bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparing the implementation consequences of the immunisation and emergency department health targets in New Zealand
Authors: Tenbensel Tim , Chalmers Linda , Willing Esther
Published: September 2016

Purpose

Over the last decade there has been considerable debate about the merits of targets as a policy instrument. The purpose of this paper is to examine the implementation of two health targets that were cornerstones of New Zealand health policy between 2009 and 2012: immunisation rates for two-year-olds, and time to treatment, discharge or admission in hospital emergency departments.

Design/methodology/approach

For each policy target, the authors selected four case-study districts and conducted two waves of key-informant interviews (113 in total) with clinical and management staff involved in target implementation.

Findings

Despite almost identical levels of target achievement, the research reveals quite different mixes of positive and negative implementation consequences. The authors argue that the differences in implementation consequences are due to the characteristics of the performance measure; and the dynamics of the intra-organisational and inter-organisational implementation context.

Research limitations/implications

The research is based on interviews with clinical and management staff involved in target implementation, and this approach does not address the issue of effort substitution.

Practical implications

While literature on health targets pays attention to the attributes of target measures, the paper suggests that policymakers considering the use of targets pay more attention to broader implementation contexts, including the possible impact of, and effects on related services, organisations and staff.

Originality/value

The research focuses specifically on implementation consequences, as distinct from target success and/or changes in clinical and health outcomes. The paper also adopts a comparative approach to the study of target implementation.
External Debt and Growth Dynamics in Nigeria
Authors: Adamu Ibrahim Mohammed , Rasiah Rajah
Published: September 2016

This paper investigates the dynamic effects of external debt on economic growth in Nigeria from 1970 through 2013. We begin by constructing an external debt sustainability index using principal component analysis to capture the overall effects of external debt indicators on economic growth. The empirical analysis is based on the ARDL bound test. The results show a long‐run cointegration relationship between the variables. While external debt exerts an adverse effect of −0.069 per cent on growth in the long run, the external debt sustainability index shows a positive effect of 0.072 per cent and 0.024 per cent on growth in the long and short run. The findings suggest the government should reduce its expenditure and mobilize revenue through domestic sources to invest in projects with a high rate of return to enable debt repayment and stimulate growth. To maintain debt ratios within a manageable threshold so as to avoid being debt trapped, foreign loans should only be contracted on concessional terms.
Contributions of print exposure to first and second grade oral language and reading in Chile
Authors: Strasser Katherine , Vergara Daniela , del Río M. Francisca
Published: September 2016

This study examines the contribution of print exposure to oral language (expressive vocabulary and listening comprehension) and reading (word reading and reading comprehension) in first and second grade in Chile, and tests whether the contribution of print exposure to reading comprehension is mediated by language and word reading skills. Two‐hundred and eighty one children (mean age 6.55 years) participated. Print exposure was measured with a book‐cover recognition task in first grade, and outcomes were measured both in first and second grade. Print exposure had direct effects on all outcomes in first grade and indirect effects in second grade. Effects on first grade reading comprehension were partially mediated by listening comprehension and word reading, but not vocabulary. We discuss the importance of the findings for improving reading comprehension in countries with low access to books.
Implementation of Real‐World Experiential Learning in a Food Science Course Using a Food Industry‐Integrated Approach
Authors: Hollis Francine H. , Eren Fulya
Published: September 2016

Success skills have been ranked as the most important core competency for new food science professionals to have by food science graduates and their employers. It is imperative that food science instructors promote active learning in food science courses through experiential learning activities to enhance student success skills such as oral and written communication, critical thinking, problem solving, and team work. The aim of this study was to incorporate “real‐world” experiential learning into a food product development course. Undergraduate students enrolled in a food product development course worked on a semester‐long product development case study developed by the Instructor of the course and the Manager from ACH Food Companies, Inc. The case study was presented to students in the form of a product development competition. Students were placed into groups and given the task to develop a cake mix with specified parameters. At the end of the semester, student groups participated in a case study competition to showcase their product concepts. Each student group gave a PowerPoint presentation and was evaluated using selected criteria. Students rated the course overall as being very good. Students perceived the case study to be beneficial and informative regarding employer (ACH's) expectations. Students recommended that the Instructor minimize restrictions/specifications for product concepts and increase the quantity of course/laboratory meetings per week. This approach will continue to be used and further evaluated as an approach to incorporate active learning and provide food science undergraduates with a sense of employer expectations.
Knowledge and Attitudes of Produce and Seafood Processors and Food Safety Educators Regarding Nonthermal Processes
Authors: Pivarnik Lori F. , Richard Nicole L. , Gable Robert K. , Worobo Randy W.
Published: September 2016

