bluuebunny/crossref_metadata_2025 huggingface dataset:
Elektrochemotherapie bei fortgeschrittenen Hauttumoren und Hautmetastasen – eine retrospektive multizentrische Auswertung
Authors: Kreuter Alexander , van Eijk Tina , Lehmann Percy , Fischer Matthias , Horn Thomas , Assaf Chalid , Schley Gaston , Herbst Rudolf , Kellner Ivonne , Weisbrich Christiane , Hyun Julia , Wieland Ulrike , Schlaak Max , Rübben Albert , Lommel Kerstin
Published: March 2015

Hintergrund

Nach Ausschöpfung von klassischen Behandlungsverfahren wie Chemo‐ und Strahlentherapie existieren bei ausgedehnten Hauttumoren oder Hautmetastasen nur wenige Optionen einer lokalen Tumorkontrolle. In diesen Fällen kann die Elektrochemotherapie als Therapiealternative in Erwägung gezogen werden.

Patienten und Methodik

Im Rahmen einer retrospektiven Studie wurden klinische Charakteristika, Ansprechen und Bedingungen des Ansprechens sowie Nebenwirkungen von 56 Patienten untersucht, die an sechs deutschen Hautkliniken behandelt wurden.

Ergebnisse

Das mittlere Alter des Kollektivs (14 Männer, 42 Frauen) lag bei 69,3 Jahren. Insgesamt wurden 20 Patienten mit Hautmetastasen bei fortgeschrittenem malignen Melanom, 13 Patienten mit Hautmetastasen bei Mammakarzinom, 15 Patienten mit primären Plattenepithelkarzinomen der Haut oder kutan metastasierten Karzinomen unterschiedlicher Genese sowie 8 Patienten mit primär kutanen Lymphomen oder Sarkomen eingeschlossen. Die Therapie‐Ansprechrate lag im Kollektiv bei 44,6 % (10,7 % komplette Abheilung; 33,9 % partielles Ansprechen). Demgegenüber zeigte sich bei 31 (55,4 %) Patienten kein Ansprechen (12,5 % unveränderter klinischer Befund, 42,9 % Tumorprogredienz). Melanome und kutane Lymphome oder Sarkome sprachen signifikant besser an als Karzinome. In etwa einem Viertel der Patienten kam es zu einer Besserung von tumorbedingter Exsudation, Foetor oder chronischer Blutung.

Schlussfolgerungen

Die Elektrochemotherapie ist eine nebenwirkungsarme Therapieoption, die bei fortgeschrittenen, vortherapierten Tumorerkrankungen in etwa der Hälfte der Fälle erfolgreich war. Das Therapieansprechen scheint auch von der Tumorentität abzuhängen.
Therapie des Pyoderma gangraenosum in Deutschland: Resultate einer Befragung von Experten
Authors: Ghazal Philipp Al , Dissemond Joachim
Published: March 2015

Hintergrund

Für das Pyoderma gangraenosum (PG) fehlen bislang Therapieleitlinien.

Material und Methodik

Für die systematische Erfassung der aktuell praktizierten Therapieoptionen des PG wurde ein Fragebogen entwickelt und an Experten aus dem Fachbereich der Dermatologie in Deutschland verschickt.

Ergebnisse

Insgesamt haben wir 50 vollständig ausgefüllte Fragebögen zurückerhalten. Von den Experten wird die Diagnose PG durchschnittlich bei 15 Patienten/Jahr gestellt. Von diesen Patienten erhalten 11,1 % ausschließlich eine topische Therapie, 22,7 % ausschließlich eine systemische Therapie und 66,2 % sowohl eine topische als auch eine systemische immunmodulierende Therapie. Topisch werden am häufigsten Glukokortikoide der Klasse III von 78 % und Klasse IV von 88 % der Experten angewendet. Alle Experten (100 %) gaben an systemische Glukokortikoide in der Therapie der Patienten mit PG oft zu verwenden. Ciclosporin wird bei 74 %, TNF‐α‐Inhibitoren in 24 % und Azathioprin sowie Mycophenolatmofetil bei jeweils 20 % der Patienten angewendet. Systemische Therapeutika wie Dapson (16 %), intravenöse Immunglobuline (14 %), Methotrexat (6 %), Cyclophosphamid (4 %), Tacrolimus (4 %), Rituximab (2 %) werden hingegen deutlich seltener eingesetzt.

Schlussfolgerungen

Weltweit existiert bislang kein einheitlich akzeptierter Standard für die Therapie der Patienten mit PG. Die derzeit genutzten Behandlungsschemata, die auf der klinischen Erfahrung von Experten basieren, wurden nun in unserer Expertenbefragung erstmalig für Deutschland erfasst, ausgewertet und gewichtet dargestellt.
Neue dermatologische Systemtherapien bei Kinderwunsch, Schwangerschaft und Stillzeit
Authors: Grunewald Sonja , Jank Alexander
Published: March 2015

Mit Einführung zahlreicher neuer, überwiegend biologischer Systemtherapien in der Dermatologie stellt sich im klinischen Alltag regelmäßig die Frage, inwieweit eine Anwendung bei Kinderwunsch oder in Schwangerschaft und Stillzeit möglich ist und welche Risiken ggf. damit verbunden sind. Seriöse Informationen liefern neben Fachinformation und Roter Liste Datenbanken wie die des Pharmakovigilanz‐ und Beratungszentrums für Embryonaltoxikologie der Charité Berlin (https://www.embryotox.de) oder eine Literaturrecherche (z. B. über http://www.ncbi.nlm.nih.gov/pubmed).

