bluuebunny/crossref_metadata_2025 huggingface dataset:
Predicting inpatient hypoglycaemia in hospitalized patients with diabetes: a retrospective analysis of 9584 admissions with diabetes
Authors: Stuart K. , Adderley N. J. , Marshall T. , Rayman G. , Sitch A. , Manley S. , Ghosh S. , Toulis K. A. , Nirantharakumar K.
Published: June 2017

Aims

To explore whether a quantitative approach to identifying hospitalized patients with diabetes at risk of hypoglycaemia would be feasible through incorporation of routine biochemical, haematological and prescription data.

Methods

A retrospective cross‐sectional analysis of all diabetic admissions (n=9584) from 1 January 2014 to 31 December 2014 was performed. Hypoglycaemia was defined as a blood glucose level of <4 mmol/l. The prediction model was constructed using multivariable logistic regression, populated by clinically important variables and routine laboratory data.

Results

Using a prespecified variable selection strategy, it was shown that the occurrence of inpatient hypoglycaemia could be predicted by a combined model taking into account background medication (type of insulin, use of sulfonylureas), ethnicity (black and Asian), age (≥75 years), type of admission (emergency) and laboratory measurements (estimated GFR, C‐reactive protein, sodium and albumin). Receiver‐operating curve analysis showed that the area under the curve was 0.733 (95% CI 0.719 to 0.747). The threshold chosen to maximize both sensitivity and specificity was 0.15. The area under the curve obtained from internal validation did not differ from the primary model [0.731 (95% CI 0.717 to 0.746)].

Conclusions

The inclusion of routine biochemical data, available at the time of admission, can add prognostic value to demographic and medication history. The predictive performance of the constructed model indicates potential clinical utility for the identification of patients at risk of hypoglycaemia during their inpatient stay.
Importance of antecedent environmental conditions in modeling species distributions
Authors: Ryo Masahiro , Yoshimura Chihiro , Iwasaki Yuichi
Published: June 2017

Although species distributions can change in an unexpectedly short period of time, most species distribution models (SDMs) use only long‐term averaged environmental conditions to explain species distributions. We aimed to demonstrate the importance of incorporating antecedent environmental conditions into SDMs in comparison to long‐term averaged environmental conditions. We modeled the presence/absence of 18 fish species captured across 108 sampling events along a 50‐km length of the Sagami River in Japan throughout the 1990s (one to four times per site at 45 sites). We constructed and compared the two types of SDMs: 1) a conventional model that uses only long‐term averaged (10‐yr) environmental conditions; and 2) a proposed model that incorporates environmental conditions 2 yr prior to a sampling event (antecedent conditions) together with long‐term averages linked to life‐history stages. These models both included geomorphological, hydrological, and sampling conditions as predictors. A random forest algorithm was applied for modeling and quantifying the relative importance of the predictors. For seven species, antecedent hydrological conditions were more important than the long‐term averaged hydrological conditions. Furthermore, the distributions of two species with low prevalence could not be predicted using long‐term averaged hydrological conditions but only using antecedent hydrological conditions. In conclusion, incorporating antecedent environmental factors linked with life‐history stages at appropriate time scales can better explain changes in species distribution through time.
Unifying population and landscape ecology with spatial capture–recapture
Authors: Royle J. Andrew , Fuller Angela K. , Sutherland Christopher
Published: June 2017

Spatial heterogeneity in the environment induces variation in population demographic rates and dispersal patterns, which result in spatio‐temporal variation in density and gene flow. Unfortunately, applying theory to learn about the role of spatial structure on populations has been hindered by the lack of mechanistic spatial models and inability to make precise observations of population state and structure. Spatial capture–recapture (SCR) represents an individual‐based analytic framework for overcoming this fundamental obstacle that has limited the utility of ecological theory. SCR methods make explicit use of spatial encounter information on individuals in order to model density and other spatial aspects of animal population structure, and they have been widely adopted in the last decade. We review the historical context and emerging developments in SCR models that enable the integration of explicit ecological hypotheses about landscape connectivity, movement, resource selection, and spatial variation in density, directly with individual encounter history data obtained by new technologies (e.g. camera trapping, non‐invasive DNA sampling). We describe ways in which SCR methods stand to advance the study of animal population ecology.
Fine‐scale forest variability and biodiversity in the boreal mixedwood forest
Authors: Pinzon Jaime , Wu Linhao , He Fangliang , Spence John R.
Published: June 2017

Local spatial variation in species distributions is driven by a mix of abiotic and biotic factors, and understanding such hierarchical variation is important for conservation of biodiversity across larger scales. We sought to understand how variation in species composition of understory vascular plants, spiders, and carabid beetles is associated with concomitant spatial variation in forest structure on a 1‐ha permanent plot in a never‐cut mixedwood forest in central Alberta (Canada). Using correlations among dendrograms produced by cluster analysis we associated data about mapped distribution of all living and dead stems > 1 cm diameter at breast height with distributions of the three focal taxa sampled from regular grids across the plot. Variation in each of these species assemblages were significantly associated with several forest structure variables at various spatial scales, but the scale of the associations varied among assemblages. Variation in species richness and abundance was explained mostly by changes in basal area of trees across the plot; however, other variables (e.g. snag density and tree density) were also important, depending on assemblage. We conclude that fine‐scale habitat variation is important in structuring spatial distribution of the species of the forest floor, even within a relatively homogeneous natural forest. Thus, assessments that ignore within‐stand heterogeneity and management that ignores its maintenance will have limited utility as conservation measures for these taxa, which are major elements of forest biodiversity.
Regulation of kindling epileptogenesis by hippocampal Toll‐like receptors 2
Authors: Medel‐Matus Jesús‐Servando , Reynolds Ashley , Shin Don , Sankar Raman , Mazarati Andrey
Published: June 2017

