bluuebunny/crossref_metadata_2025 huggingface dataset:
Brentuximab vedotin, an antibody–drug conjugate, in patients with CD30‐positive haematologic malignancies and hepatic or renal impairment
Authors: Zhao Baiteng , Chen Robert , O'Connor Owen A. , Gopal Ajay K. , Ramchandren Radhakrishnan , Goy Andre , Matous Jeffrey V. , Fasanmade Adedigbo A. , Manley Thomas J. , Han Tae H.
Published: April 2016

Aims

Brentuximab vedotin, an antibody–drug conjugate (ADC), selectively delivers the microtubule‐disrupting agent monomethyl auristatin E (MMAE) into CD30‐expressing cells. The pharmacokinetics of brentuximab vedotin have been characterized in patients with CD30‐positive haematologic malignancies. The primary objective of this phase 1 open label evaluation was to assess the pharmacokinetics of brentuximab vedotin in patients with hepatic or renal impairment.

Methods

Systemic exposures were evaluated following intravenous administration of 1.2 mg kg–1 brentuximab vedotin in patients with CD30‐positive haematologic malignancies and hepatic (n = 7) or renal (n = 10) impairment and compared with those of unimpaired patients (n = 8) who received 1.2 mg kg–1 brentuximab vedotin in another arm of the study.

Results

For any hepatic impairment, the ratios of geometric means (90% confidence interval) for AUC(0,∞) were 0.67 (0.48, 0.93) for ADC and 2.29 (1.27, 4.12) for MMAE. Mild or moderate renal impairment caused no apparent change in ADC or MMAE exposures. Severe renal impairment (creatinine clearance <30 ml min–1; n = 3) decreased ADC exposures (0.71 [0.54, 0.94]) and increased MMAE exposures (1.90 [0.85, 4.21]). No consistent pattern of specific adverse events was evident, but analysis of the safety data was confounded by the patients' poor baseline conditions. Five patients died due to adverse events considered unrelated to brentuximab vedotin. All had substantial comorbidities and most had poor baseline performance status.

Conclusions

Hepatic impairment and severe renal impairment may cause decreases in brentuximab vedotin ADC exposures and increases in MMAE exposures.
Being smart or getting smarter: Implicit theory of intelligence moderates stereotype threat and stereotype lift effects
Authors: Froehlich Laura , Martiny Sarah E. , Deaux Kay , Goetz Thomas , Mok Sog Yee
Published: April 2016

This research explores implicit theory of intelligence (TOI) as a moderator of stereotype activation effects on test performance for members of negatively stereotyped and of favourably stereotyped groups. In Germany, Turkish‐origin migrants are stereotyped as low in verbal ability. We predicted that on a test diagnostic of verbal intelligence, endorsement of an entity TOI predicts stereotype threat effects for Turkish‐origin students and stereotype lift effects for German students. This effect could account for some of the performance gap between immigrants and host society members after stereotype activation. Study 1 (N = 107) established structural equivalence of implicit theories across the ethnic groups. In two experimental studies (Study 2: N = 182, Study 3: N = 190), we tested the moderating effect of TOI in a 2 (stereotype activation: diagnostic vs. non‐diagnostic test) × 2 (ethnicity: German vs. Turkish migration background) experimental design. The results showed that when the test was described as diagnostic of verbal intelligence, higher entity theory endorsement predicted stereotype threat effects for Turkish‐origin students (Study 2 and Study 3) and stereotype lift effects for German students (Study 3). The results are discussed in terms of practical implications for educational settings and theoretical implications for processes underlying stereotype activation effects.
To wake up cancer stem cells, or to let them sleep, that is the question
Authors: Takeishi Shoichiro , Nakayama Keiichi I.
Published: April 2016

Cancer stem cells (CSCs) generate transient‐amplifying cells and thereby contribute to cancer propagation. A fuller understanding of the biological features of CSCs is expected to lead to the development of new anticancer therapies capable of eradicating this life‐threatening disease. Cancer stem cells are known to maintain a non‐proliferative state and to enter the cell cycle only infrequently. Given that conventional anticancer therapies preferentially target dividing cells, CSCs are resistant to such treatments, with those remaining after elimination of bulk cancer cells potentially giving rise to disease relapse and metastasis as they re‐enter the cell cycle after a period of latency. Targeting of the switch between quiescence and proliferation in CSCs is therefore a potential strategy for preventing the reinitiation of malignancy, underscoring the importance of elucidation of the mechanisms by which these cells are maintained in the quiescent state. The fundamental properties of CSCs are thought to be governed cooperatively by internal molecules and cues from the external microenvironment (stem cell niche). Several such intrinsic and extrinsic regulators are responsible for the control of cell cycle progression in CSCs. In this review, we address two opposite approaches to the therapeutic targeting of CSCs – wake‐up and hibernation therapies – that either promote or prevent the entry of CSCs into the cell cycle, respectively, and we discuss the potential advantages and risks of each strategy.
Parents' perceptions of the services provided to children with cerebral palsy in the transition from preschool rehabilitation to school‐based services
Authors: Alsem M. W. , Verhoef M. , Gorter J. W. , Langezaal L. C. M. , Visser‐Meily J. M. A. , Ketelaar M.
Published: April 2016

Aim

To describe the course of parents' perceptions of the family centredness of rehabilitation services provided to their children with cerebral palsy (CP) before and after the transition from preschool to school‐based services.

