bluuebunny/crossref_metadata_2025 huggingface dataset:
Teaching & Learning Tips 9: Case‐based teaching with patients
Authors: Aluko Ashley , Rana Jasmine , Burgin Susan
Published: June 2018

Challenge: “Case‐based teaching” is a buzzword for engaging clinical teaching through cases, but how can it be implemented effectively in practice? We review popular case‐based teaching methods (i.e., one‐minute preceptor, SNAPPS, and the “Aunt Minnie method”) for use during traditional one‐on‐one clinical preceptorships in the ambulatory dermatological setting.
Student Migration: Evidence from Chinese Students in the US and China
Authors: Li Wei , Zhao Shengnan , Lu Zheng , Yu Wan , Li Xiaojie
Published: June 2018

This article is based on the analysis of a pair of cross‐national parallel surveys on Chinese students, respectively inside the People's Republic of China and in the US. Specifically, it makes comparisons between two cross‐sectional groups: 1) Chinese students in a PRC university who intend to study abroad (with a subset that stated that the United States is their top destination), versus 2) Chinese students already at a US university. Building on a “motility” concept while using an “Intellectual Migration” conceptual framework and chi‐square and logistic regression analyses, it demonstrates that Chinese students' possibly returning to the PRC are significantly influenced by their gender, college GPA, family finance, assessment of China's current and future development. The results on outmigration or return migration intentions are presented, and it concludes with some policy implications and future research directions.
The non‐professionally affiliated (NPA) worker as co‐producer of public services: how is the role experienced in UK mental health services?
Authors: Procter Stephen , Harrison Deborah , Pearson Pauline , Dickinson Claire
Published: June 2018

Recent workforce reforms have led to the widespread expansion of non‐professionally affiliated (NPA) support and assistant roles within UK public services. Research into these roles has been confined to a limited range of settings, with a focus on the consequence of change for professional workers. This article explores the emergence of ‘co‐production’, whereby NPA workers contribute alongside the professional in a distinct, complementary way. Findings are drawn from semi‐structured interviews with frontline workers and managers within the context of mental health workforce reform. The results build a picture of NPA working life characterised in part by autonomy and responsibility. At the same time, NPA workers rely on colleagues for support and are subject to being used indirectly by professionals. Contextual influences are considered. The conceptual implications of the analysis are brought out, both for the NPA role itself and for the broader issues involved in front line service work.
Chronic Pain and Attention in Older Community‐Dwelling Adults
Authors: van der Leeuw Guusje , Leveille Suzanne G. , Dong Zhiyong , Shi Ling , Habtemariam Daniel , Milberg William , Hausdorff Jeffrey M. , Grande Laura , Gagnon Peggy , McLean Robert R. , Bean Jonathan F.
Published: June 2018

OBJECTIVES

To examine the cross‐sectional relationship between chronic pain and complex attention in a population of community‐living older adults.

DESIGN

Prospective cross‐sectional cohort study.

SETTING

Population‐based Maintenance of Balance, Independent Living, Intellect, and Zest in the Elderly of Boston Study II.

PARTICIPANTS

Individuals aged 71 to 101 (N=354).

MEASUREMENTS

Chronic pain was measured using the pain severity and interference subscales of the Brief Pain Inventory. Four subscales of the Test of Everyday Attention were used to measure domains of attention switching and selective, sustained, and divided attention.

RESULTS

Before and after multivariable adjustment, pain severity was associated with poorer scores on measures of selective and sustained attention. Pain interference scores also were significantly inversely associated with selective attention.

CONCLUSION

Chronic pain is associated with poorer performance in selective and sustained attention in community‐dwelling older adults. Further research is needed to determine whether effective pain management could lead to better attentional performance in older adults. Older adults who live with chronic pain, often undertreated, are potentially at risk of cognitive difficulties and related functional consequences.
Fixed‐Rate Mortgages, Labor Markets, and Efficiency
Authors: LEE KANGOH
Published: June 2018

The paper studies the effects of mortgage choices between fixed‐rate mortgages (FRMs) and adjustable‐rate mortgages (ARMs) on labor market efficiency. FRMs provide insurance for risk‐averse borrowers in the sense that they pay the same rate over time and are not subject to uncertain spot market rates. FRMs, however, discourage borrowers from moving to other regions despite better employment opportunities, as they terminate the FRM contracts in order to move and their new loan interests may be higher. As FRM‐borrowers do not move to other regions due to the interest lock‐ins, entrepreneurs in other regions lose the potential surpluses from productive matches that would have occurred between borrowers‐workers and entrepreneurs. Borrowers ignore this negative externality they impose on the entrepreneurs when choosing their mortgages, and too many borrowers choose FRMs relative to the efficient level. If FRMs are eliminated and ARM‐insurance (that protects ARM‐borrowers against uncertain adjustable interest rates) is created, it will improve efficiency. The paper also assesses quantitatively the welfare effects of eliminating FRMs and providing ARM‐insurance.
Intracellular sorting and transcytosis of the rat transferrin receptor antibody OX26 across the blood–brain barrier in vitro is dependent on its binding affinity
Authors: Haqqani Arsalan S. , Thom George , Burrell Matthew , Delaney Christie E. , Brunette Eric , Baumann Ewa , Sodja Caroline , Jezierski Anna , Webster Carl , Stanimirovic Danica B.
Published: June 2018

