bluuebunny/crossref_metadata_2025 huggingface dataset:
Final assessment of nursing students in clinical practice: Perspectives of nursing teachers, students and mentors
Authors: Helminen Kristiina , Johnson Martin , Isoaho Hannu , Turunen Hannele , Tossavainen Kerttu
Published: March 2017

Aims and objectives

To describe the phenomenon of final assessment of the clinical practice of nursing students and to examine whether there were differences in assessments by the students and their teachers and mentors.

Background

Final assessment of students in clinical practice during their education has great importance for ensuring that enough high‐quality nursing students are trained, as assessment tasks affect what the nursing student learns during the clinical practice.

Design

This study used descriptive, cross‐sectional design.

Methods

The population of this study comprised nursing students (n = 276) and their teachers (n = 108) in five universities of applied sciences in Finland as well as mentors (n = 225) who came from five partner hospitals. A questionnaire developed for this study contained questions about background variables as well as structured questions scored on a four‐point scale, which also allowed the respondents to provide additional comments.

Results

When comparing the results related to nursing teachers’ presence in the final assessment situation, it was found that teachers and mentors evaluated this as being carried out more often than nursing students suggested. Nursing students noted that fair and consistent assessment is carried out more often than nursing teachers thought. Mentors and teachers said that honest and direct criteria‐based final assessment was carried out more often than nursing students evaluated.

Conclusions

Nursing students and mentors need support from educational institutions and from nursing teachers in order to ensure the completion of a relevant assessment process.

Relevance to clinical practice

The findings of this study highlight an awareness of final assessment process. It is desirable to have a common understanding, for example, of how the assessment should be managed and what the assessment criteria are, as this will ensure a good quality process.
Perceived stigma and depression in initially diagnosed pulmonary tuberculosis patients
Authors: Lee Li‐Yun , Tung Heng‐Hsin , Chen Shu‐Ching , Fu Chiung‐Hui
Published: March 2017

Aims and objectives

To investigate the status of tuberculosis stigma and depression among tuberculosis patients, to examine the relationship between demographics and tuberculosis stigma and depression among tuberculosis patients, and to identify the predictors of depression among tuberculosis patients.

Background

After the diagnosis of tuberculosis, patients suffer from disease symptoms and disease‐related stigma. Depression is also a major concern in tuberculosis patients.

Design

A cross‐sectional design was used in this study.

Methods

A total of 84 subjects, obtained through convenience sampling, enrolled in this study, which was conducted from 1 March 2013–30 December 2014. Data were collected using a structured questionnaire with a demographic component, the Tuberculosis‐related Stigma Scale, and the Beck Depression Inventory‐II. Data were analysed, using spss Version 20. Independent t tests, Pearson's correlation coefficient tests and analyses of variance were used for analysis of patient demographic characteristics, disease characteristics, and the correlation between stigma and depression. Multiple linear regression was used for determining the predictors of depression.

Results

The results showed that not disclosing one's illness to others was associated with tuberculosis stigma and depression. Multiple linear regression analysis indicated that patient‐perceived tuberculosis stigma and body mass index accounted for 34% of the variation in depression.

Conclusions

These results can serve as a reference for clinical healthcare providers to understand perceived stigma and depression in initially diagnosed tuberculosis patients.

Relevance to clinical practice

An intervention to reduce patient tuberculosis stigma, such as improving community healthcare education or offering mental health outreach, has great potential to lower the level of depression among patients with tuberculosis.
Emissions abatement R&D: Dynamic competition in supply schedules
Authors: Menezes Flavio M. , Pereira Jorge
Published: March 2017

This paper investigates the optimal environmental policy (the mix of emissions tax and research and development [R&D] subsidy) in a dynamic setting when two firms, producing differentiated products, compete in the output market over time. Firms compete in a differential game setting over supply schedules, which encompasses a continuum of imperfect competition equilibria from Bertrand to Cournot. Although production generates environmentally damaging emissions, firms can undertake R&D that has the sole purpose of reducing emissions. In addition to characterizing the optimal policy, we examine how the optimal tax and subsidy, and the optimal level of abatement, change as competition intensifies, as the dynamic parameters change, and as the investment in abatement technology changes. In this setting, competition increases welfare through its impact on the final goods price. However, lower prices result in larger quantities and more pollution. Our key contribution is to show how the impact of increased competition on welfare depends on the extent of the market and the nature of preferences and technology.
Melatonin administration to wild‐type mice and nontreated NLRP3 mutant mice share similar inhibition of the inflammatory response during sepsis
Authors: Rahim Ibtissem , Djerdjouri Bahia , Sayed Ramy K. , Fernández‐Ortiz Marisol , Fernández‐Gil Beatriz , Hidalgo‐Gutiérrez Agustín , López Luis C. , Escames Germaine , Reiter Russel J. , Acuña‐Castroviejo Darío
Published: March 2017