Background

Parents of 59 children with CP aged 2.5 to 4.5 years filled in the 56‐item Measure of Processes of Care (MPOC‐56) on three occasions pre (2) and post (1) transition to school‐based services. Friedman tests were used to describe changes in parents' perceptions over time. Mann–Whitney U tests were used to describe differences in course of parents' perceptions between regular school and special school or day care.

Results

Parents' perceptions of preschool services were stable between the ages of 2.5 and 3.5 years, with a decline after transition on four of the five domains of the MPOC (P < 0.05). The domain providing general information was scored lowest (median at baseline 3.56, IQR 2.39) compared with the four other MPOC domains, but remained stable over time. No differences in course of parental perceptions were found for school type.

Conclusion

The transition from preschool to school‐based services for children with CP is associated with a decrease in parents' perception of family centredness independent of the type of school. The transition in services has a negative impact on perceived family‐centred practices.
Chewing efficiency and maximum bite force with different attachment systems of implant overdentures: a crossover study
Authors: Elsyad Moustafa Abdou , Khairallah Ahmed Samir
Published: April 2016

Purpose

This crossover study aimed to evaluate and compare chewing efficiency and maximum bite force (MBF) with resilient telescopic and bar attachment systems of implant overdentures in patients with atrophied mandibles.

Material and methods

Ten participants with severely resorbed mandibles and persistent denture problems received new maxillary and mandibular conventional dentures (control, CD). After 3 months of adaptation, two implants were inserted in canine region of the mandible. In a quasi‐random method, overdentures were connected to the implants with either bar overdentures (BOD) or resilient telescopic overdentures (TOD) attachment systems. Chewing efficiency in terms of unmixed fraction (UF) was measured using chewing gum (after 5, 10, 20, 30 and 50 strokes), and MBF was measured using a bite force transducer. Measurements were performed 3 months after using each of the following prostheses: CD, BOD and TOD.

Results

Chewing efficiency and MBF increased significantly with BOD and TOD compared to CD. As the number of chewing cycles increased, the UF decreased. TOD recorded significant higher chewing efficiency and MBF than BOD.

Conclusion

Resilient telescopic attachments are associated with increased chewing efficiency and MBF compared bar attachments when used to retain overdentures to the implants in patients with atrophied mandibles.
Hybridization, agency discretion, and implementation of the U.S. Endangered Species Act
Authors: Lind‐Riehl Jennifer F. , Mayer Audrey L. , Wellstead Adam M. , Gailing Oliver
Published: April 2016

The U.S. Endangered Species Act (ESA) requires that the “best available scientific and commercial data” be used to protect imperiled species from extinction and preserve biodiversity. However, it does not provide specific guidance on how to apply this mandate. Scientific data can be uncertain and controversial, particularly regarding species delineation and hybridization issues. The U.S. Fish and Wildlife Service (FWS) had an evolving hybrid policy to guide protection decisions for individuals of hybrid origin. Currently, this policy is in limbo because it resulted in several controversial conservation decisions in the past. Biologists from FWS must interpret and apply the best available science to their recommendations and likely use considerable discretion in making recommendations for what species to list, how to define those species, and how to recover them. We used semistructured interviews to collect data on FWS biologists’ use of discretion to make recommendations for listed species with hybridization issues. These biologists had a large amount of discretion to determine the best available science and how to interpret it but generally deferred to the scientific consensus on the taxonomic status of an organism. Respondents viewed hybridization primarily as a problem in the context of the ESA, although biologists who had experience with hybridization issues were more likely to describe it in more nuanced terms. Many interviewees expressed a desire to continue the current case‐by‐case approach for handling hybridization issues, but some wanted more guidance on procedures (i.e., a “flexible” hybrid policy). Field‐level information can provide critical insight into which policies are working (or not working) and why. The FWS biologists’ we interviewed had a high level of discretion, which greatly influenced ESA implementation, particularly in the context of hybridization.
Use of complementary medicine in metastatic melanoma patients treated with ipilimumab within a clinical trial
Authors: Huebner Jutta , Mohr Peter , Simon Jan‐Christoph , Fluck Michael , Berking Carola , Zimmer Lisa , Loquai Carmen
Published: April 2016

Background and Objectives

In Germany, 40–90 % of all cancer patients use complementary and alternative medicine (CAM). So far, no data are available on the use of CAM by melanoma patients. The objective of our study was to gather data on CAM use, sources of information, and goals of patients with metastatic melanoma.

Patients and Methods

One hundred and fifty‐six patients from 25 study centers participated in the DecOG‐MM‐PAL‐Multibasket Study. These individuals were also asked to participate in a side study addressing CAM use. A standardized CAM questionnaire was distributed at defined points during the treatment.

Results

Overall, 55 questionnaires from 32 (21 %) melanoma patients were received. Of those, 17 (53 %) stated an interest in CAM, and seven (22 %) actually used CAM. Family and friends were the main source of information (31 %), followed by physicians (19 %). The main reasons for using CAM were boosting the immune system (41 %) and strengthening the body (34 %). Supplements (vitamins and trace elements) were most commonly used (28 %).

