bluuebunny/crossref_metadata_2025 huggingface dataset:
A randomised crossover simulation study comparing the impact of chemical, biological, radiological or nuclear substance personal protection equipment on the performance of advanced life support interventions
Authors: Schumacher J. , Arlidge J. , Garnham F. , Ahmad I.
Published: March 2017

Recent incidents involving chemical, biological, radiological and nuclear substances have stressed the importance of sufficient personal protection equipment for medical first‐responders. Modern lightweight, battery‐independent, suit ensembles may prove superior to the current protective suit used in the UK. This study compared the powered respiratory protective suit (PRPS ensemble) with a lightweight suit consisting of a SARATOGA® Multipurpose CBRN Protective Coverall Polyprotect 12 in conjunction with the Avon C50 Respirator/Avon CBRNF12CE filter canister and butyl rubber protective gloves (Polyprotect 12 ensemble). Thirty anaesthetists carried out a standardised resuscitation scenario either unprotected (control) or wearing the PRPS or Polyprotect 12 ensembles in a randomised, crossover simulation study. Treatment times for five simulated advanced life support interventions (application of monitoring; bag/mask ventilation; tracheal intubation; drug and fluid administration; and external pacing) were measured. Wearer comfort was also assessed for the two protective suits by questionnaire. All participants accomplished the treatment objectives of all study arms without adverse events. Total mean (SD) completion time for the five interventions was significantly longer for the PRPS compared with the Polyprotect 12 ensemble (204 (53) s vs. 149 (36) s, respectively; p < 0.0001). Participants rated mobility, noise, heat, vision, dexterity and speech intelligibility significantly better in the Polyprotect 12 ensemble compared with the PRPS ensemble. The combination of a lightweight Polyprotect 12 suit and an Avon C50 air‐purifying respirator is preferable to the powered respiratory protective suit during simulated emergency life support, due to a combination of shorter task completion times and improved mobility, communication and dexterity.
Time spent in outdoor activities in relation to myopia prevention and control: a meta‐analysis and systematic review
Authors: Xiong Shuyu , Sankaridurg Padmaja , Naduvilath Thomas , Zang Jiajie , Zou Haidong , Zhu Jianfeng , Lv Minzhi , He Xiangui , Xu Xun
Published: March 2017

Outdoor time is considered to reduce the risk of developing myopia. The purpose is to evaluate the evidence for association between time outdoors and (1) risk of onset of myopia (incident/prevalent myopia); (2) risk of a myopic shift in refractive error and c) risk of progression in myopes only. A systematic review followed by a meta‐analysis and a dose–response analysis of relevant evidence from literature was conducted. PubMed, EMBASE and the Cochrane Library were searched for relevant papers. Of the 51 articles with relevant data, 25 were included in the meta‐analysis and dose–response analysis. Twenty‐three of the 25 articles involved children. Risk ratio (RR) for binary variables and weighted mean difference (WMD) for continuous variables were conducted. Mantel–Haenszel random‐effects model was used to pool the data for meta‐analysis. Statistical heterogeneity was assessed using the I2 test with I2 ≥ 50% considered to indicate high heterogeneity. Additionally, subgroup analyses (based on participant's age, prevalence of myopia and study type) and sensitivity analyses were conducted. A significant protective effect of outdoor time was found for incident myopia (clinical trials: risk ratio (RR) = 0.536, 95% confidence interval (CI) = 0.338 to 0.850; longitudinal cohort studies: RR = 0.574, 95% CI = 0.395 to 0.834) and prevalent myopia (cross‐sectional studies: OR = 0.964, 95% CI = 0.945 to 0.982). With dose–response analysis, an inverse nonlinear relationship was found with increased time outdoors reducing the risk of incident myopia. Also, pooled results from clinical trials indicated that when outdoor time was used as an intervention, there was a reduced myopic shift of −0.30 D (in both myopes and nonmyopes) compared with the control group (WMD = −0.30, 95% CI = −0.18 to −0.41) after 3 years of follow‐up. However, when only myopes were considered, dose–response analysis did not find a relationship between time outdoors and myopic progression (R2 = 0.00064). Increased time outdoors is effective in preventing the onset of myopia as well as in slowing the myopic shift in refractive error. But paradoxically, outdoor time was not effective in slowing progression in eyes that were already myopic. Further studies evaluating effect of outdoor in various doses and objective measurements of time outdoors may help improve our understanding of the role played by outdoors in onset and management of myopia.
Defining the noninferiority margin and analysing noninferiority: An overview
Authors: Althunian Turki A. , de Boer Anthonius , Groenwold Rolf H. H. , Klungel Olaf H.
Published: March 2017

Noninferiority trials are used to assess whether the effect of a new drug is not worse than an active comparator by more than a noninferiority margin. If the difference between the new drug and the active comparator does not exceed this prespecified margin, noninferiority can be concluded. This margin must be specified based on clinical and statistical reasoning; however, it is considered as one of the most challenging steps in the design of noninferiority trials. Regulators recommend that the margin should be defined based on the historical evidence of the active comparator (the latter is often the well‐established standard treatment of the disease), which can be performed by different approaches. There are several factors and assumptions that need to be accounted for during the process of defining the margin and during the analysis of noninferiority. Three methods are commonly used to analyse noninferiority trials: the fixed‐margin method; the point‐estimate method; and the synthesis method. This article provides an overview of analysing noninferiority and choosing the noninferiority margin.
Pathological overproduction: the bad side of adenosine
Authors: Borea Pier Andrea , Gessi Stefania , Merighi Stefania , Vincenzi Fabrizio , Varani Katia
Published: March 2017