A needs assessment survey was designed and administered to measure knowledge of and attitudes toward food safety impacts of nonthermal processing technologies of shellfish and produce industry personnel and extension educators. An online survey was sent via e‐mail notification with the survey link through professional listserves. The survey evaluated background information, knowledge, attitude, and training needs. A variety of response formats was used. Knowledge/attitude responses were analyzed using descriptive statistics, 1‐way ANOVA and t‐tests using SPSS software and reported at P < 0.05. Industry (N = 106) and educator (N = 52) respondents had below the proficient knowledge score (80%), 50% and 67%, respectively. Question reliability was >0.9. There were no differences in attitudes and knowledge between the 2 industry groups. The total attitude score, based on a 5‐point Likert scale (1 = strongly disagree, 5 = strongly agree), of the produce and shellfish industry and educator respondents toward nonthermal processing technologies was 3.6 ± 0.4, 3.4 ± 0.5, and 3.6 ± 0.4, respectively. Respondent's slightly indifferent attitude may reflect low knowledge regarding the impact of nonthermal processing technologies on food safety and quality. Both groups indicated a desire for information and/or training. For both industry and educators, common preferred formats for outreach resources were printed materials, Internet/web‐based materials, and PowerPoint. Educators identified barriers as equipment cost, lack of information, and lack of product validation. While the majority of the respondents were aware of nonthermal processing, they were not knowledgeable, indicating a need for education and outreach in nonthermal processing methods to both shellfish/produce industry and food safety educators.
Chronic alcoholics retain dyspeptic symptoms, pan‐enteric dysmotility, and autonomic neuropathy before and after abstinence
Authors: Di Ciaula Agostino , Grattagliano Ignazio , Portincasa Piero
Published: September 2016

Objective

To carry out a comprehensive study on gastrointestinal symptoms, motility and autonomic neuropathy in chronic alcoholics before and one year after abstinence.

Methods

Dyspeptic symptoms (questionnaires), fasting and postprandial gallbladder and gastric motility (ultrasonography), oro‐cecal transit time (lactulose H2‐breath test), stool form score (indirect marker of colonic transit), and autonomic neuropathy (sweat spot test, R‐R ratio) were assessed at baseline in 268 subjects (136 chronic alcoholics and 132 healthy controls). A subgroup of 39 patients was re‐evaluated after 12 months of abstinence.

Results

Chronic alcoholics had increased dyspepsia, delayed gastric emptying and oro‐cecal transit time but faster gallbladder emptying, with slightly accelerated colonic transit. Sympathetic, but not parasympathetic, autonomic dysfunction was found. Dyspeptic symptoms and functional alterations of gastric emptying and oro‐cecal transit tests were still present after 12‐month abstinence, whereas gallbladder motility, stool form score and sympathetic function improved.

Conclusions

Chronic alcoholics exhibit combined and interdependent presence of dyspeptic symptoms, impaired motility at different levels of the gastrointestinal tract, with sympathetic dysfunction. Only a few of these abnormalities improve after one year of abstinence from alcohol.
Uncoupling associations of risk alleles with endophenotypes and phenotypes: insights from the ApoB locus and heart‐related traits
Authors: Kulminski Alexander M. , Kernogitski Yelena , Culminskaya Irina , Loika Yury , Arbeev Konstantin G. , Bagley Olivia , Duan Matt , Arbeeva Liubov , Ukraintseva Svetlana V. , Wu Deqing , Stallard Eric , Yashin Anatoliy I.
Published: September 2016

Traditionally, genomewide association studies (GWAS) have emphasized the benefits of large samples in the analyses of age‐related traits rather than their specific properties. We adopted a realistic concept of genetic susceptibility to inherently heterogeneous, age‐related traits driven by the elusive role of evolution in their properties. We analyzed in detail the associations of rs693 and rs562338 polymorphisms representing the Apolipoprotein B locus with endophenotypes (total cholesterol [TC] and high‐density lipoprotein cholesterol) and phenotypes (myocardial infarction [MI] and survival) in four large‐scale studies, which include 20 748 individuals with 2357 MI events. We showed that a strong, robust predisposition of rs693 and rs562338 to TC (β = 0.72, P = 7.7 × 10−30 for rs693 and β = −1.08, P = 9.8 × 10−42 for rs562338) is not translated into a predisposition to MI and survival. The rs693_A allele influences risks of MI and mortality after MI additively with lipids. This allele shows antagonistic effects—protecting against MI risks (β = −0.18, P = 1.1 × 10−5) or increasing MI risks (β = 0.15, P = 2.8 × 10−3) and mortality after MI, in different populations. Paradoxically, increased TC concentrations can be protective against MI for the rs693_A allele carriers. Our results uncouple the influences of the same alleles on endophenotypes and phenotypes despite potential causal relationships among the latter. Our strategy reveals virtually genomewide significance for the associations of rs693 with MI (P = 5.5 × 10−8) that is contrasted with a weak estimate following the traditional, sample‐size‐centered GWAS strategy (P = 0.16) in the same sample. These results caution against the use of the traditional GWAS strategy for gaining profound insights into genetic predisposition to healthspan and lifespan.
Antioxidants reveal an inverted U‐shaped dose‐response relationship between reactive oxygen species levels and the rate of aging in Caenorhabditis elegans
Authors: Desjardins David , Cacho‐Valadez Briseida , Liu Ju‐Ling , Wang Ying , Yee Callista , Bernard Kristine , Khaki Arman , Breton Lionel , Hekimi Siegfried
Published: September 2016