This study examined whether Toll‐like receptors 2 (TLR2) contribute to rapid kindling epileptogenesis. A TLR2 agonist, lipoteichoic acid (LTA), LTA antibody (LTA‐A), or normal saline (control) was administered daily over 3 consecutive days, unilaterally into ventral hippocampus of adult male Wistar rats. Thirty minutes after the last injection, the animals were subjected to a rapid kindling procedure. The ictogenesis was gauged by comparing afterdischarge threshold (ADT) and afterdischarge duration (ADD) before the treatments, after the treatments prior to kindling, and 24 h after kindling. Kindling progression and retention were analyzed using video recording. The results showed that before kindling, LTA produced an ADT reduction. Neither LTA nor LTA‐A affected baseline ADD. On kindling progression, LTA accelerated occurrence of generalized seizures, whereas LTA‐A delayed this effect. Treatment with LTA‐A reduced the number of secondary generalized complex partial seizures. Twenty‐four hours after kindling, the rats of both the saline and LTA groups showed increased hippocampal excitability as compared with prekindling parameters. Administration of LTA‐A prevented kindling‐induced increase of hippocampal excitability. Immunostaining revealed that LTA‐A attenuated the inflammatory response produced by seizures. These findings suggest that the activation of TLR2 in the hippocampus may facilitate limbic epileptogenesis.
Postictal hypoperfusion/hypoxia provides the foundation for a unified theory of seizure‐induced brain abnormalities and behavioral dysfunction
Authors: Farrell Jordan S. , Colangeli Roberto , Wolff Marshal D. , Wall Alexandra K. , Phillips Thomas J. , George Antis , Federico Paolo , Teskey G. Campbell
Published: June 2017

A recent article by Farrell et al. characterizes the phenomenon, mechanisms, and treatment of a local and severe hypoperfusion/hypoxia event that occurs in brain regions following a focal seizure. Given the well‐established role of cerebral ischemia/hypoxia in brain damage and behavioral dysfunction in other clinical settings (e.g., stroke, cerebral vasospasm), we put forward a new theory: postictal hypoperfusion/hypoxia is responsible for the negative consequences associated with seizures. Fortunately, inhibition of two separate molecular targets, cyclooxygenase‐2 (COX‐2) and l‐type calcium channels, can prevent the expression of postictal hypoperfusion/hypoxia. These inhibitors are important experimental tools used to separate the seizure from the resulting hypoperfusion/hypoxia and can allow researchers to address the contribution of this phenomenon to negative outcomes associated with seizures. Herein we address the implications of this postictal stroke‐like event in acute behavioral dysfunction (e.g., Todd's paresis) and sudden unexpected death in epilepsy (SUDEP). Moreover, anatomic alterations such as increased blood–brain barrier permeability, glial activation, central inflammation, and neuronal loss could also be a consequence of repeated hypoperfusion/hypoxic events and, in turn, underlie chronic interictal cognitive and behavioral comorbidities (e.g., memory deficits, anxiety, depression, and psychosis) and exacerbate epileptogenesis. Thus these seemingly disparate and clinically important observations may share a common point of origin: postictal hypoperfusion/hypoxia.
Canopy height and N affect herbage accumulation and the relative contribution of leaf categories to photosynthesis of grazed brachiariagrass pastures
Authors: Yasuoka J. I. , Pedreira C. G. S. , da Silva V. J. , Alonso M. P. , da Silva L. S. , Gomes F. J.
Published: June 2017

The effects of three canopy heights (10, 25 and 40 cm) and two N rates (50 and 250 kg ha−1 year−1) on herbage accumulation (HA), participation of leaf categories in the leaf area index (LAI) and photosynthesis of grazed “Mulato II” brachiariagrass (Brachiaria brizantha × B. decumbens × B. ruziziensis) were investigated during two summer growing seasons in Piracicaba, São Paulo, Brazil. The HA and LAI increased linearly from 8560 to 13600 kg DM ha−1 year−1 and 2.3 to 5.5 m2 m−2, respectively, as canopy height increased. Mulato II brachiariagrass maintained at 10 cm canopy height showed greater proportion of young leaves, but was less productive than taller canopies. Taller canopies had greater proportion of mature leaves in the LAI as well as greater photosynthesis. The greater N rate contributed to increased LAI, leaf and canopy photosynthesis rates and HA but did not affect the LAI composition. The total leaf area is more important to HA than the proportion of young leaves in the LAI, as taller canopies were more productive, suggesting that maintaining Mulato II brachiariagrass at 25 or 40 cm is advantageous for this grass.
The efficacy of commercial tooth storage media for maintaining the viability of human periodontal ligament fibroblasts
Authors: Lee W. , Stover S. , Rasoulianboroujeni M. , Sherman K. , Fahimipour F. , Dashtimoghadam E. , Zito C. , Jazayeri H. E. , Tayebi L.
Published: June 2017

Aim

To evaluate Save‐A‐Tooth (SAT), EMT Toothsaver (EMT) and Hank's Balanced Salt Solution (HBSS) for their influence on the viability and proliferative capacity of human periodontal ligament fibroblasts (HPDLFs).

