bluuebunny/crossref_metadata_2025 huggingface dataset:
Chemical biofilm removal capacity of endodontic irrigants as a function of biofilm structure: optical coherence tomography, confocal microscopy and viscoelasticity determination as integrated assessment tools
Authors: Busanello F. H. , Petridis X. , So M. V. R. , Dijkstra R. J. B. , Sharma P. K. , van der Sluis L. W. M.
Published: October 2018

Aim

To investigate the influence of biofilm structure on the biofilm removal capacity of endodontic irrigants and to study changes in the architecture of the remaining biofilms.

Methodology

Streptococcus oralis J22 and Actinomyces naeslundii T14V‐J1 were cocultured under different growth conditions on saliva‐coated hydroxyapatite discs. A constant depth film fermenter (CDFF) was used to grow steady‐state 4‐day biofilms. Biofilms were grown under static conditions for 4 and 10 days within a confined space. Twenty microlitres of 2% NaOCl, 2% Chlorhexidine (CHX), 17% Ethylene‐diamine‐tetra‐acetic acid (EDTA) and buffer were applied statically on the biofilms for 60 s. Biofilm removal was evaluated with optical coherence tomography (OCT). Post‐treated biofilms were assessed via low load compression testing (LLCT) and Confocal laser scanning microscopy (CLSM). Optical coherence tomography data were analysed through a two‐way analysis of variance (ANOVA). Low load compression testing and CLSM data were analysed through one‐way ANOVA and Dunnett's post hoc test. The level of significance was set at a < 0.05.

Results

The initial biofilm structure affected the biofilm removal capacity of the irrigants. NaOCl demonstrated the greatest chemical efficacy against the biofilms and was significantly more effective on the static than the CDFF biofilms (P < 0.001). CHX was ineffective and caused a rearrangement of the biofilm structure. Ethylene‐diamine‐tetra‐acetic acid exhibited a distinct removal effect only on the CDFF biofilms. Biofilm age influenced the structure of the remaining biofilms. The 4‐day grown remaining biofilms had a significantly different viscoelastic pattern compared to the respective 10‐day grown biofilms (P ≤ 0.01), especially in the NaOCl‐treated group. Confocal laser scanning microscopy analysis confirmed the CHX‐induced biofilm structural rearrangement.

Conclusions

Biofilm structure is an influential factor on the chemical efficacy of endodontic irrigants. Optical coherence tomography allows biofilm removal characteristics to be studied. NaOCl should remain the primary irrigant. Ethylene‐diamine‐tetra‐acetic acid was effective against cell‐rich/EPS‐poor biofilms. Chlorhexidine did not remove biofilm, but rather rearranged its structure.
A bibliometric analysis of the scientific literature on Fairtrade labelling
Authors: Ruggeri Giordano , Orsi Luigi , Corsi Stefano
Published: October 2018

Since its foundation, the Fairtrade movement has attracted the attention of consumers, practitioners, media and scholars. Discussing the role that Fairtrade can play on a global yet locally rooted scale is very complex, as research reports contrasting results about its usefulness and effectiveness. This study examines scientific research on Fairtrade over the last decades by conducting a bibliometric analysis of the literature published on the ISI Web of Knowledge Core Collection, which included 876 papers by 1,293 authors in 432 journals. Results show that despite this being a relatively recent field of study, Fairtrade has been approached from different disciplines with different methodologies and objectives. The structured quantitative study of the literature enabled us to inspect how research has evolved over the years in the light of the changes faced by Fairtrade, to explore its scope in the broader field of the global market, to detect current research schools and perspectives within the network and to identify hitherto unaddressed issues and unconnected subfields.
Geography, climate, ecology: What is more important in determining bee diversity in the Aegean Archipelago?
Authors: Kaloveloni Aggeliki , Tscheulin Thomas , Petanidou Theodora
Published: October 2018

Aim

Understanding which factors drive α‐ and β‐diversity is fundamental to ecological and biogeographical research. Especially in archipelagos, diversity patterns are interesting due to the numerous factors influencing them. Here, we investigate the importance of climate and ecogeographical factors in shaping α‐ and β‐diversity patterns of bee species in the Aegean Archipelago, a bee diversity hotspot.

Location

Nineteen islands in the Aegean Archipelago, located along a N–S climate gradient.

Methods

We systematically sampled the bee fauna of phryganic communities in 100 sites across 19 islands. Using generalized linear models (GLMs), we tested climatic (viz. annual mean temperature and annual precipitation), geographical (island area, proportion of surrounding land mass, distance to climatically similar land mass, and maximum step length of pathway to nearest island/mainland), and ecological parameters (viz. floral abundance) as determinants of bee diversity. Following a multimodel island species–area relationship (ISAR) framework, we ranked islands according to the observed richness to identify biodiversity hotspots. Furthermore, we estimated the effect of the above factors on overall β‐diversity as well as on turnover and nestedness components, using multiple regression models on distance matrices.

Results

Island area was the best predictor, positively affecting α‐diversity, together with precipitation, surrounding land mass proportion, and floral abundance. Temperature was found to have a significant negative effect on α‐diversity. Among all study islands, Samothraki and Kea stood out as bee diversity hotspots, with a bee richness higher than predicted by the multimodel ISAR. The overall β‐diversity was mainly driven by the turnover component and positively related to precipitation differences, whereas the nestedness component was positively affected by differences in area and surrounding land mass proportion.