Reactive oxygen species (ROS) are potentially toxic, but they are also signaling molecules that modulate aging. Recent observations that ROS can promote longevity have to be reconciled with the numerous claims about the benefits of antioxidants on lifespan. Here, three antioxidants [N‐acetylcysteine (NAC), vitamin C, and resveratrol (RSV)] were tested on Caenorhabditis elegans mutants that alter drug uptake, mitochondrial function, and ROS metabolism. We observed that like pro‐oxidants, antioxidants can both lengthen and shorten lifespan, dependent on concentration, genotypes, and conditions. The effects of antioxidants thus reveal an inverted U‐shaped dose–response relationship between ROS levels and lifespan. In addition, we observed that RSV can act additively to both NAC and paraquat, to dramatically increase lifespan. This suggests that the effect of compounds that modulate ROS levels can be additive when their loci of action or mechanisms of action are sufficiently distinct.
Developing strengths‐based recovery systems through community connections
Authors: Best David
Published: September 2016

Commentary to: Making the hard work of recovery more attractive for those with substance use disorders
Every caesarean section must count
Authors: Ellwood David , Oats Jeremy
Published: September 2016

Caesarean section rates (CSR) have climbed over the last three decades but some authors have argued that there is no reason to count them, claiming that this practice may lead to inappropriate attempts to lower CSR. However, there are many adverse effects of CS and these are short, medium and long‐term for both mother and baby. There is likely to be an optimal CSR which gives the best perinatal outcomes and unless each caesarean counts, and is counted, CSR will be higher than they need to be for best perinatal outcomes.
Early surgical treatment of retinal hemangioblastomas
Authors: van Overdam Koen A. , Missotten Tom , Kilic Emine , Spielberg Leigh H.
Published: September 2016

Purpose

To evaluate the clinical course after early surgical treatment with excision of retinal hemangioblastomas (RHs) before development of major complications.

Methods

Interventional case series of four eyes (four patients) with a peripheral RH that had not yet been treated by laser or cryotherapy prior to surgery. All eyes underwent 23‐gauge vitrectomy with lesion excision. One patient underwent ligation of the feeder vessel prior to lesion excision. Best‐corrected visual acuity and clinical course were assessed during a follow‐up period of at least 4 years.

Results

Four patients (mean age 27.3 years; range 19–32) were included, of whom two had von Hippel–Lindau syndrome. Visual acuity improved in three patients (mean 4.8 lines; range 3–10) and remained stable at 0.0 logMAR in one patient. There were no intraoperative complications. Postoperative complications included transient mild vitreous haemorrhage (n = 2), and local epiretinal membrane formation at the excision location (n = 1). At 4 years postoperatively, there were no long‐term complications. There was one case of a new lesion, which was effectively treated with laser.

Conclusion

Vitrectomy with RH excision seems to be an effective approach for larger RHs and could be considered an early treatment option in selected cases. Postoperative complications were limited in scope of this case series. Important points to consider during vitrectomy are effective closure of feeder and draining vessels as well as complete removal of posterior hyaloid and epiretinal membranes in order to avoid postoperative vitreous haemorrhage and proliferative vitreoretinopathy.
Analysis of the impact of allergy and atopy on new onset of uveitis
Authors: Grajewski Rafael S. , Barahmand Pour Niusha , Burian Katja , Caramoy Albert , Kirchhof Bernd , Cursiefen Claus , Heindl Ludwig M.
Published: September 2016

Purpose

The inappropriate immune response to harmless foreign and self‐antigens is a common feature of allergy, atopy and autoimmune disease. The influence of environmental factors in the initiation of autoimmunity is not well understood. It is conceivable that immune responses to allergens may also serve as a trigger of bystander immune reactions, including autoimmunity such as uveitis. Therefore, we wanted to investigate the prevalence of allergies and atopy in patients with different types of uveitis in comparison to a control cohort.

Methods

In total, 530 consecutive patients with new‐onset anterior, intermediate, posterior and panuveitis were compared to a non‐uveitis control cohort consisting of 1.060 consecutive new‐referral patients who attended our specialized outpatient clinics for other reasons than uveitis. Allergy and atopy status as well as demographic data (age, gender and ethnicity) were obtained by standardized interviewer‐assisted questionnaires.

Results

Uveitis case cohort and control cohort did not differ significantly in the allergy status (p = 0.910), such as the history of pollen allergy (p = 0.671), history of drug allergy (p = 0.920), history of food allergy (p = 0.941), history of house dust mite allergy (p = 0.197) or history of other allergens (p = 0.593), nor in the atopy status (p = 0.802), such as the history of atopic dermatitis (p = 0.365), history of asthma (p = 0.430) or history of allergic rhinitis (p = 0.115).

Conclusions

Our results argue against a substantial influence of allergies and atopy on the onset of uveitis.
High correlation between performance on a virtual‐reality simulator and real‐life cataract surgery
Authors: Thomsen Ann Sofia Skou , Smith Phillip , Subhi Yousif , Cour Morten la , Tang Lilian , Saleh George M. , Konge Lars
Published: September 2016

Purpose

To investigate the correlation in performance of cataract surgery between a virtual‐reality simulator and real‐life surgery using two objective assessment tools with evidence of validity.