The NLRP3 inflammasome is involved in the innate immune response during inflammation. Moreover, melatonin blunts the NF‐κB/NLRP3 connection during sepsis. Thus, we compared the roles of the NLRP3 inflammasome and/or melatonin treatment in the septic response of wild‐type and NLRP3−/− mice. Mouse myocardial tissue was used for this purpose. The nuclear turnover of NF‐κB was enhanced during sepsis, with an increase in TNFα, iNOS, and pro‐IL‐1β. The lack of inflammasome in NLRP3−/− mice significantly reduced that response and blunted IL‐1β maturation due to the lack of caspase‐1. Clock and Bmal1 did not change in both mouse strains, enhancing Chrono expression in mutants. RORα, which positively regulates Bmal1, was enhanced at a similar extend in both mouse strains, whereas the expression of the Bmal1 repressor, Rev–Erbα, increased in WT but was depressed in NLRP3−/− mice. Nampt, transcriptionally controlled by Bmal1, increased in WT mice together with Sirt1, whereas they remained unchanged in NLRP3−/− mice. Melatonin treatment reduced the septic response in a comparable manner as did the lack of NLRP3, but unlike the latter, it normalized the clock genes turnover through the induction of RORα and repression of Rev–Erbα and Per2, leading to enhanced Nampt and Sirt1. The lack of NLRP3 inflammasome converts sepsis to a moderate inflammatory disease and identifies NLRP3 as a main target for the treatment of sepsis. The efficacy of melatonin in counteracting the NLRP3 inflammasome activation further confirms the indoleamine as a useful therapeutic drug against this serious condition.
Sleep‐dependent consolidation of face recognition and its relationship to REM sleep duration, REM density and Stage 2 sleep spindles
Authors: Solomonova Elizaveta , Stenstrom Philippe , Schon Emilie , Duquette Alexandra , Dubé Simon , O'Reilly Christian , Nielsen Tore
Published: March 2017

Face recognition is a highly specialized capability that has implicit and explicit memory components. Studies show that learning tasks with facial components are dependent on rapid eye movement and non‐rapid eye movement sleep features, including rapid eye movement sleep density and fast sleep spindles. This study aimed to investigate the relationship between sleep‐dependent consolidation of memory for faces and partial rapid eye movement sleep deprivation, rapid eye movement density, and fast and slow non‐rapid eye movement sleep spindles. Fourteen healthy participants spent 1 night each in the laboratory. Prior to bed they completed a virtual reality task in which they interacted with computer‐generated characters. Half of the participants (REMD group) underwent a partial rapid eye movement sleep deprivation protocol and half (CTL group) had a normal amount of rapid eye movement sleep. Upon awakening, they completed a face recognition task that contained a mixture of previously encountered faces from the task and new faces. Rapid eye movement density and fast and slow sleep spindles were detected using in‐house software. The REMD group performed worse than the CTL group on the face recognition task; however, rapid eye movement duration and rapid eye movement density were not related to task performance. Fast and slow sleep spindles showed differential relationships to task performance, with fast spindles being positively and slow spindles negatively correlated with face recognition. The results support the notion that rapid eye movement and non‐rapid eye movement sleep characteristics play complementary roles in face memory consolidation. This study also raises the possibility that fast and slow spindles contribute in opposite ways to sleep‐dependent memory consolidation.
A Sleep Position Trainer for positional sleep apnea: a randomized, controlled trial
Authors: Laub Rasmus R. , Tønnesen Philip , Jennum Poul J.
Published: March 2017

We tested the effect of the Sleep Position Trainer, a vibrational device, for positional sleep apnea in an open, randomized controlled trial with 101 patients, where 52 patients were allocated to Sleep Position Trainer and 49 patients to a non‐treatment control group for 2 months (Part 1). All patients were then followed as a cohort for a period of 6 months with use of the Sleep Position Trainer (Part 2). The participants were assessed with polygraphy at entry, and after 2 and 6 months. The mean apnea–hypopnea index supine was 35 per h (SD, 18) in the Sleep Position Trainer group and 38 per h (SD, 15) in the control group at entry. In a per protocol analysis, the mean total apnea–hypopnea index at entry and after 2 months in the Sleep Position Trainer group was 18 per h (SD, 10) and 10 per h (SD, 9; P < 0.001) versus 20 per h (SD, 9) and 18 per h (SD, 10; NS) in the control group. The mean supine sleep time decreased from 47% (SD, 22) to 17% (SD, 18; P < 0.001) in the Sleep Position Trainer group after 2 months. In the control group, the mean supine sleep time was 48% (SD, 20) at entry and 39% (SD, 21; NS) after 2 months. The positive effect of Sleep Position Trainer was maintained in all patients treated with Sleep Position Trainer after 6 months. Daytime sleepiness improved after 6 months. Compliance with the Sleep Position Trainer device during the first 2 months, defined as use of Sleep Position Trainer >4 h per night for all weekdays, was 75.5% (SD 21.2). The discontinuation rate was 28.8 and 49.4% after 2 and 6 months, respectively.
Avoiding the dry season: dispersal time and syndrome mediate seed dormancy in grasses in Neotropical savanna and wet grasslands
Authors: Ramos Desirée M. , Diniz Pedro , Ooi Mark K.J. , Borghetti Fabian , Valls José F.M.
Published: March 2017

Question

In seasonal rainfall systems, seed dormancy is a strategy to avoid germination and seedling emergence in the dry season. Grass species in Brazilian savannas (Cerrado) show variation in seed dispersal timing and mechanisms, and occur in different habitat types (distinguished by soil moisture) within a seasonal rainfall environment. However, it is unknown whether dormancy has evolved in these systems as a dominant way in which germination is deferred, or how it correlates with other key traits such as dispersal, where known trade‐offs exist for avoiding competition. We asked whether seed germination and dormancy vary with dispersal and abiotic factors in savanna systems. Specifically, we assessed dormancy by comparing seeds: (1) from species living in habitats with contrasting soil moisture during the dry season (open savannas vs wet grasslands); (2) dispersed at different times (early in the wet season, late in the wet season and in the dry season); and (3) showing alternate dispersal syndromes (barochoric vs anemochoric).

Location

Open savannas and wet grasslands in central Brazil.