Main conclusion

This study highlights the importance of geography and climate in shaping both α‐ and β‐diversity of bees in the Aegean and suggests that both factors are likely to be crucial for analysing and predicting bee diversity responses to future environmental changes.
Efficacy and safety of azilsartan medoxomil/chlortalidone fixed‐dose combination in hypertensive patients uncontrolled on azilsartan medoxomil alone: A randomized trial
Authors: Collier David J. , Juhasz Attila , Agabiti‐Rosei Enrico , Lloyd Eric , Hisada Michie , Zhao Lin , Kupfer Stuart , Caulfield Mark J.
Published: October 2018

Patients with grade 2‐3 essential hypertension and postplacebo mean clinic systolic blood pressure (SBP) 160‐190 mm Hg and 24‐hour SBP 140‐175 mm Hg by ambulatory blood pressure monitoring (ABPM) received 40 mg azilsartan medoxomil (AZL‐M) monotherapy for 4 weeks. “Nonresponders” were then randomized to 8 weeks of double‐blind treatment with AZL‐M 40 mg, AZL‐M/chlortalidone (CLD) 40/25, or AZL‐M/CLD 40/12.5 mg. After 8 weeks, mean clinic SBP change was −21.1 (±1.04) mm Hg for AZL‐M/CLD 40/25 mg, −15.8 (±1.08) mm Hg for AZL‐M/CLD 40/12.5 mg, and −6.4 (±1.05) mm Hg for AZL‐M 40 mg (P < 0.001 for both AZL‐M/CLD vs AZL‐M, ANCOVA). Drug discontinuation rates were 8.9% (AZL‐M/CLD 40/25 mg), 7.5% (AZL‐M 40 mg), and 3.9% (AZL‐M/CLD 40/12.5 mg). Creatinine increased in 8.1% (AZL‐M/CLD 40/25), 3.1% (AZL‐M/CLD 40/12.5 mg), and 3.0% (AZL‐M 40 mg) of patients. AZL‐M/CLD was effective and well tolerated in patients not achieving blood pressure targets with AZL‐M.
Evaluation of an interprofessional continuing professional development course on comprehensive diabetes care: A mixed‐methods approach
Authors: Beckman Darrick , Wardian Jana , Sauerwein Tom J. , True Mark W.
Published: October 2018

Rationale

Since there are only 33 endocrinologists within the Department of Defence and over 150 000 beneficiaries with diabetes, most patients with diabetes will be treated by primary care providers (PCPs). Comprehensive diabetes care visits are extensive and the clinical practice guidelines (CPGs) routinely change; thus, providing current evidence‐based care is difficult. Most professional development courses aim to update PCPs on CPGs but are often inadequate as they focus on only the PCPs (not the interdisciplinary team) without a plan to implement changes into practice.

Objective

To evaluate the biannual (twice yearly), 3‐day, interprofessional Diabetes Champion Course (DCC) developed by the US Air Force Diabetes Center of Excellence on comprehensive diabetes care.

Methods

A mixed‐methods approach was used to evaluate three iterations of the DCC course (Sept 2014‐Sept 2015). Quantitatively, pre‐course and post‐course surveys were used to obtain impact on knowledge, skills, and intention to change clinical practice. Qualitatively, semi‐structured phone interviews were conducted with participants to obtain benefits to their clinic related to attending the DCC and barriers to implementation of the CPG process improvement project.

Results

Twelve of 19 responding clinics (63%) reported implementing all or part of their original CPG project developed at the DCC, and 17 of 19 clinics (89%) reported improvements associated with attending the DCC. Post‐course surveys, from on location participants, revealed significant improvements in knowledge (P < 0.01). Likewise, foot exam skills and ability to demonstrate glucose meters to patients improved. Even with high pre‐course confidence, 97% of providers reported acquiring new knowledge about prescribing and titrating insulin.

Conclusion

The DCC is innovative as it employs a team‐based, interprofessional, didactic, and interactive approach that is effective in improving knowledge, skills, and intention to change clinical practice, which should translate to better care for patients with diabetes.
Wnt‐induced activation of glucose metabolism mediates the in vivo neuroprotective roles of Wnt signaling in Alzheimer disease
Authors: Cisternas Pedro , Zolezzi Juan M. , Martinez Milka , Torres Viviana I. , Wong Guang William , Inestrosa Nibaldo C.
Published: October 2018