Den aktuellen Wissensstand aus o. g. Quellen zum Einsatz bei Kinderwunsch oder in Schwangerschaft und Stillzeit fasst dieser Artikel für Biologika bei Psoriasis (Infliximab, Adalimumab, Etanercept, Ustekinumab), für die neuen Systemtherapien des metastasierten Melanoms (Vemurafenib, Dabrafenib, Imatinib, Ipilimumab), des inoperablen bzw. metastasierten Basalzellkarzinoms (Vismodegib) und kutaner Lymphome (Rituximab) sowie für weitere Präparate aus dem Bereich Allergologie (Omalizumab, Anakinra) zusammen.
Wnt‐Signalwege bei kutaner Homöostase und Pathologie
Authors: Augustin Iris
Published: March 2015

Die Säugerhaut stellt die primäre Grenzfläche zwischen Körper und externer Umwelt dar und ist zugleich die erste Abwehrlinie gegen Pathogene, mechanische Traumata, Schädigungen durch Sonnenlicht und chemische Belastungen. Um die Barrierefunktion aufrechtzuerhalten, ist ein einwandfreier physischer, biochemischer und immunologischer Zustand der Haut nötig. Die Haut ist also ein komplexes, dynamisches Organ mit hohem zellulärem Turnover während der normalen Gewebeerneuerung und Wundheilung. Stammzellreservoirs garantieren die konstante Erneuerung der Haut.

Der Wnt‐Signalweg kontrolliert den Stammzellenerhalt sowie Entscheidungen bezüglich des Zellschicksals in verschiedenen Geweben und spiegelt einen zentralen Pfad in der Kontrolle von Hautentwicklung und Homöostase wieder. Die Unterbrechung des Wnt‐Signalweges in der Haut verursacht Erkrankungen wie Alopezie, chronisch inflammatorische Hauterkrankungen oder Krebs. Dieser Bericht fasst Funktionen des Wnt‐Signalweges während der Hauterneuerung, Homöostase und bei Erkrankung zusammen.
Biosimilars: a systematic review of published and ongoing clinical trials of antipsoriatics in chronic inflammatory diseases
Authors: Nast Alexander , Rosumeck Stefanie , Seidenschnur Karin
Published: March 2015

Biosimilars for psoriasis treatment are currently being developed. Comparison of their efficacy and safety is a challenge. For approval, the European Medicines Agency (EMA) considers indirect evidence from other indications (for example, rheumatoid arthritis) as sufficient.

Systematic review of biosimilars for psoriasis and other indications, review of ongoing trials in trial registers.

Systematic search for randomized controlled trials (RCT) on biosimilars to adalimumab, etanercept, infliximab, and ustekinumab compared to their reference medication: (1) Publications in Medline, Medline In‐Process, Embase, Cochrane Library (efficacy, safety, immunogenicity) and (2) ongoing studies in clinical trial registers.

No trials on biosimilars in psoriasis patients were identified. As to the infliximab biosimilar, there is data on patients with ankylosing spondylitis and rheumatoid arthritis, indicating no clinically relevant differences regarding efficacy and safety. Currently, there are two registered studies of an adalimumab biosimilar and one study of an etanercept biosimilar in psoriasis patients. Further ongoing studies on biosimilars to adalimumab, etanercept, and infliximab – all in rheumatoid arthritis patients – were identified.

There is currently only limited data regarding RCTs with biosimilars. Provision of further clinical data and inclusion of patients in patient registers will be crucial.
Feeding–swallowing difficulties in children later diagnosed with language impairment
Authors: Malas Kathy , Trudeau Natacha , Chagnon Miguel , McFarland David H
Published: March 2015

Aim

The aim of this retrospective study was to assess the relationship between feeding–swallowing difficulties (FSDs) and later language impairments in children.

Method

Retrospective analyses were carried out using the clinical files of 82 children with language impairments from a large urban rehabilitation center. Two subgroups of these children were established: children with motor impairments, referred to as the language impairment with motor impairment (‘LI+MI’) subgroup (n=23, mean age 4y 6mo, SD 8.7mo), and children without motor impairments, referred to as the language impairment without motor impairment (‘LI–MI’) subgroup (n=59, mean age 5y, SD 8mo). The prevalence of food selectivity, difficulties in sucking, salivary control issues, and food transition difficulties was extracted. Data were compared with a general population estimate of FSDs.

Results

FSDs were documented in 62% of the clinical files; 87% of these files were from the LI+MI subgroup and 53% were from the LI–MI subgroup. Among each subgroup of children with language impairments, the prevalence of FSDs was significantly higher than the general population estimate of 20% (LI+MI:χ2=55.965, df=1, p<0.001; LI–MI: χ2 =32.807, df=1, p<0.001). Furthermore, the prevalence of FSDs was significantly higher in children with language impairments and motor impairments than in those with language impairments but without motor impairments (χ2=6.936, df=1, p<0.01). Both food transition difficulties (χ2=14.99, df=1, p<0.001) and salivary control issues (χ2=5.02, df=1, p=0.02) were more frequent in the LI+MI subgroup than in the LI–MI subgroup. Combinations of two or more FSDs were also more frequent in the LI+MI subgroup than in the LI–MI subgroup (χ2=4.19, df=1, p=0.04).