Conclusions

A relatively high number of metastatic melanoma patients used CAM despite their participation in a clinical trial. Interactions may be due to biologically based CAM, especially immunomodulatory CAM strategies. In order to avoid risks, communication between physicians and patients should be improved.
Gebrauch von Komplementärmedizin bei Patienten mit metastasierendem Melanom unter Therapie mit Ipilimumab innerhalb einer klinischen Studie
Authors: Huebner Jutta , Mohr Peter , Simon Jan‐Christoph , Fluck Michael , Berking Carola , Zimmer Lisa , Loquai Carmen
Published: April 2016

Hintergrund und Ziel

In Deutschland wenden 40–90 % aller Krebspatienten Methoden der komplementären and alternativen Medizin (KAM) an. Bis dato gibt es kein Datenmaterial zum Einsatz der KAM bei Melanompatienten. Das Ziel unserer Studie war es, Daten über den Gebrauch, die Informationsquellen und Ziele von Patienten mit metastasierendem Melanom zu erfassen.

Patienten und Methoden

Einhundertsechsundfünfzig Patienten aus 25 Studienzentren nahmen an der DecOG‐MM‐PAL Multibasket Studie teil. Die beteiligten Personen wurden auch gebeten, an einer Nebenstudie teilzunehmen, die ihren Gebrauch von KAM erfassen sollte. Dazu wurde während der Behandlung ein standardisierter Fragebogen zu genau festgelegten Zeitpunkten ausgeteilt.

Ergebnisse

Insgesamt gingen 55 Fragebögen von 32 (21 %) Melanompatienten ein. Von diesen gaben 17 (53 %) ein Interesse an KAM an, und sieben (22 %) machten von KAM Gebrauch. Die Hauptinformationsquellen (31 %) waren Familienmitglieder und Freunde, gefolgt von Ärzten (19 %). Die Hauptgründe für die Anwendung von KAM waren die Stärkung des Immunsystems (41 %) und des Körpers (34 %). Nahrungsergänzungsmittel (Vitamine und Spurenelemente) wurden am häufigsten angewendet (28 %).

Fazit

Eine relativ hohe Anzahl an Patienten mit metastasierendem Melanom machte trotz Teilnahme an einer klinischen Studie von KAM Gebrauch. Wechselwirkungen könnten durch biologisch basierte KAM auftreten, und hier besonders bei immunmodulierenden KAM‐ Strategien. Um Risiken zu vermeiden, sollte die Kommunikation zwischen den Ärzten und den Patienten verbessert werden.
Are the classic diagnostic methods in mycology still state of the art?
Authors: Wiegand Cornelia , Bauer Andrea , Brasch Jochen , Nenoff Pietro , Schaller Martin , Mayser Peter , Hipler Uta‐Christina , Elsner Peter
Published: April 2016

The diagnostic workup of cutaneous fungal infections is traditionally based on microscopic KOH preparations as well as culturing of the causative organism from sample material. Another possible option is the detection of fungal elements by dermatohistology. If performed correctly, these methods are generally suitable for the diagnosis of mycoses. However, the advent of personalized medicine and the tasks arising therefrom require new procedures marked by simplicity, specificity, and swiftness. The additional use of DNA‐based molecular techniques further enhances sensitivity and diagnostic specificity, and reduces the diagnostic interval to 24–48 hours, compared to weeks required for conventional mycological methods. Given the steady evolution in the field of personalized medicine, simple analytical PCR‐based systems are conceivable, which allow for instant diagnosis of dermatophytes in the dermatology office (point‐of‐care tests).
Sind die klassischen Methoden zur mykologischen Diagnostik noch „State‐of‐the‐Art“?
Authors: Wiegand Cornelia , Bauer Andrea , Brasch Jochen , Nenoff Pietro , Schaller Martin , Mayser Peter , Hipler Uta‐Christina , Elsner Peter
Published: April 2016

Die Labordiagnose einer Pilzinfektion der Haut basiert traditionell auf dem Nativpräparat und der Anzucht des Erregers aus dem klinischen Material. Auch der dermato‐ histologischer Nachweis von Pilzelementen ist möglich. Diese Methoden sind, sofern sie korrekt ausgeführt werden, in der Regel zum Pilznachweis geeignet. Im Zuge der personalisierten Medizin und den daraus erwachsenden Aufgaben werden jedoch neue Verfahren erforderlich, welche einfach, spezifisch und schnell sind. Der zusätzliche Einsatz von DNA‐basierten molekularen Methoden erhöht die Empfindlichkeit sowie die diagnostische Spezifität und reduziert die zum Teil wochenlange Durchführungszeit der konventionellen mykologischen Diagnostik auf 24 bis 48 Stunden. Im Zuge der stetigen Weiterentwicklung im Bereich der personalisierten Medizin sind einfache Analysensysteme auf PCR‐Basis denkbar, die in der Hautarztpraxis eine Dermatophyten‐Sofort‐Diagnostik erlauben (Point‐of‐Care‐Tests).
Aktuelle Optionen zur Behandlung pathologischer Narben
Authors: Poetschke Julian , Gauglitz Gerd G.
Published: April 2016