The blood–brain barrier (BBB) is a formidable obstacle to the delivery of therapeutics to the brain. Antibodies that bind transferrin receptor (TfR), which is enriched in brain endothelial cells, have been shown to cross the BBB and are being developed as fusion proteins to deliver therapeutic cargos to brain targets. Various antibodies have been developed for this purpose and their in vivo evaluation demonstrated that either low affinity or monovalent receptor binding re‐directs their transcellular trafficking away from lysosomal degradation and toward improved exocytosis on the abluminal side of the BBB. However, these studies have been performed with antibodies that recognize different TfR epitopes and have different binding characteristics, preventing inter‐study comparisons. In this study, the efficiency of transcytosis in vitro and intracellular trafficking in endosomal compartments were evaluated in an in vitro BBB model for affinity variants (Kd from 5 to174 nM) of the rat TfR‐binding antibody, OX26. Distribution in subcellular fractions of the rat brain endothelial cells was determined using both targeted quantitative proteomics‐selected reaction monitoring and fluorescent imaging with markers of early‐ and late endosomes. The OX26 variants with affinities of 76 and 108 nM showed improved trancytosis (Papp values) across the in vitro BBB model compared with a 5 nM OX26. Although ~40% of the 5 nM OX26 and ~35% of TfR co‐localized with late‐endosome/lysosome compartment, 76 and 108 nM affinity variants showed lower amounts in lysosomes and a predominant co‐localization with early endosome markers. The study links bivalent TfR antibody affinity to mechanisms of sorting and trafficking away from late endosomes and lysosomes, resulting in improvement in their transcytosis efficiency.

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Cover Image for this issue: doi: 10.1111/jnc.14193.
From pregnancy to cardiovascular disease: Lessons from relaxin‐deficient animals to understand relaxin actions in the vascular system
Authors: Jelinic Maria , Marshall Sarah A. , Leo Chen H. , Parry Laura J. , Tare Marianne
Published: June 2018

Early maternal vascular adaptations to pregnancy are predominantly driven by changes in vascular tone, reactivity, and remodeling. Failure of the maternal systemic vasculature to adapt sufficiently can lead to serious complications of pregnancy. The hormone relaxin is widely recognized for its contribution to the essential renal and systemic hemodynamic adaptations in early pregnancy through direct actions on the maternal vasculature. Studies in relaxin gene knockout mice revealed that endogenous relaxin is not only a “pregnancy hormone” but has pleiotropic actions in various tissues in males and non‐pregnant females. There is strong interest in relaxin's actions in the vasculature and its utility in the treatment of vascular diseases. Relaxin treatment in rodents for 2‐5 days or acute intravenous injection enhances endothelium‐dependent relaxation and decreases myogenic tone in resistance arteries. These vascular actions are prolonged, even in the absence of circulating relaxin, and are underpinned by the production of endothelium‐derived relaxing factors including nitric oxide, endothelium‐derived hyperpolarization, and prostacyclin. Relaxin is also capable of remodeling the vascular wall in a variety of blood vessels in disease conditions. Lessons learned in pregnancy research have aided studies investigating the potential therapeutic potential of relaxin in cardiovascular disease.
LOL2 and LOL5 loci control latex production by laticifer cells in Euphorbia lathyris
Authors: Castelblanque Lourdes , Balaguer Begoña , Marti Cristina , Orozco Marianela , Vera Pablo
Published: June 2018

Laticifers are specialized plant cells capable of indefinite elongation that ramify extensively and are responsible for latex biosynthesis and accumulation. However, the mechanisms underlying laticifer cell differentiation, growth and production of latex remain largely unknown.

In a search for mutants showing enhanced accumulation of latex we identified two LOT OF LATEX (LOL) loci in Euphorbia lathyris. lol2 and lol5 mutants show enhanced production of latex contained within laticifer cells. The recessive lol2 mutant carries increased biosynthesis of the plant hormone jasmonoyl‐isoleucine (JA‐Ile) and therefore establishes a genetic link between jasmonic acid (JA) signaling and latex production in laticifers. Instead, heightened production of latex in lol5 plants obeys to enhanced proliferation of laticifer cells.

Phylogenetic analysis of laticifer‐expressed genes in E. lathyris and in two other latex‐bearing species, Euphorbia corallioides and Euphorbia palustris, allowed the identification of canonical JA responsive elements present in the gene promoter regions of laticifer marker genes. Moreover, we identified that the hormone JA functions not as a morphogen for laticifer differentiation but as a trigger for the fill out of laticifers with latex and the associated triterpenoids.