Methods

We collected seeds of 29 grass species and tested viability and dormancy using germination trials with fresh seeds, which was then repeated after dry storage for 3, 6, 9 and 12 mo. GLMM were used to test whether the degree of dormancy was dependent on habitat type, seed dispersal time and seed dispersal syndrome.

Results

Seeds from wet grasslands lived longer and had consistently higher germination rates than seeds from open savannas. Additionally, fresh seeds dispersed late in the wet season had higher levels of seed dormancy compared to seeds dispersed early in the wet season. Finally, we found that anemochoric seeds had lower levels of dormancy than barochoric seeds.

Conclusions

Seed dormancy among Neotropical grasses was higher for seeds of species from dry habitats, dispersed late in the wet season, and with short distance dispersal (barochory). These results suggest that seed dormancy is a key mechanism by which seeds avoid seedling emergence in the dry season, an effect offset by habitat‐specific soil moisture availability. The trade‐off between dormancy and seed dispersal suggests that both strategies are costly and had non‐additive benefits.
Toxicity of Four Chemotherapeutic Agents to Rabbitfish Siganus rivulatus
Authors: Nasser Nivin , Babikian Jessica , Monzer Samer , Saoud Imad Patrick
Published: March 2017

As aquaculture evolves from extensive pond culture to intensive tank and cage systems, chemical dips and baths are increasingly being used to treat a concomitant increase in ectoparasitic and bacterial infestations. Some of the main disease‐causing agents are ectoparasites on the skin and gills of fish. Consequently, application of chemotherapeutics is increasing in aquaculture industries in order to control outbreaks of parasitic infestations. However, the toxic effect of commonly used chemotherapeutic agents on specific aquacultured fish species is often unknown. The present work was performed to test the effect of four commonly used chemical treatments on rabbitfish, Siganus rivulatus. The lethal concentrations for 50% of population (LC50) of formalin, copper sulfate, potassium permanganate, and hydrogen peroxide for S. rivulatus juveniles treated for 1 h were assessed. Formalin and potassium permanganate tolerance values were determined by calculating 72‐h LC50 values through probit analysis. The 72‐h LC50 values for the formalin toxicity tests were 551.0 and 1.68 mg/L, respectively. LC50 of copper sulfate and hydrogen peroxide could not be determined from the concentrations tested but were found to be >3 and >700 mg/L, respectively. Accordingly, treatment concentrations of formalin and potassium permanganate used for other fish species could be lethal to S. rivulatus, but the species appears to be quite tolerant to copper sulfate and hydrogen peroxide.
Temperate forest methane sink diminished by tree emissions
Authors: Pitz Scott , Megonigal J. Patrick
Published: March 2017

Global budgets ascribe 4–10% of atmospheric methane (CH4) sinks to upland soils and have assumed until recently that soils are the sole surface for CH4 exchange in upland forests.

Here we report that CH4 is emitted from the stems of dominant tree species in a temperate upland forest, measured using both the traditional static‐chamber method and a new high‐frequency, automated system.

Tree emissions averaged across 68 observations on 17 trees from May to September were 1.59 ± 0.88 μmol CH4 m−2 stem h−1 (mean ± 95% confidence interval), while soils adjacent to the trees consumed atmospheric CH4 at a rate of −4.52 ± 0.64 μmol CH4 m−2 soil h−1 (P < 0.0001). High‐frequency measurements revealed diurnal patterns in the rate of tree‐stem CH4 emissions.

A simple scaling exercise suggested that tree emissions offset 1–6% of the growing season soil CH4 sink and may have briefly changed the forest to a net CH4 source.
Is an objective refraction optimised using the visual Strehl ratio better than a subjective refraction?
Authors: Hastings Gareth D. , Marsack Jason D. , Nguyen Lan Chi , Cheng Han , Applegate Raymond A.
Published: March 2017

Purpose

To prospectively examine whether using the visual image quality metric, visual Strehl (VSX), to optimise objective refraction from wavefront error measurements can provide equivalent or better visual performance than subjective refraction and which refraction is preferred in free viewing.

Methods

Subjective refractions and wavefront aberrations were measured on 40 visually‐normal eyes of 20 subjects, through natural and dilated pupils. For each eye a sphere, cylinder, and axis prescription was also objectively determined that optimised visual image quality (VSX) for the measured wavefront error. High contrast (HC) and low contrast (LC) logMARvisual acuity (VA) and short‐term monocular distance vision preference were recorded and compared between theVSX‐objective and subjective prescriptions both undilated and dilated.

Results

For 36 myopic eyes, clinically equivalent (and not statistically different)HC VAwas provided with both the objective and subjective refractions (undilated mean ± S.D.was −0.06 ± 0.04 with both refractions; dilated was −0.05 ± 0.04 with the objective, and −0.05 ± 0.05 with the subjective refraction).LClogMAR VAprovided by the objective refraction was also clinically equivalent and not statistically different to that provided by the subjective refraction through both natural and dilated pupils for myopic eyes. In free viewing the objective prescription was preferred over the subjective by 72% of myopic eyes when not dilated. For four habitually undercorrected high hyperopic eyes, theVSX‐objective refraction was more positive in spherical power andVApoorer than with the subjective refraction.

