bluuebunny/crossref_metadata_2025 huggingface dataset:
Environmental contributions to gastrointestinal and liver cancer in the Asia–Pacific region
Authors: Ko Kwang‐Pil , Shin Aesun , Cho Sooyoung , Park Sue K , Yoo Keun‐Young
Published: September 2017

In the Asia–Pacific region, gastric, colorectal, and hepatocellular (liver) cancer show substantial regional variation in incidence consistent with the presence of important environmental factors. For gastric cancer, global incidence is concentrated in Asia with substantially higher rates in East Asia than in South‐East Asia and Australia. The differences in incidence rates for gastric cancer in the Asia–Pacific region may be due, in part, to differences in the prevalence of Helicobacter pylori infection and the prevalence of H. pylori virulence factors. Smoking is also correlated with gastric cancer risk and is responsible for the highest population attributable fraction among men in East Asia. Colorectal cancer has increased rapidly in incidence to become the third most common digestive cancer in Asia. According to cohort studies in Asia, smoking, alcohol use, obesity, and physical inactivity increase the risk of colorectal cancer. Unlike West Asia, East Asia and Australia have high incidence rates for colorectal cancer that correlates to a high Human Development Index and a high prevalence of alcohol consumption and obesity. Liver cancer is the second most common digestive cancer in Asia. The high incidence of liver cancer in East Asia and South‐East Asia is concordant with the high prevalence of hepatitis B virus and hepatitis C virus infection. Other important risk factors include alcohol use, smoking, and diabetes. The identification of the earlier and other environmental factors (currently under investigation) is central to the development and implementation of effective cancer control programs for the region.
Home Health Agency Performance in the United States: 2011–15
Authors: Wang Yun , Spatz Erica S. , Tariq Maliha , Angraal Suveen , Krumholz Harlan M.
Published: September 2017

Objectives

To evaluate home health agency quality performance.

Design

Observational study.

Setting

Home health agencies.

Participants

All Medicare‐certified agencies with at least 6 months of data from 2011 to 2015.

Measurements

Twenty‐two quality indicators, five patient survey indicators, and their composite scores.

Results

The study included 11,462 Medicare‐certified home health agencies that served 92.4% of all ZIP codes nationwide, accounting for 315.2 million people. The mean composite scores were 409.1 ± 22.7 out of 500 with the patient survey indicators and 492.3 ± 21.7 out of 600 without the patient survey indicators. Home health agency performance on 27 quality indicators varied, with the coefficients of dispersion ranging from 4.9 to 62.8. Categorization of agencies into performance quartiles revealed that 3,179 (27.7%) were in the low‐performing group (below 25th percentile) at least one time during the period from 2011–12 to 2014–15 and that 493 were in the low‐performing group throughout the study period. Geographic variation in agency performance was observed. Agencies with longer Medicare‐certified years were more likely to have high‐performing scores; agencies providing partial services, with proprietary ownership, and those with long travel distances to reach patients had lower performance. Agencies serving low‐income counties and counties with lower proportions of women and senior residences and greater proportions of Hispanic residents were more likely to attain lower performance scores.

Conclusion

Home health agency performance on several quality indicators varied, and many agencies were persistently in the lowest quartile of performance. Still, there is a need to improve the quality of care of all agencies. Many parts of the United States, particularly lower‐income areas and areas with more Hispanic residents, are more likely to receive lower quality home health care.
Progressive evolution of whole‐rock composition during metamorphism revealed by multivariate statistical analyses
Authors: Yoshida Kenta , Kuwatani Tatsu , Hirajima Takao , Iwamori Hikaru , Akaho Shotaro
Published: September 2017

The geochemical evolution of metamorphic rocks during subduction‐related metamorphism is described on the basis of multivariate statistical analyses. The studied data set comprises a series of mapped metamorphic rocks collected from the Sanbagawa metamorphic belt in central Shikoku, Japan, where metamorphic conditions range from the pumpellyite–actinolite to epidote–amphibolite facies. Recent progress in computational and information science provides a number of algorithms capable of revealing structures in large data sets. This study applies k‐means cluster analysis (KCA) and non‐negative matrix factorization (NMF) to a series of metapelites, which is the main lithotype of the Sanbagawa metamorphic belt. KCA describes the structures of the high‐dimensional data, while NMF provides end‐member decomposition which can be useful for evaluating the spatial distribution of continuous compositional trends. The analysed data set, derived from previously published work, contains 296 samples for which 14 elements (Si, Ti, Al, Fe, Mn, Mg, Ca, Na, K, P, Rb, Sr, Zr and Ba) have been analysed. The KCA and NMF analyses indicate five clusters and four end‐members, respectively, successfully explaining compositional variations within the data set. KCA indicates that the chemical compositions of metapelite samples from the western (Besshi) part of the sampled area differ significantly from those in the east (Asemigawa). In the west, clusters show a good correlation with the metamorphic grade. With increasing metamorphic grade, there are decreases in SiO2 and Na2O and increases in other components. However, the compositional change with metamorphic grade is less obvious in the eastern area. End‐member decomposition using NMF revealed that the evolutional change of whole‐rock composition, as correlated with metamorphic grade, approximates a stoichiometric increase of a garnet‐like component in the whole‐rock composition, possibly due to the precipitation of garnet and effusion of other components during progressive dehydration. Thermodynamic modelling of the evolution of the whole‐rock composition yielded the following results: (1) the whole‐rock composition at lower metamorphic grade favours the preferential crystallization of garnet under the conditions of the garnet zone, with biotite becoming stable together with garnet in higher‐grade rock compositions under the same P–T conditions; (2) with higher‐grade whole‐rock compositions, more H2O is retained. These results provide insight into the mechanism suppressing dehydration under high‐P metamorphic conditions. This mechanism should be considered in forward modelling of the fluid cycle in subduction zones, although such a quantitative model has yet to be developed.
Effective absorption correction for energy dispersive X‐ray mapping in a scanning transmission electron microscope: analysing the local indium distribution in rough samples of InGaN alloy layers
Authors: WANG X. , CHAUVAT M.‐P. , RUTERANA P. , WALTHER T.
Published: September 2017