The identification of LOL loci represents a further step towards the understanding of mechanisms controlling latex production in laticifer cells.
Chronic oral infection: An emerging risk factor of cerebral small vessel disease
Authors: Aarabi Ghazal , Thomalla Götz , Heydecke Guido , Seedorf Udo
Published: June 2018

Chronic oral infections (gingivitis/periodontitis) have been associated with age‐related diseases such as diabetes, coronary heart disease, and acute ischemic stroke. In addition, imaging surrogates of cerebrovascular ischemia beyond acute ischemic stroke (i.e., silent strokes and brain white matter hyperintensities) may also be associated with chronic oral infections. The pathology underlying lacunar strokes and brain white matter hyperintensities (WMH) relates to small vessel disease in the brain. In this review, we highlight recent progress in exploring potential associations of oral infections with cerebral small vessel disease and its surrogates (silent strokes, white matter hyperintensities) and clinical sequelae (i.e., vascular dementia). Recent evidence suggests that periodontitis aggravates cerebral small vessel disease and increases lacunar stroke risk. Moreover, periodontitis interacts with Alzheimer's disease to increase the severity of clinical dementia and to accelerate its manifestations. The results suggest that periodontitis may be an emerging risk factor of small vessel disease‐associated cerebrovascular disorders and that the risk increase may be mediated by the systemic inflammation resulting from chronic oral infections. Large cohort studies employing state‐of‐the‐art magnetic resonance techniques to identify specific cerebral pathologies as a function of time, oral health status, and systemic inflammation are needed to further substantiate the hypothesis.
Drought‐induced changes in root biomass largely result from altered root morphological traits: Evidence from a synthesis of global field trials
Authors: Zhou Guiyao , Zhou Xuhui , Nie Yuanyuan , Bai Shahla Hosseini , Zhou Lingyan , Shao Junjiong , Cheng Weisong , Wang Jiawei , Hu Fengqin , Fu Yuling
Published: June 2018

Extreme drought is likely to become more frequent and intense as a result of global climate change, which may significantly impact plant root traits and responses (i.e., morphology, production, turnover, and biomass). However, a comprehensive understanding of how drought affects root traits and responses remains elusive. Here, we synthesized data from 128 published studies under field conditions to examine the responses of 17 variables associated with root traits to drought. Our results showed that drought significantly decreased root length and root length density by 38.29% and 11.12%, respectively, but increased root diameter by 3.49%. However, drought significantly increased root:shoot mass ratio and root cortical aerenchyma by 13.54% and 90.7%, respectively. Our results suggest that drought significantly modified root morphological traits and increased root mortality, and the drought‐induced decrease in root biomass was less than shoot biomass, causing higher root:shoot mass ratio. The cascading effects of drought on root traits and responses may need to be incorporated into terrestrial biosphere models to improve prediction of the climate–biosphere feedback.
Combined liver and pancreas transplantation in two children with cystic fibrosis—First experience in Australia and New Zealand
Authors: Shankar Sahana , Bolia Rishi , Hodgson Alexandra , Bishop Jonathan R. , Evans Helen M. , Oliver Mark R.
Published: June 2018

We report the first two pediatric patients with CF who underwent successful combined liver‐pancreas transplantation in Australia and New Zealand for CF liver disease and CF‐related diabetes mellitus.
Body Anatomical UV Protection Predicted by Shade Structures: A Modeling Study
Authors: Religi Arianna , Backes Claudine , Moccozet Laurent , Vuilleumier Laurent , Vernez David , Bulliard Jean‐Luc
Published: June 2018

Shade is an important means of protection against harmful effects of sun ultraviolet (UV) exposure, but not all shades are identically protective. UV rays scattered by the atmosphere and surroundings can reach the skin indirectly. To evaluate the relative contribution of the direct, diffuse, and reflected radiation in UV protection provided by different sizes of shade structure, we used SimUVEx v2, a numeric tool based on 3D graphic techniques and ambient ground UV irradiance. The relative UV exposure reduction was expressed by the predictive protection factor (PPF). Shade structures were found to predominantly reduce exposure from direct radiation (from 97.1% to 99.9% for the upper body areas such as the head and the neck), with greater protection from larger shade structures and structures closer above the subject. Legs were the least protected anatomical zone from any shade structure above the subject with PPF ranging from 18.5% to 68.1%. Throughout the day, except for lower solar zenith angles (SZA), small and high shade structures provide the lowest protection (between 20% and 50%), while small and low shade structure show PPF between 35% and 65% and large and high shade structures reach PPF higher than 60%.
The sedimentology of river confluences
Authors: Sambrook Smith Gregory H. , Nicholas Andrew P. , Best James L. , Bull Jonathan M. , Dixon Simon J. , Goodbred Steven , Sarker Maminul H. , Vardy Mark E.
Published: June 2018

Channel confluences are key nodes within large river networks, and yet surprisingly little is known about their spatial and temporal evolution. Moreover, because confluences are associated with vertical scour that typically extends to several times the mean channel depth, the deposits associated with such scours should have a high preservation potential within the rock record. Paradoxically, such scours are rarely observed, and their preservation and sedimentological interpretation are poorly understood. The present study details results from a physically‐based morphodynamic model that is applied to simulate the evolution and alluvial architecture of large river junctions. Boundary conditions within the model were defined to approximate the junction of the Ganges and Jamuna rivers, Bangladesh, with the model output being supplemented by geophysical datasets collected at this junction. The numerical simulations reveal several distinct styles of sedimentary fill that are related to the morphodynamic behaviour of bars, confluence scour downstream of braid bars, bend scour and major junction scour. Comparison with existing, largely qualitative, conceptual models reveals that none of these can be applied simply, although elements of each are evident in the deposits generated by the numerical simulation and observed in the geophysical data. The characteristics of the simulated scour deposits are found to vary according to the degree of reworking caused by channel migration, a factor not considered adequately in current conceptual models of confluence sedimentology. The alluvial architecture of major junction scours is thus characterized by the prevalence of erosion surfaces in conjunction with the thickest depositional sets. Confluence scour downstream of braid bar and bend scour sites may preserve some large individual sets, but these locations are typically characterized by lower average set thickness compared to major junction scour and by a lack of large‐scale erosional surfaces. Areas of deposition not related to any of the specific scour types highlighted above record the thinnest depositional sets. This variety in the alluvial architecture of scours may go some way towards explaining the paradox of ancient junction scours, that while abundant large scours are likely in the rock record, they have been reported rarely. The present results outline the likely range of confluence sedimentology and will serve as a new tool for recognizing and interpreting these deposits in the ancient fluvial record.
How One-Factor-at-a-Time Experimentation Can Lead to Greater Improvements Than Orthogonal Arrays
Authors: Frey Daniel D. , Jugulum Rajesh
Published: June 2018