Dysregulated Wnt signaling is linked to major neurodegenerative diseases, including Alzheimer disease (AD). In mouse models of AD, activation of the canonical Wnt signaling pathway improves learning/memory, but the mechanism for this remains unclear. The decline in brain function in AD patients correlates with reduced glucose utilization by neurons. Here, we test whether improvements in glucose metabolism mediate the neuroprotective effects of Wnt in AD mouse model. APPswe/PS1dE9 transgenic mice were used to model AD, Andrographolide or Lithium was used to activate Wnt signaling, and cytochalasin B was used to block glucose uptake. Cognitive function was assessed by novel object recognition and memory flexibility tests. Glucose uptake and the glycolytic rate were determined using radiotracer glucose. The activities of key enzymes of glycolysis such as hexokinase and phosphofructokinase, Adenosine triphosphate (ATP)/Adenosine diphosphate (ADP) levels and the pentose phosphate pathway and activity of glucose‐6 phosphate dehydrogenase were measured. Wnt activators significantly improved brain glucose utilization and cognitive performance in transgenic mice. Wnt signaling enhanced glucose metabolism by increasing the expression and/or activity of hexokinase, phosphofructokinase and AMP‐activated protein kinase. Inhibiting glucose uptake partially abolished the beneficial effects of Wnt signaling on learning/memory. Wnt activation also enhanced glucose metabolism in cortical and hippocampal neurons, as well as brain slices derived from APPswe/PS1E9 transgenic mice. Combined, these data provide evidence that the neuroprotective effects of Wnt signaling in AD mouse models result, at least in part, from Wnt‐mediated improvements in neuronal glucose metabolism.
Estrogen therapy associated with mechanical vibration improves bone microarchitecture and density in osteopenic female mice
Authors: Moura Márcio Luis A. , Fugimoto Mariana , Kawachi Ana Paula M. , de Oliveira Mônica L. , Lazaretti‐Castro Marise , Reginato Rejane D.
Published: October 2018

We investigated the effects of estrogen therapy (ET) associated with low‐intensity and high‐frequency mechanical vibration (MV) on bone tissue in osteopenic female mice. Fifty 3‐month‐old female Swiss mice were ovariectomized (OVX) or sham‐operated, and distributed after 4 months into the following groups, with 10 animals per group: Sham; Control, OVX + vehicle solution; MV, OVX + MV; ET, OVX + 17β‐estradiol; and MV + ET, OVX + MV and 17β‐estradiol. Both vehicle solution and 17β‐estradiol (10 μg kg−1 day−1) were injected subcutaneously 7 days per week, and vibration (0.6 g, 60 Hz) was delivered 30 min per day, 5 days per week. Bone mineral density (BMD) and body composition were evaluated by densitometry at baseline and after 60 days of treatment when the animals were euthanized, and their femurs underwent histomorphometric and histochemical analyses. The Control group showed increased weight and fat percentage, while the ET and MV + ET groups showed increased lean mass but decreased fat percentage. At the end of the treatment period, the BMD decreased in Control, remained constant in Sham and MV, and increased in ET and MV + ET. The MV + ET group showed the greatest bone volume compared with Sham (129%), Control (350%), MV (304%) and ET (14%). No differences occurred in cortical thickness. The Control group showed the highest content of mature collagen fibers, while the MV + ET group showed the highest content of immature collagen fibers. In conclusion, ET plus MV was effective in improving bone quality in osteopenic female mice, and this improvement is associated with specific changes in trabecular but not cortical bone.
Workplace violence perpetrated by clients of health care: A need for safety and trauma‐informed care
Authors: Beattie Jill , Griffiths Debra , Innes Kelli , Morphet Julia
Published: October 2018

Aims

To examine the relationship between workplace violence perpetrated by clients, their innate neurophysiological response to dis‐ease and the resulting interactions with healthcare providers.

Background

Client‐on‐worker violence remains a problem globally. Workplace violence risk factors have been documented. A gap remains in understanding what has happened to clients that perpetrate violence, and the link between adverse childhood experiences (ACE), the neuroscience of threat and trauma‐informed care.

Design

This explanatory study was part of a larger descriptive study.

Methods

Managers, directors, health/safety staff, nurses and educators (n = 99) from Australian rural and metropolitan health services participated in individual and group interviews. Following inductive thematic analysis, a secondary analysis, informed by understandings of ACE, polyvagal theory and trauma‐informed care, was conducted. Analysis was guided by the question: What happens to clients that causes them to instigate violence against healthcare workers? Reporting of this research adheres to the COREQ guidelines.

Results

Clients can react aggressively when under perceived threat. Themes included are as follows: client stress and trauma, previous client trauma, impact of care provision on client and trauma‐informed care.

Conclusion

Healthcare services can be experienced as stressful environments. Coupled with high incidences of past trauma, clients’ assessment of risk and safety can be compromised resulting in inappropriate reactivity when staff are trying to provide care. Care provision can be perceived as a threat to clients’ physical and psychological safety, activating the fight protective response resulting in aggression. Understanding and applying neuroscience and implementing a cultural change of trauma‐informed care have the potential to reduce workplace violence. Even with these understandings, it is imperative that healthcare staff are protected and feel safe at work.

Relevance to clinical practice

Understanding trauma and the neuroscience of threat and safety can assist staff to understand what happens to clients that causes them to instigate violence against healthcare providers and implement systems and strategies to respond to such threat.
Diabetes knowledge of primary health care and specialist nurses in a major urban area
Authors: Daly Barbara M. , Arroll Bruce , Scragg Robert Keith R.
Published: October 2018

Aim and objectives

To examine trends since a previous 2006–2008 survey in diabetes knowledge held by primary health care nurses and their use of national diabetes guidelines, perceived ability to advise diabetes patients and preferences for further diabetes education.

Background

The obesity epidemic has led to a rapid increase in the prevalence of prediabetes and type 2 diabetes and to greater expectations for an expanded role for primary health care nurses in the prevention and community management of diabetes.

Design

Cross‐sectional survey using a self‐administered questionnaire and telephone interview and adheres to the STROBE guidelines.