Methodology

Primary HPDLFs were seeded into 96‐well cell culture plates and exposed to SAT, EMT, HBSS and water (negative control) for 0.5, 1, 3, 6, 12 and 24 h at room temperature (22 °C). After each exposure time, cell viability was measured through quantifying adenosine triphosphate (ATP) using a luminescent dye. The proliferative capacity was also quantified using the PrestoBlue assay after 12 or 24 h storage in each medium. The data were analysed statistically by two‐way anova and post hoc Least Significant Difference (LSD) test (P < 0.05). The morphology of the cells after 12 h storage was also investigated through live/dead viability/cytotoxicity kit together with fluorescence microscopy.

Results

There was no significant difference in cell viability amongst HBSS, SAT and EMT groups up to 6 h. SAT was effective in maintaining cell viability only up to 12 h and then became detrimental to HPDLF; after 24 h, the effectiveness of SAT in maintaining cell viability was similar to that of water (P > 0.05). Amongst all the media, only EMT could maintain the proliferative capacity of HPDLFs significantly higher than the negative control, that is water (P < 0.05) after 24 h storage.

Conclusion

EMT maintained the proliferative capacity of HPDLFs after 24 h storage.
Functional analysis of female‐biased odorant binding protein 6 for volatile and nonvolatile host compounds in Adelphocoris lineolatus (Goeze)
Authors: Sun L. , Wang Q. , Yang S. , Wang Q. , Zhang Z. , Khashaveh A. , Zhang Y.‐J. , Guo Y.‐Y.
Published: June 2017

The polyphagous mirid bug Adelphocoris lineolatus relies heavily on olfactory cues to track suitable host plants. Thus, a better understanding of the molecular basis of its olfactory detection could contribute to the development of effective pest management strategies. In the present study, we report the expression profile of the odorant binding protein gene A. lineolatus odorant binding protein 6 (AlinOBP6). Quantitative real‐time PCR experiments suggest that AlinOBP6 is female adult antennae‐biased. Cellular immunolocalization analyses show that AlinOBP6 is highly expressed in the lymph of both multiporous sensilla basiconica and uniporous sensilla chaetica. A ligand binding analysis showed that recombinant AlinOBP6 not only bound tightly to host plant volatile compounds but also to nonvolatile compounds. Homology modelling and molecular docking analyses confirmed these unusual ligand binding profiles and revealed that the amino acid residues involved in the recognition of volatile and nonvolatile compounds are distinct. The results of our study are the first to suggest that an antenna‐ and female‐biased OBP in an hemipteran insect is expressed in both olfactory and gustatory sensilla as a mechanism to respond to volatile and nonvolatile host compounds. These findings warrant further research into the molecular mechanisms of chemosensation for mirid bugs in responsive to host plant location.
Development of a colloidal gold immunochromatographic assay (GICA) for the rapid detection of Spiroplasma eriocheiris in commercially exploited crustaceans from China
Authors: Liu H , Xiu Y , Xu Y , Tang M , Li S , Gu W , Meng Q , Wang W
Published: June 2017

Spiroplasma eriocheiris is an emerging pathogen in freshwater crustaceans. In recent years, Eriocheir sinensis, Procambarus clarkii, Litopenaeus vannamei, Macrobrachium rosenbergii and Macrobrachium nipponense had been infected by this pathogen in China. An immunochromatographic strip test using gold nanoparticles was developed for rapidly detecting this pathogen. The strip test based on the principle of sandwich immunoassay by the specific combination between the pathogen and polyclonal antibody on a nitrocellulose membrane. Positive samples were displayed as red lines at the test and control zones of the nitrocellulose membrane, while negative samples resulted in a red line only at the control zone. The limit of detection was proved to be 106 Color Change Unit/ml. The test strip could be visually detected within 15 min and do not have cross‐reaction with other aquatic bacteria. This test strip allows on‐site rapid detection of S. eriocheiris in crustacean without the requirement of specialized equipment and professional personnel. The one‐step test strips developed in our study had high sensitivity, specificity, reproducibility and stability. In conclusion, this method was proved to be convenient, feasible, rapid and effective for detecting S. eriocheiris.
Grasping damage analysis of apple by end‐effector in harvesting robot
Authors: Ji Wei , Qian Zhijie , Xu Bo , Tang Wei , Li Junle , Zhao Dean
Published: June 2017

According to the grasping damage of apple during the process of robot picking apple, the variation of interior tensions inside the apple skin in the grasping process of apple with different type finger of robot end‐effector is researched. The finite element model for apple is established by ANSYS. Some simulations for the grasping process of apple with plane and arc‐shaped finger are carried out. The Von Mises stress nephograms of apple different tissue under different load force by different type fingers are obtained. The experimental results show that the apple cortex is more easily to get damaged due to its small failure stress. And the deformation and stress of apple caused by arc‐shaped finger are smaller than by plane finger. At last, the actual experiment for apple grasping damage of end‐effector with arc‐shaped finger validates the reliability of simulated results. The research results demonstrated that the finite element method can make accurate evaluation for apple damage.