Adenosine is an endogenous ubiquitous purine nucleoside, which is increased by hypoxia, ischaemia and tissue damage and mediates a number of physiopathological effects by interacting with four GPCRs, identified as A1, A2A, A2B and A3. Physiological and acutely increased adenosine is mostly associated with beneficial effects that include vasodilatation and a decrease in inflammation. In contrast, chronic overproduction of adenosine occurs in important pathological states, where long‐lasting increases in the nucleoside levels are responsible for the bad side of adenosine associated with chronic inflammation, fibrosis and organ damage. In this review, we describe and critically discuss the pathological overproduction of adenosine and analyse when, where and how adenosine exerts its detrimental effects throughout the body.
Ethnic Socialization in Neighborhood Contexts: Implications for Ethnic Attitude and Identity Development Among Mexican‐Origin Adolescents
Authors: White Rebecca M. B. , Knight George P. , Jensen Michaeline , Gonzales Nancy A.
Published: March 2017

Neighborhood Latino ethnic concentration, above and beyond or in combination with mothers' and fathers' ethnic socialization, may have beneficial implications for minority adolescents' ethnic attitude and identity development. These hypotheses, along with two competing hypotheses, were tested prospectively (from  = 12.79–15.83 years) in a sample of 733 Mexican‐origin adolescents. Neighborhood ethnic concentration had beneficial implications for ethnic identity processes (i.e., ethnic exploration and perceived peer discrimination) but not for ethnic attitudes. For Mexico‐born adolescents, high maternal ethnic socialization compensated for living in neighborhoods low on ethnic concentration. Findings are discussed vis‐à‐vis the ways in which they address major gaps in the neighborhood effects literature and the ethnic and racial identity development literature.
The vitamin D metabolite ratio (VMR) as a predictor of functional biomarkers of bone health
Authors: Aloia John , Fazzari Melissa , Shieh Albert , Dhaliwal Ruban , Mikhail Mageda , Hoofnagle Andrew N. , Ragolia Lou
Published: March 2017

Context

The vitamin D metabolite ratio (VMR) (serum 24,25(OH)2D3/25(OH)D3) has been proposed as a biomarker of vitamin D sufficiency to replace serum 25(OH)D.

Objective

To examine the relationships of 24,25(OH)2D3 and VMR to functional biomarkers of bone health following vitamin D supplementation.

Setting

An ambulatory research centre.

Design

Serum from a previous research study of dose response of PTH, calcium absorption and bone turnover to vitamin D supplementation was analysed for vitamin D metabolites (25(OH)D, 24,25(OH)2D3).

Outcome

The relationship of serum 24,25(OH)2D3 and VMR to calcium absorption, PTH and bone turnover markers was examined.

Results

Although there were strong correlations of serum 25(OH)D with 24,25(OH)2D3 and free 25(OH)D, its correlation with VMR was lower. After vitamin D supplementation, the change in 25(OH)D, 24,25(OH)2D3 and VMR was associated with the change in calcium absorption, PTH and CTX. The correlation of the change in PTH with the change in metabolites was the lowest for VMR. Moreover, estimated dose response for standardized values of vitamin D metabolites showed a beta‐coefficient for VMR that was significantly less in magnitude compared to other metabolites.

Conclusion

Serum 24,25(OH)2D3 is closely associated with the dose response of serum 25(OH)D to vitamin D supplementation. However, the VMR does not appear to be equivalent to either of these metabolites in its response to increasing vitamin D intake or its association with PTH. It is unlikely that VMR will replace 25(OH)D as a biomarker for vitamin D sufficiency.
A retrospective study on 1592 consecutively performed operations in one private referral clinic. Part II: Peri‐implantitis and implant failures
Authors: Jemt Torsten , Karouni Michel , Abitbol Jérémy , Zouiten Ons , Antoun Hadi
Published: March 2017

Background

Few large‐scale follow‐up studies are reported on routine implant treatment.

Purpose

To report retrospective data on peri‐implantitis and overall implant failures at one private referral clinic (effectiveness study).

Materials and Methods

A total of 1017 patients were consecutively provided with 3082 implants with an anodized surface during 1592 operations between 2000 and 2011. All patients with any of four events of problems were identified; “peri‐implantitis,” “surgery related to peri‐implantitis,” “overall implant failure,” and “late implant failures.” A logistic multivariate analysis was performed to identify possible factors with association to the four events.

Results

“Lower jaw surgery” (HR = 3.03) and “immediate gingival grafting” at implant surgery (HR = 3.34) were factors with the highest risk associated to the two peri‐implantitis events, respectively. Risk of peri‐implantitis increased by year of inclusion from year 2000 (HR = 1.28). “Overall implant failures” were associated to “smoking” (HR = 2.11), “surgical technique” (highest for direct placement; HR = 1.67), and “type of implant” (NobelActive CC; HR = 2.48). NobelActive CC was more used in upper jaws, using immediate or one‐stage surgery with bone and mucosa grafting procedures than other implants (P < .05). Implants lost after first year only showed an association to “lower jaw” (HR = 2.63) and “early inflammation” (HR = 17.95).