Methods

All nurses who provide community‐based care in a major urban area were identified, and stratified by group, prior to random selection to participate in the study. A total of 1,416 practice, district (home care) and specialist nurses were identified who provide community‐based care. Of the 459 who were randomly selected, 336 (73%) participated in 2016 and were compared with a representative sample of 287 nurses surveyed in 2006–2008.

Results

Compared with nurses in 2006–2008, significantly more nurses in 2016 used diabetes guidelines, knew that stroke was a diabetes‐related complication, had a greater understanding of the pathology of diabetes and reported having sufficient knowledge to advise patients on laboratory results and improving outcomes through lifestyle changes. Despite these improvements, in 2016, only 24% of nurses could state that stroke was a complication of type 2 diabetes, only 37% felt sufficiently knowledgeable to advise patients on medications, and <20% could state that hypertension, smoking and the dyslipidaemia profile were important modifiable risk factors.

Conclusion

There have been improvements in nurse's knowledge but gaps remain for cardiovascular outcomes and associated modifiable risk factors and medication management.

Relevance to clinical practice

Education programmes should focus on improving cardiovascular risk management in patients with type 2 diabetes.
Breastfeeding woman or lactating object? A critical philosophical discussion on the influence of Cartesian dualism on breastfeeding in the neonatal intensive care unit
Authors: van Wijlen Jacqueline Elizabeth
Published: October 2018

Aim

This discursive paper aims to bring to the foreground the ongoing influence of Cartesian dualism and other important contextual complexities on breastfeeding in the neonatal intensive care unit (NICU).

Background

Breastfeeding is widely supported as the optimal form of nutrition for the first 6 months of life and beyond. Amidst a myriad of contextual factors, current breastfeeding rates are below globally targeted goals. For premature and/or critically ill infants, the importance of receiving breast milk is often encouraged based on its immunological and nutritive benefits as opposed to the entirety of the breastfeeding interaction, underscoring the influence of dualism in the NICU.

Design

The impact of Cartesian dualism and other sociocultural underpinnings of breastfeeding focused within the NICU environment are illustrated through a critical, philosophical discussion.

Methods

Relevant historical context is provided followed by an overview of the realities of contemporary breastfeeding. These are presented as a frame of reference for the NICU breastfeeding experiences currently encountered by many mothers of preterm and critically ill neonates, further illustrated using a clinical exemplar as well as the author's own observations from neonatal nursing practice.

Relevance to clinical practice

Shifting away from a dualistic approach requires rethinking breastfeeding support interactions between NICU nurses and mothers. To address the disembodied and often mechanistic approach to care inherent in the dominant Western medical model, a relational approach to breastfeeding support in the NICU is suggested and discussed.

Conclusion

Future research from a more critical lens is needed to examine the complex dynamics involved when nurses and mothers are negotiating decisions and processes related to infant feeding. In focusing on the relational dimensions of the breastfeeding experience, nurses can resist the dualistic influence and dominant discourses impacting infant feeding and motherhood in the 21st century.
Broken expectations of early motherhood: Mothers’ experiences of early discharge after birth and readmission of their infants
Authors: Feenstra Maria M. , Nilsson Ingrid , Danbjørg Dorthe B.
Published: October 2018

Background and aim

Today, mothers are discharged early after birth, and national monitoring shows an increase in readmission of infants. Readmission of the infant might diminish the possibility of bonding and weaken maternal confidence in taking care of the infant. The aim was to explore how new mothers experience the time from birth to being discharged after readmission with their infants.

Design

A phenomenological and hermeneutic study. Data were collected through telephone interviews. The study followed the COREQ requirements and was conducted in the Region of Southern Denmark in a University Hospital setting. Convenience sampling was applied, and eight mothers were included from November 2015–February 2016. Seven were interviewed.

Results

The data analysis revealed the following six themes: “Early discharge,” “Being at home,” “Readmission—shock or relief,” “Problems with breastfeeding in early motherhood,” “Empowering or disempowering guidance” and “Back home with broken expectations.” These six themes were all covered by the overall theme: “Broken expectations of a tranquil beginning of early motherhood.”

Conclusions

Our study points out that mothers wish for a tranquil beginning with their infants at home. Some already experienced problems at home, while others first were confronted at the check‐up at the outpatient clinic. Yet the common denominator was that the mothers experienced broken expectations regarding early motherhood when facing readmission. Readmission may influence the initial process either positively or negatively, depending on how the mothers experience their challenges and how the healthcare professionals support them. This highlights the importance of the way in which healthcare professionals support new mothers when they are readmitted. The study emphasises the importance of maternal feelings of security and confidence in their maternal role, as they are closely connected to the process of becoming a mother.
THE INTERSECTION OF THE FIELDS OF ENTREPRENEURSHIP AND DEVELOPMENT ECONOMICS: A REVIEW TOWARDS A NEW VIEW
Authors: Hessels Jolanda , Naudé Wim
Published: October 2018