Methods

Cataract surgeons with varying levels of experience were included in the study. All participants performed and videorecorded three standard cataract surgeries before completing a proficiency‐based test on the EyeSi virtual‐reality simulator. Standard cataract surgeries were defined as: (1) surgery performed under local anaesthesia, (2) patient age >60 years, and (3) visual acuity >1/60 preoperatively. A motion‐tracking score was calculated by multiplying average path length and average number of movements from the three real‐life surgical videos of full procedures. The EyeSi test consisted of five abstract and two procedural modules: intracapsular navigation, antitremor training, intracapsular antitremor training, forceps training, bimanual training, capsulorhexis and phaco divide and conquer.

Results

Eleven surgeons were enrolled. After a designated warm‐up period, the proficiency‐based test on the EyeSi simulator was strongly correlated to real‐life performance measured by motion‐tracking software of cataract surgical videos with a Pearson correlation coefficient of −0.70 (p = 0.017).

Conclusion

Performance on the EyeSi simulator is significantly and highly correlated to real‐life surgical performance. However, it is recommended that performance assessments are made using multiple data sources.
Teachers’ knowledge in content, pedagogy and technology integration: A comparative analysis between teachers in Saudi Arabia and United States
Authors: Alqurashi Emtinan , Gokbel Elif N. , Carbonara David
Published: September 2016

Teachers’ technological pedagogical content knowledge (TPACK) involves an awareness of instructional approaches, methods, and knowledge of building on technology to enhance students’ learning. The purpose of this study was to evaluate the TPACK of teachers in Saudi Arabia and USA, and then describe the factors affecting teachers’ TPACK through an analysis of covariance that incorporates age, teaching experience, and education level as covariates, and the seven levels of TPACK as dependent variables. Differences found between teachers in the US and Saudi Arabia in terms of TPK, and TPCK. The analysis of variance indicated that teachers’ from the US and Saudi Arabia differ in their perceived TPACK when controlled by years of teaching experience, and educational levels. Teachers in both the US and Saudi Arabia had higher rating of their knowledge in content and pedagogy than technology knowledge. Teachers in Saudi Arabia, however, had higher TK, TCK, TPK and TPCK than teachers in the US.
24‐month durability after crossover to the prostatic urethral lift from randomised, blinded sham
Authors: Rukstalis Daniel , Rashid Prem , Bogache William K. , Tutrone Ronald F. , Barkin Jack , Chin Peter T. , Woo Henry H. , Cantwell Anthony L. , Cowan Barrett E. , Bolton Damien M.
Published: September 2016

Objective

To evaluate the 24‐month effectiveness of the prostatic urethral lift (PUL) procedure in men with lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH) assessed through a crossover study.

Patients and Methods

In all, 53 patients underwent a sham procedure as part of the blinded, randomised L.I.F.T. (Luminal Improvement Following prostatic Tissue approximation for the treatment of LUTS secondary to BPH) study at 19 centres and elected to enrol in this crossover study. The crossover procedure involved placement of permanent implants (UroLift® system) into the prostatic lateral lobes. Patients were followed for 3 months after the sham procedure and then for 24 months after crossover to PUL, with assessments of urinary symptom relief, quality of life (QoL), urinary flow rate, sexual function, and adverse events.

Results

At 24 months after crossover to PUL, the International Prostate Symptom Score (IPSS), QoL, BPH Impact Index, and maximum urinary flow rate improved 36%, 40%, 54%, and 77% from baseline, respectively. Each IPSS parameter on average improved significantly from baseline (P < 0.005) and remained stable throughout follow‐up. Symptom response after the sham procedure indicated initial improvement at 1 month with significant decay by 3 months. Adverse events were typically mild to moderate and patients returned rapidly to normal activity. Four patients (8%) required intervention with transurethral resection of the prostate and one patient required additional PUL implants within the 24‐month period. There were no reported instances of de novo sustained erectile or ejaculatory dysfunction.

Conclusions

The PUL procedure is associated with rapid symptom relief, increased urinary flow rate and QoL improvement that remain stable over 24 months. Morbidity is low and sexual function is preserved.
Wolf population genetics inEurope: a systematic review, meta‐analysis and suggestions for conservation and management
Authors: Hindrikson Maris , Remm Jaanus , Pilot Malgorzata , Godinho Raquel , Stronen Astrid Vik , Baltrūnaité Laima , Czarnomska Sylwia D. , Leonard Jennifer A. , Randi Ettore , Nowak Carsten , Åkesson Mikael , López‐Bao José Vicente , Álvares Francisco , Llaneza Luis , Echegaray Jorge , Vilà Carles , Ozolins Janis , Rungis Dainis , Aspi Jouni , Paule Ladislav , Skrbinšek Tomaž , Saarma Urmas
Published: September 2016