Interpretations

These findings suggest that early FSDs may be used as a potential marker for language impairment. However, larger prospective studies are needed to confirm this.
Shank1 regulates excitatory synaptic transmission in mouse hippocampal parvalbumin‐expressing inhibitory interneurons
Authors: Mao Wenjie , Watanabe Takuya , Cho Sukhee , Frost Jeffrey L. , Truong Tina , Zhao Xiaohu , Futai Kensuke
Published: March 2015

The Shank genes (SHANK1, 2, 3) encode scaffold proteins highly enriched in postsynaptic densities where they regulate synaptic structure in spiny neurons. Mutations in human Shank genes are linked to autism spectrum disorder and schizophrenia. Shank1 mutant mice exhibit intriguing cognitive phenotypes reminiscent of individuals with autism spectrum disorder. However, the molecular mechanisms leading to the human pathophysiological phenotypes and mouse behaviors have not been elucidated. In this study it is shown that Shank1 protein is highly localized in parvalbumin‐expressing (PV+) fast‐spiking inhibitory interneurons in the hippocampus. Importantly, a lack of Shank1 in hippocampal CA1 PV+ neurons reduced excitatory synaptic inputs and inhibitory synaptic outputs to pyramidal neurons. Furthermore, it is demonstrated that hippocampal CA1 pyramidal neurons in Shank1 mutant mice exhibit a shift in the excitatory and inhibitory balance (E–I balance), a pathophysiological hallmark of autism spectrum disorder. The mutant mice also exhibit lower expression of gephyrin (a scaffold component of inhibitory synapses), supporting the dysregulation of E–I balance in the hippocampus. These results suggest that Shank1 scaffold in PV+ interneurons regulates excitatory synaptic strength and participates in the maintenance of E–I balance in excitatory neurons.
Pathway analysis of genome‐wide association datasets of personality traits
Authors: Kim H.‐N. , Kim B.‐H. , Cho J. , Ryu S. , Shin H. , Sung J. , Shin C. , Cho N. H. , Sung Y. A. , Choi B.‐O. , Kim H.‐L.
Published: March 2015

Although several genome‐wide association (GWA) studies of human personality have been recently published, genetic variants that are highly associated with certain personality traits remain unknown, due to difficulty reproducing results. To further investigate these genetic variants, we assessed biological pathways using GWA datasets. Pathway analysis using GWA data was performed on 1089 Korean women whose personality traits were measured with the Revised NEO Personality Inventory for the 5‐factor model of personality. A total of 1042 pathways containing 8297 genes were included in our study. Of these, 14 pathways were highly enriched with association signals that were validated in 1490 independent samples. These pathways include association of: Neuroticism with axon guidance [L1 cell adhesion molecule (L1CAM) interactions]; Extraversion with neuronal system and voltage‐gated potassium channels; Agreeableness with L1CAM interaction, neurotransmitter receptor binding and downstream transmission in postsynaptic cells; and Conscientiousness with the interferon‐gamma and platelet‐derived growth factor receptor beta polypeptide pathways. Several genes that contribute to top‐ranked pathways in this study were previously identified in GWA studies or by pathway analysis in schizophrenia or other neuropsychiatric disorders. Here we report the first pathway analysis of all five personality traits. Importantly, our analysis identified novel pathways that contribute to understanding the etiology of personality traits.
Testing the applicability of regionalIUCNRed List criteria on ladybirds (Coleoptera, Coccinellidae) in Flanders (north Belgium): opportunities for conservation
Authors: Adriaens Tim , San Martin y Gomez Gilles , Bogaert Johan , Crevecoeur Luc , Beuckx Jean‐Pierre , Maes Dirk
Published: March 2015

Red Lists assess the extinction risk of species and are an important tool to prioritise species conservation and management measures. Worldwide, quantitative IUCN criteria are used to estimate the threat status of species at the regional level.

In Flanders (north Belgium), about 70 000 distribution records of ladybirds were collected in 36% of all the grid cells (1 × 1 km2) since 1990 during a large‐scale citizen‐science project.

Applying the IUCN criteria to the 36 resident ‘conspicuous’ ladybirds in Flanders resulted in twoRegionally Extinctspecies, threeEndangeredspecies and sixVulnerablespecies. A further seven species were consideredNear Threatenedand the remaining 15 species (39%) were assessed asLeast Concern. Three species were classified asData deficient. Using the Red List status, we delineated ladybird hotspots that were mainly located in grid cells with large areas of Natura2000 sites.

For calculating a distribution trend, we advocate the use of a high grid cell resolution (e.g. 1 × 1 km2or 5 × 5 km2).

The ladybird data set from Flanders provides evidence that IUCN Red List criteria can be applied to this charismatic, but relatively under‐surveyed insect group. For estimating the geographic range, the use of extent of occurrence instead of area of occupancy is advisable when the survey coverage is relatively low. We discuss the opportunities of the availability of a ladybird Red List for regional conservation measures.
Maternal use of flaxseed oil during pregnancy and lactation prevents morphological alterations in pancreas of female offspring from rat dams with experimental diabetes
Authors: Correia‐Santos André Manoel , Vicente Gabriela C. , Suzuki Akemi , Pereira Aline D. , dos Anjos Juliana S. , Lenzi‐Almeida Kátia C. , Boaventura Gilson T.
Published: March 2015