Practical applications

A major problem associated with robot harvesting is the mechanical damage of apple caused by end‐effector of robot. When the apple is grasped by the end‐effector, the mechanical damage is often occurred underneath apple skin thus, which is difficult to find by the naked eye immediately. The results in our paper can accurate evaluation for apple damage and provide a foundational basis to develop an injury‐reduce device of apple harvesting robot.
Rapid determination of oil quantity in intact rapeseeds using near‐infrared spectroscopy
Authors: Wan Linsheng , Sun Hongqin , Ni Zhengbin , Yan Guohong
Published: June 2017

The present study aims to predict the oil quantity in % using Near‐infrared spectroscopy (NIRS) directly from spectral data acquired on rapeseeds (Brassica napus). In total 637 samples were used to construct and test the mathematic model. The correlation coefficient (R2) between the NIRS predicated results and the chemical extraction method was .98, .97, and .96 for the calibration, cross validation, and external validation, respectively. For external validation, the average relative error and the mean absolute error was 0.78 and 2.02%, respectively, compatible with those of chemical extraction method. Further determination suggested that 1.5 g was the minimal quantity of sample loading to obtain stable results and the NIRS method showed a similar repeatability to the chemical extraction method. Taken together, NIRS method enables the rapid detection of oil quantity of intact B. napus seeds.

Practical applications

The present study constructed a mathematic model for the measurement of oil content of rapeseed using the NIRS technology. Compared with the traditional method for oil content determination using the chemical extraction, the NIRS method is cheaper, safer, more rapid, and convenient. It shows similar repeatability to the chemical extraction method and needs not to destroy the samples. Thus, the method raised in the present study could be used to detect the oil content of intact rapeseeds in food and breeding industries.
A Typology of Interprofessional Teamwork in Acute Geriatric Care: A Study in 55 units in Belgium
Authors: Piers Ruth D. , Versluys Karen J. J. , Devoghel Johan , Lambrecht Sophie , Vyt André , Van Den Noortgate Nele J.
Published: June 2017

Objectives

To explore the quality of interprofessional teamwork in acute geriatric care and to build a model of team types.

Design

Cross‐sectional multicenter study.

Setting

Acute geriatric units in Belgium.

Participants

Team members of different professional backgrounds.

Measurements

Perceptions of interprofessional teamwork among team members of 55 acute geriatric units in Belgium were measured using a survey covering collaborative practice and experience, managerial coaching and open team culture, shared reflection and decision‐making, patient files facilitating teamwork, members’ belief in the power of teamwork, and members’ comfort in reporting incidents. Cluster analysis was used to determine types of interprofessional teamwork. Professions and clusters were compared using analysis of variance.

Results

The overall response rate was 60%. Of the 890 respondents, 71% were nursing professionals, 20% other allied health professionals, 5% physicians, and 4% logistic and administrative staff. More than 70% of respondents scored highly on interprofessional teamwork competencies, consultation, experiences, meetings, management, and results. Fewer than 55% scored highly on items about shared reflection and decision‐making, reporting incidents from a colleague, and patient files facilitating interprofessional teamwork. Nurses in this study rated shared reflection and decision‐making lower than physicians on the same acute geriatric units (P < .001). Using the mean score on each of the six areas, four clusters that differed significantly in all areas were identified using hierarchical cluster analysis and scree plot analysis (P < .001).

Conclusion

Interprofessional teamwork in acute geriatric units is satisfactory, but shared reflection and decision‐making needs improvement. Four types of interprofessional teamwork are identified and can be used to benchmark the teamwork of individual teams.
The malleable brain: plasticity of neural circuits and behavior – a review from students to students
Authors: Schaefer Natascha , Rotermund Carola , Blumrich Eva‐Maria , Lourenco Mychael V. , Joshi Pooja , Hegemann Regina U. , Jamwal Sumit , Ali Nilufar , García Romero Ezra Michelet , Sharma Sorabh , Ghosh Shampa , Sinha Jitendra K. , Loke Hannah , Jain Vishal , Lepeta Katarzyna , Salamian Ahmad , Sharma Mahima , Golpich Mojtaba , Nawrotek Katarzyna , Paidi Ramesh K. , Shahidzadeh Sheila M. , Piermartiri Tetsade , Amini Elham , Pastor Veronica , Wilson Yvette , Adeniyi Philip A. , Datusalia Ashok K. , Vafadari Benham , Saini Vedangana , Suárez‐Pozos Edna , Kushwah Neetu , Fontanet Paula , Turner Anthony J.
Published: June 2017

One of the most intriguing features of the brain is its ability to be malleable, allowing it to adapt continually to changes in the environment. Specific neuronal activity patterns drive long‐lasting increases or decreases in the strength of synaptic connections, referred to as long‐term potentiation and long‐term depression, respectively. Such phenomena have been described in a variety of model organisms, which are used to study molecular, structural, and functional aspects of synaptic plasticity. This review originated from the first International Society for Neurochemistry (ISN) and Journal of Neurochemistry (JNC) Flagship School held in Alpbach, Austria (Sep 2016), and will use its curriculum and discussions as a framework to review some of the current knowledge in the field of synaptic plasticity. First, we describe the role of plasticity during development and the persistent changes of neural circuitry occurring when sensory input is altered during critical developmental stages. We then outline the signaling cascades resulting in the synthesis of new plasticity‐related proteins, which ultimately enable sustained changes in synaptic strength. Going beyond the traditional understanding of synaptic plasticity conceptualized by long‐term potentiation and long‐term depression, we discuss system‐wide modifications and recently unveiled homeostatic mechanisms, such as synaptic scaling. Finally, we describe the neural circuits and synaptic plasticity mechanisms driving associative memory and motor learning. Evidence summarized in this review provides a current view of synaptic plasticity in its various forms, offers new insights into the underlying mechanisms and behavioral relevance, and provides directions for future research in the field of synaptic plasticity.

image

Read the Editorial Highlight for this article on page 788.