This paper attempts to explain the empirically demonstrated phenomena that, under some conditions, one-at-a-time experiments outperform orthogonal arrays (on average) in parameter design of engineering systems. Five case studies are presented, each based on data from previously published full factorial experiments on actual engineering systems. Computer simulations of adaptive one-at-a-time plans and orthogonal arrays were carried out with varying degrees of pseudo-random error added to the data. The average outcomes are plotted for both approaches to optimization. For each of the five case studies, the main effects and interactions of the experimental factors are presented and analyzed to explain the observed simulation results. It is shown that, for some types of engineering systems, “one-at-a-time” designs consistently exploit interactions despite the fact that these designs lack the resolution to estimate interactions. It is also confirmed that orthogonal arrays are adversely affected by confounding of main effects and interactions.
A common misunderstanding in lung ultrasound: the comet tail artefact
Authors: Yue Lee Francis Chun , Jenssen Christian , Dietrich Christoph F
Published: June 2018

The comet tail artefact is probably one of the most commonly and imprecisely used to describe vertical artefacts found in lung ultrasound. Two distinct artefacts are commonly observed: the lung comets and the B-lines. Both artefacts differ with regard to generation mechanism and clinical significance. This review explores the current understanding and use of these two artefacts in lung ultrasound and suggests how to avoid the pitfalls related to confusing comet tail artefacts with other vertical artefacts.
Introduction: Digital Communities
Authors: Thompson Kirsten Moana , Cameron Allan , Kavka Misha
Published: June 2018

Introduction to the Digital Communities special issue
Special Issue: Agenda 2020 Imagining the Future of New Zealand Media
Authors: Mollgaard Matt
Published: June 2018

This edition of MEDIANZ was generated from papers, presentations and discussions at the Agenda 2020: NZ Media Futures Symposium at AUT in April 2017. The Symposium was designed as a forum to encourage debate about the media and its audiences in Aotearoa/New Zealand. This was thematically connected to the electoral cycle and engineered to look beyond it. The 2017 General Election has allowed media academics, workers, owners and audiences an opportunity to re-engage with media policy in New Zealand – an area that has slipped from political debate in recent years. This is critical work, as the way New Zealanders understand the issues that shape our society are heavily influenced by the media that they engage with. In the lead-up to the 2017 general election, we have had an opportunity to scrutinise political parties’ media policies and to see into the future of our critical media infrastructure in a time of change, disruption and challenge. The name Agenda 2020 was adopted to reflect both media power in framing information and the intention of the project – to meet, debate, and develop solutions to the media issues facing Aotearoa/New Zealand.
Pie in the Sky? The Political Economy of the Failed Vodafone-Sky Merger
Authors: Thompson Peter
Published: June 2018

In June 2016 Sky Network Television Limited, New Zealand’s predominant satellite pay-TV operator, and Vodafone Europe BV applied to the New Zealand Commerce Commission1 for clearance to enter into a $3.44 billion merger. The proposal was for Sky TV to acquire 100% of the shares in Vodafone New Zealand Limited while the latter’s European parent company would acquire a controlling 51% stake in the post-acquisition Sky Network Television Limited. The primary motive was the opportunity to develop new triple or quadruple-play bundles of landline, mobile, internet and audiovisual content in response to the emergence of new subscriber video-on-demand services. The ‘Skodafone’ application was opposed by rival commercial interests in the telecommunications and television sectors who argued that the merged entity would have the ability and incentive to develop bundles of services including Sky’s premium sports content (notably New Zealand rugby) against which rivals would be unable to compete. Sky and Vodafone argued that premium sports was not ‘must-have’ content for market entry into subscriber video-on-demand (SVOD) services, pointing to Spark’s development of Lightbox in 2014 and the launch of Netflix in 2015. After numerous cross-submissions from various stakeholders, in April 2017 the Commerce Commission’s final determination declined the application. Although Vodafone and Sky lodged a legal appeal against the ruling, they subsequently decided not to pursue the case.Arising in the same timeframe as the (also declined) NZME-Fairfax merger application, the Vodafone-Sky case is symptomatic of several intersecting structural conditions in the New Zealand media ecology: deregulation, financialisation and convergence. On one level, the drive for consolidation and vertical integration can be regarded as a direct response to these pressures. However, there are also institutional-level contingencies which shape how structural pressures are articulated into decision-making as well as contested normative and epistemic assumptions about the definition of media markets, the nature of the public interest and the implications of the merger for competition. Drawing on document analysis of the merger submissions, this article analyses the significance of the Vodafone-Sky case through a critical institutionalist perspective and examines the key factors shaping the outcome. It concludes that while the Commission’s decision was correct, it would be premature to conclude that existing competition law is sufficiently robust to prevent public interest considerations being subordinated to those of financial investors. Rather, the Commission’s decision serves to underline the extent to which the commercial imperatives of the corporate media have sought to secure the political-economic conditions for accumulation by exploiting New Zealand’s historically feeble regulatory framework.
Highly efficient fluorescence quenching with chemically exfoliated reduced graphene oxide
Authors: Srivastava Shubhda , Senguttuvan Thanikachalam Devarajan , Gupta Bipin Kumar
Published: June 2018