Conclusions

A method of simultaneously optimising sphere, cylinder, and axis from wavefront error measurements, using the visual image quality metricVSX, is described. In myopic subjects, visual performance, as measured byHCandLC VA, with thisVSX‐objective refraction was found equivalent to that provided by subjective refraction, and was typically preferred over subjective refraction. Subjective refraction was preferred by habitually undercorrected hyperopic eyes.
Osteoid Osteoma: Benign Osteoblastic Tumor of the Lumbar L4 Transverse Process Associated with Radicular Pain: A Case Report
Authors: Nebreda Carlos L. , Vallejo Ricardo , Mayoral‐Rojals Victor , Ojeda Antonio
Published: March 2017

Osteoid osteomas of the spine are benign bone tumors typically presenting with progressive pain without neurological deficit. This report presents a case of an osteoid osteoma in the lumbar spine associated with radicular pain. The patient, a young male athlete, presented with severe chronic nightly left low‐back pain radiated to the ipsilateral lower extremity who failed to respond to physical therapy and analgesic medications. Initial radiologic examination was reported as normal, but closer inspection of the T1‐ and T2‐weighted magnetic resonance image as well as technetium‐99m total body bone scan and a computed tomography scan revealed a bony lesion in the left transverse process of the L4 vertebra consistent with the diagnosis of osteoid osteoma. A selective L3 nerve root block provided significant relief. Surgical excision of the osteoid osteoma resolved the symptoms. This case emphasizes the importance of early suspicion and diagnostic interventions in the detection and treatment of osteoid osteoma.
Pain Correlates with Sleep Disturbances in Parkinson's Disease Patients
Authors: Fu Yun‐Ting , Mao Cheng‐Jie , Ma Li‐Jing , Zhang Hui‐Jun , Wang Yi , Li Jie , Huang Jun‐Ying , Liu Jun‐Yi , Liu Chun‐Feng
Published: March 2017

Objectives

Both sleep disorders and pain decrease quality of life in patients with Parkinson's disease (PD). However, little is known about the relationship between objective sleep disturbances and pain in patients with PD. This study aimed to (1) examine the clinical characteristics of pain in PD patients and (2) explore the correlation between pain and sleep disturbances in PD patients.

Methods

Parkinson's disease patients (N = 144) underwent extensive clinical evaluations of motor and nonmotor symptoms and characteristics of pain. Overnight video‐polysomnography was also conducted. Clinical characteristics and sleep parameters were compared between PD patients with or without pain.

Results

Pain was reported by 75 patients (52.1%), with 49 (65.3%) reporting pain of at least moderate severity. PD patients with pain were older and had longer disease duration, more severe PD symptoms as assessed by Hoehn and Yahr stage and the Unified Parkinson's Disease Rating Scale, and higher L‐dopa equivalent daily dose compared with PD patients without pain. PD patients with pain also showed significantly decreased sleep efficiency (57.06% ± 15.84% vs. 73.80% ± 12.00%, P < 0.001), increased nonrapid eye movement stage 1 (N1) sleep (33.38% ± 19.32% vs. 17.84% ± 8.48%, P < 0.001), and decreased rapid eye movement sleep (12.76% ± 8.24% vs. 16.06% ± 6.53%, P = 0.009). Binary logistic regression analysis revealed that poorer activities of daily living, depressed mood, higher percentage of N1 sleep, and lower sleep efficiency were independent predictors of pain in patients with PD.

Conclusions

Musculoskeletal pain is the most common type of pain in patients with PD. Disrupted sleep continuity, altered sleep architecture, depressed mood, and compromised activities of daily living may be associated with pain in patients with PD.
Expression of lima bean terpene synthases in rice enhances recruitment of a beneficial enemy of a major rice pest
Authors: Li Fengqi , Li Wei , Lin Yong‐Jun , Pickett John A. , Birkett Michael A. , Wu Kongming , Wang Guirong , Zhou Jing‐Jiang
Published: March 2017

Volatile terpenoids play a key role in plant defence against herbivory by attracting parasitic wasps. We identified seven terpene synthase genes from lima bean, Phaseolus lunatus L. following treatment with either the elicitor alamethicin or spider mites, Tetranychus cinnabarinus. Four of the genes (Pltps2, Pltps3, Pltps4 and Pltps5) were up‐regulated with their derived proteins phylogenetically clustered in the TPS‐g subfamily and PlTPS3 positioned at the base of this cluster. Recombinant PlTPS3 was able to convert geranyl diphosphate and farnesyl diphosphate to linalool and (E)‐nerolidol, the latter being precursor of the homoterpene (E)‐4,8‐dimethyl‐1,3,7‐nonatriene (DMNT). Recombinant PlTPS4 showed a different substrate specificity and produced linalool and (E)‐nerolidol, as well as (E,E)‐geranyllinalool from geranylgeranyl diphosphate. Transgenic rice expressing Pltps3 emitted significantly more (S)‐linalool and DMNT than wild‐type plants, whereas transgenic rice expressing Pltps4 produced (S)‐linalool, DMNT and (E,E)‐4,8,12‐trimethyl‐1,3,7,11‐tridecatetraene (TMTT). In laboratory bioassays, female Cotesia chilonis, the natural enemy of the striped rice stemborer, Chilo suppressalis, were significantly attracted to the transgenic plants and their volatiles. We further confirmed this with synthetic blends mimicking natural rice volatile composition. Our study demonstrates that the transformation of rice to produce volatile terpenoids has the potential to enhance plant indirect defence through natural enemy recruitment.
Dopamine as a potential rescue therapy for refractory protein‐losing enteropathy in Fontan‐palliated patients
Authors: Friedland‐Little Joshua M. , Gajarski Robert J. , Schumacher Kurt R.
Published: March 2017