The grey wolf (Canis lupus) is an iconic large carnivore that has increasingly been recognized as an apex predator with intrinsic value and a keystone species. However, wolves have also long represented a primary source of human–carnivore conflict, which has led to long‐term persecution of wolves, resulting in a significant decrease in their numbers, genetic diversity and gene flow between populations. For more effective protection and management of wolf populations inEurope, robust scientific evidence is crucial. This review serves as an analytical summary of the main findings from wolf population genetic studies inEurope, covering major studies from the ‘pre‐genomic era’ and the first insights of the ‘genomics era’. We analyse, summarize and discuss findings derived from analyses of three compartments of the mammalian genome with different inheritance modes: maternal (mitochondrialDNA), paternal (Ychromosome) and biparental [autosomal microsatellites and single nucleotide polymorphisms (SNPs)]. To describe large‐scale trends and patterns of genetic variation inEuropean wolf populations, we conducted a meta‐analysis based on the results of previous microsatellite studies and also included new data, covering all 19European countries for which wolf genetic information is available:Norway,Sweden,Finland,Estonia,Latvia,Lithuania,Poland,CzechRepublic,Slovakia,Germany,Belarus,Russia,Italy,Croatia,Bulgaria,Bosnia andHerzegovina,Greece,Spain andPortugal. We compared different indices of genetic diversity in wolf populations and found a significant spatial trend in heterozygosity acrossEurope from south‐west (lowest genetic diversity) to north‐east (highest). The range of spatial autocorrelation calculated on the basis of three characteristics of genetic diversity was 650−850 km, suggesting that the genetic diversity of a given wolf population can be influenced by populations up to 850 km away. As an important outcome of this synthesis, we discuss the most pressing issues threatening wolf populations inEurope, highlight important gaps in current knowledge, suggest solutions to overcome these limitations, and provide recommendations for science‐based wolf conservation and management at regional andEurope‐wide scales.
Equity and Justice in Developmental Science: Discrimination, Social Exclusion, and Intergroup Attitudes
Authors: Killen Melanie , Rutland Adam , Yip Tiffany
Published: September 2016

In this article, the authors assert that (a) the topics of equity and justice reflect important areas of developmental science theory and research which have not yet been recognized as central areas of research in child development and developmental science, (b) a concern for social inequalities serves as a common thread binding equity and justice research across different areas in developmental science, and (c) equity and justice research can inform policies and practices that are designed to improve the lives of all children (including those who are members of stigmatized groups) reduce prejudice and bias, and create programs to rectify social inequalities. For this special section of Child Development, the authors provide the context for this research, and highlight the articles in this special section to demonstrate cutting‐edge research in developmental science regarding equity and justice. The authors review current research and make recommendations for new lines of inquiry.
Developmental Dynamics of Intergroup Contact and Intergroup Attitudes: Long‐Term Effects in Adolescence and Early Adulthood
Authors: Wölfer Ralf , Schmid Katharina , Hewstone Miles , van Zalk Maarten
Published: September 2016

Intergroup contact represents a powerful way to improve intergroup attitudes and to overcome prejudice and discrimination. However, long‐term effects of intergroup contact that consider social network dynamics have rarely been studied at a young age. Study 1 validated an optimized social network approach to investigate intergroup contact (N = 6,457;Mage = 14.91 years). Study 2 explored the developmental trajectories of intergroup contact by applying this validated network approach in a cross‐sequential design (four‐cohort–four‐wave;N = 3,815; 13–26 years). Accelerated growth curve models showed that contact predicts the development of attitudes in adolescence, whereas acquired attitudes buffer against decreasing contact in adulthood. Findings highlight the potential of social network analysis and the developmental importance of early intergroup contact experiences.
Commentary: The Role of Race/Ethnicity in a Developmental Science of Equity and Justice
Authors: Graham Sandra
Published: September 2016

This commentary makes a case for the role of school racial/ethnic diversity in a new developmental science of equity and justice with a focus on intergroup attitudes, discrimination, and social exclusion. Creative ways to conceptualize and measure ethnic diversity as a multifaceted, dynamic, and fluid construct that changes across time and space are discussed. The commentary concludes with policy implications of this approach for improving the lives of children growing up in an increasingly multiracial/multiethnic society.
Minority Adolescents in Ethnically Diverse Schools: Perceptions of Equal Treatment Buffer Threat Effects
Authors: Baysu Gülseli , Celeste Laura , Brown Rupert , Verschueren Karine , Phalet Karen
Published: September 2016

Can perceptions of equal treatment buffer the negative effects of threat on the school success of minority students? Focusing on minority adolescents from Turkish and Moroccan heritage in Belgium (Mage = 14.5; N = 735 in 47 ethnically diverse schools), multilevel mediated moderation analyses showed: (a) perceived discrimination at school predicted lower test performance; (b) experimentally manipulated stereotype threat decreased performance (mediated by increased disengagement); (c) perceived equal treatment at school predicted higher performance (mediated by decreased disengagement); and (d) personal and peer perceptions of equal treatment buffered negative effects of discrimination and stereotype threat. Thus, (situational) stereotype threat and perceived discrimination at school both undermine minority student success, whereas perceived equal treatment can provide a buffer against such threats.
Adverse drug reactions of botulinum neurotoxin type A in children with cerebral palsy: a pharmaco‐epidemiological study in VigiBase
Authors: Montastruc Jeanne , Marque Philippe , Moulis Florence , Bourg Véronique , Lambert Valérie , Durrieu Geneviève , Montastruc Jean‐Louis , Montastruc François
Published: September 2016

Aim

The aim of this study was to assess the risk of adverse drug reactions (ADRs) with botulinum neurotoxin type A (BoNT‐A) in children with cerebral palsy (CP) using the World Health Organization global individual case safety report (ICSR) database, VigiBase.