Fluorescence quenching is a valuable tool to study many macromolecular assemblies. It is well-known that graphitic systems such as the reduced graphene oxide (rGO) can strongly quench the emission of dye molecules through energy transfer. In this work, the authors demonstrate comparative study of fluorescence quenching between different graphitic system such as rGO, graphene oxide (GO), and graphite, which is not reported so far. As compared to graphite and GO sheets, rGO shows more quenching capability because of more surface area and efficient π-π stacking. The fluorescence quenching has been performed using Rhodamine B dye. The scanning electron microscopic micrographs revealed that Rhodamine B dye is uniformly absorbed on rGO. The fluorescence quenching has been done with the fixed concentration of Rhodamine organic dye with all three forms of carbon. The spectroscopic results exhibit that the chemically exfoliated rGO was almost 16 times better than graphite and GO. The obtained results suggest that rGO can be used for better quenching capability in biosensing applications.
China takes new steps to lure science talent from abroad
Authors: Normile Dennis
Published: June 2018

Generous funding and the chance to lead projects are helping attract foreign scientists.
A selfish genetic element confers non-Mendelian inheritance in rice
Authors: Yu Xiaowen , Zhao Zhigang , Zheng Xiaoming , Zhou Jiawu , Kong Weiyi , Wang Peiran , Bai Wenting , Zheng Hai , Zhang Huan , Li Jing , Liu Jiafan , Wang Qiming , Zhang Long , Liu Kai , Yu Yang , Guo Xiuping , Wang Jiulin , Lin Qibing , Wu Fuqing , Ren Yulong , Zhu Shanshan , Zhang Xin , Cheng Zhijun , Lei Cailin , Liu Shijia , Liu Xi , Tian Yunlu , Jiang Ling , Ge Song , Wu Chuanyin , Tao Dayun , Wang Haiyang , Wan Jianmin
Published: June 2018

Sterility in rice via toxin and antidote

Crossing wild and domestic rice often results in hybrid sterility. Such genetic barriers can prevent the movement of potentially beneficial genes from wild rice into domestic varieties. To understand the barriers preventing gene flow, Yu
et al.
mapped a quantitative trait locus (QTL) that determines sterility between wild-type and domestic rice. This QTL encodes two open reading frames (ORFs) that are both expressed during gametogenesis. The ORFs encode a toxin, which affects the development of pollen, and an antidote, which is required for pollen viability. Thus, selfish genetic elements can underlie evolutionary strategies that facilitate reproductive isolation.

Science
, this issue p.
1130
Exploring early human embryo development
Authors: Rossant Janet , Tam Patrick P. L.
Published: June 2018

Stem cell–derived models enable understanding of human embryogenesis
Stanley Falkow (1934–2018)
Authors: Monack Denise , Strauss Evelyn
Published: June 2018

Founder of molecular pathogenesis who discovered how antibiotic resistance spreads
Still not ready for Ebola
Authors: Frieden Thomas R.
Published: June 2018

Ebola is back. The disease that killed more than 11,000 people in West Africa just a few years ago has returned, striking the Democratic Republic of the Congo (DRC). Last week, intervention with a new vaccine was initiated to help contain the outbreak, adding another tool to a response that is exponentially better than it was 4 years ago. But we are not out of the woods. No matter how long this Ebola outbreak continues, the world faces critical tests in its battle against deadly pathogens. Unlike 2014, when delayed recognition of Ebola led to undetected disease spread, the DRC promptly admitted it had an outbreak and called for assistance. The World Health Organization (WHO) did not try to minimize the problem. Rapid response units from within the DRC and around the world deployed immediately. And, fortunately, the DRC has well-trained epidemiologists as well as laboratory capacity to test for the virus.
Potency of Solithromycin against Fast- and Slow-Growing Chlamydial Organisms
Authors: Gao Leiqiong , Wang Yao , Hua Ziyu , Liu Enmei , Shen Li
Published: June 2018

Evidence is provided that solithromycin is a bactericidal against not only fast-growing chlamydial organisms but also those slowed by gamma interferon (IFN-γ)
in vitro
. At sublethal concentrations, Sol impedes homotypic fusion of
Chlamydia
-containing vacuoles and reduces secretion of the type III secretion (T3S) effector IncA.
Colistin Does Not Potentiate Ceftazidime-Avibactam Killing of Carbapenem-Resistant Enterobacteriaceae In Vitro or Suppress Emergence of Ceftazidime-Avibactam Resistance
Authors: Shields Ryan K. , Nguyen M. Hong , Hao Binghua , Kline Ellen G. , Clancy Cornelius J.
Published: June 2018