We have applied our previous method of self‐consistent k*‐factors for absorption correction in energy‐dispersive X‐ray spectroscopy to quantify the indium content in X‐ray maps of thick compound InGaN layers. The method allows us to quantify the indium concentration without measuring the sample thickness, density or beam current, and works even if there is a drastic local thickness change due to sample roughness or preferential thinning. The method is shown to select, point‐by‐point in a two‐dimensional spectrum image or map, the k*‐factor from the local Ga K/L intensity ratio that is most appropriate for the corresponding sample geometry, demonstrating it is not the sample thickness measured along the electron beam direction but the optical path length the X‐rays have to travel through the sample that is relevant for the absorption correction.
Differentiation of human hair by colour and diameter using light microscopy, digital imaging and statistical analysis
Authors: MILLS M. , BONETTI J. , BRETTELL T. , QUARINO L.
Published: September 2017

This research introduces and evaluates a novel method that offers the potential of providing objective criteria to forensic microscopical hair comparisons. The method combines hair diameter with numeric characterisations of red, green, and blue colour content as determined with the use of digital imaging at defined locations of the hair.

Thirty hairs were collected from each of twenty participants, all with naturally coloured brown hair. The hairs were examined with an Olympus BX53® polarising light microscope and digital images were viewed with an Olympus DP72® camera under 400× magnification. Using Olympus cellSens™ Entry software, hair diameter was measured at 1000, 1500 and 2000 m from the base of the root. The Olympus cellSens™ Entry software uses a red, green and blue (RGB) colour model to quantitatively define the colour of each pixel on an image based on its composition of these three principal colour components. This software was used to collect numerical characterisations of hair colour at each distance interval.

The diameter and colour values for each hair were compared using discriminant analysis (DA) and principal component analysis. Although a large amount of intrapersonal variation was observed, the degree of interpersonal variation was greater and enabled the statistical model to differentiate between the hair samples from each participant. The DA model achieved sample reclassification with an error rate of 7.33%. A validation study was conducted on a subset of hair samples from which 18 of the 20 were correctly assigned to the participant from whom they originated. These results support the potential of this method to provide an objective addition to current microscopical hair comparison practices.
Atomic structure of ‘W’‐type quantum well heterostructures investigated by aberration‐corrected STEM
Authors: KÜKELHAN P. , BEYER A. , FUCHS C. , WESELOH M.J. , KOCH S.W. , STOLZ W. , VOLZ K.
Published: September 2017

The atomic structure of (GaIn)As/Ga(AsSb)/(GaIn)As‐‘W’‐type quantum well heterostructures (‘W’‐QWHs) is investigated by scanning transmission electron microscopy (STEM). These structures were grown by metal organic vapour phase epitaxy and are built for type‐II laser systems in the infrared wavelength regime. For two samples grown at 525°C and 550°C, intensity profiles are extracted from the STEM images for each sublattice separately. These intensity profiles are compared to the one obtained from an image simulation of an ideal ‘W’‐QWH that is modelled in close agreement with the experiment. From the intensity profiles, the width of the different quantum wells (QWs) can be determined. Additionally, characteristics connected to the growth of the structures, such as segregation coefficients and material homogeneity, are calculated. Finally, composition profiles are derived from the STEM intensity profiles to a first approximation. For these composition profiles, the expected photoluminescence (PL) is computed based using the semiconductor luminescence equations. The PL spectra are then compared to experimental measurements for both samples.
Comparative anatomy of neonates of the three major mammalian groups (monotremes, marsupials, placentals) and implications for the ancestral mammalian neonate morphotype
Authors: Ferner Kirsten , Schultz Julia A. , Zeller Ulrich
Published: September 2017

