bluuebunny/crossref_metadata_2025 huggingface dataset:
There's no place like home: seedling mortality contributes to the habitat specialisation of tree species across Amazonia
Authors: Fortunel Claire , Paine C. E. Timothy , Fine Paul V. A. , Mesones Italo , Goret Jean‐Yves , Burban Benoit , Cazal Jocelyn , Baraloto Christopher
Published: September 2016

Understanding the mechanisms generating species distributions remains a challenge, especially in hyperdiverse tropical forests. We evaluated the role of rainfall variation, soil gradients and herbivory on seedling mortality, and how variation in seedling performance along these gradients contributes to habitat specialisation. In a 4‐year experiment, replicated at the two extremes of the Amazon basin, we reciprocally transplanted 4638 tree seedlings of 41 habitat‐specialist species from seven phylogenetic lineages among the three most important forest habitats of lowland Amazonia. Rainfall variation, flooding and soil gradients strongly influenced seedling mortality, whereas herbivory had negligible impact. Seedling mortality varied strongly among habitats, consistent with predictions for habitat specialists in most lineages. This suggests that seedling performance is a primary determinant of the habitat associations of adult trees across Amazonia. It further suggests that tree diversity, currently mostly harboured in terra firme forests, may be strongly impacted by the predicted climate changes in Amazonia.
Detection vs. selection: integration of genetic, epigenetic and environmental cues in fluctuating environments
Authors: McNamara John M. , Dall Sasha R. X. , Hammerstein Peter , Leimar Olof
Published: September 2016

There are many inputs during development that influence an organism's fit to current or upcoming environments. These include genetic effects, transgenerational epigenetic influences, environmental cues and developmental noise, which are rarely investigated in the same formal framework. We study an analytically tractable evolutionary model, in which cues are integrated to determine mature phenotypes in fluctuating environments. Environmental cues received during development and by the mother as an adult act as detection‐based (individually observed) cues. The mother's phenotype and a quantitative genetic effect act as selection‐based cues (they correlate with environmental states after selection). We specify when such cues are complementary and tend to be used together, and when using the most informative cue will predominate. Thus, we extend recent analyses of the evolutionary implications of subsets of these effects by providing a general diagnosis of the conditions under which detection and selection‐based influences on development are likely to evolve and coexist.
Niche partitioning due to adaptive foraging reverses effects of nestedness and connectance on pollination network stability
Authors: Valdovinos Fernanda S. , Brosi Berry J. , Briggs Heather M. , Moisset de Espanés Pablo , Ramos‐Jiliberto Rodrigo , Martinez Neo D.
Published: September 2016

Much research debates whether properties of ecological networks such as nestedness and connectance stabilise biological communities while ignoring key behavioural aspects of organisms within these networks. Here, we computationally assess how adaptive foraging (AF) behaviour interacts with network architecture to determine the stability of plant–pollinator networks. We find thatAFreverses negative effects of nestedness and positive effects of connectance on the stability of the networks by partitioning the niches among species within guilds. This behaviour enables generalist pollinators to preferentially forage on the most specialised of their plant partners which increases the pollination services to specialist plants and cedes the resources of generalist plants to specialist pollinators. We corroborate these behavioural preferences with intensive field observations of bee foraging. Our results show that incorporating key organismal behaviours with well‐known biological mechanisms such as consumer‐resource interactions into the analysis of ecological networks may greatly improve our understanding of complex ecosystems.
Evaluation of the relaxant effect of levetiracetam on isolated rat duodenum
Authors: Salem Hesham A. , Al‐Shorbagy Muhammad Y.
Published: September 2016

Levetiracetam (LEV) is an approved drug for the treatment of some epileptic disorders. With few and controversial reports addressing its possible pharmacodynamic interactions, the current study aimed at studying the effect of LEV on isolated rat duodenal strips to enlighten its possible intestinal adverse effects using the isolated smooth muscle strips of rat duodenum. LEV showed a dose‐dependent inhibition in KCl (80 mm)‐induced contractions in normal Tyrode's solution. Moreover, preincubation with LEV (3 mm) in K+‐rich/Ca2+‐free medium led to a significant decrease in the maximum contractions (Emax) coupled to a right shift of the cumulative CaCl2 concentration curves implying a possible Ca2+ channel blocking potential. In addition, LEV exhibited a typical noncompetitive inhibition in the cumulative carbachol concentration curves evidenced as a decrease in Emax without the alteration of EC50, thus eliminating any possible role of the muscarinic receptors in the relaxant effect. To rule out other possible relaxant mechanisms, tests were conveyed in Tyrode's solution containing either 100 μm l‐NAME or 10 μm glimepiride to test the possible relaxant roles exhibited by nitric oxide (NO) and KATP channel opening, respectively. None of the tested pathways was involved in LEV‐mediated relaxation. Taken altogether, the results of the current study entail that LEV might exert a relaxant effect on intestinal smooth muscles through blocking L‐type voltage‐operated calcium channels, but not involving either NO release or KATP channel opening.
How are elderly patients treated after a diagnosis of metastatic colorectal cancer in real‐life practice? A study in a French teaching hospital
Authors: Gouverneur Amandine , Rouyer Magali , Grelaud Angela , Robinson Philip , Colombani Françoise , Terrebonne Eric , Smith Denis , Fourrier‐Réglat Annie , Noize Pernelle
Published: September 2016