Cover Image for this issue: doi: 10.1111/jnc.13815.
Effects of Messages Delivered by Mobile Phone on Increasing Compliance With Shoulder Exercises Among Patients With a Frozen Shoulder
Authors: Chen Hui‐Chun , Chuang Tai‐Yuan , Lin Pi‐Chu , Lin Yen‐Kuang , Chuang Yeu‐Hui
Published: June 2017

Purpose

The aim of this study was to examine the effects of reminders, encouragement, and educational messages delivered by mobile phone on shoulder exercise compliance and improvements in shoulder function among patients with a frozen shoulder.

Design and Methods

A randomized controlled trial design was used. A convenience sample of patients with a frozen shoulder in an orthopedic outpatient clinic was recruited. All participants were instructed on how to do shoulder exercises and were provided with a printed pamphlet about shoulder exercises. Then, the intervention group received reminders, encouragement, and educational messages by mobile phone daily for the next 2 weeks, while the comparison group did not.

Findings

The intervention group had higher compliance with shoulder exercises than did the comparison group (t = 2.263, p = .03) and had significant improvements in shoulder forward flexion (F = 12.067, p = .001), external rotation (F = 13.61, p = .001), and internal rotation (F = 5.903, p = .018) compared to those in the comparison group after the 2‐week intervention.

Conclusions

The text messages significantly increased patient compliance with shoulder exercises and thus improved patients’ shoulder range of motion.

Clinical Relevance

Hospital or clinics can send appropriate messages to patients via text message platforms in order to remind and encourage them to do shoulder exercises.
Oxidative stress and psychiatric morbidity in patients with facial acne
Authors: Awad Sara M. , Morsy Hanan , Sayed Ayat A. , Mohamed Nahed A. , Ezzat Ghada M. , Noaman Mostafa M.
Published: June 2017

Background

Acne vulgaris is a common cosmetic problem that is frequently associated with psychosocial disturbances as well as increased oxidative stress. However, oxidative stress and psychological aspects have been studied separately in acne.

Objective

To evaluate the relationships between oxidative stress, anxiety, depression, and quality of life in acne patients.

Methods

Sixty patients with facial acne and 40 age‐ and sex‐matched healthy individuals were included in the study. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS), and quality of life (QoL) was measured by the Cardiff Acne Disability Index. Disease severity was assessed using the Combined Acne Severity Classification. The serum levels of zinc and malondialdehyde (MDA) and total antioxidant capacity (TAC) were measured in patients and healthy subjects.

Results

The mean HADS scores for anxiety and depression were higher in patients than controls (P<.001 for both). Acne patients showed higher serum MDA and lower TAC and serum zinc levels compared with control subjects (P=.019, P<.001, and P=.028, respectively). Anxiety and depression scores did not correlate with oxidative stress parameters. Patients with moderate/severe acne had worse anxiety scores than mild acne (P=.048), and higher anxiety scores were associated with poorer quality of life (r=.436, P=.001).

Conclusion

Our results indicate that the high levels of anxiety and depression in patients with facial acne were not related to oxidative stress. Anxiety was more common than depression and was directly related to QoL impairment.
Nursing assessment as an effective tool for the identification of delirium risk in older in‐patients: A case–control study
Authors: Solà‐Miravete Elena , López Carlos , Martínez‐Segura Estrella , Adell‐Lleixà Mireia , Juvé‐Udina Maria Eulàlia , Lleixà‐Fortuño Mar
Published: June 2017

Aims and objectives

To evaluate the usefulness of comprehensive nursing assessment as a strategy for determining the risk of delirium in older in‐patients from a model of care needs based on variables easily measured by nurses.

Background

There are many scales of assessment and prediction of risk of delirium, but they are little known and infrequently used by professionals. Recognition of delirium by doctors and nurses continues to be limited.

Design and methods

A case–control study. A specific form of data collection was designed to include the risk factors for delirium commonly identified in the literature and the care needs evaluated from the comprehensive nursing assessment based on the Virginia Henderson model of care needs. We studied 454 in‐patient units in a basic general hospital. Data were collected from a review of the records of patients’ electronic clinical history.

Results

The areas of care that were significant in patients with delirium were dyspnoea, problems with nutrition, elimination, mobility, rest and sleep, self‐care, physical safety, communication and relationships. The specific risk factors identified as independent predictors were as follows: age, urinary incontinence, urinary catheter, alcohol abuse, previous history of dementia, being able to get out of bed/not being at rest, habitual insomnia and history of social risk.