The existing different modes of reproduction in monotremes, marsupials and placentals are the main source for our current understanding of the origin and evolution of the mammalian reproduction. The reproductive strategies and, in particular, the maturity states of the neonates differ remarkably between the three groups. Monotremes, for example, are the only extant mammals that lay eggs and incubate them for the last third of their embryonic development. In contrast, marsupials and placentals are viviparous and rely on intra‐uterine development of the neonates via choriovitelline (mainly marsupials) and chorioallantoic (mainly placentals) placentae. The maturity of a newborn is closely linked to the parental care strategy once the neonate is born. The varying developmental degrees of neonates are the main focus of this study. Monotremes and marsupials produce highly altricial and nearly embryonic offspring. Placental mammals always give birth to more developed newborns with the widest range from altricial to precocial. The ability of a newborn to survive and grow in the environment it was born in depends highly on the degree of maturation of vital organs at the time of birth. Here, the anatomy of four neonates of the three major extant mammalian groups is compared. The basis for this study is histological and ultrastructural serial sections of a hatchling ofOrnithorhynchus anatinus(Monotremata), and neonates ofMonodelphis domestica(Marsupialia),Mesocricetus auratus(altricial Placentalia) andMacroscelides proboscideus(precocial Placentalia). Special attention was given to the developmental stages of the organs skin, lung, liver and kidney, which are considered crucial for the maintenance of vital functions. The state of the organs of newborn monotremes and marsupials are found to be able to support a minimum of vital functions outside the uterus. They are sufficient to survive, but without capacities for additional energetic challenges. The organs of the altricial placental neonate are further developed, able to support the maintenance of vital functions and short‐term metabolic increase. The precocial placental newborn shows the most advanced state of organ development, to allow the maintenance of vital functions, stable thermoregulation and high energetic performance. The ancestral condition of a mammalian neonate is interpreted to be similar to the state of organ development found in the newborns of marsupials and monotremes. In comparison, the newborns of altricial and precocial placentals are derived from the ancestral state to a more mature developmental degree associated with advanced organ systems.
Developing nurses’ intercultural/intraprofessional communication skills using the EXCELLence in Cultural Experiential Learning and Leadership Social Interaction Maps
Authors: Henderson Saras , Barker Michelle
Published: September 2017

Aims and objectives

To examine how the use of Social Interaction Maps, a tool in theEXCELLence in Cultural Experiential Learning and Leadership Program, can enhance the development of nurses’ intercultural/intraprofessional communication skills.

Background

Nurses face communication challenges when interacting with others from similar background as well as those from a culturally and linguistically diverse background. We used the EXCELLence in Cultural Experiential Learning and Leadership Program's Social Interaction Maps tool to foster intercultural/intraprofessional communication skills in nurses. Social Interaction Maps describe verbal and nonverbal communication behaviours that model ways of communicating in a culturally appropriate manner. The maps include four stages of an interaction, namely Approach, Bridging, Communicating and Departing using the acronymABCD.

Design

Qualitative approach was used with a purposeful sample of nurses enrolled in a postgraduate course.

Methods

Fifteen participants were recruited. The Social Interaction Map tool was taught to participants in a workshop where they engaged in sociocultural communication activities using scenarios. Participants were asked to apply Social Interaction Maps in their workplaces. Six weeks later, participants completed a semistructured open‐ended questionnaire and participated in a discussion forum on their experience of using Social Interaction Maps. Data were content‐analysed.

Results

Four themes identified in the use of the Social Interaction Maps were (i) enhancing self‐awareness of communication skills; (ii) promoting skills in being nonconfrontational during difficult interactions; (iii) highlighting the importance of A (Approach) and B (Bridging) in interaction with others; and (iv) awareness of how others interpret what is said C (Communicating) and discussing to resolve issues before closure D (Departing).

Conclusions

Application of the EXCELLence in Cultural Experiential Learning and Leadership Social Interaction Mapping tool was shown to be useful in developing intercultural/intraprofessional communication skills in nurses.

Relevance to clinical practice

Professional development programmes that incorporate EXCELLence in Cultural Experiential Learning and Leadership Social Interaction Maps can enhance nurses’ intercultural/intraprofessional communication competencies when engaging with others from culturally and linguistically diverse backgrounds and improve the way nurses communicate with each other.
Incidence and risk factors associated with the development of pressure ulcers in an intensive care unit
Authors: González‐Méndez María Isabel , Lima‐Serrano Marta , Martín‐Castaño Catalina , Alonso‐Araujo Inmaculada , Lima‐Rodríguez Joaquín Salvador
Published: September 2017

Aims and objectives

To determinate the incidence, incidence rate and risk factors of pressure ulcers in critical care patients.

Background

Pressure ulcers represent one of the most frequent health problems in clinical practice. Specifically, critical patients who are hospitalised in intensive care units have a higher risk of developing a pressure ulcer, with an incidence that fluctuates between 3.3–39.3% according to previous studies.

Design

Prospective cohort study.

Methods

Three hundred and thirty‐five adult patients (over 18 years old) who were hospitalised in intensive care units for at least 24 hr were monitored for a maximum of 32 days. They were excluded if they had a pressure ulcers at admission. The survival rate for pressure ulcers, from stages I–IV, was calculated using the Kaplan–Meier method. A multivariate Cox regression model was adjusted to identify the main risk factors for pressure ulcers: demographic, clinical, prognostic and therapeutic variables.

Results

The incidence of pressure ulcers in critical patients was 8.1%, and the incidence rate was 11.72 pressure ulcers for 1,000 days of intensive care units stay; 40.6% of pressure ulcers were of stage I and 59.4% of stage II, mainly in the sacrum. According to the Cox model, the main risk factors for pressure ulcers were in‐hospital complications, prognostic scoring system (SAPS III) and length of immobilisation.

Conclusions

The incidence of pressure ulcers is lower than that shown in recent studies. Complications on the unit and the prognosis score were risk factors associated with pressure ulcers but, surprisingly, length of immobilisation was a protective factor.