Method

We extracted all children ICSRs for ADRs with BoNT‐A used as anti‐spastic drug in CP recorded between 1995 and 2015 in VigiBase. We also performed a case/non‐case method (disproportionality analysis) to assess the link between exposure to BoNT‐A and each ADR of interest in children and adults, calculating reporting odds ratios (RORs).

Results

In VigiBase, 162 ICSRs were registered. They involved mainly males (n=95, 59%) and mean (SD) age was 7 years 11 months (4y 4mo). The most frequent ADR was dysphagia (27 ICSRs, 17%) followed by asthenia and muscular weakness (25 ICSRs each, 16%). Nineteen ICSRs (12%) were lethal. There was a significant association between BoNT‐A and death in children (ROR=11.1 95%, confidence interval [CI] 7.0–17.7) but not in adults.

Interpretation

In children with CP, most ADRs seem to be linked to a systemic spread of BoNT‐A. Our study suggests a higher risk of ADRs with BoNT‐A in children than in adults.
Echocardiographic consequences of smoking status in middle‐aged subjects
Authors: Kraen Morten , Frantz Sophia , Nihlén Ulf , Engström Gunnar , Löfdahl Claes‐Göran , Wollmer Per , Dencker Magnus
Published: September 2016

Background

Smoking is known to have many short‐ and long‐term cardiovascular effects. Cardiac index (CI), which is cardiac output indexed to body surface area, is considered to be a valid measure of cardiac performance. We investigated whether there were any differences in CI or other echocardiographic variables between never smokers, ex‐smokers, and current smokers in a cardiopulmonary healthy population.

Methods

Subjects (n=355) from a previous population‐based respiratory questionnaire survey (never smokers, ex‐smokers, and current smokers without significant chronic obstructive lung disease) were examined with echocardiography, and CI (L/min/m2) was calculated.

Results

Current smokers had a higher CI than never smokers 2.61±0.52 L/min/m2 vs. 2.42±0.49 L/min/m2 (P<.01). Ex‐smokers had a nonsignificant, numerically higher value for CI than never smokers 2.54±0.54 L/min/m2 vs. 2.42±0.49 L/min/m2 (P>.05). Smoking status had no significant effect on other echocardiographic variables.

Conclusion

We conclude that currents smokers without known cardiac disease or significant chronic obstructive lung disease show signs of slightly altered hemodynamics.
Eco‐evolutionary dynamics in fragmented landscapes
Authors: Legrand Delphine , Cote Julien , Fronhofer Emanuel A. , Holt Robert D. , Ronce Ophélie , Schtickzelle Nicolas , Travis Justin M. J. , Clobert Jean
Published: September 2016

It is widely recognized that ecological dynamics influence evolutionary dynamics, and conversely that evolutionary changes alter ecological processes. Because fragmentation impacts all biological levels (from individuals to ecosystems) through isolation and reduced habitat size, it strongly affects the links among evolutionary and ecological processes such as population dynamics, local adaptation, dispersal and speciation. Here, we review our current knowledge of the eco‐evolutionary dynamics in fragmented landscapes, focusing on both theory and experimental studies. We then suggest future experimental directions to study eco‐evolutionary dynamics and/or feedbacks in fragmented landscapes, especially to bridge the gap between theoretical predictions and experimental validations.
Predicted trajectories of tree community change in Amazonian rainforest fragments
Authors: Ewers Robert M. , Andrade Ana , Laurance Susan G. , Camargo José Luis , Lovejoy Thomas E. , Laurance William F.
Published: September 2016

A great challenge for ecologists is predicting how communities in fragmented tropical landscapes will change in the future. Available evidence suggests that fragmented tropical tree communities are progressing along a trajectory of ‘retrogressive succession’, in which the community shifts towards an early or mid‐successional state that will persist indefinitely. Here, we investigate the potential endpoint of retrogressive succession, examining whether it will eventually lead to the highly depauperate communities that characterise recently abandoned agricultural lands. We tested this hypothesis by using neural networks to construct an empirical model of Amazonian rainforest‐tree‐community responses to experimental habitat fragmentation. The strongest predictor of tree‐community composition in the future was its composition in the present, modified by variables like the composition of the surrounding habitat matrix and distance to forest edge. We extrapolated network predictions over a 100 yr period and quantified trajectories of forest communities in multidimensional ordination space. We found no evidence that forest communities, including those near forest edges, were converging strongly towards a composition dominated by just one or two early successional genera. Retrogressive succession may well be stronger in fragmented landscapes altered by chronic disturbances, such as edge‐related fires, selective logging, or intense windstorms, but in this experimental landscape in which other human disturbances are very limited, it is unlikely that forest edge communities will fully revert to the species poor assemblages observed in very early successional landscapes.
Effects of soil and climatic factors on arbuscular mycorrhizal fungi in rhizosphere soil underRobinia pseudoacaciain theLoessPlateau,China
Authors: He F. , Tang M. , Zhong S. L. , Yang R. , Huang L. , Zhang H. Q.
Published: September 2016