PLE is an important cause of morbidity and mortality in patients who have undergone Fontan palliation. While multiple PLE therapies have been reported, none has proved consistently effective. Patients who do not respond to “standard” PLE therapies face poor long‐term outcomes. We report here a significant response to dopamine infusion in three patients with chronic, refractory PLE. We hypothesize that this response may be at least partially due to a dopamine effect on lymphatic receptors rather than to an augmentation of cardiac output.
Aquaporin 9 is expressed in the epididymis of immature and mature pigs
Authors: Schimming BC , Baumam CAE , Pinheiro PFF , de Matteis R , Domeniconi RF
Published: March 2017

Contents

Aquaporins (AQPs) are channel proteins that facilitate the transepithelial and bidirectional movement of water. AQP9 is an aquaporin that is expressed in the mammalian epididymis. This water transport contributes to epididymal sperm concentration. This study aimed to examine the morphology of epididymal epithelium in piglets and boars, as well as the expression and immunolocalization of AQP9. The piglets presented an epididymal epithelium in differentiation with principal, basal and apical cells. The cellular population of the epididymal epithelium in boars consisted of principal, basal, apical, clear and narrow cells. The migratory cells known as halo cells were observed in the epididymis of both piglets and boars. AQP9 expression presented differences between piglets and boars. Moderate intensity of AQP9 immunoreaction was observed in the apical border of the epididymal epithelium of the caput and cauda regions in the piglet epididymis. A moderate‐to‐intense reaction for AQP9 was observed in the nuclei of epithelial cells of the three epididymal regions in the boar epididymis. The region of the cauda epididymis showed reactivity for AQP9 also in the apical border of the epithelium. It is believed that the AQP9 is already functional in piglets at only 1 week of age and is more active, playing a pivotal role in the caput and cauda regions of the epididymis. Moreover, the intense AQP9 expression in the apical border of epithelial cells in the cauda region of the boar epididymis suggests a higher performance of AQP9 in this region, where sperm complete their maturation process, stored and concentrated.
Supplementation with cumulus cell masses improves the in vitro meiotic competence of porcine cumulus–oocytes complexes derived from small follicles
Authors: Matsunaga R , Funahashi H
Published: March 2017

Contents

The present study was conducted to examine the supplemented effect of cumulus cell masses (CCMs) derived from middle follicle (MF; 3–6 mm diameter) on the morphology and the meiotic or developmental competence of oocytes from small follicles (SF; 1–2 mm diameter). The number of cumulus cells surrounding oocytes just after collection was also lower in cumulus–oocyte complexes (COCs) from SF than MF. The ooplasmic diameter of oocytes was significantly smaller in SF‐derived oocytes than MF‐derived ones before and after in vitro maturation (IVM), whereas the diameter significantly increased during the culture. Co‐culture of SF‐derived COCs with MF‐derived CCMs during IVM significantly improved the meiotic competence of the oocytes to the metaphase‐II stage. Furthermore, the ooplasmic diameter of SF‐derived COCs during IVM was increased to the similar size of MF‐derived those in the presence of MF‐derived CCMs. The abilities of oocytes to be penetrated, to form male pronuclear formation and to cleave or develop to the blastocyst stage were not affected by the co‐culture with CCMs. Electrophoretic analysis of CCM secretions clearly showed the presence of more protein(s) approximately 27.6 kDa in the conditioned medium when supplemented with MF‐derived CCMs. In conclusion, we demonstrate that supplementation with MF‐derived CCMs improves the ooplasmic diameter and meiotic competence of SF‐derived oocytes.
Is bronchial thermoplasty cost‐effective as treatment for problematic asthma patients? Singapore's perspective on a global model
Authors: Nguyen Hai V. , Bose Saideep , Mital Shweta , Yii Anthony Chau Ang , Ang Shin Yuh , Lam Sean Shao Wei , Anantham Devanand , Finkelstein Eric , Koh Mariko Siyue
Published: March 2017

ABSTRACT

Background and objective

Bronchial thermoplasty (BT) has been shown to be effective at reducing asthma exacerbations and improving asthma control for patients with severe persistent asthma but it is also expensive. Evidence on its cost‐effectiveness is limited and inconclusive. In this study, we aim to evaluate the incremental cost‐effectiveness of BT combined with optimized asthma therapy (BT‐OAT) relative to OAT for difficult‐to‐treat and severe asthma patients in Singapore, and to provide a general framework for determining BT's cost‐effectiveness in other healthcare settings.

Methods

We developed a Markov model to estimate the costs and quality‐adjusted life years (QALYs) gained with BT‐OAT versus OAT from the societal and health system perspectives. The model was populated using Singapore‐specific costs and transition probabilities and utilities from the literature. Sensitivity analyses were conducted to identify the main factors determining cost‐effectiveness of BT‐OAT.

Results

BT‐OAT is not cost‐effective relative to OAT over a 5‐year time horizon with an incremental cost‐effectiveness ratio (ICER) of $US138 889 per QALY from the societal perspective and $US139 041 per QALY from the health system perspective. The cost‐effectiveness of BT‐OAT largely depends on a combination of the cost of the BT procedure and the cost of asthma‐related hospitalizations and emergency department (ED) visits.

Conclusion

Based on established thresholds for cost‐effectiveness, BT‐OAT is not cost‐effective compared with OAT in Singapore. Given its current clinical efficacy, BT‐OAT is most likely to be cost‐effective in a setting where the cost of BT procedure is low and costs of hospitalization and ED visits are high.
Computed tomography scoring system for discriminating between parapneumonic effusions eventually drained and those cured only with antibiotics
Authors: Porcel José M. , Pardina Marina , Alemán Carmen , Pallisa Esther , Light Richard W. , Bielsa Silvia
Published: March 2017

Background and objective

Due to limited data, we aimed to develop and validate a computed tomography (CT)‐based scoring system for identifying those parapneumonic effusions (PPEs) requiring drainage.