Metastatic colorectal cancer (mCRC) is frequent among elderly patients. However, in the era of new targeted therapies, little is known about real‐life mCRC treatment in this population. This study aimed to describe elderly mCRC patients and the current real‐life treatment practices. mCRC patients aged ≥65 years were identified using the registry of multidisciplinary team meetings, mandatory for all cancer patients, held between January 1, 2013 and June 30, 2014 at the Bordeaux University Hospital. Data were collected from medical records using a standardized questionnaire. Treatment type was defined as follows: at least one anticancer medication administered vs. best supportive care (BSC). A total of 78 patients were included; median age was 74 years and the M/F sex ratio 1.6. Eleven patients (14.1%) were referred to a geriatric oncology consultation. One patient died before treatment initiation, 28 (35.9%) had BSC, and 49 (62.8%) were treated with anticancer medications: 20 (25.6%) had chemotherapy combined with a targeted therapy, and 28 (35.9%) chemotherapy alone (one missing data for treatment). Compared to patients treated with anticancer medications, BSC patients were older (P < 0.0001) and had more often metachronous metastases (P = 0.01), more comorbidities (P = 0.05), and a greater number of concomitant medications (P = 0.004). This study is one of the rare investigations providing insight to treatment practices in all elderly mCRC patients, not just those who receive anticancer medications. Our results suggest that efforts must be pursued to better integrate geriatric oncology in daily clinical practice.
The Availability of Conscious Knowledge: A Comment on Lindseth (2016)
Authors: Krashen Stephen
Published: September 2016

Lindseth (2016) reported that direct instruction and practice using the German verb‐inversion rule resulted in higher accuracy in an oral test for college students, supporting the hypothesis that explicit linguistic knowledge can become implicit linguistic knowledge. It is quite likely, however, that the conditions for the use of conscious knowledge (the monitor) were met on the test.
Interaction diversity of North American seed‐dispersal mutualisms
Authors: Vander Wall Stephen B. , Moore Christopher M.
Published: September 2016

Aim

We determine the prevalence of mutualistic seed‐dispersal interactions across the North American landscape and then test the hypothesis that patterns in interaction diversity are correlated with latitude, longitude, precipitation, midpoint elevation and the elevational range of sites.

Location

North America north of the Mexican border.

Methods

We used regional plant lists to determine the diversity of animal seed‐dispersal interactions across North America (over more than 48° of latitude). For each plant list (n = 197 sites, 12,424 terrestrial plant species and 123,519 plant records), we assigned plant species to one of four seed‐dispersal modes (i.e. frugivory, scatter hoarding, myrmecochory or non‐mutualist) and to an animal vector (e.g. bird, carnivorous mammal, rodent, ant).

Results

We identified 14 types of animal‐mediated seed dispersal. Plants with seed‐dispersal mutualists are most diverse in the south‐eastern portion of the continent. Dispersal by frugivores and scatter hoarders is strongly negatively correlated with latitude but myrmecochory is not. The diversity of interaction types is significantly correlated with precipitation and elevational range and negatively correlated with latitude, longitude and midpoint elevation.

Main conclusions

The diversity of seed‐dispersal mutualisms varies dramatically across the continent, suggesting that the co‐evolutionary processes that produce these interactions are stronger in certain regions and vegetation types and weaker in others. Elucidation of these patterns and their causes will help us to better understand the co‐evolutionary processes that shape communities.
WORLD WAR II ‘VON UNTEN’: CHILDHOOD AND YOUTH IN LISA TETZNER'S IST PAUL SCHULDIG? (1945)*
Authors: Pinfold Debbie
Published: September 2016

Literary presentations of children in war tend to depict them exclusively as innocent victims. Indeed, even those texts featuring children who have been subjected to, and have ostensibly absorbed, Nazi indoctrination continue to insist on a Romantic myth of childhood as the embodiment of a prelapsarian past and redemptive potential for the future. This essay, however, focuses on the way the exiled author Lisa Tetzner (1894–1963) uses images of childhood to negotiate concepts of guilt and responsibility in her novel for younger readers, Ist Paul schuldig? (1945), the seventh volume of her series Die Kinder aus Nr. 67. It will argue that the novel anticipates debates about German guilt first fully articulated in Karl Jaspers's Die Schuldfrage (1946), as well as later debates about German wartime suffering. It will further suggest that by focusing on the moral guilt of an individual adolescent whose childhood backstory is very familiar to the reader, the novel creates a challenging and yet sympathetic space where not only youthful German readers might have explored the extent of their personal responsibility for the Third Reich in 1945.