Relevance to clinical practice

Survival analysis of pressure ulcer allows for identification of risk factors associated with this health problem in the intensive care units. Identifying these factors can help nurses establish interventions to prevent pressure ulcers in this healthcare scenario, given that pressure ulcers prevention is an indicator of nursing quality.
Sleep quality and mood in mothers and fathers accommodated in the family‐centred paediatric ward
Authors: Angelhoff Charlotte , Edéll‐Gustafsson Ulla , Mörelius Evalotte
Published: September 2017

Aims and objectives

To describe sleep quality and mood in parents accommodated with their sick child in a family‐centred paediatric ward. Secondary aims were to compare mothers’ and fathers’ sleep quality and mood in the paediatric ward and to compare the parents’ sleep quality and mood between the paediatric ward and in a daily‐life home setting after discharge.

Background

Frequent interruptions, ward noise and anxiety affect parents’ sleep quality and mood negatively when accommodated with their sick child in paediatric wards. Poor sleep quality and negative mood decrease the parents’ ability to sustain attention and focus, and to care for their sick child.

Methods

This was a prospective and descriptive study. Eighty‐two parents (61 mothers and 21 fathers) with children (median age 6.25 years) admitted to six paediatric wards participated in the study. Uppsala Sleep Inventory, a sleep diary and the Mood Adjective Checklist were used to measure sleep quality and mood.

Results

The parents had a good sleep quality in the paediatric ward even though they had more nocturnal awakenings compared to home. Moreover, they were less alert, less interested and had reduced concentration, and were more tired, dull and passive in the hospital than at home after discharge. Vital sign checks, noises made by the staff and medical treatment were given reasons influencing sleep. Poor sleep quality correlated with negative mood.

Conclusion

Parents’ sleep quality in family‐centred paediatric care is good. However, the habitual sleep efficacy before admittance to the hospital is lower than expected and needs to be further investigated.

Relevance to Clinical Practice

The healthcare professionals should acknowledge parents’ sleep and mood when they are accommodated with their sick child. Further should care at night be scheduled and sleep promoted for the parents to maintain health and well‐being in the family.
Effects of Gingival Retraction Paste and Subsequent Cleaning with Hydrogen Peroxide on the Polymerization of Three Elastomeric Impression Materials: An In Vitro Study
Authors: Abduljabbar Tariq S. , Al Amri Mohammad D. , Al Rifaiy Mohammad Q. , Al‐Sowygh Zeyad H. , Vohra Fahim A. , Balous Moneeb A. , Alqarni Adel S. , Alotaibi Abdulmajeed O.
Published: September 2017

Purpose

It has been hypothesized that there are no effects of Expasyl and subsequent cleaning with hydrogen peroxide on polymerization of selected commonly used impression materials. Therefore, the aim of this study was to evaluate the effect of Expasyl paste on the polymerization of three impression materials with and without subsequent cleaning using 3% hydrogen peroxide (H2O2).

Materials and Methods

Nine standardized stainless steel specimens were fabricated. One hundred and eighty impressions were made using 3 materials (60 each) as follows: group I: poly(vinyl siloxane) (PVS) (Virtual); group II: polyether (Monophase); group III: polyether (Impregum). Groups were subdivided into 3 categories: control without intervention (n = 20), pre‐application of Expasyl and subsequent 1‐minute washing with water and air‐drying (n = 20), and pre‐application of Expasyl and subsequent cleaning with 3% H2O2 for 10 seconds (n = 20). All impressions were made by one operator using auto‐mixing cartridges under standardized conditions at room temperature. Evaluation of the polymerization inhibition was blindly and independently performed by three practitioners with comparable experience using a visual scale. The observation was subjectively categorized as noninhibited or inhibited. Data were tabulated and analyzed using Fisher's exact test with significance level set at p ˂ 0.05.

Results

Significant differences were found between the control group and the impressions made after contamination with Expasyl (p < 0.001). Polymerization inhibition of PVS and Impregum was similar (in 85% and 90% of the specimens, respectively) when washed with water. There was a statistically significant reduction in polymerization inhibition in both upon cleaning with H2O2 (p < 0.001); however, polymerization inhibition occurred in 100% of Monophase specimens when contaminated with Expasyl despite the washing technique used.

Conclusions

Under these in vitro conditions, it can be concluded that the remnants of Expasyl on specimens caused a significant polymerization inhibition of the 3 impression materials tested. Subsequent cleaning with 3% H2O2 significantly reduced this inhibitory effect on polymerization. Expasyl should not be used with Monophase polyether material.
Role of a naturally varying flow regime in Everglades restoration
Authors: Harvey Jud W. , Wetzel Paul R. , Lodge Thomas E. , Engel Victor C. , Ross Michael S.
Published: September 2017

The Everglades is a low‐gradient floodplain predominantly on organic soil that undergoes seasonally pulsing sheetflow through a network of deepwater sloughs separated by slightly higher elevation ridges. The seasonally pulsing flow permitted the coexistence of ridge and slough vegetation, including the persistence of productive, well‐connected sloughs that seasonally concentrated prey and supported wading bird nesting success. Here we review factors contributing to the origin and to degradation of the ridge and slough ecosystem in an attempt to answer “How much flow is needed to restore functionality”? A key restoration objective is to increase sheetflow lost during the past century to reestablish interactions between flow, water depth, vegetation production and decomposition, and transport of flocculent organic sediment that build and maintain ridge and slough distinctions. Our review finds broad agreement that perturbations of water level depth and its fluctuations were primary in the degradation of landscape functions, with critical contributions from perturbed water quality, and flow velocity and direction. Whereas water levels are expected to be improved on average across a range of restoration scenarios that replace between 79 and 91% of predrainage flows, the diminished microtopography substantially decreases the probability of timely improvements in some areas whereas others that retain microtopographic differences are poised for restoration benefits. New advances in predicting restoration outcomes are coming from biophysical modeling of ridge–slough dynamics, system‐wide measurements of landscape functionality, and large‐scale flow restoration experiments, including active management techniques to kick‐start slough regeneration.
Serial chest CT in cryptogenic organizing pneumonia: Evolutional changes and prognostic determinants
Authors: Chung Man P. , Nam Bo D. , Lee Kyung S. , Han Joungho , Park Jai S. , Hwang Jung H. , Cha Min J. , Kim Tae J.
Published: September 2017