Methods

A retrospective review of all patients with PPE who underwent thoracentesis and a chest CT scan before any attempt to place a tube thoracostomy, if applicable, over an 8‐year period was conducted. Eleven chest CT characteristics were compared between 90 patients with complicated PPEs (CPPEs), defined as those which eventually required chest drainage, and 60 with non‐complicated effusions (derivation sample). A scoring system was devised with those CT findings identified as independent predictors of CPPE in a logistic regression analysis, and further validated in an independent population of 59 PPE patients.

Results

CT scores predicting CPPE were pleural contrast enhancement (3 points), pleural microbubbles, increased extrapleural fat attenuation and fluid volume ≥400 mL (1 point each). A sum score of ≥4 yielded 84% sensitivity (95% CI: 62–85%), 75% specificity (95% CI: 62–85%), 81% diagnostic accuracy (95% CI: 73–86%), likelihood ratio (LR) positive of 3.4 (95% CI: 2.1–5.4), LR negative of 0.22 (95% CI: 0.13–0.36) and area under the receiver operating characteristic curve (AUC) of 0.829 (95% CI: 0.754–0.904) for labelling CPPE in the derivation set. These results were reproduced in the validation sample. The CT grading scale also exhibited a fair ability to identify patients who needed surgery or would die from the pleural infection (AUC: 0.76, 95% CI: 0.61–0.9).

Conclusion

A novel CT scoring system for adults with PPE may allow clinicians to predict the need for chest tube drainage with good accuracy.
The Elective Affinities of Anti‐Semitic and Anti‐American Resentments in Germany
Authors: Beyer Heiko , Liebe Ulf
Published: March 2017

Objective

Recent works on anti‐Americanism have indicated a link between anti‐American and anti‐Semitic resentments but neither an explication of the underlying mechanisms nor satisfying empirical data regarding such a relationship exist. This article offers historical insights and theoretical reflections as well as quantitative data for the case of Germany with which the theoretical assumptions are tested.

Methods

The sample of the study consists of 1,201 respondents randomly selected from the German population older than 18 years (computer‐assisted telephone interviews survey). The data are analyzed using seemingly unrelated regression models.

Results

Anti‐American and anti‐Semitic attitudes correlate substantially. Multivariate models show that this correlation can be explained via the common function of both to rationalize social change.

Conclusion

The historical ties of European anti‐Semitism and anti‐Americanism are still prevalent today. They combine into a comprehensive symptom that is constituted by the uncertainty caused by “globalization” and an accelerated “capitalism.”
Identification of the novel HLA‐B*40:01:41 allele by polymerase chain reaction sequence‐based typing in a Chinese cord blood donor
Authors: Chen N.‐Y. , Wang W. , Dong L.‐N. , He J. , Zhu F.‐M.
Published: March 2017

HLA‐B*40:01:41 differs from
HLA‐B*40:01:01 by a single nucleotide substitution at position 195 G>A.
Metabolomics comparison of red cells stored in four additive solutions reveals differences in citrate anticoagulant permeability and metabolism
Authors: Rolfsson Ó. , Sigurjonsson Ó. E. , Magnusdottir M. , Johannsson F. , Paglia G. , Guðmundsson S. , Bordbar A. , Palsson S. , Brynjólfsson S. , Guðmundsson S. , Palsson B.
Published: March 2017

Background and Objectives

Metabolomics studies have revealed transition points in metabolic signatures of red cells during storage in SAGM, whose clinical significance is unclear. We set out to investigate whether these transition points occur independent of storage media and define differences in the metabolism of red cells in additive solutions.

Materials and Methods

Red cell concentrates were stored in SAGM, AS‐1, AS‐3 or PAGGSM, and sampled fourteen times spanning Day 1–46. Following quality control, the samples were split into extracellular and intracellular aliquots. These were analysed with ultra‐high‐performance liquid chromatography coupled to mass spectrometry analysis affording quantitative metabolic profiles of both intra‐ and extracellular red cell metabolites.

Results

Differences were observed in glycolysis, purine salvage, glutathione synthesis and citrate metabolism on account of the storage solutions. Donor variability however hindered the accurate characterization of metabolic transition time‐points. Intracellular citrate concentrations were increased in red cells stored in AS‐3 and PAGGSM media. The metabolism of citrate in red cells in SAGM was subsequently confirmed using 13C citrate isotope labelling and shown to originate from citrate anticoagulant.

Conclusion

Metabolic signatures that discriminate between ‘fresh’ and ‘old’ stored red cells are dependent upon additive solutions. Specifically, the incorporation and metabolism of citrate in additive solutions with lower chloride ion concentration is altered and impacts glycolysis.
Evaluating the impact of the ABO blood group on the clinical outcome of thrombotic thrombocytopenic purpura associated with severe ADAMTS13 deficiency
Authors: Hussein E. , Teruya J.
Published: March 2017

Background and Objectives

Thrombotic thrombocytopenic purpura (TTP) is caused by the decrease of ADAMTS13, leading to the accumulation of ultra large von Willebrand factor (ULVWF). It was proposed that the distribution of blood group O among TTP patients may be potentially lower than expected because of the lower levels of VWF. The aim of this study was to explore the relationship between various blood groups and the clinical outcome in TTP.

Materials and Methods

Thirty‐three patients with TTP with severe ADAMTS13 deficiency were studied. Data on blood group, relapse, number of plasma exchange sessions, replacement fluid and mortality were analysed.