Literarische Kriegskinder werden zum großen Teil als ausschließlich unschuldige Opfer dargestellt. Auch in Texten, in denen Kinder der nationalsozialistischen Ideologie ausgesetzt werden und diese scheinbar übernehmen, wird ein romantischer Mythos von Kindheit als Verkörperung einer ursprünglichen Unschuld und eines erlösenden Zukunftspotenzials aufrechterhalten. Dieser Aufsatz aber analysiert Ist Paul schuldig? (1945), den siebten Band der Jugendromanserie Die Kinder aus Nr. 67, in dem die Exilautorin Lisa Tetzner (1894–1963) Kindheitsbilder benutzt, gerade um sich mit Vorstellungen von Schuld und Verantwortung auseinanderzusetzen. Es wird argumentiert, dass dieser Roman sowohl Debatten über deutsche Schuld vorwegnimmt, die zum ersten Mal in Karl Jaspers Die Schuldfrage (1946) ausführlich dargelegt wurden, als auch spätere Debatten über deutsches Kriegsleiden. Ferner wird argumentiert, dass Tetzner durch ihre Beschreibung der moralischen Schuld eines einzelnen Heranwachsenden, dessen Kindheitsgeschichte dem Leser vertraut ist, nicht nur jugendlichen Lesern einen relativ geschützten Raum bietet, sich 1945 offen mit dem Ausmaß ihrer persönlichen Verantwortung für die Ereignisse des Dritten Reiches auseinanderzusetzen.
NOT JUST DEATH AND RUINS: THE YOUNG, AND NEW BEGINNINGS IN GERMAN ‘RUBBLE FILMS’
Authors: Wölfel Ute
Published: September 2016

The article looks at ‘Trümmerfilme’ from different zones of occupation and discusses the roles which the young were allocated on German post‐war screens. While in all films under‐age characters are central to negotiating the severe national crisis following the end of World War II and the defeat of the Nazi dictatorship, the analysis highlights emerging differences in the depiction of the young between films from the Soviet Zone and the Western zones of occupation. Despite the general use of the young as figures of distraction from the adults’ involvement in Nazi crimes, children in films from the Soviet Zone help to articulate a new national ideal based on collective, public productivity, while the young in films from the Western zones help to formulate the dangers inherited from the immediate past. These differences are reflected in the opposing depictions of the young as innocent in the East and feral in the West, as well as in the intergenerational relations resulting from this. While the children's potential in the East replaces the parent generation, which is implicitly marked as guilty, the dangers posed by the young in the West strengthen the authority of the parents and the nuclear‐family model.

Der Aufsatz untersucht Trümmerfilme aus den verschiedenen Besatzungszonen und diskutiert die Rollen, die Kindern und Jugendlichen auf den deutschen Kinoleinwänden zwischen 1945 und 1949 gegeben wurden. Während Minderjährige in allen Filmen eine wichtige Rolle spielen bei der Aufarbeitung der nationalen Krise nach dem Ende des Zweiten Weltkriegs und der Niederlage der NS Diktatur, stellt die Analyse auch Unterschiede heraus, die sich in der Darstellung von Kindern und Jugendlichen zwischen den Filmen der SBZ und jenen der westlichen Zonen bereits abzeichnen. Ungeachtet der allgemeinen Verwendung von Kindern als Figuren der Ablenkung von der Einbindung der Erwachsenenwelt in die Verbrechen des Nationalsozialismus, helfen Kinderfiguren in Filmen aus dem Osten ein neues Ideal zu formulieren, das auf öffentlicher, kollektiver Produktivität beruht, wogegen Jugendliche in Filmen der westlichen Zonen die gefährliche Hinterlassenschaft der unmittelbaren Vergangenheit verkörpern. Diese Unterschiede schlagen sich nieder in der entgegengesetzten Darstellung von Kindern als unschuldig im Osten und gefährlich im Westen, sowie in dem daraus resultierenden Generationenverhältnis: Während das Potential der Kinderfiguren im Osten eine implizit schuldige Elterngeneration ersetzt, werden im Westen die Elterngeneration und das Kleinfamilienmodell durch die Gefährdung, die von den Jugendlichen ausgeht, gestärkt.
EAST OR WEST, RODINA IS BEST: SHAPING A SOCIALIST ‘HEIMAT’ IN GERMAN AND SOVIET FILM OF THE OCCUPATION PERIOD
Authors: Kostetskaya Anastasia
Published: September 2016

This essay examines how films of the occupation period encode the gradual consolidation of a post‐war national identity for East Germans in the emerging GDR. For this purpose, this article offers a comparative analysis of the two films Irgendwo in Berlin (1946) by Gerhardt Lamprecht and U nikh est’ rodina (1949) by Aleksandr Fainzimmer, translated into German as Sie haben eine Heimat. I focus on how the films employ images of children in order to foreground and illuminate the culturally specific but overlapping concepts of homeland – ‘Heimat’ and rodina – as essential for the ideas of nation and belonging. Both films provide ideological commentary on the post‐war occupation of Germany through the theme of the family fragmented by the war and the need for familial restoration. Hence a child‐parent paradigm becomes central to the exposition of the opposing perspectives: those of the infantilised occupied and the paternalistic occupier. My discussion uncovers cross‐cultural, historical continuity between the films. It demonstrates that the Soviet film provides ‘solutions’ to the problems of German post‐war identity posed in Irgendwo in Berlin, while the concept of ‘Heimat’ offers a viable framework for the appropriation of Soviet‐style socialism by the GDR.