Background and objective

Cryptogenic organizing pneumonia (COP) is corticosteroid responsive but residual computed tomography (CT) chest changes are often noted. The present study examined clinical and HRCT features of COP in which there was incomplete resolution.

Methods

We studied 93 patients with histopathologically confirmed COP and serial HRCT imaging. Clinical features were assessed, and serial CT images were analysed. Uni‐ and multivariate analyses were performed to determine clinical or imaging factors related to incomplete resolution on CT.

Results

Complete resolution on CT imaging was seen in 21/93 patients (23%) and residual abnormalities were seen in 72/93 patients (77%). In univariate analysis, total lesion (P = 0.036), degree of consolidation (P = 0.011), treatment duration (P < 0.001) and single‐breath carbon monoxide diffusing capacity of lung (P = 0.021) were significantly associated with residual imaging abnormalities. In multivariate analysis, extent of consolidation (P = 0.018; odds ratio (OR) = 14.92) and treatment duration (P = 0.011; OR = 1.32) remained as significant factors linked to residual abnormalities. CT images in unresolved COP were akin to fibrotic non‐specific interstitial pneumonia (fNSIP) in 53/72 (74%) patients.

Conclusion

Clinical, radiological and lung diffusion measurements were related to incomplete resolution on CT after COP. Imaging abnormalities on CT chest generally resembled fNSIP.
Efficacy and safety of transbronchial lung biopsy for the diagnosis of lymphangioleiomyomatosis: A report of 24 consecutive patients
Authors: Koba Taro , Arai Toru , Kitaichi Masanori , Kasai Takahiko , Hirose Masaki , Tachibana Kazunobu , Sugimoto Chikatoshi , Akira Masanori , Hayashi Seiji , Inoue Yoshikazu
Published: September 2017

Background and objective

Lymphangioleiomyomatosis (LAM) is a diffuse cystic lung disease that occurs in women of childbearing age. LAM can be diagnosed on a clinical basis in patients with typical high‐resolution computed tomography (HRCT) patterns and at least one other corroborating disease feature, such as chylothorax, angiomyolipoma, tuberous sclerosis complex or elevated serum vascular endothelial growth factor (VEGF)‐D. However, patients who do not meet these criteria require tissue confirmation for a definitive diagnosis, and the utility of methods that are less invasive than surgical lung biopsy, such as transbronchial lung biopsy (TBLB), are not well studied. We retrospectively studied the efficacy and safety of TBLB for the diagnosis of LAM.

Methods

From January 1991 to August 2015, 131 consecutive LAM patients were prospectively registered in our study, and a TBLB was conducted for 24 patients. We retrospectively studied the yield and safety of TBLB in this cohort.

Results

All 24 patients were women; the median age was 42 years. HRCT showed multiple round thin‐walled cysts diffusely scattered throughout the lungs. The median level of serum VEGF‐D was 2109 pg/mL. Characteristic pathological findings for LAM were identified in 17 patients (70.8%) by two expert pathologists. The %predicted value for diffusing capacity of carbon monoxide was significantly lower in the 17 TBLB‐positive LAM patients compared to the seven TBLB‐negative LAM patients (P = 0.046). There were no serious adverse events such as pneumothorax or uncontrollable bleeding due to TBLB.

Conclusion

TBLB is a safe and effective method for the pathological diagnosis of LAM.
Novel clinical scoring system to identify patients with pneumothorax with suspicion for Birt–Hogg–Dubé syndrome
Authors: Ebana Hiroki , Mizobuchi Teruaki , Kurihara Masatoshi , Kobayashi Etsuko , Haga Takahiro , Okamoto Shoichi , Takahashi Kazuhisa , Seyama Kuniaki
Published: September 2017

Background and objective

Birt–Hogg–Dubé syndrome (BHDS) is a rare hereditary disease that presents with multiple lung cysts and pneumothorax (PTX). Although some reports propose that findings from chest computed tomography enable one to distinguish BHDS from primary spontaneous pneumothorax (PSP), it is still unclear whether clinical features are useful for identifying patients with suspicion of BHDS from those with PTX.

Methods

We retrospectively reviewed the medical records of patients with PTX who underwent video‐assisted thoracoscopic surgery at Nissan Tamagawa Hospital from January 2012 to December 2015.

Results

We identified a total of 1141 patients with PTX, including 54 with BHDS and 517 with PSP. Among them, logistic regression analysis segregated five features that were significantly associated with BHDS: familial history of PTX, past history of bilateral PTX, age at the first episode of PTX (≥25 years old (y.o.)), body mass index (≥18.5) and gender (female). We assigned scores of 3, 3, 2, 2 and 1 to the five features, respectively, to establish a system with a calculated score from 0 to 11. The cut‐off value of a calculated score ≥ 4 yielded the highest sensitivity of 93% and specificity of 86%. Receiver operating characteristic (ROC) analysis showed the area under the curve reflecting an accuracy of this diagnostic test as 0.953.