Conclusions

Comprehensive nursing assessment is a valid and consistent strategy with a multifactorial model of delirium, which enables the personalised risk assessment necessary to define a plan of care with specific interventions for each patient to be made.

Relevance to clinical practice

The identification of the risk of delirium is particularly important in the context of prevention. In a model of care based on needs, nursing assessment is a useful component in the risk assessment of delirium and one that is necessary for developing an individualised care regime.
Genetic landscape and deregulated pathways in B‐cell lymphoid malignancies
Authors: Rosenquist R. , Beà S. , Du M.‐Q. , Nadel B. , Pan‐Hammarström Q.
Published: June 2017

With the introduction of next‐generation sequencing, the genetic landscape of the complex group of B‐cell lymphoid malignancies has rapidly been unravelled in recent years. This has provided important information about recurrent genetic events and identified key pathways deregulated in each lymphoma subtype. In parallel, there has been intense search and development of novel types of targeted therapy that ‘hit’ central mechanisms in lymphoma pathobiology, such as BTK, PI3K or BCL2 inhibitors. In this review, we will outline the current view of the genetic landscape of selected entities: follicular lymphoma, diffuse large B‐cell lymphoma, mantle cell lymphoma, chronic lymphocytic leukaemia and marginal zone lymphoma. We will detail recurrent alterations affecting important signalling pathways, that is the B‐cell receptor/NF‐κB pathway, NOTCH signalling, JAK‐STAT signalling, p53/DNA damage response, apoptosis and cell cycle regulation, as well as other perhaps unexpected cellular processes, such as immune regulation, cell migration, epigenetic regulation and RNA processing. Whilst many of these pathways/processes are commonly altered in different lymphoid tumors, albeit at varying frequencies, others are preferentially targeted in selected B‐cell malignancies. Some of these genetic lesions are either involved in disease ontogeny or linked to the evolution of each disease and/or specific clinicobiological features, and some of them have been demonstrated to have prognostic and even predictive impact. Future work is especially needed to understand the therapy‐resistant disease, particularly in patients treated with targeted therapy, and to identify novel targets and therapeutic strategies in order to realize true precision medicine in this clinically heterogeneous patient group.
The mobile dso-gene-sso element in rolling-circle plasmids of staphylococci reflects the evolutionary history of its resistance gene
Authors: Wassenaar T.M. , Cabal A.
Published: June 2017

The qacC and lnuA genes of Staphylococcus species were recently proposed to comprise a mobile element when residing on rolling-circle plasmids. Here we present other examples of resistance genes on staphylococcal rolling-circle plasmids, including fosB producing resistance to fosfomycin, cat resulting in resistance to chloramphenicol and cadB for resistance to the toxic heavy metal cadmium. For three of these genes (qacC, lnuA and fosB), evidence was obtained that the genes have spread between different plasmid backgrounds. The lack of mutations in qacC suggests that the spread occurred relatively recently, while the build up of mutations in lnuA and fosB suggests their mobilization occurred in the more distant past. These observations can be explained by the use of the respective antibiotics over time. However, the cat and cadB genes sequences analysed had not collected any mutations, an observation that is not completely understood but possible explanations are discussed.

Significance and Impact of the Study

We have analysed five resistance genes in Staphylococcus aureus that are positioned between the replication elements of rolling-circle plasmids. For three of these genes, evidence was obtained indicative of recent mobilization. The historical use of the antibiotics to which the genes produce resistance could be related to the number of mutations collected in these genes. However, two other resistance genes have not collected any mutations over time, and the reasons for this are discussed. The analyses presented provide insights into the spread and evolution of antibiotic resistance genes.
Prospective associations between environmental heavy metal exposure and renal outcomes in adults with chronic kidney disease
Authors: Tsai Chun‐Chieh , Wu Chia‐Lin , Kor Chew‐Teng , Lian Ie‐Bin , Chang Chin‐Hua , Chang Teng‐Hsiang , Chang Chia‐Chu , Chiu Ping‐Fang
Published: June 2017

Aim

In Taiwan, Changhua County residents were exposed to high heavy metal pollution and exhibited high heavy metal levels in blood and urine. We examined associations between heavy metals in residential soil and renal outcomes of residents with chronic kidney disease (CKD).

Method

From 1 January 2003 to 30 June 2015, we retrospectively identified CKD patients with an estimated glomerular filtration rate of <60 mL/min per 1.73 m2 at one tertiary care centre. We linked data displaying heavy metal concentrations from farm soil adjacent to the patients' residences to clinical outcomes. We included 2343 CKD patients (533 with progression to end‐stage renal disease [ESRD] and 1810 without]. We followed these patients for 3.49 ± 2.27 years, until death or initiation of maintenance dialysis.

Results

There were high correlations among the concentrations of the eight metals: arsenic, cadmium, chromium, mercury, copper, lead, nickel, and zinc. After factor analysis, chromium, copper, nickel, and zinc were grouped and labelled Factor 1. High Factor 1 concentration near the patients' residences was associated with diagnoses of hypertension, diabetes mellitus, and cerebral vascular accident. Patients living in areas with high Factor 1 concentrations were at higher risk of ESRD. After multivariate adjustment [adjusted hazard ratio: 1.08, 95% Confidence interval: 1.01–1.14, P = 0.02], only zinc and nickel were risk factors for progression to ESRD.