Results

Mortality rate was 15·2% and it was not impacted by blood group. The distribution of group O among patients with idiopathic TTP was lower (12%) than expected (30%). Patients with blood group O required more sessions to achieve remission than did those with group B (P = 0·02). Cryo‐supernatant was used in three refractory patients with group O, who failed to respond to fresh‐frozen plasma and complete remission was achieved. The overall number of relapsing episodes was 7 of 33 (21·2%), and it was not impacted by blood group.

Conclusion

Although blood group O appeared to provide protection against TTP, more sessions were required to achieve remission. Cryo‐supernatant improved the clinical outcome in refractory patients with group O. Future studies may be warranted to determine whether higher baseline VWF can be a trigger for TTP, or can confer protection by competing with a newly secreted ULVWF for platelet binding.
Long‐term outcome of an intra‐articular allograft technique for treatment of spontaneous cranial cruciate ligament rupture in the dog
Authors: Biskup Jeffery J. , Balogh Daniel G. , Scott Ruth M. , Conzemius Michael G.
Published: March 2017

Objective

To determine the 12‐month outcome in dogs with spontaneous cranial cruciate ligament (CCL) rupture after repair with an intra‐articular decellularized allograft.

Study Design

Prospective pilot case series.

Animals

Ten client‐owned dogs with unilateral CCL rupture.

Methods

An intra‐articular, decellularized, deep digital flexor tendon allograft was secured in the stifle with a femoral cross pin and tibial spiked washers and screws. An interference screw was placed in the tibial tunnel. Dogs were evaluated with an owner questionnaire, radiographs, and force platform gait analysis before and 2, 6, and 12 months after surgery.

Results

Owners reported improvement in level of pain and mobility throughout the study, especially over the first 6 months. Peak vertical force and vertical impulse improved across all time points. Ground reaction force asymmetry index for peak vertical force and vertical impulse at 12 months showed 3 dogs within a normal index (<6%), 4 dogs as nonvisibly lame (6‐20%), and 3 dogs as visibly lame (≥20%). For most dogs, osteoarthritis scoring did not change over the 12‐month period and some femoral‐tibial translation was detected on standing horizontal beam radiographs.

Conclusion

Intra‐articular repair using a decellularized allograft can provide functional clinical outcomes in dogs with CCL disease. A better understanding of long‐term engraftment after this procedure is needed.
Delay-Dependent Robust Control for Discrete-Time Uncertain Stochastic Systems With Time-Varying Delays
Authors: Ku Cheung-Chieh , Chen Guan-Wei
Published: March 2017

This paper investigates a delay-dependent robust control problem of discrete-time uncertain stochastic systems with delays. The uncertainty considered in this paper is time-varying but norm-bounded, and the delays are considered as interval time-varying case for both state and input. According to the considerations of uncertainty, stochastic behavior, and time delays, the problem considered in this paper is more general than the existing works for uncertain stochastic systems. Via the proposed Lyapunov–Krasovskii function, some sufficient conditions are derived into the extended linear matrix inequality form. Moreover, Jensen inequality and free matrix equation are employed to reduce conservatism of those conditions. Through using the proposed design method, a gain-scheduled controller is designed to guarantee asymptotical stability of uncertain stochastic systems in the sense of mean square. Finally, two numerical examples are provided to demonstrate applicability and effectiveness of the proposed design method.
Self-Powered Dynamic Systems in the Framework of Optimal Uncertainty Quantification
Authors: Khoshnoud Farbod , Esat Ibrahim I. , de Silva Clarence W. , McKerns Michael M. , Owhadi Houman
Published: March 2017

The energy that is needed for operating a self-powered device is provided by the energy excess in the system in the form of kinetic energy, or a combination of regenerative and renewable energy. This paper addresses the energy exchange issues pertaining to regenerative and renewable energy in the development of a self-powered dynamic system. A rigorous framework that explores the supply and demand of energy for self-powered systems is developed, which considers uncertainties and optimal bounds, in the context of optimal uncertainty quantification. Examples of regenerative and solar-powered systems are given, and the analysis of self-powered feedback control for developing a fully self-powered dynamic system is discussed.
Full-Scale Fairing Qualification Tests
Authors: Constantinides Yiannis , Liapis Stergios , Spencer Don , Islam Mohammed , Skaugset Kjetil , Batra Apurva , Baarholm Rolf
Published: March 2017

Production risers as well as drilling risers are often exposed to ocean currents. Vortex-induced vibrations (VIVs) have been observed in the field and can cause fatigue failure and excessive drag on the riser. In order to suppress VIV, fairings are often used. This paper presents qualification tests for two types of fairings: the short-crab claw (SCC) fairings and the AIMS dual flow splitter (ADFS) fairings. The short-crab claw fairing design is a novel design patented by the Norwegian deepwater project (NDP). As will be detailed in this paper, both the SCC and ADFS designs offer very low drag, completely suppress VIV, and are effective even when they are in tandem. A model test campaign was undertaken in the 200-m towing tank facility at the ocean, coastal, and river engineering in St. John's, NF, Canada. A rigid pipe with a diameter of 0.3556 m (14 in) was utilized for the experiments. This corresponds to prototype size for a production riser and a 1:3.8 scaled model for a 1.3716 m (54 in) drilling riser. Given that these tests were conducted at prototype scale, they were used to qualify the fairings for field deployment. Both fairings (SCC and ADFS) were very effective in suppressing VIV and reducing drag. The ADFS fairings are most effective for a span to diameter ratio of 1.75. For all fairing geometries, it was found that a small taper increases the fairing effectiveness considerably.
Reactive high-power impulse magnetron sputtering of ZrO2 films with gradient ZrOx interlayers on pretreated steel substrates
Authors: Belosludtsev Alexandr , Vlček Jaroslav , Houška Jiří , Čerstvý Radomír
Published: March 2017