Conclusion

Peri‐implantitis seem to be associated to surgical protocols more often in the posterior lower jaw in routine practice. The problems seem to increase during the inclusion period, possibly related to increased use of direct implant placement technique and grafting protocols. Early inflammatory problems have in the previous report on the present patient group been associated to the mid‐aged patient. Overall/late implant failures were shown to be associated to earlier inflammatory problems, smoking habits, surgical technique, and treatment in the posterior lower jaw.
POTENTIAL STATE‐LEVEL CARBON REVENUE UNDER THE CLEAN POWER PLAN
Authors: Fullerton Don , Karney Daniel H.
Published: March 2017

In 2015, the U.S. Environmental Protection Agency issued the Clean Power Plan under which each state can set a mass‐based target to meet its assigned electric power sector carbon dioxide emission reductions. If it proceeds, states can design policies to meet those requirements and also raise revenue via a carbon tax or cap‐and‐trade program with auctioned permits. We calculate each state's potential revenue and demonstrate its significance. In 13 states, carbon revenue could replace all of corporate tax revenue. In addition, we collect budget projections from six key states to determine if and how carbon revenue can substantially reduce deficits. While such revenue is not free money, we discuss its advantages over use of distortionary taxation. Finally, we consider distributional aspects and potential external fiscal effects on federal revenue. (JEL H2, H3, H7, Q5)
The acute muscular response to blood flow‐restricted exercise with very low relative pressure
Authors: Jessee Matthew B. , Mattocks Kevin T. , Buckner Samuel L. , Mouser J. Grant , Counts Brittany R. , Dankel Scott J. , Laurentino Gilberto C. , Loenneke Jeremy P.
Published: March 2017

To investigate the acute responses to blood flow‐restricted (BFR) exercise across low, moderate and high relative pressures. Muscle thickness, maximal voluntary contraction (MVC) and electromyography (EMG) amplitude were assessed following exercise with six different BFR pressures: 0%, 10%, 20%, 30%, 50% and 90% of arterial occlusion pressure (AOP). There were differences between each time point within each condition for muscle thickness, which increased postexercise [+0·47 (0·40, 0·54) cm] and then trended towards baseline. For MVC, higher pressures resulted in greater decrements than lower pressures [e.g. 10% AOP: −20·7 (−15·5, −25·8) Nm versus 90% AOP: −24 (−19·1, −28·9) Nm] postexercise. EMG amplitude increased from the first three repetitions to the last three repetitions within each set. When using a common BFR protocol with 30% 1RM, applying BFR does not seem to augment acute responses over that of exercise alone when exercise is taken to failure.
123I‐MIBG imaging for detection of anthracycline‐induced cardiomyopathy
Authors: Laursen Adam H. , Thune Jens Jakob , Hutchings Martin , Hasbak Philip , Kjær Andreas , Elming Marie B. , Ripa Rasmus S.
Published: March 2017

Due to improvements in early detection and treatment of malignant disease, the population of cancer survivors is constantly expanding. Cancer survivors are faced with chemotherapy‐related long‐term side effects, including irreversible cardiac injury with risk of heart failure (HF). Numerous antineoplastic regimens are associated with risk of cardiac side effects, but anthracyclines in particular carry a severe risk of cardiotoxicity. Currently, serial echocardiographic evaluation of resting left ventricular ejection fraction (LVEF) is the gold standard for monitoring anthracycline‐induced cardiac side effects from chemotherapy. LVEF measurements are, however, limited by their low sensitivity. A normal LVEF does not exclude cardiotoxicity and declines in LVEF are usually not observed before the occurrence of irreversible cardiomyopathy. Hence, a clinically applicable high‐sensitivity diagnostic tool for early detection of chemotherapy‐related cardiotoxicity is still lacking and alternative non‐invasive imaging modalities are therefore being investigated. 123I‐MIBG is a noradrenaline (NA) analogue used for evaluation of cardiac adrenergic function, including assessment of HF prognosis and evaluation of HF treatment response. However, the role of 123I‐MIBG for monitoring chemotherapy‐related cardiotoxicity is still unclear. Here, we review the value of 123I‐MIBG imaging for early detection and prevention of anthracycline‐induced cardiomyopathy.
Etanercept, Adalimumab und Ustekinumab bei Psoriasis: Analyse von 209 Behandlungsreihen in Österreich
Authors: Richter Leo , Vujic Igor , Sesti Alma , Monshi Babak , Sanlorenzo Martina , Posch Christian , Rappersberger Klemens
Published: March 2017

Hintergrund und Ziele

Biologika werden häufig zur Behandlung der Psoriasis eingesetzt und wurden in zahlreichen klinischen Studien getestet. Allerdings können sich Wirkungen und Nebenwirkungen (AEs) bei „real‐world“‐Patienten unterscheiden, da diese keiner solch strengen Auswahl und Überwachung unterzogen werden. Wir haben Therapieadhärenz („Medikamenten‐Überlebenszeit“), Wirksamkeit und AEs (Qualität, Zeitpunkt des Auftretens) bei „real‐world“‐Psoriasis‐Patienten, die mit Etanercept, Adalimumab oder Ustekinumab behandelt wurden, untersucht.

Patienten und Methoden

Retrospektive Datenanalyse (1. Januar 2004 bis 30. Juni 2015) an Patienten, die an einer Psoriasis‐Klinik in einem österreichischen Krankenhaus behandelt wurden. Alle Patienten, die mindestens eine Dosis von Etanercept, Adalimumab oder Ustekinumab erhalten hatten, wurden in die Analyse einbezogen. Wir analysierten Demographie, Therapieadhärenz, den Psoriasis Area and Severity Index (PASI) sowie Qualität und Zeitpunkt des Auftretens von AEs.