Die Entstehung von Narben ist die Konsequenz von Operationen, Traumata und verschiedenen Hautkrankheiten. Neben frischen unreifen Narben, die im Laufe der Heilung in reife Narben übergehen und in der Regel keiner weiteren Behandlung bedürfen, existieren lineare hypertrophe Narben, flächige hypertrophe Narben, Keloide und atrophe Narben, die aufgrund von Symptomen wie Juckreiz und Schmerzen, einer Stigmatisierung, funktionellen und ästhetischen Einschränkungen für die betroffenen Patienten sehr störend und Grundlage für einen Behandlungswunsch sein können. Für die Behandlung und Prävention von Narben existiert heutzutage eine Vielzahl von Optionen. Zur Anwendung kommen können Externa, basierend auf Silikon oder Zwiebelextrakt, intraläsionale Injektionsverfahren mit kristallinen Glukokortikoiden (häufig in Kombination mit Kryotherapie) oder 5‐Fluorouracil sowie ablative und nichtablative Laserverfahren. Um die Vielfalt an Behandlungsansätzen und die aktuelle Datenlage für die behandelnden Ärzte zusammenzufassen, existieren aktuelle Leitlinien, mit deren Hilfe für jeden einzelnen Narbentyp klare Therapieempfehlungen gegeben werden können. Dies erlaubt es, Patienten zu schnellerer Beschwerdefreiheit zu verhelfen und ihren ästhetischen Ansprüchen gerecht zu werden. Neben der immer wichtiger werdenden Narbenprävention nimmt auch der zunehmende Einsatz modernster Laserverfahren einen zentralen Stellenwert in der klinischen Narbenbehandlung ein. Zugleich liegt großes Augenmerk darauf, aktuelle Therapieverfahren mit Hilfe zeitgemäßer Studiendesigns zu evaluieren, um die Evidenz der Narbenbehandlung zunehmend zu verbessern.
Effects of size and sex on swimming performance and metabolism of invasive mosquitofish Gambusia holbrooki
Authors: Srean Pao , Almeida David , Rubio‐Gracia Francesc , Luo Yiping , García‐Berthou Emili
Published: April 2016

In freshwater ecosystems, abiotic factors such as flow regime and water quality are considered important predictors of ecosystem invasibility. The aim of this study was to investigate the critical swimming capacity and metabolism of the eastern mosquitofish, Gambusia holbrooki, focusing on sex and size effects, to evaluate the influence of water flow on its invasive success. Specimens of mosquitofish were captured from the Ter Vell lagoon (L'Estartit, north‐eastern Spain) in July 2014, and we measured the critical swimming speed (Ucrit) and oxygen consumption of individual fish (30 females and 30 males) using a mini swim tunnel. The mean Ucrit of this poeciliid fish was estimated at 14.11 cm·s−1 (range = 4.85–22.26), which is lower than that of many other fishes of similar size and confirms that this species is limnophilic and its invasive success might be partially explained by hydrologic alterations. However, the Ucrit and maximal metabolic rate vary markedly with fish size and sex, with males having much higher values for the same body mass, and thus probably being more resistant to strong water flows. Multiple regression models illustrate that multivariate analyses might increase the predictive power and understanding of swimming performance and metabolic traits, compared to results from conventional simple regressions.
Effect of pH and prior phosphate application on the reaction of fluoride with soils from northern India
Authors: Barrow N. J. , Debnath Abhijit , Chatterjee S.
Published: April 2016

We investigated whether long‐term application of phosphate fertilizers, often as phosphate rock, had led to the accumulation of soluble fluoride in soil from tea estates in northern India. We also compared fluoride sorption and desorption with that of sulphate and of phosphate. We found no evidence of build‐up of soluble fluoride and ascribed this to the very heavy rainfall of about 3 m, nearly all of which occurs during a 4‐month monsoon period. Fluoride sorption was more sensitive than phosphate or sulphate sorption to the build‐up of a negative charge caused by long‐term application of phosphate fertilizers. We think that this occurred because the fluoride ion is smaller and the mean centre of charge is, therefore, located closer to the surface. When the negative charge is increased, it, therefore, experiences a greater decrease in potential than ions for which the mean centre of charge is further from the surface. When the phosphate status of the soil was low, fluoride showed sorption–desorption hysteresis. That is the desorption curve differed from the sorption curve. When the phosphate status of the soil was higher, this was not the case. Similar effects have been observed previously for both phosphate and sulphate. We had speculated that the fluoride ion, being smaller, might have been able to penetrate pores ‘blocked’ by a previous reaction with phosphate, but this did not happen. We conclude that characterizing the charge on sorbed ions, its location and especially the accumulation of a negative charge following a long‐term reaction with phosphate is important for understanding specific sorption on ions.

Highlights

We investigated the effects of long‐term application of phosphate rock on tea estates.

We ascribed the lack of build‐up of soluble fluoride to monsoon rainfall of about 3 m.

Fluoride sorption was more sensitive than phosphate or sulphate sorption to the build‐up of a negative charge caused by long‐term application of phosphate fertilizers.

Characterizing the charge on sorbed ions, its location and the accumulation of a negative charge is important.
Prognostic significance of pulsatile tinnitus in cervical artery dissection
Authors: Kellert L. , Kloss M. , Pezzini A. , Debette S. , Leys D. , Caso V. , Thijs V. N. , Bersano A. , Touzé E. , Tatlisumak T. , Traenka C. , Lyrer P. A. , Engelter S. T. , Metso T. M. , Grond‐Ginsbach C. ,   the Cervical Artery Dissection and Ischemic Stroke Patients (CADISP) study group
Published: April 2016

Background and purpose

Our aim was to investigate whether pulsatile tinnitus (PT) in cervical artery dissection (CeAD) has prognostic significance.

Methods

All CeAD patients from the CADISP (Cervical Artery Dissection and Ischemic Stroke Patients) study with documentation of PT were analysed. The presence of PT was systematically assessed using a standardized questionnaire. Stroke severity at admission was defined according to the National Institutes of Health Stroke Scale (NIHSS). Excellent outcome after 3 months was defined as a modified Rankin Scale of 0–1.