Nutritional recommendations have promoted the increased need to consume n‐3 polyunsaturated fatty acids. Flaxseed is the richest dietary source of n‐3 fatty acids among plant sources and is widely used for its edible oil. This study aimed to investigate whether maternal use of flaxseed oil has effects on pancreas morphology in the female offspring of diabetic mothers. Female Wistar rats (n = 12) were induced into diabetes by a high‐fat diet and low dose of streptozotocin. After confirmation of the diabetes, rats were mated, and once pregnancy was confirmed, they were allocated into three groups (n = 6): high‐fat group (HG); flaxseed oil group (FOG); and control group (CG) (non‐diabetic rats). At weaning, female offspring (n = 6/group) received standard chow diet. The animals were euthanized at 180 days. Pancreas was collected for histomorphometric and immunohistochemistry analysis. HG showed hypertrophy of pancreatic islets (P < 0.0001), whereas FOG offspring had islets with smaller diameters compared to HG (P < 0.0001). HG offspring showed higher percentage of larger (P = 0.0061) and lower percentage of smaller islets (P = 0.0036). HG showed lower islet insulin immunodensity at 180 days (P < 0.0001), whereas FOG was similar to CG (P < 0.0001). Flaxseed oil reduced the damage caused by maternal hyperglycaemia, promoting normal pancreas histomorphometry and β‐cell mass in female offspring.
Social Capital and Mental Health among Brazilian Immigrants in Japan
Authors: Takenoshita Hirohisa
Published: March 2015

Abstrac

This study investigates the effect of social capital on the psychological well‐being of Brazilian immigrants in Japan. Social capital in immigrants has drawn considerable attention from sociologists and other social scientists because many advanced countries have accepted a large number of immigrants from other countries. Previous studies of immigration in the US have emphasized the important role of bonding social capital with family and co‐ethnic friends in helping immigrants obtain social and emotional support from others. Conversely, other studies of immigration in European countries have suggested that bonding social capital with co‐ethnic members does not necessarily lead to better outcomes. These contrasting findings demonstrate that social capital is largely embedded in the institutional settings within which immigrants deploy it. In this study, we explored how the psychological well‐being of Brazilian immigrants in Japan depended on different forms of social capital. The results indicate that despite the lack of economic resources in their ethnic communities, Brazilian immigrants benefited significantly from bonding social capital with their extended families in terms of improved mental health. This study suggests that the effectiveness of bonding social capital substantially differs in terms of the objective and subjective realities of immigrants.
The effects of technostress and switching stress on discontinued use of social networking services: a study of Facebook use
Authors: Maier Christian , Laumer Sven , Weinert Christoph , Weitzel Tim
Published: March 2015

Although much research has been performed on the adoption and usage phases of the information systems life cycle, the final phase, termination, has received little attention. This paper focuses on the development of discontinuous usage intentions, i.e. the behavioural intention in the termination phase, in the context of social networking services (SNSs), where it plays an especially crucial role. We argue that users stressed by using SNSs try to avoid the stress and develop discontinuous usage intentions, which we identify as a behavioural response to SNS‐stress creators and SNS‐exhaustion. Furthermore, as discontinuing the use of an SNS also takes effort and has costs, we theorize that switching‐stress creators and switching‐exhaustion reduce discontinuous usage intentions. We tested and validated these effects empirically in an experimental setting monitoring individuals who stopped using Facebook for a certain period and switched to alternatives. Our results show that SNS‐stress creators and SNS‐exhaustion cause discontinuous usage intentions, and switching‐stress creators and switching‐exhaustion reduce these intentions.
FOXP3+ and CD39+ regulatory T cells in subtypes of cutaneous lupus erythematosus
Authors: Gambichler T. , Pätzholz J. , Schmitz L. , Lahner N. , Kreuter A.
Published: March 2015

Background

Lupus erythematosus (LE) is an autoimmune disease in which regulatory T cells play a pathogenetic role.

Objectives

We aimed to assess and compare the quantities of lesional Tregs in subtypes of cutaneous LE (CLE) including chronic discoid LE (CDLE), LE tumidus (LET) and subacute CLE (SCLE).

Methods

Thirty‐nine patients with CLE were enrolled in the study. Immunohistochemistry was performed for CD4, CD8, FOXP3 and CD39.

Results

We studied nine CDLE patients, 21 LET patients and nine patients with SCLE. SCLE lesions [37 (0–134)] showed a significantly (P = 0.024) decreased percentage of CD4+ cells when compared with CDLE [125 (0–146)] and LET [124 (0–240)] lesions. Moreover, the CD4/CD8 ratio in SCLE lesions [0.7 (0.5–1.8)] was significantly (P = 0.027) decreased when compared with CDLE [1.9 (1.5–2.8)] and LET [1.6 (0.8–2.9)] lesions. FOXP3 immunopositivity was significantly (P = 0.017) decreased in LET [0 (0–6)] and SCLE [1 (0–2)] lesions when compared with CDLE [6 (0–38)]. Moreover, in LET [2 (0–6)] and SCLE [2 (0–2)], we observed a significantly (P = 0.0049) diminished CD39‐immunoreactivity when compared with CDLE [4 (2–12)]. CD4+ cell count is a significant (P = 0.0133) negative predictor for the diagnosis of SCLE (Odds ratio 0.978, 95% CI 0.960–0.99).