We tested ceftazidime-avibactam and colistin against 24 carbapenem-resistant
Enterobacteriaceae
(CRE) isolates by time-kill studies. Ceftazidime-avibactam at 0.25×, 1×, and 4× the MIC was bactericidal against 8%, 21%, and 88% of the isolates, respectively.
Comparison of Herpes Simplex Virus PCR with Culture for Virus Detection in Multisource Surface Swab Specimens from Neonates
Authors: Dominguez Samuel R. , Pretty Kristin , Hengartner Randy , Robinson Christine C.
Published: June 2018

The American Academy of Pediatrics currently recommends herpes simplex virus (HSV) culture or PCR for testing of swabs of the conjunctivae, mouth, nasopharynx, and rectum (surface swabs) from neonates. The objectives of this study were to compare the performance and time to results of HSV PCR with those of HSV culture with surface swabs from neonates.
Divergent Human-Origin Influenza Viruses Detected in Australian Swine Populations
Authors: Wong Frank Y. K. , Donato Celeste , Deng Yi-Mo , Teng Don , Komadina Naomi , Baas Chantal , Modak Joyanta , O'Dea Mark , Smith David W. , Effler Paul V. , Cooke Julie , Davies Kelly R. , Hurt Aeron , Kung Nina , Levy Avram , Loh Richmond , Shan Songhua , Shinwari Mustaghfira W. , Stevens Vittoria , Taylor Joanne , Williams David T. , Watson James , Eagles Debbie , McCullough Sam , Barr Ian G. , Dhanasekaran Vijaykrishna
Published: June 2018

We describe the evolutionary origins and antigenic properties of influenza A viruses isolated from two separate Australian swine populations from 2012 to 2016, showing that these viruses are distinct from each other and from those isolated from swine globally. Whole-genome sequencing of virus isolates revealed a high genotypic diversity that had been generated exclusively through the introduction and establishment of human influenza viruses that circulated in past seasons. We detected six reassortants with gene segments derived from human H1N1/H1N1pdm09 and various human H3N2 viruses that circulated during various periods since 1968. We also found that these swine viruses were not related to swine viruses collected elsewhere, indicating independent circulation. The detection of unique lineages and genotypes in Australia suggests that isolated swine populations that are sufficiently large can sustain influenza virus for extensive periods; we show direct evidence of a sustained transmission for at least 4 years between 2012 and 2016.
Parental history of type 2 diabetes is associated with lower resting energy expenditure in normoglycemic subjects
Authors: Nyenwe Ebenezer A , Ogwo Cherechi C , Owei Ibiye , Wan Jim Y , Dagogo-Jack Samuel
Published: June 2018

Objective

Resting energy expenditure (REE) is linked to obesity, insulin resistance and type 2 diabetes (T2DM). REE and T2DM are inherited traits. Therefore, we investigated the effect of parental T2DM on REE in normoglycemic subjects.

Methods

Eighty-seven subjects with parental T2DM and 83 subjects without parental T2DM were matched in age, gender, race, BMI, weight and waist circumference. Subjects underwent a 75 g oral glucose tolerance test; REE was determined by indirect calorimetry and body composition was assessed by dual energy X-ray absorptiometry. Statistical analysis was performed using Student’s t-test, analysis of variance and regression analysis.

Results

The mean age was 38.8±11.3 years, 57% were females and 53% were African-Americans. The mean BMI was 28.5±6.1 kg/m2, waist circumference 91.8±15.1 cm, weight 83.9±20.3 kg, fat mass 31.0%±10.0%, mean fat-free mass (FFM) 54.4±12.9 kg. REE was significantly lower in subjects with parental diabetes, normalized REE 1364.4±263.4Kcal/day vs 1489.4±323.2 Kcal/day, p=0.006 and 29.2±5.3Kcal/kg FFM/day vs 31.9±6.0 Kcal/kg FFM/day, p=0.002. African-Americans had a lower REE compared with Caucasians 28.6±5.4Kcal/kg FFM/day vs 32.6±5.5 Kcal/kg FFM/day, p<0.0001. In a multiple regression model, ethnicity (p<0.0001), parental history of T2DM (p=0.006) and FFM (p=0.021) were independent predictors of REE.

Conclusion

Compared with subjects without parental diabetes, offspring with parental T2DM had lower REE, which was more pronounced in African-Americans. This metabolic alteration could increase the risk of obesity, insulin resistance and dysglycemia.
Paid and unpaid working hours among Swedish men and women in relation to depressive symptom trajectories: results from four waves of the Swedish Longitudinal Occupational Survey of Health
Authors: Peristera Paraskevi , Westerlund Hugo , Magnusson Hanson Linda L
Published: June 2018

Background

Long working hours and unpaid work are possible risk factors for depressive symptoms. However, little is known about how working hours influence the course of depressive symptoms. This study examined the influence of paid, unpaid working hours and total working hours on depressive symptoms trajectories.

Methods

The study was based on data from four waves of the Swedish Longitudinal Occupational Survey of Health (SLOSH 2008–2014). We applied group-based trajectory modelling in order to identify trajectories of depressive symptoms and studied paid and unpaid working hours and total working hours as risk factors.