Results

Sixty‐three of 778 patients (8.1%) reported PT. PT+ patients presented less often with ischaemic stroke (41.3% vs. 63.9%, P < 0.001), more often with dissection in the internal carotid artery (85.7% vs. 64.2%, P = 0.001), less often with vessel occlusion (19.0% vs. 34.1%, P = 0.017) and more often with excellent outcome at 3 months (92.1% vs. 75.4%, P = 0.002). Logistic regression analysis identified PT as an independent predictor of excellent outcome after 3 months [odds ratio (OR) 3.96, 95% confidence interval (CI) 1.22–12.87] adjusted to significant outcome predictors NIHSS on admission (OR 0.82, 95% CI 0.79–0.86), Horner syndrome (OR 1.95, 95% CI 1.16–3.29) and vessel occlusion (OR 0.62, 95% CI 0.40–0.94) and to non‐significant predictors age, sex, pain and location of CeAD.

Conclusion

The presence of PT in CeAD is associated with a benign clinical course and predicts a favourable outcome.
Enhancing conservation of Australian freshwater ecosystems: identification of freshwater flagship fishes and relevant target audiences
Authors: Ebner Brendan C , Morgan David L , Kerezsy Adam , Hardie Scott , Beatty Stephen J , Seymour Jamie E , Donaldson James A , Linke Simon , Peverell Stirling , Roberts David , Espinoza Thomas , Marshall Nadine , Kroon Frederieke J , Burrows Damien W , McAllister Ryan R J
Published: April 2016

Flagship species, especially mammals and birds, are commonly used to increase awareness of conservation issues in marine and terrestrial ecosystems. However, flagship species oriented programs are often ad hoc with initiatives scarce in the freshwater context. Here, we aim to identify potential flagship candidates that would appeal to a broad cross section of society at a continental scale where freshwater ecosystems are under threat from human impacts. We identified 19 species from a list of 299 Australian freshwater fishes on the basis of body size, trophic guild and threatened species status assuming these characteristics of flagship species are transferable from previous work on terrestrial flagship species. We considered the potential of species to be of international appeal but focused mostly on eight relevant interest groups within Australia. This followed the rationale that public engagement with conservation issues in freshwater systems might be more effective if the link between fish species and the decisions people make were better understood, and we acknowledge the diverging interests of stakeholders. This scoping work contributes towards addressing the challenges of connecting societies to the principles of sharing water resources with ecosystems, and represents the first continental‐scale assessment of its kind.
How do tumor cells respond to HDAC inhibition?
Authors: Newbold Andrea , Falkenberg Katrina J. , Prince H. Miles , Johnstone Ricky W.
Published: April 2016

It is now well recognized that mutations, deregulated expression, and aberrant recruitment of epigenetic readers, writers, and erasers are fundamentally important processes in the onset and maintenance of many human tumors. The molecular, biological, and biochemical characteristics of a particular class of epigenetic erasers, the histone deacetylases (HDACs), have been extensively studied and small‐molecule HDAC inhibitors (HDACis) have now been clinically approved for the treatment of human hemopoietic malignancies. This review explores our current understanding of the biological and molecular effects on tumor cells following HDACi treatment. The predominant responses include induction of tumor cell death and inhibition of proliferation that in experimental models have been linked to therapeutic efficacy. However, tumor cell‐intrinsic responses to HDACi, including modulating tumor immunogenicity have also been described and may have substantial roles in mediating the antitumor effects of HDACi. We posit that the field has failed to fully reconcile the biological consequences of exposure to HDACis with the molecular events that underpin these responses, however progress is being made. Understanding the pleiotrophic activities of HDACis on tumor cells will hopefully fast track the development of more potent and selective HDACi that may be used alone or in combination to improve patient outcomes.
Grazing behaviour, intake and performance of dairy ewes with restricted access time to berseem clover (Trifolium alexandrinum L.) pasture
Authors: Molle G. , Decandia M. , Giovanetti V. , Manca C. , Acciaro M. , Epifani G. , Salis L. , Cabiddu A. , Sitzia M. , Cannas A.
Published: April 2016

The effects of restricted access time to pasture (2, 4 or 6 h d−1; 2H, 4H or 6H) on ingestive behaviour and performance were assessed on four occasions per target grazing day (D1, initial day; D4, intermediate day; and D7, final day) in dairy ewes rotationally grazing berseem clover with a 7‐day grazing period and a 21‐day recovery period. A randomized block design with two replicates per treatment was used. All ewes were supplemented daily with 700 g per head of concentrates and 700 g per head of ryegrass‐based hay. Pasture subplot and animal group data were analysed by a factorial model including access time (AT), grazing day (D) and their interaction as fixed factors. Sward height decreased from D1 (P < 0·001) and green leaf mass from D4 (P < 0·001) onwards during the grazing period. Grazing time as a proportion of AT was higher in 2H than in 4H and 6H ewes on D1 and D4 but not on D7 (P < 0·05 for AT × D). Herbage intake rate was higher in 2H than in 4H and 6H ewes (P < 0·001). Herbage and total intakes were higher in 4H and 6H than in 2H ewes (P < 0·001), with herbage intake varying non‐linearly during the grazing period (P < 0·05). Milk yield was higher in 4H and 6H than in 2H ewes (P < 0·01). To conclude, despite the evidence of compensatory behaviour, restricting access time to 2 h d−1 constrained intake and performance of dairy ewes rotationally grazing berseem clover.
Deconstructing Institutionalisation of the European Standards for Quality Assurance: From Instrument Mixes to Quality Cultures and Implications for International Research
Authors: Kohoutek Jan
Published: April 2016