Conclusions

Our data indicate that there are differences in quantities of lesional T helper cells, CD4/CD8 ratio and Tregs among subtypes of CLE. Interestingly, a more significant decrease in Tregs, which likely reflects greater loss of immune‐tolerance, is observed in the more photosensitive subtypes of CLE such as SCLE and LET.
Ovarian nests in cultured Russian sturgeon Acipenser gueldenstaedtii and North American paddlefish Polyodon spathula comprised of previtellogenic oocytes
Authors: Żelazowska M. , Jankowska W. , Plewniak E. , Rajek U.
Published: March 2015

Ovarian nests in the ovaries of sexually maturing Russian sturgeon Acipenser gueldenstaedtii and North American paddlefish Polyodon spathula were investigated. They comprised early previtellogenic, diplotene stage oocytes and somatic cells. In the nucleoplasm, these oocytes contained chromatin in the form of grains, threads and lampbrush chromosomes, primary nucleoli and multiple nucleoli. Two stages of oocytes in nests were distinguished by differences in the distribution of mitochondria with distorted cristae and lipid droplets in the ooplasm. These stages were as follows: pre‐early stage 1 (PE 1) and early stage 1 (EP 1) previtellogenic oocytes. In PE 1 oocytes few mitochondria with distorted cristae and lipid droplets were distributed randomly. The ooplasm of PE 1 oocytes was not differentiated into homogeneous and granular compartments. In EP 1 oocytes, mitochondria with distorted cristae were more numerous and grouped in the vicinity of the nucleus, lipid droplets accumulated near these mitochondria. In the nucleoplasm of EP 1 oocytes several low electron‐dense spherical bodies, possibly Cajal bodies, were present.
Longitudinal growth and health outcomes in nutritionally at‐risk children who received long‐term nutritional intervention
Authors: Huynh D. T. T. , Estorninos E. , Capeding R. Z. , Oliver J. S. , Low Y. L. , Rosales F. J.
Published: March 2015

Background

The benefits of short‐term oral nutritional supplementation (ONS) in undernourished children are well‐established. The benefits of long‐term ONS in promoting longitudinal growth and health in children who are at risk of undernutrition have not been reported previously.

Methods

In this 48‐week prospective, single‐arm, multicentre trial, 200 Filipino children aged 3–4 years with weight‐for‐height percentiles from 5th to 25th (WHO Child Growth Standards) were enrolled. Parents received dietary counselling at baseline, and at weeks 4 and 8. Two servings of ONS (450 mL) were consumed daily, providing 450 kcal, 13.5 g protein and micronutrients. Weight, height, dietary intake using 24‐h dietary recalls, and physical activity and appetite using the visual analogue scales were assessed at baseline and weeks 4, 8, 16, 24, 32, 40 and 48. The number of sick days for acute illnesses was collected over the study period.

Results

At baseline, mean age was 41.2 months with 50% being male. Weight‐for‐height percentiles showed the greatest increase in the first 4 weeks (12.1 and 12.8 percentiles, respectively, P < 0.0001) and remained significantly higher than baseline (P < 0.0001) but were relatively stable from week 4 onwards. Height‐for‐age percentiles increased steadily over time and became significantly higher than baseline from week 24 onwards (P < 0.0001). Appetite and physical activity scores at all post‐baseline visits improved from baseline (P < 0.0001), and a reduction in the number of sick days from week 16 onwards was also observed (P < 0.0001). Higher parental education level, being male and higher baseline weight‐for‐height percentiles were significantly associated with higher ponderal and linear growth over time in repeated measures analysis of covariance.

Conclusions

Intervention consisting of initial dietary counselling and continued ONS helped sustain normal growth after a catch‐up growth in nutritionally at‐risk children.
The cost‐effectiveness of identifying and treating malnutrition in hospitals: a systematic review
Authors: Mitchell H. , Porter J.
Published: March 2015

Background

Disease‐related malnutrition is known to have significant clinical and economic consequences. This systematic review of recent evidence aimed to establish the cost‐effectiveness of identifying and treating malnutrition in the hospital setting.

Methods

A search of four electronic databases and the Internet was conducted for relevant publications from 2003 to 2013. The search strategy considered both nutritional care and healthcare costs. Hospitalised adults with, or at risk of malnutrition, were the focus of the review. Eligibility criteria included publications of original research to identify or treat malnutrition through usual care. Studies with a focus on enteral and parenteral nutrition interventions were beyond the scope of the review. Methodological quality was assessed using the Consensus on Health Economic Criteria checklist.

Results

Of the 1174 records identified through database searching, 19 full‐text articles were assessed for eligibility. Three studies were included in the final review, highlighting the absence of recent high quality cost‐effectiveness studies in this field. One economic modelling study and two prospective clinical trials were included of moderate to high methodological quality.

Conclusions

Definite conclusions could not be drawn regarding the cost‐effectiveness of individual interventions because of the heterogeneity of treatments, controls and populations. The present review highlights an evidence gap in the care of malnourished hospitalised adults, limiting the ability of clinicians and healthcare managers to make informed, cost‐effective treatment decisions. Further economic evaluations are needed and should be considered as a routine component of future research.
Cryogenic‐temperature electron microscopy direct imaging of carbon nanotubes and graphene solutions in superacids
Authors: KLEINERMAN O. , PARRA‐VASQUEZ A. NICHOLAS G. , GREEN M.J. , BEHABTU N. , SCHMIDT J. , KESSELMAN E. , YOUNG C.C. , COHEN Y. , PASQUALI M. , TALMON Y.
Published: March 2015