Dieser Aufsatz untersucht, wie Filme der Besatzungszeit die allmähliche Festigung der staatlichen Nachkriegsidentität der Ostdeutschen in der Sowjetischen Besatzungszone kodieren. Dazu wird eine vergleichende Analyse von zwei Filmen, Irgendwo in Berlin (1946) von Gerhardt Lamprecht, und U nikh est’ rodina (1949) von Aleksandr Fainzimmer, übersetzt ins Deutsche als Sie haben eine Heimat, vorgelegt. Ich konzentriere mich darauf, wie die Filme Darstellungen von Kindern nutzen, um die kulturspezifischen aber überlappenden Konzepte des Geburtslandes – Heimat und rodina – als wesentlich für die Vorstellung von Nationalität und Zugehörigkeit zu beleuchten. Beide Filme liefern mit dem Motiv der im Krieg zerrütteten Familie und der Notwendigkeit der Familienerneuerung einen ideologischen Kommentar zur Besetzung Deutschlands. Daher wird ein Eltern‐Kind‐Paradigma zum zentralen Element bei der Darstellung gegensätzlicher Perspektiven: der des infantilisierten Besetzten und der des paternalistischen Besetzers. Meine Erörterung zeigt eine interkulturelle historische Kontinuität zwischen den beiden Filmen auf. Sie veranschaulicht, dass der sowjetische Film ‘Lösungen’ für die in Irgendwo in Berlin aufgeworfenen Probleme der deutschen Nachkriegsidentität bietet, während das Heimat‐Konzept einen praktikablen Rahmen für die Aneignung eines Sozialismus sowjetischen Stils durch die DDR bietet.
Inherent Errors in the Quantitation of Dialysis Delivery: Implications For CAPD and Daily Hemodialysis
Authors: Sherman Richard A. , Kapoian Toros
Published: September 2016

When compared to intermittent dialysis, the theoretical advantages of continuous dialysis may be less important than its practical disadvantage: the inability to accurately quantify dialysis. With intermittent dialysis the change in blood urea nitrogen over the course of the treatment allows the ratio of K (urea clearance) to V (volume of distribution of urea or total body water) to be determined, hence an accurate Kt/V. In continuous dialysis this approach cannot be used due to the steady‐state nature of blood urea levels. Instead, V is estimated, generally from the Watson equations. This estimate has sufficient inaccuracy to result in substantial unrecognized underdialysis in many patients.
Does Increasing Dialyzer Blood Flow Always Improve Dialysis Efficiency?
Authors: Depner Thomas A.
Published: September 2016

As dialyzer blood flow is increased during hemodialysis, diminishing increments in clearance are inevitable. In addition, as clearance increases, diminishing increases in solute removal from the patient are inevitable. The causes of these equally self‐defeating and additive effects are the fundamental self‐limitation of the dialysis itself due to first‐order kinetics, membrane‐limited diffusion within the dialyzer, and disequilibrium within the patient. Access recirculation is a specialized cause of solute disequilibrium that is separately measurable and preventable. Cardiopulmonary recirculation (CPR) is a predictable form of solute disequilibrium that is found in all patients with peripheral arteriovenous shunts and is absent during vein‐to‐vein dialysis. Other forms of blood flow‐dependent disequilibrium probably also play a role in diminishing the efficiency of hemodialysis. Sequestration of urea in muscle during hemodialysis is suggested by reduction in the magnitude of rebound when patients exercise (and increase muscle blood flow) during hemodialysis. This discussion is not intended to discourage attempts to increase solute removal by increasing blood flow, but rather to place this maneuver in a proper perspective. Other maneuvers such as increasing dialysis frequency may be more effective as a means of improving dialysis efficiency.
Efficacy of Heat Disinfection With the Aksys Personal Hemodialysis System
Authors: Kenley Rodney S.
Published: September 2016

The first objective of this study was to validate the use of water at 85°C ± 5°C to achieve high‐level disinfection of a clean‐in‐place extracorporeal dialysis circuit. The second objective was to demonstrate that applying this hot water method to the entire fluid pathways of a newly designed dialysis instrument, including an integral reverse‐osmosis membrane, routinely allowed the production of back‐filtered dialysate meeting the U.S. Pharmacopeia (USP) standard for the water for injection (WFI). In a first study, six dialyzers were inoculated with P. aeruginosa, incubated, and subjected to 75°C water for 30 minutes. No organisms could be recovered from the experimental dialyzers nor from three negative controls, but they were recovered from three positive controls. In a second study, the carbon tanks in the water inlet line and the dialysate tank were both inoculated with massive amounts of dialysis water‐adapted Gram‐negative organisms, followed by seven dialysis treatments using bovine blood, where the fifth and sixth procedures were separated by 2 idle days and the sixth and seventh procedures were separated by 3 idle days. In addition, the bovine blood used in each treatment was highly contaminated. In every case, the back‐filtered dialysate met the WFI standard.

From the above results we conclude that a hot water disinfection process is efficacious in reducing even grossly exaggerated contamination in the Aksys personal hemodialysis system to the point where it can produce water and dialysate that greatly exceed the Association for the Advancement of Medical Instrumentation (AAMI) standards and priming and rinse‐back solution (back‐filtered dialysate) that meets the USP standard for WFI.
The Buttonhole Technique of Fistula Access: A Personal Experience
Authors: Harper George
Published: September 2016

Iam a 16‐year home hemodialysis patient using the buttonhole method of needle insertion into my arteriovenous fistula. From the beginning of my home training I was taught to stick myself. Like most patients, I was taught to rotate needle sites up and down my arm. I used this method for 10 years. In 1990, I learned about the buttonhole technique; I started using it and am still using it today with great success. In this method needles are inserted in the exact same holes. There is no pain with this technique, and there is a great sense of confidence in having fixed, well‐known sites; I am certain to have a successful stick almost every time. The buttonhole technique practically eliminated infiltrations. Since I see no reason why the buttonhole sites cannot be used on a daily basis, I am looking forward to using the technique when daily hemodialysis becomes available.
Successful Long-Term Central Venous Access; Daily Home Hemodialysis Blood Access
Authors: Geary Gregory L.
Published: September 2016