Despite the popularity of promoting entrepreneurship and small and medium enterprises (SMEs) for economic development, there is little scientific basis on which policy makers can lean. The scholarly fields of entrepreneurship economics and development economics have been elaborated in isolation and only recently started to intersect. This growing intersection is, however, still fragmented, ad hoc, not based on a unifying theoretical approach and suffering from lack of proper measurement. Better policy making will hence benefit from the extension and deepening of the intersection of these fields. We contribute in this regard by providing a conceptual basis for the eventual elaboration of such a unified theoretical approach. We do so by providing an up‐to‐date review of the intersection of the two fields by noting the progress and gaps; by delineating the externalities associated with entrepreneurship in development and by proposing a synthesis definition of entrepreneurship.
Antiplasmodial activity and cytotoxicity, isolation of active alkaloids, and dereplication of Xylopia sericea leaves ethanol extract by UPLC-DAD-ESI-MS/MS
Authors: Gontijo Douglas Costa , Brandão Geraldo Célio , Nascimento Maria Fernanda Alves do , Braga de Oliveira Alaíde
Published: October 2018

Objectives

To assess the antiplasmodial activity of the ethanol extract of Xylopia sericea leaves, Annonaceae, often associated with antimalarial use and to perform a bioguided isolation of active compounds.

Methods

Dereplication of ethanol extract by the UPLC-DAD-ESI-MS/MS technique allowed the identification of the major constituents, isolation and identification of alkaloids. The antiplasmodial and cytotoxic activity of the extract, fractions and isolated compounds was evaluated against the chloroquine-resistant W2 strain Plasmodium falciparum and HepG2 cells, respectively.

Key findings

Ethanol extract showed high reduction of parasitemia as well as moderate cytotoxicity (86.5 ± 3.0% growth inhibition at 50 μg/ml and CC50 72.1 ± 5.1 μg/ml, respectively). A total of eight flavonoids were identified, and two aporphine alkaloids, anonaine and O-methylmoschatoline, were isolated. Anonaine disclosed significant antiplasmodial effect and moderate cytotoxicity (IC50 23.2 ± 2.7 μg/ml, CC50 38.3 ± 2.3 μg/ml, SI 1.6) while O-methylmoschatoline was not active against P. falciparum and showed a low cytotoxicity (33.5 ± 1.9% growth inhibition at 50 μg/ml, CC50 274.4 ± 0.5 μg/ml).

Conclusions

Characterization of Xylopia sericea leaves ethanol extract by UPLC-DAD-ESI-MS/MS as well as its antiplasmodial activity and the occurrence of anonaine and O-methylmoschatoline in this Xylopia species are reported by the first time.
Investigation into the causes of aspirin resistance in healthy dogs
Authors: Haines Jillian M. , Lee Pamela M. , Hegedus Rachel M. , Hwang Julianne K. , Court Michael H.
Published: October 2018

Antiplatelet effects of acetylsalicylic acid (ASA, aspirin) may be poor in some individuals. Additionally, no method exists for predicting poor ASA response (resistance) in individual dogs. This study's main objective was to determine whether poor ASA response results from pharmacodynamic or pharmacokinetic causes. ASA concentrations causing 50% inhibition of platelet aggregation (in vitro IC50) were determined using whole blood collected from 21 drug‐free healthy dogs to evaluate intrinsic sensitivity of platelets to ASA. Dogs were then administered ASA at 4 mg/kg once orally. Percent decrease in platelet aggregation from baseline, and plasma ASA and salicylic acid (SA) concentrations (expressed as AUC values) were measured for up to 3 hr. By 3 hr, 13/21 (62%) dogs showed >50% aggregation inhibition, while 8/21 (38%) dogs showed <50% inhibition. Aggregation inhibition values were negatively correlated with in vitro IC50 values (Rs = −0.49; p = 0.028) and positively correlated with ASA concentrations (Rs = 0.48; p = 0.03). Furthermore, ASA concentrations were strongly negatively correlated (Rs = −0.88; p < 0.001) with SA/ASA concentration ratios, an index of ASA metabolism to SA by esterase enzymes. Multiple linear regression analysis indicated that 59% (p < 0.001) of interindividual variability in aggregation inhibition was explained by in vitro IC50 values (29% of variability) and ASA concentrations (29% of variability). Consequently, poor in vivo ASA response in these dogs resulted from both pharmacodynamic (decreased platelet sensitivity) and pharmacokinetic (lower ASA concentrations) causes. Lower ASA concentrations may be explained by reduced bioavailability associated with higher esterase activities.
Do prey availability, human disturbance and habitat structure drive the daily activity patterns of Amur tigers (Panthera tigris altaica)?
Authors: Yang H. , Han S. , Xie B. , Mou P. , Kou X. , Wang T. , Ge J. , Feng L.
Published: October 2018

The daily activities of animals are influenced by various factors, including their physiological adaptations and preferred habitat distributions, as well as prey availability and human disturbances. For felids, the main drivers of activity patterns appear to be prey availability and anthropogenic disturbances, as suggested by previous studies. In this study, we explore a set of variables that influence the activity patterns of Amur tigers (Panthera tigris altaica) in Jilin and Heilongjiang Provinces in north‐east China near south‐western Primorsky Krai, Russia. This area is currently the only occupied tiger habitat in China. Prey availability (e.g. wild boar, sika deer and roe deer), human disturbances (e.g. human activity, distance to human settlements and intense forest livestock grazing), and habitat structure were analysed. Our results revealed crepuscular and nocturnal activity of Amur tigers. Although the temporal overlaps between the tigers and their prey species were high, the spatial overlap indices were low. Although the presence of tigers decreased near human settlements, tigers showed a preference for walking along roads. Tigers also avoided high‐elevation coniferous and mixed hardwood forests. Overall, our results indicated that (1) tigers spatially and temporally avoided human disturbances and tigers respond behaviourally to human disturbances and (2) human disturbances may determine the activity of Amur tigers in north‐east China. In the future, to address conflicts between tigers and local humans and to improve tiger conservation, conservation planning should incorporate the spatio‐temporal activity patterns of tigers and humans.
Periodontitis is associated with incident chronic liver disease—A population‐based cohort study
Authors: Helenius‐Hietala Jaana , Suominen Anna Liisa , Ruokonen Hellevi , Knuuttila Matti , Puukka Pauli , Jula Antti , Meurman Jukka H. , Åberg Fredrik
Published: October 2018