Results

Six trajectory groups were identified with symptoms: ‘very low stable’, ‘low stable’, ‘doubtful increasing’, ‘high decreasing’, ‘mild decreasing’ and ‘high stable’. More time spent on unpaid work was associated with the ‘low stable’ (OR 1.16, 95% CI 1.04 to 1.30) and the ‘high stable (OR 1.40, 95% CI 1.18 to 1.65) symptom trajectories compared with being in the ‘very low stable’ symptom group. In addition, more total working hours was associated with a higher probability of having ‘high decreasing’ (OR 1.30, 95% CI 1.14 to 1.48) and ‘high stable’ (OR 1.22, 95% CI 1.01 to 1.47) symptoms, when adjusting for sex, age, civil status and socioeconomic status. The results, however, differed somewhat for men and women. More unpaid working hours was more clearly associated with higher symptom trajectories among women. More total working hours was associated with ‘high stable’ symptoms among women only.

Conclusions

This study supported heterogeneous individual patterns of depressive symptoms over time among the Swedish working population. The results also indicate that a higher burden of unpaid work and longer total working hours, which indicate a double burden from paid and unpaid work, may be associated with higher depressive symptom trajectories, especially among women.
Identifying socioeconomic, epidemiological and operational scenarios for tuberculosis control in Brazil: an ecological study
Authors: Pelissari Daniele Maria , Rocha Marli Souza , Bartholomay Patricia , Sanchez Mauro Niskier , Duarte Elisabeth Carmen , Arakaki-Sanchez Denise , Dantas Cíntia Oliveira , Jacobs Marina Gasino , Andrade Kleydson Bonfim , Codenotti Stefano Barbosa , Andrade Elaine Silva Nascimento , Araújo Wildo Navegantes de , Costa Fernanda Dockhorn , Ramalho Walter Massa , Diaz-Quijano Fredi Alexander
Published: June 2018

Objectives

To identify scenarios based on socioeconomic, epidemiological and operational healthcare factors associated with tuberculosis incidence in Brazil.

Design

Ecological study.

Settings

The study was based on new patients with tuberculosis and epidemiological/operational variables of the disease from the Brazilian National Information System for Notifiable Diseases and the Mortality Information System. We also analysed socioeconomic and demographic variables.

Participants

The units of analysis were the Brazilian municipalities, which in 2015 numbered 5570 but 5 were excluded due to the absence of socioeconomic information.

Primary outcome

Tuberculosis incidence rate in 2015.

Data analysis

We evaluated as independent variables the socioeconomic (2010), epidemiological and operational healthcare indicators of tuberculosis (2014 or 2015) using negative binomial regression. Municipalities were clustered by the k-means method considering the variables identified in multiple regression models.

Results

We identified two clusters according to socioeconomic variables associated with the tuberculosis incidence rate (unemployment rate and household crowding): a higher socioeconomic scenario (n=3482 municipalities) with a mean tuberculosis incidence rate of 16.3/100 000 population and a lower socioeconomic scenario (2083 municipalities) with a mean tuberculosis incidence rate of 22.1/100 000 population. In a second stage of clusterisation, we defined four subgroups in each of the socioeconomic scenarios using epidemiological and operational variables such as tuberculosis mortality rate, AIDS case detection rate and proportion of vulnerable population among patients with tuberculosis. Some of the subscenarios identified were characterised by fragility in their information systems, while others were characterised by the concentration of tuberculosis cases in key populations.

Conclusion

Clustering municipalities in scenarios allowed us to classify them according to the socioeconomic, epidemiological and operational variables associated with tuberculosis risk. This classification can support targeted evidence-based decisions such as monitoring data quality for improving the information system or establishing integrative social protective policies for key populations.
Burden of herpes zoster in 16 selected immunocompromised populations in England: a cohort study in the Clinical Practice Research Datalink 2000–2012
Authors: Yanni Emad A. , Ferreira Germano , Guennec Morgane , El Hahi Yassine , El Ghachi Amale , Haguinet François , Espie Emmanuelle , Bianco Veronique
Published: June 2018

Objectives

Herpes zoster (HZ) is caused by reactivation of varicella-zoster virus which remains latent in individuals after a varicella infection. It is expected that HZ will be more frequent in immunocompromised (IC) individuals than in immunocompetent (IC-free). This study assessed the incidence rate (IR) of HZ in individuals with a wide set of IC conditions and in IC-free individuals.

Setting

A retrospective cohort study was conducted in England using data (January 2000 to March 2012) from the Clinical Practice Research Datalink with linkage to the Hospital Episodes Statistics.

Participants

A cohort of 621 588 individuals with 16 selected IC conditions and a gender/age-matched cohort of IC-free individuals were identified. The IC conditions included haematopoietic stem cell transplant (HSCT), solid organ transplant, malignancies, autoimmune diseases and users of immunosuppressive medications.

Outcomes

IR of HZ per 1000 person-years (PY) was estimated. Proportions of postherpetic neuralgia (PHN) and other HZ complications within 90 days of HZ onset were also estimated among patients with HZ. Risk factors for PHN in IC individuals with HZ were assessed by a multivariate regression model.