Successful long‐term central venous access is a complex subject. The concept of “long term” implies that continued surveillance will be required. This also requires the catheter to be placed, initially, in its best configuration. To achieve long‐term performance and durability, a thorough understanding of all aspects related to the catheter, catheter placement, and catheter maintenance is essential.
‘We have education, I can say that’: worldview and access to education for adult refugees
Authors: Perry Kristen H. , Mallozzi Christine A.
Published: September 2016

We present a discourse analysis of narratives from two adult Congolese refugees, focused on the influence of worldview (including cultural mindset, personal world, and perspective) on thinking about accessing higher education. We examined narrative structure (Gee 2011), subject statements, and Underhill's (2009) three elements of worldview in the narratives. Both participants held a cultural mindset that highly valued education, but their personal worlds and perspectives differed, perhaps explaining their different decisions about accessing higher education. Findings suggest implications for supporting adult refugee education, particularly their aspirations for accessing higher education.
Are mental health staff getting better at asking about abuse and neglect?
Authors: Sampson Maria , Read John
Published: September 2016

This study ascertained the extent to which abuse and neglect are identified and recorded by mental health services. A comprehensive audit of 250 randomly selected files from four community mental health centres in Auckland, New Zealand was conducted, using similar methodology to that of a 1997 audit in the same city so as to permit comparisons. Significant increases, compared to the 1997 audit, were found in the rates of child sexual and physical abuse, and adulthood sexual assault (but not adulthood physical assault) identified in the files. Identification of physical and emotional neglect, however, was poor. Male service users were asked less often than females; and male staff enquired less often than female staff. People with a diagnosis indicative of psychosis, such as ‘schizophrenia’, tended to be asked less often and had significantly lower rates of abuse/neglect identified. Despite the overall improvement, mental health services are still missing significant amounts of childhood and adulthood adversities, especially neglect. All services need clear policies that all service users be asked about both abuse and neglect, whatever their gender or diagnosis, and that staff receive training that address the barriers to asking and to responding therapeutically to disclosures.
Virtual communication about psychiatric intensive care units: Social actor representatives claim space on Twitter
Authors: Salzmann‐Erikson Martin
Published: September 2016

Psychiatric intensive care units (PICU) provide care for those with the worst phases of mental illness. What defines a PICU is often decided locally at hospitals. The aim of the present study was to explore and describe a contemporary discourse on how PICU are socially constructed from virtual discussions. An explorative and descriptive study design was applied for this qualitative inquiry using discourse methodology. The data were collected in Twitter's search string and consists of 215 Twitter postings. A framework of social actor representatives that form the discourse was established and presented in three categories: (i) hospital and agencies communicating about PICU; (ii) health‐care professionals communicating about PICU; and (iii) service users and relatives communicating about PICU. Hospitals, agencies, and health‐care professionals hold great power and responsibility for informing the public about PICU. Transparent and informative tweets could turn the mystery of PICU into more specific, positive portrayals.
Peer support interventions seeking to improve physical health and lifestyle behaviours among people with serious mental illness: A systematic review
Authors: Stubbs Brendon , Williams Julie , Shannon Jennifer , Gaughran Fiona , Craig Tom
Published: September 2016

People with serious mental illness (SMI) experience a premature mortality gap of between 10 and 20 years. Interest is growing in the potential for peer support interventions (PSI) to improve the physical health of people with SMI. We conducted a systematic review investigating if PSI can improve the physical health, lifestyle factors, and physical health appointment attendance among people with SMI. A systematic search of major electronic databases was conducted from inception until February 2016 for any article investigating PSI seeking to improve physical health, lifestyle, or physical health appointment attendance. From 1347 initial hits, seven articles were eligible, including three pilot randomized, control trials (interventions: n = 85, controls: n = 81), and four pretest and post‐test studies (n = 54). There was considerable heterogeneity in the type of PSI, and the role of the peer support workers (PSW) varied considerably. Three studies found that PSI resulted in insignificant reductions in weight. Evidence from three studies considering the impact of PSI on lifestyle changes was equivocal, with only one study demonstrating that PSI improved self‐report physical activity and diet. Evidence regarding physical health appointment attendance was also unclear across four studies. In conclusion, there is inconsistent evidence to support the use of PSW to improve the physical health and promote lifestyle change among people with SMI. The small sample sizes, heterogeneity of interventions, outcome measures, and lack of clarity about the unique contribution of PSW means no definitive conclusions can be made about the benefits of PSW and physical health in SMI.
Speaking my patient's language: bilingual nurses’ perspective about provision of language concordant care to patients with limited English proficiency
Authors: Ali Parveen Azam , Johnson Stacy
Published: September 2016

Aim

The aim of this study was to explore bilingual nurses’ perspective about providing language concordant care to patients with limited English proficiency (LEP) and its impact on patients and nurses. Factors affecting the provision of language concordant care to patients LEP were also explored.

Background

With an increase in migration and mobility of people across the world, the likelihood of experiencing language barriers while providing and receiving care is high. Nurses are responsible for providing care to patients regardless of their culture, religion, ethnic background or language. Language barriers, however, are hurdles that hamper development of effective communication between nurses and patients. Eliminating language barriers is a crucial step in providing culturally competent and patient‐centred care.