Ergebnisse

In 209 Behandlungsreihen variierte die geschätzte mittlere Therapieadhärenz zwischen den verschiedenen Behandlungen: 21 Monate (SE: 6,9) für Etanercept, 61 Monate (SE: 9,4) für Adalimumab und 65 Monate (SE 1,4) für Ustekinumab. Männliches Geschlecht und Vorbehandlung mit einem Biologikum waren positive Prädiktoren für längere Therapie mit Adalimumab. Wir fanden keinen signifikanten Unterschied in der am PASI gemessenen Arzneimittelwirksamkeit.

Schlussfolgerungen

Die meisten AEs treten während des ersten Jahres der Behandlung auf. Adalimumab und Ustekinumab zeichnen sich im Vergleich zu Etanercept durch eine längere Therapieadhärenz aus.
Die Bedeutung der blauen Farbe in der Dermatoskopie
Authors: Popadić Mirjana , Sinz Christoph , Kittler Harald
Published: March 2017

Hintergrund und Ziele

Hautläsionen mit blauer Färbung werden häufig chirurgisch entfernt, um Malignität auszuschließen zu können. Das Ziel der vorliegenden Studie war es, die Bedeutung der blauen Färbung zu untersuchen.

Methoden

Wir untersuchten dermatoskopische Bilder retrospektiv auf blaue Farbe und klassifizierten sie gemäß der Musteranalyse.

Ergebnisse

Von 1.123 pigmentierten Hautläsionen wiesen 144 (12,8 %) eine blaue Färbung auf. Von diesen waren 92 (63,9 %) bösartig. Unter den Läsionen mit Blaufärbung waren Nävi (n = 35, 24,3 %) und seborrhoische Keratosen (n = 8, 5,6 %) die häufigsten gutartigen Diagnosen. Von 103 (71,5 %) Läsionen mit einem strukturlosen blauen Muster waren acht (7,8 %) vollständig blau gefärbt und 95 (92,2 %) teilweise blau, davon zeigten 81 (78,6 %) periphere oder fleckige und 14 (13.6 %) eine zentrale Blaufärbung. Die meisten Läsionen mit peripherer oder fleckiger blauer Färbung waren Melanome (n = 47, 58 %), wohingegen die meisten Läsionen mit zentraler Blaufärbung Nävi darstellten (n = 9, 64,3 %). Von 28 Läsionen mit blauen Schollen waren 17 (60,7 %) Basalzellkarzinome. Bezüglich der Malignität war der positive prädiktive Wert der blauen Farbe 63,9 % (95 % KI: 56,0–71,8 %).

Schlussfolgerungen

Unter blaugefärbten bösartigen Läsionen ist eine strukturlose periphere oder fleckige blaue Farbe ein Hinweis auf Melanome, während blaue Schollen auf ein Basalzellkarzinom hinweisen. Als Fallstricke können sich seborrhoische Keratosen erweisen, die eine Blaufärbung zeigen können, sowie einige Nävi, vor allem kombinierte.
Lymphomatoid papulosis – making sense of the alphabet soup: a proposal to simplify terminology
Authors: Kempf Werner , Mitteldorf Christina , Karai Laszlo J. , Robson Alistair
Published: March 2017

Clinically, lymphomatoid papulosis (LYP) is characterized by recurrent papulonodular lesions. Unlike this stereotypical clinical presentation, the histological spectrum of LYP is very wide, comprising distinct growth patterns, variably sized neoplastic cells, and different immunophenotypes. The revised 2016 WHO classification includes the histological LYP types A to E as well as another type characterized by a specific chromosomal alteration. In addition, new LYP types are going to be proposed, based not only on histological but also on clinical and genetic features. The ensuing expansion of the alphabetical list of histological types will add to the complexity of the terminology of LYP, thereby potentially increasing the risk of complicating rather than facilitating the diagnostic approach to the disease. Moreover, there may be overlap between individual disease types. This development raises the question as to how to simplify the terminology of LYP while still respecting its histological complexity. Herein, we advocate a practical approach to the terminology of LYP based on descriptive terms rather than the designation of LYP types by alphabetical characters. Our proposal aims to contribute to a pragmatic and user‐friendly approach, thus not only facilitating the diagnostic process but also the communication between clinicians and pathologists.
Glycaemic control and hypoglycaemia burden in patients with type 2 diabetes initiating basal insulin in Europe and the USA
Authors: Mauricio Dídac , Meneghini Luigi , Seufert Jochen , Liao Laura , Wang Hongwei , Tong Liyue , Cali Anna , Stella Peter , Carita Paulo , Khunti Kamlesh
Published: March 2017

Aims

To evaluate short‐ and long‐term glycaemic control and hypoglycaemia incidence in insulin‐naïve patients ≥30 years of age with type 2 diabetes (T2DM) initiating basal insulin (BI) with or without oral anti‐hyperglycaemic drugs (OADs).

Methods

This was an observational, retrospective longitudinal analysis of electronic medical records from 5 European countries and the USA. A multivariable logistic regression model assessed baseline and short‐term (0‐3 months post BI initiation) factors associated with long‐term (3‐24 months) glycaemic control and hypoglycaemia.