Conclusion

BHDS has several clinical features distinct from PSP. Our scoring system consists of only five clinical variables that are easily evaluated and efficiently separate BHDS patients from those who have PTX without relying on an imaging study. Further prospective study is needed to confirm our findings.
Surfactant protein D multimerization and gene polymorphism in COPD and asthma
Authors: Fakih Dalia , Akiki Zeina , Junker Kirsten , Medlej‐Hashim Myrna , Waked Mirna , Salameh Pascale , Holmskov Uffe , Bouharoun‐Tayoun Hasnaa , Chamat Soulaima , Sorensen Grith L. , Jounblat Rania
Published: September 2017

Background and objective

A structural single nucleotide polymorphism rs721917 in the surfactant protein D (SP‐D) gene, known as Met11Thr, was reported to influence the circulating levels and degree of multimerization of SP‐D and was associated with both COPD and atopy in asthma. Moreover, disease‐related processes are known to degrade multimerized SP‐D, however, the degree of the protein degradation in these diseases is not clarified. We aimed to determine the distribution of multimerized (high molecular weight (HMW)) and non‐multimerized (low molecular weight (LMW)) species of serum SP‐D and their correlation with genetic polymorphisms and presence of disease in Lebanese COPD and asthmatic patients.

Methods

Serum SP‐D levels were measured by ELISA in 88 COPD, 121 asthmatic patients and 223 controls. Randomly selected subjects were chosen for genotyping of rs721917 and multimerization studies. HMW and LMW SP‐D were separated by gel permeation chromatography.

Results

Serum SP‐D levels were significantly increased in patients with COPD, but not in asthmatic patients, when compared to controls. Met11Thr variation strongly affected serum SP‐D levels and the degree of multimerization, but was not associated with COPD and asthma in the study. Remarkably, HMW/LMW serum SP‐D ratio was significantly lower in Met11/Met11 COPD and asthmatic patients compared to controls.

Conclusion

Collectively, non‐multimerized species of serum SP‐D were dominant in COPD and asthmatic patients suggesting that degradation of SP‐D takes place to a significant degree in pulmonary disease. Assays that can separate SP‐D proteolytic breakdown products or modified forms from naturally occurring SP‐D trimers may result in optimal disease markers for pulmonary inflammatory diseases.
Human capital consequences of violence in schools: Estimating the impact of violence in schools on education outcomes in Brazil
Authors: Deole Sumit S.
Published: September 2017

Implementation of policies to reduce the incidence of violence in schools needs a comprehensive understanding of the phenomenon and its consequences for the victims, perpetrators, and witnesses alike. However, much of the existing literature either focuses on the impact of violence on victim students or studies the specific cases of violent conflicts. Using Brazilian education data, this paper examines the impact of violence in schools on educational outcomes of the schooling system and emphasizes the human capital consequences of recorded violent incidents in schools. First, the paper establishes the psychological stress–threat mechanism by which violent incidents in schools directly impact students' mathematics test scores as well as school level average of these test scores. Thereafter, the paper demonstrates the reduced learning mechanism by which violence further detriments the quality of education, albeit indirectly, by disengaging the teachers and students from their professional responsibilities. The main results are tested for robustness and policy implications are discussed.
Swedish primary healthcare nurses’ perceptions of using digital eHealth services in support of patient self‐management
Authors: Öberg Ulrika , Orre Carl Johan , Isaksson Ulf , Schimmer Robyn , Larsson Håkan , Hörnsten Åsa
Published: September 2017

Background

Nurses have expressed doubts about the ongoing digitalisation of Swedish primary health care. Given the potential role of eHealth in primary health care, including supporting interactive self‐management for people with chronic conditions, it is important to highlight nurses’ experiences. This study is part of a larger project aimed at implementing person‐centred interactive self‐management support (iSMS) in primary health care.

Aim

The aim of this study was to describe Swedish primary healthcare nurses’ perceptions of using digital eHealth systems and services to support patient self‐management.

Methods

Focus group interviews were conducted with primary healthcare nurses (n = 20). The interview transcriptions were analysed using qualitative content analysis.

Results

Three themes emerged from the content analysis: caregiving in the midst of digital chaos; a lack of overview and control in daily work; and mixed feelings towards digitalisation. Each theme was subdivided into three subthemes.