The paper enquires into the implementation of the European Standards and Guidelines for Internal Quality Assurance of Higher Education Institutions (ESG 1). The enquiry uses data from universities in the Czech Republic and compares them against those obtained in the relevant pan‐European survey. The aims are to empirically deconstruct ESG 1 translation through instrument mixes, to identify the corresponding implementation styles and to explore the implications of such styles for institutional quality cultures. In these respects, the enquiry yielded three corresponding findings. First, the ESG 1 instrument mixes are complex and entail the application of up to four major types of tools, cutting across the substantive and procedural categories over time. Second, two typical ESG 1 implementation styles were identified: managerial and academic. Third, the managerial style was found to bear on regenerative culture while the academic style bore on reproductive culture. Furthermore, utilisation of hybrid quality cultures (regenerative–reproductive, reproductive–regenerative) was found, depending on internal institutional configurations. It is through verification of these findings in other policy settings that international research on higher education quality assurance may gainfully proceed.
A pilot assessment tool of the need for oral health care and cost prediction in institutionalized elderly people
Authors: Miremadi SR , Cosyn J , Janssens B , De Bruyn H , Vanobbergen J , De Visschere L
Published: April 2016

Objective

To assess the dental treatment backlog and associated costs among institutionalized elderly people using a novel composite index, called the oral health index.

Background

Despite numerous reports about oral health of old individuals, there is still lack of a systematic and practical method to estimate their treatment need covering all relevant aspects of oral health. In addition, little has been published on associated treatment costs and prediction of such costs.

Materials and Methods

An observational study was performed on 143 dentate institutionalized elderly people, whereby several clinical parameters were registered. The collected data were included in the oral health index representing the need for oral health care. This covered the number of caries lesions, number of residual roots, periodontal health condition, plaque score and denture condition with a final score of 0–9. To investigate the validity of the index, the treatment costs were estimated using the measured clinical parameters and later compared with the actual expenditure of the patients for the following 2 years.

Results

The average score of the index was 4.6 (SD 1.4) with 65.1% of the individuals having a score between 3 and 6 and 27.3% having a score of 6 and more, exhibiting medium and high need for oral health care, respectively. Only 30% of the patients underwent all the indicated treatments. The major reason of non‐completion of the treatment was patient's refusal. From the fully treated group, 61.5% of the subjects actually spent within the predicted range while 38.5% of them spent more than estimated. The underestimation was related to yearly calculus removals leading to repeated calculation of the same costs and newly emerging dental problems (33% developed new caries and 20% was confronted with tooth fracture within the 2‐year period).

Conclusion

The novel index can be helpful to determine oral treatment needs and associated costs. Further research is needed to extend the clinical applicability of the index.
Why do Firms Purchase Used Assets?
Authors: Baxamusa Mufaddal , Javaid Saima , Harery Khadija
Published: April 2016

We hypothesize that the increase in expectation about future technological change decreases the likelihood for the purchase of new assets because the change may make the new assets obsolete. To test this hypothesis, we use patents and citations data to represent the expected technological change. We find that the purchases of and the amount spent on used assets increase with the expectation of technological change, while time to completion of the purchase and the number of bids decrease with the increase in expectations about technological change. We exploit industry deregulations to establish identification. In contrast to the literature, we find no empirical support for financial constraint as a reason for purchasing used assets.
University of Texas Roundtable on Financing and Managing Energy Investments in a Low‐Price Environment
Authors: Adkins Marshall , Beard Greg , Clark Bernard “Buddy” , Shepherd Gene , Vaughan George , Titman Sheridan
Published: April 2016

During the past 18 months, the U.S. oil industry has seen oil prices plunge from well over $100 a barrel to under $30. In a session that was part of a recent Private Equity Conference at the University of Texas in Austin, the CEO of a small independent producer and a representative of a large global oil and gas company discussed the challenges of financing and operating energy companies in today's low‐price environment with the director of energy research at a brokerage firm, the senior partner responsible for the natural resource investments of a well‐known private equity firm, and the head of the oil and gas restructuring practice of a national law firm.

The panelists appeared to reach a consensus on at least the following three arguments:

Although the causes of the oil price crash of 2014–2015 are often identified as the weakness of global (and particularly Chinese) demand, and the unwillingness of OPEC nations to cut production in the face of the slowdown, the more fundamental cause has been the dramatic increase in the productivity of the U.S. oil and gas industry and the doubling of U.S. oil output since 2008 attributable to the new shale gas technology. But if large price drops are the expected consequence of such technological change and productivity gains, most of the panelists also believe that the current supply‐demand imbalance will disappear in the next few years and prices will return to a level at which efficient “marginal” U.S. producers earn acceptable returns—a level the collective best guess put at around $60–65 a barrel.

The greatest financial opportunity involves the purchase of the debt—some of which now trades for as little as 20% of face value—of highly leveraged and distressed U.S. “E&P” companies, possibly (though not necessarily) with the aim of gaining control of the company. But if such price discounts represent investment opportunities for private equity and other distressed investors, they also present opportunities for the companies themselves find a way to increase their own values by either renegotiating or finding a way to buy back their discounted debt.