Results

Overall, 40 627 patients were included; 20.9% and 27.8% achieved the general HbA1c target of ≤7% at 3 and 24 months post BI initiation, respectively. Failure to achieve HbA1c ≤7% at 3 months was associated with increased risk of failing to achieve target at 24 months (odds ratio [OR], 3.70 [95% CI, 3.41‐4.00]). Over 24 months, 8.9% of patients experienced a recorded hypoglycaemic event. Hypoglycaemia during the initial 3‐month period was associated with longer‐term risk of these events over the ensuing 3 to 24 months (OR, 5.71 [95% CI, 4.67‐6.99]).

Conclusions

Initiating BI with or without OADs is associated with short‐ and long‐term suboptimal glycaemic control; the majority of patients fail to achieve HbA1c target ≤7% in the first 3 months, or after 2 years of BI treatment. Treatment response and hypoglycaemia incidence by 3 months post BI initiation are associated with longer‐term glycaemic control and hypoglycaemic risk, respectively. These results support the need for early anti‐hyperglycaemic interventions that more effectively control blood glucose levels without increasing the risk of hypoglycaemia.
STATEHOOD EXPERIENCE, LEGAL TRADITIONS, AND CLIMATE CHANGE POLICIES
Authors: Ang James B. , Fredriksson Per G.
Published: March 2017

This study investigates how the implementation of modern climate change policies is related to former colonies' length of state history and their legal heritage. We argue that countries with longer statehood experience around the time of colonization were better equipped to implement the legal philosophies transplanted by their colonial powers. Therefore, the implications of receiving British common law versus French civil law should be particularly important in countries with a greater accumulated history of statehood. Using a cross‐section of up to 78 former colonies, our results provide support for this hypothesis. In particular, our estimates demonstrate that common law countries have weaker modern climate change policies than civil law countries and the difference is inflated by a longer statehood experience, measured by the length of state history from 1 to 1800 AD. Legal origin has no effect in areas which, by the time of colonization, had no statehood experience. Finally, we report similar results for the pattern of labor market regulations. (JEL K15, K31, K32, O44, Q54, Q58)
The Double Intentionality of Emotional Experience
Authors: Cochrane Tom
Published: March 2017

I argue that while the feeling of bodily responses is not necessary to emotion, these feelings contribute significant meaningful content to everyday emotional experience. Emotional bodily feelings represent a ‘state of self’, analysed as a sense of one's body affording certain patterns of interaction with the environment. Recognising that there are two sources of intentional content in everyday emotional experience allows us to reconcile the diverging intuitions that people have about emotional states, and to understand better the long‐standing debate between bodily feeling‐based and appraisal‐based theories of emotion.
Factors related to continuous and discontinuous attendance at memory clinics
Authors: Hishikawa N. , Fukui Y. , Nakano Y. , Morihara R. , Takemoto M. , Sato K. , Yamashita T. , Ohta Y. , Abe K.
Published: March 2017

Background and purpose

Few studies have examined why some patients with dementia stop attending medical consultations. We conducted a retrospective study to investigate factors associated with discontinuous clinic attendance.

Methods

Participants were 988 patients with dementia from university hospital (UH) clinics and affiliated local hospital (LH) clinics. We compared continuous and discontinuous attenders on cognitive and affective functions and activities of daily living (ADL), and also compared UH and LH patients (UH: continuous, n = 176; discontinuous, n = 207; LH: continuous, n = 418; discontinuous, n = 187).

Results

The total annual rate of discontinuation was 8.0%, and the mean period of attendance before discontinuation was 2.2 ± 2.4 years (UH, 2.8 ± 3.0; LH, 1.5 ± 1.3, P < 0.01). Scores for the Mini‐Mental State Examination, Hasegawa Dementia Scale – Revised, Geriatric Depression Scale, apathy scale, Abe's behavioral and psychological symptoms of dementia (BPSD) score, and ADL were significantly worse in the discontinuous group than the continuous group for both UH and LH patients (P < 0.01). The best predictor of discontinuation was ADL decline (UH and LH) and Abe's BPSD score (UH). The most common reason for discontinuation was returning to the family doctor (39.1% for UH), and cessation of hospital attendance at their own discretion (35.3% for LH).

Conclusions

We identified the main reasons for discontinuation of attendance as returning to the family doctor and cessation of hospital attendance at their own discretion. The best predictors of discontinuation were ADL decline and worsening BPSD. There were significant differences in discontinuation between UH and LH patients with dementia.
Prevalence of Parkinson's disease: a population‐based study in Portugal
Authors: Ferreira J. J. , Gonçalves N. , Valadas A. , Januário C. , Silva M. R. , Nogueira L. , Vieira J. L. M. , Lima A. B.
Published: March 2017

Background and purpose

Portugal has been identified as one of the countries with a high prevalence of LRRK2‐G2019S, considered to be the most frequent known cause of familial and sporadic Parkinson's disease (PD). The aim of this study was to evaluate the prevalence of PD in Portugal using a door‐to‐door methodology.

Methods

A cross‐sectional study was conducted in the Portuguese community‐dwelling population; that is, elderly people living in the community on their own, aged ≥50 years and resident in mainland Portugal, in two phases: (i) a questionnaire was applied to screen potential cases of PD; and (ii) screened cases were evaluated by an expert in PD to confirm diagnosis.

Results

The adjusted prevalence of PD for the Portuguese community‐dwelling population aged ≥50 years was 0.24%. The estimated total number of cases of PD for the Portuguese population is 180/100 000 inhabitants.