Cryogenic electron microscopy (cryo‐EM) is a powerful tool for imaging liquid and semiliquid systems. While cryogenic transmission electron microscopy (cryo‐TEM) is a standard technique in many fields, cryogenic scanning electron microscopy (cryo‐SEM) is still not that widely used and is far less developed. The vast majority of systems under investigation by cryo‐EM involve either water or organic components. In this paper, we introduce the use of novel cryo‐TEM and cryo‐SEM specimen preparation and imaging methodologies, suitable for highly acidic and very reactive systems. Both preserve the native nanostructure in the system, while not harming the expensive equipment or the user. We present examples of direct imaging of single‐walled, multiwalled carbon nanotubes and graphene, dissolved in chlorosulfonic acid and oleum. Moreover, we demonstrate the ability of these new cryo‐TEM and cryo‐SEM methodologies to follow phase transitions in carbon nanotube (CNT)/superacid systems, starting from dilute solutions up to the concentrated nematic liquid‐crystalline CNT phases, used as the ‘dope’ for all‐carbon‐fibre spinning. Originally developed for direct imaging of CNTs and graphene dissolution and self‐assembly in superacids, these methodologies can be implemented for a variety of highly acidic systems, paving a way for a new field of nonaqueous cryogenic electron microscopy.
Facilitating Access to Prenatal Care Through an Interprofessional Student‐Run Free Clinic
Authors: Danhausen Kathleen , Joshi Deepa , Quirk Sarah , Miller Robert , Fowler Michael , Schorn Mavis N.
Published: March 2015

Introduction

Addressing the persistent challenge of inadequate prenatal care requires innovative solutions. Student‐run free health centers are poised to rise to this challenge. The Shade Tree Clinic Early Pregnancy Program, jointly operated by university medical and nursing programs, functions as an ongoing access‐to‐care portal for pregnant women without health insurance. The clinic is run by medical students and nurse‐midwifery students and uses a service‐based learning model that allows students to work and learn in supervised, interprofessional teams while providing evidence‐based prenatal care.

Methods

All data reported in this paper were obtained from a retrospective chart review of women served by the prenatal clinic. These data are descriptive in nature, and include the patient demographics and services provided by the clinic to 152 women between the years of 2010–2013.

Results

During this time period, the clinic served a demographically diverse clientele. Approximately half lacked documentation of legal immigration status. The majority of women seeking care were in their first trimester of pregnancy and had previously given birth. Several women had medical or obstetric complications that required timely referral to specialist care; and many women received treatment for infection and other primary care concerns.

Discussion

Shade Tree Clinic provides the basic components of prenatal care and assists women with other medical needs. Women also receive help when applying for and accessing public maternity insurance, and the clinic facilitates entry to any necessary specialist care while that insurance is processed. In many cases, necessary and time‐sensitive care would be delayed if Shade Tree Clinic's prenatal services were not available. In addition, the clinic presents a valuable opportunity for interprofessional socialization, increased respect, and improved collaboration between students in different but complementary professions, which is an important experience while we move to meet national goals for interprofessional care among health professionals. This article is part of a special series of articles that address midwifery innovations in clinical practice, education, interprofessional collaboration, health policy, and global health.
Tax‐Time Savings among Low‐Income Households in the $aveNYC Program
Authors: Key Clinton , Tucker Jenna N. , Grinstein‐Weiss Michal , Comer Krista
Published: March 2015

This article explores savings outcomes for participants in the $aveNYC tax‐time matched savings program compared with a group of New York City tax filers who were not offered the program. $aveNYC was administered at Volunteer Income Tax Assistance sites during the 2008–2010 tax seasons. The program offered taxpayers the opportunity to open a savings account with their tax refund and receive a 50% match on their initial deposit. The study's primary outcome is savings held by respondents 6–11 months after receipt of matching funds. We compare participants in the 2009 program cohort to a comparison group on the following outcomes: level of savings, having nonzero savings, and having enough savings to cover one or two months of expenses at current consumption levels. We find significant differences on savings levels, the presence of any savings, and the likelihood of having savings to meet one month's expenses.
Defining the key clinical indicators for ineffective breathing pattern in paediatric patients: a meta‐analysis of accuracy studies
Authors: de Sousa Vanessa Emille Carvalho , Lopes Marcos Venícios de Oliveira , da Silva Viviane Martins , Keenan Gail M
Published: March 2015

Aims and objectives

The purpose of this study was to identify the key clinical indicators of ineffective breathing pattern among paediatric patients.

Background

When nurses perform clinical reasoning, certain characteristics represent the clinical indicators necessary to confirm the presence of a particular diagnosis. Some quantitative studies have reported the prevalence of ineffective breathing pattern in different samples of patients. However, these findings should be synthesised.

Design

Meta‐analysis of quantitative nursing studies.

Methods

Studies were identified via systematic searches of CINAHL, LILACS, PubMed and Scopus using the key search terms ‘ineffective’, ‘breathing’ and ‘pattern’. Additional quality‐related inclusion criteria were gleaned from the Cochrane Collaboration for Systematic Reviews of Diagnostic Test Accuracy, the Standards for Reporting of Diagnostic Accuracy and the Quality Assessment of Diagnostic Accuracy Studies. The pertinent results from each study were extracted and analysed via meta‐analysis.

Results

Six studies using paediatric populations met the inclusion criteria. Summary measures indicated that the following defining characteristics had the highest accuracy values for ineffective breathing pattern among children: bradypnoea, dyspnoea, nasal flaring, orthopnoea, tachypnoea and the use of accessory muscles to breathe.

Conclusion

This meta‐analysis provides information regarding the accuracy of the clinical indicators of ineffective breathing pattern from studies sampling diverse paediatric populations.