Background & Aims

Chronic liver disease is a major health concern worldwide and the identification of novel modifiable risk factors may benefit subjects at risk. Few studies have analyzed periodontitis as a risk factor for liver complications. We studied whether periodontitis is associated with incident severe liver disease.

Methods

The study comprised 6165 individuals without baseline liver disease who participated in the Finnish population‐based Health 2000 Survey (BRIF8901) during 2000‐2001, a nationally representative cohort. Follow‐up was until 2013 for liver‐related admissions, liver cancer and mortality from National Hospital Discharge, Finnish Cancer Registry and Causes of Death Register, Statistics Finland. Mild to moderate periodontitis was defined as ≥1 tooth with periodontal pocket ≥4 mm deep, and advanced periodontitis as ≥5 teeth with such pockets. Multiple confounders were considered.

Results

A total of 79 subjects experienced a severe liver event during follow‐up. When adjusted for age, sex and number of teeth, hazards ratios by Cox regression regarding incident severe liver disease were, for mild to moderate periodontitis, 2.12 (95% CI 0.98‐4.58), and, for advanced periodontitis, 3.69 (95% CI 1.79‐7.60). These risk estimates remained stable after additionally adjusting for alcohol use, smoking, metabolic risk, serum gamma‐glutamyltransferase, dental‐care habits, lifestyle and socioeconomic status. Periodontal disease‐associated liver risk was accentuated among subjects with non‐alcoholic fatty liver disease or heavy alcohol use at baseline.

Conclusions

Periodontitis was associated with incident liver disease in the general population independently of various confounders. As a preventable disease, periodontal disease might present a modifiable risk factor for chronic liver disease.
Lysine propionylation modulates the transcriptional activity of phosphate regulator PhoP in Saccharopolyspora erythraea
Authors: Xu Ya , Li Yu‐Xin , Ye Bang‐Ce
Published: October 2018

Phosphate concentration extensively modulates the central physiological processes mediated by the two‐component system PhoR‐PhoP in actinobacteria. The system serves a role beyond phosphate metabolism, mediating crucial functions in nitrogen and carbon metabolism, and secondary metabolism in response to the nutritional states. Here, we found that the phosphate‐sensing regulator PhoP was propionylated, and thus lost its DNA‐binding activity in vivo and in vitro in Saccharopolyspora erythraea. Two key conserved lysine residues 198 and 203 (K198 and K203) in winged HTH motif at the C‐terminal domain of PhoP are propionylated by protein acyltransferase AcuA (encoding by sace_5148). Single amino acid mutation of these two lysine residues resulted in severely impaired binding of PhoP to PHO box. The addition of propionate (to supply precursors for erythromycin biosynthesis) increases the intracellular propionylation level of PhoP, resulting in the loss of response to phosphate availability. Furthermore, simultaneous mutation of K198 and K203 of PhoP to arginine, mimicking the non‐propionylated form, promotes the expression of the PhoP regulon under the condition of propionate addition. Together, these findings present a common regulatory mechanism of genes’ expression mediated by posttranslational regulation of OmpR family transcriptional regulator PhoP and provide new insights into the multifaceted regulation of metabolism in response to nutritional signals.
Earning or Learning? How Extending Closing Time in the Retail Sector Affects Youth Employment and Education
Authors: Bensnes Simon S. , Str⊘m Bjarne
Published: October 2018

This paper estimates the causal impact of increased demand for low‐skilled workers on youth employment, and short and long run education. We exploit quasi‐experimental demand shifts for retail workers due to changes in allowed opening hours for retail stores across Norwegian municipalities. We find that relaxed restrictions on opening hours increased employment in the sector and permanently reduced educational attainment for affected high school students. The results suggest that policies or shocks that increase demand for low‐skilled workers in the short term might have negative long‐run effects in terms of reduced educational attainment.
Prognostic value of noninvasive programmed stimulation in patients with implantable cardioverter defibrillator
Authors: Futyma Piotr , Sander Jarosław , Głuszczyk Ryszard , Maciołek Marcin , Futyma Marian , Kułakowski Piotr
Published: October 2018

Background

Implantable cardioverter defibrillator (ICD) offers an opportunity to examine vulnerability to ventricular tachycardia (VT) or ventricular fibrillation (VF) by performing noninvasive programmed ventricular stimulation (NIPS). Whether NIPS can predict VT/VF recurrences has not yet been established.

Purpose

To examine the predictive value of NIPS for identification of patients with VT/VF recurrences.