Conclusion and relevance to clinical practice

The results of this study provide insight into a number of concerns that stand in the way of success when it comes to the implementation and use of digital technology. If nurses are to adapt to the new policies and practices that accompany the current digitalised development in Swedish primary health care, the concept of a nurse's traditional work role needs to be amended in terms of the scope of work tasks and established views of traditional nursing. The study also highlights the need for more research to enable eHealth systems/services to be designed to fulfil multiple requirements. The digitised systems should be a tool for achieving good quality self‐management support as well as giving the primary healthcare nurses adequate resources to support patients’ self‐management while still maintaining the values associated with person‐centred care.
Reviewer Acknowledgements
Authors: Smith Robert
Published: September 2017

Journal of Education and Training Studies (JETS) would like to acknowledge the following reviewers for their assistance with peer review of manuscripts for this issue. Many authors, regardless of whether JETS publishes their work, appreciate the helpful feedback provided by the reviewers. Their comments and suggestions were of great help to the authors in improving the quality of their papers. Each of the reviewers listed below returned at least one review for this issue.Reviewers for Volume 5, Number 10Adem İşcan, TurkeyAkif Arslan, TurkeyAli Özkan, TurkeyAnne M. Hornak, Central Michigan University, USABora Bayram, TurkeyErica D. Shifflet-Chila, Michigan State University, USAIoannis Syrmpas, University of Thessaly, GreeceIşık Bayraktar, TurkeyJohn Cowan, Edinburgh Napier University, UKLaima Kyburiene, Kaunas University of Applied Sciences, LithuaniaLisa Marie Portugal, Grand Canyon University, USALorna T. Enerva, Polytechnic University of the Philippines, PhilippinesMehmet Boyacı, İstanbul Medeniyet University, TurkeyMichail Kalogiannakis, University of Crete, GreeceMin Gui, Wuhan University, ChinaMustafa Altunsoy, TurkeyNerina Fernanda Sarthou, Univ. Nacional del Centro de la Provincia de Buenos Aires, ArgentinaNiveen M. Zayed, MENA College of Management, JordanÖzgür Murat Çolakoğlu, Bülent Ecevit University, TurkeyPirkko Siklander, University of Lapland, FinlandRecep Soslu, TurkeyRichard H. Martin, Mercer University, USARichard Penny, University of Washington Bothell, USASamad Mirza Suzani, Islamic Azad University, IranSeher Mandacı Şahin, Niğde Ömer Halisdemir University, TurkeySelloane Pitikoe, University of Kwazulu-Natal, South AfricaSeyfullah Tingir, Florida State University, USAStamatis Papadakis, University of Crete, GreeceThomas K. F. Chiu, The University of Hong Kong, Hong KongTurgay Kabak, TurkeyUfuk Töman, TurkeyYi Lu, American Institute for Research, USARobert SmithEditorial AssistantOn behalf of,The Editorial Board of Journal of Education and Training StudiesRedfame Publishing9450 SW Gemini Dr. #99416Beaverton, OR 97008, USAURL: http://jets.redfame.com
Pro‐arrhythmic atrial phenotypes in incrementally paced murine Pgc1β−/− hearts: effects of age
Authors: Valli Haseeb , Ahmad Shiraz , Fraser James A. , Jeevaratnam Kamalan , Huang Christopher L.‐H.
Published: September 2017

New Findings

What is the central question of this study?

Can we experimentally replicate atrial pro‐arrhythmic phenotypes associated with important chronic clinical conditions, including physical inactivity, obesity, diabetes mellitus and metabolic syndrome, compromising mitochondrial function, and clarify their electrophysiological basis?

What is the main finding and its importance?

Electrocardiographic and intracellular cardiomyocyte recording at progressively incremented pacing rates demonstrated age‐dependent atrial arrhythmic phenotypes in Langendorff‐perfused murine Pgc1β−/− hearts for the first time. We attributed these to compromised action potential conduction and excitation wavefronts, whilst excluding alterations in recovery properties or temporal electrophysiological instabilities, clarifying these pro‐arrhythmic changes in chronic metabolic disease.

Atrial arrhythmias, most commonly manifesting as atrial fibrillation, represent a major clinical problem. The incidence of atrial fibrillation increases with both age and conditions associated with energetic dysfunction. Atrial arrhythmic phenotypes were compared in young (12–16 week) and aged (>52 week) wild‐type (WT) and peroxisome proliferative activated receptor, gamma, coactivator 1 beta (Ppargc1b)‐deficient (Pgc1β−/−) Langendorff‐perfused hearts, previously used to model mitochondrial energetic disorder. Electrophysiological explorations were performed using simultaneous whole‐heart ECG and intracellular atrial action potential (AP) recordings. Two stimulation protocols were used: an S1S2 protocol, which imposed extrasystolic stimuli at successively decremented intervals following regular pulse trains; and a regular pacing protocol at successively incremented frequencies. Aged Pgc1β−/− hearts showed greater atrial arrhythmogenicity, presenting as atrial tachycardia and ectopic activity. Maximal rates of AP depolarization (dV/dtmax) were reduced in Pgc1β−/− hearts. Action potential latencies were increased by the Pgc1β−/− genotype, with an added interactive effect of age. In contrast, AP durations to 90% recovery (APD90) were shorter in Pgc1β−/− hearts despite similar atrial effective recovery periods amongst the different groups. These findings accompanied paradoxical decreases in the incidence and duration of alternans in the aged and Pgc1β−/− hearts. Limiting slopes of restitution curves of APD90 against diastolic interval were correspondingly reduced interactively by Pgc1β−/− genotype and age. In contrast, reduced AP wavelengths were associated with Pgc1β−/− genotype, both independently and interacting with age, through the basic cycle lengths explored, with the aged Pgc1β−/− hearts showing the shortest wavelengths. These findings thus implicate AP wavelength in possible mechanisms for the atrial arrhythmic changes reported here.
New materials for next-generation robots
Authors: Yang Guang-Zhong , Fischer Peer , Nelson Bradley
Published: September 2017

