. There are limited therapeutic options for this infection. The management includes the use of different antifungals such as amphotericin B, flucytosine, or fluconazole, either alone or in combination. However, numerous therapeutic failures, as well as the limited effectiveness of such therapeutics, have been described. Diphenyl diselenide is a chemically synthesised molecule with was found to have antimicrobial activity. In this study, we evaluated the antifungal activities of fluconazole, amphotericin B and flucytosine, in combination with diphenyl diselenide against 30 clinical isolates of Cryptococcus spp. using CLSI M27‐A3 method and the checkerboard microdilution technique. Our results show that the combination of flucytosine and diphenyl diselenide displayed 100% of synergism. However, when we analysed (PhSe)2 plus AMB or FLZ we observed around 70% of indifference. Our results suggest that the combination of diphenyl diselenide with other antifungal agents deserves attention as a new option for the development of alternative therapies for cryptococcosis.
Harm reduction: Philosophical drivers of conceptual tensions and ways forward
Authors: Jiao Sunny
Published: February 2019

Of the various debates surrounding harm reduction, a conceptual tension that perhaps has the most relevance for the provision of services is that of harm reduction as a technical solution versus a contextualized social practice. The aim of this paper was to examine this conceptual tension. First, the two perspectives will be presented through the use of examples. Second, philosophical drivers that serve to underpin and justify each perspective will be explicated at the level of the knowledge that we privilege; the ideologies that we subscribe to; and the interests that we stand to serve. In this paper, I argue that the existing tension between technical and social approaches to harm reduction is embedded within discord pertaining to ways of knowing, paradigms of inquiry, prevailing ideologies, and notions of harm and risk. Building on these sources of tension, I suggest a means of philosophical reconciliation between the two approaches and ways forward, namely through acknowledging multiple sources of knowledge, through embracing paradigmatic incommensurability, through considering alternative conceptions of people who use drugs as political subjects, through involving service providers and end‐users in shared decision‐making, and lastly through reaffirming people who use drugs as the intended beneficiaries of services.
Is gastroparesis a gastric disease?
Authors: Cogliandro Rosanna F. , Rizzoli Giada , Bellacosa Lara , De Giorgio Roberto , Cremon Cesare , Barbara Giovanni , Stanghellini Vincenzo
Published: February 2019

Background

Gastroparesis is a digestive syndrome characterized by delayed gastric emptying (GE) and by symptoms that are suggestive of gastroduodenal motor disorders. There are three grades of gastroparesis of increasing severity: (a) mild gastroparesis; (b) compensated gastroparesis; and (c) gastric failure. GE abnormalities are partially related to symptom type and severity, and other mechanisms may be involved.

Aim

To investigate enteric dysmotility (ED) in patients with suspected gastroparesis.

Methods

Patients with symptoms suggestive of gastroparesis were consecutively included in the study and underwent a 13C‐octanoic acid GE breath test and small bowel manometry (SBM). Clinical features were recorded using predefined, validated questionnaires at entry.

Key Results

The study enrolled 88 patients (71 women; mean age: 37.8 ± 14.3 years). Gastric emptying was delayed in 25 patients (28.4%), and 70 patients (79.5%) presented small bowel motor abnormalities including bursts, abnormal activity fronts, inability to respond to meal ingestion, and hypocontractility. Gastric emptying was delayed in 24 of the 70 patients with ED (34.3% vs 5.5% of patients with normal SBM). Enteric dysmotility was detected in 24 of 25 patients (96%) with delayed GE. Patients with and without delayed GE showed similar moderate/severe gastroparesis manifestations, but patients with ED significantly more often had moderate/severe gastroparesis manifestations than patients with normal SBM (grade 1:14% vs 39%, grade 2:62% vs 56%, grade 3:24% vs 5%, respectively).

Conclusions and Inferences

Enteric dysmotility was more frequent than delayed GE in patients with symptoms suggestive of gastroparesis. Gastroparesis severity was associated with small bowel motor abnormalities but not with delayed GE.
Pediatric chondrodermatitis nodularis helicis (CNH) in a child with Beckwith‐Wiedemann syndrome (BWS)
Authors: Fix William C. , Cornejo Christine , Duffy Kelly A. , Hathaway Evan R. , Kalish Jennifer M. , Rubin Adam I. , Treat James R.
Published: February 2019

Chondrodermatitis nodularis helicis is an idiopathic degenerative process that presents as a painful nodule, papule, or ulcer on the helix or antihelix. It predominantly affects adults and is thought to be associated with trauma to the ear. We describe a case of pediatric chondrodermatitis nodularis helicis occurring in a child with a history of Beckwith‐Wiedemann syndrome that was successfully treated with an excisional biopsy and relief from a recurrent source of pressure on the ear.
Primary non‐gestational uterine choriocarcinoma mimicking leiomyoma
Authors: Sano Rikiya , Moriya Takuya , Suzuki Soichiro , Saito Wataru , Shimoya Koichiro , Shiota Mitsuru
Published: February 2019

Uterine choriocarcinoma is a trophoblastic neoplasm that is most commonly gestational but can also be non‐gestational in origin. However, primary non‐gestational uterine choriocarcinoma is very rare, with only few cases having been reported. We report a case of a premenopausal woman who had initially been diagnosed with myoma delivery but who was discovered to have primary non‐gestational uterine choriocarcinoma. This 46‐year‐old woman had no history of pregnancy. She was referred to our hospital for treatment of the myoma delivery. After tumor removal, histological examination led to the diagnosis of choriocarcinoma. The serum human chorionic gonadotropin level (207,300 mIU/mL) prior to surgery was abnormally high, and because the computed tomography scans additionally revealed lung metastasis, the patient was diagnosed with FIGO stage III choriocarcinoma. Due to the lack of pregnancy history and abstinence from sexual intercourse for >1 year, we performed short tandem repeat analysis, and diagnosed the patient with non‐gestational choriocarcinoma. Despite treatments using multiple anticancer agents after the surgery, the patient died 1 year after starting the treatments. On this occasion, we report a very rare case of a premenopausal woman who was diagnosed with primary non‐gestational uterine choriocarcinoma mimicking leiomayoma.