Conclusions

The results of this study show that a geographical region with a high frequency of a causal mutation for PD does not automatically imply a high prevalence of patients with PD.
Evidence‐based therapy for atypical myopathy in horses
Authors: Fabius L. S. , Westermann C. M.
Published: March 2017

The aim of this review is to establish the best therapy for equine atypical myopathy with a view to improving the survival rate. To this end, the currently used symptomatic therapy and literature on other metabolic diseases in horses or other animals have been analysed. The best treatment strategy consists of several elements. Advice with evidence: management with restricted movement, keeping warm, rehydration, glucose and insulin supplementation and administration of carnitine, vitamin E, selenium and riboflavin is advised. Acepromazine can be used as a muscle relaxant when indicated. Nonsteroidal anti‐inflammatory drugs should be used for pain relief. Regular emptying of the bladder might provide relief from some discomfort. Advice without evidence: laxatives or activated charcoal could be helpful. Contraindicated: Alpha 2 agonists as muscle relaxants because these drugs inhibit insulin release. Without further research glycine is also discouraged.
Post‐operative reflux – a surgeon's perspective
Authors: Freeman D.
Published: March 2017

Post‐operative ileus (POI) is a well‐recognised complication of colic surgery that accounts for a high proportion of post‐operative deaths. Although much has been written about the pathophysiology and management ofPOIin horses, most studies seem to apply research findings to the clinical case without full regard for the clinical evidence. Although much attention has focused recently on the role of inflammation, this narrow focus might explain our failure to make important advances in managing horses with this complication. This commentary is offered to redirect our current thinking aboutPOIaway from an approach that predominantly emphasises a functional disorder and medical management, to one that addresses surgical prevention.
The Integration of Service‐Learning Research into a Community Nutrition Course
Authors: Gray Virginia B. , Galvan Christine , Donlin Ayla
Published: March 2017

Service learning uses real‐world experience to develop skills, create connections between academic study and public concerns, and foster social change. In Spring 2015, a graduate‐level community nutrition course at a university in southern California was amended to include a research‐focused service‐learning project. Four phases of service learning were included in course content. The phases were as follows: (1) a needs assessment; (2) development, implementation, and evaluation of nutrition lessons; (3) reflection; and (4) celebration. Reflective assignments indicated that students valued needs assessment as a basis for program development and growth in assessing program impacts. Modest gains in vegetable consumption patterns were evidenced among program participants.
Development of Food Group Books for Three‐ and Four‐Year‐Old Children
Authors: Barnes Jessica L. , Warren Cynthia A.
Published: March 2017

Food preferences can be established in young children and these food preferences could extend into adulthood. This article is about MyPlate Food Group Books which are five nonfiction books. Each book covers one food group. The books were developed with input from 4‐year‐old children, preschool educators, and specialists in nutrition education and child development. The books were tested for acceptance and potential for behavior change with a small group of 3‐year‐old children. After the books were read once a day for 2 weeks by teachers, the authors tested the effect of book exposure on food consumption by measuring aggregate plate waste. Although changes in food consumption behaviors were not observed, the teachers indicated changes in the preschooler's attitudes toward trying new foods. Positive attitudes toward new foods could result in increased familiarity and eventually changes in food behavior.
Knowledge and Practice: Implications for Cash and Credit Management Behaviors
Authors: Woodyard Ann Sanders , Robb Cliff , Babiarz Patryk , Jung Ji‐young
Published: March 2017

This study explored the relationships between subjective and objective financial knowledge with cash and credit behavior. A nationally representative sample of American consumers over the age of 18 were surveyed online in 2012 about four financial behaviors: (1) maintenance of an emergency account, (2) prompt payment of credit card balances, (3) checking credit reports, and (4) avoiding checking account overdrafts. The results of logistic regressions indicated that higher levels of both objective and subjective knowledge were significant indicators of positive financial behavior and avoidance of negative behavior. However, a “false‐positive” condition of high subjective knowledge and low objective knowledge demonstrated questionable cash and credit behavior linked to overconfidence. This suggests that financial counselors and financial therapists could provide assistance in helping consumers improve their subjective and objective knowledge to reinforce positive cash and credit behavior, which should improve consumer decision making.
Parents' Influence on Retirement Planning in Malaysia
Authors: Kimiyaghalam Fatemeh , Mansori Shaheen , Safari Meysam , Yap Stanley
Published: March 2017

Many studies have indicated that the development of children's behavior is strongly influenced by their parents’ behavior during childhood. This paper applied the theory of planned behavior as a basis for the analysis of data from a sample of 520 Malaysians aged 18 and over. Regression analysis was used to assess the relationship between parents’ financial behavior and their children's retirement planning. Results showed that: (a) parents play a significant role as agents of financial socialization for their children's retirement planning behavior, and (b) saving attitude mediates this relationship. Suggestions for policymakers and future research are presented.
Histone H1 chaperone activity of TAF‐I is regulated by its subtype‐dependent intramolecular interaction
Authors: Kajitani Kaori , Kato Kohsuke , Nagata Kyosuke
Published: March 2017