The next generation of robotics will require new materials, actuators, and fabrication processes.
Evaluation of the cobas Cdiff Test for Detection of Toxigenic Clostridium difficile in Stool Samples
Authors: Peterson Lance R. , Young Stephen A. , Davis Thomas E. , Wang Zi-Xuam , Duncan John , Noutsios Christopher , Liesenfeld Oliver , Osiecki John C. , Lewinski Michael A.
Published: September 2017

Nucleic acid amplification tests (NAATs) are reliable tools for the detection of toxigenic
Clostridium difficile
from unformed (liquid or soft) stool samples. The objective of this study was to evaluate performance of the cobas Cdiff test on the cobas 4800 system using prospectively collected stool specimens from patients suspected of having
C. difficile
infection (CDI). The performance of the cobas Cdiff test was compared to the results of combined direct and broth-enriched toxigenic culture methods in a large, multicenter clinical trial. Additional discrepancy analysis was performed by using the Xpert
C. difficile
Epi test. Sample storage was evaluated by using contrived and fresh samples before and after storage at −20°C. Testing was performed on samples from 683 subjects (306 males and 377 females); 113 (16.5%) of 683 subjects were positive for toxigenic
C. difficile
by direct toxigenic culture, and 141 of 682 subjects were positive by using the combined direct and enriched toxigenic culture method (reference method), for a prevalence rate of 20.7%. The sensitivity and specificity of the cobas Cdiff test compared to the combined direct and enriched culture method were 92.9% (131/141; 95% confidence interval [CI], 87.4% to 96.1%) and 98.7% (534/541; 95% CI, 97.4% to 99.4%), respectively. Discrepancy analysis using results for retested samples from a second NAAT (Xpert C. difficile/Epi test; Cepheid, Sunnyvale, CA) found no false-negative and 4 false-positive cobas Cdiff test results. There was no difference in positive and negative results in comparisons of fresh and stored samples. These results support the use of the cobas Cdiff test as a robust aid in the diagnosis of CDI.
Optimizing Test Utilization in the Clinical Microbiology Laboratory: Tools and Opportunities
Authors: Pritt Bobbi S.
Published: September 2017

Optimal laboratory test utilization is important for providing high-quality clinical care and efficiently using limited health care resources. While microbiologists have long been advocates for appropriate laboratory test utilization, the widespread availability of electronic medical records capable of supporting clinician order entry and of clinical decision support tools (CDSTs) has provided expanded opportunities for implementing effective, automated test stewardship protocols. D. Nikolic et al. (J. Clin. Microbiol. 55:3350–3354, 2017,
https://doi.org/10.1128/JCM.01052-17
) describe the results of implementing a CDST at their institution to curtail stool microbiology testing for patients hospitalized for more than 3 days. Their intervention significantly decreased unnecessary test orders and saved their laboratory over $8,000 in reagent and labor costs during an 11-month postintervention period. That report provides an excellent example of how clinical microbiologists can use electronic tools to optimize laboratory test utilization in their health care system.
Differentiated Human SH-SY5Y Cells Provide a Reductionist Model of Herpes Simplex Virus 1 Neurotropism
Authors: Shipley Mackenzie M. , Mangold Colleen A. , Kuny Chad V. , Szpara Moriah L.
Published: September 2017

Neuron-virus interactions that occur during herpes simplex virus (HSV) infection are not fully understood. Neurons are the site of lifelong latency and are a crucial target for long-term suppressive therapy or viral clearance. A reproducible neuronal model of human origin would facilitate studies of HSV and other neurotropic viruses. Current neuronal models in the herpesvirus field vary widely and have caveats, including incomplete differentiation, nonhuman origins, or the use of dividing cells that have neuropotential but lack neuronal morphology. In this study, we used a robust approach to differentiate human SH-SY5Y neuroblastoma cells over 2.5 weeks, producing a uniform population of mature human neuronal cells. We demonstrate that terminally differentiated SH-SY5Y cells have neuronal morphology and express proteins with subcellular localization indicative of mature neurons. These neuronal cells are able to support a productive HSV-1 infection, with kinetics and overall titers similar to those seen in undifferentiated SH-SY5Y cells and the related SK-N-SH cell line. However, terminally differentiated, neuronal SH-SY5Y cells release significantly less extracellular HSV-1 by 24 h postinfection (hpi), suggesting a unique neuronal response to viral infection. With this model, we are able to distinguish differences in neuronal spread between two strains of HSV-1. We also show expression of the antiviral protein cyclic GMP-AMP synthase (cGAS) in neuronal SH-SY5Y cells, which is the first demonstration of the presence of this protein in nonepithelial cells. These data provide a model for studying neuron-virus interactions at the single-cell level as well as via bulk biochemistry and will be advantageous for the study of neurotropic virusesin vitro.

IMPORTANCEHerpes simplex virus (HSV) affects millions of people worldwide, causing painful oral and genital lesions, in addition to a multitude of more severe symptoms such as eye disease, neonatal infection, and, in rare cases, encephalitis. Presently, there is no cure available to treat those infected or prevent future transmission. Due to the ability of HSV to cause a persistent, lifelong infection in the peripheral nervous system, the virus remains within the host for life. To better understand the basis of virus-neuron interactions that allow HSV to persist within the host peripheral nervous system, improved neuronal models are required. Here we describe a cost-effective and scalable human neuronal model system that can be used to study many neurotropic viruses, such as HSV, Zika virus, dengue virus, and rabies virus.