Relevance to clinical practice

Nurses can better use clinical indicators to infer the presence of ineffective breathing pattern when they are aware of the most relevant defining characteristics. Nursing students and professionals can also improve their critical thinking abilities and diagnostic reasoning based on these findings.
Physical therapy management for balance deficits in children with hearing impairments: A systematic review
Authors: Fernandes Romita , Hariprasad Shalini , Kumar Vijaya K
Published: March 2015

Childhood hearing impairment is a significant problem, associated with long‐term academic, communicative and physical impairments. Studies have shown that children with hearing loss also present with balance and/or vestibular deficits along with complain of frequent falls. Various interventions have been studied to improvise postural control and balance in these children on different outcome measures. This review will provide the existing evidence on interventions to improve vestibular and/or balance functions. Three trials met our study criteria with PEDro score ≥6, and data were extracted, entered by two independent review authors. Though there was variability with regard to the focus and intensity of the intervention, subject characteristics and in outcome measures, vestibular rehabilitation has a positive influence on functional independence. Heterogeneity in the studies limits the comparisons of intervention programmes. We conclude that there was considerable evidence for a positive effect on balance outcomes among the hearing‐impaired population with vestibular deficits. Further investigations of high‐quality studies are needed to determine to compare interventions for improving vestibular deficits in hearing‐impaired children.
Malaria in Sydney, Australia: Lessons learned from case management
Authors: Thompson Kelly A , Marais Ben J , Kesson Alison , Isaacs David
Published: March 2015

Aim

To evaluate the clinical presentation and profile of malaria cases diagnosed at a tertiary children's hospital in Australia

Methods

A retrospective file review of children diagnosed with malaria at the Children's Hospital Westmead from 1 January 2000 to 31 December 2010.

Results

During the 11‐year study period, 40 children were diagnosed with malaria; 30 (75%) presented with fever; 14 (35%) complained of nausea, vomiting or abdominal pain; and eight (20%) were completely asymptomatic. The median time between arrival in Australia and malaria diagnosis was 32 (range 4–434) days. Sixteen (40%) were refugees from sub‐Saharan Africa, six (15%) were immigrants from South‐East Asia, and seven (18%) recently travelled to or visited friends and family in malaria‐endemic areas. Most (68%) cases had Plasmodium falciparum; Plasmodium vivax was identified in four cases with exposures in India and Papua New Guinea; one had mixed P. falciparum and P. vivax infection.

Conclusion

Malaria signs and symptoms were non‐specific, with an absence of fever in a quarter of cases. Diagnostic vigilance is required in all children with potential malaria exposure in the preceding year. Asymptomatic parasitaemia should be considered in recent migrants from malaria‐endemic areas.
Assembling the challenging puzzle of algal biodiversity: species delimitation within the genus Asterochloris (Trebouxiophyceae, Chlorophyta)
Authors: Škaloud Pavel , Steinová Jana , Řídká Tereza , Vančurová Lucie , Peksa Ondřej
Published: March 2015

The genus Asterochloris represents one of the most common, widespread, and diverse taxa of lichen photobionts. In this report, we describe and characterize six new species (A. echinata, A. friedlii, A. gaertneri, A. leprarii, A. lobophora, and A. woessiae) that were identified during our recent investigation of photobiont diversity. We found that the species differed genetically, morphologically, ecologically, and with respect to their mycobiont partners. Statistical analyses revealed significant morphological differentiation of all six newly described species, as well as their separation from previously described Asterochloris species. Chloroplast morphology represented the best morphological marker for species delineation. In fact, each species can be recognized by the dominance and unique assemblage of particular chloroplast types. Although genetically well recognized by rapidly evolving internal transcribed spacer rDNA and actin intron markers, all 13 investigated Asterochloris species shared identical small subunit rDNA sequences. We therefore demonstrated that morphologically and ecologically diverse species can frequently be grouped into a single taxonomic unit in whole‐transcriptome sequencing studies, considerably affecting the resulting estimates of species diversity. Finally, we demonstrated the presence of isogamous sexual reproduction in Asterochloris, disputing the current symbiotic dogma of the loss of sexual reproduction in algal symbionts.
Discovery of the mineral brucite (magnesium hydroxide) in the tropical calcifying alga Polystrata dura (Peyssonneliales, Rhodophyta)
Authors: Nash Merinda C. , Russell Bayden D. , Dixon Kyatt R. , Liu Minglu , Xu Huifang
Published: March 2015

Red algae of the family Peyssonneliaceae typically form thin crusts impregnated with aragonite. Here, we report the first discovery of brucite in a thick red algal crust (~1 cm) formed by the peyssonnelioid species Polystrata dura from Papua New Guinea. Cells of P. dura were found to be infilled by the magnesium‐rich mineral brucite [Mg(OH)2]; minor amounts of magnesite and calcite were also detected. We propose that cell infill may be associated with the development of thick (> ~5 mm) calcified red algal crusts, integral components of tropical biotic reefs. If brucite infill within the P. dura crust enhances resistance to dissolution similarly to crustose coralline algae that infill with dolomite, then these crusts would be more resilient to future ocean acidification than crusts without infill.
Landscape integration of North Patagonian mountain lakes: a first approach using characterization of dissolved organic matter
Authors: Garcia Patricia E. , Dieguez María C. , Queimaliños Claudia
Published: March 2015