We explored arbuscular mycorrhizal fungi (AMF) in the rhizosphere soil underRobinia pseudoacaciaL.,Leguminosae (black locust), and evaluated the relations between their diversity and soil and climatic factors in the semi‐aridLoessPlateau of northwestChina. A total of 23AMFspecies were identified at six sites. Of these, six belonged to the genusFunneliformis(Glomeraceae), five toRhizophagus(Glomeraceae), three toGlomus(Glomeraceae), two toAcaulospora(Acaulosporaceae), two toClaroideoglomus(Claroideoglomeraceae), two toSeptoglomus(Glomeraceae), one toAmbispora(Ambisporaceae), one toScutellospora(Gigasporaceae) and one toSclerocystis(Glomeraceae). The species that occurred in the largest proportion of soil samples wereRhizophagus intraradices(75%) andFunneliformis dimorphicum(66.7%). Soil‐available potassium was positively correlated with mycorrhizal colonization and species richness. Spore density was negatively correlated with soilpH, whereas theShannon–Wiener diversity index was positively correlated with total potassium. Most of the soil and climatic factors measured affected theAMFindices directly rather than indirectly. The relative abundances of 13AMFspecies were strongly affected by precipitation, temperature, total nitrogen, ammonium nitrogen and available potassium. This suggests thatAMFspecies are diverse andFunneliformiswas the most common and dominantAMFgenus in the rhizosphere soil under black locust in theLoessPlateau. Precipitation directly affectedAMFstatus and diversity in this distinctive semi‐arid ecosystem.

Highlights

Analysis of the effects of soil and climatic factors on mycorrhizal colonization andAMFdiversity of black locust.

Improved understanding ofAMFcommunities and their function in soil under black locust.

Precipitation was the strongest direct factor that affectedAMFin the semi‐arid region.

Funneliformiswas the most commonAMFgenus in rhizosphere soil under black locust.
The extreme hyper‐reactivity of selected cysteines drives hierarchical disulfide bond formation in serum albumin
Authors: Bocedi Alessio , Fabrini Raffaele , Pedersen Jens Z. , Federici Giorgio , Iavarone Federica , Martelli Claudia , Castagnola Massimo , Ricci Giorgio
Published: September 2016

After mild reduction of serum albumin, seven among the 34 cysteines forming the disulfide network displayed a surprising hyper‐reactivity. Compared to the thiol group of glutathione, the average reactivity of these cysteines towards disulfides and thiol reagents was more than 100 times higher. Using mass spectrometry and kinetic data, we identified all these unusual residues, with Cys75, Cys123 and Cys264 showing the highest reactivity. This effect was mainly due to a low pKa of the sulfhydryl groups and may explain the very fast formation of early disulfides in the nascent protein suggesting the existence of a hierarchical propensity to form such covalent links in selected regions during oxidative folding. An identical pattern of hyper‐reactive cysteines was found in albumins from six different mammals. This hyper‐reactivity is much higher than the one found in other proteins containing multiple cysteines only devoted to structural disulfide bonds. It is possible that such hyper‐reactive cysteines could also be present in other proteins, although their existence has been completely ignored so far.
Planning for the worst: estimates of obesity and comorbidities in school‐age children in 2025
Authors: Lobstein T. , Jackson‐Leach R.
Published: September 2016

Background

Member states of the World Health Organization have adopted resolutions aiming to achieve ‘no increase on obesity levels’ by 2025 (based on 2010 levels) for infants, adolescents and adults.

Objectives

We aimed to assess the scale of the problem facing health planners and service providers.

Methods and Results

Using data prepared by the Global Burden of Disease collaborative for 2000 and 2013, we have estimated that by 2025 some 268 million children aged 5‐17 years may be overweight, including 91 million obese, assuming no policy interventions have proven effective at changing current trends. We have also estimated the likely numbers of children in 2025 with obesity‐related comorbidities: impaired glucose tolerance (12 million), type 2 diabetes (4 million), hypertension (27 million) and hepatic steatosis (38 million). A supplemental table provides estimates for each of 184 nations.