Methods

The study group consisted of consecutive 105 ICD recipients included in the prospective NIPS‐ICD study (ClinicalTrials ID: NCT02373306) (88 males, age 65 ± 11 years). The patients underwent NIPS using the protocol up to three premature extrastimuli at 600–500‐ and 400‐ms drive cycle lengths. The endpoint of NIPS was induction of sustained VT or VF or completion of the protocol.

Results

VT/VF was induced in 29 (27.6%) patients. During a 12‐month follow‐up NIPS‐inducible patients had significantly more frequently appropriate ICD therapy than noninducible patients (17% vs 4%, P = 0.023). NIPS‐induced VT/VF had a sensitivity of 63%, specificity of 75%, positive predictive value of 17%, and negative predictive value of 96% for identification of patients with future VT/VF. Apart from NIPS, age ≥ 65 years, QRS duration, treatment with angiotensin‐converting enzyme, history of coronary artery bypass grafting, history of VT/VF prior to NIPS, and prior appropriate ICD therapy were also associated with VT/VF recurrences. Multivariate analysis showed that, together with QRS duration, NIPS result was an independent predictor of future VT/VF. Predictive value of NIPS was significantly higher in ischemic than nonischemic patients.

Conclusions

NIPS result is associated with future VT/VF. Noninducibility at NIPS identifies those patients with high accuracy who will have uneventful follow‐up.
Autonomic cardiac regulation after general anesthesia in children
Authors: Venet Théa , Pichot Vincent , Charier David , Scalabre Aurélien , Patural Hugues
Published: October 2018

Background

General anesthesia dramatically decreases the activity of the autonomic nervous system. Most of the hypnotic agents used to induce anesthesia inhibit sympathetic cardiovascular regulation and baroreflex control in a dose‐dependent manner, lowering cardiac adaptability during the operation. The consequence of this effect in children during and after surgery has never been studied to date.

Aim

The aim of this study was to follow the variations in autonomic cardiac indices in children younger than 8 years old after general anesthesia (6‐24 hours) in programmed surgery.

Method

A prospective descriptive monocentric study of 44 children under 8 years old who underwent scheduled surgery at our hospital center (Saint‐Étienne University Hospital, France) was performed between June 1, 2016 and November 1, 2016. Heart rate variability was monitored for 24 hours using Holter‐ECG devices and the resulting data were interpreted using linear and nonlinear analyses.

Results

Compared to baseline thresholds before surgery, all heart rate variability indices decreased dramatically during general anesthesia. After awakening, a slight reduction in sympathetic activity persisted 6 hours after surgery, but all measurements of sympathetic and parasympathetic activity had returned to baseline thresholds 12 hours after the operation. Twenty‐four hours after surgery, some parameters had increased above the corresponding baseline levels.

Conclusion

Autonomic nervous function normalizes rapidly (within 12 hours) in prepubertal children. This study indicates that general anesthesia does not seem to increase the long‐term risk of autonomic dysfunction in these patients.
A simple care bundle to reduce unplanned admission rate for day case pediatric circumcision
Authors: Stoeter David Joel , Roberts Stephen
Published: October 2018

Background

An electronic review of unplanned day case admission rates in our hospital demonstrated an average annual rate for pediatric circumcision of 2%‐3% in recent years with high levels of perioperative strong opiate use. This lay above target unplanned admission rates (<2%) set out by the Royal College of Anaesthetists for day case surgery. A targeted quality improvement initiative was undertaken to improve patient flow through the pediatric day case surgery unit for elective circumcision. Among the reasons for unplanned admission, factors modifiable by the anesthetist (pain, postoperative nausea and vomiting, somnolence) are significant contributors.

Methods

A prospective audit was undertaken over a 3‐month period. Our practice was compared with evidence‐based analgesic and antiemetic interventions in accordance the Association of Paediatric Anaesthetists of Great Britain and Ireland. Perioperative strong opiate administration rates occurred in 44% of cases. Four strategic interventions were selected based on quality of evidence, ease of implementation, and low cost: selection of higher concentration local anesthetic use for penile blocks, intravenous dexamethasone, and preoperative paracetamol combined with maximum dose nonsteroidal anti‐inflammatory.

Results

The audit was duplicated a year later demonstrating a significant increase in application of these interventions with a parallel fall in strong opiate use from 44% to 9% and an unprecedented zero unplanned admission rate in our unit for 10 months in a row after implementation.

Conclusion

Regular scrutiny of patient electronic data helps identify high impact areas for audit and intervention. Unplanned admission in pediatric day case surgery is an area amenable to such targeted intervention.
Negligible impact of birth on renal function and drug metabolism
Authors: Anderson Brian J. , Holford Nick H.G.
Published: October 2018

Background

Transition from the intrauterine to the extrauterine environment in neonates is associated with major changes in blood flow and oxygenation with consequent increases in metabolic functions. The additional impact of birth on renal function and drug metabolism above that predicted by postmenstrual age and allometry is uncertain. Increased clearance at birth could reduce analgesic effect attributable to a lowering of plasma concentration. These elimination processes can be described using the clearance concept.

Methods

Data from four publications that investigated the time course of glomerular filtration rate and clearance of paracetamol, morphine and tramadol were reanalyzed. The effect of birth, based on postnatal age, was used in conjunction with a theory‐based allometric size scaling and maturation based on postmenstrual age.