Design

Qualitative descriptive study.

Methods

During January‐August 2015, 59 nurses, working in acute hospitals in the UK, participated in 26 individual in‐depth interviews and three focus group discussions. The data were analysed using thematic analysis.

Findings

Four themes: ‘when we speak the same language’; ‘when I speak my patient's language’; ‘what facilitates provision of language concordant care’ and ‘what hinders the provision of language concordant care’ were identified. Factors affecting nurses’ ability to provide language concordant care included individual factors (confidence; years of experience as a nurse; years of experience in the work setting; and relationship with colleagues), patients’ expectation, attitudes of other patients, colleagues and nurse managers, organizational culture and organizational policies.

Conclusion

Bilingual nurses can play a very important role in the provision of language concordant for patients with LEP. Further research is needed to explore patient perspective.
MXRA5 is a TGF‐β1‐regulated human protein with anti‐inflammatory and anti‐fibrotic properties
Authors: Poveda Jonay , Sanz Ana B. , Fernandez‐Fernandez Beatriz , Carrasco Susana , Ruiz‐Ortega Marta , Cannata‐Ortiz Pablo , Ortiz Alberto , Sanchez‐Niño Maria D.
Published: September 2016

Current therapy for chronic kidney disease (CKD) is unsatisfactory because of an insufficient understanding of its pathogenesis. Matrix remodelling‐associated protein 5 (MXRA5, adlican) is a human protein of unknown function with high kidney tissue expression, not present in rodents. Given the increased expression of MXRA5 in injured tissues, including the kidneys, we have suggested that MXRA5 may modulate kidney injury. MXRA5 immunoreactivity was observed in tubular cells in human renal biopsies and in urine from CKD patients. We then explored factors regulating MXRA5 expression and MXRA5 function in cultured human proximal tubular epithelial cells and explored MXRA5 expression in kidney cancer cells and kidney tissue. The fibrogenic cytokine transforming growth factor‐β1 (TGFβ1) up‐regulated MXRA5 mRNA and protein expression. TGFβ1‐induced MXRA5 up‐regulation was prevented by either interference with TGFβ1 activation of the TGFβ receptor 1 (TGFBR1, ALK5) or by the vitamin D receptor agonist paricalcitol. By contrast, the pro‐inflammatory cytokine TWEAK did not modulate MXRA5 expression. MXRA5 siRNA‐induced down‐regulation of constitutive MXRA5 expression resulted in higher TWEAK‐induced expression of chemokines. In addition, MXRA5 down‐regulation resulted in a magnified expression of genes encoding extracellular matrix proteins in response to TGFβ1. Furthermore, in clear cell renal cancer, von Hippel–Lindau (VHL) regulated MXRA5 expression. In conclusion, MXRA5 is a TGFβ1‐ and VHL‐regulated protein and, for the first time, we identify MXRA5 functions as an anti‐inflammatory and anti‐fibrotic molecule. This information may yield clues to design novel therapeutic strategies in diseases characterized by inflammation and fibrosis.
Population structure and cryptic speciation in bonnethead sharks Sphyrna tiburo in the south‐eastern U.S.A. and Caribbean
Authors: Fields A. T. , Feldheim K. A. , Gelsleichter J. , Pfoertner C. , Chapman D. D.
Published: September 2016

Population structure and lineage diversification within a small, non‐dispersive hammerhead shark species, the bonnethead shark Sphyrna tiburo, was assessed. Sphyrna tiburo is currently described as one continuously distributed species along the Atlantic continental margins of North, Central and South America, but recent genetic analysis of an insular population (Trinidad) suggests the possibility of cryptic speciation. To address this issue S. tiburo were sampled at six sites along c. 6200 km of continuous, continental coastline and from one island location (Grand Bahama) across a discontinuity in their distribution (the Straits of Florida), in order to test if they constitute a single lineage over this distribution. A total of 1030 bp of the mitochondrial control region (CR) was obtained for 239 S. tiburo, revealing 73 distinct haplotypes, high nucleotide diversity (0·01089) and a pair of highly divergent lineages estimated to have separated 3·61–5·62 million years ago. Mitochondrial cytochrome oxidase I and nuclear internal transcribed spacer loci show the same pattern. Divergence is similar within S. tiburo to that observed between established elasmobranch sister species, providing further evidence of cryptic speciation. A global AMOVA based on CR confirms that genetic diversity is primarily partitioned among populations (ΦST = 0·828, P < 0·001) because the divergent lineages are almost perfectly segregated between Belize and North America–The Bahamas. An AMOVA consisting solely of the North American and Bahamian samples is also significantly different from zero (ΦST = 0·088, P < 0·001) and pairwise FST is significantly different between all sites. These findings suggest that S. tiburo comprises a species complex and supports previous research indicating fine population structure, which has implications for fisheries management and biodiversity conservation.
Fabrication, performance evaluation and optimization of Sal (shorea robusta) seed decorticator
Authors: Shashi Kumar C. , Pradhan Rama Chandra , Mishra Sabyasachi
Published: September 2016

Sal (Shorea robusta) seed is a nontimber forest product, mainly processed for its oil. This oil is used in various food and nonfood industries. Prior to extraction of oil, sal seeds are manually broken to obtain sal kernel. This traditional manual de‐shelling process is very tedious, time consuming and unhygienic. Hence, in this research, a sal seed decorticator was designed, fabricated and its performance was evaluated. The performance parameters of the machine were tested with varying moisture content from 10.49% to 21.95% (d.b) and different concave clearance varying from 10 mm to 19 mm. The decorticating efficiency, machine efficiency, and kernel percentage were found to have a maximum value of 99.15
0.04%, 93.62
0.87%, and 62.71
1.73%, respectively at 13.63% (d.b) moisture content and 13 mm concave clearance. Results were fitted in response surface methodology to optimize the parameters and to find the level of significance between the independent and dependent variables.