Conclusion

The 2025 targets are unlikely to be met, and health service providers will need to plan for a significant increase in obesity‐linked comorbidities.
Karl Barth's Doctrine of Creation: Church‐bells beyond the stars
Authors: Fergusson David
Published: September 2016

Despite its apparent distance from our contemporary context, Barth's theology can be read as offering a distinctively Christian account of the world as God's good creation, while maintaining its distance from more philosophical and experiential approaches. Barth's iteration of the traditional doctrine reveals significant scriptural, personalist and christological features while insisting upon more than a mere account of origination. Though defending key features of his account, this article also suggests that at times his work displays an ingrained anthropocentrism, a pneumatological deficit and a systematic urge that threatens to constrict the theology of creation.
A not‐so‐sweet diagnosis – leukocytoclastic vasculitis masquerading as squamous cell carcinoma
Authors: Mensa Mussa , Jessop Zita M , Wilson‐Jones Nick , Whitaker Iain S
Published: September 2016

Leukocytoclastic vasculitis (LCV) is a rare small‐vessel vasculitis characterised by neutrophilic inflammation of post‐capillary venules. Incidence varies from 3 to 4.5 per 100 000 people per year. Patients typically present with painful, itchy purpura and erythema, although clinical manifestations can vary making diagnosis a challenge. We report the case of a 75‐year‐old man with a history of a previously completely excised and grafted squamous cell carcinoma (SCC) on the dorsum of his hand, who presented with an acutely swollen, erythematous and ulcerated lesion adjacent to the graft site. A shave biopsy failed to definitively exclude SCC recurrence. He was referred to the Plastics team who initially suspected Sweet's syndrome but could not rule out SCC recurrence. The patient underwent formal mapping incisional biopsies that later diagnosed LCV. He was managed conservatively and made an excellent recovery. We present clinical photographs and histology to illustrate disease progression. LCV is typically self‐limiting with a good overall prognosis, but a minority of patients follow a protracted course, which may require treatment in the form of systemic corticosteroids or colchicine. LCV can only be confirmed histologically. We present this case in order to highlight the importance of adequate tissue biopsy when there is diagnostic uncertainty with an acute dermatosis, particularly in the context of previous skin malignancy.
Squamous cell carcinoma complicating a chronic lesion of hidradenitis suppurativa: a case report and review of the literature
Authors: Jourabchi Natanel , Fischer Alexander H , Cimino‐Mathews Ashley , Waters Kevin M , Okoye Ginette A
Published: September 2016

Squamous cell carcinoma (SCC) arising from chronic hidradenitis suppurativa (HS) is rare; however, the morbidity associated with this presentation is high and management has not been standardised or optimised. We present a case of HS of the perineum and buttocks complicated by SCC, requiring multiple extensive surgical resections. Adjuvant radiotherapy was withheld initially because of concern for poor healing of the surgical wound but was eventually initiated after a second recurrence was identified. The patient ultimately expired 4 years after the initial diagnosis of SCC. We also review 80 cases of SCC complicating HS found in the English literature. Case reports and mechanistic studies suggest the possibility that human papilloma virus and smoking may be risk factors associated with SCC in HS. Despite the majority of SCC cases being well‐differentiated tumours in HS, the highly aggressive nature of SCC in HS and its high likelihood for rapid progression, recurrence, metastasis and high mortality suggests the need to advocate for aggressive treatment. We recommend an aggressive approach to management at the time of SCC diagnosis in HS, which includes appropriate imaging to establish the extent of the tumour, large and deep surgical excision, sentinel lymph node evaluation, consultation with radiation oncology for potential adjuvant radiation therapy and close surveillance.
Should nurses be role models for healthy lifestyles? Results from a modified Delphi study
Authors: Kelly Muireann , Wills Jane , Jester Rebecca , Speller Viv
Published: September 2016

Aim

To explore the expectation that nurses should be role models for healthy behaviours.

Background

Nurses are expected to be role models for healthy behaviours. Whether this is a realistic and acceptable expectation has not been explored.

Design

Modified Policy Delphi study with two rounds of data collection.

Method

Purposive sampling was used to explore areas of agreement and disagreement among six stakeholder groups who influence nursing roles: practising nurses, nursing students, service users, policy makers, workforce development leads and stakeholders working in nurse education. Two rounds of a modified Policy Delphi study were conducted between February ‐ June 2015. The first round used telephone interviews for an open exploration of opinions. The second round used attitude statements to explore convergence and divergence of opinions across stakeholder groups. Responses were analysed thematically.

Results

Policy and professional discourse that asserts that nurses should be healthy role models was seen as unrealistic and unhelpful. Contrary to the view that nurses should epitomize and demonstrate healthy behaviours to encourage patients and to be credible in advice, stakeholders agreed that it was more important to be seen as ‘human’ and understand the challenges of health behaviour change. Student and practising nurses did not see role modelling healthy behaviours as a reasonable professional expectation.

Conclusions

The findings challenge the assumptions underpinning the argument that nurses be healthy role models. Further research is needed to understand the views of frontline nurses and to further explore avenues by which health services staff health can be improved.
Detecting Target‐Driven Earnings Management Based on the Distribution of Digits
Authors: Ullmann Robert , Watrin Christoph
Published: September 2016

We present a novel research design to detect target‐driven earnings management in accounting data. As a particular concern in this line of research, information about the exact earnings target value of a given firm is often not available. We therefore develop an empirical strategy that does not require such information. To this end, we rely on the concept of the distribution of digits rather than the distribution of the earnings metric itself. We then theoretically derive that the mean of the distribution of digits, in particular, exhibits a specific pattern around the earnings target that can be exploited to investigate target‐driven earnings management. This pattern arises regardless of the distribution of digits that obtains in unmanaged data. We extensively test our theoretical predictions using both simulated and archival data.