Results

Postnatal age had a short‐term effect on the time course of clearance distinguishable from the well‐known slower maturation based on postmenstrual age. While elimination might be relatively reduced by 15%‐45% at birth, there is a rapid increase in elimination for 1‐3 weeks after birth to be 15% greater than that predicted by postmenstrual age alone.

Conclusion

Birth is associated with a small increase in clearance in addition to that described by postmenstrual age for common analgesic drugs cleared by glucuronide conjugation (morphine, paracetamol) or by the P450 cytochrome oxidase (tramadol) and renal systems. While the increase is of biological interest, it would not be expected to have any clinically relevant impact on renal function or drug dosing. The processes of maturation described by these models are potentially applicable to any drug elimination process.
Successful treatment of a traumatic tattoo in a pediatric patient using a 755‐nm picosecond laser
Authors: Jeon Hana , Geronemus Roy G.
Published: October 2018

We report a case of successful treatment of a traumatic tattoo in a 2‐year‐old patient. He presented with a green discoloration on the left infraorbital region after his sister accidentally hit him with a face paint brush while playing together. A single treatment with an alexandrite picosecond laser resulted in a complete clearance without any side effects for this disfiguring condition.
Supervisors’ work‐related and nonwork information sharing: Integrating research on information sharing, information seeking, and trust using self‐disclosure theory
Authors: Nifadkar Sushil S. , Wu Wen , Gu Qian
Published: October 2018

Although significant scholarly attention has been devoted to understanding subordinates’ information seeking from supervisors, researchers have not paid adequate attention to information sharing by supervisors. Moreover, research on supervisors’ information sharing behavior has focused almost exclusively on work‐related information sharing, disregarding supervisors’ sharing of information not related to work (e.g., that related to family). Drawing on self‐disclosure theory, we argue that supervisors share both work‐related and nonwork information with their subordinates and propose that these two forms of information sharing are conceptually distinct. Furthermore, to unravel the role of supervisors’ nonwork information sharing, we develop an interactive model to test how it may be associated with important employee outcomes. We conducted pilot studies using five samples and, through a sixth study, tested the hypothesized model using a four‐wave data collection design. This study makes three major contributions to research and theory. First, it integrates information sharing and information seeking literatures. Second, it underlines the importance of supervisors’ nonwork information sharing in organizations by testing its direct and interactive effects. Third, it contributes to theory by presenting trust as a mechanism that links information disclosure in dyads. Results obtained using structural equation modeling generally supported the proposed model.
Persistent inaccuracies in completion of medical certificates of stillbirth: A cross‐sectional study
Authors: Higgins Lucy E. , Heazell Alexander E. P. , Whitworth Melissa K.
Published: October 2018

Background

The UK Medical Certificate of Stillbirth (MCS) records information relevant to the cause of stillbirth of infants ≥24 weeks’ gestation. A cross‐sectional audit demonstrated widespread inaccuracies in MCS completion in 2009 in North West England. A repeat study was conducted to assess whether practice had improved following introduction of a regional care pathway.

Methods

266 MCS issued in 14 North West England obstetric units during 2015 were studied retrospectively. Cause of death was assigned following review of information available at the time of MCS completion. This was compared to that documented on the MCS, and to data from 2009.

Results

Twenty‐three certificates were excluded (20 inadequate data, 3 late miscarriages). 118/243 (49%) MCS contained major errors. Agreement between the MCS and adjudicated cause of stillbirth was fair (Kappa 0.31; 95% CI 0.24, 0.38) and unchanged from 2009 (0.29). In 2015, excluding 34 terminations of pregnancy, the proportion of MCSs documenting “unexplained” stillbirths (113/211; 54%) was reduced compared to 2009 (158/213; 74%); causality could be assigned after case note review in 78% cases. Recognition of fetal growth restriction (FGR) as a cause of stillbirth improved (2015: 30/211; 14% vs 2009: 1/213; 0.5%), although 71% cases were missed. 47% MCSs following termination of pregnancy documented an iatrogenic primary cause of death.

Conclusions

Completion of MCSs remains inaccurate, particularly in recognition of FGR as a cause of stillbirth. Detailed case note review before issuing the MCS could dramatically improve the usefulness of included information; evaluation of practitioner education programmes/internal feedback systems are recommended.
Extended Lagrangian approach for the defocusing nonlinear Schrödinger equation
Authors: Dhaouadi Firas , Favrie Nicolas , Gavrilyuk Sergey
Published: October 2018

We study the defocusing nonlinear Schrödinger (NLS) equation written in hydrodynamic form through the Madelung transform. From the mathematical point of view, the hydrodynamic form can be seen as the Euler–Lagrange equations for a Lagrangian submitted to a differential constraint corresponding to the mass conservation law. The dispersive nature of the NLS equation poses some major numerical challenges. The idea is to introduce a two‐parameter family of extended Lagrangians, depending on a greater number of variables, whose Euler–Lagrange equations are hyperbolic and accurately approximate NLS equation in a certain limit. The corresponding hyperbolic equations are studied and solved numerically using Godunov‐type methods. Comparison of exact and asymptotic solutions to the one‐dimensional cubic NLS equation (“gray” solitons and dispersive shocks) and the corresponding numerical solutions to the extended system was performed. A very good accuracy of such a hyperbolic approximation was observed.