Results

The overall IR of HZ in the IC cohort was 7.8/1000 PY (95% CI 7.7 to 7.9), increasing with age from 3.5/1000 PY (3.4–3.7) in individuals aged 18–49 years to 12.6/1000 PY (12.2–13.0) in individuals aged ≥80 years. This IR in the IC-free cohort was 6.2/1000 PY (6.1–6.3). The overall IR of HZ varied across IC conditions, ranging from 5.3 (5.1–5.5) in psoriasis to 41.7/1000 PY (35.7–48.4) in HSCT. The proportions of PHN and other HZ complications were 10.7% (10.2–11.1) and 2.9% (2.7–3.2) in the IC cohort, but 9.1% (8.7–9.5) and 2.3% (2.1–2.6) in the IC-free cohort, respectively.

Conclusion

IC population contributes to the public health burden of HZ in England. Vaccination might be the most preferable HZ preventive measure for the IC population.
Multinational comparative cross-sectional survey of views of medical students about acceptable terminology and subgroups in schizophrenia
Authors: Rathod Shanaya , Irfan Muhammad , Bhargava Rachna , Pinninti Narsimha , Scott Joseph , Mohammad Algahtani Haifa , Guo Zhihua , Gupta Rishab , Nadkarni Pallavi , Naeem Farooq , Howells Fleur , Sorsdahi Katherine , Thorne Kerensa , Osman-Hicks Victoria , Pallikadavath Sasee , Phiri Peter , Carr Hannah , Graves Lizi , Kingdon David
Published: June 2018

Aim

The aim of this study was to inform thinking around the terminology for ‘schizophrenia’ in different countries.

Objectives

The objective of this study was to investigate: (1) whether medical students view alternative terminology (psychosis subgroups), derived from vulnerability-stress models of schizophrenia, as acceptable and less stigmatising than the term schizophrenia; (2) if there are differences in attitudes to the different terminology across countries with different cultures and (3) whether clinical training has an impact in reducing stigma.

Design

This is a cross-sectional survey that examined the attitudes of medical students towards schizophrenia and the alternative subgroups.

Setting

The study was conducted across eight sites: (1) University of Southampton, UK; (2) All India Institute of Medical Science, India; (3) Rowan University, USA; (4) Peshawar Medical College, Pakistan; (5) Capital Medical University, China; (6) College of Medicine and Medical sciences, Bahrain; (7) Queens University, Kingston, Canada and (8) University of Cape Town, South Africa.

Method

This study extended an initial pilot conducted by the Royal College of Psychiatrists on the term schizophrenia and psychosis subgroups to assess whether the subgroup terminology might have an effect on the attitudes of a convenience sample of medical students from eight different countries and potentially play a role in reducing stigmatisation.

Results

1873 medical students completed a questionnaire recording their attitudes to schizophrenia and the psychosis subgroups. A reduction in negative perceptions were found for the psychosis subgroups, especially for the stress sensitivity psychosis and anxiety psychosis subgroups. Negative perceptions were found for drug-related psychosis. Participants who had undergone clinical training had overall positive attitudes. Differences across different countries were found.

Conclusion

The attitudes towards psychosis subgroups used in this study have shown mixed results and variation across countries. Further research is warranted to investigate acceptability of terminology. Methods of reducing stigma are discussed in line with the findings.

Ethics

The study received ethical approval from ERGO (Ethics and Research Governance Online; ID: 15972) and subsequently from the ethics committee at each site.
Tackling the workforce crisis in district nursing: can the Dutch Buurtzorg model offer a solution and a better patient experience? A mixed methods case study
Authors: Drennan Vari M , Calestani Melania , Ross Fiona , Saunders Mary , West Peter
Published: June 2018

Despite policy intentions for more healthcare out of hospital, district nursing services face multiple funding and staffing challenges, which compromise the care delivered and policy objectives.

Objectives

What is the impact of the adapted Buurtzorg model on feasibility, acceptability and effective outcomes in an English district nursing service?

Design

Mixed methods case study.

Setting

Primary care.

Participants

Neighbourhood nursing team (Buurtzorg model), patients and carers, general practitioners (GPs), other health professionals, managers and conventional district nurses.

Results

The adapted Buurtzorg model of community nursing demonstrated feasibility and acceptability to patients, carers, GPs and other health professionals. For many patients, it was preferable to previous experiences of district nursing in terms of continuity in care, improved support of multiple long-term conditions (encompassing physical, mental and social factors) and proactive care. For the neighbourhood nurses, the ability to make operational and clinical decisions at team level meant adopting practices that made the service more responsive, accessible and efficient and offered a more attractive working environment. Challenges were reported by nurses and managers in relation to the recognition and support of the concept of self-managing teams within a large bureaucratic healthcare organisation. While there were some reports of clinical effectiveness and efficiency, this was not possible to quantify, cost or compare with the standard district nursing service.

Conclusions

The adapted Buurtzorg model of neighbourhood nursing holds potential for addressing issues of concern to patients, carers and staff in the community. The two interacting innovations, that is, a renewed focus on patient and carer-centred care and the self-managing team, were implemented in ways that patients, carers, other health professionals and nurses could identify difference for both the nursing care and also the nurses’ working lives. It now requires longer term investigation to understand both the mechanism for change and also the sustainability.