The industry has collectively failed to do a good job of hedging its oil price risk, which has proved especially destructive for those companies operating with significant financial leverage. For those companies that have hedged, the typical hedges have extended only 12–18 months forward, thereby failing to provide protection against exposures created by oil reserve lives (on which debt financings are often premised) that typically run as long as 10–20 years.
Joy and happiness: a simultaneous and evolutionary concept analysis
Authors: Cottrell Laura
Published: April 2016

Aim

To report a simultaneous and evolutionary analysis of the concepts of joy and long‐term happiness.

Background

Joy and happiness are underrepresented in the nursing literature, though negative concepts are well represented. When mentioned in the literature, neither joy nor happiness is adequately defined, explained, or clearly understood. To promote further investigation of these concepts in nursing and to explore their relationship with health and healing, conceptual clarity is an essential first step.

Design

Concept analysis.

Data sources

The following databases were searched, without time restrictions, for articles in English: Academic Search Complete, Anthropology Plus; ATLA Religious Database with ATLASerials; Cumulative Index of Nursing and Allied Health Literature (CINAHL); Education Research Complete; Humanities International Complete; Psych EXTRA; and SocINDEX with Full Text. The final sample size consists of 61 articles and one book, published between 1978–2014.

Method

An adapted combination of Rodgers' Evolutionary Model and Haase et al.'s Simultaneous Concept Analysis (SCA) method.

Results

Though both are positive concepts, joy and happiness have significant differences. Attributes of joy describe a spontaneous, sudden and transient concept associated with connection, awareness, and freedom. Attributes of happiness describe a pursued, long‐lasting, stable mental state associated with virtue and self‐control.

Conclusion

Further exploration of joy and happiness is necessary to ascertain their relationship with health and their value to nursing practice and theory development. Nurses are encouraged to consider the value of positive concepts to all areas of nursing.
Cost‐effectiveness of a nurse practitioner‐family physician model of care in a nursing home: controlled before and after study
Authors: Lacny Sarah , Zarrabi Mahmood , Martin‐Misener Ruth , Donald Faith , Sketris Ingrid , Murphy Andrea L. , DiCenso Alba , Marshall Deborah A.
Published: April 2016

Aims

To examine the cost‐effectiveness of a nurse practitioner‐family physician model of care compared with family physician‐only care in a Canadian nursing home.

Background

As demand for long‐term care increases, alternative care models including nurse practitioners are being explored.

Design

Cost‐effectiveness analysis using a controlled before‐after design.

Methods

The study included an 18‐month ‘before’ period (2005–2006) and a 21‐month ‘after’ time period (2007–2009). Data were abstracted from charts from 2008–2010. We calculated incremental cost‐effectiveness ratios comparing the intervention (nurse practitioner‐family physician model;n = 45) to internal (n = 65), external (n = 70) and combined internal/external family physician‐only control groups, measured as the change in healthcare costs divided by the change in emergency department transfers/person‐month. We assessed joint uncertainty around costs and effects using non‐parametric bootstrapping and cost‐effectiveness acceptability curves.

Results

Point estimates of the incremental cost‐effectiveness ratio demonstrated the nurse practitioner‐family physician model dominated the internal and combined control groups (i.e. was associated with smaller increases in costs and emergency department transfers/person‐month). Compared with the external control, the intervention resulted in a smaller increase in costs and larger increase in emergency department transfers. Using a willingness‐to‐pay threshold of $1000CAD/emergency department transfer, the probability the intervention was cost‐effective compared with the internal, external and combined control groups was 26%, 21% and 25%.

Conclusion

Due to uncertainty around the distribution of costs and effects, we were unable to make a definitive conclusion regarding the cost‐effectiveness of the nurse practitioner‐family physician model; however, these results suggest benefits that could be confirmed in a larger study.
Accuracy of computed tomographic angiography in the diagnosis of patients with inferior vena cava partial obstruction in Budd–Chiari syndrome
Authors: Liu Shi‐Yi , Xiao Ping , Cao Hui‐Cun , Jiang Hao‐Sheng , Li Tian‐Xiao
Published: April 2016

Background and Aim

The diagnosis of the partially obstructed inferior vena cava (IVC) in Budd–Chiari syndrome (BCS) patients has received little attention. We aimed to evaluate the diagnostic accuracy of computed tomographic angiography (CTA) for patients with BCS and a partially obstructed IVC.

Methods

A total of 329 patients with BCS and an obstructed IVC were endovascularly treated with balloon dilation and/or stent placement. All patients underwent a CTA examination prior to endovascular treatment, and the data were retrospectively reviewed. The presence of a round, oval, irregular shape or jet sign low‐density area without enhancement within the enhanced proximal IVC was considered a sign of a partially obstructed IVC. Digital subtraction angiography was used as the gold standard.

Results

The results from the digital subtraction angiography revealed a partially obstructed IVC in 108 BCS patients and a complete obstruction in 221 patients. The CTA discovered a partially obstructed IVC in 99 patients and a completely obstructed IVC in 230 patients. From the CTA results, 15 were false negatives, and six were false positives. The patient‐based evaluation yielded an accuracy of 93.6%, a sensitivity of 86.1%, specificity of 97.3%, positive predictive value of 93.9%, and negative predictive value of 93.5% for the detection of BCS patients with a partial IVC obstruction.