Linker histone H1 is involved in the regulation of gene activity through the maintenance of higher‐order chromatin structure. Previously, we have shown that template activating factor‐I (TAF‐I or protein SET) is involved in linker histone H1 dynamics as a histone H1 chaperone. In human and murine cells, two TAF‐I subtypes exist, namely TAF‐Iα and TAF‐Iβ. TAF‐I has a highly acidic amino acid cluster in its C‐terminal region and forms homo‐ or heterodimers through its dimerization domain. Both dimer formation and the C‐terminal region of TAF‐I are essential for the histone chaperone activity. TAF‐Iα exhibits less histone chaperone activity compared with TAF‐Iβ even though TAF‐Iα and β differ only in their N‐terminal regions. However, it is unclear how subtype‐specific TAF‐I activities are regulated. Here, we have shown that the N‐terminal region of TAF‐Iα autoinhibits its histone chaperone activity via intramolecular interaction with its C‐terminal region. When the interaction between the N‐ and C‐terminal regions of TAF‐Iα is disrupted, TAF‐Iα shows a histone chaperone activity similar to that of TAF‐Iβ. Taken together, these results provide mechanistic insights into the concept that fine tuning of TAF‐I histone H1 chaperone activity relies on the subtype compositions of the TAF‐I dimer.
Controls on Methane Occurrences in Aquifers Overlying the Eagle Ford Shale Play, South Texas
Authors: Nicot Jean‐Philippe , Larson Toti , Darvari Roxana , Mickler Patrick , Uhlman Kristine , Costley Ruth
Published: March 2017

Assessing natural vs. anthropogenic sources of methane in drinking water aquifers is a critical issue in areas of shale oil and gas production. The objective of this study was to determine controls on methane occurrences in aquifers in the Eagle Ford Shale play footprint. A total of 110 water wells were tested for dissolved light alkanes, isotopes of methane, and major ions, mostly in the eastern section of the play. Multiple aquifers were sampled with approximately 47 samples from the Carrizo‐Wilcox Aquifer (250‐1200 m depth range) and Queen City‐Sparta Aquifer (150‐900 m depth range) and 63 samples from other shallow aquifers but mostly from the Catahoula Formation (depth <150 m). Besides three shallow wells with unambiguously microbial methane, only deeper wells show significant dissolved methane (22 samples >1 mg/L, 10 samples >10 mg/L). No dissolved methane samples exhibit thermogenic characteristics that would link them unequivocally to oil and gas sourced from the Eagle Ford Shale. In particular, the well water samples contain very little or no ethane and propane (C1/C2+C3 molar ratio >453), unlike what would be expected in an oil province, but they also display relatively heavier δ13Cmethane (>−55‰) and δDmethane (>−180‰). Samples from the deeper Carrizo and Queen City aquifers are consistent with microbial methane sourced from syndepositional organic matter mixed with thermogenic methane input, most likely originating from deeper oil reservoirs and migrating through fault zones. Active oxidation of methane pushes δ13Cmethane and δDmethane toward heavier values, whereas the thermogenic gas component is enriched with methane owing to a long migration path resulting in a higher C1/C2+C3 ratio than in the local reservoirs.
Clinical characteristics and prognostic factors of liver cirrhosis patients with systemic inflammatory response syndrome
Authors: Yang Danhong , Xie Yuanjun , Pan Hongying , Huang Yicheng , Dai Yining , Tong Yongxi , Chen Meijuan
Published: March 2017

Aim

Our objective is to study the clinical characteristics of cirrhosis patients with SIRS and investigate its prognostic factors.

Methods

We analyzed 285 consecutive patients and their data were evaluated retrospectively. Data were compared in patients with/without SIRS during hospitalization. Univariate and multivariate Cox regression analyses were undertaken separately for cirrhotic patients with SIRS to assess predictive factors for 90‐day mortality.

Results

The mortality was 38.24% (52/136) in patients with SIRS and 6.04% (9/149) in patients without SIRS for 90‐day follow‐up (P < 0.001). The univariate analysis showed gastrointestinal hemorrhage (P < 0.001), hepatic encephalopathy (P < 0.001), albumin <30 g/L (P < 0.037), creatinine (Cr) >175 µmol/L (P < 0.001), cholinesterase(ChE) activity <3000 U/L (P = 0.019), white blood cell count ≥10 000 (109/L) (P = 0.018), neutrophils ≥80% (P = 0.018), C‐reactive protein (CRP) ≥25 mg/L (P < 0.001), procalcitonin ≥1.0 ng/mL (P = 0.007), Child–Pugh class C (P < 0.001), septicemia (P < 0.001), pulmonary infection (P < 0.001),multi‐site infection (P = 0.001), acute‐on‐chronic liver failure (ACLF) (P < 0.001), and advanced hepatocellular carcinoma (HCC) (P < 0.001). In multivariate analysis, only Cr ≥175 µmol/L (hazard ratio [HR] = 2.768; confidence interval [CI], 1.53–5.04; P = 0.001), C‐reactive protein ≥25 mg/L (HR = 3.179; CI, 1.772–7.03; P = 0.004), multi‐site infection (HR = 19.427; CI, 7.484–50.431; P < 0.001), ACLF (HR = 7.308; CI, 3.048–17.521; P < 0.001), advanced HCC (HR = 2.523; CI, 1.019–6.248; P = 0.045) were independent predictors of 90‐day mortality in cirrhotic patients with SIRS.