High-power impulse magnetron sputtering with a pulsed O2 flow control was used for reactive deposition of densified stoichiometric ZrO2 films with gradient ZrOx interlayers onto floating Si and steel substrates at low substrate temperatures (less than 150 °C). The depositions were performed using a strongly unbalanced magnetron with a planar Zr target of 100 mm diameter in Ar + O2 gas mixtures at the total pressure close to 2 Pa. Two kinds of gradient ZrOx interlayers with different depth profiles of the stoichiometric coefficient, x, from x ≅ 0 to 2, were deposited using the feedback pulsed O2 flow control. Prior to deposition, a modification of the substrate surfaces was performed by high-power impulse magnetron sputtering of the Zr target in Ar gas at the same pressure of 2 Pa and a direct current substrate bias from −965 to −620 V in a target pulse and low substrate temperatures (less than 150 °C) for 10 min. It was shown that the pretreatment of the steel substrates is a necessary condition for good adhesion of the zirconium oxide (both pure ZrO2 and ZrO2 + ZrOx interlayer) films and that the adhesion of the ZrO2 films is substantially higher when the gradient ZrOx interlayers are used. The densified stoichiometric ZrO2 films (refractive index of 2.21 and extinction coefficient of 4 × 10−4 at the wavelength of 550 nm) deposited onto the gradient ZrOx interlayers exhibited a high hardness (15–16 GPa) and an enhanced resistance to cracking.
Enhancement of Zika virus pathogenesis by preexisting antiflavivirus immunity
Authors: Bardina Susana V. , Bunduc Paul , Tripathi Shashank , Duehr James , Frere Justin J. , Brown Julia A. , Nachbagauer Raffael , Foster Gregory A. , Krysztof David , Tortorella Domenico , Stramer Susan L. , García-Sastre Adolfo , Krammer Florian , Lim Jean K.
Published: March 2017

One antibody for all and all antibodies for one

Antibodies against related flavi-viruses such as dengue (DENV) and West Nile (WNV) can cross-react with Zika virus (ZIKV) and could thereby increase disease severity. Bardina
et al.
tested whether DENV and WNV antibodies from humans, or even yellow fever vaccination, could enhance ZIKV infection. In a mouse model, low titers of DENV and WNV antibodies enhanced ZIKV viremia, especially in the spinal cord and testes, whereas high titers remained protective. Generally, WNV antibodies were less disease-enhancing than DENV antibodies, and, in macaques, yellow fever vaccination had very little effect.

Science
, this issue p.
175
Draft Genome Sequence of Bacillus thuringiensis INTA Fr7-4
Authors: Navas Laura E. , Berretta Marcelo F. , Ortiz Elio M. , Sauka Diego H. , Benintende Graciela B. , Zandomeni Rubén O. , Amadio Ariel F.
Published: March 2017

We report here the complete annotated 6,035,547-bp draft genome sequence of
Bacillus thuringiensis
INTA Fr7-4. This strain contains three
cry8
and two
vip1
and
vip2
insecticidal toxin genes.
Draft Genome Sequence of Streptococcus caviae Strain Cavy grass 6
T
, Isolated from Domesticated Guinea Pig Fecal Samples
Authors: Palakawong Na Ayudthaya Susakul , Marshall Ian P. G. , Schreiber Lars , Plugge Caroline M.
Published: March 2017

Streptococcus caviae
strain Cavy grass 6
T
, isolated from fecal samples of pet guinea pigs, can metabolize a range of plant mono- and disaccharides, as well as polymeric carbohydrates. Here, we report the draft genome sequence of this strain, which comprises 2.11 Mb.
Draft Genome Sequence of Pseudomonas putida Strain GM4FR, an Endophytic Bacterium Isolated from Festuca rubra L
Authors: Wemheuer Franziska , Hollensteiner Jacqueline , Poehlein Anja , Granzow Sandra , Daniel Rolf , Vidal Stefan , Wemheuer Bernd
Published: March 2017

Pseudomonas putida
GM4FR is an endophytic bacterium isolated from aerial plant tissues of
Festuca rubra
L. Functional annotation of the draft genome (7.1 Mb) revealed 6,272 predicted protein-encoding genes. The genome provides insights into the biocontrol and plant growth-promoting potential of
P. putida
GM4FR.
Complete Genome Sequence of Staphylococcus aureus Strain Wood 46
Authors: Balachandran Manasi , Riley Matthew C. , Bemis David A. , Kania Stephen A.
Published: March 2017

Here, we report the first complete genome sequence of the
Staphylococcus aureus
strain Wood 46. Wood 46 has played an important role in understanding the virulence and pathogenesis of
S. aureus
infections. This report will assist efforts in vaccine development against methicillin-resistant
S. aureus
(MRSA) infections.
Draft Genome Sequences of 14 Staphylococcus aureus Sequence Type 5 Isolates from California, USA
Authors: Hau Samantha J. , Bayles Darrell O. , Alt David P. , Nicholson Tracy L.
Published: March 2017

Staphylococcus aureus
is part of the human epithelial microbiota; however, it is also a pathogen. The acquisition of mobile genetic elements plays a role in the virulence of
S. aureus
isolates and contributes to treatment failures. This report details the draft genome sequences of 14 clinical
S. aureus
isolates.