Practical applications

A sal seed decorticator was developed based on physical and mechanical properties of sal seed. The developed machine is designed to run by manpower (manually operated) which can be suitable for hilly and forest region. This decorticator can be used to decorticate sal seeds to get sal kernels. At a seed moisture content of 13.63% (d.b.), the decorticator yields 62.71% of kernels (machine efficiency of 93.62%). These kernels are processed for extraction of oil. This machine is very useful for rural people, farmers and small‐scale industries for post‐harvest processing of sal seeds.
Quality of meta‐analyses in major leading gastroenterology and hepatology journals: A systematic review
Authors: Liu Pengfei , Qiu Yuanyu , Qian Yuting , Chen Xiao , Wang Yiran , Cui Jin , Zhai Xiao
Published: September 2016

Background and Aim

To appraise the current reporting methodological quality of meta‐analyses in five leading gastroenterology and hepatology journals, and to identify the variables associated with the reporting quality.

Methods

We systematically searched the literature of meta‐analyses in Gastroenterology, Gut, Hepatology, Journal of Hepatology (J HEPATOL) and American Journal of Gastroenterology (AM J GASTROENTEROL) from 2006 to 2008 and from 2012 to 2014. Characteristics were extracted based on the PRISMA statement and the AMSTAR tool. Country, number of patients, funding source were also revealed and descriptively reported.

Results

A total of 127 meta‐analyses were enrolled in this study and were compared among journals, study years, and other characters. Compliances with the PRISMA statement and the AMSTAR checklist were 20.8 ± 4.2 out of a maximum of 27 and 7.6 ± 2.4 out of a maximum of 11, respectively. Some domains were poorly reported including describing a protocol and/or registration (item 5, 0.0%), describing methods, and giving results of additional analyses (item 16, 45.7% and item 23, 48.0%) for PRISMA and duplicating study selection and data extraction (item 2, 53.5%), and providing a list of included and excluded studies (item 5, 14.2%) for AMSTAR. Publication in recent years showed a significantly better methodological quality than those published in previous years.

Conclusions

This study shows that methodological reporting quality of MAs in the major gastroenterology and hepatology journals has improved in recent years after the publication of the developed PRISMA statement, and it can be further improved.
Can a Healthy Lifestyle Compress the Disabled Period in Older Adults?
Authors: Jacob Mini E. , Yee Laura M. , Diehr Paula H. , Arnold Alice M. , Thielke Stephen M. , Chaves Paulo H. M. , Gobbo Liana Del , Hirsch Calvin , Siscovick David , Newman Anne B.
Published: September 2016

Objectives

To determine whether lifestyle factors, measured late in life, could compress the disabled period toward the end of life.

Design

Community‐based cohort study of older adults followed from 1989 to 2015.

Setting

Four U.S. communities.

Participants

Community‐living men and women aged 65 and older (N = 5,248, mean age 72.7 ± 5.5, 57% female, 15.2% minority) who were not wheelchair dependent and were able to give informed consent at baseline.

Measurements

Multiple lifestyle factors, including smoking, alcohol consumption, physical activity, diet, body mass index (BMI), social networks, and social support, were measured at baseline. Activities of daily living (ADLs) were assessed at baseline and throughout follow‐up. Years of life (YoL) was defined as years until death. Years of able life (YAL) was defined as years without any ADL difficulty. YAL/YoL%, the proportion of life lived able, was used to indicate the relative compression or expansion of the disabled period.

Results

The average duration of disabled years was 4.5 (out of 15.4 mean YoL) for women and 2.9 (out of 12.4 mean YoL) for men. In a multivariable model, obesity was associated with 7.3 percentage points (95% confidence interval (CI) = 5.4–9.2) lower YAL/YoL% than normal weight. Scores in the lowest quintile of the Alternate Healthy Eating Index were associated with a 3.7% (95% CI = 1.6–5.9) lower YAL/YoL% than scores in the highest quintile. Every 25 blocks walked in a week was associated with 0.5 percentage points (95% CI = 0.3–0.8) higher YAL/YoL%.

Conclusion

The effects of healthy lifestyle factors on the proportion of future life lived free of disability indicate that the disabled period can be compressed, given the right combination of these factors.
Challenges for Nurses Caring for Individuals with Peripherally Inserted Central Catheters in Skilled Nursing Facilities
Authors: Harrod Molly , Montoya Ana , Mody Lona , McGuirk Helen , Winter Suzanne , Chopra Vineet
Published: September 2016

Objectives

To understand the perceived preparedness of frontline nurses (registered nurses (RNs), licensed practical nurses (LPNs)), unit nurse managers, and skilled nursing facility (SNF) administrators in providing care for residents with peripherally inserted central catheters (PICCs) in SNFs.

Design

Exploratory, qualitative pilot study.

Setting

Two community based SNFs.

Participants

Residents with PICCs, frontline nurses (RNs, LPNs), unit nurse managers, and SNF administrators.