Conclusion

Patients with CKD, with long‐term exposure to soil‐based heavy metals, had rapid progression to ESRD. Groups of minerals from the same source of contamination may accumulate and lead to additional harm.
Incidence of episiotomy in Slovenia: The story behind the numbers
Authors: Jug Došler Anita , Mivšek Ana Polona , Verdenik Ivan , Škodič Zakšek Teja , Levec Tina , Petročnik Petra
Published: June 2017

Episiotomy is a surgical cut of the perineum performed in the second stage of labor in order to widen the vaginal opening and thus facilitate the birth of an infant. Despite current recommendations against the routine use of episiotomy, it is one of the most commonly performed surgical interventions during childbirth. This retrospective study explores the number of episiotomies performed in Slovenian maternity hospitals and the differences in episiotomy rates in relation to parity. Data were obtained from the Slovenian National Perinatal Information System and pooled for 2013. A causal and non‐experimental method of empirical research was used. The results of the study show that episiotomy rates vary widely across Slovenian maternity hospitals, ranging from 2.5% to 51.7%. Moreover, the majority of Slovenian maternity hospitals exceed the recommended rate, with an overall incidence of episiotomy as high as 31.3%. Further research is recommended to obtain relevant information from women as well as from midwives and to draw new, evidence‐based conclusions related to the maternal benefits and adverse effects of episiotomy.
Trictide, a tricellulin‐derived peptide to overcome cellular barriers
Authors: Cording Jimmi , Arslan Basak , Staat Christian , Dithmer Sophie , Krug Susanne M. , Krüger Anneliese , Berndt Philipp , Günther Ramona , Winkler Lars , Blasig Ingolf E. , Haseloff Reiner F.
Published: June 2017

The majority of tight junction (TJ) proteins restrict the paracellular permeation of solutes via their extracellular loops (ECLs). Tricellulin tightens tricellular TJs (tTJs) and regulates bicellular TJ (bTJ) proteins. We demonstrate that the addition of recombinantly produced extracellular loop 2 (ECL2) of tricellulin opens cellular barriers. The peptidomimetic trictide, a synthetic peptide derived from tricellulin ECL2, increases the passage of ions, as well as of small and larger molecules up to 10 kDa, between 16 and 30 h after application to human epithelial colorectal adenocarcinoma cell line 2. Tricellulin and lipolysis‐stimulated lipoprotein receptor relocate from tTJs toward bTJs, while the TJ proteins claudin‐1 and occludin redistribute from bTJs to the cytosol. Analyzing the opening of the tricellular sealing tube by the peptidomimetic using super‐resolution stimulated‐emission depletion microscopy revealed a tricellulin‐free area at the tricellular region. Cis‐interactions (as measured by fluorescence resonance energy transfer) of tricellulin–tricellulin (tTJs), tricellulin–claudin‐1, tricellulin–marvelD3, and occludin–occludin (bTJs) were strongly affected by trictide treatment. Circular dichroism spectroscopy and molecular modeling suggest that trictide adopts a β‐sheet structure, resulting in a peculiar interaction surface for its binding to tricellulin. In conclusion, trictide is a novel and promising tool for overcoming cellular barriers at bTJs and tTJs with the potential to transiently improve drug delivery.
The validity of register data to identify children with atopic dermatitis, asthma or allergic rhinoconjunctivitis
Authors: Stensballe Lone Graff , Klansø Lotte , Jensen Andreas , Hærskjold Ann , Thomsen Simon Francis , Simonsen Jacob
Published: June 2017

Background

The incidence of atopic dermatitis, wheezing, asthma and allergic rhinoconjunctivitis has been increasing. Register‐based studies are essential for research in subpopulations with specific diseases and facilitate epidemiological studies to identify causes and evaluate interventions. Algorithms have been developed to identify children with atopic dermatitis, asthma or allergic rhinoconjunctivitis using register information on disease‐specific dispensed prescribed medication and hospital contacts, but the validity of the algorithms has not been evaluated. This study validated the algorithms vs gold standard deep telephone interviews with the caretaker about physician‐diagnosed atopic dermatitis, wheezing, asthma or allergic rhinoconjunctivitis in the child.

Methods

The algorithms defined each of the three atopic diseases using register‐based information on disease‐specific hospital contacts and/or filled prescriptions of disease‐specific medication. Confirmative answers to questions about physician‐diagnosed atopic disease were used as the gold standard for the comparison with the algorithms, resulting in sensitivities and specificities and 95% confidence intervals. The interviews with the caretaker of the included 454 Danish children born 1997‐2003 were carried out May‐September 2015; the mean age of the children at the time of the interview being 15.2 years (standard deviation 1.3 years).

Results

For the algorithm capturing children with atopic dermatitis, the sensitivity was 74.1% (95% confidence interval: 66.9%‐80.2%) and the specificity 73.0% (67.3%‐78.0%). For the algorithm capturing children with asthma, both the sensitivity of 84.1% (78.0%‐88.8%) and the specificity of 81.6% (76.5%‐85.8%) were high compared with physician‐diagnosed asthmatic bronchitis (recurrent wheezing). The sensitivity remained high when capturing physician‐diagnosed asthma: 83.3% (74.3%‐89.6%); however, the specificity declined to 66.0% (60.9%‐70.8%). For allergic rhinoconjunctivitis, the sensitivity was 84.4% (78.0‐89.2) and the specificity 81.6% (75.0‐84.4).