North‐western Patagonia contains a variety of glacially formed mountain lakes located at different positions from the treeline in the Andean Patagonian forest region. Water chemistry of six North Patagonian lakes located in an altitudinal gradient, above, at and below the treeline (~41°S) were analysed in this study. The relative importance of allochtonous to autochthonous carbon inputs along a marked catchment vegetation gradient encompassing altoandino vegetation and Nothofagus forests was addressed. The dissolved organic carbon (DOC) concentration varied among the study lakes, with the lakes located higher in the landscape exhibiting lower DOC concentrations (<1 mg L−1) than lakes located at or below the treeline (>2 mg L−1). Analysis of coloured and fluorescent dissolved organic matter (CDOM and FDOM, respectively) followed the DOC pattern, despite the contrasting catchments of the study lakes. The results indicated the CDOM in all the lakes had low molecular weight and low aromaticity. The excitation–emission matrices (EEMs) highlighted three distinctive fluorophores in the FDOM, including two humic‐like (peak A and peak C) revealing the presence of humic terrestrial material, and a protein‐like fluorophore (peak T) generally associated with autochthonous DOM. The increased intensities of the humic fluorophores in the lakes located below the treeline suggest higher allochtonous carbon inputs from their catchments. This evidence collectively suggests that mountain lakes exhibit some heterogeneity in terms of DOM, likely attributable to their position in relation to the treeline, which determines the contribution of the catchment. As remote lakes are extremely sensitive to changes in their catchments, these North Patagonian mountain lakes may accurately track the impact of climate and anthropogenic changes on the landscape.
The impact of Quaternary climate oscillations on divergence times and historical population sizes in Thylamys opossums from the Andes
Authors: Giarla Thomas C. , Jansa Sharon A.
Published: March 2015

Climate oscillations during the Quaternary altered the distributions of terrestrial animals at a global scale. In mountainous regions, temperature fluctuations may have led to shifts in range size and population size as species tracked their shifting habitats upslope or downslope. This creates the potential for both allopatric speciation and population size fluctuations, as species are either constrained to smaller patches of habitat at higher elevations or able to expand into broader areas at higher latitudes. We considered the impact of climate oscillations on three pairs of marsupial species from the Andes (Thylamys opossums) by inferring divergence times and demographic changes. We compare four different divergence dating approaches, using anywhere from one to 26 loci. Each pair comprises a northern (tropical) lineage and a southern (subtropical to temperate) lineage. We predicted that divergences would have occurred during the last interglacial (LIG) period approximately 125 000 years ago and that population sizes for northern and southern lineages would either contract or expand, respectively. Our results suggest that all three north–south pairs diverged in the late Pleistocene during or slightly after the LIG. The three northern lineages showed no signs of population expansion, whereas two southern lineages exhibited dramatic, recent expansions. We attribute the difference in responses between tropical and subtropical lineages to the availability of ‘montane‐like’ habitats at lower elevations in regions at higher latitudes. We conclude that climate oscillations of the late Quaternary had a powerful impact on the evolutionary history of some of these species, both promoting speciation and leading to significant population size shifts.
The F‐box protein Fbp1 functions in the invasive growth and cell wall integrity mitogen‐activated protein kinase (MAPK) pathways in Fusarium oxysporum
Authors: Miguel‐Rojas Cristina , Hera Concepcion
Published: March 2015

F‐box proteins determine substrate specificity of the ubiquitin–proteasome system. Previous work has demonstrated that the F‐box protein Fbp1, a component of the SCFFbp1 E3 ligase complex, is essential for invasive growth and virulence of the fungal plant pathogen Fusarium oxysporum. Here, we show that, in addition to invasive growth, Fbp1 also contributes to vegetative hyphal fusion and fungal adhesion to tomato roots. All of these functions have been shown previously to require the mitogen‐activated protein kinase (MAPK) Fmk1. We found that Fbp1 is required for full phosphorylation of Fmk1, indicating that Fbp1 regulates virulence and invasive growth via the Fmk1 pathway. Moreover, the Δfbp1 mutant is hypersensitive to sodium dodecylsulfate (SDS) and calcofluor white (CFW) and shows reduced phosphorylation levels of the cell wall integrity MAPK Mpk1 after SDS treatment. Collectively, these results suggest that Fbp1 contributes to both the invasive growth and cell wall integrity MAPK pathways of F. oxysporum.
Working in the New Low‐Wage Economy: Understanding Participation in Low‐Wage Employment in the Recessionary Era
Authors: Visser M. Anne , Meléndez Edwin
Published: March 2015

This paper examines the factors that influence the likelihood of engaging in low‐wage work during the recessionary and post‐recessionary era. Using micro data from the 5‐year 2008–2012 American Community Survey Estimates, we examine human capital, structural, and labor market characteristics that induce workers' participation into low‐wage jobs and labor markets, as well as how these vary between and within various ethnic/racial, age, and gender groups, including Hispanic/Latino ethnic groups. We find that the factors influencing engagement in low‐wage employment largely mirror those identified in pre‐recessionary studies and analyses but that there is a differential effect across ethnicity, race, gender, and age that may lead to and lock specific groups of workers into low‐wage employment. Using a post‐estimation technique to generate predicted probabilities, we discuss how these factors influence a worker's likelihood to engage in low‐wage employment across and within ethnic and racial populations, and the implications these present for contemporary scholarship, policy, and praxis.
Rebuilding the House of Labor: Unions and Worker Centers in the Residential Construction Industry
Authors: Theodore Nik
Published: March 2015

This article explores strategies for organizing workers in residential construction in light of the decades long restructuring of the industry. It begins by charting the course of this restructuring and the impacts it has had on employment conditions, including changes in union density, the deterioration of labor standards, and the rise of various labor market intermediaries that assist employers in managing contingent labor. The article then turns to day labor and the controversial topic of whether worker centers should operate hiring halls. It argues that, unlike temporary staffing agencies and other labor brokers, the operation of day labor worker centers is complementary to union organizing strategies. These hiring halls help monitor employer practices while also raising the floor on wages and working conditions. It concludes with a call for ongoing innovation in worker organizing.