Conclusion

Cr ≥ 175 µmol/L, CRP ≥ 25 mg/L, multi‐site infection, ACLF, and advanced HCC independently predicted a higher rate of 90‐day mortality in liver cirrhosis with SIRS
Education, Skills, and Wage Gaps in Canada and the United States
Authors: Smith William C. , Fernandez Frank
Published: March 2017

We analyse data from the Programme for the International Assessment of Adult Competencies to reveal that immigrants in Canada and the United States make over $200 less per month than native‐born workers. In the United States, immigrants disproportionately work in low‐wage occupations, leading to large mean national differences between immigrants and native workers. The wage differential disappears after accounting for education and cognitive skills, indicating policies must focus on reducing education and skill gaps in the United States. In Canada, an immigrant wage gap persists in nearly all occupational fields, suggesting that the better skilled and educated immigrants in Canada are not receiving the same wage premium as native workers. We close with implications for policy and future research.
The Pointing–Vocal Coupling Progression in the First Half of the Second Year of Life
Authors: Aureli Tiziana , Spinelli Maria , Fasolo Mirco , Garito Maria Concetta , Perucchini Paola , D'Odorico Laura
Published: March 2017

This study investigated the development of the pointing–vocal coupling system. We were interested in the infants’ behavior to attune prosody with pointing intentions. Twenty‐five children were involved at 12, 15, and 18 months of age in an experimental procedure devised to elicit imperative and declarative pointing. Pointing, vocality associated with pointing, and the prosody of that vocality were analyzed. A significant increase in the coupling of pointing and vocality was observed from 12 to 15 months, and in the ability to differentiate prosody with respect to the intention of the gesture from 15 to 18 months. Also, the infants who pointed declaratively at 12 months were likely to couple declarative pointing with vocality at 15 months, and the infants who coupled at 15 months were likely to differentiate prosody by the pointing intention at 18 months. Results suggest that the match between prosody and pointing intentions emerges gradually during the first half of the second year of life. They also show a relationship between earlier and later pointing–vocal coupling, and a role for declarative communication in promoting that progression. Overall, our study supports the view of intentional communication as a time‐based and context‐based developmental process.
Is hyperbaric oxygen therapy indispensable for saving mutilated hand injuries?
Authors: Chiang I‐Han , Tzeng Yuan‐Sheng , Chang Shun‐Cheng
Published: March 2017

Mutilated hand injuries are a profound challenge to the plastic surgeon, and such injuries often lead to limb loss and severe functional impairment. Hyperbaric oxygen therapy (HBOT) appears to counteract tissue hypoxia and stimulate acute wound healing. This study was performed to evaluate the efficacy of HBOT as an adjunctive therapy in patients with a mutilated hand injury. Between January 2006 and December 2014, 45 patients with a mutilated hand injury were enrolled. After reconstruction or revascularisation, patients underwent 120 minutes of HBOT with oxygen at 2·5 atmospheres absolute while breathing 100% oxygen. Outcomes such as amputee survival and surgery‐related complications were recorded. The patients were 38 men and 7 women with average age of 37·2 years (range 18–62). The mean defect area was 131·5 cm2 (range 40–300). Most patients experienced a pure crush injury (53%). The average number of operations from the initial debridement to the first reconstruction was 3·8 (range 1–6). A total of 33 patients (73%) underwent replantation during the initial reconstruction. For flap coverage, most patients received a free flap using an anterolateral thigh flap (18 patients) or local flap using an abdomen/groin flap (nine patients). The average time from the first reconstruction or revascularisation to the first HBOT was 6·5 hours (range 2–12). The average number of HBOT sessions was 9·1 (range 6–14 sessions). The survival rate of the replanted fingers was 81%, and the survival rate of the palms was 100%. Most complications in the initial reconstruction involved partial loss of an avulsed flap, and most complications in the chronic stage (≥3 months) involved scar contracture. When combined with delicate microsurgery, early intervention using adjunctive HBOT was effective in preserving partially viable tissue and restoring hand function in patients with a mutilated hand injury.
Large electrocaloric responses in [Bi1/2(Na,K)1/2]TiO3‐based ceramics with giant electro‐strains
Authors: Fan Zhongming , Liu Xiaoming , Tan Xiaoli
Published: March 2017

The electrocaloric effect (ECE) is investigated through indirect measurement in two lead‐free [Bi1/2(Na,K)1/2]TiO3‐based ceramics that were previously reported to display giant electro‐strains. In the Nb‐doped ceramic, denoted as BNKT‐2.5Nb, a decent temperature change of ΔT=1.85 K and an electrocaloric responsivity of ΔT/ΔE=0.37 (10−6Km V−1) are found around room temperature (32°C). While in the Ta‐doped ceramic, BNKT‐1.5Ta, a wide operation temperature range (Tspan ~55 K) is observed near room temperature. Additional electrical measurements, as well as transmission electron microscopy experiments, are performed to identify the mechanisms of the ECE in both ceramics.
Controlling Shareholders’ Incentive and Corporate Tax Avoidance: A Natural Experiment in China
Authors: Li Oliver Zhen , Liu Hang , Ni Chenkai
Published: March 2017

The split share structure reform removes a significant market friction in China's capital market by allowing previously non‐tradable shares to be freely tradable at market prices. Such a reform reduces the agency conflict between controlling shareholders and minority shareholders as the former now care more about stock prices. We find that state‐owned firms, but not non‐state‐owned firms, significantly increased their tax avoidance activities after the reform. We attribute this differential effect to the dual role of the government as state‐owned firms’ controlling shareholder as well as the tax claimant. Further, this effect is more pronounced for state‐owned firms that are more likely to be influenced by the government prior to the reform. Finally, the reform reinforces a positive association between tax avoidance and firm value. Overall, our study suggests that when controlling shareholders are more concerned about stock prices, state‐owned firms engage more in tax avoidance activities to enhance firm value.