Conclusion

The algorithms are valid and valuable tools to identify children with atopic dermatitis, wheezing, asthma or allergic rhinoconjunctivitis on a population level using register data.
Psychopathology in pediatric bone marrow transplantation survivors and their mothers
Authors: Sürer Adanir Aslı , Taşkiran Gülseren , Küpesiz Osman Alphan , Özatalay Esin
Published: June 2017

Background

Bone marrow transplantation (BMT) is used to treat various hematologic, oncologic and metabolic diseases. While the treatment is lifesaving, it is also associated with anxiety, post‐traumatic stress disorder, depression and psychosocial problems both in children and parents.

Methods

The aim of this study was to investigate the psychopathology in pediatric BMT survivors and their mothers compared with healthy controls. All children were interviewed using Kiddie Schedule for Affective Disorders and Schizophrenia to assess lifelong psychopathology. For the mothers, the Symptom Checklist‐90‐Revised (SCL‐90‐R) was used.

Results

In the BMT group, 17 children (63%) had at least one psychiatric disorder, while 15 (53.6%) did in the control group. Although lifelong prevalence of psychopathology in the BMT group did not differ significantly from the control group generally, anxiety disorders were significantly higher in the BMT group. When the SCL‐90‐R scores of the mothers were compared, Anxiety, Obsessive–Compulsive, Interpersonal Sensitivity and Phobic Anxiety were significantly higher in the mothers in the BMT group, indicating more difficulty in these areas.

Conclusions

Bone marrow transplantation is a significant stressor, especially for mothers. Clinicians should address the child and family as a whole in assessments and be aware of psychiatric symptoms in mothers and children who have had such a life‐threatening condition.
Diffusion of Innovation and the Technology Adoption Curve: Where Are We? The Zimbabwean Experience
Authors: Dube Cinderella , Gumbo Victor
Published: June 2017

The introduction of the Internet has led to the development of new technologies and applications that have been adopted by organisations and their users to enable them to survive in this age of technology. Online technologies have penetrated Zimbabwe, particularly in the retail industry, however, little research has been done to link the research results to theory particularly the technology adoption theories. Therefore the objective of this study was to explore the current extent of adoption of online transaction platforms in the retail industry in Zimbabwe. Furthermore, this paper purposed to determine the extent of this adoption on the Technology Adoption Curve. The online transaction platforms studied were Internet banking, Automated Teller Machines, Mobile banking, Point of Sale and Mobile money. The study took a mixed method approach where both qualitative and quantitative strategies were used. A three-sample dataset comprising of 268 bank and supermarket customers, 56 bank managers and 31 supermarket managers was used. The resultant adoption rates were plotted on Moore’s Technology Adoption Curve. The results indicated that although the retail industry had made great strides to adopt online technology platforms, but the adoption by customers was relatively low at a market penetration of 14.5%. The study thus concluded that Zimbabwe’s online technologies were in their infancy stage on the maturity model adoption curve and were inside Moore’s chasm on the technology adoption curve. The study recommended to customers to use the adopted online technologies in order to keep abreast with the digital era. On the other hand, banks and supermarkets were urged to devise marketing strategies in an effort to cross the chasm in the Technology Adoption Curve.
Extreme and extremist geographies: commentary on the revanchist impulse and its consequences for everyday bordering
Authors: Scott James Wesley
Published: June 2017

As Fassin and Windels (2016) argue, political xenophobia needs to be explained politically. At the same time, while political xenophobia is not a necessary consequence of neoliberalism, the idea of what counts as ‘political’ needs to be expanded.  I suggest that one fruitful, non-reductionist strategy for understanding the consequences of identitary bordering consists in exploring links between securitization and the politicization of identity and national belonging. Inspired by the ideas of Henk van Houtum and Rodrigo Lacy, I approach the extreme geographies of identity politics from an ethical and philosophical perspective, arguing that a powerful revanchist and self-referential narrative of authenticity and autonomy is influencing both everyday bordering practices and the way security is discursively framed.
Ultrasound field characterization using synthetic schlieren tomography
Authors: Pulkkinen Aki , Leskinen Jarkko J. , Tiihonen Aimo
Published: June 2017

Synthetic schlieren imaging, also known as background oriented schlieren imaging, is used to determine the acoustical field of a focused ultrasound transducer operating at 1.01 MHz frequency with peak pressure amplitude of 0.97 MPa. The measurement setup is composed of a commercial off-the-shelf digital single-lens reflex (DSLR) camera with an ordinary objective, a high power light-emitting diode driven in pulsating mode, water tank, ultrasound transducer, rotation stage, and driving electronics. Measurements are performed in tomographic fashion by rotating the ultrasound transducer within the water tank and photographing an imaged target behind the ultrasound field. The photographs are processed with a Horn-Schunck-type algorithm, commonly used in optical flow analysis, in order to determine the deflection of light rays as caused by ultrasound field induced acousto-optic effect. Inverse Radon transform is then used, with the deflection data, to obtain three-dimensional spatial distribution of the pressure field gradient, from which an approximation of the ultrasonic pressure field is computed. The pressure field obtained with synthetic schlieren tomography is then compared to hydrophone measurements mainly qualitatively.