Conclusions

Computed tomographic angiography offered a high diagnostic accuracy and sensitivity in BCS patients with a partially obstructed IVC. The low‐density area within the enhanced proximal IVC above the membrane in artery phase can be considered a reliable indicator of a stenotic IVC in BCS patients.
Cost‐effectiveness analysis of antiviral therapy in patients with advanced hepatitis B virus‐related hepatocellular carcinoma treated with sorafenib
Authors: Zhang Pengfei , Yang Yu , Wen Feng , Wheeler John , Fu Ping , Li Qiu
Published: April 2016

Background and Aim

Antiviral therapy has been demonstrated to significantly improve the survival in patients with advanced hepatitis B virus (HBV)‐related hepatocellular carcinoma (HCC). The aim of the study was to investigate the cost‐effectiveness of antiviral therapy in patients with advanced HBV‐related HCC treated with sorafenib.

Methods

To conduct the analysis, a Markov model comprising three health states (progression‐free survival, progressive disease, and death) was created. The efficacy data were derived from medical records. Cost data were collected based on the Chinese national drug prices. Utility data came from the previously published studies. One‐way sensitivity analyses as well as probabilistic sensitivity analyses were performed to explore model uncertainties.

Results

In the base‐case analysis, addition of antiviral therapy to sorafenib generated an effectiveness of 0.68 quality‐adjusted life years (QALYs) at a cost of $25 026.04, while sorafenib monotherapy gained an effectiveness of 0.42 QALYs at a cost of $20 249.64. The incremental cost‐effectiveness ratio (ICER) was $18 370.77/QALY for antiviral therapy group versus non‐antiviral therapy group. On the other hand, the ICER between the two groups in patients with high or low HBV‐DNA load, with or without cirrhosis, normal or elevated alanine aminotransferase/aspartate aminotransferase were $16 613.97/QALY, $19 774.16/QALY, $14 587.66/QALY, $19 873.84/QALY, $17 947.07/QALY, and $18 785.58/QALY, respectively.

Conclusions

Based on the cost‐effectiveness threshold ($20 301.00/QALY in China), addition of antiviral therapy to sorafenib is considered to be a cost‐effective option compared with sorafenib monotherapy in patients with advanced HBV‐related HCC in China from the patient's perspective.
Neuroendocrine Regulation of Metabolism
Authors: Cornejo M. P. , Hentges S. T. , Maliqueo M. , Coirini H. , Becu‐Villalobos D. , Elias C. F.
Published: April 2016

Given the current environment in most developed countries, it is a challenge to maintain a good balance between calories consumed and calories burned, although maintenance of metabolic balance is key to good health. Therefore, understanding how metabolic regulation is achieved and how the dysregulation of metabolism affects health is an area of intense research. Most studies focus on the hypothalamus, which is a brain area that acts as a key regulator of metabolism. Among the nuclei that comprise the hypothalamus, the arcuate nucleus is one of the major mediators in the regulation of food intake. The regulation of energy balance is also a key factor ensuring the maintenance of any species as a result of the dependence of reproduction on energy stores. Adequate levels of energy reserves are necessary for the proper functioning of the hypothalamic‐pituitary‐gonadal axis. This review discusses valuable data presented in the 2015 edition of the International Workshop of Neuroendocrinology concerning the fundamental nature of the hormonal regulation of the hypothalamus and the impact on energy balance and reproduction.
Low‐dose intensive insulin therapy in patients with Acute Coronary Syndrome accompanied by Left Ventricular Failure: audit of two UK hospitals
Authors: Manning Nicola , Albarran John W
Published: April 2016

Aims and Objectives

To determine whether a low‐dose intravenous insulin regimen reduces blood glucose levels at a timely rate and associated side effects among patients with Acute Coronary Syndrome and Left Ventricular Failure.

Background

Induced hypoglycaemia and the associated risks have questioned the benefits of intensive insulin therapy in patients presenting with raised blood glucose levels and Acute Coronary Syndromes. Local audit data identified that patients with Acute Coronary Syndrome and Left Ventricular Failure experienced more hypoglycaemic episodes than those with Acute Coronary Syndrome alone. Consequently, a new regimen of low‐dose insulin for this group was implemented and audited over 12 months.

Design

Audit.

Methods

Thirty‐six consecutive patient notes with a diagnosis of Acute Coronary Syndrome and blood glucose of ≥10 mmol/l treated with a new insulin therapy regimen were analysed. Data were extracted using a standardised form and entered into an Excel spreadsheet for analysis.

Results

The mean age of the sample was 70 years with 66% of subjects being men and 50% presenting with Acute Coronary Syndrome and Left Ventricular Failure. The low‐dose regimen was effective in achieving normoglycaemia, (range 4–8 mmol/l) for a consecutive six‐hour period. This was achieved in 72% of patients and within a median time of 13 hours.

Conclusion

The audit suggests that a low‐dose insulin regimen can effectively stabilise blood glucose in patients presenting with both Acute Coronary Syndrome and Left Ventricular Failure. The importance of regularly monitoring blood sugar levels is vital and highlights the role of nurses in minimising patient risk and promoting safety.

Relevance to practice

Nurses are instrumental in the safe implementation of intensive insulin guidelines. Close monitoring of patients is essential, enabling timely adjustments to treatments and ensuring patient safety. Regular audits allow nurses to evaluate care provision and continue to drive practice forward.