Methods

Over 36 weeks, 56 residents with PICCs and their nurses were observed and informally interviewed, focusing on PICC care practices and documentation. In addition, baseline PICC data were collected on placement indication (e.g., antimicrobial administration), placement setting (hospital vs SNF), and dwell time. Focus groups were then conducted with frontline nurses and unit nurse managers, and semistructured interviews were conducted with SNF administrators to evaluate perceived preparedness for PICC care. Data were analyzed using a descriptive analysis approach.

Results

Variations in documentation were observed during weekly informal interviews and observations. Differences were noted between resident self‐reported PICC concerns (quality of life) and those described by frontline nurses. Deficiencies in communication between hospitals and SNFs with respect to device care, date of last dressing change, and PICC removal time were also noted. During focus group sessions, perceived inadequacy of information at the time of care transitions, limited availability of resources to care for PICCs, and gaps in training and education were highlighted as barriers to improving practice and safety.

Conclusion

Practices for PICC care in SNFs can be improved. Multimodal strategies that enhance staff education, improve information exchange during care transitions, and increase resource availability in SNFs appear necessary to enhance PICC care and safety.
Green tea extract and catechol‐O‐methyltransferase genotype modify the post‐prandial serum insulin response in a randomised trial of overweight and obese post‐menopausal women
Authors: Dostal A. M. , Arikawa A. , Espejo L. , Bedell S. , Kurzer M. S. , Stendell‐Hollis N. R.
Published: September 2016

Background

Green tea extract (GTE) may be involved in a favourable post‐prandial response to high‐carbohydrate meals. The catechol‐O‐methyltransferase (COMT) genotype may modify these effects. We examined the acute effects of GTE supplementation on the post‐prandial response to a high‐carbohydrate meal by assessing appetite‐associated hormones and glucose homeostasis marker concentrations in women who consumed 843 mg of (−)‐epigallocatechin‐3‐gallate (EGCG) or placebo capsules for 11–12 months.

Methods

Sixty Caucasian post‐menopausal women (body mass index ≥ 25.0 kg m–2) were included in a randomised, double‐blind feeding study. GTE was consumed with a breakfast meal [2784.0 kJ (665.4 kcal); 67.2% carbohydrate]. Blood samples were drawn pre‐meal, post‐meal, and every 30 min for 4 h. Participants completed six satiety questionnaires.

Results

Plasma leptin, ghrelin and adiponectin did not differ between GTE and placebo at any time point; COMT genotype did not modify these results. Participants randomised to GTE with the high‐activity form of COMT (GTE‐high COMT) had higher insulin concentrations at time 0, 0.5 and 1.0 h post‐meal compared to all COMT groups randomised to placebo. Insulin remained higher in the GTE‐high COMT group at 1.5, 2.0 and 2.5 h compared to Placebo‐low COMT (P < 0.02). GTE‐high COMT had higher insulin concentrations at times 0, 0.5, 1.0, 1.5 and 2.0 h compared to the GTE‐low COMT (P ≤ 0.04). Area under the curve measurements of satiety did not differ between GTE and placebo.

Conclusions

GTE supplementation and COMT genotype did not alter acute post‐prandial responses of leptin, ghrelin, adiponectin or satiety, although it may be involved in post‐meal insulinaemic response of overweight and obese post‐menopausal women.
Adding glucose to food and solutions to enhance fructose absorption is not effective in preventing fructose‐induced functional gastrointestinal symptoms: randomised controlled trials in patients with fructose malabsorption
Authors: Tuck C. J. , Ross L. A. , Gibson P. R. , Barrett J. S. , Muir J. G.
Published: September 2016

Background

In healthy individuals, the absorption of fructose in excess of glucose in solution is enhanced by the addition of glucose. The present study aimed to assess the effects of glucose addition to fructose or fructans on absorption patterns and genesis of gastrointestinal symptoms in patients with functional bowel disorders.

Methods

Randomised, blinded, cross‐over studies were performed in healthy subjects and functional bowel disorder patients with fructose malabsorption. The area‐under‐the‐curve (AUC) was determined for breath hydrogen and symptom responses to: (i) six sugar solutions (fructose in solution) (glucose; sucrose; fructose; fructose + glucose; fructan; fructan + glucose) and (ii) whole foods (fructose in foods) containing fructose in excess of glucose given with and without additional glucose. Intake of fermentable short chain carbohydrates (FODMAPs; fermentable, oligo‐, di‐, monosaccharides and polyols) was controlled.

Results

For the fructose in solution study, in 26 patients with functional bowel disorders, breath hydrogen was reduced after glucose was added to fructose compared to fructose alone [mean (SD) AUC 92 (107) versus 859 (980) ppm 4 h–1, respectively; P = 0.034). Glucose had no effect on breath hydrogen response to fructans (P = 1.000). The six healthy controls showed breath hydrogen patterns similar to those with functional bowel disorders. No differences in symptoms were experienced with the addition of glucose, except more nausea when glucose was added to fructose (P = 0.049). In the fructose in foods study, glucose addition to whole foods containing fructose in excess of glucose in nine patients with functional bowel disorders and nine healthy controls had no significant effect on breath hydrogen production or symptom response.

Conclusions

The absence of a favourable response on symptoms does not support the concomitant intake of glucose with foods high in either fructose or fructans in patients with functional bowel disorders.